HomeMy WebLinkAboutT15N R2W SEC 25 LT 150B
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP231116 Effective Date:
Work Type: SepticTank Upgrade Expiration Date:
Tax Code Number: 05131613000
Site Legal Address: T1 5N R2W SEC 25 LT 150B G:0653
Site Mailing Address: 15217 BELSEY ST, Eagle River
Owner: HAGGE HALE Lot Size in Sq Ft:
Design Engineer: NORTH RIM ENGINEERING Total Bedrooms:
This permit is for the construction of:
nzcnt S
�0
,' � r
I epartment
6/7/2023
6/6/2024
50828
❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions: No waiver is needed for the STEP tank replacement as long as the proposed berm is
installed to create a minimum 100' travel way separation from tank to surface water. If the berm is not
constructed a waiver will be required.
Received By: s S UCD to (�O
Issued By:
Date:
Date: ZO Z
3
MUNICIPALITY OF ANCHORAGE
1
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 05131613000
Property owner(s) HAGGE HAL
Mailing address 15217 BELSEY ST
Site address same
Day phone 863-6969
Legal description (Sub's., Block & Lot) T1 5N R2W SEC 25LT 150B
Legal description (Township, Range & Section)
Lot Size 50,828 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field ❑ Initial ❑
Single Family (SF) 0
Septic Tank 0 Upgrade 0
(w/wo AD U)
Holding Tank ❑ Renewal ElDuplex
(D) El
Privy ❑
Multiple Dwellings ❑
(SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that
this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 4 2 Z -.5� Waiver Fees:
Date of Payment: _;//A Date of Payment:
Receipt Number: 0055u ID Receipt Number:
Permit No. 05)0'a`5 I It C Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
SteveEng.com T15N R2W SEC 25 LT 150B
SPECIFICATIONS & DESIGN GUIDELINES
Wastewater System Sizing: This is an existing 3-bedroom, single family home. This is a
developed subdivision. A tank pump revealed that the existing STEP tank requires
replacement. The existing tank to be decommissioned. No adverse impacts are expected
from STEP tank upgrade. No conflicts to the other lots will take place by this septic
system construction upgrade. The existing absorption trench to remain in place. An
existing waiver between the tank and pond exists at 55 To mitigate any overflow from
the tank to the pond, a 1 - high berm to be placed as indicated on the Plan. Easements
depicted in the area, private water wells as depicted in drawing. A survey shall take place
prior to construction, staking the STEP tank location.
Specification Requirements: All components and work must comply with the
Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water
Regulations and Wastewater Regulations.
New 1500 Gallon STEP tank. MOA-Approved.
Decommission old tank per UPC. MOA-Spec Material Under Tank.
10 minimum between the tank- trench, tank- house. 10 to property lines,
4 of cover or insulation is required for tank; 2 Minimum thickness for insulation can
substitute for 1 cover.
Tank & solid pipe must be set on well compacted, stable soil.
4 inch diameter cleanouts with airtight caps are required 1 to 4 from foundation
wall, prior to any 90 degree bend in 4 inch line, in each tank compartment, and two
adjacent opposing cleanouts between the tank and the absorption field, not more than
10 from the tank positioned to provide cleanout access towards the tank and towards
the absorption field.
All cleanouts must extend to at least ground level.
In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron.
Force main to be 1.25 Schedule 40 PVC or equal.
The finish grade must be mounded to promote drainage away from excavation.
Insulation must be placed over any pipe installed under driveways or parking areas.
Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789,
ABS ASTM D2661,
Sewer Service Line is minimum 2% slope.
Septic Tank to be pumped every two years or when required.
Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal)
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231116, Curtis Townsend, 06/07/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231116, Curtis Townsend, 06/07/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231116, Curtis Townsend, 06/07/23
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
DISTANCES
Address ~ TO SEPTIC ABSORPTION
I~=IZ <~ ~',~. I~. ~',~c~Z ~"%L ~.',,,r FROM ~ TANK . FIELD
Permd NO. .o. of ~ed,~oms WErE
LEGAL DESCRIPTION LOT LINE ~,/ 3 / ~.,.~.
