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Home My WebLink AboutT15N R2W SEC 25 LT 48 Municipality of Anchorage On -Site Water and Wastewater Section - (907) 343-7904 Page 1 of 3 ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP251184 PID Number: 051-281-47. Dwelling: F0 Single Family (SF) Fj with ADU M Duplex (D) El Two Single Family Project: n New nN Upgrade Name Kathi Olmstead ABSORPTION FIELD El Deep Trench no Wide Trench El Bed El Mound Site Address 16030 Cline St E] Other Phone Number of Bedrooms Soil Rating depth from original grade 907-244-8020 13 1.0 GPD/SF ITotal 6.8 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 6.3 Ft. Gravel depth beneath pipe 0.5 Ft. Subdivision Block Lot 48 Fill added above original grade 0.0 Ft. Gravel length 90.0 Ft. Township Range Section 15N 2W 25 Gravel width 5.0 Ft. Beds: Number of Lines N/A Distance between lines >6 Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line ,450.0 Ft2,2 >6.0 Ft.. Well >100' >100' N/A NA >25 TANK FEI Septic [:1 S.T.E.P. El Holding [I Other Manufacturer Greer Capacity 1000 Gal. Surface Water >1 00' >100' N/A N/A Material Plastic Number of compartments 2 Lot Line >5' >10' N/A N/A NA Foundation >10' >1 0' N/A N/A lQFT-,-%TATION IManufacturer Capacity Remarks Deep -burial tank Gal. Existing log crib decommissioned Alarm location rica lied by Elect�� PIPE MATERIAL House to tank D3034 drainfieldTankto D3034 Installer Whitters Excavation Drainfield D3034 CO/MT D3034 Inspector Justin Earls BENCH MARK (Assumed elevation) 100 ft Inspectes:tion 15t 7/29/25 7/30/25 Location and description da 2nd rd Bottom of siding SW corner 41h 3 ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Ak, Conditional Approval: Date *e` % "; .......... 'Benjar*RSchiller CE 12592 Septic System Approved A Date 9/16/25 0 PROFESS0 I Note: this approval does not include well permit requirements. (Rev 05/02/18) T15N R2W SEC 25, LOT 48 PE Lot 3811 RMIT # OSP251184 PID # 051-281-47 WELLS ON NEIGHBORING LOTS MORE L.1 37 TWAM Inn' AMAIAV �`��\�� LEGEND - 4j CO - CLEANOUT Av TM+ Ar SEPTIC PLAN 2CO - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE P.Benja i Schiller j 0 50 100 MH - MANHOLE F CE 2592 MT - MONITORING TUBE ,,P:::2:a�``��r FEET ROFES510N .,. ._ � SV -SEPTIC VENT 1 —50 TH -TEST HOLE uj 4m - C FCO 18.3 MH 64.9 _ 18.1 SV 69.0 15.2 2CO 72.2 13.6 C01 18.3 18.9 MT1 19.7 17.5 CO2 11.3 32.9 MT2 12.1 31.2 CO3 55.6 64.0 MT3 55.6 63.6 C04 58.8 55.2 MT4 57.2 51.9 Tl 5N R2W SEC 25, LOT 48 PERMIT # OSP251184 PID # 051-281-47 OF- 2 0 99.6 FINISH GRADE 0 99.6 ORIGINAL GRADE 2i 0 93.3 DRAI NFIELD ROCK 93.3 x MOA APPROVED SAND 92.892.8 EAST TRENCH 451 NO GROUNDWATER 6/5/25 0 r C14 04 Ce) M �— 85.6 �— 0 0:R 99.6 FINISH GRADE 99.6 ORIGINAL GRADE � 0 93.3 92.8- nnH ENGIN E E R I N G DRAINFIELD ROCK MOA APPROVED SAND WEST TRENCH 45' NO GROUNDWATER 6/5/25 85.6 PROFILE AS -BUILT (NO SCALE) 93.3 m 7H .......... .......... BenjanWSchiller CE 12592 9/16/25 Lot 38 i Lot Lot 37 PIONEE N 1/2 R DRIVE Lot 61 30.0' I I I I I I� y I I I I I I I I I I I I I I I I I L Lot 60 NOTES: GROUND LEVEL IMPROVEMENTS SHOWN ARE APPROXIMATE. DATE OF SURVEY: 05 AUGUST 2025 PLOT PLAN AS BUILT X SCALE 1" --50' GRID NW0753 Protect No. J25-123/A2 t t /� inc. Box 210005 Long Associates, ins. Anchorage, Alaska 99521-0005 JI -.4-0 MM'61 Z-grz57 (907) 522-6476 "' 0 F A Professional Land Surveyors survey0langsurvey.com o�F, q p I hereby certify that I have surveyed the following described property: LOT 48, SECTION 25, T15N, R2W, SEWARD MERIDIAN, ALASKA p 4 '•. a Anchorage Recording District, Alaska, and that the improvements situated thereon are B " """" within the property lines and do not encroach onto the property adjacent thereto, that no improvements on the property lying adjacent thereto encroach on the surveyed premises and that there are no roadways, transmission lines or other visible J easements on said property except as indicated hereon. U Dated this the °�% V � •�S-9944. JOG Day of E/h�z at Anchoraga, Alaska p a �0 0 4�QROF'ESSIONAL �o It is the responsibility of the owner to determine the existence of any easements, WNp � covenants, or restrictions which do not appear on the recorded subdivision plat. State of Alaska AECC963 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP251184 Work Type: Septic Upgrade Tax Code Number: 05128147000 Site Legal Address: T15N R2W SEC 25 LT 48 G:0753 Site Mailing Address: 16030 CLINE ST, Eagle River Owner: KOJO LLC Design Engineer: FORGE ENGINEERING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: 6/12/2025 6/12/2026 108900 2 Disposal Field Z Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing co i/ Lo C-C- i7,o 3 Received By: Issued By: Date: Date: r! Z2-0 ON -SITE SEPTIC/WELL PERMIT APPLICATION Parcel I.D. 051-281-47 Property owner(s) KOJO LLC Day phone Mailing address 11525 Old Glen Highway, Eagle River, AK 99577 Site address 16030 Cline St Legal description Tract 15N Range 2W Section 25, Lot 48 Number of Bedrooms 3 Engineering Firm Forge Engineering Building Permit Number Not Applicable R APPLICATION IS FOR: APPLICATION IS AN: (F1 all that apply) Absorption Field El Initial El Septic Tank 0 Upgrade F1 Holding Tank ❑ Renewal 0 Privy 0 Well ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: Permit/Rush Fees: " q/t 5,-110 Waiver Fees: Date of Payment: W/O Date of Payment: Permit No. O's P 9 S-1 L �- q Waiver No. June 5, 2025 MOA Development Services, On-Site Water & Wastewater Program 4700 Elmore Rd Anchorage, AK 99507 Subject: Tract 15N Range 2W Section 25, Lot 48 Septic system design Dear On-Site Services Engineer: The owner of this lot has a 3-bedroom home on the property. The existing tank is over 30 years old and steel, therefore it must be replaced per muni code. The old septic disposal system is a log crib and is required by the muni to be decommissioned if any other septic work is being done. So, we are submitting this permit application for the construction of a new septic system. The attached site plan identifies the location of the home as well as the existing well and proposed septic location. No conflicts exist between this proposed system and any other well or septic system, whether on this lot or adjacent lots. The ground surface on the lot has a mild slope from the east to the west. There are no slopes greater than 25% within 50 feet downslope of either the primary or alternate site. Contours are shown on the site plan showing the grade and direction of flow. Stormwater drainage will not impact this septic system. The new trench will be constructed parallel to the slope as much as possible. Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from all wells and surface water, and more than 5’ away from the septic tank. Please refer to the attached test hole logs, plan and profile pages for the septic design. If this design is followed, there will be no adverse impacts to adjacent properties. Sincerely, Benjamin Schiller, PE Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251184, Curtis Townsend, 06/12/25 T15N R2W SEC 25, LOT 48 PERMIT # OSP251184 i Lod 381 WELLS ON NEIGHBORING LOTS MORE THAN 100' AWAY • INSTALL 2CO IN PLACE OF FCO EXISTING TANK TO BE DECOMMISSIONED AND REMOVED INSTALL NEW 1000-GAL SEPTIC TANK EXISTING LOG CRIB TO BE DECOMMISSIONED PER MUNI CODE. Lot 47 EXCAVATE AND FILL WITH CLASSIFIED SOILS (2) 45' LONG X 5' WIDE, 0.5' EFFECTIVE DEPTH TRENCHES Amw 11 Benja i Schiller r,�92 C/3125 .� PROFE5510NP�,."