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HomeMy WebLinkAboutATELIER #1 BLK 3 LT 3Atelier #1 Block 3 Lot 3 #041-031-39 Municipality of Anchorage Development Services Department �., Building Safety Division On-Sile Water and Wastewater Program, 4700 Elmore St. P.O. Boz 196650 Anchorage, AK 9951 M650 Page of www.ci.anchorage ak.us (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: S W 080057- PID Number: _011 - O 31- Na"" Jo Wastewaters stem: ❑ New Upgrade Y£Yrs{,w An $cls b 6 jade.° -7100 Moe Ion •r le ABSORPTION FIELD E Phare Numar of Bad owns D Deep Tnrcil D $h Wow Trench D Bed t] Mowk O other. LEGAL DESCRIPTION Sol Rating Total Depth ham W91" Grade GPDIFIt c,. Block Lot Suhdnlaon Deppl to Poo bottom from mgrW aha Waw apm beneath Ppa 3 3 ATC-LIF IL f Ft. Ft To 0.p Rag. saWw FA added Wove mg-mil aaa Gravel LONM Ft. FI. Well: [:]New ❑ Upgrade Grant «Nn. NumarolIwe Dlalana atwsen hms iL ; n FI. Ft claaehcatron (Pnnu. W B. ci. Total Depth caaad to Total pbm aha Waoc P,pa w1ma1 FI. Fit Dmer Data DONS SMO: Wat«LavN Matallar1 DbT Cen Dale MNMlsd (01210e, FL r- tion Y,Md Pump Set at cs.naH"MAavaCr TANK GPM il. F! SEPARATION DISTANCES CaSeptic ❑Holding ❑S.T.E.P. ❑other. To Septic Absorption Lift Holding lUblicrPrOate adp1w -rE avaolr From Tank Field Station Tank Sewer Line I _ Gr, 1150 IatMM Numoar OI Cary«Imema wee too + ?51+ 5♦•et� 2 S�aceWaler loop+ LIFT STATION :e apurar Lot La :{ Gal t 'Pump an' lev at 'Pump air Wv at H1ah vn1« alarm W Gounaeon S 4hl ut M. Pump Make a Model ecoma pedo W by Eleemea, Mpm C«len DlMm /V-0. R*Oadm 1 k BENCH MARK ,. tlDn o„ tIt Loaem and Deempam `` MQ A�e(,y .r GnrA 17 mW levaom too FL Lip 11 `` Inspections performed by: LABS Sour lakA Dates: 1" b i 08 = L pF A(``It zne i : 9 !/� Development Services Department Approval S y 49L Conditional Approval Date: � LARa S=1JRKLA\0;�c•� •1o�2L 0(3 Reviewed and approved by: Date: (R« NoelOL I A T I I I Lot I INSTALLED 1250 GAL SEPTIC TANK CONNECT TO EXISTING DRAINFIELD E L I E R # 1 \LACK 3 Lot VACA T 2 3 ABAND\ EXISTING SEPTIC TANK PER AI0 CODE REOUIRMENTS\ i sw�c rra (4 CANT) i IS NOT A SJR'iftED PUT" RILL d S[?GC i Q L0:AL'0h5 1A.T1N TRCV ON-S'Tf Wd ICR AND w4S1F'm'lu LVOr,VENT DOCU,VCN(ATIOIr'. ALL LOCAr(0h'5 SNLk'.4 A,4C i AFPR0X'vA1C. 50 0 50 100 150 200 250 300 SCALE+ i' = 100 FTT, DOUBLE CLEANOi l-2 FEET COVER GUMMED TV EXIST DRAINFIELD 1250 gal. septic tank I III INSULATION >FRUNVAT II N10 CLEANOUT ASSUfOW VM E A C 100 IarUKALANU LKWKLLKR9GI I ATELIER 1 BLOCK 3 LOT 3 I I SEPTIC SYSTEM ASBUILT ANCH. AK. 99501 W 15TH. AVENUE JOANN SCHNELLBA£CHER DATE.- OCT, 22, 2008 ANC (907) 279-3916 7100 MONTAGNF SHEET. 1/1 GRID: 2141 PERMIT # SVO80052 PID # 041-031-39 ATELIERM30DLDV6 C.._2 -o g XP a -0 0 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: May 20, 2008 Expiration Date: May 20, 2009 Permit Number: SWO80052 Parcel ID: 041-031-39 Legal Description: ATELIER #1 BLK 3 LT 3 Design Engineer: 0007 SPURKLAND ENGINEERING Site Address: Owner Name: JOANN SCHNELLBAECHER Lot Size: 109771 SQ. FT. Owner Address: 7100 MONTONGE CIR Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE. AK 99507-0000 This permit is for the construction of: ❑ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specked in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By ✓ Date: 5 2 Issued By. Date: 20 O Municipality of Anchorage • --\ Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, Alaska 99507 www.muni.org/onsite (907) 343-7904 ON-SITE SEWERMELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcell.D._ hLlI-o:--")(-59 Property owner(s) 3o Ant) S ArN t l l to z, el r- 11 A Day phone Z 3o - } 5 33 Mailingaddress _4100 NOAH n Q. -ale. An hora4 AK Zip Code 8450 -- Site address _ —S am6 —Zip Code Legal description (Sub'd., Block & Lot) /' //1� r licr Ili B6,k 3 W 3 Legal description (Township, Range & Section) Lot Size. Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field ❑ Septic Tank 0 Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms THIS APPLICATION IS AN: Initial Upgrade Renewal certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Liw Waiver Fees: Date of Payment: 6 Lc"O' o Date of Payment: Receipt Number: �Q%710 Receipt Number. (Rev. 1I05) Environmental Consulting and Design Municipality of Anchorage May 19, 2008 Development Services Department Building Services Division On-site Water and Wastewater Program 4700 Dragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Subject: SEPTIC TANK PERMIT APPLICATION ATELIER # 1 BLOCK 3 LOT 3 We are submitting an application to upgrade the septic tank for this lot. The submittal consists of one (1) drawing showing the present improvements on the lot and the proposed improvements of the lot, of which only the septic tank is subject to this permit application. There are no wells within one hundred feet of the proposed replacement site. The installation of this septic tank will not prevent wells and septic systems from being installed on the adjacent lots. There are no developed or natural surface / sub surface drainage courses within 100 feet of the proposed septic tank location. The proposed septic tank will not change the general slope of the area. Ponding and/or concentration of surface runoff will not result from this installation. If you have any questions or are in need of additional information please contact me at 279-3916. Sincerely, Lars SpuPkland~ P.E. 203 West 151h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (907) 276-6013, SpurklandEngCagci.net ATELBLORK31 IL� cAB2 ABANDON EXISTING i Lot 3 SEPTIC TANK PER IMOA CODE REOU(RM£NTS\ ALL 1150 GAL SEPTIC TANK CONNECT TO EXISTING DRA/NF/ELD�� Lot 4 (VACANT) IN 50 0 50 1007 150 200 250 300 SCALEr I' = 100 FT. DOUBLE CLEANOf " 1— 4 FEET COVER UT ��..• ' 'Iy mol...... 49th....------ ........... LABS SPURKLAND CONNECTED TO '��� '' EXIST BRA INFIELD • 1250 gal. septic tank '�•:;;5;;.:�'' 20 J W 4N0 ENGINEERING ATELIER 1 BLOCK 3 LOT 3 SEPTIC SYSTEM DESIGN 203 W AK. AVENUE JOANCHNELLBAECH£R DATE: MAY 19, 2008 ANCH. AK. 99501 907 279-3916 7100 MONTAGNE SHEET: 1/1 GRID. 2142 PERMIT # PID k ATELIERV830DI.DVG JIMspa �d C�go�c��r�o�g 1. Environmental Consulting and Design Single Family On-site Wastewater Disposal System Construction and Material Specifications Subject Property: ATELIER #1 BLOCK 3 LOT 3 Date: May 19, 2008 General: 1. The owner shall contract with a contractor to perform the work outlined in these specifications and plans in accordance with the attached MOA permit. There is not contractual arrangement between the contractor and the Engineer. The Engineer shall be the owner's representative and will inspect the work to document the contractors activities. Final acceptance of the contractors work rests with the owner and the MOA. 2. The scope of the work includes the installation of a new 1250 gallon septic tank. The location of the drainfield is shown on the attached site plan drawings. All components of the proposed septic system must be constructed a minimum of 100 feet from any surface water or water wells in the area. A minimum of 4 feet of earthen cover is required over the septic tank. If less than 4 feet of cover is available, 2 -inch thick, 40 psi, direct bury board foam shall be Installed directly over the septic tank and all installed piping. 3. Construction shall be in accordance with the approved site plan and design drawings and any special provisions noted on the Municipal well and/or septic permit. All materials, components, workmanship and construction practices shall comply with the Municipality of Anchorage's latest ordinances regarding wells and septic systems, as well as MOA, Development Services Department, On-site Water and Wastewater Program (DSD) policies. 