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':
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MFIX
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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
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--~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./