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HomeMy WebLinkAboutMANN BLK 5 LT 3Onsite File #020-481-03 Municipality of Anchorage Page 1 of__2 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 545-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: SW990277 PIG Number: 020-051-09 Name: LARRY WILLIAMS Wastewater System: [] New · Upgrade Address: 16041 SAINT JAMES ST. ABSORPTION FIELD Ph°ne:(907) 276--2761/227--5242 lNG. of Bedrooms: 3 [] Deep Trench [] Shallow Trench · Bed [] Mound · Other* Soil Rating: Total Depth from original grade: LEGAL DESCRIPTION 2 aPg/sq, n. **2.98 -- 3.79 Ft. Lot: Block: Subdivision: Depth to pipe bottom from original grads: ! Grovel depth beneath pipe: 3 5 MANN 0.53- 1.34 ~ 0.27 Ft. Township: Range: Section: Fill added above original grade: Grovel length: - - - 0.8- 1.65 ~ 20 Ft.  Grovel width: Number of lines: Distance between lines: WELL: [] New [] Upgrade 18'+ ~ 8 2.5 Classification (Pflvote, A,B,C): fatal ~ Cased To: Total absorption area: Pipe material: Ft. Ft. 360 SO. Et_ ASTM D3054; SCH 40 PVC Driller:. ~~ Date Drilled: Static Water Level: Inatallen Dcte instclled: ~. G & G EQUIPMENT 9/9/99 - 9/15/99 ~Yield"-~~ GPM ii Pump ~ Ab Ft. Casing Height Above Ground:Ft. TAN K SEPARATION DISTANCES [] Septic [] Holding · S.T.E.P. To Septic Absorption Lift Holding Public/PrivatE Manufacturer". Capeclty in gallons: From Tank Field Station Tank Sowor U.e. ANCHORAGE TANK 1250 Mctertcl: Number of comportments: Well 100'+ 100'+ 100'+ - 25'+ STEEL 2 Surface 100'+ 100'+ 100'+ - - LIFT STATION Water Lot Size in gallons: Manufacturen Line 5'+ lO'+ 5'+ - - 1250 ANOHORAGE TANK 'Pump on' level ab 'Pump off' level ob High water alarm at~.5. Foundation 5'+ 10'-I- 5'+ - - 41" 41" Curtain Pump Make & Model: Electriccl Inspections performed by: Drain -- NONE KNOWN = 20 OSI 05 HHF M.O.A. I I Remarks: * TH~S ~S AN iNNOVATiVE BO~OMLESS BENCH MARK Location and Description: INTERMITFENT SAND FILTER. BO~-FOM STAIR NEAR POINT "A". · * 2.18 FEET OF M.O.A. APPROVED SAND FILTER. Aa .... d Elevation: 100.00 Ft. ENGINEER'S SEAL _~2',,?.,-" .... "-~. ~ 2nd979/99-9/13/99 ~, :: 1t iLJ~/~i-~..._~ 3rd 9/10/99 ,&c,~ ~?Jffre,, A.'-C~rnessZ "(I,,'~',./ % ~---7953 ." Department of Health and Human Services approval 't)~. '.. ,u ..' ..~_ Reviewed and approved by: ./)~//'~,.-'/ ~C/. J4::)~Date: / - / J- O0 ~2-0~ (..v. g/gO .o^ ~5 c:///- ~ - ~"~"o"~¢: AS BUILT DRAWING 020-051-09 ,<f:;;, 'B" TO 'D" = 74.7' ,,~, DB~ 36.3 34.1 (~~o,~ ~~ j: MT~ 58.7 MT2 74.9 49.3 DB~ ~2 MT4 62.6 27.4 ~ ~ ~ ~ / ~ ~~MT2 POINT 'B' * ~l~ ~ - iOI A+/- / / ~ STYE Wl~ O~NGE ~ ~ / ~ SP~Y PAINT ffi // 5f2 ~W 12~0 5~LON Af INt~T - ~¢ EXCAVAT ON DEPTH ;;'::':;', <::',:;';:,,:::.~ ,: :; :;:',-~ :;': ;.:.:.. ,:: ,~:.-,;.c ',-: -. :.,:.,,;: ':¢: ;;,;~¥:::,,?.c: ::,~: 5 IN~ ~ PlP~ ~AS~ WATER ~ WASTEWATER CONS~T~TS, ~C. ~~%~-~c LE6AL DESCRIPqON: ~ :,~ ~ AS-BUILT OF SEPTIC SYSTEM UPGRADE ;~[~ ':'"'~, ~RRY WILLIAMS (907) /227-5242 I I *' I .......... DATE:9/27/99 D~WN BY: SCA~: 1 = PAGE: 2 Of 2 ~{~ fess;~ DBL1 35.2 33.8 DBL2 36.3 34.1 ST1 37.6 33.9 ST2 43,8 34.,7 MT1 58,7 37.~- MT2 74.9 49,3 MT3 78.0 41,6 MT4 62.6 27.4 MH 45.7 34.7 09/24/99 FRI 16:26 FAX 9073461388 G & G Contractin~ ~ ~ o~ a~ INSPECTION REPORT [~OOl INSPECTIONS: Voic~ FY OF ANCHORAGE --BUILDING SAFETY DMSION 3500 EAST TUDOR ROAD, ANCHORAGE, ALASKA (957) $f~3.