~J~N , ~ ~. ~ ddveway, water bodies, etc.) /
I
TANKS II
~ SEPTIC wl2;~4 ~ HOLDING
~/ /o ,~. ~ ~ ~"~ ~ ,.
~ TRENCH g BED ~ W. DRAIN ~ OTHER
Depth to pipe bottom from ~ Total depth from original grade j jj
original grade / FT J ~. ~ F1
FT FT
Gravel length Gravel width
~Z.~ FT ~.~ FT
Total abs0,p[i0n area ~ista~ce betwee~ li~e8
~ 7 ~ S~ F~ ~/~ FI I
Number of lines Soil rating /e~ Pipe material J
WELLS
~ PRIVATE. . ~ OTHER (Identify) J
Cla~ificatio~ (A,~,C) - Total Depth Cased to
REMARKS: ~ /~ ./~ ~, ~/ ~ ~.~,g
~,~%~. ~yr~: '~'~:~;~ ~ .~,~ / Inspections Pedormed by:
I cedilv that Ibis inspeaien was
Municipal and siat, ~uidelin, in effect 0n Ihis dar,: ~ C~, ~, ~= C:~S736
72-013 (3/85)
Tom Fink,
Mayor
unicip lity of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
November 30, 1990
Lou Butera, P.E.
Eagle River Engineering Services
PO Box 773294
Eagle River, Alaska 99577
Subject: Waiver Request for T15N R2W Section 25 Lot
Waiver Request ~WR900019,
150B
PID ~051-316-13, SW900011
Dear Mr. Butera:
Your request for waiver of the required 10 foot separation
between a septic system and a lot line has been approved.
waived distance is 3 feet.
The
This approval applies to the existing septic system lot line
separation only. Any future upgrade to the septic system will
require all separations be met Or another approval from this
department.
Sincer.ely, /~
Robert W. Robinson
Civil Engineer
On-site Services
Concur: / /
~_ohn Smitfi, P.E.
Program Manager
On-site Services
ljw~7
EAGLE
RIVER
ENGINEERING
SERVICES
Lou Butera, P.E.
P.O. Box 773294
Eagle River, Alaska 99977
Telephone (997) 694-5195
November 29, 1990
Mr. Robbie Robinson
Division of Health & Human Svcs
825 L Street
Anchorage, Ak 99502
RE: Lot 15OB, T16N R2W, Sec. 25
MUNICIPALITY OF ANCHORAGI~
DEPT, OF HEALTH &
ENVIRONMENTAL PROTECTION
RECEIVED
Dear Mr. Robinson,
As per your review, we had intended to request a 3' lot line waiver
in our original waiver submittal and it was overlooked. We are
therefore formally applying for the waiver at this time. Waiver was
required to fit trench to the site topography and should not adversely
affect Lot 15OA as their well radius is already eliminating that area
from septic consideration.
If you have any questions or any further concerns please call me
at 694-5195.
Sincerely,
~--~ ~~<:::~__~-,_ .........
Louis Butera, P.E.
Torn Fink,
Mayor
A unicipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
June 8, 1990
Lou Butera, P.E.
Eagle River Engineering Services
P.O. Box 773294
Eagle River, Alaska 99577
Re: waiver Request For Lot 150B T15N R2W Section 25, Waiver
Request Number WR9000-t'6', P.I.N. 051-316-13
Dear Mr. Butera:
Your request for waiver of the required 100 feet separation of a
septic tank/lift station package plant to surface water has been
granted. The approved proposed separation distance is 55 feet°
This waiver approval is conditional based upon the fulfillment
of the following construction techniques:
1. The septic tank/lift station package plant shall be
completely sealed and constructed from 10 gauge steel.
The tank will be constructed with cathodic protection
on both ends.
2. All of the pipe connections will be a Romex type or
equivalent and high density polyethylene pipe will be
used from the tank to the absorption field.
3. The tank will be bedded and backfilled with a clean
sand to within one foot from the surface of the
ground. The engineer will verify that any portions of
the protective coating that have been accidentally
removed from the tank are repaired prior to backfilling.
If you have any questions, please call me at 343-4744.
