The URL can be used to link to this page

Home My WebLink AboutT12N R3W SEC 15 LT 50T12N R3W ec. 15 Lot 50 #015-052-21 Municipality of Anchorage MAY 2 4 2022 On-Site Water and Wastewater Section • (907) 343-7904 Page of ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP201083 . PID Number: 015-052-21 Dwelling: ❑E Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑N Upgrade Name Masten Family Trust ABSORPTION FIELD F-1 Deep TrenchWide Trench El Bed E] Mound Site Address 9400 Carlson Rd, Anchorage AK Other Phone of Bedrooms Soil Rating Total depth from original grade 907-244-3095 rNumber GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot 50 Fill added above original grade Ft. Gravel length Ft. Township Range Section T12N R3W 15 Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 100'+ 25'+ TANK X Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Capacity Infiltrator 1530 Gal. Surface Water 100'+ Material Polyethylene Number of compartments 2 Lot Line 51+ NA Foundation 10'+ LIFT STATION Manufacturer Capacity Remarks 5'+ separation to drainfield verified. Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 ARM Services Drainfield CO/MTD3034 Inspector Crewdson Engineering, LLC BENCH MARK (Assumed elevation) 100 ft Inspection es: 15' 06/02/2020 Zed 06/03/2020 Location and description 3rd 06/04/2020 411 06/08/2020 Bottom of Siding, See "BM" on Record Drawing ON-SITE WATER AND WASTEWATER SECTION APPROVAL ,..zk OF A4q 1 Conditional Approval: Date )" - A!'TH* /�,'• aures A. Crewdson. Septic System 011527' .•�� Approve t,•r Date l2 Z 7� 2 �l� 1\ \OFESSI4P= Note: this approval does not include well permit requirements.\\ %RCv UJ/UL/ 10) SWING TIES (feet) D1 MH1 S1 S2 D2 C1 M1 a 47.3 1 62.3 1 66.9 1 69.5 1 70.7 66.9 68.3 31 35.7 1 55.7 1 57.9 1 59.7 62.1 64.3 65.6 C1 MH1 M1 0 �\ EDGE OF DF a1 BE D2 , o S2 BL S BENCHMARK BOS ELEV r LOT 50 00' WELL RADIUS c'rMr11^ r w uv LLL V/ -%I IVIVJ. TOT 91.3' INLET INV 90.6' OUTLET INV 90.4' Crewdso Engineering, CLC' C IVII & EnvIlrMuen ErgkieUlng PO Box 671389 Chugiak AK 99567 • cellc.1@outic Ceil/Tex1:907-280-9493 • Fax:907-688-2295 PLAN SCALE: 1"=20' IT PROFILE NOT TO SCALE NOTES LEGEND 1. All construction IAW code. BE - 4x4 electrical post 2. SEPTIC TANK BL - blower Infiltrator IM -1530 with BM - bench mark BioMicrobics RetroFAST in BOS - bottom of siding second chamber BR - bedroom 3. Edge of the drainfield was C# - cleanout located to ensure 5'+ septic D# - double cleanout tank separation. DF - drainfield ELEV - elevation FG - finish grade IAW - in accordance with INS - insulation INV - invert M# - monitor tube MH# - 24"0 manhole S# - standpipe SFH - single family home TOT - top of tank T1 2N, R3W, Section 15, Lot 50 Record Drawing Plan and Profile Prepared for: Celia Masten Date: 5-24-2022 Permit: OSP201083 Page: 1 of 1 ALL INFORMATION SHOWN ON THIS DOCUMENT IS THE PROPERTY OF CREWDSON ENGINEERING. LLC AND SHALL NOT BE USED FOR ENGINEERING OR CONSTRUCTION PURPOSES WITHOUT WRITTEN PERMISSION FROM CREWDSON ENGINEERING, LLC q�q•l>�k VIC 7 ,1 . 49 J es . Crewdson C11527 • �``�® ♦♦ pROFESSIONP�.