HomeMy WebLinkAboutT12N R3W SEC 27 LT 4712N R3W Section 27
Lot 47
N"ml,.,rAAM4@
EMA&
Municipality of Anchorage
On-Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP241358 PID Number: 018-092-30
Dwelling: RN Single Family (SF) El with ADU El Duplex (D) ❑ Two Single Family Project: M New RE Upgrade
Name
James McGrady
A RPTION FIELD
`0
Trench
c
rR OD Trench FlWideTrench FIBed F�Mound
Site Address
4480 E 138th Ave
Phone
Number of Bedrooms
Soil RatingTotal
depth from original grade
907-250-4227
3
ISF
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original Gravel depth beneath pipe
Ft.
Subdivision Block Lot
47
Fill added above original grade rGi I length
Ft. Ft.
Township Range Section
T12N R3W 27
Gravel width
Ft.
Beds: Number of Lines
Dist between lines
N� Ft.
SEPARATION
DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between t hes
From
Tank
Field
Tank
Line
Ft2,
Well
>100'
>1 00'
N/A
N/A
>25
TANK 9 Septic El S.T.E.P. ❑ Holding n Other
Manufacturer
Greer
Capacity
1000 Gal.
Surface Water
>1 00'
>100'
N/A
N/A
Material
Plastic
Number of compartments
2
Lot Line
>5'
>10'
N/A
N/A
NA
Foundation
>1 0'
>1 0'
N/A
N/A
gf-�. LATION
Manufacturer
Capacity
Gal.
Remarks Deep-burial septic tank
Alarm location
Alarm
Electra ' alled by
PIPE MATERIAL House to tank D3034 drainfield Tank to
D3014A
34
Installer
Anderson Construction & Engineering
—
Drainfield N/A CO/MT N/A
Inspector B Schiller
BENCH MARK (Assumed elevation) 100 ft
Inspection 15` 12/5/24Location
and description
dates: 2nd
th
door threshold
3rd 4 IlFront
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Fk
Conditional Approval: Date
;1101 49 TH
............. OW
Septic Syst
Approved
Benjarfx'pSchiller
CE 12592
Da
2/12/25, , - *��AW'
/
ote: this approval does not include well permit requirem ratsPROFESSIQ0
I
kwl,�Z_-Ii;�_1;0�
(Rev 05/02/8)
EXISTING WELL W/
100' RADIUS
Benjamin Schiller
CE 12592R
E
GISTEREDPROFE S S I O N A L E N GINEER
1"=40'
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
LEGEND
PERMIT # OSP241358 PID # 018-092-30
T12N R3W SEC 27, LOT 47
A B
CO1 43.3
MH 40.6
SV 37.5
A
B
2CO 33.6
CO2 21.5
27.9
26.9
26.0
24.4
37.0
FEET
0 40 80
PLAN AS-BUILT
2/12/2025
50' ROADWAY AND PUBLIC UTILITIES RIGHT OF WAY
EXISTING 38' TRENCH
3-BDRM HOME
GARAGE
NEW 1000-GAL
SEPTIC TANK W/
20" MANWAY
2CO
DECK
NEIGHBORING 100'
WELL RADIUS
NEIGHBORING WELL
W/ 100' RADIUS
CO1
FCO
MH
SV
CO2
BM
PROFILE AS-BUILT
(NO SCALE)
93.2
88.8
93.7
97.8
FC
O
MH
SV
PERMIT # OSP241358 PID # 018-092-30
T12N R3W SEC 27, LOT 47
2C
O
92.9
Benjamin Schiller
CE 12592
R
E
GISTEREDPROFE S S I O N A L E N GINEER
2/12/25
1000 GAL
SEPTIC TANK
CO
1
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: OSP241358
Work Type: SepticTank Upgrade
Tax Code Number: 01809230000
Site Legal Address: T1 2N R3W SEC 27 LT 47 G:2936
Site Mailing Address: 4480 E 138TH AVE, Anchorage
Owner: MCGRADY JAMES EDWARD
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
Effective Date
Expiration Date:
Lot Size in Sq Ft
Total Bedrooms:
10/28/2024
10/28/2025
54450
❑ Disposal Field Q 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
Issued By:
Date:
Date: I c2
3
ON-SITE SEWERIWELL PERMIT APPLICATION
Parcel I.D. 018-092-30
Property owner(s) James McGrady
Mailing address 8816 Stonebrook Lane, Columbia MID 21046
Site address 4480 E 138th Ave, Anchorage, AK 99516
Legal description (Sub'd., Block & Lot)
Legal description (Township, Range & Section)
Day phone 907-250-4227
T1 2N R3W SEC 27 Lot 47
Lot Size - 54,450 _Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(Z all that apply)
Absorption Field
F-1
Initial ❑
Single Family (SF)
RX
(w/wo ADU)
Septic Tank
RX
Upgrade RX
Duplex (D)
❑
Holding Tank
R
Renewal
Multiple Dwellings
❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A VARIANCE / 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: *2_Z5- Waiver Fees:
Date of Payment: 1 10 Z � (. Date of Payment:
Receipt Number: Receipt Number:
Permit N o. 0:�-P7 q Waiver No.