Sincerely,
Daniel J. Roth
Civil Engineer
On-Site Services
Con~r r~nce, ~
On-Site Services
~ ~$TE/~ ~.f~$ I~,'YTIfLL ~0 lb' }qY~--/~nY- /~,o
LIFT
C ~A T / ~,6 ,
· EAGLE
RIVER
ENGINEERING
SERVICES
Lou Butera, P.E.
P.O. Box 773294
Eagle River, Alaska 99577
Telephone [907) 694-5195
May 10, 1990
Mr. Dan Roth
Municipal!fy of
825 'L' Street
Anchorage Ak. 99501
Re: Lot !50B TISN, R2W, Sec. 25
Dear Mr. Roth,
MUNICIPAL[fY OF ANCHORAGE
ENVIRONMENTAL SERVICES DIViSiON
MAY 1 5 ]990
RECEIVED
~ Mr. r,=~'~ Hacge we are submitting a
On behalf of our cm=ent, ~ ,
~ ~ace water distance
request fo~ walver of septic t~n~/==~ station to ="~
of 55'
The o~g~al plan submitted to your office called for the tank w~th
· ~ ~ from pond adjacent to the leach
lift station to be p~acee !00' the .,
=~ was found, upon. further exploration, that 'the
located 55' from the pond, was at a depth of 9.3' With the surface
trade that exists around the home this would place our new tank at a
.... ~ 21.3" to bottom Am. ' " ~ ~ of
depth of 16.3' to top of tank ~,~ ·
this type is impractical, if not impossible, due to location of leach
trench and Dhysica! constraints of lot. When bac.z~,==~ng to that depth
~ loading.
there are also concerns with sewer .... e
A more practical solution is to allow a waiver of the 'tank to 'the
pond distance. As~nstif~ ~ offer the following. The. tank~, is
...... ~ ~ ~ ~ sealed, se~f contaln~ and
to be a modern steel ~+ co,,p~et~¥ ~-
desicned 'to be placed submer~ed in a water table. The 'tank '~.be
contains h~ch water alarm to alert possible to over zxow and a manhole
that allows inspection. Ail sewer line connections .x~= be Rome~ type.
Sewer lines are allowed to be adjacent 'to surface water with a similar
potential. If necessary we could utilize HDPE delivery line 'to the
leachfie!d.
The new system is a large improvement over the existing system wi%h
leachfield at 40-50' from the pond area. =m , pond is a small feeder
pond ~nd a conditional waiver was granted in the past to allow temporary
use of the system. A~ac~- are ~'
Subsurface soil is GM type rated 183.
~ you have any qu~s~o,.~ ~ '
at 694-5!95.
S=nce~e~y,
Louis Butera. P.E.
NEIGHBOR'S
WELL
WELLS ~
' / ~ N uNNAMED
ffi WE~
20' ~1~ ACC~S ~SEME~
· - MONITOR ~BE
o - S~ER CL~O~
NO KNOWN CURTAIN DRAINS :::::::m:- PROPOSED ~OHR~
~EME~
SEPTIC SITE PLAN
LEGAL: LOT 150B, T15N, R2W, SEC 25 ~...-
CONTRACTOR:
JOB ~ 89-118~ DATE: 10/09/89J SCALE 1" = 40'
EAGLE R~VER, A~ 99577
(907) 694-5195 F~: (907) 694-3297
LOT
AS-BUILT
150 B, SE I/4, SEC. 25,
TI 5N, R2W,
AI~CHORAGE RECORDING DISTRICT
REFERENCE PLAT FILE NO:. 70-$18
S,M.
:OUND
{EBAR
2UND
EBAR
WELL ·
~ LOT 150 A,
24,0'
STORY I~ ~ SEp~,G
FRAME ~'
HOUSE ~ "~ / CLEANOUTS
WELL
HOUSE
73.1~ '~'
18.0' .
WELL / ~ .
d UTILITY /ACCESS x ¢~,~/ ~o~
~ EASEMENT ~ ~ ~ ~
~ ~ m~.88' U~ASU~D ~ FOUU~
I" I.R
JAMES WAY
N
SCALE ill = 40I
z
I HEREBY CERTIFY THAT THIS
PLAT REPRESENTS A SURVEY
DONE BY MYSELF ON JUNE IO~
1986 AND THAT ALL DIMENSION
ARE COR.R, ECT AS SHOWN,
DATE/~/-~4~ /31 /~
....