® � ALLC #112279 LSIX3 SIN3WHDVM21DN3 ON ONV S3NIl A1213dONd 3HINIHIIM3dV NO3N3H1O31Vn115 SIN3W3AO8dW13HI IVHI S31=lliN3D ONV 9NIM"(3 SIHI NO NMOHS SV A1213dONd �� I �_ -IidO A3MjnS IVDISAHd V 031DnONOD SVH DNI 'HD31NV1'9Dl :NOI1VDId1I213D A3A8n5 FV1 30- LZ-ZSO-S LO :# 13D8Vd '02f NOSI2JVD OOb6 :SS3d(](]V •HD3INM OOl JO 1N3SN03 N311121M 03SS32idX3 3H11f10H11M JVld 101d V SV 35f1210d 031JI00A 38 ION -nVHS ONIMV2i0 SIHI :310N .oS Z 0 0 r) D 'S3SMind NVld-101d 210d W'S3Nn �Da0 pOOM b3d02id 9NIHS118ViS3 HO:l'NOIiDndiSNOD Wd (33Sn 38 NO3u3H VIVO ANV OInOHS LA —X—X— 3DN3j S3DNVISWnDHD ON N30Nn '1Vld NOISIAIOBns O3ONOD3213Hi NO iJV ddV ION 'SINVN3AOD'SIN3W3SV3 2ueyjan0 ® 113M H3IVM )O HDIHM SONINVIAVM-20-iHDIU 80 SNOLLDRi1SM ANV d0 )N31SIX33H13NIVY8 .iA00IAIIl181SNOMU,SUf NMO3HISI1I:310NAUVNOISnl:)X3 ° OIDDUOD � 0D# ln0 NV31D '0310N NVHi83HIO • Iane�9 :ON3'E)31 LSIX3 SIN3WHDVM21DN3 ON ONV S3NIl A1213dONd 3HINIHIIM3dV NO3N3H1O31Vn115 SIN3W3AO8dW13HI IVHI S31=lliN3D ONV 9NIM"(3 SIHI NO NMOHS SV A1213dONd �� I �_ -IidO A3MjnS IVDISAHd V 031DnONOD SVH DNI 'HD31NV1'9Dl :NOI1VDId1I213D A3A8n5 FV1 30- LZ-ZSO-S LO :# 13D8Vd '02f NOSI2JVD OOb6 :SS3d(](]V •HD3INM OOl JO 1N3SN03 N311121M 03SS32idX3 3H11f10H11M JVld 101d V SV 35f1210d 031JI00A 38 ION -nVHS ONIMV2i0 SIHI :310N .oS Z 0 0 r) D x LA OI Z x A � N O D os V/N :dR 99/L L8 :Od/9d Ob = „ L :3lVDS 9£bZMS :012f9 DS :A8 03>ID3HD S L 33S M£2f NZ Ll :1Vld db/SGV :AS NMV]Cl L£OOZ 2i3a21O MOM OZOZ/6Z/9 :31V0 NMVd(I NOISIAloonS SlDtIdl llVNS W18 'M£2i 'NZ Ll 'S L J3S "OS iol :NOI1dNDS30 1V931 N31SVW VI13D :A9 a3213(RiO 899 3734 �, �rPay, vnPNrvaa�!�a - S868-EbZ auoyd ��ry aulluleW ouj LI'JTY�� L6ZS-Z9S au04d juawlieda0 Aan.InS LOS66 2NSelV'a.2e.loyDuV 1aa.IIS H OSZ Ln O 49'L8Z 3LSZ.99°68S 1332115 NO1S31111 Ln O o �puolssaJof d4 C-1 4 p� -v2on—s� ��laa NVHV-nV3 N3A31S ................................ H16V MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP201083 Work Type: SepticTank Upgrade Tax Code Number: 01505221000 Site Legal Address: T1 2N R3W SEC 15 LT 50 G:2436 Site Mailing Address: 9400 CARLSON RD, Anchorage Owner: MASTEN FAMILY TRUST Design Engineer: CREWDSON ENGINEERING, LLC This permit is for the construction of: Effective Date: Expiration Date: r V r 1 r Department Lot Size in Sq Ft: Total Bedrooms: 5/6/2020 5/6/2021 32306 Disposal Field 2 Septic Tank Holding Tank Privy Private Well Water Storage All construction shall 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 shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing 4 Special Provisions: ** The beginning of the field is to be located prior to installing the tank. If the tank has to be moved to meet all required separations contact Onsite prior to installing. Received By: fezl Issued By: Date: Date: __61X Ilzrj MMHMP ,\ UTY OF Development Services Department 00;_ On-Site Water & Wastewater Section Parcel I.D. 015-052-21 AHCHORAGE ON-SITE SEPTIC/WELL PERMIT APPLICATION Phone: 907-343-7904 Fax: 907-343-7997 Property owner(s) Celia Masten Day phone 907-244-3095 Mailing address 9400 Carlson Rd., Anchorage, AK 99507 Site address same Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T12N, R3W, Sec 15, Lot 50 Lot Size 32,306 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank ED Upgrade 0 Duplex (D) ❑ Holding Tank ElRenewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Oi ��J l �0� 7�J� Waiver Fees: Date of Payment: Y1130 Date of Payment: Receipt Number: PIheReceipt Number: Permit No. OP ,12 01093 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\For\Client FormsTermit Application.doc COV ID -N 25% DISCOUNT APPLIED Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201083, Deb Wockenfuss, 05/06/20 