Permit App_'-'- : - :-'.,'c I
October 15, 2024
MOA Development Services, On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: T12N R3W SEC 27 Lot 47 - 4480 E 138th Ave
Septic Tank Replacement
Dear On-Site Services Engineer:
The owner of the above lot has a septic tank that has reached its end of useful life, so we are
submitting this permit application for its replacement. The attached site plan identifies the location
of the home as well as the wells and septic location. No conflicts exist between this proposed
system and any other wells or septic system, whether on this lot or adjacent lots. We are replacing
the septic tank with the same size designed for 3 bedrooms.
In addition to the tank replacement, we are specifying some repairs to the septic pipes , some of
which have been damaged, frost jacked, or otherwise needing fixed to allow for adequate testing
of the septic trench.
The new septic tank will be a minimum of 100’ from all wells and surface water. Please refer to
the attached plan for the septic design. If this design is followed, there will be no adverse impacts
to adjacent properties.
Sincerely,
Benjamin Schiller, PE
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241358, Deb Wockenfuss, 10/28/24
EXISTING WELL W/
100' RADIUS
Benjamin Schiller
CE 12592REGISTEREDPROFESSION A L E N GINEER
1"=40'
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
LEGEND
T12N R3W SEC 27, LOT 47
FEET
0 40 80
SEPTIC PLAN
10/14/2024
50' ROADWAY AND PUBLIC UTILITIES RIGHT OF WAY
APPROX LOCATION OF
38' LONG TRENCH TO
REMAIN IN SERVICE.
VERIFY DEPTH AND
INTEGRITY OF EXISTING
PIPES. REPAIR AS
NEEDED
3-BDRM HOME
GARAGE
NEW 1000-GAL
SEPTIC TANK W/
20" MANWAY
NEW 2CO
DECOMMISSION
EXISTING
SEPTIC TANK
PER UPC
DECK
LOCATE/REPAIR
MISSING CO
NEIGHBORING 100'
WELL RADIUS
NEIGHBORING WELL
W/ 100' RADIUS
LOCATE/VERIFY
INTEGRITY OF
EXISTING FCO
≥10'
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241358, Deb Wockenfuss, 10/28/24
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF NEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAl. ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
ADD ESS
EGAL DESCRIPTION /
LOCATION
NO. OF BEDROOMS
DISTANCE TO: ~.¢..~ ~
Liq, capacity in gallons IF HOMEMADE:
DISTA~
Well Dwelling
PERMIT NO.
[ Well Foundation Nearest lot line
DISTANCE TO: Length-~'~-~of 0
No, of lines
each,~le~ , Total length of lin~ width
] of tile to finish grade .,~ , Matelial beneath tile /J~
inche
Crib d~ameter
Depth
depth
PERMIT NO,
OISTANCE TO:
Driller
Length
~ctive absorption
PERMIT NO.
