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HomeMy WebLinkAboutT12N R3W SEC 33 LT 18 Dottglas T. Kettle), P.E, 8176, 9960E P,J]in Drive, Palmer, Alaska 99645 (907) 746-1073 March 26, 1997 Mr. Jim Williams Municipality of Anchorage Dept. of Health and Human Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 RECEIVED· MAP, 2 '1997 MltlliOiOality O~ Oept, Nealth & I-fumarl Serv,ce~ Re: Tract 12N, Range 3 W, Section 33, Lot A, Anchorage, Alaska Mr. Williams: Yesterday we had a discussion over the telephone regarding the on-site wastewater disposal system at the above referenced property. Measurements taken after construction of the system show that both the tank and secondary absorption trench have settled after backfilling took place. The tank is approximately 2-inches out of the level and the secondary absorption trench is approximately 3-3/4-inches out of level over the length of the pipe. Following our discussion yesterday, I contacted Anchorage Tank and Welding, the manufacturer of the septic tank that was installed. They have confirmed that the tank will operated as designed, although 2-inches out of level, without any adverse effects. As you cautioned yesterday, further settlement could result in standing wastewater before the tank and the owner will be notified of this concern. Given the manufacturer's statement that the tank will function as designed, although slightly out of level, I am prepared to state that no adverse health concerns will occur as a result of this condition. Concerning the secondary absorption trench. The secondary trench is isolated from the primary trench with a bull valve. That only impact that will occur as a result of that trench being out of level is that it may fail prematurely at the lower end if it is ever used. The owner did not need to install the secondary trench and only did so to provide for a safety margin ahead of time. The parcel still has plenty of room for a third system if it is ever needed. Given the porosity of the soils at the location of the absorption system I am also prepared to state the no adverse health concerns will result from the secondary trench being out of level. You indicated yesterday that, if it was my opinion that no adverse health concerns would result from the above described conditions, you would be able to issue the Health Authority Approval with no conditional clauses regarding the new system. Thank you for your assistance in this matter. Please contact me directly with any questions or comments you may have that would expedite the completion of your review. Sincerely :, Douglas T. Kenley, ]~.~. AK. P.E.#8176 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION 'rEST PERFORMED FOR: 3 4 5 6 7 8 9 10 11 13 14 15 16 17 18 19 20- WAS GROUND WATER ENCOUNTERED? SLOPE SITE PLAN S IF YES, AT WHAT -- ~) DEPTH? P E Depth to Water Alter ~ Monitoring? -'~/~ '~'~: Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE -- (m~nutestmch) PERC HOLE DIAMETER PERFORMED By. '~'V',,[ ~ ~':,'C'~, / '~ I ~' 'fl ' , / '~"~'4~-2~'~"2-)~''/CERTIFY THA'I THIS TEST wAS PERFORMED IN ' ' ' ' / '~' 0 ~ ~' /~ .d~--~ ~l ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE,[~ATE: fV[~ { t { 72-008 (Rev. 4~85) Permit No. SW96051 Poge / Municipolity of Anchoroge DEPARTMENT Of= HEALTH AND HUMAN SERVICE8 ENVlBONMENTAL 8ERVlOE8 DNiSION P.O. Box 196650 · Anchoroge, Alosko 99519-6650° Telephone 343-4744 On-Site Wasteweter Disposal System and/or Well Impection Report Le ol Description: BLM LOT 18, SEC. 53, T12N, R3W, SM, ALASKA___~.PiD No.:~ 72-015 A (2/91) MOA 25 Permit No. L_egol D e~s_cript,!,on: SW96051 Page. 2~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650oTelephone 343-4744 ~-~ On-Site Wastewa, ter Disposa, I System a~:l/or Well Inspect on Report ~.