HomeMy WebLinkAboutT12N R3W SEC 33 LT 52
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904
ON -SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP221363
PID Number: 018-192-17
Page 1 of 3
Dwelling: M Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: n New n L)nnrarla
Name
y
MARY & EIVIN BRUDIE
ABSORPTION FIELD I SOUTH/NORTH
❑ Deep Trench ❑® Wide Trench ❑ Bed ❑ Mound
Site Address
14320 SABINE STREET *ANCHORAGE, AK
❑ Other
Phone Tmber of Bedrooms
907-240-0135
Soil Rating Total depth from original grade
0.8 GPD/SF 8.7/8.07 AAAYI Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade Gravel depth beneath pipe
SEE DWG. Ft. 4/4 Ft.
Subdivision Block Lot
52
Fill added above original grad
SEE DWG. M?1?
Gravel length
Township Range Section
T12N R3W 33
II
�' Ft.42/43
Ft.
Gravel width
5�
Beds: Number of Lines
-
Distance between lines
SEPARATION DISTANCES
To Septic Absorption Holding Sewe7
Tank Lift Station
Field
From Tank
__ Ft.
Total absorptio area
Number of trenches
- Ft.
Dist. between trenches
Lind
SS—C' ` W
2
$+ Ft.
Well
100'+
100'+
100'+
-
25'+
AN El3S is [9 S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Capacity
Surface Water
100,+
100,+
100,+
-
GREER TANK
1500 Gal.
Material
Number of compartments
Lot Line
5'+
10'+
5'+
-
NA
PLASTIC
2
Foundation
10,+
10'+
10'+
-
LIFT STATION
Manufacturer
Capacity
Remarks OLD TANK DECOMMISSIONED PER UPC PER CONRACTOR
GREER TANK
500 Gal.
Alarm location
Electrical installed by I
n Wnf
Installer
PIPE MATERIA House to tank D3034 Tank to D 1785
drainfield
GLW
Drainfield D3034 CO/MT D3034
Inspector GEG AND MOA
BENCH MARK (Assumed elevation) 100.00 ft
Inspectiones: 1s' 10/19/22 2�a 10/24/22
Location and description
3- 10/24/22 4- 10/25/22
GARAGE SLAB
B
ON -SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval: Date
oo6�Op��
o ��.•••"• �
H .70 0
..
..............................
{
Septic System
Approved
O .Je je* AGa . rness.:
09. AG-795 �QD
00E
Date r I zo zoz
4pfe� t 1�
Note: this approval does not include well permit requirements.
Qea i �� o
p p�°fessi°n°o�
��0`�p0o�
(Rev 05/02/1A)
#AECC884
VISTA tt/27lz3
ERMIT NUMBER:
POSP221363 RECORD D RAW I N G PARCEL ID NUMBER:
018-192-17
A
I B
DBL1
47.6
53.6
DBL2
47.7
53.9
MH1
47.3
54.2
MH2
47.6
56.4
C01
69.8
79.0
MTi
68.9
78.1
CO2
79.3
75.1
MT2
80.3
76.0
z
CO3
91.9
w
I
MT3
NLUC04
91.4
MT4
92.44
NOTE: PIPE LOCATIONS ARE
H
SHOWN PER GEG SHOTS
o
TAKEN WITH LEICA DISTO
S910 LASER DISTANCE
I
METER. SWING -TIES TO
HOUSE CORNERS WERE
I
GENERATED IN AUTOCAD.
MT
ICO
F
C O
MT
CONVERTED TO 4"
PRIOR TO FLOW SPLITTER
D3034 10'
�. NEW 1500 GALLON HOPE GREER
TANK,
USED AS STEP TANK—
I
IT IS REPORTED THAT THERE IS AN FCO INSIDE
THE HOUSE IN THE BASEMENT SHOWER
DRAINFIELD
�02
2
♦♦
7.H.#1 /
,DBL1,h(2 /
EXISTING 4
BEDROOM HOUSE
DRIVEWAY
EXACT LOCATION OF EXISTING SEWER LINE IS
UNKNOWN. SEWER LINE AND WELL WERE
INSTALLED PRE-1982 AND THERE WAS NO
SEPARATION DISTANCE REQUIRED AT THAT TIME
i fit EE ING GRO" U P, Ltd
ENGINEERING SALES* NSUMNfi
3701 E. TUDOR ROAD, SUITE 101 -ANCHORAGE, AK 99607 -PHONE (907) 337E179 -PAX (907) 336.3246 ` WEBSITE: w .games gineering.wm
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
MARY AND EIVIN BRUDIE 907-240-0135 2 OF 3
LEGAL DESCRIPTION: DRAWN BY:
T12N R3W SECTION 33 LOT 52 D.J.G.