` EDGE OF PAVEMENT PID # 051-281-47 Lot 37 i ,�I ` EXISTING WELL � ui r f a cp 2' COMPACTED CLASSIFIED 4~ CO FILL BELOW PIPE GOING 3 THROUGH DECOMMISSIONED CRIB LOCATION i ENSURE �10' SEPARATION FROM T TRENCH TO FOUNDATION MT Co PIONEER o` 1 SEPTIC PLAN 0 50 100 FEET 50' RIGH T-OF*AY RESERVATION Lu LLi cp 'Lu C) r--- L.ot 60 LEGEND CO - CLEANOUT 2C0 - DOUBLE CLEANOUT FCO - FOUNDATION CLEANOUT FS - FLOW SPLITTER VALVE MH - MANHOLE MT - MONITORING TUBE SV - SEPTIC VENT TH - TEST HOLE TRACT 15N RANGE 2W, SECTION 25 LOT 48 TYPICAL TRENCH SECTION (NO SCALE) NOTES: 1. GRADE AREA OVER TRENCH TO DRAIN AWAY 2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2' WITH 2" OF INSULATION 3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER 4" PERFORATED PVC (HOLES DOWN) DRAINFIELD ROCK DESIGN FACTORS:SYSTEM REQUIREMENTS: 450 GPD PEAK FLOW PERK RATE: <1 MIN/IN APPLICATION RATE: 1.0 GPD/SF 5' WIDE TRENCH SYSTEM w/ 2' SAND FILTER 1000-GAL SEPTIC TANK BOTTOM OF TRENCH: 4.0' BELOW GRADE (MAX DEPTH 8') FLOW LINE ELEVATION: 3.5'' BELOW GRADE 450 GPD / 1.0 GPD/SF / 5' WIDE * 1.0 RED FACTOR [0.5' DEEP] = 90 LF TRENCH REQUIRED (90 LF SPECIFIED) GEOTEXTILE FABRIC 6/5/25 PROVIDE ADDITIONAL FILL TO ACCOUNT FOR SETTLEMENT 6" 5' 2' 6" 3' MOA APPROVED SAND Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251184, Curtis Townsend, 06/12/25 LEGAL DESCRIPTION: PERFORMED FOR: DATE: PARCEL ID#: SOILS LOG AND PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 DEPTH (feet) TEST HOLE 1 DATE READING NET TIME (minutes) DEPTH to WATER NET DROP PERCOLATION RATE: (MIN/INCH) (inches)(inches) DATE OF MONITORING DEPTH TO WATER AFTER MONITORING <1 5/29/25 1 2 3 4 5 6 GM (SILTY SANDY GRAVEL) Professional Engineers Stamp: TOWNSHIP 15N RANGE 2W, SECTION 25 LOT 48 5/29/25 051-281-47 KATHI OLMSTEAD 159 8 16 OB 0.2 Benjamin Schiller CE 12592REGISTEREDPROFESSION A L E N GINEER PERC TEST LOCATION TECHNICIAN: JUSTIN EARLS 165 8 16 N/A 6/5/25 COMMENTS: SITE PLAN 6 0 16 USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED 6/5/25 MOISTURE NOTED AT TIME OF DIGGING?NO 159 8 160.2 165 8 16 6 0 16 159 8 160.2 165 8 16 6 0 16 159 8 160.2 165 8 16 6 0 16 159 8 160.2 165 8 16 6 0 16 159 8 160.2 165 8 16 6 0 16 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP251184, Curtis Townsend, 06/12/25 Lot 38 _ — — — � � Lot 37 N 89'55'00"W 327.78' CR I I I 13~I LO I I o I Lot 48 108,900 s.f. (MOA) :`. WELL oo. GRP�E� �o I s2. 76.2' F� 5 0 v L Of U I N N N (n �< v � U 2.0�� 2.0' I LO N 0 Z Py I Lot 47 SEPTIC W PIPES I a (n O 157.5 32.s U o W °' Z rn o Z 0 I I 50' RIGHT-OF-WAY I _ RESERVATION I L EDGE OF PAVEMENT N 89'54'W 4.970 chains(R) 328.02'(CR PIONEER DRIVE N 1 /2 Lot 61 Lot 60 NOTES: GROUND LEVEL IMPROVEMENTS SHOWN ARE APPROXIMATE. DATE OF SURVEY: 14 MAY 2025 PLOT PLAN ___ AS BUILT _X_ SCALE 1_== 50__ GRID _ NW0753 Project No J25-123,_(A1 P.O. Box 210005 Lang & Associates inc 4 0 g � • Anchorage, Alaska 99521-0005 po00 (907) 522-6476 0o Professional Land Surveyors survey@langsurvey.com O F A 000�� .. • • I herebycertify that I have surveyed the following described OAP. O Y Y g property: -�• LOT 48, SECTION 25, T15N, R2W, SEWARD MERIDIAN, ALASKA Anchorage Recording District, Alaska, and that the improvements situated thereon are 0.."' """"""" "Q within the property lines and do not encroach onto the property adjacent thereto, that !f- no improvements on the property lying adjacent thereto encroach on the surveyed • • • • • • ......� premises and that there are no roadways, transmission lines or other visible easements on said property except as indicated hereon. ' • moo Dated this the Day of _6-&Y __- zozs at Anchorage, Alaska Op�Fop'•LS 44.•'o5ov 404R�FESSNA� �a� It is the responsibility of the owner to determine the existence of any easements, pIO10 covenants, or restrictions which do not appear on the recorded subdivision plat. State of Alaska AECC963 437 "E" STREET, SUITE 303 ANCHORAGE~ ALASKA 99501 STEVE COWPER, GOVERNOR 274-2533 June 22, 1987 Hr. Lou Butera, PE Eagle River Engineering Services, Inc. PO Box 773294 Eagle River, Alaska 99577 SUBJECT: Lot 48, T15N, R2W, SECTION 25, Eagle River 8721-FA-131 Dear Hr. Butera: The Oepartmedt has reviewed the Engineer As-built plans for the subject project, Final approval is hereby given for the water system. Any future expansion of the subject project will require additional approval from this office, Sincerely, SWE:pkk ENCLOSURE · '~ STATE OF ALASKA , , DEPARiMENT OF ENVIRONMENTAL CONSERVATION APPROVAL OF ON-SITE RESIDENTIAL WATER AND SEWER SYSTEMS PROPERTY DESCRIPTION Lot, BlOCk & Subdivision or U,S, Su~ey This approval does not constitute a guarantee of any kind, explicit or implied, as to the performance of the water supply and wastewater disposal systems. A recent water sample wa~ tested and found to meet Department of Environmental Conservation drink- lng water standards for total coliform bacteria. WASTEWATER DISPOSAL water s stem was The do~e~ waste y : [] Inspected"t:~.