Loading...
HomeMy WebLinkAboutSKY RANCH ESTATES #2 BLK 2 LT 26 Municipality of Anchorage Page / of ~ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: _~IA/' ~-¢/7~ PID Number: '-¢' ~¢,..¢~o ¢~ Q ' N.~: .)~ ~S~ Wastewater System: O New ~Upgrade Address: ~OO [~41S~ ~p~ ABSORPTION FIELD Phone: ~ No. of Bedrooms: ~O~ ~ Deep Trench ~allow'French D Bed 0 Mound ~ Other LEGAL DESORIPTI ON so,, Rating: ,~¢ GPO/Sq. Ft. Total Depth from original grade:lC Lot: Block: S~bdivision: Depth to pipe boitom Irom original grade: Gravel depth beneath pipe Township: Range: Section: Fill added above original grade: Gravel length: WELL: O New~. ~ Upgrade Gravelwidth: ¢ Ft. ~ ~. /~ Ft. Classilication (Private. A.B,C): Total Depth: ~ased TO: Total absorption area: Pipe material: ~ ~"' ~O ~ ~ SEPARATION DISTANCES ~pti, U Holding [3 S.T.E.P. TO Sept,c Absorption LiFt Holding P,blic/Prlvat, ~S~rer~ Cap;city in gallons; Line ~¢/' ~ ~ ~ Size in gallo.s: Manufacturer: "Pump on" level at: ~~evel al: High water alarm Foundstion //~ /~ I Drain Remarks: BENCH ~ARK k Assumed Elevation: / ¢ ~ ~, EN6 NEER'S SEAL Department of Health and Human Services approval Reviewed and approved by: Date:/~ -/¢- ~ ~ "' 72-013 (Rev. 9/9~) MOA 25 Permit No.. ~v'~cls"Ol"Ic] Page ~' of- ~/' Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater DisPOsal System and/or Well Inspection Report Legal De?cription: ?l I Permit No.. ~t~)cis'O/Tc) Page_ ,-~ of ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit No. _5'~ c/~'O I-7~ ...e_ q- _o~3- Municipality of Anchorage DEPARTMENT OF HEALTH AN[:) HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Wel~ Inspection Report Rick Mystrom. Mayor Mtmicipality of Anchorag,e Department of Health and Human Services 825 "U' Street P.O. Box 196650 Anchorage, Alaska 99519-6650 October 20, 1995 Michael E. Anderson, P.E. Anderson Engineering PO Box 240773 Anchorage, Alaska 99524 Subject: Waiver Request for Lot 26 Block 2 Sky Ranch Estates #2 Waiver Request #WR950055, PID #015-302-50, SW950179 Dear Mr. Anderson: Your request for a waiver of the required 10 foot separation between a septic system and a lot line has been approved. The waived distance is 5 feet from the north property line. 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. Sincerely, Daniel J. Roth Civil Engineer On-site Services DJR/ljm MUNICIPALITY OF ANCHORAGE Depar~ment of Health and Human Services On-site Services Section Waiver Revzew Worksheet WR~ WR950055 PID~ 015-302-50 HA= Permit Date Received: October 11, 1995 Legal Description: Lot 26 Block 2 Sky Ranch Estates ~2 Engineer: Michael E. Anderson. P.E., Anderson Engineering ~ SW950179 PO Box 240773, Anchorage, Alaska 99524 Applicant: John Darst Waiver Requested: Lot line wamver of 5' of the north property line Criteria: 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special CondLtlons: Poinus: 3. Other: Waiver is Granted: _ ~ List Conditions or Reasons Waiver zs NOT Granted: for above: ~E Ft~6;~r ~TT~ Name of Reviewer Rec ~: ~01379/3543 Amo~[nt: $ 115.00 Date Paid: 10-11-95 October 10, 1995 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 ANDERSON ENGINEERING P.O. BOX 240773 A,C.ORAGE, A~.ASKA 99524R [ C [ IV [ D COT l~11995 Municipality of Anchorage Dept, Health & Human Services Subject: Lot 26, Block 2, Sky Ranch Estates Subdivision