HomeMy WebLinkAboutBEAR VALLEY BLK 1 LT 4Bear Valley
Block 1
Lot 4
#020-431-30
Municipality of Anchorage
Community Development Department Page 1 of 3
On-Site Water & Wastewater Program
4700 Elmore St. • P.O.
Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907)343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP141196
PID Number: 020-431-10 ❑ New ®Upgrade
Nome: MARSHA BROWN
ABSORPTION FIELD
❑ Deep Trench ® Shallow Trench ❑ Bed ❑ Mound
Address:
9200 HONEY BEAR LANE,
ANCHORAGE, AK, 99516
❑ Other
Phone:
No. of Bedrooms:
Soil Rating:
Total Depth from anginal grade:
(907) 301-5944
3
1.0 GPD/sq. R.
SEE DWG. Ft.
LEGAL DESCRIPTION
Depth to pipe Invert from original grade:
Gravel depth beneath pipe:
SEE DWG. Ft.
0.5+ Ft.
Subdivision:
Block: Lot:
nll added above original grade:
Gravel length:
BEAR VALLEY
1 4
SEE DWG. Ft.
2 ® 45' Fl.
Township: Range:
Section:
Grovel width:
Reds Number of linea
Distance between linea:
5/5 FL
Ft.
SEPARATION DISTANCES
Total absorption area:
450
Number of trenches,
2
Dist. between trenches:
10+
To
Septic
Absorption
Lift
Holding
Public/Private
From
Tank
Field
Station
Tank
Sewer Lines
54. n.
Ft.
Well
100'+
too'+
too'+
—
25'+
TANK ❑ Septic ® S.T.E.P. OHolding ❑Other
Manufacturer:
CaPacity:
Surface water
100'+
100'+
too'+
—
ANCHORAGE TANK
1250 Gal.
Lot Line
5'+
10'+
s'+
-
N/A
Material:
STEEL
Number of comportments:
2
LIFT STATION
Foundation
5'+
10'+
5'+
—
Curtain Drain
NONE KNOWN
Manufacturer:
Capacity.
ANCHORAGE TANK/ORENCO
1250 cal.
'Pump on' level at:
'Pump off- level at:
High water alarm at:
Remarks:
{.
rs
45" -
PER CONTRACTOR, OLD TANK WAS ABANDONED PER UPC.
Pump Make m Model:
ORENCO PF-2005
Electrical Inspections performed by:
JADE ELECTRIC, LLC
PIPE MATERIAL
SCH 40
House to tank EXISTING Tank to D2665
droinfield
Installer
Drainfield D3034 CO/MT D3034
WILCO CONTRACTORS
Inspector GEG, Ltd.
BENCHMARK (Assumed elevation)
Ft.
Inspection100.00
Location and Description:
Dates: 1st 7/25/14
2nd 7/25/14
3rd 7 28 14
4th —
TOP OF FOUNDATION BLOCK, SW CORNER OF HOUSE
ENGINEER'S SEAL
Community Development Department Approval
ooOFoo �4
Conditional approval:
Date:
'•.Je turn ss:' O
Q E— 95 qi�p
Approved:
/ Date:
professtonao
�40000��
PERMIT NUMBER: PARCE
ID NUMBER:
OSP141196 AS -BUILT DRAWING 020-431-10
L
I I
I I
I I
I I
1
I
100' WELL RADIUS
II RESERVE SITE
CO2
MT2_—
TH#1 SPLITTER
/ CO3
IMT3 -----
INEW DRAINFIELDS
MT1
Col
C04
MT4
)
4'x4" INSULATION. GEG
VISUALLY VERIFIED A
PORTION OF IT DURING
TANK INSTALLATION
A /
EXISTING 3
BEDROOM
HOUSE /
\ \ \ FOUNDATION CLEANOUT IN CRAWLSPACE /
/ LOCATED AND INSPECTED BY GEG, LTD.
J-__,/
I
1�
1\
RADIUS
GARNESS ENGINEERING GROUP, Ltd
- CIVIL & ENVIRONMENTAL ENGINEERS
3901 E. WWR ROM, SURE 101 • MIGW ME, W 99507 • PHONE (909) S 7-8179 • FM (909) 338-3298 ° WE85RE mm.9am9mmgInWN.aom
PREPARED FOR: I PHONE NUMBER: PAGE NUMBER:
MARSHA BROWN 301-5944 2 OF 3
LEGAL DESCRIPTION: DRAWN BY: y J
BEAR VALLEY; BLOCK 1, LOT 4 A.J.G.'"g �3
TYPE OF WORK: DATE: ♦♦♦+1 ftFESS\6`%
AS -BUILT DRAWING OF SEPTIC UPGRADE 8/11/2014 ����„`����
RADIUS
GARNESS ENGINEERING GROUP, Ltd
- CIVIL & ENVIRONMENTAL ENGINEERS
3901 E. WWR ROM, SURE 101 • MIGW ME, W 99507 • PHONE (909) S 7-8179 • FM (909) 338-3298 ° WE85RE mm.9am9mmgInWN.aom
PREPARED FOR: I PHONE NUMBER: PAGE NUMBER:
MARSHA BROWN 301-5944 2 OF 3
LEGAL DESCRIPTION: DRAWN BY: y J
BEAR VALLEY; BLOCK 1, LOT 4 A.J.G.'"g �3
TYPE OF WORK: DATE: ♦♦♦+1 ftFESS\6`%
AS -BUILT DRAWING OF SEPTIC UPGRADE 8/11/2014 ����„`����
PERMIT NUMBER:
OSP141196
NOTE: EXCAVATION HOLE
FOR TANK WAS DRY
DURING CONSTRUCTION. NO
BUOYANCY CONCERNS.
TOP OF TANK
AT INLET = 96.09
INVERT OF BUNG
AT INLET = 95.47
AS -BUILT DRAWING
4" INSULATION
STI /FINAL GRADE = 98.54-99.92
ST2 MH
jj � TOP OF TANK
/ AT OUTLET = 96.03
NEW 1250 GALLON
S.T.E.P. TANK
3:1 SLOPES ON MOUND WAS TOPSOILED AND SEEDED
ALL EXCEPT AFTER CONSTRUCTION. VEGETATION WAS
EAST END OF OBSERVED ON 8/12/2014
NORTH TRENCH FILTER
NEAR HOUSE FINAL GRADE = INSULA
103.87-104.35 (PER CONT
TH#1
FILTER FABRI
INSULATION
ORIGINAL GRADE TOP OF SAND
= IDO.10 = 101.57
GROUNDWATER ® HIGHEST
MEASURED POINT = 95.10
RELATIVE ELEVATION OF BOTTOM
OF TESTHOLE = 85.10
PARCEL ID NUMBER:
020-431-10
FINAL GRADE
104.84-105.68
INVERT OF PIPE
= 102.07
5'-I
SOUTH TRENCH
GROUNDWATER 0 HIGHEST
MEASURED POINT = 96.07
RELATIVE ELEVATION OF BOTTOM
OF TESTHOLE = 86.07 -
NOTE: TESTHOLE WAS DRY TO 12'
BELOW GRADE ON 7/25/2014.
MEASUREMENTS COULD NOT BE
MADE BELOW 12' DUE TO A
BLOCKAGE.
GARNESS ENGINEERING GROUP, Ltd
BOTTOM OF --�
E9ENVIRONMENTAL G1E S
:,1.<:.:'.:.;
=`!'2' OF EXCAVATION
TOP OF SAND";�.,�
APPROVED '�+; 99.57
= 100.51
:.x
PAGE NUMBER:
INVERT OF PIPE
MARSHA BROWN
= 101.04
BOTTOM OF
EXCAVATION
NORTH TRENCH I- lo, I
= 98.51
DRAWN BY:
GROUNDWATER ® HIGHEST
MEASURED POINT = 95.10
RELATIVE ELEVATION OF BOTTOM
OF TESTHOLE = 85.10
PARCEL ID NUMBER:
020-431-10
FINAL GRADE
104.84-105.68
INVERT OF PIPE
= 102.07
5'-I
SOUTH TRENCH
GROUNDWATER 0 HIGHEST
MEASURED POINT = 96.07
RELATIVE ELEVATION OF BOTTOM
OF TESTHOLE = 86.07 -
NOTE: TESTHOLE WAS DRY TO 12'
BELOW GRADE ON 7/25/2014.
MEASUREMENTS COULD NOT BE
MADE BELOW 12' DUE TO A
BLOCKAGE.
GARNESS ENGINEERING GROUP, Ltd
E9ENVIRONMENTAL G1E S
01 E. WWR , WNE 191 • MHO, M 9�(907) WW :
.•••..
/
PREPARED FOR:
PHON301N44
E UMBER:-59
PAGE NUMBER:
,��
MARSHA BROWN
3 OF 3
J
LEGAL DESCRIPTION:
DRAWN BY:
���
BEAR VALLEY; BLOCK 1, LOT 4
A.J.G.
TYPE OF WORK: -
DATE:
�l PROFILE AS -BUILT DRAWING OF SEPTIC UPGRADE
8/2/2014
CE
TH#1
E:
10260 Sextant Circle, Anchorage, AK 99515, Ph. 907-229-2698, Fax 907-336-1074
To: Wilco Contractors
16701 Ransom Ridge Road
Anchorage, AK 99516
Thru: Engineer/Designer
Subject: Electrical Certification Letter
To Whom it May Concern,
The septic system electrical, to include the control panel and remote alarm, located at 9200 Snowbear,
were installed in accordance with the State, Municipal and National Electrical Code (NEC) standards.