~he Department of Environmental Conservation and found to be in compliance with applicable re~'ui~nts of 18 AAC 72; - [] inspected by _a Pro_f_e~al Engineer who certifies that the system complies with applicable re- qui'rements.'of 18 AAC 72~..~ [] ln~ Installer who"s~ifies that the system complies with applicable requirements of 18 AAC 72;or [] tenet who cer~if!es'th~ the performance of the system Is satisfactory a~he rninimum s'~.~on distances specified In 18 AAC 72. This approval is valid for a' [] single family [] multi-family u~ total of bedrooms. Name TIIle ~ Date 18-0404 (Rey. 8/85) DISTRIBUTION: WHITE--BANK/LENDING INSTITUTION; CANARY--APPLICAN~ PINK--DEPARTMENT DOG CO. r~Oa P.O. BOX 670272, CHUGIAK, ALASKA g§se,7 * TELEPHONE 688-2759 OWNER OF LAND ADDRESS LEGAL DESCRIPTION / ~ 01~ -~'~.'¢. DATE - Started y ~'/6~7 Ended PERMIT NUMBER DEl'TH OF WELL [ 0 0 STATIC LEVEL OF WATER FT. DRAW DOWN FT. KIND OF FORMATION: From From ~ Ft, to From ~ Ft. to Fmm.~.Ft. to Ft .~ro~ From Ft. to__Ft. From $0 Ft. to /O~ Ft.~~, From Ft. to Ft, From Ft. to Ft. F~m Ft. to , Ft. From ,Ft. to Ft. From Ft. to Ft. Fmm.~ Ft. to~ Ft. From Ft. to~ Ft. From Ft. to Ft. F~m Ft. to Ft, MI~CL. INFOIAMATION: From __Ft. to Fr. From Ft. to Fl, From~Ft. to Ft. From__Ft. to Ft~ From FI. to Ft From Ft. to Ft. From FI. to Ft. From__F~. to Ft.. Fromm. FL to Ft. From Ft. to ' .Ft. From Ft. to Ft._ From Ft. to ,Ft, From Ft. to Ft, From Ft. to__Ft From ,Ft. to Ft. From__Ft. to Ft. From~ Ft. to ,Ft 37 7'0 ~o DRILLER'S NAME ~ June;: 4, . .!987': ' . ENGLNV. V. RING ERVICES P.O. l~ox 773."fl4 Eagle Rivet, Alaska Telephone (!to'7) $94-519g · . ..... Depar tment' '-o f -Environmental Conservation '.. ........ .~ ' .... ' :' REFF:'Lot 48, T15N, R2W, Section 25 5-F:'U ~:~7::~:~Eikl% RiVer, Alaska ~:'.:.f'::On -'behalf of. ~ur client, Howard Relocation Services :we are ..... applylng;~..for,.a. ~Class C Certlflcate to construe and operate for an ?. ~'existfngTwellYlocated on the above referenced lot. "'. The well is located as shown on the attached plot plan. There are no waivers requested, as proper setback dj'stances are observed. ~ The..well:~.' produces a sustained 20 minute flow of 10 GPM with a storage capacity in the well and pressure tank of 107'~allons. At the present time, this is more than adequate to meet ID and daily requirements for .a .3 ..bedroom capacity that is the expected demand volume. Water "sampI-es -have 'been taken for coliform bacteria and nitrate content with ' the results attached. I'f .there-.ii are any questions me 'at~::694~5196.-qr ~-". -::_ Since~.elT;..:'-.:::-:--'%. -:,. · . LB. bls..:..;, .,_-.,: .......... . please feel free to call P. O. Box 773294 :: .' *. EAGLE RIVER. ALASKA 99577 CALCUL~ED DY ~" ~'~-z¢"~--'~ Phone 694-5195 .' ~, CHECKED DY. DATE 150' R, ND CDNTAMINATIFIN .... SEPTIC · -, LEACH PIT HSE I 50' ESMT, 108,900 S,F. .11 50' ESMT, -388'- EXISTING L~'Ar-J'; NE%/ LEACJ'I FI,F. LO CLEANDUT SCALD 1'" ~/ELL AND SEPTIC SITE PLAN LEGAL~ LOT 48, T15N, PAV/,SEC,B5 /NER, HB~CARD RELOCATION SERVICE CONTRACTOR, N/A EAGLE RIVER ENGINEERING SERVICES PO BX 773894 EAGLE RIVER, AK, 99577 694-5195 MUNICIPALI'TY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG -- PERCOLATION TEST /~ SOILS LOG [] PERCOLAT(ON TEST PERFORMED FOR: /Z//~-~ ~,~/Oc~,~'~. -~-W.~'~/- /~Y~'~-';~'~( DATE PERFORMED: LEGAL DESCRIPTION: ,~o~-~' ~'f~--~ ,/~/4~/ ..~-~_~ ..~-~'~ 3 4' 5 6 7 8 9 10 11 12 13- 14,' 15- 16- 17- 18- 19.