er line
~-- [ ~ [Absorption area(s}
Septic tank .{_ (O()
DISTANCE TO: Building foundatio~¢, l(~
OTHER
PIPE MATERIALS
SOl L 'rE§T R~,~FI N~Gd '
INSTALLER
REMARKS
DATE
LEGAL
l:::'[iil:.':H ]: I I',I0 ( ;::",::ff-I ?,::1:1
:1: ii !::I1"1 I:::'l::ll"l:lil.:l:f:ll~: 1,1]: I"H 'I'IIE I:;i:l:i:[:i:!ll:f:l:;i:li:l"ll~:l",l'l':i!; t:::CII;? f'lt",l'~:~i;:l' I~ :~:;E'I,II!]I::i::E; F:lh,ll)l.,ll:!:! I:!; Fl'i;
F: OFif!'l' I E',"~' t'11E I'iLtI",I ]: (:: ]: I:::'1::tl ]: I":" OF
'":': :l H :[ I _t ]: I",IS"I I::II I 'f'HE ..... t..f I :1:t",1 Fff::(::()l;i D :: ", CE I,.I :[ '1"11 'l'flt:
1 I"tt:::l"l~ I;'.I((i:!il]:I:;?E:
:ii:: iii I fHI:)I~:F ~;' :::ND !IIFI[ I'ttl!i; O1",t ::i;] I'1:::: :i~I~:I,IFF: .:
i::t:ti:; :1: I)I!:I',ICE ~ :iii I:;i:El'lOl)l!:l.lii:D -I0 ]: I",f ~:1..I. tl:::,li: I'1(:11:;i:1~: THI::!H i:!i:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEAI..TH AND ENVIRONMENTAL PROTECTION
PoucE 6-650, Anchora0u, Alaska 99502 276-222!
SOILS LQG -- PERCOLATION TEST
PERCOLATION
TEST
DATE
10~
~2
13
~4
17
~0
SL PE SITE PLAN
WAS GROUND WATER-~"~L \ ~,~ SL '
ENCOUNTERED? --- 0
P
Reading
Date Time
Time
PERCOLATION RATE (nlinu [es/hlch)
o
o
o
r~c~ ~
Ou
MUNICIPALITY OF ANCHORAGE
r
Development Services Department Phone: (907)343-7904
On -Site Water & Wastewater Section Fax: (907)343-7997
Parcel ID 018 -092-30
Certificate of On -Site Systems Approval
OSC251142
Expiration Date: 8/20/2025
Legal description T1 2N R3W SEC 27 LT 47
Site address 4480 E 138TH AVE
Current property owner(s) MCGRADY JAMES EDWARD
X The On-site system(s) is/are approved for 3 bedrooms
By,
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
Original Certificate Date: 5/2/2025
This. Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage,
Development Service Department (DSD) issues COSAs based upon representations provided by an
independent professional engineer. The Municipality of Anchorage is not responsible for errors or
omissions in the professional engineer's submittal.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
re�
Aft"
'W
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I. D. 018-092-30
Complete legal description T 12 N R3W Section 27 Lot 47
Location (site address) 4480 E 138th Ave
Current property owner(s) James McGrady Day phone 907-250-4227
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
3. TYPE OF WATER SUPPLY: 0 Private Well ❑ Private Well serving 2 dwelling units
El Private Well serving 3+ dwelling units Fj Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: [10-1 Private Septic ❑ Private Septic serving 2 dwelling units
F1 Holding Tank El Community Septic or Public Sewer
6. SEPTIC TANK: E] Steel X Plastic ❑ Concrete F-1 Fiberglass
Age New - See advisory if steel older than 20 years
6. ABSORPTION FIELD: M AWWTS R Bed RN Deep Trench R Wide Trench R Seepage Pit
Waiver request for: Distance:
Expedited review requested: R
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ %S G , a �0
Date of Payment Lf /;-I b -S
COSA # 0 5 (- ),5114)
Waiver Fee $
Date of Payment
Waiver #
COSA Application June 2022
T12N R3W Section 27 Lot 47 018-092-30
1
6.7
8/22/78 152 N/A
152
2.79
12 ND
3/11/25 Forge Engineering
62 8/20/24
N/A
NEW
1978
6.1
3.0*
3.1
2000 3/11/25
N/A
3/11/25
44.5
569
37.5
1440
24
>450
42
28
14
(907) 522-7773
Benjamin Schiller, P.E.
4/30/25, 8:51 AM
134 Outlook
Re: 4480 E 138th AVE
From James M <kraden04@gmail.com>
Date Tue 4/29/2025 6:39 PM
To Jared Earls <ja red @forgecivil.com >
Hi Jared,
To my knowledge, the septic has never frozen.