-34S4 Fax: 007) $43-$255 INFORMATION: 007) 343-$211 _ DAY?E: NrlfEN ~ORRECTION$ ARE MADE, PLEASE CALL FOR INSPEC~ON DO NOT REMOVE 274I, V NOTICE. MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Aug 13, 1999 Expiration Date: Aug 12, 2000 Permit Number: SW990277 Legal Description: MANN BLK Design Engineer: Owner Name: Owner Address: 5LT 3 0041 AK Water & Wastewater Consulta Larry Williams 16041 Saint James St. Anchorage, AK 99516-4937 Parcel ID: 020-051-09 Site Address: 016041 ST JAMES ST Lot Size: 44800 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] SepticTank [] Holding Tank [~ Privy [] Private Well Water Storage Alt 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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. 5. The following special provisions. blDSF - This permit is for a bottomless intermittant dosing sand filter system. Received By: Issued By: Alaska Water & Wastewater Consultants, Inc. 6901 Debarr Road, Suite 2B ~ Anchorage - Alaska 99504 (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers July 15, 1999 Municipality of Anchorage Department of Health & Human Services Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic Design for Mann Subdivision, Lot 3, Block 5 To whom it may concern: The existing 3 bedroom house is served by a private well and septic system. The existing septic system is failed and in need of an upgrade prior to obtaining a Health Authority Approval for the sale of the house. Comments regarding the proposed design are summarized as follows: 1. SOILS: Attached are the soil logs for the two test holes that were performed on the reference property. Test hole #1 (excavated on 6/24/99) had organics and fill to a depth of 6.5'. Groundwater was found at 9' below grade and rose to 8' over the course of one week. Below the organics was a GM layer of 1'. From 7.5' deep to 9.5' deep was a dense ML layer which transitioned back to a GM material from 9.5' to the bottom of the test hole (14.5'). One perk test was performed in this test hole at a depth of 7.5 feet and the soils were found to be impermeable or saturated. Test hole #2 was excavated on 7/6/99 to a depth of 13'. Groundwater was initially encountered at 9.5' below grade and rose to be 7' 4" below grade one week later. There was approximately 0' - 1' of organics at the surface of the test hole. Below the organics to the bottom of the hole was a GM material. A perk test was performed at a depth of 4.5' and the soils perked at a rate of 14.5 min./inch. 2. TRENCH DESIGN: Due to the shallow groundwater, poor soil conditions and limited space, we believe that a bottomless intermittent dosing sand filter system is the best option for the septic system upgrade. a. Percolation Rate: 14.5 minutes/inch b. Application Rate: 2 gallons/day/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 225 ft2 f. Total Depth to Bottom of sand: 4 feet g. Effective Depth: 2.5 inches h. Width: 20 feet i. Length: 18 feet j. Reduction Factor: N/A k. Effective absorption area = 360 ft2 (225 ft2+) 3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed upgrade. 4. TOPOGRAPHY: The area where the proposed bed is to go is virtually flat. In short, there are no slope concerns. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you for your assistance. 'i ely,. i' /' JeffreY' IA. !~arness, P.E., M.S. Preside'nt ", ~ NOTE: Attached is a site plan drawing, a design drawing, a detail drawing of the proposed bed, two soil logs and a 4 page construction specification letter which are all part of the design package for this septic system. GOLDENVIEW MIDDLE SCHOOL k\ ~ 161 STREET ? LOT 4, BLOCK 5 LOT 5, BLOCK 5 MANN S/D GOLDENVIEW SUBDIVISION CITY WATER AND SEWER EXISING SEPTIC SYSTEM / MANN S/D C S PT,C SEPTIC (SEE DESIGN, PAGE 2 OF 3) ~ACAN.~J_D LOT 6, BLOCK 5 MANN S/D LOT 2, BLOCK 5 MANN S/D LOT 1, BLOCK 5 MANN S/D C~-ACAN_.