~ BLM LOT 18, SEC. 33, T12N, R3W, SM, ALASKA PID No.: 018-~1-19 72-013 A (2/91) MOA 25 PERFORMED FOR: LEGAL DESCRIPTION: 2 3 4- 5 6 7 8 9- 10 12 13 15 16 17 18' 19- 20 Municipality of Anchorage ~: ~ DEPARTMENT OF HEALTH & HUMAN SERVI~f~ 825 "L" Street, Anchorage, Alaska 99502-06~ ~ SO,LS LOG -- PERCOLAT'ON TES~.~e Township, Range, Section: ~-- SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? ~,~ O IF YES, AT WHAT --. DEPTH? P E Oept, lo Water Alter (//l.~/~,.~____ Monitoring? ~op~*-" Date: / /¢ lO PERCOLATION RATE ¢ immules~ncnl PERC HOLE DIAMETER TEST RUN BETWEEN ~ __ FTAND ~ FT 3OMMENTS ACCORDANCE WiTh ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE Municipality of Anchorage Page _ / of / DEPARTMENT OF HEAl_TH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 o Anchorage. Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Name: ~'.~-~->,~A~ ~-, ~/~r~,¢~ / Wastewater System: ~3~New [] Upgrade Address; ~//z;'~J-¢~4-' ' ABSORPTION FIE,-D Pbone: .~_~ / ~ / ~//~.~, I N°'°f ~re°ms: LEGAL DESCRIPTION Lot: Block: Subdivision: Township: /. ~..,~,~ I Range:~2 ~f? ~. /.~ Section: WELL: [~New [] Upgrade Classification (Private, A,B,C): Totsl Depth: SEPARATION DISTANCES From To Septic Litt Public/Private Tank Station Sewer Lines Well / ,¢~" Surface Water Lot Line E~/Deep Trench Soil Rating: ~ Total Depth from original grade: ~¢. b¢ GPD/Sq. Ft. 3epth to pLpe bottom from origina~ grade: Gravel depth beneath pipe Fill added above o dg,~:~a~l g rade; IGr~ve"~"gth: Gravel width: [] Shallow Trench []Bed [] Mound []Other TANK [~Septic [] HoLding ~nufacturer: LIFT STATION on" level at; []S.T.E.P. Capacity in gallons: ~mber of Compartments: Drain BENCH MARK Inspections performed by: ~',~,:-~ ~,~' ,'~,~'Y Dates: lst_/¢.~'¢ 2nd_~ Department of He~th and ¢~n,~rrvi:es ap~r°val, Assumed Elevation: FI, E N G I N EI~..~.~ ~EAL D~PA~TMENT OD H~ALTH AND HUMAN ~E~VIOE~ ENVI~ONMENTAL. ~VIOE~ DIVISION On-Site Wastewater Diapoad System and/or Well Inspedion Report ,,x],: Hez$,:il,tion: Utlvl Lu/ 18, °E': 'o, T!.'~'h k. b, _wi, / /_t,n [*1/) No.: ENGINEER'S SEAL '/?,,~96051 Page '~ of ~' Pe~ mit l',lo . ivIJ~i<ipoliLy o[ Arlcho"(~ge DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION Pu. ['ox 196{ih0 o Anchorage, /\hask,1 99519 6650~ relephonu 343 ,17,14 On-Site Wastewater Disposal System and/or Well Inspection Report .. ~, .. BIbl LOT 18, <F:: 3~, !11..'[,~ ~3'v"~ S,~, A~ASK/~ PD No: 018 ' L ENGINEER S SEA 7'2 /113 ,~, (2/'!~ ) ',~ I ,'5 ivlunicipoliL¥ ©¢ /\.ncl;orage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION i'0 [,o,: i96f;'50 o /'\r~ '~o~ag~, /'tlosk~:l 99519 On-Site Wastewater Disposal System and/or Well Inspection Report . Flfg i01 18 S~ 55, II'l'!, R3W. S,, A /'tS<dx PI[) No: 018 19/ 72 0i.5 A (:'/" 1/ Ivi0/x 2r5 ENGINEER'S SEAL NOV,-18'961~0N) 13:21 ALASKA ~IAGAZ IN~ TEL:907-$61-5669 P.O. Box 110378 · 10330 Old Seward Highway (90?) 