Thanks,
James
Mail - Jared Earls - Outlook
On Tue, Apr 29, 2025, 20:48 Jared Earls <jared forgecivil.com> wrote:
Good afternoon
We are finishing up the paperwork with the MUNI, one last thing we need, and an e-mailed
statement from you indicating that your septic system has never frozen.
Jared Earls
Forge Engineering
(907) 205-7334
https://www.forgecivil.com/
*i4
https://outlook.office.com/mail/in box/id/AQQkAGM4YzkwMAItMGYzZC 1 iZDB kLTAwAiOwMAoAEABT6iw5W 16KTrrzCTgAY1 oB? nativeVersion=1.2025.... 1 /1
Lot 25A I Lot 26
E. 138th AVENUE
i — I S 89'51'E 165.07'
i
Lot 27
I
I
O
O
GRAVEL ROAD
— — — — — —
50' ROADWAY AND PUBLIC
UTILITIES RIGHT—OF—WAY
Lot 47
54,450 s.f. (MOA)
GRAVEL -
p
O
�
Lot 48A
m
Lot 46
SEPTIC PIPES
'.•
w
N
W
N
cp
x
tp
00
21.3'
v
F m
17.9 , 27.3' �5 ... ,... •� --
�
j�..�M—AN—'H�OLj
^6.0'
CANT
J�
1P
48.0' 1 STORY
1p'o.
FENCE 0
\
RESIDENCE
WITH LOFT
y
\
4.0' x 8.3' / 41.3'
BALCONY
8 O
o
)Z
CHAIN-LINK FENCE
/ 1.5' CANT
J
I v C
N
IFENCE WELL
S 89'50'W 165.07'
I \ I
I � I
Log 57A i \ Lot 58 i Lot 59
NOTES: GROUND LEVEL IMPROVEMENTS SHOWN ARE APPROXIMATE. DATE OF SURVEY: 23 APRIL 2025
PLOT PLAN __— AS BUILT _X_ SCALE 1__= 40' GRID SW 2936 Project No J24-205 A2
Lang & Associates, inc..O. or Box Alaska
• Anchorage, Alaska 99521-0005 Z"�"obbO�O�O
(907) 522-6476 oal OF A opp
Professional Land Surveyors survey@langsurvey.com pv,`C�...• .9 0
S4
I hereby certify that I have surveyed the following described property: /�u
LOT 47, SECTION 27, T12N, R3W, SEWARD MERIDIAN, ALASKAAnchorage Recording District, Alaska, and that the improvements situated thereon are' ""within the property lines and do not encroach onto the property adjacent thereto, thatno improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible C. LANGeasements on said property except as indicated hereon.Dated this the Day of _Afe � 2�?J , at Anchorage, AlasRS ..... ao opt
pp FfSS100- a�
It is the responsibility of the owner to determine the existence of any easements, WOpppoo1
covenants, or restrictions which do not appear on the recorded subdivision plat. State of Alaska AECC963
Parcel I.D. #
1.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services ITYO~A'
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650 ~VlC~SOIVI$1~ON
343-4744 OCT 0 1 1997
CERTIFICATE OF HEALTH AUTHOF~ITY
APPROVAL FOR, A SINGLE FAMILY DWELLING RECEIVED
\
GENERAL INFORMATION
Complete, legal descripti(~n '-T 1~_¢4 ~ ¢-2 ~J_¢ --q¢:~---
Location (site address or directions)
Property owner
Day phone
Mailing address
Lending agency ~"~
Mailing address
Agent
Address
Day phone
Day phone_,---'"
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: -~ ~
TYPE OF WATER SUPPLY:
NOTE:
Individual well
Community well
Public water
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OFWASTEWATER DISPOSAL:
NOTE:
Individual on-site
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72~25 (Rev. 1/91) Fronl MOA #21
5. STATEMENT OF INSPECTION BY ENGINEER-
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
oi'dinances, and regulations in effect on the date of this inspection.
Name of Firm /~ ,t~0¢§6~V"qou¥ Phone '~7--~/77
..... [ Ii~Ill ~ W~s:ewa~er Semites ~~/W
:nglneers slgna~ur~% '~4% 3~¢o:~riF~a D; Date
DHHS SIGNATURE
Y
Approved for -~
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
Date
The Municipality of Anohorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineeCs work.