If you have any questions, feel free to call or email me.
Thu
i
Paul T. Lincoln
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On -Site Wastewater Disposal System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP141196
Tax Code Number: 02043110000
Work Type: Septic Upgrade
Permit Effective Dates: July 01, 2014 to July 01, 2015
Design Engineer: GARNESS ENGINEERING GROUP LTD
Subdivision: BEAR VALLEY
Site Legal Address: BEAR VALLEY BLK 1 LT 4 G:3242
Owner/Address: FISCHER MICHAEL S &
-7—P-5 =-/rf
BROWN MARSHA 9200 HONEY BEAR LN ANCHORAGE AK 995166911
Site Mailing Address: 9200 HONEY BEAR LN, Anchorage Lot Size in Sq Ft: 55876
Total Bedrooms: 3
This permit is for the construction of:
Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Cvi vev'se� �l.e tnnovv.d s �esleAes �o oMow a i who IkcJed-
Received By:
I/-/ a- - 10
0:6-01
Municipality of Anchorage
P.O. Box 196650 • 4700 Elmore Road
Anchorage Alaska 99519-6650 0 (907) 343-7904 • Fax (90 7) 343-7997
hfti3://www.muni.org/Onsite
Development Services Division
On -Site Water and Wastewater Program
n e
,o F
Department
**** VARIANCE/WAIVER REVIEW ****
Waiver#: OSP141197 COSA#: Permit#:OSP141196
P I D#: 020-431-10
Legal Description: Bear Valley Block 1 Lot 4
Engineer: Garness Engineering Group
Applicant: Marsha Brown
Your request for a waiver of the required 50 feet horizontal separation from the absorption field
to the excessive slope has been approved. The approved separation distance is 40.0 feet. In
addition, the trenches are approved to be on a slope no greater than 35%.
This waiver approval applies to the proposed absorption field only. Any future upgrade to the
on-site wastewater disposal system will require all separation distances be met or another
approval from this department.
❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected
adjacent property.
® Adjacent properties are not affected by this waiver.
................................................•.............................1
Waiver is Granted: X Waiver is not Granted:
Date: %ZI
If Approved by:(N/rt/+�
Name of Revi er
......................................................... .....................
Rec#: 00624G Amount: $215.00 Date Paid: 6/13114
**** VARIANCE/WAIVER REVIEW ****
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Fax: 907- 343-7997
On -Site Water & Wastewater Program
Mayor Dan Sullivan
On -Site Sewer/Well Permit Application
For A Single Family Dwelling
Parcel I. D. 020-431-10
Property owner(s) MARSHA BROWN Day phone 301-5944
Mailing address 9200 HONEY BEAR LANE *ANCHORAGE, AK
Site address 9200 HONEY BEAR LANE *ANCHORAGE AK
Legal description (Sub'd, Block & Lot ) BEAR VALLEY; BLOCK 1, LOT 4
Legal description (Township, Section & Range)
Lot Size
Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DEWELLING:
(F all that apply)
Absorption Field
Initial ❑
®
Single Family (SF)
Upgrade ®
(w/wo ADU)
Septic Tank
®
Duplex (D) F-1❑
Renewal
F-1
Holding Tank
MultipleDwellings []
Privy
r](SF
and/or D)
Private Well
❑
�A !F
U 0 • • �jyj • ,
Water Storage
❑
JUN 13 2014 L
THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR:
SLOPE WAIVER Distance: 0'
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal codes.
GARNESS ENGINEERING GROUP, Ltd.
(Signature of property owner or authorized agent)
Permit/Rush Fees: Waiver Fees: 04T
Date of Payment: 6O i3 Date of Payment: (0//_3h(/
Receipt Number: b q rA Receipt Number:
Permit No. of it "f (V Waiver No.
(Rev. 01/11)
A..s
GARNESS ENGINEERING GROUP, Ltd..,�j�j���' �+ o
----- - CIVIL& ENVIRONMENTAL ENGINEERS LT"J+r'•�1�
June 5, 2014
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
Ref: Proposed Septic System for Bear Valley; Block 1, Lot 4;
To whom it may concern:
The existing 3 bedroom house is served by a private well and septic system. The drainfield is in a
state of failure and needs to be upgraded. We are proposing to install a new 1250 gallon STEP tank
and a dual 5 -wide trench type drainfields. One testhole was excavated on the property. The
drainfields will be installed around the 30 foot radius of this testhole. Comments regarding the design
are summarized as follows:
1. SOILS: See the attached log which show the soil classifications, groundwater monitoring, and
the percolation test results.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface water concerns.
4. TOPOGRAPHY & WAIVER REQUEST: As can be seen on the attached topography drawing, the
average topography around the proposed drainfields are 30-35% running southeast to northwest.
We are requesting the proposed drainfield be installed on a slope no greater than 35%. The
following are justifications for the waiver;
• The slopes below the proposed drainfields site are vegetated.
• The existing drainfields were installed on similar slopes and functioned without daylighting
(even when surcharged).
• For mounded systems your department only requires slopes of 3:1, we are requesting the
same requirement be made in this case as well. The proposed installation is more
conservative because the slopes below the drainfield are insitu and already vegetated.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you [Ave any questions, please contact us at 337-6179. Thank you for your assistance.
.E., M.S.
3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259
Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineedng.com
�\ ,SFAR VALLEr; 111 QCK 2,
/' I 1QO'-WELL RAD' IUS' LOT 3 \\
\ J BEAR VALLEY; LOCK 2, / \
LOT � /
i I 100' WELL RADIUSII
LOT 3
AREA
100 ILL
11
11 o
\/ BEAR VALLEY; BLOCK 1.
LOT 2 \ / / / I APPX. 100' WELL I
RADIUS
BEAR VALLEY; BLOCK >/
y \ LOT 5 /
\ PROPOSED 100' \ /
WELL RADIUS L \ /
y \
\ BEAR VALLEY; BLOCK 1,
\ LOT i
DONALD W. GOODMAN
HOMESTEAD
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
3'!01 E NOON SOLD. SUITE 101 • N HO E. SN 90507 • PHONE (907) 337-S11. • Pix Po07)
DESCRIPTION:
AR VALLEY; BLOCK 1, LOT 4
TYPE OF WORK:
SITE PLAN
ZONE NUMBER: PAGE NUMBER:
301-5944 1 OF 3
DRAWN BY:
PNB
BEAR VALLEY; BLOCK 2,
LOT 2
y
_d\ne
BEAR VALLEY; BLOCK 1
LOT 6
_FESS s
E7
OF BEDROOMS: 3
LETTER THAT PERTAINS TO THIS DESIGN.
PER DAY (GPD): 450
TO OBTAIN A COPY OF THE LETTER
'ION RATE/S: <1 MIN/INCH
CONTACT GEG. BY PROCEEDING FORWARD
D APPLICATION RATE: 1.0
WITH THIS INSTALLATION, THE ENGINEER,
DRAINFIELD SQ.FT.: 450 W
WELL DRILLER, CONTRACTOR AND
PROPERTY OWNER AGREE THAT THEY
HAVE READ THESE SPECIFICATIONS AND
IELD DESIGN:
AGREE TO ACCEPT THE TERMS AND
MAXIMUM DEPTH OF EXCAVATION: 1.5 FI
WIDTH: 5 FEET
LENGTH: 2 0 45 FEET, 90 FEET TOTAL
EFFECTIVE: 0.5 FEET
REDUCTION FACTOR: N/A
M.O.A. SAND FILTER: 2 FEET
ACTUAL SQ.FT.: 450 FT'
BEAR VALLEY; BLOCK 1, LOT 3
NOTE: NO WELL LOG FOR
LOT 3 WAS EVER FILED. NO
WELL WAS OBSERVED BY
GEG, LTD. IN THE HEAVILY
VEGETATED AREA OF LOT 3
WITHIN 100' OF THE
PROPOSED SEPTIC SYSTEM.
HOWEVER, IT IS POSSIBLE
THAT ONE MAY EXIST.
I I
100' WELL S1I PROPOSED 1250
GALLON S.T.E.P. TANK
I I RESERVE SITE
°T = FS
\Ij( TH$1�_
CO MT — — _
/ I PROPOSED
DRAINFIELDS
,BFAR VALI\EY; BLOCK 1, LOJ 2 /
100' WELL RAdIVS I I NOTE: RESERVE SITE WILL
I REQUIRE CATEGORY II ADVANCED
L TREATMENT. 4.0 GPD/FF, 25'x5',
0.5' EFFECTIVE, 125 Fr.
BEAR VALLEY,( BLOCK 1, LOT 1
i
NOTE: THE CONTRACTOR
\ SHALL HAVE THE WEST LOT
\ LINE, AND ALL WELL RADII \
FLAGGED BY A REGISTERED
LAND SURVEYOR PRIOR TO
CONSTRUCTION.
HONE -
\Po•
a_✓
LANE \
TANK TO BE
'COMMISSIONED
PER UPC. INSTALL FCD
ONE IS NOT
PRESENT
/ Jy�
/ JO
\ / IN
4" THICK 4' WIDE
h INSULATION OVER SEWER
LINE UNDER DRIVEWAY.
_—J—�
�— 1.PVC
PRESSURIURI ZED LINE
TO 4" PVC
�1
\
NOTE: MOUNDED TRENCHES
AND 3:1 SLOPES SHALL BE
TOPSOILED AND RE—VEGETATED
AFTER INSTALL
GARNE55 ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
3701 E. TUDOR ROM). SURE 101 • MlCHORAOE. M( 99W7 • PWM (907) 337-61'18 • FM (907) 336-3246 * MERSRE: w qon nge rings
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
MARSHA BROWN 301-5944 2 OF 3
LEGAL DESCRIPTION: DRAWN BY:
BEAR VALLEY; BLOCK 1, LOT 4 A.J.G.