349-8535 ANCHORAGE, ALASKA 9951 t P, 001 DRILLING LOG WeZI Owner_ STEVEN COTE --UseofWeLDOMESTIc Loc~t~o~ (add~es~ of: Township, Range, ,~mt~on, ~ ~own; or ~s~ce ma~ road LOT 18 SECTION 33 T12N RBN Size of StaUc water level Screen ( ANCHO. RARE~ ALASKA ~7.1 ~t. ~)' ~ow) l~d su~ace. F~h of well (check one) open ~a ~ ); ); Pe~orated ( ~ )., oi ~awdo~ ~om s~c ~1,. " AS BOU~LT NOTES: WELL DRY GROUTED WZTH 100~ of BENTO 9ate o~ comple~on. O9 SEPTEHB~R' 1~96 - Depth h~ feet £~"om ~'otmcl sm'-Zace W~:LL LOG Gi,m det~d1~ of formations penetrated, size of m~terial, color ~nd hardness CA~NG STICK UP . f.~.]O~P SOZL & BOUL~DE~RS: LOO_SE.~i_ O~R~A.~.N_IC.~S~ SANDY __;BOULDER _.__P,I_AYt gT'l IY 94 TO 104 104.TO__ '110 __ ] 1D.TO 1~3 1~TO--.-~ ~l'O. 1 -- CUSTOMER /Vtq t MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT NUMBER:SW960151 DESIGN ENGINEER:DOUGLAS T. KENLEY, P.E. OWNER NAME:COTE STEVEN L OWNER ADDRESS:P.O. BOX 113061 ANCHORAGE, AK. 99511-3061 PAGE 1 OF PERMIT ~ [~ DATE ISSUED: 7/~9/96 E×PIRATION DATE: 7/~9/~'7 PARCEL ID:0t819119 LEGAL DESCRIPTION: T12N R3W SEC 33 LT 18 LOT SIZE: 108900 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM 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 {18AACS0) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343~4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: 1.) 2.) RECEIVED BY: ISSUED BY: EXCAVATE ADDITIONAL TEST HOLE TO A DEPTH OF 15.5FT AT THE PROPOSED TRENCH LOCATIONS AND SUBMIT SOILS LOG WITH ASBUILT. A FLOW DIVERTER (BULLRUN VALVE OR EQUAL) MUST BE INSTALLED DOWNSTREAM OF THE SEPTIC TANK TO DIVERT THE FLOW FROM TRENCH TO TRENCH. Dougla.~ T. Kenley, PE tlCOI Box 603,1, Palmer, Alaska 99645 (907) 746-1073 July 16, 1996 Mr. Jim Williams Municipality of Anchorage Health & Human Services On-site Services Re~ Revisions to a pem~itted septic system [Jot 18, Section 33, TI2N, R3W SM Owner: Mr. Steven L. Cote' Dear Mr. Williams: This letter is to request several revisions to a permitted septic system reviewed by yourself earlier this summer. The Owner has requested that he be allowed to up-grade to a four bedroom system also that we design and install both the primary and secondary systems at the same time so that he will have the option of alternating between the two trenches every year or so. In accommodating this request, we have re-designed the trench length m2t averaging the two pemolation rates as we had previously done. We have also increased the depth of the trenches by 6-inches. We request that we be allowed to dig a new test pit at the time of installation to verify the depth to an impermeable layer is sufficient to allow this increased depth. The revised trench length is now 63-feet for both the primary and secondary system. The revised drawing also shows a corrected dimension to the middle of the two trenches. A splitter valve will be installed at tbe junction of the two trenches. I am aware the Department has a particular valve that has worked well in the past. I would appreciate it if you would let me know the type of valve we should use so that I can ensure it is installed. There is presently an existing well and septic system on the pamel se~wing a small residence. The Owner had originally intended on demolishing the house and both the well and septic system. He would now like to have the original house remain with it's well and septic system. A new well and septic system will be installed to serve the new residence. We have therefore, revised the site plan to show the proposed location for a second well. The Owner would like to keep open the possibility of subdividing the lot at a later date. Sincerely, CE #8176 ~ MBH 'N~LI '88 NOliO~8 'GL iO~ ~lO0 '9 N~A~I$ 'H~ i 6'0" 5'0" MR. GREGORY B, WILCOX -- IF ,l T12N R3W SEC. 4 LOT 59W2 , ANCHORAGE, ALASKA MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PAGE 1 OF PERMIT ~ PERMIT NUMBER:SW960151 DESIGN ENGINEER:DOUGLAS T. KENLEY, P.E. OWNER NAME:COTE STEVEN L OWNER ADDRESS:2701 E 142ND AVE ANCHORAGE, ~LASKA 99516 PARCEL ID:01819119 DATE ISSUED: 6/26/96 EXPIRATION DATE: 6/26/97 Tm~ ~. LEGAL DESCRIPTION: T12N R3W SEC 33 LT 18 LOT SIZE: 108900 (SQ. FT. NUMBER OF BEDROOMS: 3 THIS PERMIT: THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM 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 (iSAACS0) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: 1. ABANDON EXISTING SEPTIC SYSTEM INCLUDING THE SEPTIC TANK. 2. EXCAVATE ADDITIONAL TEST HOLE TO A DEPTH OF 15 FT. AT THE PROPOSED TRENCH LOCATION AND SUBMIT SOILS LOG WITH ASBUILT. 3. A FLOW DIVIDER (ZABEL Z200 OR EQUIVILANT) MUST BE INSTALLED DOWNSTREAM OF THE SEPTIC TANK TO EQUALLY DISTRIBUTE THE EFFLUENT INTO BOTH TRENCHES. Douglas T. Kenle¥, P.E. __ HC01 Box 6034, Pahncr, Alaska 99645 (907l 746-1073 May 9, 1996 Mr. Steven L. Cote' Lot 18, Section 33, T12N, R3W, SM, Alaska PERCOLATION TEST RESUI~TS AND GENERAL SITE INVESTIGATION REPORT On April 27, 1996, the above-referenced 2-1/2 acre BLM parcel was inspected in conjunction with soil perk tests being performed for application and approval for the installation of an on-site waste water disposal system. The site is located to the east of the intersection of DeArmoun Road and Lake Otis Parkway on the second driveway off of DeArmoun Road to the south. The private driveway is used by two residential homes. The parcel is roughly 330' x 330'. The lot is flat with no significant difference in elevation, and the site is moderately treed with birch, spruce and poplar. On-site observation and physical survey show that there are no water wells nor private wastewater disposal systems within a 100' radius of the proposed system. No surface water was observed at the time of the inspection, and it appears that there is no potential for contamination of adjacent water wells or streams The proposed septic system has been designed to minimize impacts to the adjacent properties. There is an older house on the southwest corner of Lot 19, which is also 2-1/2 acres in size. Lot 47, another 2-1/2 acre parcel south of and adjacent to Lot 18, has been subdivided into seven lots, with one house on the lot designated as Lot 47C in the northeast corner of Lot 47. Because these seven lots are each tess than an acre in size, they could not be serviced by both a well and septic system under current regulations. The parcel to the west is another 2-1/2 acre lot with only one house on it at the present time, serviced by a well and septic system. The adjacent property to the north, Lot 15B, is a ve~ irregular shape, greater than an acre in size. The proposed primary and replacement sites are not encroaching upon any existing 100' radius well systems, and they will not preclude the development of any other lots. There is ample space remaining on the property to the north of the primary site for a replacement septic system. Two percolation tests were taken at the site to assess the adequacy of subsurface soils to accommodate both the primm,j and replacement on-site wastewater disposal systems. The results of these tests are attached to this report. The test site had adequate percolation