4. The contractor is responsible for obtaining all underground utility locates, layout of the proposed system, and verifying and maintaining all required separation distances to lot lines, surface water, wells, steep slopes, etc. S. The property owner shall be responsible for final grading any depressions formed from settlement of backfill material. The property owner is also responsible for vegetation of all areas disturbed by septic system installation activities. 6. Contractors installing wastewater disposal systems must be certified to do so by the MOA DSD, On-site Water Wastewater Program. Property owners installing their own systems must receive advanced approval from MOA DSD prior to system installation activities. 7. The contractor shall ensure that ALL materials being used are in compliance with the most current guidelines established by the Municipality of Anchorage. Refer to "Standards and Specifications for Component Parts and Materials Used in the Construction of On-site Wastewater Disposal Systems", Dated December 2000, as provided by MOA DSD, On-site Water and Wastewater Program. 203 Nest 15'" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, LspurklandCgci.nct Environmental Consulting and Design Septic Tank Installation: 1. A new septic tank, of the size specified In the design drawings, shall be procured from a qualified manufacture/supplier if the existing septic tank Is found to be defective. Construction shall include two 4" diameter deanouts for pumping access. 2. The burial rating of the tank shall be adequate for the actual burial depth encountered. 3. The tank shall be level and sufficiently bedded to prevent settling of shifting of the tank. 4. All standpipes on the tank shall extend a minimum of 12inches above the final grade. S. Tanks Installed with less than 4 feet of cover shall be insulated. 6. The sewer service line from the house to the tank shall have a minimum slope of 2% unless prior approval is obtained from the engineer. 7. The inlet and outlet lines from the tank shall be bedded in drainrock or the soil shall be sufficiently compacted to prevent future settlement of the soil. S. Septic tank inlets, outlets and cleanouts shall be fitted with water tight couplings. 9. A cleanout shall be Installed 1 to 4 feet from the foundation. 10. Post tank deanouts shall be installed per MOA requirements. Does not apply to pressurized lines. 11. In areas with high ground water, the septic tank shall be sufficiently anchored to resist buoyancy forces when there is not adequate soil cover to resist uplift force. The contractor shall refer to the engineer for direction regarding this matter. 12. The tank backfill shall be graded sufficiently to ensure positive drainage away from the tank. 13. All holding tank and lift stations shall have an audible and visible alarm inside the residence being served. 14. All lift stations shall be wired in compliance with all MOA guidelines and the Uniform Electrical Code. A municipal electrical permit and Inspections must be obtained where required by the MOA. 15. The contractor shall verify that the septictank/lift station is a minimum of 100 feet from any residential water well, 150' from any class `C well and 200 feet from any community water wells. Additional separation distances must also be maintained. 16. The contractor shall remove or abandon the existing tank in compliance with the Unform Plumbing Code. Inspections: 1. A minimum of one Inspections are required by the Municipality of Anchorage. These Inspections must be conducted under the supervision of a Professional Engineer licensed to practice In the State of Alaska. 2. The septic tank may be set In place, but may not be backfilled. 3. The contractor shall provide a legible copy of all field notes relating to system layout and construction to the engineer for the use In preparing the record drawings. 