72~25 (Rev. 1/91) Bsck MOAt21
Municipality of Anchorage u
DE:PARTMENT OF HEALTH & H.UMAN SERVIC~NMEANL~¥L
Environmental Service,,, Division
825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 340Pr.,z~74)~-I 1997
Legal Description:
A, WELL DATA ....
Well type
Health Authority Approval Checklist
"7"IZ~J ~_,,..2% ~<~C:, ¢?.) L,~7~ 4'3 Parcel I.D.:
RECEIVE[)
If A, B, or C, attach ADEC letter. ADEC water system number
_ Date completed
Cased to / -~ ~ /
FROM WELL LOG
Log present (Y/N) "") ~---~
/
Total depth
Sanitary seal (WN)
Casing height (above ground)
Wires properly protected (Y/N) '"/
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform ~
Date of sample:
Nitrate
,~T INSPECTION
g.p.m.
1>u~p~_.,p ~--o,¢-~ '7 /
· ~ 7~ ~/~ Other bacteria _
Collected by: ~P~
cj.~.m. . . ~%
El. SEPTIC/HOLDING TANK DATA / ? ~/~
Dateinsta,ad Tar, k,i,e
Foundation cleanout (Y/N) "./~.;--(~ _ Depression (Y/N)
Date of Pumping _ ~'/~'~' Pumper ~,~.,q. d~£
C. ABSORPTION FIELD DATA
Number of Compartments
,,.Jo High water alarm (Y/N)
Date installed ll/~/7 (~ Soil rating (g.p.d./fF or fF/bdrm)
Length ~ ~ / Width Gravel thickness below pipe
Effective absorption area ?¢~'(~ Monitoring Tube present (Y/N).
Date of adequacy test ~/~/~ ~ Results (Pass/Fail)
Fluid depth in absorption field before test (in.);
Fluid depth 2o~' (ins) Minutes later:
Peroxide treatment (past 12 months) (Y/N) ~
72-026 (Rev. 3/96)*
System type
/
~ . Total depth
. Depress on over field (Y/N) t,J(3
For ~ bedrooms
Immediately after gal, water added (in.): ,,~7 ~ ¢'
Absorption rate =
If yes, give date
'4~t~'E) + _g.p.d.
Date install:ed ~ Size in gal
Manhole/Access (Y/N) ~~~' "Pump off" level at*.
High water alarm level at*
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/hOlding tank on lot IOO +
Absorption field on lot J
Public sewer main
Sewer/septic service line 2 ~/+
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Lift station /~J
'SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
/ /
Foundation ~ 4- Property line ~'0 '~ Absorption field ~¢
Water main/service line {~/+ Surface water/drainage 100 [~- Wells on adjacent lots
/O/+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
/
Property line 50 + Building foundation 2o rt' Water main/service line
Surface water I oo % Driveway, parking/vehicle storage area
Curtain drain t4o~.________________~_ ~¢jot..ot-.J Wells on adjacent lots 100/4
ENGINEER'S CERTIFICATION
I certify that / have deter~/?~nedt~.ld inspections
in conformance~/~H~yCe~es in effect on
Signature L ~17~//1TM ~_2 - '
Engineer's Name /~
Date
this date.
HAA Fee $. '¢~¢'/~' ~
Date of Payment/~)/f~'//~/~
Receipt Number
Waiver Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
,~ CT&E Environmental Servk:e~ Inc,
CT&E Ref.#
Client Name
Froj ec~ Name///
Client Sample ID
Matrig
Ordered By
PWSID
975392001
Lo~ ~7~S~ 27,TI2N,R3W,S.M
Ddnkiag Water
0
Cliff PO//
Printed Date/Time 09/12/97 16:36
CollectedDate/Time 09/~0!97 09:37
Received Oo.t~'Time 09/10197 11:50
T~i~l DIr~or: Stephen C. Erie
Rd~ed By ~
glrrate~fl 0,876 0.100 ~g/L sN!8 650fI-NO~F 10 ~,8X 09/i~/97 JSL
Total Coliform 0,00 coL/ldO~L sl41~ 92Z~ 09/10/97 THN
I El'I'lL P, 02
8471 Brookridge Drive ~ Anchorage ~ Alaska 99504
Phone (907) 33%6179 ~ Fax (907) $38-3246
Consulting Engmce~ s
September 30, 1997
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 9951%6650
Subject: CONDITIONAL HAA for Private Well & Septic System. T12N, R3W, Sec 27,
Lot 47
To whom it may concern:
The subject lot has a 3 bedroom house on it which is se~wed by a private well and septic system.
