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HomeMy WebLinkAboutT12N R3W SEC 33 LT 225AT12N R3W Sec 33 Lot 225A #018-332-24 Municipality of Anchorage '' .0 Development Services Department Building Safety Division " On-Site Water and Wastewater Program, 4700 Bragaw St. P.O. Boz 196650 Anchorage, AK 99519-6650 Page of w A.snchorege.ak.us (907) 343.7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SWO60356 PID Number 01"32-24 Wastewater System: [:]New 0 Upgrade Norlin & use Webers �W 3700 Dora Avenue Anchorage, AK 99516 ABSORPTION FIELD per. 440-4787 Munwae.eaa�r.4 o0m;,Twa mstWw Tm 139W OMona Ooarr sa PAWg carorpn Ran.gp p•uo LEGAL DESCRIPTION 1.2 rmo tl 6 Fl. 6ine.rrm DFM M pw aapao Rom onrul Vbr 011",0-Mwren ppo: 4 225A 2 Fl. FL Soman rarnrrp 12N Rr'v3W 33 Fa•aara MiM opw p.a•: 1-2 Gw!rpm n 5o Fl. Ft. Gy wMn Mrraratw Onrow Mr' Well: ❑ New ❑ Upgrade 5 Fl. 1 FI cw.nwAn (nnv.er, A B. cl. car orpII1 c"i° 1° ram tlwmixt 4MI.F? Soo ASTM ittotm 034 PVC Existing Fl. R pry Drslxr.a soot wrrt� wuMr Owner Installed 0•u nroura 11/1712006 n r.n Purpsrrt c.rrw�Wr�oor.Grou+a TANK GPM Fl. Fl SEPARATION DISTANCES 0 Septic ❑ Holding ❑ S.T.E.P. ❑ Other. To Septic Absorption UR Holding ub11JPrMte Ray's Services 1,300 Gr Fmm Tank Field Station Tank aerar Line MrrW. Munro a Cmponrrr. Iva >100' >100' >100' WA >2T HDPE TWO 'LIFT STATION ' srt.mwr« >100, >100' >100' N/A utu. >g >10' >6 WA 550 or uoua. Fat Boy-Ray's Services 'qnp an' Iwri •L 'I ar rw of rrpn wMr rrm r. Farermn >S >10' >S N/A 44 „ Pu Mw 6 Ma EMammi Jr-P a pntarur by C~Gr.n None Noted Goulds 20ES05 Muni of Anchorage Rr BENCH MARK Existing Septic Tank Pumped and Removed from Site. tmmn rr priapnn. Existing Absorption Trench Abandoned In Place. Garage Slab urvaoen 100.00 Fl. �qWf� Inspections performed by: A. Harala Dates: 1" 11/172006 OF �qs�0 r+r�F.�....... 2m 11/17/2006 4. tP•'rr' • 'f'+A •.' * �• 49� *�� Development Services Department Approval01 .N : .N •« Approval Date: Conditional .•Yw• ..o.« jOr LlOaua E AlDNl011 .�, or itE 4!381 i Date:. Reviewed and approved byA::4 i �t►�' lilt tx« o+mat Municipality of Anchorage Page 2 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 Bragaw Street Anchorage. AK 99519-6855-343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit No. SW060356 PID No. 018-332-24 ----------------- DORA AVENUE Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 Onsite Wastewater Disposal System or Well Inspection Report Permit Number. SWO60356 N N N = n nn 1,300 Gallon Septic Tank IJ 7-550 Gallon J/ Fat Albert 89.8 Pump Chamber PID No. 018332-24 PROFILE AS -BUILT - Scale: V-10' 91.5 t/ INSPECTION REPORT MUNICIPALITY OF ANCHORAGE, BUILDING SAFTY DIVISION 4700 ELMORE ROAD INSPECTION INFORMATION and HELP: (907) 343-7962 INSPECTION REQUEST: VOICE (907)343-8300 FAX (90T) 249•T77T ONLINE: www.munl.orcilBSDIinsoections.etm i00® TYPE OF INSPECTION: LIFT vm-noiJ REINSPECTION: YES NO COMMENTS: (FOR INSPECTORS USE ONLY) mex,reE.R RE-0oRr FbC2, U"l[>EIRcV-R00f-J Wtmt►JCT SF C�� G• LIFT S-rA-Y� onJ E t-- fZ,I GA Lr F t jJA-L— A�p�DV PRINTED DATE: 7 — H— Enos 9018 VOR OOZE etc 106 ZV3 WOO NOR 80/LO/LO Municipality of Anchorage .1 Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: Mike Anderson Legal description: T12N R3W Sec.33 Lot 225A ❑Permit ®C.O.S.A. ®Inspection Report The attached paperwork has been reviewed and is being returned for the following reasons: 1. M.T. for HDPE tank was not installed. Name of reviewer: Jeff Date: July 24, 2008 Please supply the necessary information and re -submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524, MEMORANDUM DATE: September 4, 2008 TO: Jeff Poet FROM: Mike Anderson, P.E. rU l SUBJECT: T1 2N, R3W, Section 33, Lot 225A The monitor tube for the HDPE septic tank has been installed. ; IV/it� r> , MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Nov 01, 2006 Expiration Date: Nov 01, 2007 Permit Number: SWO60356 Parcel ID: 018-332-24 Legal Description: T12N R3W SEC 33 LT 225A Design Engineer: 0014 ANDERSON ENGINEERING Site Address: 003700 DORA AVE Owner Name: NORLIN & LISA WITHERS Lot Size: 49439 SO. FT. Owner Address: 3700 DORA AVENUE Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99516 - This permit is for the construction of: Q Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy E] Private Well E] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: /(-/.0G Date: i MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water d Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Nov 01, 2006 Expiration Date: Nov 01, 2007 Permit Number: SWO60356 Parcel ID: 018-332-24 Legal Description: T12N R3W SEC 33 LT 225A Design Engineer: 0014 ANDERSON ENGINEERING Site Address: 003700 