4. The contractor shall coordinate all inspections with the Engineer. A minimum of 24 hours notice is required prior to the start of construction. If necessary, a preconstruction meeting will be held on-site. 203 Nest 15'" Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916 Fax: (866) 354-1597, LspurklandCagci.net // MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 82.5 L Street - Anchorage, Alaska 99501 Telephone 264-472.0 �- ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE � NFW /� / o;,n /`Fl�i'C��C7 ------ `/ �TS— I�_r7 UPGRADE MAILING ADDRESS - ------ ----- _El S'R /� a3 a/ LEGAL DESCRIPTION 3 8 3 /4 TE L -i f,re s/b LOCATION L b 12- NO. OF BEDR,DOMS v W I DISTANCE TO: v � Absorption area Dwelling PERMIT NO. �0 CL Q Manufacturer �n Material No, of compments W I.- fC. c.� �� w Liq. rapacity in gallons IF HOMEMADE: Inside length Width Liquid depth iO DISTANCE TO: Well Dwelling PERMIT NO. CD Z 02< Manufacturer Material Liquid capacity in gallons 0 LU DISTANCE TO: Well P Foundation / Nearest lot line PERMIT NO J LL Z zx No. of lines :Z Length of each line .Z Total length of lines, /� Trench width _ -� ,36 inches Distance between lines/ cc�_ Top of tile to finish grade Material beneath tile Total effective absorption area O I .2-3 inehes Length Width Depth PERMIT NO. W C7 Q V- Type of crib Crib diameter Crib depth Total effective absorption area a� LU N DISTANCE TO: Well Building foundation Nearest lot line J ClassDepth Driller Distance to lot line PERMIT NO. J .6190 TA W � I DISTANCE TO: Building foundation Sewer line - Septic tank Absorption area(s) dA- � OTHER S PIPE MATERIALS f- i Dac)34 rl pE&aA4ca SOIL TEST RATING INSTALLER 4Yl I7)/LO C C7 REMARKS oas Ed 2 ° OIL ' (?46-k�w — s v,ds-d `0"-1 D o 3 73 ru ►- APPROVED DATE LEGAL /// � �l • OCA • / n 72.013 (Rev. 3/78) 0 TirELL LOG .Drilled: /Static Water Level � S feet Draw Down feet Type Material Drilled: Gallons Per Minute +7 Total Feet of Casing y() 0 feet to to to to to to 0+ Hefty Drilling S.R.A. Box 1553 H Anchorage OAlaska 99507 B I k. 3 r t"I t.1 vm ..~�_� ��������� DEPHRTMENT HEHLTH AND ENVIRONMENTAL ROTECTION 825 'L' STREET, ANCHORAGE, HK. 99501 264-4720 --- 14 K 1.. 0 1=1 164 low CA lyi_���� PERMIT NO. ( 820428 ) �] APPLICANT MARION HRTORO SRH 2]84H 5"ua» LOCATION ~' 1"1' T LEGHL L] B] ATELIER S/D LOT SIZE 109771 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (SQ FT/BR)= 280 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: [ON K F" 1- 1-4=E.'-.-- RESPONSIBILITY F­���= � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR [RAIWFIELD THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET), THERE IS NO SET WIDTH FOR TRENCHES, THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). ��F." E__�� ��.� � �-=I P.A I F_ 7,E5, C3i F:o &_��p'll� PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. ___ �IAJ C) K! 12 > .1 PA _T- 1' C-8 r-4 SF FA FT E= K EE Ca Li 3: K EE Ex BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETNEEN H NELL AND ANY ON—SITE SEWHGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTHNCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET HMD TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS' OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. J":DwfF:":jF;TFom5; E>E=C1EEtlE3EEF;? I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON—SITE SEWERS AND WE FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES ]: I UNDERSTAND THAT THE ON—SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS- �xSIGNED: ..... _____ _______________ APPLICANT MHRION�HRy�� / - �� ISSUED B .... ..... .... ____..... DHTE ______ Y4. 0 xSOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: "✓ y— `� /✓ /" Y� DATE PERFORMED: LEGAL DESCRIPTION: Y"�A� 3 o nr� SLOPE EET er" 2!a7 f Ct 1 e." 2 S0"1d (s, P) 3 / S� 4 5 -ffm _S' /-/ 6 8 911 511 /1 10 11 12 13-��*'-� 14 15 16- See 17 18 19 WAS GROUND WATER /�O L ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? Reading Date Gross Time Net Time Depth to Water Net Drop / Z. l d Z Z4 -- - 5.1v.0""e re if- 4P 3DB✓' 0,3-- 20 I I PERCOLATION RATE 6 � (minutes/inch) TEST RUN BETWEEN . I'D FT AND 6'`'miFT COMMENTS ��.22 AM if Z � a . 