TYPE OF WORK: DATE:
SEPTIC DESIGN UPGRADE REVISED 7/1/14
BEAR VALLEY; BLOCK 1,
LOT 5
CE-
Iv
�/
• � ' �, � L�o�'Tuu
�[�
D.CUMENTED, d,,BURIED OR — ° DE
QPERLY A� ANDONED ��` °
E ON SITE.
a.
a
R S t
fALLON S.T.E.P,: TANK
I o
3
\ I r RESERVE
r.ax CO MT
rr
'o ADIUS -
# C O°
MT f
ry Fru ,: PROPOSED DRATNN
RAdIU ...
,s• .t
.Eli -BLACK 1, LOT 1
---T.O GPD /F 0.5'
EFFECTIVE..A°12.5 FT Z ¢ UIRp-'"
5 FT2 PROPOSED
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
3101E TU°JRROAO.SUNE101`ANd10 E.MNE07'PHONE (90T, M78179'FA (NON 3383249'VEBSITE:�gemw—gine"g.PoM
LEGAL DESCRIPTION: _ BEAR VALLEY S/D; BLOCK 1, LOT 4
PERFORMED FOR: MARSHA BROWN DATE: 6/4/2014
DEPTH — ORGANICS
(feed TEST HOLE #1 WINER SMH
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
GM SILTY GRAVEL
Wl SOME SAND
DEPTH TO
GROUNDWATER
SOIL
CLASSIFICATIONS
6/4/2014
12'
GP
5'
GW WELL GRADEDGW
GRAVEL Wl BROWN
SAND
ORG
ML
::':>
2
2:45
GM
3 5/8"
CL
3
2:45
GC
6"
OL
4
"s o
SW
3 3/4"
MH
5
': �'• :
SP
6"
CH
6
3:45
SM
/
OH
SC
GM SILTY GRAVEL
Wl SOME SAND
DEPTH TO
GROUNDWATER
DATE
DRY
6/4/2014
12'
6/11/2014
5'
6/24/2014
6"
-
PRpFESS��Pi
DATE READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
6/4/2014 1
2:15
6"
-
2
2:45
30
3 5/8"
2 3/8"
3
2:45
6"
4
3:15
30
3 3/4"
2 1/4"
5
3:15
-
6"
'
6
3:45
30
33/4"
21/4"
19 PERCOLATION RATE 13.3 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 5.5 FT. AND 6.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: E YES ❑ NO
SOILS LOGGED BY: ANDREW GRAY PERCOLATION TEST PERFORMED BY: ANDREW GRAY
COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH.
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PE OR ED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE:
Clig A S
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
3701 E. TUWR ROAD. SUITE 101' PNCWR AKSSW7-PHONE IB3]1 337A1] -FM 183]1 3383248' MBSITE:vmw.P�nSNceMO,cm
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: BEAR VALLEY S/D; BLOCK 1, LOT 4
PERFORMED FOR: MARSHA BROWN DATE: 6/4/2014
DEPTH ORGANICS
(teen TEST HOLE #1 '4FPER'' NCH -
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
GM SILTY GRAVEL
W/SOME SAND
DEPTH TO
GROUNDWATER
SOIL
CLASSIFICATIONS
6/4/2014
12'
GW
5'
GW WELL GRADED
ORG
GRAVEL WI BROWN
SAND
GP
ML
:;{i.: t.`tC
CL
GC
OL
0 o°o o
mW
SW
MH
SP
CH
SM
OH
sc
GM SILTY GRAVEL
W/SOME SAND
DEPTH TO
GROUNDWATER
DATE
DRY
6/4/2014
12'
6/11/2014
5'
6/24/2014
�e
co
DATE READING CLOCK NET TIME WATER LEVEL NET DROP
TIME (MINUTES) READING (INCHES)
6/4/2014
PERK BENCH ABSORBED 5 GALLONS OF WATER IN LESS THAN 4 MINUTES.
t9 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 3.0 FT. AND 4.0 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: ❑ YES ENO
SOILS LOGGED BY: ANDREW GRAY PERCOLA PION TEST PERFORMED BY: ANDREW GRAY
COMMENTS: PERCOLATION READINGS ARE WITHIN 1/16 OF INCH.
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WASP RFO MED IN ACCORDANCE
WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: Zqy
O Development Services Department
Building Safety Division
On -Site Water Wter program
B
4700 ragawStreet
P.O Box 196650
Mark Begich Anchorage, Ar 99519-6650
Mayor M., mun; nrrgfoms,te
(907)343.7904
Pump Installation Log
Well Drilling Permit Number: SSV_ Date of Issue:
Parcel Identification Number:Q9Q-'/31' /D
Legal Description /
Ly
Prop�rfya�ynert Address:
ga00 Honey 4 A an%e
Pump Installation Date:
Pump Intake Depth Below Top of Well Casing:/4 feet
Pump hfanufacturer'sName: R{d Tdde4
Pump Model: /a v 6 ,
Pump Size � hp C Saod .
Pitless Adapter Burial Depth: /3i feet
Pitless Adapter Manufacturer's Name: N4
Pitless Adapter Installer:lvk
Well Disinfected Upon Completion? Yes ❑ No
1llethod of Disinfection:
Comments:
Pum Installer Nam ANCHORAGE WELL & PUMP SERVICE, INC
Pump .,30 EAST 76TH AVE. ANCHORAGE, ALASKA 99518
(907)243-0740 - FAX:(907)243-0742
E-MAIL: pumpmanjim@att.net
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT
EmriOronm HEALTH
Health HU on SERVICES �y 2 a
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 V
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name DISTANCES
Address TO SEPTIC ABSORPTION WELL
FROM TANK FIELD
}WELL I
Phone(s) ermd No No. of Bedroomss
LEGAL DESCRIPTION LOT LINE
Lot Block Sub on
FOUNDATION
Township, Range, Section
AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation,
W lQ
driveway, water bodies, etc.)
TA KS0.
,<SEPTIC ❑ HO ING
Manufacturer Capacity in gallons
1 4 Material No. of Compartmen
� Z t
TYPE OF SYSTEM G t Iall
r
XRENCH ❑ BED ❑ W. DRAIN ❑ OTHER
Depth to pipe bottom from Total depth from original grade
original grade
FT FT
Fill added above original grade Gravel depth beneath pipe
q� FT FT liD
Gravel length Gravel width
FT � FT
Total absorption area Distance between lines
2,;5_C> SO FT FT
Number of lines Soil rating Pipe material
l 2J1SQ FT -
Instal Date Installed
11'1 c> •
WELLS
PRIVATE ❑ OTHER tldentliv)
Classification (A,B,C) Total Depth Cased to
N.5T— FTJ FT
Installer I Installed:
Ws ` • '�L Scale' N►'"f • �j ENGINEER'S SEAL
Inspectio /r(1le�d by:
M
+ r
Date: �..— �rS !, L';,{ i'`x)
�x
17034 Eagle River Loop Road certily the this inspection was performed according to all _.-... »...�•tp <.
Cagle River, Alaska 99577 lob*il A. 3t •
Municipal and State guidelines in effect is date: Z !J ^�'�•e Ede i4W74 A, 4
tt •
Health Department Approval: Date: 6
i,
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
PO BOX 196650 ANCHORAGE, ALASKA 99519 343-4744
HAND WRITTEN PERMIT
Permit Number: SW900/-�-S_ Permit Type:
Date Issued: j --.3-e �10 Expiration Date:t 3,/
Design Engineer: S f s-
/S -
Owner Name: .5e,,1 Yeti/�� ��t�� ��� Day Phone: 3
�
Owner Address: / ���j �c_�y� �� `�rs7L
Parcel ID: 6 AGO-- �1(3/--- /&
Lot Legal: Subdivision: 6�- ��i� Lot: y Block:)
Section: Township://,�/ Range:
Lot Size: `�5"7( (sq.ft. or acres)
Max Bedrooms: This Permit:f,�,) Total Capacity: 7"
SEPTIC TANK: Minimum septic tank capacity:/:2-.SZ gallons. Each
septic tank must have at least 2 compartments, insulation is
required if depth to top of septic tank(s) is less than 4.0'.
Lift stations require an appropriate electrical inspection.
WELL LOG: A copy of the well log must be sent to DHHS within 30
days of the well's completion.
i
I CERTIFY THAT:
1. I will install the on-site sewer system and/or well in
accordance with all codes and regulations of the
Municipality of Anchorage (MOA) and State of Alaska , and
in compliance with the design criteria of this permit.
2. I will adhere to all MOA and State of Alaska requirements
for separation distances from any existing well, septic
system, or surface water on this or any adjacent or
nearby lot.
3. I understand that this permit is va id for a single
family dwelling with a maximum of L4 bedrooms. I also
understand that any enlargement will require an
additional permit.
.4. I understand permit is issued for the calendar year
and expire on De ember 31 of the year issued.
5. I will n ify DHH prior to all inspections by the
engine or well driller.