DORA AVE Owner Name: NORLIN & LISA WITHERS Lot Size: 49439 SO. FT. Owner Address: 3700 DORA AVENUE Total Bedrooms: 3 Permit Bedrooms: 3 ANCHORAGE. AK 99516 - This permit is for the construction of: E Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specked 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 engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Issued By: Date: /' - / - ()G Date: t Municipality of Anchorage -■ Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsfte (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 018-3 32-24 Property owner(S) Nowlin and Lisa Withers Day phone 440-4787 Mailing address 3700 Dora Avenue Anchorage, AK Zip Code 99516 Site address 3700 Dora Avenue Anchorage, AK Zip Code 99516 Legal description (Sub'd., Block & Lot) Lot 225A, T12N, R3W, Section 33 Legal description (Township, Range & Section) Lot Size 49.439 SF Sq. Ft. THIS APPLICATION IS FOR (® all that apply): Absorption Field El Septic Tank El Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ Number of Bedrooms Three (3) THIS APPLICATION IS AN: Initial ❑ Upgrade 0 Renewal ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. 4 (Signature of property owner or authorized agent) Permit/Rush Fees: L(J Waiver Fees: Date of Payment: r"I'Z't" /U(O Date of Payment: Receipt Number. W/O Receipt Number. (Rev. 11/05) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX October 26, 2006 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 225A, T12N, R3W, Section 33 Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The existing absorption system on the subject lot has failed and must be upgraded. We are therefore requesting a permit be issued for the upgrade of the septic system to accommodate the three-bedroom home on the lot. The attached Site Plan and backup documentation identify the locationand configuration of the proposed septic system. The existing septic tank will be pumped, crushed and backfilled with sand. The existing absorption system will be connected to the new system with a ball valve for possible future use. No conflicts exist between the proposed septic system and the systems on adjacent lots. Drainage arrows are shown indicating the current drainage patterns. The drainage patterns will be maintained after construction. The test hole placed on the lot at the location of the new absorption trench indicated poorly graded gravel with some sand (GP). The percolation rate was determined to be 3 minutes per inch. We are proposing to construct a 1,300 gallon HDPE septic tank and a 500 Gallon Fat Boy Lift Station with a 50' long by 5' wide absorption trench with 4' of gravel beneath the distribution pipe. The distribution pipe in the trench will be placed at 2' below the surface with the total depth at 6'. Groundwater was encountered during placement of the test hole at 10.2' below the surface and has stabilized at that depth during the monitoring period which has included very wet conditions. The ground surface on the lot in the area of the absorption trench slopes from the north at a grade approximating 10%. The trench will be placed parallel to the contours of the ground as much as possible and in conformance with design criteria. A minimum of 100' will be maintained between all components of the septic system and any surface water in the area and all private wells in the area. Lot 225A, T12N, R3W, Section 33 October 26, 2006 Page Two If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sin�cer'ely, A Zn ^ Michael E. Anderson, P.E. Attachments V 49th y MICHAEL E. ANDERSON v No. CE -4381 . 15A 215C 216 215B DORA AVENUE y I 1 \t 225B 225A /101 246 247 1 ..._N\\\\• 2 lot ,' • � ai 49th t�•• •...... T..�.�.A... .. ..... ''``"`-` AREA MAP •1� ; No, CEr3e1 ••••O\\ ESS; i��� SCALE I' - 100' DORA AVENUE r------------------------------------------ 161.n ' eW n««r+ --- 1 1 1 ' I 1 o � I GI I� iaryue� 15' u.a TM1® 1 1 1 I Flo a v.w. • Cnwal b 1 5 � ' iee � Fawa - 5.0m Ta I I 1 jFao I &drpe,,, Ilam $g 4 1 F F 1 1 1 g c 1 g� 1 I I 1 I I Z 1 1 1 1 1 I I I 1 1 I FAVwA MVI I 1 I I LOT 225A, T12N, R3W, SECTION 33 1 ' 1 16.1]6 L. i i I L---------------------------------------------- - M756'14'W 164.65 .tle"uNMM6, gg •, SITE PLAN I 9th 49th °. 