2 i .moi � j yl � •r �n Clw PERFORMED BY: _h �e� / ✓ ��'me CERTIFIED BY: A td- DATE: �� t7 ` Q � � �•P z' � d r, J`%aur �" 72-008 (6/79) C� ey A,E.C.s,, INC. 1220 W. 2511-I, AVENUE ANURAGE, AK, 99501. Supplemental. Soils Information. Subdivision_ Block LOT LOT LOT LOT TH TH TH q TH IDEPTH - �4F�T DEPTH vy3�' �C.CUL� �i C�-n�C. ". T) COL% (FEFT) 2 `- 2 2 $i 2 3 3 C14-7 A. 3 3- 4 t` —4 ..� 4 All'-� Ibr k2z f //4� 6 6 %" �z✓3, Sr T `CS _ f� 8t 9 to D /`ii. t�n� 9 'c� % /1 � - 9 9 10 10 AaLl 10 10 11 11 11 t � 11 12 12 12 12 13 13 13 13 14 14 14 14- 15- 15 15 15 16 16 16 16 17 17 17 17 18 18 18 18 19 19 19 19 20 20 20 20 , ALASKA RUIROW11TAL C011TROL SRICCS, Inc. Engineering & Environmental Studies PERCOLATION TEST DATA SHEET CLIENT b-cl_�, _/ TU`��y DATE ADDRESS ZIP CODE CLOCK TIME NET TIME DEPTH TO DATUM LEGAL LOCATION L 3 13 3 Ale e,— �0 TOTAL DEPTH OF HOLE 3D ft. ZONE TESTED .3.5"� ft TO 4,—S— 6- 2 --&- ft READING # CLOCK TIME NET TIME DEPTH TO DATUM NET DROP RATE (min/in) S �s' 3D a l —0, l -- ___----- FINAL PERCOLATION RATES (min/in) PERFORMED BY sJ - Ge r��- r• 1220 West 25th Avenue • Anchorage, Alaska 99503 • (907) 276-1361 ALASKA RUIROMPTAL COnTROL SMUS, InC. 6nqineerinq & 6nuironmental Studies PERCOLATION TEST DATA SHEET CLIENT DATE ADDRESS ZIP CODE LEGAL LOCATION to t -3 )6 3 4 j� TOTAL DEPTH OF HOLE l z ft. ZONE TESTED _?w ft TO '/, J_ —ft 7.S ' Ao le , READING # CLOCK TIME NET TIME DEPTH TO DATUM NET DROP RATE (min/in) '0 0 L o /0 0 yo ...... . .. .. 61 f3 0.0-) 0 _$_� _.__ - �__ cq, 0 IT - 1.- 0v /0 v, � 4 c), 0 s. FINAL PERCOLATION RATE (min /in) PERFORMED BY j fee l -e (C-) J- S`6 _7_/1 a -3 1220 West 25th Auenue • Ancharaqe, Alaska 99503 • (907) 276-1361 MUNICIPALITY OF ANCHORAGE AAL • DEPARTMENT OF HEALTH & HUMAN SERVICES MjMQ Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel l.D. # CLL \ - � - HAA # h` C -A LIQ C) 1 U_, 1. GENERAL INFORMATION Complete legal description L-© T- 3 , BLOCK 3, 5/� Location (site address or directions) -7100 r� of GNs c)ric��� /� NCHo2A, A- rK q 9 So -7 Property owner IZt---V- X M2s• MA12) oN3 A-rz-T'uR-0 Day phone 2-72-2-1"31 Mailing address -7100 MOnNrAGNr= G12Gc-E. 4NG4n24GE. AK 9ci-07 Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well 1 Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm i ►J c. Phone -7 2 ^`? 33 6 Address 2_o6 E.� ar t=�..r(E �E STE. 2-0I Ar�cr+oraq�� A -cc �jgso3 Engineer's signature _e�� Date !!S- 6. - 6. D``H//HS SIGNATURE Approved for Disapproved. By: j f _lQ_ bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments WAIVEL /✓ti) qN750 RFTr� E= J UC -L 41t2oK- aUTlrl The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICkECEIVED Environmental Services Division 825"L" Street, Room 502 • Anchorage, Alaska 99501• (907) 343-4744 MAY 21 1996 De Municipality vt Anchorage Health Authority Approval Checklist Pt. Health & Human Services Legal Description: LOT- 3, 49LO ►c Parcel I.D.: A. WELL DATA Well type P2\ FATE If A, B, or C, attach ADEC letter. ADEC water system number NIA Log present & y Date completed 6— 2 1` 8 2 Total depth 401 Cased to 40 Casing height (above ground) ) 2 Sanitary seal (!?YM \(E: S Wires properly protected 6 y FROM WELL LOG AT INSPECTION Date of test 21- 8 2 4 — 19 —9G Static water level 2 S 26 Well production 7 g.p.m. 9— p.m-WATER SAMPLE RESULTS: Coliform cc, /0'I;c 11014 L Nitrate `' / m - Other bacteria D colo n, eS X00,,, C Date of sample: L+ — 19 -- 9 cc, Collected by: Si /tet 0 /J S C 42 04D E- r?, B. SEPTIC/HOLDING TANK DATA Date installed S — 2 Tank size 12150 c,Ri. Number of Compartments 2 Cleanouts (DN)__y Foundation cleanout SYN) y Depression (YO N High water alarm (Y(D N Date of Pumping 3— 29 _q to Pumper s S A 4 C S C. ABSORPTION FIELD DATA Date installed 6 - 8 — 8 2 Soil rating (g.p.d./W o ft2/bdrm 280 System type TrZEN CH Length 17q I Width 3 Gravel thickness below pipe 4� Total depth 6 '— % Effective absorption area 13 9 2 Monitoring Tube present&N)_ Depression over field (Yo N