SIGNED: DATE:
( w ignee)
ISSUED BY: '►
C �t L DATE: rN30
db/115
-SCALE
-I JPG��/r���
ot�
ljs
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do
all
to
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14- fs,
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iN
.1 ........ .....
e Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: ` eg:y=f DAT
LEGAL DESCRIPTION: 1✓- l Township, Range, Section:
.t TZ- t�l'Zr , P I,l SLOPE
2 «y
K � ,
3 ire
4 &'
5
6?� .d
7-
'I--
8
`I--8 O C .v
f�
9-9 p
10
Fj
WAS GROUND WAT
7`
vb
ENCOUNTERED?
11
IF YES, AT WHAT
`+ G DEPTH?
12
13-
14-
15-
16-
17
314151617
18
19
cl
COMMENTS
I
7yyr dgeudd .
%I ---
p �
9 Osb • i
nV�f rr •1n sin A•6Pd�A W'
Nom,
11467-6
Sep•
F
SEAL)
Cd®pWtiv11A Q]V'•�® � '�'
S
L
E
PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN TFT AND FT
S & S ENGINEERINU
PERFORMEPA)§4 6"Is River L mI2 Road No 904
577
ACCORDA�Il/�T}iLL^ STATE AND MUNICIPAL GUID
72-008 (Rev. 4/85)
CERTIFY THAT THIS TEST WAS PERFORMED IN
ECT ON THIS DATE. DATE: Z � V
MUNICIPALITY OF ANCHORAGE DEPT. OF NEAt-TII R,
ENVIRONMEI\ tA� PRO',. CT ION
,E DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION �}G! r
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 tea 8dd
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION ISENEM I Ur r r%
NAME
e rO�G�YYS
IP _ EW
i�/ ) V r IL�/'CJPGRADE
MAILING DRESS -/
1474.
S7
LEGAL DESCRIPTION
lam 4� L o c k�—
LOCATION
NO. OF BED OMS
Well olAbsorption
DISTANCE TO:/��
area
Dwelling !
PERMI N
/
U
_Y
CL za
Manufacturer
Materiayy
No. of compartments
LU
y
Liq. rapacity in gallons
I �S0,
IF HOMEMADE:
Inside length
Width
Liquid depth
Y
DISTANCE TO:
Well
Dwelling
PERMIT NO.
JAZ
O F
Manufacturer
Material
Liquid capacity in gallons
w=
DISTANCE TO:
Well !
Foundation /
��
Nearest lot line /
PER IT NO.
gnCiwps!/�iv� r/r I
J LL Z
No. of lines /
Length of each line
/
Total IQn hof lines
I
Trench width
Distance between lines
BZW
!.�
inches
Q H
Top of tile to finish grade tjXy/,o jrf
3�o d
Material beneath tile /
,!
0
Total effective absorption area
O
ws C CO
inches
0 f
Length
Width
Depth
PERMIT NO.
W
C7
Q I-
w°
Type of crib
Crib diameter
Crib depth
Total effective absorption area
W
DISTANCE TO:
Well
Building foundation
Nearest lot line
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
W
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
PIPE MATERIALS
J
-'V-
SOIL TEST RATING
INSTALLER
[>
Inv
RE ARKS
// J /'
C7/±V �3' /✓jam! L �� l�Vl�
40
/ c o--�-• �� G�l� tr v Q
I
o �•
C
,C
reeweeee e
. ..
«q�.,� ..
1141, 7 0� CA,/ 6� 's
Cf-
APPROVED - yj^j- DATE LEGAL
/_U T
72-013 (Rev. 3/78) q, !
/ MUNICIPALITY OF ANCHORAGE
/ O DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
\ 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
\ ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
I y� /' //�� �J
I^ M— eA --fv —TM rl!/C� S
PHONE
'7e3
NEW
'GRADE
MAI LI NG ADDRESS
P-oq tvp/ , A-jr, q 9 Ste.
_
LEGAL DESCRIPTION
!,Or �r rz _V�Ll�y Sur I n! Z c
LOCATIO
'Li/r 77l GLS/c S A
NO. OF BEDROOMS
DISTANCE TO:
Well
Absorption area
Dwelling ry
PERMIT NO.
UY
CL Q Manufacturer
�_ _ - —
Materi
No. of comg� rents
LU
L
y
Liq, ca a?ty6 gallons
IF HOMEMADE:
InsiVA n
A
Width
Liquid depth
D
J 2
DISTANCE TO:
_turer
Well
Dwelling
PERMIT NO.
z
Manufac
Material
Liquid capacity in gallons
a
=
DISTANCE TO:
Well try
�+j
Foundation
Z�
Nearest lot line ^ /
PERMI O
J LL Z
z Lu
No. of lines
engthcQf_each line /
Total length of lines "w
(f
Trench width��T"
Distance betwee lines
F
�weliet
f
Top of tile to finish grade
S
Material beneath tile
'tJASr(e))
_
Total effec ive absor ion area
3
q inches
0
Length
Width
Depth
PERMIT NO.
W
Q F
0—
Type of crib
Crib diameter
Crib depth
Total effective absorption area
y
DISTANCE TO:
Well
Building foundation
Nearest lot line
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
DISTANCE TO:
Building founds
Sewer line
Septic tank
Absorption area(s)
OTHER
PIPE MATERIALS
t
Z�
7�7 4V 3!R it F . S ICO 6 ux40vu
_
01 L TEST RATING
INSTALLER
_ t-WN%P— —&0_�_ GH�3T ?2
REMARKS
/yC 77CAJ 11VAL
rZV;7
i
—
—
-D
—
—
E
•
\� V` %�• 18w ••
LEGAL
_
�►� PROFE&510NA�/�
APPROVED /� DATE
3
9MJALSRKql�//9
iL-V-1.5 (tiev. ii/d)
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMEN'[A. PRO'i LOTION
'40k V86E 12 Edd
CORWIN & ASSOCIATES, INCRECEIE,®
CONSULTING ENGINEERS ... ► i .� ,� „� v`
4321 GRAPE PLACE SUITE 204 ANCHORAGE, ALASKA 99504
(907) 561-6151
April 13, 1984 NO11J3IONd 1d1N31NNOWANJ
V HL1b3H d0 AdiQ
aft0a Y dO AUW4 91NM
Mr. Keith Bandt
Environmental Engineering Manager a� AA ��1��j
Anchorage Department of Health & J Ca
Environmental Protection
Pouch 6-650 y l• 80
Anchorage, Alaska 99507 WOUMGad 1V1N3WNO3Wq
Re: Lot 4, Block 1, Bear Valley Subdivision '8 HMN d0 'WaaWRON[w40Auwd1:jm
Dear Keith:
This will follow up our conversation of April 11, 1984 regarding
the geometry of the well and septic system on the referenced lot.
I measured the distance between the well and the septic tank
cleanout on April 10, 1984. The distance was 90 feet.
The topography indicates that surface drainage will flow to the
west. Although the ground at the well is about 7 feet lower than
the ground at the septic tank, surface drainage would generally
tend to travel in a line perpendicular to the line joining the
two.
Ground water, in general, would travel with the slope of the
surface. The static water level in the well is 40 feet. The
soil profile shows a granular material which should have good
filtering action.
Therefore, if the septic tank leaked, the contaminant would tend
to be filterea out by the soil. If contamination did reach the
water table, it would tend to flow in a direction away from the
well.
Based on the foregoing, I recommend a waiver of the 100 feetIf'
separation distance for this system..' f`
Sincerely yours,
CORWIN & ASSOCIATES, INC.
Stanley Brust, P.E.
Associate
SB:kjh
cc: Forrest Metsker
WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological a Geophysical Surveys
Drilling Permit No.
LOCATION OF WELL (Please complete either la, Ib or Ic.) A.D.L. No.
la. Borough Subdivision Lot4 Block 1/4gtrs. Section No. Township No Range E❑ Meridian
Anch Bear Val ey 1 af—
r—lof—of-
S❑ w❑
Ic. DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS
3. OWNER OF WELL
Alyeska Contracts
Address:
Street Address and Area of Well Location
Feet Below
2. WELL LOG
Surface
4. WELL DEPTH: ( final)
5. DATE OF COMPLETION
2 ft.
10 — V
Material Type Top Bottom
--3--
gravely till lenses of 0 43
6. ❑ Coble tool )Rotary ❑ Driven ❑ Dug
❑ Auger Jet ted ❑ Bored ❑ Other
cemented Z
bedrock 4.3 162
7.USE:) Domestic ❑ Public Supply ❑ Industry
❑ Irrigation ❑ Recharge ❑ commerical
❑ Test Well ❑ Other:
2 m
S. CASING: 11 Threaded ® Welded
diom. 6 in. to 43 ft. Depth Weight Ibs./ft.
diam. In, to ft. Depth Stickup ft.
9. FINISH OF WELL:
Type: ne►`l bole Diameter:
slot/ Mes Slse; Length:
Set between ft. and ft.
Backfilling Gravel pack
10. STATIC WATER LEVEL: '410 ft.
❑ Above or x Below land surface Date
Equipment used: ILVeC
11 . PUMPING LEVEL below land surface and YIELD
ft. after hrs, pumping g.p.m.
ft. after hrs. pumping g. p.m.
12.GROUTING Well Grouted: O Yes [-]No
Material: ❑ Neat Cement El Other:
13. PUMP: (if available) HP
Length of Drop Pipe ft. capacity g.p.m.