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP201083, Deb Wockenfuss, 05/06/20 I I LILL.E',STON _ EAST (BLM) I. Lo (EAST 260.24) S 89'55'25" F I FOUND #5 REBAR-W/ -- I 6/28/97YELLOW L7STrC CAP I � 50 W I I O I N00 ° J DRAIN FIELD 1' MS'D 1986 .4 x za xaoo 1 oweu rxwe House z.ie noow:. } GRAVEL q g In I NO MONITER PIPES IN I DRAIN FIELD 100' WELL olo° I PROTECTION RADIUS \ uuaewcRouHo, . DRNf O W FOUND 2 1/2" OIA. PfPE MON. 6/18/97 N >' Hmw-uHx rcwcF (m) 89'58'35 E \� 281.87+ 3500 CRITTENDEN I MS'D 1986 UI 235-1911 _ (EAST 280.21 (COMP)) -_--- JOB NUMBER: �— RECORD DATA p I I TYR x/ �J ` ` 31W 50'' 4 j it) V) i k 1IZ- CERTIFICATION OF AN T —BUILT SURVEY ATED 5/21/86 NOTE: ALL BEARINGS AND DISTANCES SHOWN ARE RECORD, UNLESS NOTED OTHERWISE. EXCLUSION NOTE: IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. - AS -BUILT CERTIFICATE_: S 112 3 0 FEB 4 2004 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: _ BZAf LOT 50_ ,5'_k'C770N 15, T 1A9 N+ AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. L07: J0 ,2-La SECTION 1 5 TOWNSHIP RANGE • 12 N 3 W SEWARD MERIDIAN Eric P. Fuglestud pye c,,® PLAT No. N/A No.7218-S ,• Jas D °..,• Seo ANCHORAGE RECORDING DISTRICT •♦ ♦qo ,S,S�••PiP• PAS•' GRID: 2436 ERIC �q 0 50 �'1 N J� LAND SURVEYOR 3500 CRITTENDEN HOMER, AK 99603 DATE: 235-1911 FAX 235-8639 JOB NUMBER: F.B. NUMBER: 7-01.03 EPF10.54 x/ �J CHEC EO EPF 50'' it) V) i k 1IZ- IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY EASEMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT APPEAR ON THE RECORDED SUBDIVISION PLAT. UNDER NO CIRCUMSTANCES SHOULD ANY DATA HEREON BE USED FOR CONSTRUCTION OR FOR ESTABLISHING BOUNDARY OR FENCE LINES. - AS -BUILT CERTIFICATE_: S 112 3 0 FEB 4 2004 1 HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY: _ BZAf LOT 50_ ,5'_k'C770N 15, T 1A9 N+ AND THAT NO ENCROACHMENTS EXIST EXCEPT AS INDICATED. L07: J0 ,2-La SECTION 1 5 TOWNSHIP RANGE • 12 N 3 W SEWARD MERIDIAN Eric P. Fuglestud pye c,,® PLAT No. N/A No.7218-S ,• Jas D °..,• Seo ANCHORAGE RECORDING DISTRICT •♦ ♦qo ,S,S�••PiP• PAS•' GRID: 2436 ERIC P. FUGLESTAD J� LAND SURVEYOR 3500 CRITTENDEN HOMER, AK 99603 DATE: 235-1911 FAX 235-8639 JOB NUMBER: F.B. NUMBER: 7-01.03 EPF10.54 SCALE: DRAWN: CHEC EO EPF 50'' GWER ANCHORAGE AREA BORCf H HEALTH DEPARTMENT N? 203 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING NAME �iL 6/l GGr O�Z'.N�L� ADDRESS BOX 3S.Pe2 42'4 fi PHONE �"✓`j`f% 9�f00 LOCATION o o O Sa- O LEGAL DESCRIPTION SEPTIC TANK: NUMBER OF DISTANCE FROM WELL �D ® MATERIAL QviC/C. COMPARTMENTS LIQUID CAPACITY�.S .ice GALLONS. INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH ENGTH , ERI Ij LINING ERIAL . D ANCE FROM WELL BUILDING FOUNDATION , NEAREST LOT LINE . TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) - SQ. FT. TILE DRAIN FIELD TOTAL DISTANCE FROM WELL /� ®' FOUNDATION oO �� NEAREST LOT LINE �0 /� OFLENGTH NESr�O i NUMBER OF LINES �` p DISTANCE BETWEEN LINES �� / TRENCH WIDTH / IN. TOTAL EFFECTIVE ABSORPTION AREA 4 / SQ. FT. LENGTH OF EACH LINE- -2to DEPTH: TOP OF TILE i0 FINISH GRADE -7 DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILEl ii WELL: DISTANCE FROMWATER �� TYPE �2�/��r� , DEPTHo2,2�7 ,BUILDING FOUNDATION. Z� f SAMPLE l'�O , NEAREST NEARELOT LINE �fl f' EWERS INE Ate, TANK SYSTEM /�D SEEPAGE � s _7sl� SYSTEM, CESSPOOL __ _SO�ijj ES_ DISTANCES: DATE A� S ,'4976 DIAGRAM OF