TYPE OF WORK: DATE:
SEPTIC SYSTEM RECORD DRAWINGS 11/29/2022
'E;,�.. Ni,
AV
c,' �1
.�.,...4 ....................
.'; ;�.. Oka.... ......... .;
#♦� CE- 953 .� �!
� ,.•�' i
LICENSE ft. M\\�\�+►•
#AECC884 J
PERMIT NUMBER: RECORD D RAW I N G PARCEL ID NUMBER:
OSP221363 018-192-17
TOP 01
INVERT OF I
ORIGINAL GRADE AT
HIGHEST POINT = 103.09
T.H. #1
NEW 1500 GREER TANK WITH ANCHORAGE TANK
COMPONENTS TO BE USED AS LIFT STATION
NORTH SOUTH
T
4.0'
T
RELATIVE ELEVATION OF
BOTTOM OF T.H. = 87.09 (DRY)
).M
1.87-99.99
cT = 91.35
FINAL GRADE = 103.17-103.35 ILT O FINAL GRADE = 103.03-103.51
ORIGINAL GRADE AT
HIGHEST POINT = 103.75
r FILTER FABRIC 1 T.H. #1
TER FABRIC
INVERT OF PIPE = 99.03
INVERT OF
PIPE = 99.05
BOTTOM OF TRENCH = 95.02
S—` I BOTTOM OF
TRENCH = 95.05
8'+
RELATIVE ELEVATION OF
BOTTOM OF T.H. = 87.75 (DRY)
AV
4
a ................ ..... ..
- ENGINEERINGoSALES* CONSULTING
3701 E. TUDOR ROAD SUITE 101 'ANCHORAGE, AK 99507 -PHONE (907) 337-6179 • FAX (907) 33&3246' WES&TE: wv. v.garneeeengneenN,. ............ ....... • 0
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: ••••• f ~
MARY & EIVIN BRUDIE 907-240-0135 3 OF 3 `j :'. a' re AV
LEGAL DESCRIPTION: DRAWN BY: #� �Y(�•••.• 1•. �E-79153amess
•% `
T12N R3W SECTION 33 LOT 52 D.J.G. �,'• �� ;� . P ♦��►
TYPE OF WORK: DATE:
SE
� SEPTIC TANK PROFILE 11/29/2022 LICE
84v, lkik"**
LW
0
0
O
Oi
CA
w
m
(A
G.W
O
0
r r\
S 89'58'33" E
329.71 '
T r ron-t. Se -back
f
i
no 1
a ,U1
v)
Septic
Shed
Q-
Field
WOW
17' x 12'
'.�.
I
®C 0
C.O.
n i
Septic
Ta n k
o
/Lids
—1b j
67.3
a
c
S 89'59'27" E 329.66'
House
1 i t
I
I
I �u
4
Gravel 1 c, z
Driveway (T)w a
w
W
a
L 52
I^
Building Detail
Paved
24.0' Entry
4%. o Deck
-a
8.0
0 20` 5
�O O
I ,
r, r, Deck 45.1
NOTES I Basement Window Egress'
1. Bearings and distances are record per referenced plat unless otherwise noted.
2. Sufficient boundary evidence was recovered to establish the subject parcel on the ground. Not all
controlling evidence is shown hereon.
J
OF At;q tl
49TH ..
Robert 0. Lumpkin : Q
�i•- No.10459 �A'
farpoint Land Services, LLC
LEGEND
SURVEYING, MAPPING, LAND PLANNING, GIS
Rebar
!iarpoin
Monument
1 13 1 E. 7Gth Ave., 5uite 101 Anchorage, Alaska 995 18
n Septic Vent
FtAK.com • (907) 522-7770 • survey@farpointak.com
ILc-O
ASBUT SURVEY OF:
SURVEY CERTIFICATION: FARPOINT has conducted a physical
Power pole
T12N R3W Sec 33 Lot 52,
survey of the subject property, the improvements situated
O Septic Lid
Anchorage, Alaska
thereon are within the property lines as shown.