Date of adequacy test 4 — 19 —9 6 Results as ail) P/rS S For q bedrooms Fluid depth in absorption field before test (in.); _� Immediately atier600gal. water added (in.): 12 Fluid depth _(ins.) Minutes later: Absorption rate = 1 -00 g.p.d. Peroxide treatment (past 12 months) (Yo lU If yes, give date )VZA D. LIFT STATIOl Date installed Manhole/Access High water alarm 'level at* N/A Size in gallons "Pump on" level *Datum Cycles tested E. SEPARATION DISTANCES "Pump off' level at* SEPARATION DISTANCES FROM WELL ON LOT TO Septic/holding tank on lot �-� y . I -i► �., ; On adjacent lots I O O Absorption field on lot / /0 On adjacent lots Public sewer main; 100 't Public sewer manhole/cleanout 100' + Sewer /septic service line 1001+ Lift station N / A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 29 Property line I (DO t Absorption field 10 Water meWservici line Surface water/drainage I o�� "t' Wells on adjacent lots 100 t SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation 8 Property Line -7.3 Water main/service line Surface water I 0 + Driveway, parking/vehicle storage area 3 S Curtain drain �� r 't' Wells on adjacent lots 100' F. ENGINEER'S OERTIFICATION 1 certify that I have determined th r Id inspections and review of Municipal recon 1,14149 Ubj* 3 gems are in conformance th OA gu'de Ines in effect on this date. ��r.'•' ,"1 Signature" r6esName �Uj�OHN E. StmPSot�14P.E', HAA Fee $ 3 C UU Date of Payment Receipt Number Rev. 8/95 OSS: haa.wk.doc Waiver Fee $ Date of Payment Receipt Number 'I John Earl Simpso�d° c Cr 04111'1- 'yr 15.3 7 (_T: E ESI AI ICHi (RAGE 90r'722415 I Ii I. 15-7PCI--' CT&E Environmental Services Inc. zsmt,&L:j' Laboratory Division ►,I/////I�/I►Ertl►��►./,///ti��././.����i/�►�rE/«/.i�./t e►��i Laboratory Analysis Report CT&E Ref.# 961386.11518 Collected Date 04/19/96 Client Sample 1D ARTURO OUTSIDE FAUCET) 1386-01 Matrix Drinking Water Technical Director: Stephen C, Ede PWSID 0 Released Byy-r--i Sample Remarks: Parameter Results OC POL Units Method Allowable Prep Analysis Init Oual Limits Date Date Nitrite -N 0.100 U 0,100 mg/L EPA 353,2 04/19/96 EMB Nitrate -N 1.47 0.100 mg/L EPA 353.2 04/19/96 EMB U Undetected LT Less than GT - Greater than D Secondary Dilution J Below the calibration rant 200 IN, Pottei Drivo, Anchorage. AK 99518-1605 — Tel: (907) 562-2343 Fax (907) 561-5301 3180 Pegel Road, Fairbanks, AK 99709-5471 — Tel: (907) 474-8656 Fax: (907) ENVIRONMENTAL FACILITIES IN ALASKA, CALIFORNIA, FLORIDA, ILLINOIS, MARYLAND, MICHIGAN, MISSOURI, NEW JERSEY, OHIO, WEST VIRGINIA Municipality of Anchorage Department of Health and Human Services 825 "L" Street Rick Mystrom, Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 June 19, 1996 John Earl Simpson, P.E. Environmental Management, Inc. 206 East Fireweed Lane Suite 201 Anchorage, Alaska 99503 Subject: Waiver Request for Lot 3 Block 3 Atelier Subdivision #1 Waiver Request #WR960023, PID 041-031-39, HA960188 Dear Mr. Simpson: Your request for a waiver of the required 100 foot horizontal separation of the septic tank to the private well on the referenced property has been approved. The approved separation distance is 97 feet. This waiver approval applies to the existing septic tank to private well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. If there are questions or concerns regarding this waiver, please call our office at 343-4744. Sincerely, G v Lev James P. Williams Civil Engineer On-site Services JPW/1jm:waiverArturo MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR960023 PID# 041-031-39 HA# HA960188 Permit # Date Received: June 6, 1996 Legal Description: Lot 3 Block 3 Atelier Subdivision #1 Engineer: John Earl Simpson, P.E. 206 East fireweed Lane Suite 201 Anchorage, Alaska 99503 Applicant: Marion Arturo Waver Requested Waiver of Private well to on -sine septic tank of 9 ' }-# Criteria: 1. Geology: Points: A. Water Table ;L.