~D LOT 7, BLOCK 5 MANN S/D LOT 9, BLOCK 5 MANN S/D ALASKA WATER AND WASTEWATER CONSULTANTS, INC. 6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504 PHONE: (907) 337-6179/FAX: (907) 538-3246 LEGAL DESCRIPTION: MANN SUBDIVISION; LOT ,5, BLOCK 5 'I'YPE OF WORK: SITE PLAN PREPARED FOR: LARRY WILLIAMS PHONE NUMBER: (907) 276-2761/227-5242 DATE:7/15/99 IDRAWN BY: IscALE: IPACE: A.C.G. 1 = 100' 1 OF 5 // / TANK TO BE PUMPED. CRUSHED .~ / / AND BuR,eD. """~"~'~' ..,~,-~"'"~ / /--* PROPOSED 1250 GALLON ¢ /~~ NN ~ /~~T ~ ~ % N ~/ % (SEE D~AIL PAGE ~ ~ EXISTING BED TO BE %x ABANDONED COMPL~ELY } LOT 2. BLOCK 5 ~ MANN S/D ~AS~ WATER ~ WASTEWATER CONS~T~TS, ~C. 6901 DEBARR ROAD, SUITE 2B. ANCHO~GE, AK, 99504 PHONE: (907) 337-6179/F~: (907) 338--3246 ..~ / MANN SUBDIVISION; LOT 5, BLOCK 5, ~ ...... !...W.i..,v. ........ : .... ~PE OF WORK: SITE PLAN ~ -~'¢[;¢~%~' PREPPED FOR: PHONE NUMBER: ~RRY WILLIAMS (907) 276-276~/227-5242 ~["4' ~-7953 .." q~ ~¢ '.. , ...~ A.C.G. I = 50' 2 OF 5 ¢' l)lA, CORiNN~R, PUt~OP-AI~i[:2 ~TV~[~N TOP OP 5ANl) ANl) l)ISllqB~ON PIP~ IN'R1', ( l)Rltt IX ~ INCH MA HOLI~5) 16' × :20' BOTTOMUUS5 15P,-/ NO LINUR ON BOTTOM, PRU%LIRU PIPINQ I)B51~NBP BY ORUNCO ANl) SLFPLIUP BY ANCHOP. h:::;iU TANK, -- PLLI~IN~ VAI.~5 (WITH ?ROfCCflV~ CO~RS) RR LINU COIL 5°/C~l) AT APPROX, 2 PBBT, OI~NCO WAS1~PLOW" 17PF. PROVII)BI) BY ANCHOP-.A~ TANK, PLAN VIEW 5/¢' PlA, %H, '~0 FVC LAfbF. AI.5 (HOL~5. ~IBLI)5. ANP PLLISHIN~ VFI.~5 PBR OI~NCO l)~516N) Mf 5, .u FVC LA11~P-F/.5 Mf 2" INS~LAqON O~R PLA Q~V~L 6" LAYP-R OP 5/5" PLA d~VP.L WITH THP. PVC LAll~RAI.5 BLRIBI) MIl)WAY IN THB 51'F. A11JM, (G~VP.L ~LOW FI?B ~ 2,F~'~ + ) :2 PBBT Mli',l, OF PILI?.R AIR LIND 15" BBLOW TOP OP 5ANl) -- :2' MINI, OF COVP. R PROFILE VIEW ALASKA WATER & WASTEWATER CONSULTANTS, INC. 7320 EAST CHESTER HEIGHTS CIRCLE, ANCHORAGE, ALASKA 99504 PHONE: (907) 337-6179 / FAX: (907) 338-3246 LEGAL DESCRIPTION: MANN SUBDIVISION; LOT 3, BLOCK 5 TYPE OF WORK: BOTTOMLESS SAND FILTER (ISF) DETAIL PREPARED FOR: PHONE NUMBER: LARRY WILLIAMS 276-2761/227-5242 DATE: J DRAWN BY: I SCALE: J PAGE: 7/15/99 J.L.M. N.T.S. 3 OF .3 ALASKA WATER &: WASTEWATER CONSULTANTS, INC. PHONE (907) 337-6179 * FAX (907) 338-3246 ~"':' PERFORMED FOR: ~RRY WILLIAMS DATE PERFORMED: 6/24/99 -~ ~ f; · TEST HOLE ffl tOfess~O DEPTH ~ (feet) 2 ~'"':.'.': <":1;! ~~g'i}~~ ~E PL~,N~ ~ ............. : t r.: :::?::: ::::: [~ I GW ORG ['z::::~;;:~:~ ORGANIC FILL : GP ML ; ~ "'>': (NOT NATIVE) GM : CL ~::: ', :: :~ ::~:::: :::::::::::::::::::::::::: SW ~/li ~ZIi HH 7-- G~ DEPTH TO , GROUNDWATER DATE ~ ~-~ / TH~i 9 ~ 10~ 11 ~ DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) ~¢:~ 6/28/99 PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING 12~ , GM 13 1 4:55 6" 2 5:03 50 5 7/8" 1/8" 19~ PERCOLATION RATE 120+ (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 20 TEST RUN BETWEEN 7.5 FT. AND 8.0 FT. COMMENTS: ?~? ~;~ ~"~0 ~ ~ (-, ~,~ PERFORMED__ -BY-A~SKA WATER ~ WASTEWATER. I, JEFFR~ A. GARNESS, CERTI~ THAT THIS WAS PERFUMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON DEPTH TO GROUNDWATER DATE SEEP @ 9' 6/24/99 8' 6/28/99 ALASKA WATER & WASTEWATER CONSULTANTS INC. 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK. 99504 l SOIL LOG - PERCOLATION TEST I DATE PERFORMED: 7/6/99 ORGANICS/ TEST HOLE ~2 DEPTH ~ (feet) '% ~'~ LOAM , 5 SP CH 7-- DEPTH TO DATE GROUNDWATER L~._ ~ /TH~i+ 11- DATE READING CLOCK NET TIME WATER LEVEL NET DROP TIME (MINUTES) READING (INCHES) 12-I : 6/28/99 PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING 151 5:00 6" B.O.H. 2 5:~0 50 4 5/4" 1 1/4" 14I 5 5:51 6" 15 -- 4 4:01 50 4" 2" 5 4:02 16~ ' 6 4:~2 50 5 15/16" 2 1/16" 17~ 18I 19-- PERCOLATION RATE 14.5 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES) 20 II TEST RUN BETWEEN 4.5 FT. AND 5.0 FT. COMMENTS: PERFORMED BY A~SKA WATER & WASTEWATER. I, JEFFR~ A. GARNESS, CERTI~ THAT THIS ~.s .