rate to support the proposed three-bedroom residence. Subsurface soils were found to be silty sand with some gravel overlain by 12" of surface organics. The average percolation rate for the two test hole sites was found to be approximately 17.5 minutes per inch. If there should be any questions concerning the percolation rate or characteristics of the site, please call me at (907) 746-1073. Sincerely, PE#8176 MR. STEVEN L. COTE' LOT 18, SECTION 88, T12N, RSW SM ANCHORAGE, ALASKA DOUGLAS T. K~F~LEY, P.E. J DRIVEWAY EASEMENT \ / / / / / / () 5' 6~' 3'-0" 9'0" MRr GREGORY Br WILCOX T12N R3W SEC. 4 LOT 50W2 ANCHORAGE, ALASKA Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TES'r PERFORMED FOR: .~'~"~-/~J~_J ~ , ~&2~ /2 LEGAL DESCRIPTION: ~7' .'~¢' Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth te Waler Monitoring? Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE /'~-' U*nmutes/mch) PERC HOLE DIAMETER TEST RUN BETWEEN '~t/~"~-~ FT AND , ~-- FT COMMENTS ~ -2'~/..¢ ~,,*¢¢~/L~'~ ~/.¢'-~;~ .~.~ ~-~.~2~.~,/~.,..¢2~-j~:) ,(.~] , ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev, 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN Municipality o! Anchora§e DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchora§e, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: DATE PERFORMI LEGAL DESCRIPTION: / ~.Z./,~) .,~,.~"Z..¢...~ .D"z:~¢_. ,.4'~ Z~,~'.,2C-ownship, Range, Section: 1 2 3- 4- 5- 6- 7 8 9 10 11 12 13 14 15 16 17 18 19 2O COMMENTS SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? geplh to Water Altos Monitoring? SITE ELAN Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE '~v~ (minutes/inch) PERC HOLE DIAMETER __ TEST RUN BETWEEN '~/~-- FT AND ~ FT ACOORDANCEWlTHALLSTATEANDMUNICIPALGUIDELNES N BFFt/EGTONTNISDA. DATB: ~-/~1 ~[~t 72-008 (Rev. 4/85) GP" ~.TER ANCHORAGE AREA BORO'"'~H H EAL?H DEPARTMENT $27 EAGLE S¥. ANCHORAGE, ALASKA 99501 279-2511 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM N? 440 SEPTIC TANK: MAILING ADDRESS ,-,(~'"-',~-/df,;'~,,~/'~, NUMBER OF DISTANCE FROM WELl · ""~ ~ / '-/< MAIERIAL~/"Z-'~'"~(~'"~(~'---',-~//'/~~5~- COMPARTMENTS '~75'~'""'~'4~'$~//' '~'/~'~'"~-~'/~/~"~ ~/~ LIQUID LIQUID CAPACITY__./,/~/~)/~2 GALLONS. INSIDE LENGTH ~/ _INSIDE WIDTH '// DEPTH SEEPAGE SYSTEM: SEEPAGE PiT: NUMBER OF PITS ,/" OUTSIDE DIAMETER / OR WIDTH__/,"-;) LINING MAIERIAL C~~',~///~: DISTANCE FROM WELL _/~.z~ NEAREST LOT LINE. TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) LENGTH ,~ s DEPTH · BUILDING FOUNDATION sQ. ET. TILE DRAIN FIELD: .~'--- ~ TOTAL LENGTH DISTANCE FROM WELL ,/ FOUNDATION_ ~, EAREST LOT LINE , OF LINES NUMBER OF LIN[:s~~DIsTANCE BBTWEEN LINES ENCH WIDTH ~-,KL-?b~A[i-E~FF~CTIVE ABSORP,,.~..* ~,_A SQ. FI. LENGTH OF EACH LINE / DEPTH: ~OP OF TILE TO FINISH GRADE DEPIH OF FILTER MATERIAL BENEATH ]ILE IN. ABOVE TILE DISIANCE FROM WATER WELL: TYPE /)IZ/L.~ DEPTH :Z2~' //- ,BUILDING FOUNDATION, /-) SAMPLE , NEAREST NEAREST OTHER LOT LINE ~.// / 7z~ SEWER LINE / SEPTIC SEEPAGE / , TANK , SYSTEM~-~_~'~'.~__, CESSPOOL DISTANCES: APPROVED ~' "~- HEALJH AUIHORJIY GAAB-HD-2 GREATEIF 327 Eagle St. ANCHORAGE AREA itEALTlt DEI'ARTMENT Anchorage, Alaska 99501 9ROUGH 279-2511 Case No.~ SEWAGE DISPOSAL SYSYEM - APPLICA'I'ION & PERMI'I' ? RESIDENCE ADDRESS LOCATION OF iNSTALLATION / LEGAL. DESCRIPTION.T ]~ v'(," ~.-% ~'~" ;~, .~5 APPLICATION TO INSTALL: SEPTICTANK~ ~-~,SEEPAGE PIT ~--~,DRAIN FIELD ,OTHER TO SERVE THE FOLLOWING FACILITY ~ ~l ~q , -~ ~C'/ ~d~/¢~ TO BE INSTALLED BY_ ~ ~.