SYSTEM GAAB-14 -E- GREATESANCHORAGE AREA WROUGH Case No. HEALTH DEPARTMENT 327 Eagle St. Anchorage, Alaska 99501 279.2511 <� U h / `/� D SEWAGE DISPOSAL SYSTEM -APPLICATION & PERMIT NAME OF APPLICANT 2u MAILING ADDRESS 4"/ PHONE NO. RESIDENCE ADDRESS LOCATION OF INSTALLATION LEGAL DESCRIPTION " Kt 41 50r144/ f APPLICATION TO INSTALL: SEPTIC TANK_, SEEPAGE PIT_ , DRAIN FIELD , OTHER TO SERVE THE FOLLOWING FACILITY FINANCED THROUGH_` `% Af0 BE INSTALLED BY_ PERCOLATION TEST RESULTS ANTICIPATED DATE OF THIS IS TO SERVE AS lNA 'ClU6 4- , PERMIT TO INSTALL AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED 5 ,SEPTIC TANK SIZ TYPE C-4"1 14_01 SEEPAGE AREA sl t 6 DISTANCES: l;26 141-yre cxr / " I 'W"J."t 7 tA�d HEALTH AUTHORITYOR LICENSED DESIGNER ertify that I am familiar with the requirements of Greater Anchorages Area.Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. DATE LI -1 APPLICANTS SIGNATOR w CREATER A. CNOx:s i': MEA BOROUGH' V?AF:TMEt T CASCASE Y-EA.,m•: , t, D. 37"I;AAL: e7REET ANC`iORAGL. ALA^KA 99501 Date Per`Drmed--�_� � %Ct 70 Performed For Ge 9f � a� _ D +ea�sio _ _lon' � - S�dbtasion Legal. Descrf tsan. not 6� Bloc. -+�----:._,.....m.. -- p Soso ercoiat .on Tes . This Form Reports a: Depth Feet soil Chir= -c 'is.ics The SQdi- erds ih tars Cnrec Were tiryAfy evrafi[. 1The wewc airly ,�maur 'w f"� A low ci10 eortfent Was Ground Water Encountered? Location Sketch If Yes, At '+'r -;at tepth_.— Net Drop Reading Date Gross 'gime � Net T.ip;e � Depth Ta H 0 a son a e v-'1 L':.L ii1dLG Pranased Installat Seepage Pit Drain ^Held Deptt. 4f Inlet _ �` Depth To Bottom Of Pi.t Cr 'Tench . /, C'k � f .7. 57 �/EJP.71 Test Performed MUNICIPALITY OF ANCHORAGE t DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION i DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date mRU F y /9ryYi 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) 8i-rn (ter So 5err I S T I Z. hJ R 3 (10 Location (address or directions) (b) Applicant Name Telephone: Home -3/4-)-7-26A Business Applicant Address (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder; Buyer ❑ ; Other ❑ (explain); (d) Lending Institution A4sL4 _Pact Ei &4,, k Telephone Address / / (e) Real Estate Company and Agent Alti5 6 84-AtP// C t UrLG a cue - ea nna Address Telephone (f) Mail the HAA to the following address: TcEo,��=- OAt Fcen A,- 34(a- f (uI 2. TYPE OF RESIDENCE Single -Family Multi -Family 11 Other Number of Bedrooms " % 3. WATER SUPPLY Individual Well P' Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite [g 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. Page 1 of 2 r_-025 (11/84) 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 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 FirmF__`SE r i�r75 Telephone Address a3 A✓—"ia4 mgx'` Date 91 DHEP A13PROVA Approved for )bE Approved Engineer's Seal Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) F HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 gLryt Cor SO Legal Description: cSEcrloN IS Tt2.1IJ 2BU) A. WELL DATA Well Classification If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) Date Completed (J AXSJa a -J Yield +J r OSS Total Depth ZOO'S Fr Cased to HctFr Depth of Grouting _WA Static Water Level JPS Pr Pump Set At UNxNow�J Casing Height Above Ground )Z•r' 14 Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) 'J Separation Distances from Well: To