~.~o~.~ ,~ .cco.~..c~ ~,T...~ ST.T~ ..~ .U.,C.~.. ~U.~,.~S ,. ~CT O. DATE: '~/'.57~! DEPTH TO DATE GROUNDWATER WEEP @ 9.5' 7/6/99 7'4" 7/14/99 FROM~. RLP-SKA WATER ~ WASTEWATER PHONE NO. : 90733S3245 Jul. 29 1999 10:5?AM P2 ~ROPERTY OWNER AGREEIVIENT FOR THE ~NANCE OF AN ON-SITE WASTEWATF]~. DISPOSAL SYSTEM Anchorage Dep~ of Health and/Human Servic~s..(DHHS) anti thc pr~ ,- This a~ is made for the purpose of main~g an.on-site wastewger deposal system on t~ subject property. The proper~ owners agree to ~e following: Sub~t to t~ MunicipaLi~ of Anchorage, on an annual basiz, an inspection and operation stammen£ from a register~ professional engineer. Th~ insp~'tion anti operation statement shall verify that the engineer.has ~ect~ all effluent and air pumps, tlm~rs, and ahrms, and t~ any deficiencies have been r~paired and flag system i~ fut~ioning as d~signed. · (Pri,u~ Name) $~a~e of ! , x._ 5 l~ol;arize Here '1/,'., personally appeared before  who is personally known ~o me ~ whose tdenti~y I proved on the basis of --whose identity I provdd on the bach/affi~=ion of , a credible wi~ess ~o be the signer o~ the aboy~ document, and he/she acknowledged t~C he/she si~ed Nota~ MUNICIPALITY OF ANCHOt~AGE DEPARTMEN'r OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telel)hone 2.64-4720 ON-SITE SEWAGE DISPOSAl.. SYSTEM AND/OR WELL INSPECTION REPORT ~)~' NEW [] UPGRADE LEGAL DESCRIPTION LOCAT ON [ ~' [ Liq. c~ac~W in gallons ] . ~de length g= I DISTANCE TO: I ~ $~,O ~NCE TO: IMaterial ~-rench~id,t~ inches NO, OF BEDROOMS PERMIT NO. Liquid capacity in gallons Dista.~ge betv~een lines Tota~ eff, c.~tiNe absorption ar~e~ ~ PERMIT NO, lot line lot I)ne Total effective absorption area PERMIT NO. OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NA'rURAL RESOURES Division of Geologicol 6~ GeophyslcDI Surveys Drilling Permit No. ' : LOCATION OF WELL (Pleose complete either la, lb or lc.) A.D.L. No. -io--~.JRorough Subd,via[on Lot Block I-~.I '/4qtr$. Section No. Townahip N[~ Range ..... ' ~of~of~of ~ ; S~ W~ ,c.JJDISTANCE AND D,IRECTION FROM ROAD INTERSECTIONS 5. OWNER OF WELL; 2. WELL LOG Feet Below 4. WELL DEPTH; (final) 5. DATE OF COMPEETION Material Type Top BoHom - ; :j ~ 6, ~ Coble IDol E] Rotary ~ Driven ~Dug J ' .; D Auger ~deffed ~ Cored ~Other: ' ' 7. USE: ~ Domestic ~ Public Supply ~ Industry 8, CASIN~: ~ Threoded ~ Welded 9. FINISH OF WELL: Set between fl. ~nd ft. ~ . .,, · r ' Backfilling Grovel pock, . . - ~ ~ ; ' ~ : [ -~; , ; ~ Above or ~ Below land surfoce ff. otter hfs, pumping g.p.m. I~,GROUTING Well Grouted: ~ Yes ~ No . . ~ . ~::/ Length of Orop Pipe ' ' ft. capacity __g.p,m, 16. WATER WELL CONTRACTOR'S CERTIFICATION: 15. Wafer Temperolure o ~ F ~ C This well wes drilled .under.my jur[sdlclion end Ibis report is lrue lo the besl of m7 knowledge end bel[ef; Authorized Represenlolive Form O8-WWR (11/81) Cop~ Distribution; WHITE-Stele OGGS~ PINK-DriHer~ CANARY-Customer PERM i "l" I'.,JC~: C:OI",I TI:::]C'I" F:'FiOI",tE: 17 ]: CI-.ll:::ff~'.l], E',U'I"'I"EU'.,I ;700 P.I :L..":,4.'TH .t:l:2~S';."' R N C H O F;: FI G E., F:I K ~¢ :i;m 5 i~':1 5 d;:L..- 4 3 :E:d; LEI::!if:IL.. r3, EE;C:R .T. F': LOT 5; I ;i!:E: MFIX L ]: :~J;'I"EI.".:, BEI....OI-,.t FIRE 'T'H[E OF:'T :i: ONS {::{'v'F:l :[ L..RF3LE 'TO %.'131J I N DES :[ GN :1; h,tEi '¢OUR SEPT :i.':"r':R;Tlii:l'"l. CHOOS;liE 'T'HE O!:::"1': I ON "l"l'"lF:l"['~ E~E:!!i;'I" F ]: -r'2; 'T'f.')lJ[;i: :!