~¢.¢4 '-.,,S,E, COR.
~ N TS...,,,,,~
82.23 R.
TRIANGLE SURVEYS, INC.
SEA 6282 YADON DR.,PALMER,AK.
$73-0234
150A
150 B
CERTIFICATE OF OWNERSHIP
DTI0024@7
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LEGAL: LOT 150B, T15N, R2W, SEC.25
.GENERAL
1.
3.
The well and septic plan are for a single family residence only.
The drawing and or site plan shall be a part of this specification.
All materials and workmanship shall meet the Anchorage Department of
Health and State Department Of Environmental Conservation
requirements. ~
· 4. All soil tests are advisory to the desi, gn and are to be verified om
modified in.the field by the engineer.
5. 'Al'l excavations and depths are advisory end are to be verified or
modified in the field by the contractor to meet Muni~iealf-ty of
Anchorage, Department of Environmental Conservation requirements.
6. It is the responsibility of the owner to obtain all necessary permits
or easements and to locate any adjacent multi-family wells.
7. Th~ excavation is to be exactly in the area showr on the site plan,
any deviation requires engineer approval.
8. It is always recommended that a surveyor locate the nearest lot line
position and the location of any easements.
TRENCH ,
1. The trench is to follow the natural land contour to mairtain uniform
total depth of the trench bottom.
2. The bottom of the trench shall be level, plus or minus 1.5".
The total depth of the trench excavation ts not to exceed 10' at any.
point.
4. Tbs sewer tank is to replace the existing sewer lins that l~ad~ to
the existing tank.
5. The trench grave] is to be covered with typar fabric material.
B. Soil or combination of soil and extruded board insulation to a depth
of 4' or equivalent is to be placed over the leachfisld.
7. The area over the trench is to ba finish graded to prevsn~ pending
8. The septic tank and leachfield must no= be closer than 100' to any
existing private well, 150' to any Class "C" well. or 200 ~sst to
any community well.
RECOMMENDED LEACHFIELD DIMENSIONS
TOTAL DEPTH = 10' GRAgEL DEPTH = 9'
TRENCH LENGTH =.J~ TRENCH WIDTH = 36"
Sci1 Rating = 18~
Bedroom Capacity = 3
Septic Tank Size = 1000 + Lift Station =
NOTE=
.NOTE:
NOTE:
~iNOTE:
1250 gallons .
Lift station required wired to M.O.A. code with EMT (metal) .r'issre.
2" burial foam and 2' mounded soil over leach trench. "..
Tank Burial depth = 8' (10 gauge tank required.)
Abandon existing tank & pit
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SOILS LOG
PERCOLATION
TEST
PERFORMED FOR:
HAL ~-~ ~ll b ~]'G~ DATE PERFORMED:
LOT /~o ~% d-'~BN, Q'zd; f~,~_ 7_5
SLOPE SiTE PLAN
LEGAL DESCRIPTION:
5
6
7
8
9
10
11
12
13
17
,3 ,~..~_~
'¢.'"%'/i
.-'~
CE-6736 P
2O
COMMENTS
WAS GROUND WATER S
L
ENCOUNTERED? //D//~ O
P
E
IF YES, AT WHAT
DEPTH? 7 ~'~.~ /o ~--~
Gross Net Depth to Net
Reading Date Time Time Water Drop
~oA )< J o-5-'~~
PERCOLATION RATE
TEST RUN BETWEEN
(minutes/inch) '" /23
PERFORMED BY:
72-008 (6/79)
Eggle River Engineering Services
Eagle River, AK 99577
694-§195
CERTIFIED BY:
DATE:
~ / ~ X t UNNAMED
~ WELL ~ /~~ ~
20' ~ ACCESS ~SEMENT
JAMES WAY ~ - ~
· - MONITOR
o - S~ER
NO KNOWN CURTAIN DRAINS :::::::m:- PROPOSED L~CHFIELD
~EME~
SEPTIC SITE PLAN
~-~/':' '.%'";'t
LEGAL: LOT 1509, T15N, R2W, SEC 25 ~;;?~
OWNER: HAL HAGGE ¢~?~,'
CONTRACTOR: N/A ~ .,¢~m
JOB ¢ 89-1181 DATE: 10/09/891 SCALE 1" = 40' ~~~'
A ~,~ .