No. 2 Septic System As-Built Lot Line Waiver Request Dear On Site Services Engineer: The attached as-built indicates tile location of the absorption trenches recently installed on the subject lot. Due to the marginal soils and limited surface area the trenches were placed within 5' of the north lot line. No other area was available as the lot is only 13;790 square feet and the original absorption trench was left in place for possible future use. We therefore request a lot line waiver be issued allowing the absorption trenches to be placed within 5' of the lot line. The subdivision is served by a community water system so no wells in the area are impacted by the location of the new absorption trenches. In addition, tile system located on the adjoining lot is more than 50' away from the trenches. It was not possible to locate the trenches in any other area on the lot. Since placing the trench within 5' of the lot line will have no impact on other lots or easements in the area I recommend the waiver be granted. Please let me know if you have additional questions. Sincerely, Michael E. Anderson, P.E. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 'ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT MUMBER:SW950179 DESIGN ENGINEER:SKY LABORATORY OWNER NAME:DARST JOHN CALVIN OWNER ADDRESS:5400 WHISPERING SPRUCE DR ANCHORAGE, AK 00515 DATE ISSUED: 7/26/95 EXPIRATION DATE: 7/26/96 PARCEL ID:01530250 LEGAL DESCRIPTION: SKY RANCH ESTATES #2 BLK 2 LT 26 LOT SIZE: 13790 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: l. 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 (18AACS0) . THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EADH INSPECTION~ PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. 1 SPECIAL PROVISIONS: A HANCOR OR EQIVILANT TYPE VALVE MUST BE USED TO ATTAIN EQUAL DISTRIBUTION OF THE SEPTIC EFFLUENT INTO ALL THREE RECEIVED BY: DATE: Sky Laboratory Soils and Materials Testing, Geotechnical and Environmental Engineering July 14, 1995 Robby Robinson On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Septic System Replacement Lot 26, Block 2, Sky Ranch Estates No. 2, Anchorage, Alaska Dear Mr. P, obinson: This letter is to provide an addendum with a revised design plan sheet for the on-site waste water disposal system replacement design submitted for the above referenced site. Revisions include the addition of a distribution box and a diversion valve and line to the existing drainfield system. We discussed this on July 11,199 . .... A distribution box, as described in the EPA Onsite Wastewater Treatment and Disposal Systems Design Manual Section 7.2.8.1.d, or an equivalent flow distribution valve shall be incorporated to evenly split the effluent flow to the three trenches. A diversion valve and additional line to the existing drainfield system may be included with the system upgrade pending excavation and inspection of the existing effluent lines and concurrent approval by the engineer and owner. I hope these revisions will meet your concerns and satisfy the requirements. If you have any questions or require clarification, please call our office at 688-0344. Sincerely, James A. Smith, P.E. Attachments: On-Site Design Site Plan, Revision 1 P.O. Box 670371, Chttgiak, Alaska 99567 Phone/Fax: (907) 688-0344 / / / I/ 'x L_o~ ~5 / GARAGE Lot 27 FOUR BEDROOM HOUSE REPLACEMENT TANK [ ~/ENCL DSED DECK TEST HeLE 0CLEANOUT · MONITOR TUBE DISTRIDUTION O ~.'