❑ Subm. ❑ Jet ❑ Centrifical ❑ Other
14. REMARKS:
16, WATER WELL CONTRACTORS CERTIFICATION:
15. Wafer Temperature ° � F ❑ C
This well was drilled under my jurisdiction and this report is true lathe best
of my knowledge and belief;
Alaska Now-Nell-Vern's Drilling & Ent
AA 3327
Registered Business Name Contract
License Number
SRA Box 1560 Anchorage, Ak 99516
Address:
Signed: r -le
Date:
Authorized Representative
Form 02-WWR (11/81) Copy Distribution: WHITE -State DGGS, PINK -Driller, CANARY -Customer
s
���1 P7-:: 11---- F-oK_��� CA FO Fi t4 CT VA CA F1 FA Ci E_
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L STREET, ANCHORAGE, HK 99501
264-4720
PERMIT NO: 840195 UPGRHDE
DATE ISSUED: 04/17/84
APPLICANT: HLYESKH CONTRACTORS
ADDRESS: P O BOX 149
GIRDWOOD, HK 99587
CONTACT PHONE: 783-2106
LEGAL DESCRIP: SUBDIVISION: BEAR
VALLEY LOT: 4 BLOCK: 1
SECTION:
6 TOWNSHIP: 11N RANGE: 2W
LOT
SIZE: 55876
(SQ.FT. OR
ACRES.:-
CRES)LOT
LOT
LOCATION: HONEY BEAR
LANE
I CERTIFY
THAT:
1.
I HM FAMILIAR WITH
THE REQUIREMENTS
FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY
OF
ANCHORAGE (MOH) AND THE STATE OF ALASKA.
2.
I WILL INSTALL THE
SYSTEM IN
ACCORDANCE WITH ALL MOH CODES AND REGULATIONS,
AND IN COMPLIANCE
WITH THE DESIGN
CRITERIA OF THIS PERMIT.
I
I WILL ADHERE TO ALL
MOH HND
STATE OF ALASKA REQUIREMENTS FOR THE SET BACK
DISTANCES FROM ANY
EXISTING WELL,
WASTEWATER DISPOSAL SYSTEM OR PUBLIC
SEWERAGE SYSTEM ON
THIS OR ANY
ADJACENT OR NEARBY LOT.
IF H
LIFT STATION IS INSTALLED
IN
AN AREA COVERED BY MOH BUILDING CODES,
THEN
(1) AN ELECTRICAL
PERMITAND
INSPECTION MUST BE OBTAINED/ (2) HS-BUILTS
WILL
NOT BE APPROVED WITHOUT
AN ELECTRICAL
INSPECTION REPORT/ AND (]) THE
ELECTRICAL
WORK MUST BE
DONE BY H
LICENSED ELECTRICIAN.
SIGNED' DHTE:
__________________ -----------------
APPLICANT:
______________HPPLICHNT: HLYESKH CONTRACTORS
ISSUED BY DHTE
�
___________________________ _______________
MUNICIPALITY OF ANCHORAGE
Department 5 Health and Environmenta' ?rotectian
825 L Street, Anchorage, AK. 9501r.�
264-4720
� �' :'' ! ` # # # HANDWRITTEN PERMIT
Permit #
ON-SITE SEWER PERMIT
r
Applicant: .�rc;ati'�-- ��-�-���•-'� Mailing Address:
Location: 17—G /(/�� �f S P�h/Jone Number : �,� - ��, 6
Legal Description: G t S Lot Size: S"5 76
Type of Soil Absorption System Is:
Trench: �„Drainfield: _ Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: --f--- Soil Rating(sq.ft/br)'
The Required Size of the Soil Absorption System Is:
DEPTH LENGTH C T � H AVEL DEPTWIDTH
The length dimension is the lengthfin fed, the trench o drainfiel The
depth of a 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).
C
* * REQUIRED SEPTIC(HOLDING) TANK SIZE _ _ `� GALLONS #
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. '
* # * TWO(2) INSPECTIONS ARE REQUIRED # #
Backfilling of any system without final inspection and approval by this departmen+.
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feel
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on Visite sewer system may require enlargement if
the re ce,'s--ri -led to include more that 3 bedrooms.
a
Signed:- �� .'C'' Issued by•
App],c ,nt
Date:����
SWP/024 (1/81) Ae -G�;
MUNICIPALITY OF ANCHORAGE lie Department = Health and Environmental '3rotection Nv
825 Street, Anchorage, AK. _)501
264-4720
# HANDWRITTEN PERMIT # #
Permit # &: sbc/� -� ON-SITE SEWER PERMIT
Applicant:
[oIZS Mailing Address: /"Q / 9i.Ac�culoc��5�7
Location: Phone Number:
Legal Description: (I 4911K / BEAAe JA11 F.!. Lot Size:
Type of Soil Absorption System Is:
Trench: Drainfield: ✓ Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: _ Soil Rating(sq.ft/br) Q
DEPTH
The
71
Required Size of the Soil Absorption System Is:
LENGTH _ .GRAVEL DEPTH 3 WIDTH s
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a 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).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = �� S -C7 GALLONS #
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.
* # * TWO(2) INSPECTIONS ARE REQUIRED # #
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
# # PERMIT EXPIRES DECEMBER 31, 1 9 3 3
I certify that:
(1) I 'am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the residence is remodeled to include more that bedrooms.
Signed: ` Issued by: a_l'nv
plicant � /�3
Date:
SWP/024 (1/81) �EP`E'�- S 1
S & S BIWILKEERS, INC Ja• SOILS LOG
7125 Old Seward Hwy. Anchorage, Alaska 99502 [� PERCOLATION
349-6561 rEsr
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: At `t' F sot,` L-9 A), �A �; DATE PERFORMED:
LEGAL DESCRIPTION: —.
SLOPE SITE PLAN
'D�PYR' r
1
2
3
A
5
6
�7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
I r7)
iaROFESS10%P\•,I�
iiii�
■�■.I
Gross
Net
memo!
Net
Reading
Date
Time
Time
Water
Drop
71
iEl��
'MIEN
i■IEN
■®li®
_.
I
WAS GROUND WATER S
ENCOUNTERED? r L
O
P
IF YES, AT WHATE
DEPTH?
iiiN�
Emu,
mmINE.1
000HNIM
�■I■�rif/SI,�■r
��■N® _ uM`M
PERCOLATION RATE 1 (minutes/inch)
�J
TEST RUN BETWEEN ' -� FT AND i FT
PERFORMED BY: j �C'�`�t kr1-r� CERTIFIED BY: DATE:
Gross
Net
memo!
Net
Reading
Date
PERCOLATION RATE 1 (minutes/inch)
�J
TEST RUN BETWEEN ' -� FT AND i FT
PERFORMED BY: j �C'�`�t kr1-r� CERTIFIED BY: DATE:
Gross
Net
Depth to
Net
Reading
Date
Time
Time
Water
Drop
71
_.
Z
.yl�
41
PERCOLATION RATE 1 (minutes/inch)
�J
TEST RUN BETWEEN ' -� FT AND i FT
PERFORMED BY: j �C'�`�t kr1-r� CERTIFIED BY: DATE:
Municipality of Anchorage
On -Site Water & Wastewater Program
(907)343-7904
1 `' CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 020-431-10 Expiration Date:
1. GENERAL INFORMATION
Complete legal description BEAR VALLEY S/D; BLOCK 1, LOT 4
Location (site address) 9200 HONEY BEAR LANE, ANCHORAGE, AK, 99516
Current Property owner(s) MARSHA BROWN Day phone 301-5944
Mailing address 9200 HONEY BEAR LANE, ANCHORAGE, AK, 99516
Real Estate Agent CHERI MARSTON W/ PRUDENTA SUBMITTAL Day phone 244-4440
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU) AUG IT 3 1014
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
0
Individual On-site
E
Individual Water Storaq_e
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
WeivecNauance request for: N/A Ondance:
Received by: � 3' < f Date: I
i
COSA to be released to the engineer, unless otherwise requested by the engineer_
COSA Fee $ a��,�"o •1' 1 �i.( o = 42q• (,D Waiver Fee $
Date of Payment �131lq � Date of Payment
Receipt NumberCjD c. �n Receipt Number
o5
COSA # I fl t t Waiver #
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, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) 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(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK, 99507
Engineer's Printed Name
Engineer's Comments:
JEFFREY A. GARNESS, P.E.
In conducting this evaluation, GEG, L(D. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSO Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local sails condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
6. DSD SIGNATURE
System #1 Approved for -3 bedrooms.
337-6179
Date /13164
a
E2
CE�7953
'%OFESSION�iJ��
It%I L; **
System#2 Approved for bedrooms. `\ i.itl tit
Disapproved. `��OFCyOrlr/
� y
Conditional approval for bedrooms, with the following stipulatiot ON-SITE m
WATER AND
0
Original Certificate Date: S - / 5-- Y
The MuMicipa'lity oflttsIT76rage Develop, emt Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only
upon the represenatations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTCHMENTS:
COSA Checklist
Septic System Advisory
Well Flow Advisory
(Rev. 10112112)
L�_ Nitrate Advisory
Arsenic Advisory
Other
If more than 1 septic system is on the lot:
COSA Checklist # of
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description
A. WELL DATA
BEAR VALLEY S/D; BLOCK 1, LOT 4
Parcel ID: 020-431-10
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 3/10/1984 Sanitary seal (Y/N) YES Wires properly protected (Y/N) YES
Total depth 162 ft. Cased to 43 ft. Casing height (above ground) 12+ in.
FROM WELL LOG
Date of test 3/10/1984
Static water level 40
Well production
WATER SAMPLE RESULTS:
2
AT INSPECTION
5/21/2014
Ft. 39 ft,
g.p.m. 1.29+ g.p.m.
Coliform 0 colonies/100 ml. Nitrate ND mg./L.