4 SCALE 1' 40' ••,'' No. t[-1m1 � � LOT 225A, T12N, R3W, SECTION 33 DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home 5' Wide Trench System Perc. Rate: 3 Min./inch 1,300 Gallon HDPE Septic Tank Application Rate: 1.2 GPD/SF 500 Gallon Fat Boy Lift Station 4' Drainfield Rock 4 Bedrooms' 150 GPD/Bedroom = 600 SF Absorption Area 600 SF/1.2 GPD/SF/5 SF (Wdth)'.5 (Red. Factor) = 50 LF Trench Length THEREFORE: Construct a 50' Long x 5' Wide x 4' Effective Depth Absorption Trench. Flow Line Elevation in Trench to be 2' Below Original Ground Surface. Total Depth to be 6' Below Existing Ground. Provide 3' Cover Over Absorption Trench or 2" Direct Bury Insulation and 2' of Cover. Place 4' of Cover Over Septic Tank 2' Min. Natural 1'6" Backfill C01■ � tt•7 4'0" 5' 2" Insulation and Geotextile Fabric 1" Perforated PVC (Holes Down) 3/16" Holes @ 2' Spacing Drainfield Rock TYPICAL 5' WIDE TRENCH SECTION (NO SCALE) 4 NOTE: Grade Area Over Trench to Drain Away. Jc Minimum 6' Separation From Bedrock- edrockMinimum Minimum4' Separation From Groundwater. �)v Minimum 100' Separation From Private Wells in the Area. Minimum 100' Separation From Surface Water or Streams: YKIMELEANOE(i9p1 Na CE+ l 0(1 2- 3_ G 'I 4_a 1 17- 18- 2D - • N�N I SO WAS GROUND WATER Y ENCOUNTERED? t C 8 IFYES,ATWHAT DEPTH? IO-Zr L s Depth to Water After Monftcrinp? /D.Ze E i Date: Reading Date Gross Time Net Time Depth to Water Net Drop Municipality of Anchorage ENGIIdcER'S"SEAq-'dr 9'y Development Services Department �' ��` .04 g' "• ... ••••bnnA BuildingSafe Division 00 ...r On -She Water ad Was Wastewater Program ' 4700 South Bragaw SL � : •••;•" • �•" • ` ji-, HSL' E. AN== � ^„ (0 7,6.13.. P.O. Box 196650 Anchorage, AK 99519.6650 <<''`.J, :• • CE -43-311 6. www.ei.anchoraae.sk.us (907) 343-7904 f�+ !�,! �O-2 �-Iti ;•• .�+-++r . t ✓ • •:. '. L7.9.4��~4�N Soils Log - Percolation Test "• . Performed For. Date Performed: 10 -2-V u �t Legal Description: _1-io " r .'Ly!ip A 'Township, Range, Section: . 3 w . SFG S ri Slope a Site'Plan 0(1 2- 3_ G 'I 4_a 1 17- 18- 2D - • N�N I SO WAS GROUND WATER Y ENCOUNTERED? t C 8 IFYES,ATWHAT DEPTH? IO-Zr L s Depth to Water After Monftcrinp? /D.Ze E i Date: Reading Date Gross Time Net Time Depth to Water Net Drop PERCOLATION RATE 3, o (m:.a ,Mn j PERC HOLE O METER 1p; ifj,'- � •TESTRUN9ETWEEN S.-1 FT 'AND *2 FT COMMENTS �i�ST •C Ak111z Ftr-- Sp /3•[,cD P4..[02 -TD - 7 -EST -PERFORMED BY: I / lVit k-11— E• /�rdCAjJCERTIFY THATTHIS TEST WAS PERFORMED INA CORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: /0-7-7— i4 0-7-7—OG L to 4.S u j:4- t, (0 7,6.13.. PERCOLATION RATE 3, o (m:.a ,Mn j PERC HOLE O METER 1p; ifj,'- � •TESTRUN9ETWEEN S.-1 FT 'AND *2 FT COMMENTS �i�ST •C Ak111z Ftr-- Sp /3•[,cD P4..[02 -TD - 7 -EST -PERFORMED BY: I / lVit k-11— E• /�rdCAjJCERTIFY THATTHIS TEST WAS PERFORMED INA CORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: /0-7-7— i4 0-7-7—OG L ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 225A, T12N, R3W, SECTION 33 GENERAL: The scope of this project includes the pumping, crushing and backfilling with sand or removal of the existing 1,000 gallon septic tank. It also includes furnishing and installing a new 1,300 gallon HDPE Septic Tank and a 500 -gallon Fat Boy Lift Station at the location shown on the site plan with a ball valve connection to the existing absorption trench. Work also includes the construction of a new 50' long by 5' wide by 4' effective depth absorption trench also shown on the Site Plan. A 1.25" PVC line must be placed between the lift station and the new absorption trench. The distribution pipe for the trench will be placed at 2' below the ground surface. The total depth of the trench will be 6'. The existing absorption trench will remain in tact for future use if necessary. A minimum of 2' of cover and 2" of direct bury insulation must be placed atop the trench. A minimum of 4' of cover is required over the Septic Tank and Lift Station. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. Contractor is also responsible to verify the separation distance from the well on this and adjacent lots. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Development Services Department On -Site Water and Wastewater Program for system installations. Owners installing their own systems must receive prior approval from the Development Services Department On -Site Water and Wastewater Program before beginning system installation. SEPTIC TANKILIFT STATION INSTALLATION The 1,300 -gallon HDPE septic tank and lift station must be obtained from a Municipally approved septic tank manufacturer. Lot 225A, T12N, R3W, Section 33 October 27, 2006 Page 2 of 4 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 5. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drain field. 6. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAIN FIELD CONSTRUCTION: The drain field shall be constructed to the dimensions shown on the design. The bottom of the bed shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drain field rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drain field rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drain field are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trenches to drain away. 8. A minimum 2' of accepting soil is required below the drain field rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. Lot 225A, T1 2N, R3W, Section 33 October 27, 2006 Page 3 of 4 MATERIAL SPECIFICATIONS: The lift station must be constructed by a municipally approved septic tank manufacturer. An Orenco 20 OSI 05 HHF-5 pump is recommended. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. FILTER SAND SPECIFICATION: 1. Material for Filter Sand must be classified as a masonry sand and meet the following gradation: 50% or More Passing the No. 4 Sieve 2% or Less Passing the No. 100 Sieve 1 % or Less Passing the No. 200 Sieve INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Lot 225A, T12N, R3W, Section 33 October 27, 2006 Page 4 of 4 Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. HotWire E L E C T R I C INC. October 30, 2006 Nowlin Withers 3700 Dora Ave. Anchorage, Alaska 99516 Municipality of Anchorage Development Services Department Building Safety Division On-site Water and Wastewater Program 4700 Bragaw Street Anchorage, Alaska 99519 Attn: Dan Roth Re: Owner Installation Approval Dan, Per the rules and regulations of this Department, I seek approval to install a new septic system as designed by Anderson Engineering. This system is for my residence, legal description being Lot 225A, T12N, R3W, Section 33. I have 30 years of experience in the utility construction industry, am familiar with heavy equipment and know how to read prints and shoot grade. References as to my abilities can be obtained from my current employer, Hot Wire Electric. If you require additional information, I can be reached at 258-9473, ext. 106 or by cell at 440-4787. Thank you. Sincerely, , Nowlin Withers 2100 E. 63rd Ave. Anchorage, AK 99507 Tel: 907-258-9473 Fax: 907-278-8769 72-013 Mae. 3/78) �) MUNICIPALITY OF ANCHORAGE OF HEALTH & ENVIRONMENTAL PROTECTION .DEPARTMENT 0* r"^ ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME PHONE a,,.7_7_ � NEW ❑UPGRADE MAI LING ADDRESS snz LEGAL DESCRIPTION LOCATION . NO. OF BEDROOMS'_j DISTANCE TO: Well a_ �� Absorption ar/e�a t Dwelling f PERMIT NO M 3 c7'9 W a ZQ Manufacturer Mater No. of compar ents wF rn Liq. capacityin Cons Vv Inside length IF HOMEMADE: Width Liquid depth Y DISTANCE TO: Well Dwelling PERMIT NO. J02 XFF- Manufacturer Materi capacity i a w= DISTANCE TO: Well Foun n < Nearest lot line � Jr ` PERMIT NO. om s J w z No. of lines Length of each lie Total length of line Trench wid Distance between lives es Q H X Top of tie to finish grade r I Material beneath the z Total effective a4sgrrppttion area �- �rtefres Length Width Depth PERMIT NO. W Q F- c. wwa Type crib Crib dia Crib depth To effective absorp " area y DISTANCE TO: well - g foundation Nearest o ine J 5 Depth Driller Distance to lot line PERMIT NO. L? J lI DISTANCE TO: Building foundation Sewer line Septic tank Absorption areas) OTHER PIPE MATERIALS SOIL TEST RATING I NSTA ' L REMAR S two ��r ` 30 `T a— 07"L / rF AP OV DA E LEGAL r Z`J '7 /7 A-) 72-013 Mae. 3/78) �) EXC�II/ATD �� lvlrcl3e 7q -97/G2 E -- MC_IrE ]l a y-. I.F= nL I —f -'r" 0F= A=6r4a Via YF1FYCNE= DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTEC:TIOPd 825 'L' STREET, ANCHORAGE, AK 99501 " 264-4720 L-A i— a._ Fl PA E> CA rA — So I IF EE AT E_' A En F=. F" Eo F-, &I I IF LI/� PERMIT NO. 79 432 ------- APPLICANT VIRGINIA LASTUFt A BOX 4--797 277 49 LOCATION LOCH LOMON & DORM ST cAW / 0- LEGAL T12N R3W S33 L225/1 wi x'2%- 99 LOT SIZE 49426 SQUARE FEET TYPE OF SOIL ABSORBTION SYSTEM IS: DRAINFIELD MAXIMUM NUMBER OF BEDROOMS = — SOIL RATIN ,50 FT/BR''= 125 THE REQUIRED SIZE OF THE 'SOIL ABSORPTION SYSTEM IS: E-uE^F0-FF-6= 15 LE r4n—FvA= coop a3Fes'FAk?E=L _.L THE LENGTH DIMENSION IG THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE: GROUND AMC; THE BOTTOM OF THE EXCAVATION CIN FEET). —F"E-: _ F F Z E= r-•' R= F--% 1°i l l -"'F F-1 I °= December 29, 1978 ;#780254 Virginia Lastufka Box 4-797 Anchorage, Alaska 99509 Subject: T12N Raw Section 33 Lot 225 A permit issued by this department for well and/or sewer system has expired. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal ordinance. If you have drilled the well, a well log should be sent to this department to document the installation date. If there are any further questions, please contact this office at 264-4720. Sincerely, Les N. Buchholz, R.S. Senior Environmental Specialist LNB/ljw enc: copy of permit TYPE OF SOIL HBSORBTION SYSTEM IS: DRRlNFIEi-D MRXI:UM OF BEDROOMS = ] SOIL RATING (SQ FT/GR)- 125 THE REQUIRED SIZE OF THE SOI! ABSORPTION SYSTEM IS: �E���� � �-�����= �� �������� ������ �'� THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIF[D. ThE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFHCE OF THE GROUNP ANE) THE BOTTOM OF THE EXCAVATION (lN FEET). 