EAGLE RIVER ENGINEERING ~ERVICES ,.~: [oo,:..n.,~,.
P.O. Box 773294 > ~
(907) 694-5195 FAX: (907)694-3297 //~/~'~m~*
GRE/ :R ANCHORAGE AREA BORf iGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LOCATION
MAILING ADDRESS ~ ~(~ ~:~]~/~t /~b, i~'~,~ PHONE LEGAL DESCRIPTION i~i
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
MANUFACTURER
MATERIAL
NUMBER OF
COMPARTMENTS
INSIDE WIDTH
LIQUID DEPTH
LIQUID CAPACITY / [)('~7 GALLONS.
SEEPAGE PIT:
NUMBER OF PITS ) . DIAMETER
LINING MATERIAL ~COCiC. CRIB SIZE:
BUILDING FOUNDATION 7~~], NEAREST LOT LINE
, ~'/
OR WIDTH I2-t LENGTHI~l, DEPTH
DIAMETER /)~ DEPTH ~t DISTANCE FROM: WELL
TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA) ~c~
SQ. FT.
ADDITIONAL ABSORPTION
WELL:
BUILDING
FOUNDATION
CESSPOOL
APPROVED
CONSTRUCTION ']~i~ Ujc~cc~ ltOcd:c.
NEAREST NEAREST
LOT LINE SEWER LINE
OTHER SOURCES
· DISAPPROVED REMARKS
DEPTH DISTANCE FROM:
SEPTIC SEEPAGE /~(;/
TANK ]001 SYSTEM
DISTANCES:
INSTALLED BY:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form No, EQ-O31
DIAGRAM OF SYSTEM
(/G.A.A.B.
Driller ?:~: -~. 0~
Ioo~t~--~dre~s of; Township,
~se Of well ~...w
& section0 if .~nown; or distance frO~ ~ain
ro~ , p,~::.::;m ~',~ ~,~ i?. ~ ~n,z o~ ~:~,~'.: .~:~,~ ~ ~ ~4~ ,.
DO NOT
US~ No..
, Aree,~
Size of casing_ 6" Depth.of hole' 33}:1 .f~$t .Os,sed to. 1.3
Statio water level ~h __feet. (above)(below) ~ ~rf~e. ~ish of Well (oheok
one} Open e~d (~; Soreen ( ); perfo~te~ ( ).
Desoribe soreen or perforations '
W~ll p~p~Z test ~,t .... _gallons per (hour)(~ut~') f~r '~ ....... hours ~%h
f~ot of dr~wdo~ from s~tio level
Depth in fe~t from Give de~ils
O to 4 TOP~OTI, & ~A~.
to
to
to
to
to
.,. I
to
to ' ~
f '~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
A~UNICIPALiTY OF ANC~O~AG,
DEPT. OF HEALTH &
ENVJRONMENT~,L PROT~CTIO~
: r: 5 0 1985
RECEIVED
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions) /
(b) Applicant Name ~t.- ~ ~ Telephone: Home L~,~.~ ~c~ Business
ApplicantAddress ~'P.O , ~'-¢,~=~/" ~ ~-'~i 5 t~:::;z.~,.~5~, ~_~ v",¢~.¢~,, 'l'~tL~
(c) Applicant is (check one): Lending Institution []; Owner/buitder~r--; Buyer []; Other [] (explain);
(d) Lending Institution I ~.2.2.2.2...~' k_3~'L--.
Address
(e) Real Estate Company and Agent
Address
Telephone
Telephone
(f) ~ HAA to the following address:
2. TYPE OF RESIDENCE
Single-Family.~ Multi-Family []
· Number of Bedrooms ~
Other
3. WATER SUPPLY
Individual WellJ~ Community [] Public []
Note: If community well system, must have written confirmation from the State Department of EnVironmental Conservatipn
attesting to the legality and status.