EXCLUSION NOTES: It is the owners responsibility to
PREPARED FOR:
determine the existence of any easements, covenants, or
restrictions which do not appear on the Plat used for this
Eric Brudie
14320 Sabine St
WORK ORDER No
DATE:
NOV 10, 2022
SCALE:
' —
1 '-60
ZONING:
R6
22121 � �
1
survey. NOTE: Under no circumstances should any data
hereon be used for construction or for the establishing of
Anchorage, AK 99516
DRAWN:
CHECKED:
GRID No:
FB BOOK/PAGE:
CB
ME
SW3034
164/12
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221363, Curtis Townsend, 09/27/22
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221363, Curtis Townsend, 09/27/22
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221363, Curtis Townsend, 09/27/22
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221363, Curtis Townsend, 09/27/22
GR[ ':R ANCHORAGE AREA BOP IGH
Department of Environment quality
3500 Tudor Road
Anchorage, Alaska 99507
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME f///'/ ~ ~-¢?'~ _ MAILING ADDRESS~./ ,~/-2,X'~z-/ PHONF
LOCATION--~¢-~'--'¢'~'/~/~'"~/¢'-;/~/~'//// LEGAL DESCRIPTION /~//~'_~'~.~ ...C¢~:~, ..-~g.~
SEPTIC TANK:
DISTANCE ~/~-' NUMBER OF
/
FROM WELL ~' ~ ' MANUFACTURER,~2ZP~///~'/~/Z)-¢J'' MATERIAL ~--~/~ __COMPARTMENTS
INSIDE LENGTH '-- iNSIDE WIDTH ~ LIQUID DEPTH ---' LIQUID CAPACITY~C~/,{~GALLONS.
TILE DRAIN FIELD:
~ / /~/~¢ TOTAL LENGTH
DISTANCE FROM WELL ~ FOUNDATION ~/ NEAREST LOT LINE~~/~ OF LINES
NUMBER OF LINES DISTANCE BETWEEN LINES ~ '~ TRENCH WIDTHS/ IN. TOTAL EFFECTIVE
ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE ~~~
/ DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE/~ ' ' / ~ IN.
~/~MATERIAL BENEATH TILE ~ _IN. ABOVE TILE
WELL:
TYPE ~,~E' /~-~'~-~.~ CONSTRUETION_ ' ~",/Z~/~'~'~] ___DEPTH ,¢-/~t'/-~¢ DISTANCE FROM:
BUILDING
F 0 U N D A T I 0 N~,~,~,~,~,~,~,~,~,~¢
NEAR
LOT LINE~-/¢~'J~' ,
NEAREST
SEWER LINE
SEPTIC x SEEPAGE
TANK ~'~/'/ , SYSTEM
CESSPOOL./_~'¢>'/~:~ , OTHER SOU RCES t/P/~ /C"/J/~/~-¢~/
APPROVED
DISAPPROVED
I N ST A L L E D B V: ~'A'~/) ~/~'¢¢2Z)'¢-~'
SEWER LINE DEPTH:
PIPE MATERIAL:
DIAGRAM OF SYSTEM
LOT SLOPE:
REMARKS:
G.A.A.B.
Form PW-027
SEWAGE DISPOSAL SYSTEM --~ APPI_ICA!F~ON AIND PEftMFF
5 fi:.
zl 9,9
1'1 Fi'ED WITH AI~ITIGIIT REMOVABLH CAPS.
~ATEP A!ICHQRAGE AP, /~ BOROt
DEPAP, IHE¢Ii' OF £iiV[ROFi[!Ehi;\L OUAt. ii'
350Q TUDOR ROAD
A:ICtlORAGE, ALASKA 99502
Performed For~ ¢~td~-
Leqal Descrintion: kot~_Block____
This Form Remorts Soils Loq X
Bate P e Y 'f o r rn e d _y/_2~/~]~_
Subdivision Seo 33 T ~N R 3 X.
Percolation Test
Deoth
Feet Soil Characteristics
SM si3;by sands
(~0)
Was Ground Water Encountered?___mo_
I¢ Yes, At what Denth?