7- 1- 1 Ell 7- Fit RE 04 GO 1 -1 Al I Em -p-01 X --f-ni! C-) 7 THE ORRYEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). Fit �0 Lj X to.,. K"7 r-7- to, 1- X 00 K lot 04 AT IS 3.���� PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE: INSTALLATION INSPECTIONS � ADJACENT TO THIS 11 phi 1 41, 1 1 110 To— E�d�� WELL. LOGS ARE REQUIRED HND MUST BE RETURNED TO ^10 hRLTH BE SUBJECT TO PROSECUTION. HN0 ENVIRONMENTAL TECTIONm\ HND CONSTRUCT[ON DIAGRAMS STREET� HNCH[)��HG��/ ��K99 � � 5� u�` � AVAILABLE TO INSURE PROPER INSTHLL�\TIO@ po" K lot 01 1 -1 F1 I CERTIFY THAT PERMIT NO. ( 780254 ) 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS KH �OX 4-797 HNCH 277 0049 HPPLICHNT 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. LOCO� LDCH LOMON 7777705T MAY' REQUIRE IF THE ]: I UNDERSTAND _::AT ^A 8^�� LOT SIZE 49426 SQUARE FEET _EUA T1R]N ��EC ]] TYPE OF SOIL HBSORBTION SYSTEM IS: DRRlNFIEi-D MRXI:UM OF BEDROOMS = ] SOIL RATING (SQ FT/GR)- 125 THE REQUIRED SIZE OF THE SOI! ABSORPTION SYSTEM IS: �E���� � �-�����= �� �������� ������ �'� THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIF[D. ThE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFHCE OF THE GROUNP ANE) THE BOTTOM OF THE EXCAVATION (lN FEET). 7- 1- 1 Ell 7- Fit RE 04 GO 1 -1 Al I Em -p-01 X --f-ni! C-) 7 THE ORRYEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). Fit �0 Lj X to.,. K"7 r-7- to, 1- X 00 K lot 04 AT IS 3.���� PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE: INSTALLATION INSPECTIONS OF HHY WELLS ADJACENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILLSERVE. WELL. LOGS ARE REQUIRED HND MUST BE RETURNED TO iINIMUM DISTHNCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM 100 FEET FOR H PRIVATE WELL, OR 150 TO 200 FEET SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS BACKFILLING OF ANY WELL. LOGS ARE REQUIRED HND MUST BE RETURNED TO DEPARTMENT WILL BE SUBJECT TO PROSECUTION. iINIMUM DISTHNCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM 100 FEET FOR H PRIVATE WELL, OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPOH THE TYPE OF PUBLIC NELL WELL. LOGS ARE REQUIRED HND MUST BE RETURNED TO THE DEPARTMENT WITHIN 38 DAY. OF THE WELL COMPLETION. MHY HPPLY. SPECIFICATION.-. HND CONSTRUCT[ON DIAGRAMS ARE OTHER REQ-IREMENTS AVAILABLE TO INSURE PROPER INSTHLL�\TIO@ po" K lot 01 1 -1 I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 0N -SITE SEWER SYSTEM MAY' REQUIRE IF THE ]: I UNDERSTAND THHT THE RESIDENCE IS REMODELED TO INCLADE MORE THRf-,! ] BFPR0OMS SIGNED HPPLICHNT VIRGINIA LASTUFKH i� SOILS LOG T1re�nr� MUNICIPALITY OF ANCHORAGE ye DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST Pouch 6650, Anchorage, Alaska 99502 276-2221 SOILS LOG — PERCOLATION TEST PERFORMED FOR:—Q �l�— \�` ��1� A � 5 ` u-4 4 �1 DATE PERFORMED: / 1 LEGAL DESCRIPTION: ter/ `y2� Ste_ • �� 1 � I ` 1,V/ T • SLOPE SITE PLAN 1 o0• . 0• _ 2 00- : / = grr- S 6 Sw') vw- 3 'o Grow<Ity )vace All- �_ 4 U 1 i 6 00.0• SC"-G'G" GWI o T 0'. 5 7 �I I 7 8 s- I ►��S _ii SU! a 10 s '30. 11 0v•&r'1b� WAS GROUND WATER ENCOUNTERED? 12 dk-v eor IF YES, AT WHAT 13 S' DEPTH? 14 15 16 17 18 19 Si L' O _ I_ _ E i� Reading Date Gross Time Net Time Depth to Water Net ' Drop. 1 20 PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND FT PERFORMED BY: 72-008 (7/76) -CERTIFIED d ma LU 0. z w z CA z bd z t�2 Ver2,a L;a��tu� ori ���5 ne vneSevere. SJs�m ;77 0j, &&7j,, /1�- C Gh��,eiLc�C �o�yf zt /:i / ,n '('N /y� � Jul. ✓y .if/� .- -- �A v�-Y ..]-C.-1+./J 5 ; y« August 30, 1979 425 "I" S RE ET ANC' uRAGE, ALASKA 99501 (9J7) 2444111 C >RC! ,�. SULLIVAN, \: W, IFN OR,)1LcnoN Jerome George Star Route A Box 4000-G Anchorage, Alaska 99507 Subject: T12N R3W Section 33 Lot 225A Sewer and Water System Installation Dear Mr. George: I have received your letter expressing legitimate concern over the installation of a sewer and water system on the subject lot. We are aware of your concerns as are the homeowner, builder and excavator. We will be conducting an inspection of the property on or about August 31, 1979 to locate the septic system and insure the soils are representative of the test results used to issue the permit. Please be advised that all permits carry the requirement that all sewer systems shall be at least 100 feet from all private wells and our inspections are provided to insure compliance. Should the soils at the site vary from the report used in design, a new test will be required and the permit