The results of the field investigation and adequacy tests are summarized as follows:
A. WELL: On the clay of our inspection (9/10/97) the static level was 85 feet below the top of
the casing (BTC). Water was pumped from the well at an average rate of 8.45 gpm for 71
minutes (600 gallons). The maximum drawdown achieved during the test was 4 feet, indicating
that the well was recovering as fast as the water was being pumped out. Based upon this data it
was determined that the capacity of the well exceeds the Municipal requirements for a 3 bedroom
house (450 gallons per day).
B. SEPTIC TANK: Tile existing septic tank was installed in November of 1978 (approx. 19
years old). According to the M.O.A records, it is 1000 gallons, has two compartments and is
made of steel. Most tanks of this type have a structural life of approximately 20-25 years. No
warrantee is made regarding the future life of the septic tank.
C. SEPTIC SYSTEM WAS RE.HJVENATED USING THE TERRALIFT PROCESS: The
septic system was initially found to be operating in a surcharged condition. The trench was
Terralifted on 9/15/97 by Alaska Drainfield Restoration (Jerry Leach).
D. SEPTIC SYSTEM ADEQUACY TEST: On the day of the adequacy test (9/24/97) the
monitoring tube had 8.5 inches of liquid in it. Water was introduced into the clean-out at a rate of
8.45 gpm for a total of 71 minutes (600 gallons). This caused the water level to rise 19.25 inches,
to 27.75 inches, which corresponds to 31.2 gallons per inch. During the first fourteen minutes of
the recovery period the liquid level dropped 7.5 inches, indicating a recovery of 234 gallons.
Based upon this data, it was determined that the absorption rate of the trench exceeds 450
gallons per day, as required for a 3 bedroom house.
NOTE: The adequacy ora septic system is influenced by numerous factors, #tc&ding, but not
limited to, seasonal swtface water infiltration, g~wundwater variation& septic aystem
maintenance ~'equency of septic tank pumping, usage of biolo~cal additives), condition of
drain pipe and pipe jomts (which can be damaged by seismic activity and deteriorate with age),
type of swbstances deposited in septic system (cigarette butts, sanitary napMns, misc. objects),
and the amoimt c~'water being introduced on a conanual basis. Consequently, the reswlts qf this
adequacy tesl are on& valid for the sT)ecific day of the tesL P)trthermore, because of the limited
nature of this' investigation, il is' possible that there are hidden defects' which may not have been
detected No warrantee is made regarding the fitture pe¢fot~ance of this well or septic aystem
E. WATER/SEWER SERVICE TO GARAGE: It is my understanding that, in the past, there
was water service to the garage, and a toilet inside the garage. Per the property owner (Dan
Church), the water service is shut off, and the toilet is no longer operational. The separation
distance from the abandoned water selMce line to the septic tank and sewer se~Mce line is
unknown. The separation distance should be unimportant unless the future owner chooses to
reactivate the water service line.
F. CLOSING: We are requesting the issuance of a conditional HAA, with the stipulation that
the septic system be retested 30 days after the new occupants move in. Based upon the soils data
for this lot, and the adjacent lots, and the space constraints, there appears to be adequate room to
install a new septic system should the existing system fail to pass the retest. There does not
appear to be any health/sanitation concerns associated with granting the ~:onditional HAA.
If you have any questions, please contact me at 337-6179,
1-800-481-1162. Thank you for your assistance.
Sincerely,
or on my
digital pager at
c.c. Dan & Susan Church
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Serwces Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343,-4744
Parcel I,D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
~) ] i~ _. ~)c~ ~ _ ;~ ~ HAA #
1, GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address
Agent
Address
Day phone
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
ndividual well
Community wel
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE-': If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system
72-025 IRev. 1/gl) Front MOA #21
5. STATEMENT OF INSPECTION BY ENGINEER.
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm.