4. SEWAGE DISPOSAL
OnsJte~/ ~Public [] 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 I of 2
EN~IN, EERING FIRM PROVIDING .¢JSPECTIONS, TESTS, FILE SEARCH, DA'I,-. 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 verity that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm
Address
Date ~. ~l,~ ~III~-R
Telephone
DHEP APPROVAL
Approved for ~"~*"~--- bedrooms by
Approved ~ Disa~C~ved~ '~' '~'~'~*'~ DateCondi~al
Terms of Conditional Approval
/o- ¢.,¢ -
CAUTION
The Muncipality of Anchorage 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
WELL DATA
Well Classification
Well Log Present
Total Depth ~.~,~.t
Static Water Level
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
IDJ~p]f, OF H~ALT,-i ~
ENVII~ONMENi'AL
:,i:: i 5 0 1985.
264-4720
Legal Description:
If A, B, C, D.E.C. Approved (Y/N)
Date Completed ~l;~L~..-'r'~ ~1~' Yield
Depth of Grouting
Pump Set At ~_~'
Sanitary Seal on CasingdC~N)
Depression Around Wellhead
; On Adjoining Lots
~; On Adjoining Lots
Cased to
Casing Height Above Ground J C-
Electrical Wiring in Conduit (Y~ I~--~ '~J~=-'~- ~¢s,~.
Separation Distances from Well:
To Septic/l-~Ming-Tank on Lot I ~ '
To Nearest Edge of Absorption Field on Lot ~. ,~'~--~
To Nearest Public Sewer Line ¢q J,~ To Nearest Public Sewer
Cleanout/Manhole ~'~/~' To Nearest Sewer Service Line on Lot
Water Sample Test Results
B. SEPTIC/~ TANK DATA
Date Installed ~- ~,¢t ¢
Standpipes ~/N) Air-tight Caps (~g'N)
Depression over Tank (Y/J~
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/~,~?~g Tank:
To Water-Supply Well
To Property Line ~.,'-~ ~'~'
To Water Main/~rvice Line
Course
Comments
Size I.t:;~ No. of Compartments
Foundation Cleanout (YC.~j~.
Date Last Pumped ¢[ -'~--
; 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(11184)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed '~ - t ~ -
~::'~ "~')~-~ Type of System Design
Length of Field
Width of Field I''z~ Depth of Field t'~
Gravel Bed Thickness
Square Feet of Absorption Area ~.,~'g~:~ :~' / Standpipes Present4~/N)
Depression over Field (Y/¢~ Date of Last Adequacy Test
Results of Last Adequacy Test -~.f~'f~ ~
Separation Distance from Absorption Field:
To Water-Supply Well \
To Building Foundation ~c::~ ~ ~
Lot ~ /D
To Water Main/Service Line \~ I .~
To Stream~ake/or Major Drainage Course
To Driveway. Parking Area, or Vehicle Storage Area
To Property Line cc=,
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
Dimensions
Manhole/Access (Y/N)
/~, "Pump Off" Level at Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Electrical Codes (Y/N)
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.
Amount: $
Signed ,,,~ , Date ~'/'¢"7 /,~5"
Compan~ ..... ?RD ~98)~ MOA No ~O O ~
Date of Payment ~ - ~ 6'-~
Page 2 of 2
72-026 (11/84)
P.O. BOX 665O
ANCHORAGE, ALASKA 99502-0650
(907) 264-4111
TONY KNOWLES,
MA YOR
DEPARYMENT OF HEALTH & HUMAN SERVICES
October 10, 1985
Robert A. Shafer, P.E.
S & S Engineering
SRB 196-X
Eagle River, Alaska 99577
Subject: Waiver Request WR85-038, T15N R2W Section 25 Lot 150B
Dear Mr. Shafer;
This Department has reviewed your request for a waiver of the minimum
required separation distance between a seepage pit and pond on the
subject property. This waiver request has been denied on the basis of
the information provided about the soils and topography of the subject
lot.
This decision may be appealed to the Alaska Departmen~ of Environmental
Conservation.
If you have questions regarding this matter I can be contacted at
264-4720.