will be modified to accomodate the new soils test results. Our organization has the same concern as you, that the septic system be properly designed and installed and that it function properly without creating problems. Mr. George August 30, 1.979 Page Two I hope we have not given you the impression of not caring because our business is in assisting in the proper design, installation and inspection to not only insure compliance but also a proper functioning system. If I can be of further assistance or if you have further questions, please call upon me. Sincerely, Rolf R. Strickland, R.S. Division Manager RRS/ljw cc: Ken Norman Legal Department Odin Strandberg Building Safety Department MUNICIPALITY OF _iNCHORAGE • POUCH 6-650 ANCHORAGE, ALASKA 99502 REFERENCE_ PIN FA, �� ve '4 Z".,/ 7-o" /A��.-1 / arm REPLY IN AREA BELOW TO REPLY DATE FORM 91-008(3/76) mwi� o� /74/- ff 4%v 16Ytov+eii *15 *If at l lett es ev<a olgrew dr a::$ !4 a01511 de f FROM 9�ojy w r�,. ,dow�Gal A /74�4 0004501 * a &j4 10er.:Qwe'll woe _ ,�/ epi i� e5� ale//5 r� i1 er�/ drr ®rf- Sr seiner T<tr5 �A�"o�rT'j/. / �a/ inv�ol4-Armh .Ir ,OVS_ 68. 4Y6 a� apse/ 6Y f�c -4e l Wwlf�d5 e I s5v rnj -Ass rwori ¢ 4,we✓' even /tsoteerecl , v p1✓ /o1//7'Y con��olcr aT• a"," a �/O.+vfeS�<ana� e.,ylrreee lr'l.4 47ev.�s /ar.r� 14f yvur lftw- jo vgeoflrool s4A�e u�y l4e woelue s AYriol*el / l r"cel Awrl your ioroeeeWvres /Jew t-euu.X/orrt�• eoov►a lsmwee u/i4 eXrf,Av �RGel. W-lem/olN�r� e,P am S5 ramcllwj then Avo o"On (X Ya. f , i' rA 1 /\ 4� cY YI E V rJ G sG-S[l�✓�� �Ii�I��1/�✓/h� 1, ly ti 9 y IJ P' y. \'E� r ccnn" /1CISf 71 �<��,•S �5 �/tai �l�? �,zo.-��5 �/����c� �S /�o� -r�/`'ri >a� �/��✓�IS�S ,�i� a-! l��r�rl�o-�l�i:� G�/�/��� 'D U 1 �ci e 4c ilS c GI//�"�1 ��et !s, c r"7//.� _S/I�G�C" y j`G-�. -{!✓lc-C / S ��C� !>�-cit�9/'t' �- f G� Dle `/ TJm �D/i irir5 /v long<<��oDl �'ol��Gc9v.f1 loD� /?v dn.SLve-2 60WAD � f� • l ms`s e E I , (W 167 s is- 100) s �� , 0 go c 1 11 MUNICIPALITY OF ANCHORAGE 0 DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# ©1S 33-2ZU HAA# \Q:Y���� 1. GENERAL INFORMATION Complete legal description /-&T- 22SA; 533 —112N, e3 (.y Location (site address or directions) 3 moo �Ja2 fA Property owner, tc soe�(L Day phone 2lc5 -ZZI31 Mailing address p'd'Q0`_ 4o74:7 r A m c, AK 9 9 -s -CIT Lending agency Day phone Mailing address Agent-TEI61-'2cm5A _Rkc(Ee- .0015Lry /1d4MT Day phone S6 f - 415 Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 y 3. TYPE OF WATER SUPPLY: Individual well "P Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. 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(Pev.1/91) Front MOAY21 - - 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 FirmpA^)^-*ON G � Na • S VL Phone ��2�8218 Address W, o . Engineers signatur( 6. D SIGNATURE �r Approved for NZFF bedrooms. Disapproved. Conditional approval for Additional Comments M 147 Date /2-/zz/4 ,z R. bedrooms, with the following stipulations: Date /_ y - / g 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 purchasers of homes and their lending institutions in orderto 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 engineers work.' 72-025(Ftw.1R7) Back MOAM21 Municipality of Anchorage ��yy C c DEPARTMENT OF HEALTH & HUMAN SERVICER E C E I V`/ E D Environmental Services Division 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) AA -43 1997 Municipality of Anchorage Health Authority Approval Checklist Dept, Health & Human Services Legal Description: L77SArt r27-ty M -A 4.i Parcel I.D.: of o -3:� - 72 4 r-AkIw=1 III q•Y_vr_1 Well type `T�2IUA-ra, If A, B, or C, attach ADEC letter. ADEC water system number Log present(Y/N) Date completed 4//1(7 R Total depth dOe - Cased to Sb� Casing height (above ground) 3/ v Sanitary seal (Y/N) Y Wires properly protected (Y/N) T FROM WELL LOG AT INSPECTION Date of test T It 1 /2 20! 4 4 Static water level 4 ( G Well production 70`t g,p,rn, S. f E g.p.m. WATER SAMPLE RESULTS: Coliform ® Nitrate Date of sample: r2 IZt 14-7 B. SEPTIC/HOLDING TANK DATA C% to Other bacteria -C-*) Collected by: 5'PQA,,VfJ Date installed Tank size /civ o Number of Compartments Z Cleanouts (Y/N) Y Foundation cleanout (Y/N) e Depression (YIN) ✓V High water alarm (Y/N) `— Date of Pumping 121t7,4* Pumper A� ticam& -Svc- C. vc C. ABSORPTION FIELD DATA Date installed 4 (? IF Soil rating (g.p.d./W or ftz/bdrm) 125_ System type Srw lbt Length S `1 r Width S r Gravel thickness below pipe 2 r Total depth r Effective absorption area u2 t Monitoring Tube present (Y/N) Y Depression over field (Y/N) N Date of adequacy test 121-201q7- Results (Pass/Fail) PA aS For .3 bedrooms Fluid depth in absorption field before test (in.); 13-" Immediately after—' gal. water added (in.): 22" Fluid depth 171' (ins) Minutes later: ' ✓y 4100 Absorption rate = Ysp g.p.d. Peroxide treatment (past 12 months) (YIN) ✓v If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION / Date installed N Size in gallons --------------- Manhole/Access (Y/N) "P�" at* "Pump off' level at* High water alarm E. SEPARATION DISTANCES *Datum SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot /O2. a r On adjacent lots Absorption field on lot Public sewer main Sewer /septic service line II-s- 1? 