~ .xC~ t)5/ , , PERC0kATION TEST RESULTS ANTICIPATED gATE 0F COMPkET~0N. BELOW T0 BE FILLED OUT BY HEALTH DEPARTMENT AS DESCRIBED BELOW. SIZE OF U, NIT~TO BESERVED _, TANK SIZE SEPTIC ~ , DISTANCES: TYPE ·,-~ ~..>,s/'~ SEEPAGE AREA~~''½// DIAGRAM OF SYSTEM .TYPE gray sandy gravel (ON) ' I stzng Service Inc o~ 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 Parcel I.D, # o'l ~ / ct, / CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 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 Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. 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 OF WASTEWATER 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. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, ] verify that my investigation of this Health Authority Approyal 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. Engineer's signature Phone Date DHHS SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: By: Additional Comments 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 DH HS 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~)25 (Rev. 1/91) Back MOA #21 MuniciPality of Anchorage [~ E C ~-71V E D ~ DEPARTMENT OF HEALTH & HUMAN 8ERVICE~ ~nvironmental 8e~ices Division 825"L" Street, Room 502 · Anchorage, Alaska 99501e (907) 343-~~ ~ 6 ~7 Municipality of Anc',horag~ Dept, Health & t-lurna~l 8er~[oos Health Authority Approval Checklist Legal Description: "7/~/c .4_~:/~z~:~ ~-~, .,~ ~T- we? Parcel I.D.: A. WELL DATA Well ~ype _~,~z / z/~ ~-~ Log present (Y/N) ~,~ Date completed Total depth / ~cr~/'? Cased to ~/~/ Sanitary seal (Y/10 ~ If A, B, or C, attach ADEC letter. ADEC water system mtmber Casing height (above ground) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level WATER SAMPLE RESULTS: Coliform ~ Nitrate Dateofsample: /~ .~ ,,-'Seq ~' O, / Other bacteria Collected by: /:2z~'~:v ,r>z_~. /t~:~s/ Foundation cleanout fY/N) Date of Pumping ~_~*~r/rfiy' C. ABSORPTION FIELD DATA Date installed ' Length / ~ ~7 Width Depression (Y/N) /~ Soil rating (g,p.d,/ft~ or ft2/bdrm) ~,¢~>--~z~, System typo ./,~/7/ Gravel flfickness below pipe ,~/z-/', Total depth ~ Effectiveabsorpti0naro~i" .~J4.4/?-~2~4onitormgTnbepresent(Y, qq) y' Depression over field (YfN') /L/ Date of adequacy test ~r/~-z°//(~ ;7 Results (Pass/Fail) ./4~.~Lr~ For .~5 bedrooms Fluid depth in absorption field before test (in.); ~ Immediately after~gal, water added (itt.): / Cleanouts (Y/N) .3/ High water alarm (Y/N) z~.,~ Fluid depth '-'~ (ins.] Mimttes later: Peroxide treatment (past 12 months) (Y/lq) Absorption rate Ifyes, gtve date g.p.d. g.p,m. B. SEPTIC/HOLDING TANK DATA Date installed _ ' ~'Z/';/,o Tank size/,vz)Z)d~.~.. Number of Compartme tts D. LIIFi? STATION Date installed Size ill gallons Manhole/Access (Y/N) "Pump on" level at* High water alarm level at* ..__~-~ *Datum Cyeles'tes~ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line .; On adjacent lots .; On adjacent lots Public sewer malthole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Bnilding foundation 7'~~ -/z~/ Proper~ line 2~.~-~Jx Absorption field Water main/service line Y'e~//, Surface water/drainage ~'~'~'~ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation /.g ~ ~</. Property Line O///:~/, Water main/service line Surface water m'~),*~'~e, .o~r',a'2'~e?o-~:ct Driveway, parking/vehicle storage area Curtain drain ~,o ~,o.c~'. Wells on adjacent lots w ~ ~ F. ENGINEER'S CERTIFICATION HAA Fee $ Waiver Fee $ ' ' ~%~ ~ Date of Payment Date of Payment Receipt Number Receipt Number Rev. 8/95 OSS: lma.wk.doc M~-24-1997 14:19 CTgE ESI ~NCHO~GE Environmental Services Ino, CT&E Ref.