~; ): 'T'E:. ::L :1.0 :+::.l.: [::,EPTH TO F'II::'E BO"F'TOI'"I .:::: :~:. !5 I:::"T. RE6:PJ:I:RE:ii; II'.,tSUI....FIT]:OI'-,I :+::+: DEF"T'H TEl I::'IF'E E',JZ~TTOH .:::: q.. t3 FT. f'IF:I'T' I:~:E(i:!IJI[~:E I:::1 [_:EFT :STI':ITIOI",I :+::+~ TFII",iK I"II...I!E;T I"IF::I',,"E!: I:::IT I...l!ii]:::l::ST Tt.'.IO ]: E:E:RT I F:"T' "FHFIT: :1... :[ F::ll'd F:'F~t'I ]:1.... l I::ff;;: 1.4:1: TH 'T'HE: F;:E:QI...I ]: F;:EI"tE:N'I':S I:::'O1:;i: OI",I-'.S I TIE :SE!I.,.IEEF:S FII'.,ID I.,IEL.L..S R:i'~; :'SET F:'OF;iKI"H ECr' "f'HE~: MUI",IIC:ZF'FIL. IT"r' OF:' F:IiqC:HOFi:I::IGIE <l'"lOFl> FIND THE STFITE OF I'""iL.FI'.i~.;KFI. 2, ]: I.,.I :1: L.L :[ I",tSTFII....I.... THE :i!i;h":STIEh'l :[ i",! I:::ICCOI'4;:C, FINC:E: 1.41 T'H F::IL.L. HOFI CODES; FtI",t[:' REGUL. FI'T' IONS., F:II",IC, ;[ l",l COHF'L. ]: FliqCE t.'.l ]: TH THE I:::'ES:[ ~::ii",l CF.': I TIEF.'. :[ R O1:::' TH I S F:'EF,'M :[ T. 2i:. :[ P.I:[I....L. FI[::'H!:!i:F;;:E TO RLL. MEIt::I l:::li",l[:' S'T'IaTE OF I:ILFISI':::FI I:~:E':I:::!IJI[~:EHEi",I'T'Ei; FOR THIE :SET E',I:::IC;K 13, .'[ S'T'I::ff',ICE':S F'l:;~:Old FIN'T' · lEX I S:;T]: i",]C~ t.,.tEL, t .... 141:::IS;TEt.'.ff:ITEI~: 13' ]: :ii;F'I3SFIL :S'¢STEM O1:;: I:::'LIEU..,, ]: C: SE].,.IEF~:RGE :5"r'STEf'I Ol",l T't"iZ:E; ELF;: I:::ll".!"r' FII:>JFIE:EI'4T OF..' NEFIFi:B"r' I_.CIT. 4. :1: L.II",II],EI:~:STFIIq[::, THF:IT 'T'H T:5 [::'IEI:;;:I"II "1' I :E'; ',,,'F:IL. :t: F;' FO'R FI I"tF:I',":', .T. HLJM OF:' ~: liiJEDROOMS; I::IN[:' RN'T' IENL. F:I[;i:GEM[~]".IT P.I :[ L.L. RE6!U :[ RE; FIN F::I[>[:' .T. T :[ OI",IFIL F:'EF;:M I T. L..T. F:'T' :~i'l"FtT I Ol'.,I t 5; :[ I",I:S'T'F:II..:LED :1:t',1 RI",t RF.:ER E:O',,,'EFi:IE[::, E:'¢ 1'"II3FI Bt..I IL[::, :[ I",IG E:OI:::,E:S., ,::~L::, FIN EI....[ii:E:'T'Fi:ICF:II.. F'EF~:H:[T Fli',I[:, Ii'.~::SF'IECTIOI'.,I I"'ILI'.'ST BE OEFf'F:I:[I'.,IE:D.~ ,::;'.;.'::, FIS-EHJI'L"F'.i!; l'.,iOT E:E I:::IF:'F:'RO'v'E:t~, t.,.11 THOUT F:II'.~ IS[...IECTFi: ]: CFIL. ;[ i'.,I:E;F'ECT .f. O1",t RE:F'ORT.~ RiqE:, ,:: :~:.':, TFIIE MUNICIPALITY OF ANCHORAGE ~ Health and Environmenta. ~rotection Department 825 ~. Street, Anchorage, AK. ~9501 264-4720 * * * (!'0¢1~ HANDWRITTEN PERMIT * * * Permit AND/i¢4~ ON-SITE SEWER PERMIT WEI_L Applicant: ~/~/-- ~~ Mailing Adaress:~ Location: ~ 5 ~1~ ~ ~ Z~~ne Nu~er: ~- ~/~ Legal Description:~c ~' T'/~--~ ~ LOt Size: Type of Soil ~sorption System Is: Trench: Drainfield: Seepage Bed: ~ Holding Tank Maximum Number of Bedrooms: ~ Soil Rating(sq.ft/br) /~/ The Required Size of the Soil Absorption System Is: DEPTH ~ LENGTH . .-~_~' GRAVEL DEPTH ~ WIDTH The length dimension is 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 and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall Pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = l~0~ GALLONS * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection and approval by this departmen will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fee for a private well or 150 to 200 feet from a public well depending upon the type of publ. ic well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31~ 1 9 o° 3 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site include more t-- sewer system may r~equire enlar~sement if ~~cXzmode 1 ed to Signe~: Issued by /ppl~cant ~ ~ . Date · SWP/024 (1/81) ~% ION ~ [~.c,"'~-~ .1 iZIZ~]Z ] MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) (b) (c) Lot 3; Block 5... Mann Subd~;visx'.on Location (address Or dii'ections) 1~041' S;f':. 7amo.~'; Anohcm. ago., Properiy owner. ~F.t'.~.. Fo.d¢.,~a£ Ba~k Mailing Address~' , · ,~15 Wo,~.