Address
Engineer's signature
DHHS SIGNATURE
Approved for
bedrooms.
Date. to//~/~.-
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
By: Date
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to pu mhasers 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-C25(Rev. 1/91) Back MOA~21
Rick Mystrom,
Mayor
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
October 28, 1997
Jeff Garness, P.E.
Alaska Water & Wastewater
8471Brookridge Drive
Anchorage, Alaska 99504
Subject: Waiver Request for Lot 47 T12N R3W Section 27
Waiver Request #WR970071, PID #018-092-30, HA970456
Your request for waiver(s) of the required 100 foot horizontal
separation of an on-site wastewater disposal system to a private
well has been approved. The approved separation distance(s) are
90 foot; from the well on Lot 47 to the leachfield on Lot 46 T12N R3W
Section 27.
This waiver approval applies to the existing on-site wastewater
disposal system to well separation only. Any future upgrade to either
will require all separation distances be met or another approval
from this department.
If there are any further concerns or questions regarding this waiver,
please call our office at 343-4744.
Sincerely,
Daniel J. Roth
Civil Engineer
On-site Services Program
ljm:#6
MUNICIPALITY OF ANCHORAGL
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR~ WR970071 PID~ 018-092-30 HA~ HA970456
Date Received: October 24, I997
Legal Description: T12N R3W Section 27 Lot ~ g\-]
Engineer:
Permit
Jeff Garness, P.E., Alaska Water & Wastewater Services
8471 Brookridge Drive, Anchorage, Alaska 99504
Applicant: Dan Church
Waiver Requested: T12N R3W Section 27 Lot 47's well to Lot 46 leaehfield of
90 feet.
Criteria: 1. Geology: Poinns:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3. Other:
Waiver is Granted: ~ Waiver
List Conditions or Reasons for above: ~
is NOT Granted:
Name of Reviewer
Rec =: 03352/4277 Amount: S 920.00 Date Paid: 10-24-97
J \l[a{ska Waltely & Walstewater
8471 Brookridge Drive ~ Anchorage ~ Alaska 99504
Phone (907) 337-6179 - Fax (907) 338-3246
Consulting Engineers
October 16, 1997
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Subject: HAA for Private Well & Septic System. T12N, R3W, Sec 27, Lot 47
To whom it may concern:
A conditional HAA was applied for previously this month. The intent was to retest the septic
system (30 days after it was Terralifted) and obtain an non-conditional HAA. Since the HAA
package was submitted, the 30 day waiting period has expired, and we have retested the septic
system. The results are summarized as follows:
SEPTIC SYSTEM ADEQUACY TEST: On the day of the adequacy test (10/15/97) the
monitoring tube had 10.5 inches of liquid in it. Water was introduced into the clean-out at a rate
of 7.82 gpm for a total of 66 minutes (516 gallons). This caused the water level to rise 15.25
inches, to 25.75 inches, which corresponds to 33.8 gallons per inch. One-hundred & ninety-seven
(197) minutes later the water level had dropped 12.75 inches, indicating an absorption of 431
gallons (2.19 gpm). Based upon this data, it was determined that the absorption rate of the trench
exceeds 450 gallons per day, as required for a 3 bedroom house.
NOTE: The adequacy ora septic system is it~fluenced by mtmerous fitctors, includi~g, but not
limited to, seasonal smface water i~ltratiot~, groundwater variations, septic system
maintena~ce 05'eq~te~cy of septic tcmk pumping, usage c( biological additives), cottdition of
drain pipe w~d pipe.joints (which cat~ be damaged by seismic activity and deteriorate with age),
/ype of x~tbstat~ces deposited in septic .system (cigarette butts', sa~itaty napkit~& misc. objects'),
crud the amount of water beit~g it~troduced ot~ a continual basi& Conseq~te~t]y, the results of this
adequacy test are ot~Iy valid fi)r the ~pecific day of the test. Fm'thermore, because of the limited
nantre of this investigation, it is' possible that there are hidden defects which may not have been
detected No warrat~tee is made regarding the fi#~#'e pet~tw~ance of this well or septic system
I'-
N ~"9, Na'oo'~' /G~,o?/
L[[OFI'ID
LOT CORI'I[ R8
FOUNOATION
~--- DRAINAGE ARROW8
NOTES' .