- 20- COMMENTS SLOPE SITE PLAN ~ '/¢~/-WAS G ROU N D WAT E R ./2//0 S ENCOUNTERED? ~ E IF YES, AT WHAT ~ ~,~ DEPTH~ Gross Net Depth to Net Meading Date Time Time Water Drop PERCOLATION RATE ~ ~ (minutes/inch) TEST RUN BETWEEN FT AND FT PERFORMED BY: 72-008 (6/79) Eagle River Engineering Services Eagle River, AK 09577 694-5195 CERTIFIED BY: Y~ 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.# {'~..~ - ~\-~-i-'~ 1. GENERAL INFORMATION Complete legal description Location (site address or d!~rections) Property owner Mailing address Lending agency Day phone Mailing address Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: NOTE: TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer 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. If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front 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 I~y 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 inves!i_gation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Engineer's signature David R. Dayton P.E. 2UvlU uonalar ~.~Chugiak, Alas,~a 99567 Phone DHHS SIGNATURE X Approved for -~ Disapproved. Conditional approval for bedrooms, bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in pa.ragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST A, Well Data Well type ~ If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) 7 Date completed <~,/~J~'? Driller Total depth ~ e-C.3 ' Cased to~ ~-,P ' - .5-" Casing height Sanitary seal (Y/N) ~ Wires properly protected (Y/N) ~'~,~.,~. 5'7 ~/ ~ f FROM WELL LOG AT INSPECTION Date of test ~,,/~//~ ? ~,/ Static water level ,~$ ~ ~ ;~, ~ Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot /~ Absorption field on lot Public sewer main Sewer service line WATER SAMPLE RESULTS: ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank Coliform ~ Nitrate ~-' ~ ~ Other bacteria Date of sample: ~-~ ~- ~ ~ '~ Collected by: ~ ~ m i S. SEPTIC/HOLDING TANK DATA Date installed /'~, ~ Cleanouts (Y/N) )/ High water alarm (Y/N) Tank size /Z-$'--~ Compartments / Foundation cleanout (Y/N) ~ Depression (Y/N) /t/ /'-////~' Alarm te~ted (Y/N) '~.~)- Date of pumping ~/~/~ ;:' :; Pumper ~-'~'/~'~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot To property line On adjacent lots /.~'-~ '/~- Foundation Absorption field /'~ Water main/service line Surface water/drainage /~o -/- 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N). "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Manufacturer Manhole/Access (Y/N). "Pump off" Level at Cycles tested Surface water D. ABSORPTION FIELD DATA Date installed Length E~~ /Z.' Total absorption area Date of adequacy test ~ G5~'- Soil rating (GPD/Ft2) ~"~ ~;¢.~/~ System type ,-~-~--~/~"¢~' /¢2/-r- Width ~'~/- /~' Gravel thickness ~ Total depth /~ ~ ~¢ ¢~ 5~ Cleanout present (Y/N) y Depression over field (Y/N) ~ ~/~/~ ~ Results (pass/fail) P~ for ¢- Bedrooms After test /. ~ ~ If yes, give date Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot I To building foundation On adjacent lots Surface water Curtain drain On adjacent lots I ~ ~- Property line ~ To existing or abandoned system on lot Cutbank /--?'/)- Water main/service line Driveway, parking/vehicle storage area /'~ ~ E, ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the o ~te of this inspection. Signature Engineer's Name Date David R. Dayton P.E, 20210 Dona]ar St. Dovid R. D(~yton NO. 2205-E HAA Fee $ /70 ¢D~ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back Tom Fink, Mayor N unicipality of Anchorage Department of Health and Human Services 825 "L" Street P.O, Sox' 196650 Anchorage, Alaska 99519-6650 July 28, 1993 David R. Dayton, P.E. 20210 Donlar Chugiak, Alaska 99567 Re: BLM Lot 48, Section 25, T15N, R2W waiver of Water Well Standards AMC 15.65.060 Dear Mr. Dayton: This office has reviewed your waiver request to allow an existing well serving the subject property to be perforated at depth less than 40 Ft. The waiver has been approved based on the following: 1. Water samples taken from the subject well have tested negative for bacteria and 2.39 mg/1 nitrate nitrogen. 