Sincerely,
Stephen S. Morris
Civil Engineer
On-site Services
SSM/ljw
D~I[~. OF ~NV'~RON~NT~IL ~ONS~RV~THON
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA 99501
8ILL SHEFFIELD, GOVERNOR
274-3533
October 22, 1985
S & S Engineering
SRB 196X
Eagle River, Alaska
99577
SUBJECT: Temporary Separation Waiver between Pond and Septic System
Lot 150B, T15N, Section 25, Chugiak, Alaska
(8621-WA-075)
Dear Sir:
The Department has reviewed the above waiver request. Since this system
was formerly approved by the Municipality of Anchorage, a temporary
waiver approval is given with the stipulation that:
1o Property owner shall hook up to Trunk Improvement District No.
ERT2-(Fire Lake) when constructed and operational°
f~ 2. ,Property o~er shall conduct approvable revisions to on-lot
w~er a~d/or sewerage facilities after four years if community sewer is
no~ a~ailable by that time.
Sincerely,
SE: MPL: pkk
ROBERTA. SHAFER
CIVIL ENGINEER
September 29, 1985
694-2979
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
SYSTEM DESIGN
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOIL TEST
//
STRUCTURAL&
MECHANICAL
INSPECTIONS
Municipality of Anchorage
Department of Health and Environmental
825 L Street
Anchorage, Alaska 99501
ATTENTION: Susan Oswalt
Protection
REFERENCE: Lot 150B; Section 25; T15N; R2W; SM
Request you approve the attached Health Authority and grant
a waiver to the horizontal separation distances between the
existing on-site waste water disposal system and a pond of
water located on the referenced property. Included for your
review are copies of previous Municipal approvals and the Greater
Anchorage Area Borough's on-site inspection report dated May
1975. It would appear from the design of the seepage pit that
the soils are GW. This was basically substantiated with the
results of the adequacy test performed at this time. No well
log is available, however, Municipal records indicate that
the well has a depth of approximately 134 feet and a static
water level was measured at 44 feet from the top of the casing.
The horizontal separation distances from the seepage pit to
the pond, as noted on the Borough's report, is 86 feet. The
slope between the seepage pit and the pond's surface is approximately
30%.
If we may be of further service, please contact us.
PAS/ss
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
SRB 196X EAGLE RIVER, ALASKA 99577
~-~.~UNICIPALITY OF ANCHORAGE ,~.
DEPARTMEN~ ~F HEALTH AND ENVIRONMENTA~ ~ROTECTION
825 L Street, Anchorao~. Alaska 99501
264-4720
Date Received: October 28, 1977
Time ]!.ii~O ~ _ ~2: Time ~3: Time
Date ,,-/~-~~ Date Date
Insp /~ ),f ]~~./ Insp Insp
#1:
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
1. Lending Institution Request:
Mailing Address: 4449 Business Park'Boulevard
2. Property Owner: ~oe~ Lee Abney
Mailing Address: NSA Lakeridge Drive
Lomas and Nettleton Company
Phone: 274-7661
Phone: 279-0431
688-2167
3. Legal Description: T15N R2W Section 25 Lot 150B of Lot 150
4: Single Family Residence: (x) Number of Bedrooms: Three
Multiple Family Residence: ( ) Number of Bedrooms:
Well System: Individual Well (x) Community/Public System ( )
Permit # 2m~ %qq~DePth of Well Well Log on File (
Construction ~ t~[ ~"~-~' Bacterial Analysis
Sewage Disposal System: On-site System (x) Public utility ( )
Permit # ~c-. Installed ~ ~ Installer (~0~
Septic Tank Size
Absorption Area
Manufacturer ~3.5~[(o~ C0~
Soils Rate ~ Material ~o~
to Absorption Area
7. Distances: Well to Septic Tank
to Sewer Line
Nearest Lot line
Absorption Area
to Nearest Lot Line
· -'- '~ October 26, 1977
( !I~UNICIPALITY OF ANCHORAGE/
Department of Health and Environmental Protection
825 L Street, Anchorage, Alaska 99501
279-2511, ext. 224, 225
~uest for Approval of Individual Sewer and Water Facilities
2o
Property Owner:
Mailing Address:
Name of Buyer:
Mailing Address:
Abney, Noel Lee
Unknown NSA Lakeridge Dr; Phone :Wk. 279-0431
None-Refinance
Nm. 688-2167
Phone:
Lending Institution: The Lomas and Nettleton Company
Mailing Address: 4449 Bus{ness Park Blvd., Anchorage Phone: 274-7661
0
o
Rea ltor/Agent: None
Mailing Address: Phone:
Lot 150B~0f BLM Lot 150 Section 25 T15N R2W S. M.