Arsenic: ND ug./L. Date of sample: 7/3/2014
B. SEPTIC/HOLDING TANK DATA 'INSIDE CRAWLSPACE
Tank Type/Material S.T.E-P./STEEL
Tank size 1250 gal. Number of Compartments 2
Foundation cleanout (Y/N) 'YES Depression over tank (Y/N) NO
Date of pumping NEW Pumper
Collected by: GEG, Ltd.
Date installed 7/25-28/2014
Cleanouts(Y/N) YES
High water alarm (Y/N) YES
C. ABSORPTION FIELD DATA BELOW FINAL GRADE
Date installed 7/25-28/14 Soil rating .p.d./ r Obdrm) 1_0 System type SHALLOW TRENCH
Length 45/45 ft. Width 5/5 ft. Gravel below pipe 0.5+/0.5+ ft.
'3.3-3.8/
Total depth '3.25-4.1 ft. Eff. absorption area 450 ft2 Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass/Fail) PASS For - bedrooms
Fluid depth in absorption field before test = in. Water added =gal. New depth =in.
Elapsed Time: min. Final fluid depth m in. Absorption rate >= 450+ g.p-d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date
NOTE: DRAINFIELDS WERE INSULATED. 24" SOIL COVER SATISFIED.
D. LIFT STATION FLOAT LEVELS ASSUMED BASED UPON 2" TETHER LENGTH.
Date installed 7/25=28/2014 Size in gallons 1250 Manhole/Access (Y/N) YES
"Pump on" level at 43 in. "Pump off' level at 39 in. High water alarm level at 45 in.
Datum BOTTOM OF TANK Cycles tested NEW Meets alarm & circuit requirements? YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+
Absorption field on lot 100'+
Public sewer main NIA
Sewer /septic service line 25'+
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Holding tank N/A
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation
5'+
Property line 51+ Absorption Feld 51+
Water main N/A Water service line 104 Surface water 100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main N/A
Water service line 104 Surface water 1004 Driveway, parking/vehicle storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that t have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this
date.
Engineer's Printed N�me JEFFREY A. GARNESS
Date �/ t `` I I It
(Rev. 10112/12)
•••- - •••-•-••� ren Inc INRA. IKANSACIIUN ONLY AND ASSUMES FINANCIAL UA&LITY ONLY FOR THE CO!', p" THE SURVEY.
LISTED DISTANCES PREVAIL OVER SCALING. REPRODUCTION MAY CAUSE ERRORS IN SCALE.
LOT SVRYEY SURVEY TYPE
FUMOAPI AS -BUILT --
FINAL STRUCTURE AS-BULT
PLOT PLAN ... AS -BUILT... LOT SURVEY ... TO OGRAPHY
I HI -Of PLANS & LOT SURVEYS
IT IS 'HE RESPONSIBILITY OF THE BUILDER OR OWNER, PRIOR TO
CONSTRUCTION, TO VERIFY PROPOSED BUILDING GRADE RELATIVE
I TO FINISHED GRADE AND UTILITY CONNECTIONS AND TO DETERMINE
THE EXISTENCE OF ANY EASEMENTS. COVENANTS OR RESTRICTIONS
WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT.
j SURVE- CERTIFICATION ®rrrq
IPLiT PLAN ,A`•��A/ .®�p®
I M1wNY -,Y M f nc V'in IY wilr,H'1 ���( � e,.......... ^y`(b,41!-®
Ne t h 0 oevEe! n mE "t
A.. , G 19011NM dl lul m'nn 41- •: w
Ie[ M N PI mC t .M . OI MY � J -r �•
9
M M�rtG E MIIt_arer.ti Mw Mni ! Y`
49th 9A.
IFOUNDATCN AS BL._T
i, FCCpt b M1rMY u111Y Innt I
now pH &.it Mw 0
h,.MI 6 1_41�ot d�Me� I •,••�V.,�
,k ROBERT '
e^w md..,at. ed.t Wm
c cmw+ln -o �
. 1,
FINAL STiUCRIRE AS I ®S �, ••: 412
1. A.A..MmL J_ M1wNuqnt �� y •'• .• i y 4 ®®
.o.e pwl .are Lreult v �, m. ,�
wrtw. o- �u.:: L. - . o- le. eco. .......... o• i cA �
s9M1..L: ��1® I +'+�III.° sessional�.��
Mue v.a e-._ee nne tL
SYMBOLS
SET REBAR PRW
DRAINAGE�
FOUND REBAR g.�y$ WOOD FENCE
ASSUMED ELEV._�g METAL FENCE
_,JAI ASPHALT
CONCRETE
WOOD DEG:
NOTE:
ONLY THOSE IMPROVEMENTS ABOVE GROUND s.Llfi ':4Sis I.F- WILL BE
SHOWN. FENCES, WELLS, SEPTIC CLEANOUTS, SIO—Dlll .I Y.Se DRIVEWAYS. !
ETC.. ARE SHOWN IN THEIR APPROXIMATE LOCIJA1 liV. ONLY. SNOW
MAY PREVENT SOME IMPROVEMENTS FROM BEING SLP! AMC LOCATED.
ALL DISTANCES ARE RECORD UNLESS 1)TI-I1 Y,'NISE NOTED.
t Prepared by —
Robert E. Jo: -,ns, Jr. Assoc.
Professional Land Survbyc _.
h?OD Brink Drive
ANCHORAGE, ALASKA 99504
Scale: 11I _ 6VI Rea LmS.F.-- f Plat :Ile Na. i
Date Surveyed: 05X1%U/�4 IDrrown U Rq ;I V
I[tecXed baNAV
Daee Drawn: 05/13/14 Grid: 3241 .. .0._-14-�337771 1
Legol Description:
----
Lot 4 Block 1
BEAR VALLEY
MUNICIPALITY OF ANCHORAGE`
• DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
S. STATEMENT OF INSPECTIONBY 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 forthe 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 S & 5 ENGINEERING Phone
17034 Eagle River Loop Road No. 204
Address
Engineer's signature
Date S— �q S
i :f..' :. rt ✓ .fi NF1
tJ
J
r
E? C
i r � '
6... DHHS SIGNATURE ?,�.;.•.,� �, :,'
E �d
...Approved for bedrooms. r- ^
Disapproved.
Conditional approval for bedrooms, with the following .stipulations:
.`,.' Additional Comments _
Z j
Date - ��
�ryf
CAUTION
`;",The �r1�n'ipipality of �pchorage Department of Health and Human Services (DHHS) issues Health Authority
'.%Approvak 0ertificates based only upon the representations given in paragraph 5 above by an independent
professional engin der.registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and thei 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) Beck MOA #21
Legal Description: L o 7-
A.
A. Well Data
)rvo1*410U G
Well type 10AN A r
Log present &/N) W
Total depth / (o a
Sanitary seal &N) Y -f
Date of test
Static water level
Well flow
Pump levell
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
61.K / P3ik V!/ -"y SV Parcel I.D. O c%(D -- 2-13 / -- /0
If A, B, or C, attach ADEC letter. ADEC water system number %
Date completed 3 / 10 $ Driller Y -' 4 N S
Cased to y 3 Casing height
Wires properly protected ON) Yf f
FROM WELL LOG AT INSPECTION
3 //olkq s-/ll/C7 S-
DR i t- i /,.G
9 0 f Ll 7' 70
U /K
0
o
SEPARATION DISTANCES FROM WELL TO:
Septic/hold Rg tank on lot /00
/
Absorption field on lot I� a
Public sewer main N ( A
/
Sewer service line a 5" 4 --
WATER SAMPLE RESULTS:
Coliform
Date of sample:
Nitrate
_g.p.m.
; On adjacent lots % 0 0
On adjacent lots / 0 13
Public sewer manhole/cleanout
Petroleum tank 'A' ° N f
O.J.0
Other bacteria
N
Collected by:
B. SEPTIC/2 TANK DATA 17034 Eaule River Loop Road No. 204
,I / a / / g 3 Eagle River, Alaska 99577
Date installed (4tQ c.4 r ft A 64/1`0 Tank size Compartments
Cleanouts &N) YES Foundation cleanout (YON) S Depression (Y/ I} W 0
High water alarm (Y/N) N/Ai Alarm tested (Y/N) N /A
Date of pumping �' 3 / R y Pumper D it" N Sk wit2 P441n.-44yice
SEPARATION DISTANCES FROM SEPTIC/H6t0+P4G TANK TO:
Well(s) on lot %0 0 / On adjacent lots / 6 0 /
i
To property line / C Absorption field
Surface water/drainage /00
S_/f
Foundation
Water main/service line
� 3
0 / '4-
72-026 (3/93)• Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
"Pump on"
Meets MOA electrical codes (Y,
SEPARATION DISTAXCE FROM LIFT STATION TO:
Well on lg2/ On adjacent lots
D. ABSORPTION FIELD DATA
Manufacturer
Manhole/Access
"Pump off” Level at
Cycles tested
Surface water
!?3
Date installed 6 / 1 0 Soil rating fEff ti tEj a fr �d System type a 717-df-
OA
da S-
Length W .3 � Width 3 Gravel thickness S Total depth 4f *5 Ve do
D- 5-0 rr z
Total absorption area & 4 3 c y Cleanout present O/N) Depression over field (Y/& f�
Date of adequacy test r /// /q s Results pas /fail) Pk S S for Bedrooms
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y6I iv a r 4- k ^J y w n)
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
i
On adjacent lots / 0 0 f Property line
To existin or abandoned s stem on lot
Well on lot /(9 0
To building foundation
On adjacent lots
Surface water _
Curtain drain
/a r +-
/00 ' f
N / A
-
E. ENGINEER'S CERTIFICATION
After test
If yes, give date
g Y —
Cutbank ,ry 0,- C Water main/service line
Driveway, parking/vehicle storage area
/ 0 4-
/0
/ 0 >`
1 certify that ! have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
OF
AN
`7, •'i;
Signature
g
Engineer's Name 0/312 CD r✓Ai✓ �`r
/ a ROURT c ceaVAaa ,--
Date S i S' ti, Cr 8wwC
y.. __ f:l. �. til _.•^.1'
HAA Fee $ 3&D • °-Z)
Date of Payment
Receipt Number
72-026 (3/93)' Back
Waiver Fee $
Date of Payment
Receipt Number
ALME Environmental Services Inc.