F
Readinq Date Grnss Tinle Net Time Benth to 1120 Net Drop
Fercolation Rate r!inute
Proposed Installation: Senr~aae Pit__ ~ ..... Drain Field ....
Demth of Inlet Oenkh To Roi:tom ~F Pit Or Trench
Pa~e:
MUNICIPALITY OF ANCHORAGE
i;
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Z 2 2 G
Parcel I.D. 018-192-17 Expiration Date:
Legal description T12N R3W SEC 33 LT 52
Site address 14320 SABINE ST Anchorage AK
Current property owner(s) MARVIN
X The On -site system(s) is/are approved for 4 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
By: L_
Original Certificate Date: 11 /20/2023
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 Services 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 work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory _
Absorption Field Advisory Nitrate Advisory X
Tank Age Advisory Arsenic Advisory _
Other
COSA ApprovaUune 2022
MUHMPAUTY OF ANch' ORAGE
Development Services Department A Phone: 907-34.3-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 018-192-17
Complete legal description T12N R3W SECTION 33 LOT 52
Location (site address) 14320 SABINE STREET *ANCHORAGE, AK
Current property owner(s) MARY & E I V I N B R U D I E
2. ON -SITE SYSTEMS SIZED FOR 4 BEDROOMS
Day phone 907-240-0135
3. TYPE OF WATER SUPPLY: M Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL: 0 Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel n Plastic ❑ Concrete ❑ Fiberglass
Age NEW - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed ❑ Deep Trench 0 Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
Distance:
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 $ 7ij�d Waiver Fee $
Date of Payment 11
/ � / - U -Z
COSA# OSc,Z3i/Y.34--
Date of Payment
Waiver #
COSA Application —June 2022
COSA Checklist
Legal Description: T12N R3W SECTION 33 LOT 52 Parcel ID: 018-192-17
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled `58/59? Total depth *`104.6+ ft
Cased to LINK ft
0 Sanitary seal is functioning correctly
X Wires are properly protected
Casing height (above ground) 12+ in
Date of flow test for COSA 8/24/22
Well production at time of test 7.3+ gpm
Water storage tank volume N/A gallons
Well -disinfected for coliform test? ❑ Yes N No
INI Coliform bacteria
Nitrate 3.78//�ma a/L
Arsenic ug/L
Collected by GEG
Static water level at beginning of test 98 8 ft. ate 8/3/22 6o It 40 23
Comments *PER PREVIOUS COSA **PER GEG WELL TEST
B. TANK DATA
Measured operating fluid level in septic tank NEW
Date of pumping N/A
❑ Required maintenance completed, if AWWTS
Comments: NEW INSTALL - RECORD DRAWINGS ATTACHED
D. ABSORPTION FIELD DATA NORTH/SOUTH
Which system tested (date installed) 2022
R ALL standpipes present per record drawing
Total measured depth from grade 8.3/8.5 ft (max)
Measured depth to pipe invert from grade 4.14/3.98 ft (min)
❑ N/A — pressurized field.
❑ Per record drawings, field is insulated.
0 Monitor tubes go to bottom of effective.
If not, state depth into effective
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced - gallons - date
Any rejuvenation treatment (past 12 months) -
If yes, enter date -
Comments/Deficiencies:
Negative
❑ Nitrate less than MRL (ND)
*A, rsenic less than MRL (ND)
C. LIFT STATION
0 Required maintenance completed
Age of lift station NEW years
Lift station material PLASTIC
Comments:
Adequacy test date N/A
Results Q Pass
Fluid depth prior to test - in
Water added - gal
New fluid depth - in
Elapsed time - min
Final fluid depth - in
Absorption rate 600+ gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 48 in
Effective depth used 0 in
Effective depth remaining 48 in
COSA Checklist June 2022
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100'
DYes if No ft M Yes if No ft
Neighboring Tank > 100' ❑i Yes if No ft Private Sewer/Septic Line > 25' ❑ Yes if No *LINK ft
Absorption Field on Lot > 100' E Yes if No ft Holding Tank > 100' RYes if No ft
Neighboring Absorption Fields > 100' Animal Containment > 50' R Yes if No ft
❑i Yes if No ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' MN Yes if No ft Q Yes if No ft
❑ N/A — Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10'
Q Yes
if No
ft
Surface Water > 100'
Q Yes if No ft
Tank to Property Line > 5'
Fil Yes
if No
ft
Wells on Adjacent Lots:
Field to Property Line > 10'
Q Yes
if No
ft
Private Wells > 100'
0 Yes if No ft
Water Main > 10'
no Yes
if No
ft
Community Wells > 200'
0 Yes if No ft
Water Service Line > 10'
M Yes
if No
ft
If tank or field is under driveway comment below
F. ENGINEER'S COMMENTS
*SEE RECORD DRAWINGS
- EXACT LOCATION IS UNKNOWN
G. CERTIFICATION & STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines, indicates that the on -site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm Garness Engineering Group, LTD. (GEG) Phone 907-337-6179
Engineer's Printed Name Jeffrey A. Garness Date
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in
accordance with the guidelines and regulations established by the Municipality of Anchorage and industry
practices. The reported results describe the condition of the system/s on the date/s of the evaluation.