# Client Name Project Name/# Client Sample ID Matrix Ordered By PW$ID $~p1¢ Remark: This i8 a Preliminary reDort 971321001 Doug]as Ke~¢y T12N R3W SEC 33 LOT 18 Water Drinldng Water Client PO# Printed Date/Time 03/24/97 14:06 Collected Date/Time 03/20/97 15:35 Received Date/Time 03/21/97 10:45 Tedmical Director: Stephen C. Ede Rosu[ts PQL Units Method Altowab[e Prep Anoty$1$ Lfmits Date Oate 0,100 U 0.100 mg/L SM18 4500-NO3F 10 max 7 08 w/out eoli $H18 9222B 03/21/97 JRL 03/21/97 RAM 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 ENVIRONMENTAL SERVICES DIVISION Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 1. GENERALINFORMATION 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 BEDROONIS: -"/ TYPE OF WATER SUPPLY: Individual well Community well 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: I! community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev 1191) F~onl MOA #21 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 ~?¢%-'~'-' -'~- ~- .~.-~.~-~-~- ~/ Phone ("~'~'~¢~ x¢/~ '- ~V'~ Address <~¢~'~: ~; /%~' /:~" .':0~'~:.~ /~ ~t ~'~. Date 2;) ' ~ ~ · ~ ~ Engineer's signature DHHS SIGNATURE Approved for bedrooms, Disapproved. Conditional approval for .-~cu,< (~/'). bedrooms, with the following stipulations: Escrow monies to perform all work necessary to install post tank cleanout(s) and existing crib as required. (See engineer's letter dated 3/25/97) Muui~s Lo ~.laiu iu ~c~.ow uutil fiu~l approval is g[aute~rom ~his department. All work must be completed by no later than June 15, 1997. Additional Comments By: _ 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 DH HS does th is 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~)25 (Rev 1/91) Back MOA ¢21 Douglas T. Kenlay P.E. 8176, 9960E Pttffin Drive, Pabner, Alaska 99645 (907) 746-1073 March 25, i997 Mr. Jim Williams Municipality of Anchorage Dept. of Health and Human Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 RECEIVED [,,,i,,?, 2 ~ t% ( Mu~iclpaliiy of Anchorage, Health & Human Servie~,~$ Re: Tract 12N, Range 3 W, Section 33, Lot A, Anchorage, Alaska Mr. Williams: The owner of the above referenced property wishes to apply for a conditional Health Authority Approval for the property. A new home has recently been constructed on the parcel with a new well and septic system. Also existing on the lot is a separate well and septic system, serving a separate home, that were both installed in 1970. As part of your review of the as- built documentation for the new system, you requested that the existing septic system be either abandoned and removed, or tested for adequacy. You explained this requirement is due to the fact that Health Authority Approvals are issued to a property, and not to an individual on-site system. The second system was subsequently tested, with passiug results, last week with one exception. There appears to be a slight blockage in the line between the tank and the existing seepage pit. In that this is the only detriment identified during our adequacy test we request that a conditional approval be granted until the summer when the repair can be more easily accomplished. It our opinion that no detrimental or adverse conditions would