{ B. Soil Sorption C. Permeability �, U D. Water Table Gradient E Horizontal Separation` TOTAL: 2. Special Conditions: AfIrr- oTHr*— TNA, wAtueit. mpues w 3. Other Waiver is Granted: Waiver is NOT Granted: Lista' Conditions or Reasonps� for above: �t /�% 11E4AS OF AFE (t/ sapwc. 74"ACS t5P4vf.-7 (bye MIJ, O/Umygs, PuJE rs Loca'7eo Waa FWE0 pa,vt N-airkeE'V it, A+n Date: By; Na of Reviewer Rec #: #01921/9416 Amounts,$ 625.-00 Date Paid: 6-6-96 fir v--, IM -T &t;' •� t. AND SEP7/L 7A/1 -JK -',- 1/!NG a6� / ,SWC. M�S�• DIST F( -om v) /I tL TP,Lr� /VJ0 P�,0770 +�-, Otys/ 0 1 4 lam 6Ac �. SFQ7IC 7rt P P CL EA r-� 64Au[,L- O SFia Ufa w cwt -c A,r 7; 01 OLAy S I UT 3,S. drfi'I T4+' A ;pc, ® 5 WI. A: ll Pt t 1 EL -pf /F11f fi�6f„ la tr J ToialhivS WA X ttV, x . 3 loo' '10-rF,�_ !-IrS � .1 4 tru 1 6.11 4;.8 j41e 1.46, 83 , AFTeAGA &b *11 I TE 1 LY % CO A Af%*Lf e L3 , a3, �►t����Q s,�, ++ �„ (NoaTW of Nom) L3,9 3 . A tFiIEit NO *11 (foosSou'lN Olt AA1`.NVIRONMEN IAf. NlANAGEAIEN"I 1NCORPORATEI) Date: June 6, 1996 To : Municipality of Anchorage Department of Health & Human Services Environmental Services Division 825 "L" Street, Room 502 Anchorage, Alaska 99501 From: John Simpson, P.E. Environmental Managemer; nc. 206 East Fireweed lane"Suite 201 Anchorage, Alaska 99516 RECEIVED JUN 6 1996 M1")'C'Pality of Anchorage Dept. Health & Human Services Subject: Application for Separation Distance Waiver -Well to Septic Tank, For Lot 3, Block 3, Ateiler #1 Subdivision. This waiver application is organized per Municipality of Anchorage ordinance chapter 15.65 section 15.65.1450-13 1 through B 5. B1. We are requesting a Separation Distance Waiver - of the requirement that an on site Well be 100 feet from an on site Septic Tank. This Waiver is being requested because the existing septic tank is 09.27',fr?T, he existing well. Please see drawing 1 attached. B2. Site and soil information: The lot is 109,771 Square feet in size in the Stuck Again Hills area of Chugach Mountain foot hills , Municipality of Anchorage. The site is sloping In a westerly direction at a approximate 12.% to 20% slope across the site. The well is up slope from the septic tank. There is no standing surface water on site and all surface water drains away from the well and septic in a westerly to northwesterly direction. It is assumed that the ground water gradient is in the same direction as the surface water. In this event any possible leakage from the septic tank would flow away (down gradient ) from the well. On site soil conditions as per the Anchorage area soil survey is as follows "This hilly well - drained soil formed in 5 to 10 inches of loess over very gravely till of moraines. Slopes are short and choppy. A representative profile has a layer of grayish brown silt loam about 1 inch thick. The subsoil is dark brown silt loam about 7 inches thick. The substratum, to depths greater than 48 inches, is brown or grayish brown very gravelly sandy loam till. The till varies in compactness; in some areas it is very firm. Permeability is moderate in the upper 7 inches and moderate to moderately rapid below. Runoff is rapid and erosion hazard is sever. Page 1 206 E. FIREWEED LANE, SUITE 201 • ANCHORAGE, AK 99503-2703 CONSULTING (907) 272-9336 • FAX (907) 272-4159 • TRAINING (907) 272-8852 • FAX (907) 272-0319 The available water capacity is low. Included in this soil in mapping are areas of Kasilof, Slikok, and Torpedo Lake soils, and areas of deeper Homestead silt loam. Including soils make up about 15 percent of the mapped acreage." From the well log the subsurface soil conditions are as follows; 0 'to 10' sandy gravel, 10' to 40' gravel, 40 'gravel with water. B3. Mitigating measures: There are no mitigating measures proposed at this site because evidence indicated that none are required. The owners of this property have lived on site since construction of the residents in 1982 and have indicated no noticeable effect of of the 0.733' less separation of the septic tank to their