× ~ ~ - ~E×is*in9 Seepoge Pit 7 I ~ I]R^[NFIELI) NO KNOWN CURTAIN DRAINS James A Smith, P E ' · ' · · ON-SITE DESIGN SITE PLAN "~'" dba ................. ~ .... . - . .~ .~4. ~Ny Laooratory ............... ~.. JAMES A SMITH .:~ Ohuglak, Ale.Ne ~e~Z Sewer System Replocement CADD File Name: 95-O00.dwg R.v, No, m r=2o' m 7~ t "*~ I m .Sky Laboratory Soils and Materials Testing, Oeotechnical and Environmental Engineering June 5, 1995 Jim Cross, P.E. Manager, On--Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Narrative - Septic System Replacement Lot 26, Block 2, Sky Ranch Fstates No. 2, Anchorage, Alaska Dear Mr. Cross: This letter is to provide the narrative for the on-site waste water disposal system replacement at the above referenced site. The existing system has experienced problems during spring thaw periods, and, coupled with the age of the system, replacement of the system is desired. The proposed system replacement will have very limited impact on adjacent properties for the following reasons: / 1. The surrounding lots allow sufficient room for septic sites. 2. Immediate neighboring septic systems are all plus 30 feet distance. 3. Reserve space is adequate, due to soil absorption capacity. 4. Drainage will not be affected and is not a major consideration in our design. Three test holes were excavated at the site in 1993 and are shown on the site plan. Test Hole No. 2 and No. 3 were excavated to define the existing system. Gray water was encountered in Test Hole No. 3 and I believe groundwater, encountered at 5 feet below ground surface in Test Hole No. 2, is influenced by the existing system. If you have any questions please call our office at 688-0344. Sincerely, James A. Smith, P.E. P.O. ~3ox 670372, Chugiak, Alaska 99567 Phone/Fax: (907) 688-0344 JAMES A. SMITH, P.E. Sky Laboratory P.O. Box 667371 Chugiak, Alaska 99567 (907) 688-0344 SL Project No.: 95-000 Calculated By: JAS Date: 6/5/95 Legal Description: LOT 26, BLOCK 2, SKY RANCH ESTATES No. 2 Single Family 4 Bedroom Dwelling Shallow Trench Subsurface Wastewater Disposal Field Water use at 150 gallons per bedroom = 600 gallons Percolation rate = 46 minutes per inch Wastewater application rate = 0.45 gallons per day per square foot Required absorption area = 1333 square feet Trench width (W)= 5 feet Gravel depth (D) = 4 feet Required length: Shallow trench factor * Required absorption area / W Shallow trench factor = (W + 2) / (W + 1 +2 D; Shallow trench factor = 0.50 Required length = 0.50 * 1333 / 5 Required length = 133 feet ~ ~ NO ~/ELL DR SEPTIC CONFLICT NO KNOWN CURTAIN DRAINS FOUR BEDROOM HOUSE ,/ames A. Smith, P.E. dba Sky Laboratory P.O. Box 670371 Chug/ak, Alaska 90667 Sky Projecl Number: 95-000 CADD File Name: 95-O00.dwg /~ENCLDSCD DECK 27 ON-SITE DESIGN SITE PLAN - L 26, B 2, Sky Roach Esloles No. Sewer Syslem Replacement Sky Laboratory Soils and Materials Tesling, Geotechnical and Environmental Engineering SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: LOT 26, BLK 2, SKY RANCH ESTATES No. 2 A. GENERAL 1. The well and septic plan are for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health requirements. 