~ Nn~.f'h~ Lending Institution Mailing Address Telephone: (home) Business I.igb.f',,, Bm~.Ccua#d. /,~('bn#ag¢,.; A.CaAba Telephone 27~-7884 99503 (d) Real Estate Company and Agent Address Telephone Mailthe HAAtothefollowing address:(orcheckhere,'~ifholdforpick up.) Listcontactperson and day phone numberbelow: S & S ~NGINEERING/694~2979 17034 Eagl~ River Loop Road, Suit~ 204 Eagle River, Alaska 99577 ATTENTION: Tuck&r Hearn REO #9408 (e) 2. TYPE OF RESIDENCE Single-Family~ Number of bedrooms 9 3. WATER SUPPLY Individual Well {~ Community [] Public [] Not~: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site.~ 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. 72-025 (Rev. 7/88) Page 1 of 2 ~ ,to ~ 85ed ')~JOM s,jeeu!J~ue leUO!SSe~oJd eql u! SUOISSILUO JO SJOJJe JOJ elq!suods@J ~ou s! @lbeJOqOUV ,to X],!18d!o!unw eq.t. 'penss! s! eleo!jp, JeO e eJo~aq e~ep ez,~leue Jo suoilo~dsu! lonpuoo leu op SHHQ to seeXoldLU3 'slUeLUeJ!nbeJ eie~s pue leJepej u!elJeo Ajs!~es o~ JepJo u! suo!lnl!lsu! 8u!puel J!eq~ pue seLuoq jo sJeseqoJnd oh AselJnoo e sa s!qj seep SHHG eq_L 'e~selv jo e~elS eql u! peJels!DeJ JeeuJDue leUO!SSejoJd luepuedepu! ue Aq e^oqe B qdeJSeJed u! ue^!6 suo!~e~ueseJdeJ eql uodn ,~iuo peseq peleo!tpeo leAoJddvAlpoqlnvqlleeHsenss! 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'$NOI.LO~dSNI 9NlalAO8d INI:II4 9NI~NISN~ '~ LUJh:l jo aLUeN  --~M MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) UNtCi PALI~(,~I~I;~TA'¢i] E B R UA R Y 1984 £NV[RONMENTAL SERVICES ~}~v~'~4 C)C'f' ]. 6 1989 Legal Description: ,L.. RECEIVED A. WELL DATA Well Classification _ Well Log Present (Y/N)__~_ Date Completed /-TL/~/~ Zr Total Depth~2¢,70 Cased to ~_'Depth of Grouting Static Water Level __?~ ' Casing Height Above Ground (,.,2 "-J- Electrical Wiring in Conduit (Y/N) ~' If A, B, C, D.E.C. Approved (Y/N) Yield ~ 'p ~ Pump Set At ~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots / .~O "~ [ ~/-t' ; On Adjoining Lots ! ~O '~ Jr' To Nearest Public Sewer Cleanout/Manhole ,",.)/~ SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot 'f'o Nearest Public Sewer Line To Nearest Sewer Sen)ice Line on Lot B. SEPTIC/HOLDING TANK DATA StanOpipes (Y/N)_ ~' Depression over Tank (Y/N) _ Pumping/Maintenance Contact on File (Y/N) ~/~l ; for ~-- Holding Tank High'Water Alarm (Y/N) ¢/~ Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: !__D__~ No. of Compartments ,~_ Air-tight Caps (Y/N) ~/ Foundation Cleanout (Y/N) ~/¢ ~ N) Date Last Pumped ~ ~ ~C:) '- ~ To Building Foundation _ To Disposal Field To Water-Supply Well ~,, !, ~ To Property Line /~o ' ~ To Water Main/Service Line / 0 '+ To Stream, Pond, Lake or Major Drainage Course Comments ~<~ ~.~)-7/','¢_ .t%, ,mqi4 E Q/ ~ 72-026 (Rev. 7/88) Fronl Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorptio. n_Strata Date Installed ~¢,~ ~ Width of Field ~O Square Feet of Absortion Area q/CD Depression over Field (Y/N) Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: Type of System Design __ Length of Field Depth of Field Gravel Bed Thickness /',~ - Statndpipes Present (Y/N) Date of Last Adequacy Test To Water-Supply Well To Building Foundation To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area To Property Line [~ ~ To Existing or Abandoned System on ; On Adjoining Lots *"/O -~ To Cutback (if present) ,'0/,4 Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that ~ have checked, verified, or conformed to all MOA and HAA guidelines in effect inspection. $ & $ ENGINEERING Signed 17034 Eagle River Loop ~[~a~, ~.~ ....... Eagle River, Alaska 9957~ Company Date /~-~/~./~2 ¢ Receipt No. Date of Payment Amount: $ 72-026 (Rev. 7/88) Back / Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 ,~.,~,~..