Legal Description: ~
NSA Lakeridge Dr,
Stree% Location:
Single Family Residence:
Multiple Family Residence:
(x) Number of Bedrooms:
( ) Number of Bedrooms:
3
o
Water Supply: * Individual Well ( ~ Public/Community
If Individual Well, well depthUnk___no__.w_~
If Co]mnunity System, name of system
System (
Sewage Disposal System: On-site System (x) Public System
if On-siLe System, date of installation:
*NOTE:
A well log
is required on ALL wells drilled since 6/75.
~UNICIPALIT¥ OF ANCHO,'~AGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
OCT 2 8 1977
RECEIVED
P~% T~o
°,' ' Department of
Request for Approval
Health and Environmental Protection
of Individual Sewer and Water Facilities
Legal Description: T15N R2W Section 25 Lot 150B of Lot 150
Affadavit Attached: ( ) Letter Attached: (
Disapproved: Date:
Department worksheet :~~.~ , ~ ,~
~"~. MUNI-~IPALITY OF ANCHORAG~'~' ~.C',c~[~.
DEPAR[MENT..~. ............ ~F'HEALTH AND ENVIRONMENTAL rROTECT]ON ~'~:.,.~.
· 825 L Street, ~chora~e, Alaska 99501 ' ',
· - · 279-2511, ex%. 224, 225 ..-
Da~e Received: March 24, 1977
Time ~'~. 2nd Inspection: Time
Date ~ '~ -~7 ~/~ Date
~ Inspector ~ Inspector
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
!. Lending Institution Request: Alaska Pacific Bank % Rosie Parks
Mailing Address: Post Office Box 420 99510 Phone: 276-3110
2. Property Owner: Walter/Jeanne Belsey
Mailing Address; Box 886 Eagle River 99577
Phone: 688-23.30 (h)
3. Legal Description: T15N R2W Section 25 Lot 1509
4. Single Family Residence: (x) Number of Bedrooms:
3
MulLiple Family Residence:
Well Data: Type Individual
Construction ~9.~,
( )
Number of Bedrooms:
Depth I ~ Well
Bacterial Analysis
Log Filed~
Sewage Disposal System: On-site system (x) Public Utility ( )
Permit # -- '- Installed ~" InstallerS__
Manufacturer
Septic Tank 'Size 1~O
Absorption Area ~ Soils Rate ~ Material
DisLances: Well to Septic Tank /aO
to Sewer Lines __~ Nearest Lot Line
Absorption Area to Nearest Lot Line a~
to Absorption Area
t
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L Street, Anchorage, Alaska 99501
279-2511, ext. 224, 225
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection: VA FHA_
MUNICIPALITY OF ANCHOI~AOff
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
MAR 2 4 1977
RECEIVED
coNv__
3. Name ofBu,er: ~e e ~//,5~ ~ - - .... ~
Mailing Address: ~ ¢~ ~'~ ~/Day Phone'~~~ ~'
Mailing Address:/~ ~/ff~ - y~//a Phone: ~;-~//~ .
Mailing Address:
LegaI Description:/X~--~ 2~_ c~'~ ~'
Location:
Phone:
Typeo, Facitity to be Inspected:¢~_5~'/ ',)'L~/'Z~/~
Water Supply
Type of Supply: Public Utility
If Individual, number of dwellings presently served
· No. Bdrms.. ~
Individual__J
/
If Individual, depth of well.
Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation
Individual (on-si.~e) /~,
72.003(3/7B)
Page ~wo ~
~ · ', ' ' ' Departm'en~ of Health and Environmental Protection
_ ' 'Request for Approval of Individual Sewer and Water Facilities
Legal Description:
T15N R2W Section 25 Lot 150B
Comments:
Affadavit Attached~ --~)~ Letter Attached:
Appr°ved~:<..~_
Disapproved
Date:
Date:
Department ~orksheet:~ ~'