Septic/Holding Tank on Lot /no <'r ; On Adjoining Lots !oo*Fr To Nearest Edge of Absorption Field on Lot tt SEr On Adjoining Lots loot Fr To Nearest Public Sewer Line N,/A To Nearest Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot 7SOr Water Sample Collected by $c1 t ; Date Water Sample Test Results ,%7-&50rACTe>X ( Comments B. SEPTIC/HOLDING TANK DATA Date Installed !o O Size /5'5O No. of Compartments Z Standpipes (Y/N) ( Air -tight Caps (Y/N) Foundation Cleanout (Y/N) Depression over Tank (Y/N) /J Date Last Pumped Pumping/Maintenance Contract on File (Y/N) .,J11A ; for WA Holding Tank High -Water Alarm (Y/N) t!" Temporary Holding Tank Permit (Y/N) N!A Separation Distances from Septic/Holding Tank: To Water -Supply Well tOa Fr To Building -Foundation Ar Fi- To Property Line -St' Fr To Disposal field JS Fr To Water Main/Service Line -7.5 Gr To Stream, Pond, Lake, or Major Drainage Course 6 ym Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in. Absorption Strata IZS Type of System Design Date Installed 1 n41"o Length of Field /90 LA, Width of Field ;:7- Depth of Field i Lr Gravel Bed Thickness Is - Square SSquare Feet of Absorption Area i�4� Standpipes Present (Y/N) Al Depression over Field (Y/N) /y Date of Last Adequacy Test SIZ9/A/e Results of Last Adequacy Test — cLtTlaFAcsORy Separation Distance from Absorption Field: To Water -Supply Well LIS Pr To Property Line So Pr To Building Foundation SO Fr' To Existing or Abandoned System on Lot VA ; On Adjoining Lots foo'r Ar To Water Main/Service Line 79- Fi To Cutbank (if present) nJ/A To Stream/Pond/Lake/or Major Drainage Course ^.�JA To Driveway, Parking Area, or Vehicle Storage Area W70 rr Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at — High Water Alarm Level at Tested for I Electrical Codes (Y/N) — Comments Dimensions Manhole/Access (Y/N) — "Pump Off' Level at — Vent(Y/N) Pumping Cycles during Adequacy Test. Meets MOA "* Check Permitted Bedroom Rating Against HAA Request" 1 certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date Company MOA No. Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/64) • MUNICIPALITY OF ANCHORAGE (M* HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Of N µµ &1 pN4720 MUNtC�F tt. OFt� PROtE��J81 Description: Rc-in tar SO E tRp"Mt" Ecnov T 2i.1 Q3l ) A. WELL DATA Well Classification l wars •+ C C r 1 `rlf A, 6, C,,D.E.C. Approved (Y/N) �f Well Log Present (Y/N) _ZZ Date Completed U,ur.,J0y_'1..> YiP�®�®� Total Depth n 4_ FT Cased to -SAO'` Ori- Depth of Grouting 64A Static Water Level 4: J& E- Pum I At Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot 1� i To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole "JA Water Sample Collected by A�1� Water Sample Test Results S,4T(5F Comments B. SEPTIC/HOLDING.TANK DATA Date Installed 4414;2 Size Standpipes (Y/N);�y A Depression over Tank (Y/N) —,I Sanitary Seal n Casing (Y/N) Depression Aro d Wellhead.Q Lots To Reaewer Service Lin on + ; Date No. of f ompa e is � Pumping/Maintenance Contract on File (Y/N)/ir Holding Tank High -Water Alarm (Y/N) � Separation Distances from Septic/Holding Tank F�bundation Cleanout (Y/N) Date La Pumped for Temporary Holding Tank Permit (Y/N) To Water -Supply Well 10Y5+ it To Building Foundation 3s- Fr To Property Line SD P To Disposal Field 1S" Pr To Water Main/Service Line IS Pr To Stream, Pond, Lake, or Major Drainage Course /,-) JA