~n the date Of this 7HEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. TELEPHONE (907) 562-2343 5633 B Street Anchorage, Alaska 99518 Drinking Water Analysis Report for Total Coliform Bacteria [] }(3 PRIVATE WATER SYSTEM Name Pho~ City State ~o. Bay Year TO BE COMPLETED BY WATER SUPPLIER PUB,,c WATER SYSTEM ,.D., I I I I Itl Zip Code SAMPLE TYPE: ~ Routine [] Check Sample (for routine sample with lab ref. no. [] Special Purpose .) [] Treated Water [] Untreated Water SAMPLE NO. LOCATION 2l 3 t, 4 l Time Collected Collected TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: r~Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 30 hours old at examination to indicate reliable results. Please send new sample via special delivery mail. Date Received ~'"~'-~ Time Received Analytical Method: Membrane Filter * No. of colonies/100 mi. Lab Rel. No. Result* I CF1 Analyst READ INSTRUCTIONS BEFORE COLLECTING SAMPLE BACTERIOLOGICAL WATER ANALYSIS RECORD Membrane Filter: Direct Count ~ Colltorm/100ml Verification: LTB Final Membrane Filler Results TNTC = Too Numberous To Count OB = Other Bacteria BGB Collform/100ml Time: /~, c:~ a.m. PART ONE OF TWO REMAINDER TO FOLLOW CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. / ~'~'~ 5633 B STREET ANCHORAGE, ALASKA 9~518 TELEPHONE (907) 562-2343 ~.,.,~"L;.'o~,~.-;.',~;~% FEDERAL TAX ID # 92-0040440 ANALYSIS REPORT BY SAMPLE for Work Order ~ 17012 Date Report Printed: OCT I 89 @ 13:40 Client Sample ID:L3 PWSID :UA Collected SEP 25 89 ~ 13:50 hre. Received SEP 25 89 @ 16:00 hrs. Preserved with :AS REQUIRED Client Name : S & S ENGR Client Acer : SNSENGP P.O.$ NONE RECEIVED Req $ Ordered By : Analysis Completed :SEP 27 89 Send Reports to: Laboratory Supervisor/:STEPIIEN C. EDE 1)S & $ ENGR Roleaeed By, ~ d.~_.~ 2) Special Instruct: Chemlab Roi ~: 7719 Lab Smpl ID: 1 Matrix: WATER Allowable Paramoter Tested Result/Units Mothod Limits NITRATE-N ND(O.IO) mg/1 EPa 353,2 10 Sample SAMPLE COLLECTED BY RDJ Remarks: 1 Tests Performed * See Special Instructions Above UA=Unavailable ND~ None Detected "See Sample Remarks Above NA= Not Analyzed LT-Less Than, GT~Greater Than Application Date GENERAL INFORIVIATION (a) Legal Description (include lot, block, subdivision, section, township, range) IVlUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONIVlENTAL HEALTH CERTIFICATE OF INSPECTION FOR HI:ALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 (b) (c) Location (address or directions) Applicant Name ~t~ ~ Telephone:Flome ~-~O~ Business Applicant Address ~ ~ ~ ~7 ~~ Applicant is (check one): Lending Institution~; Owner/builder~; Buyer ~; Other ~ (explain); (d) Lending Institution Address ~ ['~_ (e) Real Estate Company and Agent Address Telephone Telephone Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family~ Multi--Family Number of Bedrooms Other WATER SUPPLY Individual Well4~- Community [] Public [] Note: f community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsit~ Public [] Community [] Holding 'rank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72*025 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA 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 om.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 ~ ~ b.¢¢l,.,~ ¢.,.c~ Telephone _ ~ 4 ' ~ Address .~. ~_ ~ ~ ~ ~ ~ ~7 '// DHEP A P P~IO,V~J.