Laboratory Division i
Leborator Anal sis Re ort
CT&E Ref.* 95.1800-1 1 1 N
Matrix WATER
Client Sample Yb L4 BLKS BEAR VALLEY
Client Name S & S ENGINEERING WORN Order 14534
Ordered By R. COWAN Printed Date 05/12/95 :a 13:04 hrr.
Project Name Collected Data 05/09/95 ® 14:25 hrs.
Project# Received Date 05/09/95 Q 15:30 hro.
Pw$ ID UA
Technical Director STEPHEN C. EDE
Released Sym.,,,-,
Sample Remarks: SAMPLE COLLECTED BY: J.W.
QC Allowable Ext, Anal
Parameter Results Qual Unite Method Limits Date Dates Init
--------------------------------------------------------------------,...-.._-.,..._M._-- ----------------------------
NitraL•e-N 0.10 t1' mg/L EPA 353.2 10. 05/11/95 CMR
====caeeaa=====cc=eace------------------------------------------------------------------- —... ..............
+ See Special Instructions Above VA - Unavailable
See Sample Remarks Above NA - Not Analyzed
it = Undetected, Reported value is the practical quantification limit. LT - Less Than
Secondary dilution. GT - GreAter ThAn
.ii
200 W. Dotter Drive, Anchorage, AK 9_9518-1805 Tel: (907) 562-2343 Fax; (907) 561-5301
ENVIRONMENTAL. FACILITIES IN ALASKA, CALIFORNIA, FLORIDA, ILLINOIS, MARYLAND, MICHIGAN, MISSOURI, NEW JERSEY, OHIO, WEST VIRGINIA
206 ZS1?'0N TTZTb69LO6 F SNI1S31 1dIDN3WW00 92:2T 96/ET/90
MUNICIPALITY OF ANCHORAGE
• Department of Health & Human Services �i'� MUNIC1PALfTY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL SERVICES '�'% NVIRONMENTAL SERVICES DIVISICD
343-4744 JUN 12
1990
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING RECEIVED
Parcel I.D. # HAA # �A Q SCCc�°IL
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 4; Block 1; Bean. V
Location (address or directions)
16131 Honey Bean. Lane
(b) Property owner Jack Ott Telephone: (home) 345-4354 Business 344-2555
Mailing Address 16131 Haney Bean. Lane, Aneho&age, AWka 99516
(c) Lending Institution
Mailing Address
(d) Real Estate Company and Agent
Address
Telephone
Telephone -
(e) Mail the HAA to the following address: (or check here 5�xif hold for pick up.)
List contact person and day phone number below:
S & S ENGINEERING
17034 Eagle River Lo*p Roar( No 1204,
Eagle rzivrr, Alaska 99577 r'
2. TYPE OF RESIDENCE
Single -Family ENX Number of bedrooms _ 4
3. WATER SUPPLY
Individual Well. Community ❑ Public ❑ ----
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site ffi Public ❑ Community. ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality and status.
72-025 (Rev. 7/88) Page 1 of 2
5s
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION r
As certified by my seal affixed hereto and as of the validation date shown below, I verify"that my investigation of this
'` Heafth, Authority Approval;,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
"basedon 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 . Telephone
Address S & S ENGINEERING
17034 Eagle River LOOP Koad No. 204
Date Eagle River, Alaska 995.77
` v
SEPTIC SYSTEM HAS BEEN UPGRADED AS PER THE
-CONDITIONAL HAA ISSUED 3-29-90. SEE
ATTACHED INSPECTION REPORT.
� 71(
.•Fn""gine
.� ,>
6. DHHS APPROVAL
Approved for bedrooms by Date
Approve — Disapproved Conditional
Terms of:Con_ditional Approval
`I
CAUTION
z
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated 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. 7/88) Back Page 2 of 2
MUNICIPALITY OF ANCHORAGE
• Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D. # '231 -- \tom_ HAA # CN%n
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 4; Bloch 1; Bean Vatt?ey
Location (address or directions).,
16131 Honey Bean Lane
(b) Property owner Jack Oak Telephone: (home) 345-4354 Business 344-2555
Mailing Address 16131 Honey Bean. Lane Anchorage, A.t?a6ka 99516
(c) Lending Institution
Mailing Address
(d) Real Estate Company and Agent
Address
Telephone _
Telephone
(e) Mail the HAA to the following address: (or check hereJt X if hold for pick up.)
List contact person and day phone number below:
A I INGINEERING . 4
1YO34 gag's River Loo
Eagle River, Alaska 99577
2. TYPE OF RESIDENCE
Single -Family Rk Number of bedrooms ---4--
3. WAFER SUPPLY
Individual Well lgx Community ❑ Public ❑
Note: If, community well system,; must_ have written confirmation from the State Department :of Environmental
Conservation attesting to th legality and status:
4. SEWAGE DISPOSAL
On-site V Public ❑ Community ❑ Holding Tank ❑
Note„If commuriity, well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legailty and status.
72-025 (Rev. 7/98) Page 1 of 2
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
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 showsthat'the.on-site water supplyand/or.wastewate(,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 with all Municipal and
State codes, ordinances, and regulations in effect on the date of this inspection.'.
Name of Firm Telephone 241
S&
- 17034 Eagle Ricer Loop Road No. 204
Address
EagleRiver,'Iftska 99577
Date
RECOMMEND APPROVAL ON THE CONDITIONS
THAT THE LEACHFIELD IS UPGRADED 9 THE
SEPTIC TANK RELOCATED OUT OF THE 100'
PROTECTIVE WELL RADIUS AFTER SPRING S �S,.. `,'jr
�Sfi
BREAK-UP. s
* . er's Se
ot
,e w, saws A. stwwr t
" �b4fi
1457.11 �� tot,,
6. DHHS APPROVAL
'ate
•,.Approved �or, ,,)J, bedrooms by -3 - Z 91-- d
Approved —.r—.Disapproved Conditional Z
TOMs ofndjtional Approval TNAT U 106RA49, OF SFl°T/C S Yf ;r E/4 Q� io�+PLL•rEt�
1
Al glowof AJ_
t
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated 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 oromissions
in the professional engineer's work.
72-025 (Rev. 7/88) Back Page 2 of 2
MUNICIPALITY OF ANCHORAGE (MOA)
• ,. #ealth Authority Approval (HAA) �
uIVI:CrICKLIST -FEBRUARY 1984
I` I 343-4744
�_;l Legal Description:
A. WELL DATA E CE I V�
Well Classification L t� \i\ J, \?J 'e--1.. If A, B, C, D.E.C. Approved (Y/N)
Well Log Presents:VN) 4 Date Completed 3'k t-' Yield
`
Total Depth I lagr Cased to Depth of Grouting
Static Water Level \, Pump Set At 57 1
Casing Height Above Ground \'2 Sanitary Seal on Casing&9q)
Electrical Wiring in Conduit (VN) Depression Around Wellhead (Yo E4
SEPARATION DISTANCES FROM WELL:
1
To Septic/Holding Tank on Lot �,o ; On Adjoining Lots 1dc:> 1_�-
To Nearest Edge of Absorption Fieldo Lot \ �( ; On Adjoining Lots k � ( k
To Nearest Public Sewer Line pt To Nearest Public Sewer Cleanout/Manhole 044
t�
To Nearest Sewer Service Line on Lot
Water Sample Collected by / (' S t�ir46 ; Date
Water Sample Test Results
Comments—*
B. SEPTIC/HOLDING TANK DATA
Date Installed Size No. of Compartments
Standpipesd) PN) Air -tight CapsdyYN) Foundation Cleanout&WN)
Depression over Tank (Yk9? r) a Last Pumped 0
Pumping/Maintenance Contact on File (Y/N) j\1 ; for "`—
Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water -Supply Well n To Building Foundation S
i
To Property Line d To Disposal Field
r�
To Water Main/Service Line D
To Stream, Pond, Lake or Major Drainage Course C�'
Comments
72-026 (Rev. 7/88) Front Page 1 of 2
C- ABSORPTION FIELD DATA
Soils Rating in Absorption Strata,,,( ��/-- Type of System Design
� L�`
Date Installed �r Length of Field 4
Width of Field
i
Depth of Field 'mo
Gravel Bed Thickness 15 -
Square Feet of Absortion Area 4';!;;� -f Statndpipes Present(VM)
Depression over Field (Ykg /ri Date of Last Adequacy Test —
Results of Last Adequacy Test _�Y �"9� �z 2-- $, "
SEPARATION DISTANCE FROM ABSORPTION FIELD:
u
To Water -Supply Well To Property Line
To Building Foundation To Existing or Abandoned System on
t
Lot t 0 ; On Adjoining Lots 30 4-
To Water Main/Service Line i o I� To Cutback (if present) .P
To Stream, Pond, Lake, or Major Drainage Course r,-
�
To Driveway, Parking Area, or Vehicle Storage Area �%/Jp�2 ✓r w
Comments
2-
t`'1,
D. LIFT STATION
Date Inst led Dimensions
Size in Gallons Manhole/Access (Y/N)
"Pump On" Level at "Pump Off' Level at
High Water Alarm Level at Vent (Y/N)
Tested for Pumping Cycles during Adequacy Test.