Separation distances were measured to readily identifiable features. Hidden defects or encroachments may
exist that were not identified during the evaluation. The operational life of all wells and septic systems depend
upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate
during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing
the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not
guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding',
the future performance of the well or septic system. GEG makes no representation whether an alternative well
or septic system can be installed on the property in the event either of the current systems fail to perform
adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG .
to perform the evaluation. Reliance upon the information provided in this report by any other person or party
(including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever.
0 acs
E `a
COSA Checklist June 2022
—Nitrate Advisory
Certificate of On -Site Systems Approval # OSC231435
Subdivision: T12N R3W SEC 33 LT 52, Block: --, Lot: ---
A water sample revealed a nitrate concentration of 5.34 milligrams per liter (mg/L).
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Since nitrates are known to slowly increase, we recommend
you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for
important information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
Mailing Address P J OBpx 196650 Anchorage,'Alaska 99519 6650 * www muni org
r
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
Mailing Address P O Box 196650 *Anchorage, Alaska 99519 6650 *tiwww muni org
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTEC'I'ION
DIVISION OF ENVIRONMENTAl_ HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
GENERAL INFORMATION
(a)
(b)
(c)
Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
Applicant Name /~-:~: t/:-/~' ,,~/~'(?,?2.¥~ Telepbone: Home 8usinoss
Applicant Address
Applicant is (check one): Lending Institution []; Owner/builder I'q; Buyer[~; Other [] (expLain);
(d)
(e)
Real Estate Company and Agent
Address ~z~,/~¢
Telephone ,
(f)
Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family'[~]/ Multi-Family [] Other
N.mber of-Bedrooms
WATER SUPPLY
Individual Wel Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsit(~[~ Pubtic [] 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 72-025
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA Ar,iD INFORMATION
As cedified by my seal affixed I~ereto and as of the validation date shown below, I verify that my i nvestigatiou of this Healtl~
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 Munioipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance witi~ all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Approved for~_ bedrooms b~;~~~c~ ~ Date _~/~//~..~',
Approved ~ Disapproved Conditioi~al'~
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based sorely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does tills as a courtesy to purchasers of homes and their ]ending
institutions in order to satisfy certain lederal 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)
M~NIC[PALITY OF ANCHORAG~
DEPT. OF HEA~TH &
~NV[RONM~N~A~ pRO~ECTION
2 2 986
WELLDJ cEIVE
MUNICIPALITY OF ANCHORAGE (MOAi
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description: ~-(P/
'~"/-::/ '- If A, B, C, D.E.C. Approved (Y/N)
Well Classification ~//_~;:[/×~; ?2L: , /
Well Log Present (Y/N) /~'~"~ ~o/., Date Completed
Yield
TotalDepth ('[i~" "/~ Casedto / [_~' ¢- Depth of Grout,ng
Static Water Level
Casing Height Above Ground //~<~ '~'
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well: '
To Septic/Holding Tank on Lot __
To Nearest Edge of Absorption Field on Lot
Pump Set At
Sanitary Seal on Casing (Y/N) ~
Depression Around Wellhead (Y/N) //F/
To Nearest Public Sewer Line
Cleanout/Manhole __
Water Sample Collected by
Water Sample Test Results
Comments
; On Adjoining Lots
; On Adjoining Lots
"/?'~ ~ To Nearest Public Sewer
To Nearest Sewer Service Line on Lot .,/r'~7 ."' '