Comments Page 1 of 2 72-026(11784) C. ABSORPTION FIELD DATA • Soils Rating in Absorption Strata SF BizM Type of System DesignyN)e�CL, .J Date Installed Length of Field Width of Field Depth of Field Gravel Bed Thickness Square Feet of Absorption Ar ;,' Standpipes Present(Y/N) Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: Date of Last Adequacy Test? To Water -Supply Well jrS Fr To Property Line So Pr To Building Foundation _SZ;1 1:;F To Existing or Abandoned System on Lot ,JIM ; On Adjoining Lots IOO-fGr To Water Main/Service Line '75 -re To Cutbank (if present) NqA To Stream/Pond/Lake/or Major Drainage Course JA To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at — High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) - 'Pump Off" Level at ** Check Permitted Bedroom Rating Against HAA Request ** Pumping Cycles during Adequacy Test. Meets MOA I certify that l have checked, verified, or conformed to all MOA and HAA gui del ines in effect on the date of this inspection. Signed Company Receipt No. 3 / 0 40/ Date of Payment G —.1 "-9,6 Amount: $ 6S 0-0 Page 2 of 2 72-026 (11/64) Date lu[i1AIn C� R&M CONSULTANTS. INC. 5024 CORGOVA • BOX 6087 • ANCHORAGE, ALASKA 99502• PH. 90]-2]9-0483 • TLX. 090-25360 ENGINEERS GEOLOGISTS PLANNERS SURVEYORS April 3, 1978 R&M No. 851517 Mr. Fred Green 9400 Carlson St. Anchorage, Alaska 99507 Subject: Adequacy Test on Existing Sanitary Sewer System; BLM Lot 50, T12N R3W, Anchorage, Alaska Dear Mr. Green: At your request of March 29, 1978, we conducted a test of the septic system on the above described property. During this test the liquid level in the septic tank was monitored as water was added to the system. The measurements are summarized in the following table: Liquid Level Below Top Total Gallons Time of Standpipe Added 9:40 8.5' 25 9:42 8.5' 50 9:55 8.4' 110 10:03 8.4' 135 10:10 8.3' 160 10:32 8.4' 160 11:10 8.5' 160 The meter used during the test was a Rockwell 5/8" standard water meter which had previously been calibrated by R&M Consultants, Inc. If the 4 bedroom residence on the property is to house 8 people, the average load on the system can be expected to be 600 gallons per day or .49 gallons per minute. During the test, the system accepted 160 gallons in 95 minutes. this indicates an average effluent acceptance rate of approximately 1.7 Tions per minute at the time of the test. ANCHORAGE FAIRBANKS JUNEAU VALOEZ WASILLA r April 3, 1978 Mr. Fred Green Page -2- Because the house on the lot is occupied, we assume that the leach field was at its normal degree of saturation. We can therefore conclude that the system is disposing of effluent at an adequate rate for a 4 bedroom resi- dence. We appreciate this opportunity to be of service to you. Please contact us if you have any questions concerning this test or if we can be of additional service. Very truly yours, R&M CONSULTANTS, INC. Lynne Kosikowski Staff Geologist JMB/kah Jim McCaslin Brown, Ph.D Head, Earth Science Department Y� ♦VAC 5 t � 8 � f � . � 1 r Location: BESSE, EPPS S POTTS 2220 EAST 88 AVENUE ANCioRAGE, AK 99507 (907) 349-6451 WATER WELL TEST Subdivision: Lot: Block: Client's Name: /59E71 666E7A) Address: 9/kX) i Tester:�1/KC 41T?3i�p_ Initial Reading on Meter: (!�p,` f,JA� QFtw„�C 8580 COAL 0 Date: S �O— Imo' �.m (Ar sCi Sc-c-no.� IS T:L..) J73k.J NOTES: Prrriiirtion R.itr_: i.4S GPti 24 -Hour Capacity Callcns