occur as a result of this conditional approval. There is currently no one occupying the house served by the septic system and there will not be until the repair is made. We also confirm that the condition is not in violation of a health code. When the repair to the line is made, the conditional approval should also stipulate that the Owner add an after tank clean out as currently required by the Mulficipality. We would appreciate your consideration of request in light of the issues discussed above. Please call me directly with any questions or comments you may have that would expedite the completion of your review. Sincerely.: Douglas T. Kenley, P.E. AK. P.E.#8176 Municipality of Anchorage /~J~'~L~ DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division MUNiCIPALII'y OF ANCt 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907-)"I~N~,N~a'~',~L $1:RVI¢;[!S DIVISION Health Authority Approval Checklist A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~*-~ Cased to .-'~ o _ Casing height (above ground) .~. Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform '~-' Nitrate Date of sample: .'~z,~ //...~ / B, SEPTIC/HOLDING TANK g,p.m, g,p.m. /2~ 1 Other bacteria ~" Collected by; Date installed/~¢,~,' ~/'Y'~'~ Tank size/~-~'~ ~.-~,z- Number of Compartments ,~'- Cleanouts (WN) Y Foundation cleanout (YIN) ~ _ Depression (YIN) ~ High water alarm (YIN) Date of Pumping .~ Pumper C. ABSORPTION FIELD DATA ~ ~/'~/'~x~ Z ~'~ ~ Date installed /¢/~. ~ /2~ Soil rating (g.p.d,/fF or fF/bdrm) ~" ~'~ System type Lengthg~/A~,r~/~idth ~/~// Oravel thickness below pipe ~ Totaldepth Effective absorption area ./~/~onitorin~ Tube pm~ent (Y/N). Y _. D~pres~ion over field (Y/N) Date of adequacy test .~l~/~ Result~ (Pass/Fail) ~ For ~ b~ Fluid depth in absorption field before t~st (in.); ~ Immediately ~_~~dded (in.)'. Fluid d~pth (in~) Minutia/- Absorption rat~ = g.p.d. Bemxid~t~tment (pa~t 12 months) (Y/N) If ye~, giw date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Size in gallons "Pump on" level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line -'¢-0-"¢/~/ On adjacent lots /¢~ ,,~,z On adjacent lots ..,z, ~o .-,,-/z~ Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ,2'-4~,~','¢ Property line ~ -¢','~ Absorption field ~¢"¢~'"~'~-"~;~'-- Water main/service line '~ '¢/%,z Surface water/drainage /'¢~ '"/~ Wells on adjacent lots /¢/J ~'-/:/' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line -{'/~b-/--¢. Building foundation /-~¢,~/'/, Water main/service line Surface water / ¢ ¢ c-/r;./. Driveway, parking/vehicle storage area Curtain drain -¢~',¢~'- ,'¢-.~'¢~¢~'~ '~'~ ~x-/~/~ Wells on adjacent lots //2 z~ F, ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and revieu in conformance with MIDA HAA guidelines in effect on this date. Engineer's Name Date ~are HAA Fee $ /--/~ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number CI'&E Environmental Services Inc. CT&E Ref.# Client Name Project Name/# Client Sample ID Matrix Ordered By PWSID Sanlple Remarks: 970646001 Douglas Kenley P,E. TI2NR3WSec3Lot 18 T 12 N R3W Sec 3 Lot 18 Drinking Water Client PO# Printed Date/Time 02/14/97 10:52 Collected Date/Time 02/11/97 10:00 Received Date/Time 02/11/97 10:55 Technical Directm': Stephen C. Ede ResuLts POL Units Nethod AlLouable Prep AnaLysis Limits Date Date Init Nitrate-N 0.100 U 0.100 mg/L SM18 4500-NO3F 10 max 02/12/97 JBL Total Coliform 0 co[/100mL SH18 9222D 02/12/97 RAN