5 NSA On adjacent lots Public sewer manhole/cleanout _ N/A Lift station / 0 C -F- SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation F I Property line /p f Absorption field Water main/service line aO' Surface water/drainage / o04- Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: -f Property line / y Surface water C opt Curtain drain /17c7� F. ENGINEER'S CERTIFICATION / bo -t- Building foundation / g Water main/service line .s® Driveway, parking/vehicle storage area Wells on adjacent lots I certify that I have determined thru field inspections and review of Municipal in conformance with MOA HAA guidelines in effect on this date. Signature. Engineer's Name S NZ?A>.uNoNaVia- Date /2h—de?�- HAA Fee $ —E�2gy cu Waiver Fee $ Date of Payment- v� rt1 s Receipt Number 72-026 (Rev. 3/96)* Date of Payment Receipt Number /o`1 - .04W Aev�;wY� ,ven R. Pannone a ',I- CE 14 r '" t2(ZZl4� 5. LEGAL DESCRIPTION DATE RECEIVED .... INSPECTION APPOINTMENTS , TIME &p /7 C ?:, 4/94 TIME TIME EJOne ❑ Four EDOther �;"INGLE FAMILY ❑ Two ❑ Five DATE Three ❑ Six DATE 1 / DATE 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 INSPECTOR depth (attach log if available.) INSPECTOR INSPECTOR INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY 2C NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF HEALTH & 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL P ;OTECTION ENVIRONMENTAL SANITATION DIVISION APR 91981 Telephone 264-4720 pp (' C / REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEVVE R ELE1 iI i D DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTY OWNER PHONE MAI LING ADDRESS 9 G 1— 7 c sEJ S� 3 PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAILING ADDRESS 3. LENDING INSTITUTION PHONE MAILING ADDRESS Z) S v 4. REALTOR/AGENT PHONE MAILINGADDRESS t, 5. LEGAL DESCRIPTION oz.s 3 —Til/ J-7- /t/ — 3W — STREET LOCATION Q L E &p /7 C ?:, 4/94 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS EJOne ❑ Four EDOther �;"INGLE FAMILY ❑ Two ❑ Five ❑ MULTIPLE FAMILY Three ❑ Six 7. WATER SUP LY 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 UTILITY depth (attach log if available.) S. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Rev. 6/79) q ' (k 1 _ THIS SIDE FOR OFFICIAL USE ONLY -- 1. TYPE OF RESIDENCE ❑ SINGLEFAMILY ❑ MULTIPLEFAMILY NUMBER OF BEDROOMS - ❑ ONE ❑ TWO ❑ THREE ❑ FIVE ❑ OTHER ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATE INSTALLED INSTALLER ❑Septic/nTart{k� or ❑ Holding Tank Size: /t���'" If Tank i5 homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL n 4. DISTANCES WELL TO: Septic/Holding Tank AbsorptiorIJ Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS b-�APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 72-010 (Rev. 6/79) AS -BUILT WASTEWATER ABSORPTION SYSTEM LOT 225A, S33, T12N, R3W 4' SUMP ➢DU➢LE C.O. EXIST, 410009 SEPTIC' TANK EXIST. 3 HR HOUSE y2.y3.0,0 E`_433.41 f [ 13 ,4' V 0' 6 ,W' J p0 N4 RA TU i EXIST. WELL r gm f 'Drawing Ci\Work\225AS33.DWG .... .... ............°....... EPARED FOR Pannone Eng, Svc. ;Steven R. Pannone Rick Mosher p, ❑. BOX 142025 E % 8149 �� 3700 Dora Drive ANCHORAGE, ALASKA 99514 P.O. Box 90797 272-8218, PHONE & FAX �� Anchorage, AK 99509 DATEi 12-21-97 AS -BUILT ��� (907) 265-2431 , Steven R. Pannone, P.E. P.O. Box 142025 Consulting Engineer Anchorage, Alaska 99514 (907)272-8218 SEPTIC SYSTEM ADEQUACY TEST Legal: Lot z:zrA Block r t2N,�3w,533 Owner: 2 t c lc r� ostt �2 Residence: -Da¢w , A N 4 A cc - Septic System: -Cl- w rocs Tank Size: r ove gallons. Absorption System Type: (from Municipal records) Absorption System SizeS4'rSrt z Y Absorption Area: 412!1 s.f. Installation Date: a ! ?t *a Soil Rating: t -Z5 Date ofPumping: By:B2/tz/q�7 Date of Test: t -Z C, I q* Test Procedure: System was inspected and meassured. Tank was found with q Feet of cover. Liquid depth was measured to be ® Inches. The drain field was found to have .6' Feet of cover and a total depth of S -V . There was t 3" Inches of liquid measured in the field's monitor tube. Water was added to the system at a constant rate of -4 t G.P.M. The water levels in the tank and drain - field monitor tube were monitored. A