..,
SEPTIC/HOLDING TANK'XDATA ~/'~ ~-'~ '; .~
Date Installed ~,~~ize ~_~c/ No. of Compartments "~
Standpipes (Y/N) _ I ~/ ' Air-tight Caps (Y/N) /V Foundation Cleanout (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N) ~//;'/
Separation Distances trom Septic/H, oldin9 Tank:
To Water-Supp y We
TO Property Line r~ k""
TO Water Main/Service Line
Oate Last Pumped -:' :'/~
; for
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Course
Comments
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata ~V~'~'~'
Date Installed ~ ? '-'
Width of Field _ ,--4'?/
Square Feet of Absorption Area
Depression over Field (Y/N)
Type of System Design~
Length of Field .~', ~
Depth of Field ./~72 ~ ¢
Gravel Bed Thickness -~¢~ '"
Standpipes Present (Y/N)
Date of Last Adequacy Test
//
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well //¢~--~ (~ -
To Building Foundation
Lot
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Coursa
To Driveway, ~arking Area, or Vehicle Storage Area
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if present)
,/(/ ///
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Oft" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test, Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify thai 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. ~ ~' ~¢' ?,~ ..2_.
Date of Payment %-~-~- ~"1'-'~--~, ,~'-~? 2~-o0 ~
Amount: $ '<%~ -¢"-"~ ~ ¢-~- ~"~' ~
Page 2 of 2
72-026 ( 11/841
_~ Datum Engineering_
& Surveying, Inc.
(907) 563-3 ~ 42
4500 Business Pc~rk Blvd.
Doturn Building
Anchorage, Alaska 99503 June 11, 1986
Mr. Elvln Brudie
14320 Sabine Street
Anchorage, AK 99516
RE: Adequacy Testing on Existing Sanitary Sewer System
Lot 52, Section 33, T12N, S.M, Alaska
Dear Brudte:
On June 10, 1986, DAllJM ENGINEERING & SURVEYING, INC., performed
an adequacy test on your system. A total of 1,810 gallons of water
was introduced into the primary compartment of the existing 2,000
gallon tank. Water was injected over a 345 minute period. The average
injection rate was 5.2 gallons per minute,.
The distance between the top of the standpipe and the top of
the measuring rod was 35-1/2 inches at the beginning and remained
constant throughout the duration of the test.
The house is currently occupied and therefore the system is
at it's normal degree of saturation.
Based on a six (6) bedroom house at 150 gallons per day per
bedroom, the daily design flow should be 900 gallons per day. DATIJN
ENGINEERING & SURVEYING, INC., injected 1,810 gallons of water with
no rise in the septic system; therefore, we may conclude that the
system is adequate.
If you have any questions or require additional services, please
call.
Sincerely,
Bruce D, Patterson, P,E.
Principal
BDP/cc
~:IF..
1:1'7
II
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II
II
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1: ~t'7
II
~TY OF kA~CJ-IORAG~
MUNICIPALITY OF ANCHORAGE DEPT.
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEDTIO~NviRONM[i,q,~/\L
825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720
DIRECTIONS: Complete all parts on page 1, Incomplete requests will not be processed, Please allow ton (10) days for processing,
1, PROPERTY OWNER . PHONE
Eivin/Mary Brudie 344-2261
MAILING ADDRESS
726 K Street 99501 279-6535
PHONE
PROPERTY RESIDENT (If different from above)
~ BUYER ~
PHONE
MAILING ADDRESS
3, LENDING INSTITUTION
Alaska Pacific Bank
PHONE
274-9661
MAILING ADDRESS
Post Office Box 420 99510
4. REALTOR/AGENT
{~HONE
MAILING ADDRESS
LEGAL DESCRIPTION
T12N R3W Section 33 Lot 52
STREET LOCATION
NHN Sabine Road
6. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One [] Four
L~ SINGLE FAMILY
I~] Two [] Five
[] MULTIPLE FAMILY [] Three :~X Six
[] Other
7. WATER SUPPLY
:Xl~l~t~ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled
[] COMMUNITY since June 1975. For wells drilled prior to that date, give well
[] PUBLIC UTI LITY depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
~ iNDiViDUAL/ON.SiTE~ **If individnal/on-site, give installation date 19"Z$/74 .