~x Approv~,d /'~, Disapproved Conditional Terms of Conditional Approval 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 couMesy 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. Paqe 2 c~f 2 MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: ,~.o~" MUNICIPALITy OF A, NCHoi~AGE DEPT. OF HEALTH ENVIRONMENTAl, PI~OTECTION APR WELL DATA Well Classification "~¢1 g ¢f'T~ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) ~$ Date Completed /-{'l(~l~'~ Yield Total Depth '¢~4:2 Cased Static Water Level "~Z¢"- Casing Height Above Ground .~ Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot Depth of Grouting ___ Pump Set At Sanitary Seal on Casing (Y/N) "~¢"'~'~ Depression Around Wellhead (Y/N) I~O ~,_~¢¢-- ~-.~¢ ~.1.4~.~_~, On Adjoining Lots To Nearest Edge of Absorption Field on Lot ~; On Adjoining Lots To Nearest Public Sewer Line .13 .//~ To Nearest Public Sewer Cleanout/Manhole 10 (A To Nearest Sewer Service Line Water Sample Collected by ~.~-~4don~-~ ~ u' ~..~ ; Date Water Sample Test Results ~ .~ - Comments ~-~¢__.. /¥y'~'~ A ,'~.~,~ ~_.~ L~,~ ¢¢_, B. SEPTIC/HOLDING TANK DATA Datelnstalled ~l~ll~r'l.. Size I''~'-~:::> No. of Compartments ~L~ Standpipes (Y/N) i,~,~:;;~l Air-tight Caps (Y/N) '~/~ Foundation Cleanout (Y/N) ~k~-~ 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 _ To Property Line "~¢-¢'O~ To Water Main/Service Line Course Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) To Building Foundation To Disposal Field ~_!O, To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption ~trata Date Installed I~Ol ~,'1/~ Width of Field .~, ~)/! Square Feet of Absorption Area Depression over Field (Y/N) J'JCO Results of Last Adequacy Test ~)/ Separation Distance from Absorption Field: To Water-Supply Well ! ! !. ~ To Building Foundation C- Lot ~ / ~ To Water Main/Service Line ~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments Type of System Design Length of Field /'~'~ '°~ Depth of Field 4, O~ Gravel Bed Thickness ~-,q-~ I Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line I~( O To Existing or Abandoned System on ; On Adjoining Lots JE'"/O., O · To Cutbank (if present) 'i~z'b. ~D r 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 ~3a, v~ checked, verifij~ or co)~rmed to all MOA and HAA guidelines in effect on the date of this inspection. Signed ~/'~---/'f /'~-'~"~Date ,~'~t_~_ Company' ~ ¢~6,~ MOA No. ~ ~ Receipt No. %~q.C( 55~ Date of Payment ).}_1~ -~ Amount: $ L) %~ Page 2 of 2 72-026 (11184) BILL SHEFFIELD, GOVEI~NOI~ ~t~T.O~ ~NV~RONM~NTAL ~ONS~RVATHON ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 303 ANCHORAGE, ALASKA 99501 274-2533 March 18, 1985 Mr. Richard C. Button, P.E. 200 W. 34th, #267 Anchorage, Alaska 99503 SUBJECT: Waiver Horizontal Separation between Well and Septic Tank, Lot 3, Block 5, Mann Subdivision, Anchorage, Alaska (8521-WA-119) Dear Mr. Button: The Department has reviewed the subject waiver request and hereby waives the horizontal separation between the well and septic tank to 91 feet on the subject property for a 3 bedroom single family residence only. This waiver is contingent upon the neighbor's well being properly abandoned by filling the top 10 feet with concrete. Sincerely, District Engineer SWE/msm Richard C. Button 200 W. 34th, #267 Anchorage, Alaska 99503 April 4, 1985 Municipality of Anchorage Department of Health and Environmental Protection 825 L. Street Anchorage, Alaska 99501 Attention: Robert Robinson Dear Mr. Robinson: This letter is to inform you that the well mentioned in the State of Alaska D.E.C. letter of March 18, 1985, by Mr. Steve Eng has been abandoned according to accepted procedures: 15 feet of concrete in the well itself, with the well casing capped and sealed at the top by a steel plate continuously welded to the casing. Sincerely/, ~ /r // Richard C. Button, P.E./