4. All soil tests are advisory to tile design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. 7. The excavation is to be exactly in the area shown 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. B, DRAINFIELD 1. The drainfield is to follow the natural land contour to maintain uniform total depth of the drainfield bottom. 2. The bottom of the drainfield shall be level, plus or minus 1.5". 3. The total depth of the drainfield excavation is not to exceed 7' at any point. 4. The drainfield 9ravel is to be covered with typar fabric material. 5. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the drainfield. 6. The area over the drainfield is to be finish 9faded to prevent ponding of surface water runoff. 7. The septic tank and drainfield must not be closer than 100' to any existin9 private well, 150' to any Class "C" well, or 200 feet to any community well. DRAINFIELD DESIGN CRITERIA: SOIL RATING = 0.45 GPD/fF APPLICATION AREA = 1,333 sq.ft. BEDROOM CAPACITY = 4 MINIMUM SEP'f'IC TANK = 1,250 gal. RECOMMENDED DRAINFIELD DIMENSIONS: TOTAL DEPTH = 8.5 ft. DRAINFIELD LENGTH = 133 ft. GRAVEL DEPTH = 4 ft. DRAINFIELD WIDTH = 5 ft. Twenty-four (24) hours notice required for all inspections. P.O. Box 670371, Chugiak, Alaska 99567 Phone/Fax: (907) 688-0344 Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE PERFORMED: ~-/[~ /q % LEGAL DESCRIPTION:~'~ ~,~.y 5~::,~.cL 'EsA-~,-% s ~qo. '-2. 8 9 10 11 13 14 15 16 t7 18 19 20- Township, Range, Section: SLOPE JAMES A. SMITH CE 8816 WAS GROUND WATER ENCOUNTERED? SITE PLAN IF YES, ATWHAT DEPTH? 1% ~&- Deplh lo W~t~¢ A,er %/I ~ ~onitoring? ~ ~' Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCO'ATION RATE TEST RUN BETWEEN COMMENTS ACCORDANCE WITN ALL STA~E AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE mutes/tach) PERC HOLE DIAMETER --.~ <~'~'- FTAND ~"~ FT CERBFY THAT ~HtS TEST WAS PERFORMED IN ?2 008 (Rev 4/85J GRE ,ER ANCHORAGE AREA Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION _ LEGAL /7//¢.~, ...... SEPTIC TANK: .~ [>(~ '~*(,¢/ [///~¢ (~,. A.~,t¢/~ ~,,t{)/~1 / ///// (_~ 0 '~/' { [(~ ~/l../' /~/ DISTANCE / ,~ ~//~ ¥ NUMBER OF FROM WELL MANUFACTURER MATERIAl COMPARTMENTS INSIDE LENGTH_ INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY ___ GALLONS, TILE [)RAIN FIELD:~/~/2' ~°/y ~'O 0/~,/V/¢/ ~ / /~ / TOTAL LENGTH DISTANCE FROM WELL~Ir// ~%FOUNDATION [¢ ~ NEAREST LOT LINE OF LINES /~ / NUMBER OF LINES~/ DISTANCE BETWEEN LINE ~TRENCH WlDTb~ IN. TOTAL EFFECTIVE / ABSORPTION AREA~/~_~ SQ. FT. LENGTH OF EACFI LINE DEPTH OF FILTER WELL: TVPE~)/¢/////] ~ _CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION__ LOT LINE SEWER LINE TANK , SYSTEM CESSPOOL __ OTHER SOURCES APPROVED DISAPPROVED___ REMARKS DrSTANCES: SEWER LINE DEPTH: PIPE MATERIAL: /~)¢~- ~ --- REMARKS: Form LQ-032 ~DIAG RAM 0 ~) GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" STREET ANEHORAGE, ALASKA 99503 PERMIT NO, SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT INSTALLATION OF: SEPTIC TANK ~/ SEEPAGE PIT ., DRAIN FIELD -, OTHER SOIL TEST RESULTS NOTI"= THIS PI-'RI~II'F IS NOT VALID WITHOUT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION, EEPT,OTA"KS'ZE T.PE / FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK . SEEPAGE PIT TO NEAREST LOT LINE. WELL TO SEPTIC TANK DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD_ SEPTIC TANK, ., SEEPAGE PIT TO RIVER, LAKE, STREAM. SEEPAge AREA SIZE , DRAIN FIELD -, DRAIN FIELD SEEPAGE PIT ALSO CONSIDER AREA WELLS. -, SEEPAGE PIT . DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CFIOSSING GAP OF EXCAVATION S FEET INtO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED~,. "'SYSTEM// --[S IN F&A'CORDANCE W'TH SAID 'ODE. DATE APPLICANT'S SIGNATURE ,' GRE ER A~C~AgE AREA BO ,UGH SEWAGE DISPOSAL SYSTEM ~ APPLICATION AND PERMIT INSTALLATION LOCATION SEEPAGE PIT , DRAIN FIELD TO BE INSTALLED BY COMPLETION DATE ANTICIPATED NOTE= THIS PERMIT IS NOT VALID WITHOIJT SOIL TEST FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SU~3JECT TO PROSECUTION. MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK J~ I FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK ~ {* SEEPAGE PIT -, DRAIN FIELD TO NEAREST LOT LINE. WELL TO SePTiC 'FAN. ~.~0 / SEEPAGE PIT DRAIN ~IElD ~2 I septic ~A~x, _ /~/ , s~epAOe pit , ALSO CONSIDER AREA WELLS. SEEPAGE Pit CAST IRON iNTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIP:'ION PIPES ON SEPTIC TANK AND SEEPAGE Pit FITTED WITH Al RTJgHT rEMOVABLE CAPS. GRAVEL BACKFILl. CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION, I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCFIORAGE AREA BOROUGH ORDINANCE NO. 20-68 AND THAT THE A~3OVE DATEOE'CRI'EDSY'TEMISINACCO'DANCEWI'~NSAIDCODE'~/~'-~ ,ppLi,ANT., '',NATU,E :--~/~>~~~ - -- .~GRE 'ER ANCHORAGE AREA BOr Department of Environmental (~uality 3330 C Street Anchorage, Alaska 99503 UGH INSPECTION REPORT ON-SITE SEWAGE r)ISPOSAL SYSTEM NAME /-/~ o/.Z) LOCATION SEPTIC TANK: DISTANCE ~'~ ?-~ NUMBER OF FROM WELL(~O/w ~ MANUFACTURER_ ~K~ 7~-/~ /~- MATERIAL .~/~'a~, ~.= t.,,e._ ~1~ 12'a,, yDI -- COMPARTMENTS INSIDE LENGTH .INSIDE WIDTH. LIQUID DEPTH LIQUID CAPACITY ,/~9 GALLONS, SEEPAGE PIT: NUMBER OF PITS J DIAMETER LINING MATERIAL /~//M(~ ~ ' BUILDING FOUNDATIO~/~ ~,~ ADDITIONAL ABSORPTION CRIB SIZE: 0 R WI DTN '}-~LENGTH DIAMETER DEPTH DEPTH ./2 / DISTANCE FROM: WELL TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) _SQ. FT. WELL.: TYPE _ ~0 ~/1 BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCTION DEPTH ./ ~_~_ /~DI~J'T~N CE FROM: NEAREST ~/.o~ .... NEAR'~E~ '~'~ , ~SEPTIC ~S~GE LOT LINE ~-7 , SEWER LINE~::)~/--- TA~ , ~--'-- , SYSTEM ,..~O;FHER SOURCES DISAPPROVED REMARKS DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: ~o a~ ("~.'~',S"~ PIPE MATERIAL: LOT SLOPE: Form NO. EQ-031 .~A.A.B. SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT GREATER ANCHORAGE AREA BOROUGFi PERMIT NO, DEPARTMENT OF ENVIRONMENTAL QUALITY NOTEI THIJG PERMIT IS NOT VALIU WITHOUT 5OIL TEl.1' SEPTIC TANK TO S~EPAGE PIT WALL /¢~ / seepage Pit -~ / DRAIN FIELD ALSO CONSIDER AREA WELLS, SEPTIC TANK,/~ _, SEEPAGE PIT~~ --, DRAIN FIELD GRAVEL BACKFILL CONFORM TO E~OROUGH J~EGtJLATIONS REGARDING INSTALLATIOH. ~;!~'rcOil a ti (~ Rai:e ~i Pr(~.posed In~t'~'ij~ii'~f~[i~: Se:~)a~e Pit Drain Field MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Ser,~ices On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING c~/ .~'-- 3c, 9 - S'~-~ NAA# 1. GENERAL INFORMATION Complete legal description Lot 46; BlocI,'. ¢.; q~,u Ranch Estates Location (site address or directions) Property owner Mailing address _ Lending agency Jo[~¢ Da,~S,~ C/0 VISTA REAL ~ST/,TE 5400 (?