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BESSE, FPPS I~
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349-6451 ANCHORAGE ~ ALASKA
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October 23, 1997
Municipality of Anchorage
Dept. Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O Box 196650
Anchorage, Alaska 99519.-6650
11471 Brookridge Drive - Anchorage - Alaska 99504
Phoue (907) 337-6179 ~ Fax (907) 338-32,16
Consulting Engineers
Attn: Dan Roth
Subject: Waiver of separation distance from existing crib (T12N, R3W, Sec 27, Lot 46) to
existing private well (T12N, R3W, Sec 27, Lot 47).
Dear Dan:
The subject property (Lot 47) has a 3 bedroom house, served by a private well and septic system.
The well was drilled on 8/22/78, after the crib was constructed on Lot 46. The well is 99.5 feet
from the crib clean-out. The dimensions of the crib are unknown, so it will be assumed that the
crib sidewall is only 90 feet from the well. At this time, we are requesting that the required
separation distance from the well to the crib be waived to 90 feet. Justification for this waiver is
summarized as follows:
GENERAL: Attached is a topography map showing the general contours in the area. Shooting
the slope from the well to the crib with a clinometer, indicated that the crib was downhill from the
well at a slope of approximately 2%+. In short, surface overflow from the crib would not flow
towards the well. The other potential path of contamination would be subsurface. Analysis of
this contamination potential will be evaluated based upon the ADEC point system.
ADEC WAIVER, POINT SYSTEM LVALUATION.
Geological: The only well log on file at DHHS was for Lot 47. A copy of the log is
attached. The wells on the adjacent properties appear to be undocumented. Based upon the log
for Lot 47, no bedrock was encountered to a depth of 152 feet, and static water was 86 feet BTC.
On the day of the well test (9/10/97) the static water was 85 feet BTC. In short, the bedrock
profile does not appear to be a consideration, and the groundwater supply is quite deep.
a. Distat~ce fi'om the bottom of the crib to grouttdwater (85foot static level in well): The
bottom of the crib is approximately 10 feet below grade. The separation distance fi'om the
bottom of the crib to the static water in the well for this lot is approximately 75 feet. This
corresponds to 5.8 points.
b. Soil sorhtion below the crib: According to the well log (lot 47), the geological profile
is primarily a mix of silt, sand, and gravel, throughout the entire boring depth. I am going to
assume a point value of 0 for the gravel, 1.5 for the sand, and 3.5 for the silt. In addition, it will
be assumed that each of the soils exist in equal parts (33% gravel, 33% sand, 33% silt). This
corresponds to a point value of 1.7, calculated as tbllows: (.33(0) ~ .33 (1.5) + .33(3.5)) = 1.67.
c. Soil petwteability below the crib: I assumed the entire profile was sandy gravel,
which corresponds to a point value of 0.9.
d. Water table gradient: When performing the well adequacy test (pumping at a rate of
8.45 gpm for 71 minutes) the drawdown was only 4 feet. The hydraulic gradient, due to
drawdown, from the septic system to the well, is negligible (approximately 4%). This
corresponds to 2.7 points.
e. Horizontal separationfi'om well to crib: Given a 90 foot separation distance, the point
value is 2.6.
Total Points: 13.7
According to the ADEC waiver guidelines, a point value 12-16 indicates no bacterial
contamination is possible, and that chemical pollution (from household sources) is unlikely.
Recent water sampling/analysis (9/10/97) found no bacteria, and nitrate levels of .876 mg/l.
Copies of the lab results were submitted with the Health Certificate package. This encroachment
has existed for over 19 years, and the well water quality has not been compromised. Given these
facts, it is my recommendation that the requested waiver be approved. If you have any questions,
please contact me at 337-6179, or 244-9612. Thank you for your assistance.
Sincerely,
Pri~ ~6al(]
DRILLIk~G LOG
DRILl. IN&, IHC.
//'7
./- ,,L'
~N'ARE LOGAT[O
LEOEND
0 LOT CORNERS /,~g
FOUNDATION
~"-.-.,.---- DRAINAOE ARROWS
NOTES'
BESSE, EPPS ~
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349-6451 ANCHORAGE ~
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