total of 661-0 Gallons of water was added. During the test the level rose S Inches in the field. No rise was noted in the tank. The infiltration rate was monitored for lq*0 Minutes. During this period, a total of 4.50 Gallons were absorbed. By extending the observed infiltration rate, a total absorbption rate US -0 Gallons per day was arrived at. TESTS RESULTS: This system meets/4wmwEiRa the code requirements of the Municipality of Anchorage. The operational life of all septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. We can therefore not give any estimate of how long the system will continue to meet the operational requirements of the Municipality and State. Fi✓L�Y$ a(4ot,-.it/jk ,t P2o,&CA4A rya[ (' ;;2,s ro Cr -4 t;1 usc�u( Ltd 4 AS `C3 tLd•J V S &-dD —T' A,1- '-c"Q 5r --r-5 A nl a, ' -c La SYJT�' MS C:4wta IA-T-EoNAC ST,QTVS A -C -r 13 U= --C4-[b TLST tJNtj5�oc3S AOcpT l e� A0zY2 ANT �z a0AQAN-rr�3 A -r- '�iit� �Ys�zn w, is anN'rr.Vcl&� -Co ®��n2vl�z3 ®9'202 taw t-oNg- . CT&E Environmental Services Inc. co©©v®o©©vvvvovv©vvvoevvvoe CT&E Ref.# 977642001 Client PO# Client Name Pannone Eng Srv. Printed Date/Time 12/29/97 16:30 Project Name/# L225A S33 T12N R3W Collected Date/Time 12/21/97 11:00 Client Sample ID Garage Sink Received Date/Time 12/22/97 16:00 Matrix Drinking Water Technical Director: Stephen C. Ede Ordered By PWSID Released By t o C a Sample Remarks: Allowable Prep Analysis Parameter Results POL Units Method Limits Date Date Init Nitrate -N 0.100 U 0.100 mg/L EPA 300.0 10 max 12/22/97 GCP Waters Department Analyses Total Coliform 0.00 coL/100mL SM18 92228 12/22/97 RMV CT&E Environmental .services Inc. tai Laboratory Division wrwootrw,•�oiiiisi//////�iaii// s��iii////����s Drinking'Water Analysis Report for T otal Coliform Bacteria 200 W. Potter Drive Y P Anchorage, AK 99518.1605 BEAD INSTRUCTIONS ON REVERSE SIDE BEFORE COLLECTING SAMPLE Tel: (907) 562.2343 Fax: (907) 561-5301 J N le S6 0 PUBLIC WATER SYSTEM I.D. k m77-7 iV PRIVATE WATER SYSTEM O Send Revulb 0 Smdlnw/ee L 22S A 3 33 , c2i� 2.3 w mea>rre,vae.L'emn.y�A.m. ams... rw— Soo Send Rium is Send Invoice NRiDNt3 Nt-. SllC Ldy SAMPLE DATE: m F 92. Montlt. Day Year SAMPLE TYPE: TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be-. t7 Satisfactory O Unsatisfactory c3 Sample over 30 hours old, results may be unreliable O Sample too long in transit; sample should not be over 43 hours old at examination to indicate reliable results. Please send new sample via special ocliverymail. Date Received. Z 9 1 - Time Received Analysis Begets Analydeal Method: a( Membrane Filter tI MMO-MUG ` Number of colonies" 00 mi. Result" Analyst 977642 Cl Routine C] Treated Wate r Q Repeat'sample(for roudaesampls -Cr Uatraatidwaeete= with lab ref. no. ) D Special Purpose Time Collected SAMPLELOCATIOPt ; �` frolfieet� Bf �W ILLA[tla S_NS i.-7. nee nm re7 -C7 ,nein Fblo Jun ❑ Faced Data:- rime: - Client notiRed of Unsatisfactory results: ❑- ❑ Phase& SpoWwido Faxed Dart roue:--__._.. '.13ACTMOLOGICAL WATER ANALYSIS RECORD MMO-MUG Reaalt Tctae California E CON Hembratut ilten DfrodCaeat 0 Colonies/loomi IITIZ-11.A% "'r.Ca Verification: LTB BG COLIFiR ON-ooWit"Ie+v Faaal CoBSwm Coalfrmsdm Final Mbmbaet Filty Reeeks• CD Coliforw0w mi Reported By I? ZJ Time 20100 -hrs. Comments: Member of the SGS Group (Socia* GMirale de Surveillance) ENVIRONMENTAL FACILITIES IN ALASKA CALIFORNIA, FLORIDA ILLINOIS, MARYLAND, MICHIGAN. MISSOURI, NEW JERSEY. OHIO. WEST VIRGINIA TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM I.D. NO. I �r Water System Name Phone No. Mailing Address City SAMPLE DATE: f.Re,I Mo. Day Year 'Zip Code SAMPLE TYPE: ❑ Routine ❑ Check Sample (for routine sample ❑Treated Water with lab ref. no. �'` 11 El Untreated Water El Special Purpose SAMPLE Time Collected NO. LOCATION Collected By 2 3 I 4 5 READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06 -1220th) Rev. 1978 Date ColleC TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: /0 Satisfactory ❑ Unsatisfactory ❑ Sample too long in transit: sample should not be over 48 hours oldat examination to indicate reliable results. Please send new sample. Date Received Time Received Analytical Method: ❑ Fermentation Tube E Membrane Filter Lab Ref. No.. Result' Analyst i l../•.�I FT ED ED m *No. of colonies/ 100 ml. or No, of Positive portions. BACTERIOLOGICAL WATER ANALYSIS RECORD a.m. Date Recelvee Tlme Received P.m. Lab. No. ares. motive IOmI I loml I loml 1 10.1 1 10.1 1 1.0m1 I 0.1ml Multiple Tube Report:_ Membrane Filter: Direct Verification: LTB_ Final Membrane Filter. R Reported BY �:(" Broth 24 hours: Broth 48 hours: 10ml Tuber Potltive/Total 10nd PWtIWIa I. Dale Time- A.M. P.M.