/~".sperinq Sp/usce A¢~chora9e, AK Day phone 4~41 "B' Stre¢% Anchorage. Day phone A~ 99303 Mailing address Agent Bria,~ Brod¢.rich/ ' ~ Real Address Day phone 273--726i Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: individual well / Community well ..... '- Public water MUNICI~.~^LII'Y OF At'IC4101,(AG~ ENYIKI~I~ENTAL SERVICES DIVISION JUN 0 7 1996 RECEIVED NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. STATEMENT OF INSPECTION BY ENGINEER As certified by my seat affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and reg~t~oErcisGi~q~Gon the date of this inspection. Name of Firm 17034 Eagle River Loop Road No, 204 ' Eagle I~iYer, Aiaska 9~5~7 Phone G ,'~ '-/- ;)-~? -7 ~ Address , ,¢ f ,,~, Engineer's signature ~¢ '~ (;'%-4,..,~ Date 6/'~ /' ~/L, DHHS SIGNATURE ~ Approved for 4 Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Date The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a court~syto purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 · Anchorage Alaska 99501· (907) 343-4744 Legal Description: t-0 F- 5~ ~ A. WELL DATA h.~ / ~- Well type __ Health Authority Approval Checklist Parcell. D.: ©15---3o .>._ -' If A, B, or C, attach ADEC letter. ADEC water system number Log present(Y,q',l) Date completed Total depth _ Cased to Sanitary seal (Y/N) Date of test Static water level Well production FROM WELL LOG Nitrate Casing heigh~a~ve ground) W~rly protected (Y/N) MUNICIPALIT~ OF AT INSPECTI~i~E~~ SERVICES DIVISION JUN 07 1996 RECEIVED g.p.m, g.p.m. Other bacteria Collected by: 2. Clcanouts{~YN)_ Ye J Number of Compartments B. ~IOLDING TANK DATA Date installed ~ / q ,~ Ta~ size t ~ ~0 Foundation cle~out ~ Y¢5 Depression ~. ~o D~te ofl'mnping ~ [~ { ~ ~ C. ABSOR~ION FmLD D~TA D~te lnst~led ~ ( ~ 3~ Soil rating (g.p.d,/fl2 or fl2~flrm) O, Length ] ~ 5 re;a. Width 6" Gravel thickness below pipe High water alarm Pumper /4 'h ~/o~6 ~-~,~,,,;:,~ ~ System type _ F rt 4.~ ca Total depth Eflbctive absorption area ] 333'~ MonitoringTubepresent~)lq)¥e~ Depression over field (Y/~- Date of adequacy test t,,/4 - tv ~ ,...,, Results (Pass/Fail) .~Eov--- bedrooms Fluid depth in absorption field before test (in.) ~ er gal. water added (in.): Fluid depth ___(ins.~.Mina~ later: Absorption rate = Peroxtde treat~nt (past 12 months) (Y/N) _ If yes, give date D. LIFr STATION Date installed Manhole/Access High water alarm level at* Size iii gallons  level at* *Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: I~i~holding tank on lot Absorption field on lot ; On adjacent lots Public sewer main ~ Public sewer manhole/cleanout sew~ Lffi station · SEPARATION DISTANCES FROIVI~..~I_~OLDING TANK ON LOT TO: Building foundation I I Property line tt o ~ Absorption field Water main/service line ~. ~/4~ Surface water/drainage / 0 o ~ 4- Wells un adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation ~ i~ Property Line $- Water main/service line Surface water I o o -~ Driveway, parking/vehicle storage area Curtain drain ~o,~ /c,,~o~r~ Wells on adjacent lots ~ o o 4- ~cert~fythat~ h~edeterminedthn~eldin~pecti~nsandreview~fMunicipalr~}~r~sa~e . .... .... Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number Rev. 8/95 dSS: haa.wk.doc MUNICIPALITY OF ANCHORAGE DIVISION OF ENVIRONMENTAL HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AUTHORITY APPROVAJ~ CERTIFICATE 1. Ge~nera, 1 I__._nf__ormation Application Date (a) Legal Description (include lot, block, subdivisiou~ section, township, range) Location (address or directions) (b) Applicants Name 3~hn ~ . Te~le_~.~ho_n_e~- H~ome B_~u~s~i.~es~s ~_ Applicants Address .~o 6~$p3_r~.~f~¥~l ~mc4o~a~ (c) Applicant is (check one) Lending Institution I~ ~ 0~ner/builder Buyer ~[ ; Other (explain); (d) Lending Institution ~(~k~__m~_c~ ...... Tele_phoue (e) Real Estate Co. & Agent Address -~' Telephone ~ ~. (f) Mail the HAA to the following address: 2o T_~e of Residenpe Single~Family~ Number of Bedrooms 3. Wa~ter Su~l~ Individual Woll~ ° Multi-Family~ Other (describe) Note: if community well system, must have ~.m~itten confirmation from the State Department of Environmental Conservation attesting to the legality and status. S~~osal 0nsite ~ Public ~ Community ~ / Holding Tank ~ Note: If community well system, must have ~itten confirmation from the State Department of Environmental Conservation ~ttesting to the legality and status. [Page 1 of 2] 5, En~ineerin~ Firm]?ro__vidinJ$__Ij~i~o~~File S?~arch Data an~d Inf?___rma~_io~n Ae certified by my seal affixed hereto and as of the valida~ion date shorn below, I verify that my investigation of this Health Authori~y Approval shows that the or~-sl~e water supply and/or wastewater disposal system is safe~ functiou~ and adequata for ~he number of bedrooms and ~pe of structure indicated herein.. I further verify ~ha~, based on ~he infection obtain~ from the ~micipallgy of ~chorage files and from ~ investigation ~d inspecCion~ the om-site ~ter supply and/or ~stewa~er ~spos~ system is in compliance with ~1 ~nicipal and State codes, ordinances, a~ reg~a~ ~lous in effect om the date of this inspection. Approved for ~bedrooms By ___~&/L~C Dat~(jj~A/~ __ Approved ~, Disapproved ---- Condii:ioua ~. Te~a of CondiCion~ Approval CAUTION THE MUNICIPALITY OF A/~CHORAGE DEPARTMENT OF HF~LTH AND ENVIRONMENTAL PROTECTION (DHEP) ISSUES HEALTH AUTHORITY ~?PROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT= ATIONS GIVEN IN PARAGRAPH 5 ABO~q~ BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED IN TRIg STATE OF ALASKA. THE DHE]? DOES THIS AS A COUR%~,SY TO PURCHASERS OF HOMES AND THEIR LENDING INSTITUTIONS IN ORJ)ER TO SATISFY CERTAIN ~ZDERAL AND STATE REQULRE~ MENTS, EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS 0R ANALYZE DATA BEFORE A CERTIFICATE IS ISSUED° THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS OR OMISSIONS IN TtH~ PROFESSIONAL ENGINEER'S WORK. (DaEPS ) RR4/eJ/Di8 [Page 2 of 2] 7-19-84 MUNICIPALITY OF ANCHORAGE (MOA) HEAL:HI AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 Well Classification If A, B, o~ C, D.E.C. Approved.(Y/N) Well Log P~.esent .(Y/N) Total Eepth Cased to Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances f~om Well: To Septic/qtolding Tank on Lot To 5~arest Edge of Absorption Field on Lot To Neap, est Public Hewe~ Line Date Completed Pump Set At Yie :id Depth of Grouting. Sanitary Seal on Casing (Y/N) __ Depression A~ound Wellhead (Y/N) .... ; On Adjoining Lots ; On Adjoining Lots___ To Nearest Public Sewer Cleanout/Manhole Wate~ Sample Collected By Water Sample Test Pesults Ccmn~nts To Nearest Sewer Service Line on Lot .... ; Date B. SEPTIC/~OLDING TANK L~TA Date Installed '7- '7~, Size IZSO No. of Ccmpa~tn~nts Standpipes (Y/N) ~ Air-tight Caps (Y/N) ~ _ Foundation Cleanout (Y/N) De[z~essfon ove~ Tank .