2. According to the well log the casing is perforated at a water bearing formation between 37 Ft. to 40 Ft. Bedrock is encountered at 40 Ft. The static water level is at 23 Ft. indicating some aquifer confinement and protection. 3. AMC 15.55.060(B) allows this office to waive the minimum 40 Ft. depth requirement. All future Health Authority Approvals issued by this office will advise that the depth of the subject well is less than the required 40'Ft. and that the well should be tested annually for coliform bacteria and nitrate nitrogen· If at any time water produced from this well fails to meet primary drinking water standards, abandonment of the well will be required. This waiver applies only to the exlstl g well. Sincerely, ~ / ~r~r~m Manager, On-sit Services D..R. DAYTON, P.E., R.L.S. ]~xz~~]~ Chugiak, Alaska 99567 20210 D0nalar (907) ~ 696-24%7 June 30, 1993 Mr. John Smith Municipality of Anchorage Dept. of Health and Human Services On-Site Services P.O. Box 196650 Anchorage, Alaska 99519-6650 REF: BLM Lot 48, Sec. 25. T15N, R2W. Dear Mr. Smith, On behalf of our'client, Mr. Kenneth Barber, we are requesting that the Class "C" Well on the subject property be changed to a Private Well Status. The well was approved by DEC (Certificate #8721-FA-131) in June of 1987. Sometime since this date a septic system has been built on Lot 49. This system has encroached into the 150' radius by 30'. The separation distance from the new absorption system is 120'. The well meets all criteria for a Private well with the exception of being perforated from 37' to 40', The well is 100' deep with a silty layer from 24' to 34', The casing is seated 5" into the bedrock. Water tests show results of: Coliform 0 Other Bacteria 0 Nitrate 2.39 mg/1 The l~ts in the area are primarily 2% acre lots with single family residences. Many lots are at present undeveloped. Please review the above and if possible issue a variance from the Municipal Depth to Perforation Standards along with the attached Health Authority Approval. Attached are the well log, State of Alaska Approval Documents and septic system documentation by Eagle River Engineering Services. If there are any questions, please contact me. David R. Dayton. D,. R. DAYTON, P.E., R.LS. ~;~x~~ Chugiak, Alaska 995~7 20210 Donalar (907) June 30, 1993 ADEQUACY TEST Legal Description: BLM Lot 48, Section 25, T15N, R2W, S.M., Alaska Date of Test: June 29, 1993 Septic Tank: 1250 gallon, 1 compartment, steel tank Absorption System: 12' x 12' x 6' seepage pit Soils Rating: 85 sq. ft. per bedroom Requirements: 3 bedroom - 450 gallons per day Test: Water was pumped into the seepage pit at a measured rate, while monitoring the rise in the liquid level in the pit. After water pumping was stopped, the level was monitored to determine the seepage rate. Results: The seepage pit accepted 470 gallons of water in 90 minutes with the level rising 0.35 ft. above the original level of 1.60 ft. After the pumping was complete, the water level returned to the original level in 16 minutes. The seepage pit is currently functioning adequately for a 3 bedroom home. D..R. DAYTON, P.E., R.L.S . ~xX~J~~ Chugiak, Alaska 99567 20210 Donalar 696-2417 June 30, 1993 WELL FLOW TEST Legal Description: BLM Lot 48, Section 25, T15N, R2W, S.M., Alaska Date of Test: June 29, 1993 Well Depth: 100', perforated 37' to 40' Static Water Level: 23.2' Requirements: 3 BR - 450 gallons per day Test: The well was tested with the existing pump through an outside hose bib. The valves were fully opened for the last 60 minutes of the test. Results: 470 gallons were pumped in 90 minutes. 378 gallons were pumped in the last 60 minutes at a rate of 6.3 galloms per minute. There was no measurable drawdown in the well during the test. The well is capable of producing more than the output of the pump. The well is currently producing adequately for a 3 bedroom home. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 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) (d) (e) (f) Legal Description (include lot, block, subdivision, section, township, range) DOT ~8, ~15N; ~2W~ Section 25 Location (address or directions) 1¢;¢)3(~ ¢,f,TN-R, DRTV~, Applicant Name ~hT~'H' RARRRR Telephone: Home n/a Business Applicant Address C/O PTRS~ NA~TONAf, P.O. ~X ??ORb8: F~GLE ~R: ~ 99~77 Applicant is (check one): Lending Institution ~; Owner/builder ~; Buyer ~; Other ~ (explain); ~Q~AP.~ PRQ~ A~ AD~RE~ AR~ I,~TN~ TN~T~TON~ Lending Institution FIRSm NA~T~NAT, O~ AN~ Telephone 694-2103 Address p Q_ ~Y yT~bR, ~A~T,R RT~R, AK 99577 Real Estate Company and Agent ~TT.T. ~R~IIg~N, R~K ~,~ RRAI,~ Address 121 ~ST ~A~'H'~ T.A~, ATIT~ QOR, ANRR~RA~R, AI,AAKA 99577 Teleohone 276-0000 Mai the HAA to the following address: ~R PT~ ~Y ~A~T,~ R~R ~T~RTN~ 694-210q fLITA) TYPE OF RESIDENCE Single-Family ~ Multi-Family Number of Bedrooms Other WATER SUPPLY Individual Well ~ Community [] Public [] Note: If comm unity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4 SEWAGE DISPOSAL Onsite ~ Public [] Community [] Holding Tank [] Note: If corn munity well system, must have written confirmation from the State Department of Environ mental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) ,5. ENGINEERING FIRM PROVIDIN· .o SPECTIONS, TESTS, FILE SEARCH, DA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with ali Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm E~,~L~.. I~TVI~,R ~N'P, TN~F;I~,RTNP, S~RV]-CES Telephone 694-5~. Address P_O_ P~¥ 773294~ ~AP.T,F, RTe.,R: AK 99577 ,..,,:, i DHEP APPROVAL Approved "'~"~" Disapproved Yerms of Conditional Approval Conditional CAUTION The Muncipality of ,~nchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCH(2RAG:~ ENVIRONMENTAL SERVICE$ DIVISION WE, E EIVED Well Glassification ~/~z MUNICIPALITY OF ANCHORAGE (MO,-v HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: ~ IfA, B, C, D.E.C. Approved (Y/N) Y ~,~' ~,zT,,~.t¢~'..) Well Log Present (Y/N) Total Depth Cased to 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 To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments Date Complete61 Yield Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date B. SEPTIC/HOLDING TANK DATA Size/.~ ~*'-o ? ¢ / Date Installed Standpipes (Y/N) /Y' Air-tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well /STp / To Property Line /~'--*<~ / / To Water Main/Service Line Course ..~/~z~ ' No. of Compartments ;~ ,Y Foundation Cleanout (Y/N) Date Last Pumped ~,,/~ 7 ; for '"~/~ Temporary Holding Tank Permit (Y/N) .'~.~ To Building Foundation To Disposal Field To Stream, Pond, Lake, or Major Drainage Page I of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed /? :--~- Width of Field ~z~-, /~ ~ Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well /~.¢-,..s- / To Building Foundation ~/' Lot To Water Main/Service Line /¢/0 To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field z~.r+ Depth of Field "/¢ / Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line /'~ To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) ~.~ //d ~ / 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 Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed '~'~"~¢'"¢~-~ Date ~'.../,~ .~.~¢- ;2 Company ,./'~/¢,/~,5'. MOA No. ~-~ Receipt No. )f)OI OO~4 Date of Payment G /3dj t~ Amount: $ L (%0 ~ ;eal Page 2 of 2 72 026 (ll/84) A. 'WELL DATA Well Classificatior~ ~'/~ ~'/ '~" MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: If A, B, C, D.E.C. Approved (Y/N) · :~. Well Log Presem (Y/N) Date Completed ' Yield ::' . ~'_,_To~al· D~{~i;F': :~z2 :~?" ~:~cased tO]' : ~ :'"Depth bi Grouting ..... ;'~; :.: :;~;;;~Statlc:.Wate[ LeaF- .... ' ...... : Pump SetAt ....... . : 7:; Ele~tri~t Wiri~ ~ c'0hd'~it (Y/~) . Depression Ar0uqd Wellhea~.(~/ : - Separation'Distan~s from Well: . ~: :;:. :~: ; . : ~ , ~:. ~; ;: ~ : . :.To. SeptiS{Holding ~nk on Lot ; On Adjoining Lots - ' To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line . Cleanout/Manhole · · .*.,Water Sample Collected by -:, -. Water Sample Test Results : Comments . On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date B. SEPTIC/HOLDING TANK DATA Date 'lnst~iled /~dS- Size/..