wells water quality, over the last 14 years. On April 19, 1996 the well water was tested for Nitrate and Coliform with results within acceptable limits for drinking water. B4. Engineers Statement: This on site system is a fully functional system meeting all the requirements set out by the Municipality of Anchorage. The adequacy tests performed on the on site systems showed that the septic system is oversized and would service for a 5 bedroom house (existing home is a 4 bedroom). In general the the site is neat and clean with no refuse or out buildings on the site. I foresee no adverse impact to approving a waiver of separation distance for the amount required, 0.73'. B5. List of adjoining property owners: (From the Municipality assessors office these are adjoining property owners) • Atelier #2, BLK 3 Lt 4A, McPeck B. Hugh & Gabler Ann M., 8900 Basher Drive, Anchorage, Alaska 99507. • Atelier #1, BLK 3 Lt 213-2, Thornquist Robert K. MD & Elpida K., 18757 May Court Circle, Eagle River, Alaska 99577 Page 2 DIRECTION OF GROUND SLOPE UNDEVELOPED LOT i DETAIL A \ TO ABSORSTION FIELD SEPTIC TANK \ •� 97.97' TO WELL (ACTUAL) 1250 GALLONS \ 100' TO WELL (REOUIRED) X TO FOUNDATION CLFANOUT I co GL //<\3, \ I=} 19Sf1 llal I seolAisS uewnH V 41!r' ,.i idea 1031040UV 40 Al"r „unyV 96612 L N of v rA E "% John Earl Simpson e'4 CE - 80:61 r 07AlID 21 i LOT 3 BLOCK 3 ATEILER #1 SID DESIGNED: SHS ENVIRONMENTAL DATE 6/4/96 ---- -- MANAGEMENT — DRAWN: _SHS 44INCORPORATED SCALE: 1" = 50' CHECKED: JES - - --- --- - - --- -------- 206 EAST FIREWEED LANE, SUITE 201 ANCHORAGE, ALASKA 99503 EMI JOB NO, 6439 1907) 2729335 FAX: 272.4150 SHEET 1 OF 2 0901n1 -Ys �06� L � O'1 1 2 k SJ�Sy ��' y08.64 5569 yHS°/g, UNDEVELOPEDLOT n5)I�s ts'e a, 4• H ^� i !fe ,n -e J,7� SJ 9S 4p ^ Dr NOTE: END OF LEACH FIELD se W EP f rp Ms's y�r l7J Og WAS 105.22* FROM SURFACE e �9N4 Y �1 WATER AT THE TIME. THESE 54 loxtn•[u tame MEASUREMENTS WERE MADE Q� eJ EXPECTED DIRECTION OF SUBSURFACE a a o o° _ WASTE WATER FLOW l-+° ` 'A i - t / o o / Rn,yf +REF / J y 'A / APPROXIMATE / LOCATION OF Note:Slle Is slopeing M e westedy NOTE: STEEP SITE Q/ SLOPES RANGING FROM 18 TO A / LEACH FIELD direction at a pprox11me9y 12 to 20°/. In (� 20%. WELL DEPTH AT 81 FEET WITH / the dlrec6on of the crows, The Well botlorn Is at 40' wllh a static water WAS 0 ,�, m ^; STATIC WATERt'; / eerm +sr«afsuour at 26, LEVEL AT IV r G FROM WELL LOO. � ,AST IRON_// fouueeraucte.un,+----•� TAND PIPE ti, NJ5/2p X20.4/ fNal 39 N) )•262 �f. 7V6g152 12 ) Jg IOJ Well ., '92 82.5p7 '6d )9. b~ n 10> 10xto' CRA Bene O 11x59) P95 e+.n2 we 6A WELL UNDEVELOPED LOTT. /1 - 299' W 14'8l *2 4A It 4 11115151.11.11 el.n2 2 7A NB911n•so'w w r � p WELL 1o.1o'cu t.ne 707.12 y.w 3 11,4 �A 5A 561 7.56. NOTE: The site Is hilly and fells o9 lukkly to the wool al approximatly 25 to 30% slope, the properly Elopes to ^ w NOTE: SITE IS nEL1TIVELY FLATE IN COMPARISON TO SUROUNDING PROPER TIES WITH A 6 TO S % SLOPE ACROSS THE �c♦♦ the north at epprx. 20% and out the PROPERTY. WEL LOO ddveat epprox. Bq . There ere no ` ro SHOWS THE BOTTOM OF well loge evallWe that could be found,o THE WELL AT WITH ASTAiI T LEVEL OF e 8A N89132.22'W 151.06 ✓ Jv*, O WELL •�� S89)51106'W x•91 410.22 Y �YI y � I P 6A 9A 10 N e m 1A s 'Y^ ^5 118915v05'e 950.19 19-205 79-107 76-287 77-186 909157'05'W 164.97 77-186 Lot 3 Block 3, Ate i t e r# 1 S/d . Slop* direction local well location map DESIGNED: SHS DATE: 6/4/96 - MANAGEMENT DRAWN: SHS SCALE. NTS CHECKED: fJES 4AENVIRONMENTAL INCORPORATED EMI JOB NO. 6439 SHEET 2 OF 2 206 EAST FIREWEED LANE, SUITE got ANCHORAGE. ALASKA 99603 (907)2729336 FAX: 2724159 350.46 . . .. ......ti ...................... .. ..... ..... ronin m 0 tl mro Mxxr a, 0 rt 1 9 6 R 0 0 m 0 m m n . ..... ...... .................... ........... .. ................ .. ...... ................ - ............... .............. .. .......... . . .. . ...... k % '(99 i` AL 77 ill. �6 - 28 _-7. ve,