(Y/N) N Date Las~ Pumped ,Au~u~J- Lg~::~ ~ Pun~pinggMaintenance Contract on File .(Y/N_) N~ ; fo~ --__ Holding Tank High-Water Alarm (Y/N) ~_O_~ Temporary Holding Tank Pemnit (Y/N) Separation Distances f~cm Septic/Holding Tank: To Water-Supply Well 'Zoo' ,~ TO Building Foundation TO P~operty Line __ ~S'+ To Disposal Field Ig~e To Water Main/Service Line ~O' [~- - To Stzeam, Pond, Lake, o~ Majo~ D~ainage Course [Page 1 of 2] 2-15=84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata ~-~$ ~ Type of System-Design pi~/~ Date Installed 1~o75/ ~9~ Length of Field~y/~onkno~ ~ Width of Field or~2~0~ · Depth of Fleld umkuo~n /~_~ ..- To ~te~-Suppty ~11 ~ To ~o~ty Li~ To Building Foundation ~5'+ To Existing or ~ndo~d System Lot N~ ; ~ Adjoining ~ts To Wate~ Main/~vi~ Line 50~ To ~t~(if p~e~nt) To St~e~ond~ke/~ Majo~ ~aina~ C~se To ~iveway, Pa~king ~ea, ~ Vehicle Sto~a~ ~ea D.' LI~ S~TION Date Installed Size in Gallons "Pump On" Level at High Wate~ Alaz-m Level at Tested fo~ Electrical Codes(Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. ~ets MOA Corm~nts ** Check Permitted Bedroom Rating A~ainst HAA ~quest I certify tilat I have checked, verified, o~ conformed to all MOA HAA on the date of this inspectic~. Signed ~ ~fc~ckeq~ Date ~ Company Cc~s4~c~nq ~,¼~¢~ /u¢ MOA No. [Page 2 of 2] ',n effect 2-15-84 ~~/ ~"NO C Street Anchora-~ AlasKa 99503 274 ~ , ~)~.~ ~'~ ~! ~,~'~ d~}^ ~)~/ Date Received~~ / ~oro~a~ re~ue~e~ ~: ~ ~~~ ~ ~ Mailing Address: Phone: ~o~e~ Ow~e~: ~~ ~&. ~,o.e: Mailing Address: 4. Location: ~.%0~ ~ ~Q_~ 5. Type of facility to be inspected~t L~,~-O ~C~c~,, NO. of bedrooms Well Data: A. Type (qc~w~c'c-,t ~c~t'~ C. Construction Sewage Disposal System: ~)t~T]Cm ~.~r~x? -~ A. Installed .L~C~rl~. C. Septic Tank: 1. Size 2. Manufacturer '/ ~'"/~B, DePth ' '' D. Bacterial Analysis D. Seepage Pit: 1. Absorption Area 2,.- Ma'~erial ~. E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank , Absorption area ., Sewer Lines__ Nearest lot line , Other contamination B. Foundation to septic tank , Absorption area C. Absorption area to nearest lot line EQ-034 (1/74) Page 1 of two pages Page 2 of two pages - Rec for Approval of Individual S & Water Facilities ~~%pproval ,Valid for one year rom date signed Greater A~chorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) : MUNICIPALITY OF ANCHORAGE DEP,~,R, TMENT OF ENVIRONMENTAL QUALITY 3330 C Street, Anchorage, Alaska 99503 -- 274-4!561 1. Type of Inspection: 2. Property Owner: REOUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES FHA CONV Mailing Address: 3. Name of Buyer:,)/¢~-<~ Mailing Address: 4. Name of Lending Institution: Mailing Address: 5. Name of Realtor or Agent: Mailing Address: Day Phone Day Phone ~Ffcf- ~? /'--(/" / :, (7 ) Legal Description: Location: 7. Type of Facility to be inspected: ,_5-',--/5 No. 8drms. / 8. Water Supply ~/~¢ ....''~"' V Type of Supply: I~t~--Utility If Individual, number of dwellings presently served If Individual, depth of well 9. Sewage Disposal System Type of System: Public Utility If Individual, date of installation Individual Individual (on-site) E0-037 (1/74)