-2. Z"o ¢, ~ / _ No. of Compartments ~ Standpipes (Y/N) ,/v' Air-tight Caps (Y/N) -~' Foundation Cleanout (Y/N) /~ / '-Depression over Tank (Y/N) /~ Date Last Pumped -~,,/~' · !:L:i Pumping/Malntenance Contract on File (Y/N) /~,/~ ; for ;.:Holding:Tank High-Water-Alarm (Y/N) '/~//'~ Temporary Holding Tank Permit (Y/N) ."~'/~ ' Separati0n~ Distances from Septic/Holding Tank: ': : ' ;; :~;-T0: ~a~r:. ~ain/se~i&e ~in~; · ~/¢ :T~.Stream, Pond. Lake, or Major Drainage ABSORPTION FIELD DATA Soils Rating in Absorption Strata ' ,,~S-- Date Installed Width of Field ¢~-~-' /,¢-' Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well /.~--.~- To Building Foundation ,~ / Lot To Water Main/Service Line /¢/o / To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type ol System Design Length of Field z:-~'f~ Depth of Field .,D Gravel Bed Thickness o StandpJipes Present (Y/N) Date of Last Adequacy Test ~'--/~,./,~ 7 To Property Line /'~' To Existing or Abandoned System on ; On Adjoining Lots To Cutbank (if present) "~'/~ 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 that I have checked, veritied, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. 'Signed "~~ Date ~',../~ ~,r/P 2 MOA No. .5'~-~,=.2. 60- Company Receipt No. Date of Payment Amount: $ Page 2 of 2 ~ /~ I~ ~ REQUEST FO~ APPROVAL OF ~/ ]~ INDIVIDUA~ SEWAGE AND WATER FACILITIES ~/ [~ ~ (Fzll out in Triplicate) Name .of person requesting approval Nu~-'o~ ~edrooms in house 5. Wate~ Analysis: a. Bactemial b · Detergent Well data: a. Type , b, Depth, c. Casing Size Distance from well to closest existing or prooosed: 1. Sewer line 2. Septic tank,, . ! 3. Seepage Area~ ~..(~) (> 4, Cesspool'~ 5. Property Line Other sources of possible contamination, i.e., creeks, lakes, houses, barn~ dralnaEe ditch~ etc. · Sewage disposal System. a. Age of system ~/y~Z6~,~. b. Septic tank capacity in gallons ,/~)0 ~-~, c. Name of septic tank manufacturer 1. If "home made" show diagram on reverse ~ide of this form. Disposal field or seepage, pit size and type, ~''. ~ ~ ~ (;~ ~ ! ' l0 ~stanoe to p~o~ept7 ~e to, ~oase ~o~datio~,_ ~HA Form 2573- ]U. S, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT FEDERAL HOUSING ADMINISTRATION HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART L--TO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE SUBDIVISION NAME ,- ~, (~!) ~ ERIAL NO, BLOCK NO. LOT NO. Can a~c or other area be made into additional bedrooms? (if Yes, how many~) r-1 Yes []No SYSTEM DESIGNED FOR WATER SUPPLY [] Public system [] Community system [] Individual [] Public system [] Community system [] Individual .:~ [] Yes o PART fl.--TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH It is the opinion of the [] State [] County [] Local Department of Health that this individual water-supply system [] is [] is not satisfactory as a domestic water supply for the subject property. It is the opinion of the [] State [] County tern with proper maintenance: p~'] Can be expected to function satisfactorily, and is not likely to create an insanitary condition DATE I SIGNATURE , ( NOTE: The health authority should, complete the appropriate opinion statement above and affix date, signature and tltJe in the sp~cos provided. ....... Use of the above grid 'for Health Department nspoctor's sketch as wall as use of the back of this form is at the option of the health authority. [] Local Department of Health that this individual sewage-disposal sys- [] Cannot be expected to function satisfactorily J TITLE San~ta~n PART Ill.--FOR USE OF FHA OFFICE TO THE CHIEF UNOERWRITER: I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that the Individual water-supply system be considered [] Acceptable [] Not Acceptable Sewage disposal be considered [] Acceptable [] Not Acceptable. __i CHIEF ARCHITECT DEPUTY FOR CHIEF ARCHITECT DATE IGNATURE INDIVIDUAL ~I, IALTH AUTHORITY APPROVAL ~h rER SUPPLY AND SEWAGE DISPOSAL ,/TEM FHA Form 2573 Rev. July 19S8