If system is over two (2) yeats old an adequacy test is required
[] PUBLIC UTI LITY by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED "'--'---~
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR I NSP ECTO R INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[/~/~/SI N G L E FAMILY [~] ONE [] THREE [] FIVE [] OTHER
~ MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
I~/~"" INDIVIDUAL DEPTH OF WELL
E~] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
I~DIVI DuAL/oN -SITE CATE INSTALLED
[]PUBLICUTILITY I ~ "~ ~-
Connection Verified
Size: ,~ ~ If Tank is homemade SOILS RATING
give dimensions: ~ ~.~
TYPE OF TANK M A N U F~.~ ~-'G~ .
TOTAL ABSORPTION AREA MATERIAK , ,. ~ A
4. DISTANCI~S'i~ELLvv TO: Septic/Holding Tank Ab~rption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
O
APPROVEDFOR__~ BEDROOMS
DisNDITIONAL APPROVAL (letter m~t accompany certificate}
DATE / '~'~'~ ( t ) ///
LEGAL DESCRIPTION
72-010 (Rev, 3/7S)
I'4UNICIPALI~¥ OI-'~'A\~C)J:P/'J2d,.~i~ / ~~ ~
( DO ~ : ' ' ~ :~' ~ ~ , ~ C AN~]~ORAGE
-~ ~(equest ~or Approva~ ol ]~kd vsdua]. ,~ov. cr a~lct ~,~aLc_r ~'ac}, ~,,
RECEIVED
]. Property Owner: EIVIN & ~RY BRUDIE
Mailing Address: .._~6_K P~S~P~_~gh~a-g~.-A~ Pi(one: 33~-65~5.
Name of Buyer-: ..... ~s_~a.~e~_as~._a_b,o_v_e_ ................................
Mai] Jng Address: .................................... } hen ..
Lend in g
Mailing
Institnbion: ALASKA PACIFIC BANK
Realtor/Agent: none
Mailing Address:
Legal Description: L52, Section 33, Township 12 North, Range 3 West - s~ga~cr-~idY~n
Street Location: NHN Sabine Road
Single Family Residence:
Mulhi. ple Family Residence:
( X~ Number of Bedrooms:
( ) Number of Bedrooms:
7 . Water Supply: * Individual Well ( X~ Publ. ic/Columuni ty System ( )
If Co~mnunJty System, name of system
Sewage Diaposal System: *';On--site System kX) Public System ( )
*NOTE: A well log is required on ALL wells drilled since 6/75.
** If on---site sewer syshem is over two(2) yeats old, an adequacy
tush is required by hhis departmenk.
A fee ef $25.00 must accompany each request before procesaLng
can bo in:i Lliabod.
3/77
MUNICIPALITY OF ANCHO~AG~
January 8, 1979 R&Mgt~RO~Sg~I~06 i, ,3 ,~C~tON
Mr. Elvin Brudie
726 K Street
Anchorage, Alaska 9950]
RECEIVED
Re: Adequacy Test on Existing Sanitary Sewer System; Lot 52, Section 33,
T12N, R3W, S.M., Alaska
Dear Mr. Brudie:
Per your request of December 26, 1978, we conducted a test of the sanitary
sewer system on the above described property.
During this tes{ the liquid level in the septic tank was monitored as water
was added to the system. The measurements are sunmmrized in the following
table:
Liquid Level Below Top Total Gallons
Time of Standpipe Added
11:05 10.8' 0
11:20 10.7' 50
11:45 10.7' 150
12:10 10.7' 250
12:12 10.8' 250
12:15 10.8' 250
12:30 10.8' 250
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 6 bedroom residence on the property is to house 12 people, the average
load on the system can be expected to be 900 gallons per day or .63 gallons
per minute. During the test, the system accepted 250 gallons in 67 minutes.
This indicates an average effluent acceptance rate of approximately 3.7
gallons per minute at the time of the test.
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 6 bedroom resi-
dence.
January 8, 1979
Mr~ Elvin Brudie
Page -2-
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~
Ernest R. Raha±m
Staff Geolog±st
ERR/GAS/12-A