Meets MOA Electrical Codes (Y/N)
Comments
"'Check Permitted Bedroom Rating Against HAA Request"
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect :`�►1�►�l�ie of this
inspection. •„W.."`
Signed
Company 17034 Eactle River Loop Road No. 204
Eagle Fiver A� lask% 99577Y
Date P—
MOA No. CF 70— C%`3
Receipt No.
Date of Payment
Amount: $
Receipt No.
Waiver Fee: $
Date of Payment
72-026 (Rev. 7/88) Back Page 2 of 2
gQ�_Alei..
03
f•y
....®....r
U6ed A. Shafm a
', • No. 145741
8 m
�����p�FESSlt1�
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343
LABORATORIES FEDERAL TAX ID # 92-0040440
ANALYSIS REPORT BY SAMPLE for Work Order # 20337
Date Report Printed: MAR 13 90 @ 15:08
Client Sample ID:L4, B1; BEAR VALLEY
PWSID :UA
Collected MAR 9 90 @ 15:30 hrs.
Received MAR 9 90 @ 16:15 hrs.
Preserved with :AS REQUIRED
Client Name S & S ENGR
Client Acct SNSENGP
P.O.# NONE RECEIVED
Req #
Ordered By : R. SHAFER
Analysis Completed :MAR 12 90 Send Reports to:
Laboratory Supervisor :STEPH N C. EDE 1)S & S ENGR
Released By � 2)
Special
Instruct:
Chemlab Ref #: 900393 Lab Smpl ID: 3 Matrix: WATER
Parameter Tested
Allowable
Result Units Method Limits
---------------------------------------------------------------------------------------------------------------
NITRATE-N ND(0.10) mq/l EPA 353.2 10
Sample ROUTINE SAMPLE
Remarks: SAMPLE COLLECTED BY R.J.D.
1 Tests Performed ' See Special Instructions Above UA=Unavailable
ND= None Detected "' See Sample Remarks Above
NA= Not Analyzed LT=Less Than, GT -Greater Than
(vim'
SCALE
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.ZI Zational
Ba��Alasl�a
Mortgage Loan Department: P.O. Box 7-025 • Anchorage, Alaska 99510-7025 • (907) 265-2858
March 27, 1990
Municipality of. Anchorage
Department of Health & Human Services
825 L Street
Anchorage, AK 99519-6650
Attr.: Dan Roth
Re: Lot 4, Block 1, Bear Valley Subdivisio
Seller: ,Tack Orr
Buyer: Sean & Inez Robles -Dunn
Dear Mr. Roth:
MUNICIPALITY OF ANCHORAGIF
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
1�. P, 2 R 1990
RECEIVED
Per my telephone conversation w9.th Roger Shafer of. S & S Engineering
we are provid,ng you with the following information:
Upon receipt of the conditional septic approval and closing this
transaction at National Bank of Alaska, we, the lender will hold
funds to be applied towards upgrading the septic system. The funds
will not be released until we receive the final DEC approval on
the septic system.
Should you require additional information, feel free to contact me
at 257-3424.
Sincerely,
En?flee Cruz
Assistant Cashier
Mortgage Lender
OFFICES STATEWIDE
MUNiciPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information
Application Date
April 14, 1984
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot. 4, Block 1., Bear Valley S/D
Location (address or directions)
Clarks Road
(b) Applicants Name Alyeska Constractors 'Iblephone 783-2106
Applicants Address P. 0• Box 149, Girdwood, Alaska 99587
(c) Applicant is (check ore) Lending Institution Owner/builder x ;
Buyer � ; Other (explain) ;
(d) Lending Institution Telephone
Address
(e) Real Estate Co. & Agent
Address
Telephone
2 . Type of. Residence
Single -Family '--=T
Number of Bedrooms
3. Water Supply
Multi -Family
4
Other (describe)
Individual WellF-j Community Public
Note: If ccl mnity well system, must have written conf irmation frau the, State
Department of Environmental Conservation attesting to the legality and status.
Is the well adequate for the number of bedrooms specified in this HAA (Y/N)
4. Sewage Di� sjxosal
Onsite rX----r Public Community Holding Tank
Is the wastewater disposal system adequate for the number of bedrooms (Y/N) Y
(Page 1 of 21
2-15-84
5. Engineering Firm Providing Inspections, Tests, Data and Information
I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in
effect on the date of this inspection.
Signed Date
Name of Firm Telephone
Address
S igned by
Date
(ENGINEER SEAL)
ORIGINAL STAMP AND
SIGNATURE ON FILE
WITH DEPARTMENT OF
HEALTH & ENV. PROT.
6.DHEP Approval
Approved for 4 bedrooms By � � �. .0 Date 17%Y
Approved Disapproved Conditional
Terms of Conditional Approval
The Municipality of Anchorage Department of health and Environmental Protection does
not guarantee the continued satisfactory performance of the water supply and/cr the
wastewater disposal system. This approval indicates that, as of the validation date
shown above, based on the data and information furnished by an engineer registered in
the State of Alaska, the water supply and wastewater disposal system is safe and func-
tional for the number of bedrooms and type of structure indicated.
(DHEP SEAL)
7. Mail the HAA to the following address:
KB2/d5/s
(Page 2 of 21
2-15-84
�.l 9 `
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
A. WELL DATA
Well Classificationir
If A, B, cr C, D.E.C. Approved(Y/N)
Well .Log Present (Y/N) k! S
Date Completed = /� Gj/`7� Xie1e
�7
Total Depth �(, ,; Cased t6-7" 11-5 Depth of Grouting
Static Water Leevel-;�(
Pump Set At
Casing Height Above Ground �//41'
Sanitary Seal on Casing (Y )�e_
Electrical Wiring in Conduit (Y/N)
ff� Depression Around 'Abllhead (YM) /Vd
Separation Distances from Well:
-4-
To
To Septic/Holding Tank on Lots y'/.
7-
Adjoining Lots
To Nearest Edge of Absorption Fie1�
1_
on LOt� � , On Adjoining Lots
To Nearest Public Seer Line
To Nearest Public Sewer
Cleanout/Manhole ",-„'
To Nearest Sewer Service Line on Lot
Water Sample Collected By
Water Sample Test Results
CcasmentS /,;�/-p n/i ?r.✓1
!7;'/t�f'/ l itJG �/ `,a (�l//J�s7m�� y f r•F-n7
7)' �t L, 41. 7 /SS _ ,C-Iia/�/ �7 ,�.✓I /7
—
J
1 ''`-_.4 of ,¢....t• ..ar- rd1 - i'�- ! v i /
B. SEPTIC/HOLDING TANK DATA
Date Installed ' / -'.:. Size L 0 No. of Compartments
Standpipes (Y/N) ,�% <.:� Air -tight Caps (Y/N) '�. Foundation Cleanout (Y/N)� +l�I
Depression over Tank (Y/N) 1j1'`e� Dat:: Last Pumped -z/','
; /
Pumping/Maintenance Contract on File (Y/N) for Al
Holding Tank High -Water Alarm (Y/N) ,11/4 Temporary Holding Tank Permit (Y/N} /%�
Separation Distances from Septic/iol ing Tank:
To Water -Supply ll�'�f / J,
To Building Foundation
Tei Property Line % ,.I ` _ To Disposal Field
To Water Main/Service Line �I" To Stream, Pond, Lake, or -Major Drainage
Course
r
Comments
t
k l-
pr -_e
[Page 1 of 21
2-15-84
f
C. ABSORPTION FIELD DATA
C-) (4)
Soils Rating in Absorption Strata';-_rr/�;r Type of Svstem Design 1-
Date Installed ��'� �����`!-;%=� Length of Field(4' y
u
Width of Field �f.-> S- ' Depth. of Field
Gravel r5ed Thickness ?` �
Square Feet of Absorption Areaf"� y� -> F Standpipes Present (YM)
Depression over Field (YM) Date of Last Adequacy Test 5 ,'
Results of Last Adequacy it-st /Ld V
Separation Distance from Absorption Fields =,
SP-
To� j
Water -Supply 4%b1 _6-'`r'To Property Liffe i° -
To Building Foundation �� To Existing or Abandoned System on
i
Lot�1e/,q ern Adjoining Lots
To Water Main/Service Line % C) To Cutbank (if 2resent)
To Stream/Pond/Lake/or Major Drainage Course ly.9
To Driveway, Parking Area, or Vehicle Storage Area
Com entS
D. LIFT STATION /41,,,,,
� s
Date Installed Dimensions'
Size in Gallons p Manhole/Access (YM)
"Pump On" Level at "Pump Off " Level at
High Water Alarm Level at Vent (Y/N)
Tested for Pumping Cycles during Adequacy Test. Meets MOA
Electrical Codes(Y/N)
Comments
** Check Permitted Bedroom Rating Against HAA Request ** r rt
I certify that I have checked, verified, or, conformed to all MOA HAA Guidelines in effect
on the date of this _J_7,pejc1on.
S i .ed
qr Date
Company C'u�� /�,< MOA No. 1-3 6a
KB1/d5/s
[Page 2 of 21
ENGINEZR,81
2-15-84
