HomeMy WebLinkAboutPARK HILLS #1 BLK 2 LT 6parK fills S/a
Municipality of Anchorage Page 1 of 3
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: 13WO50169 PID Number: 017-142-23
Name:
Wastewater System: Upgrade
Marc and Cathy Bond
Address:
14720 Park Hills Circle Anchors e, AK 99516
ABSORPTION FIELD
Phone: Number of Bedrooms:
§r Wide Trench
345-6075 Four 4
Soil Rating:
Total Depth from original grade:
LEGAL DESCRIPTION
8 GPD/Ft'
6.5 Ft.
Block: Lot: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe:
2 6 Park Hills No. 1
2.5 Ft.
4 Ft.
Township: Range: Section:
Fill added above original grade:
Gravel Length:
- Fl.
90 Ft.
Gravel width:
Number of lines:
Distance between lines:
Well: Existing
5 Ft.
1
Ft.
Classification (Private, A, B, C):
Total Depth:
Cased to:
Total absorption area:
Pipe Material:
Ft.
Ft.
900 Ft2
ASTM P5054 FVC
Driller:
Date Drilled.
Static Water Level:
Installer:
Date Installed:
Ft.
Acres e S otemo
7/2-7/2003
Yield:
Pump Set at:
Casing Height Above Ground:
TANK
GPM
Ft.
Fl.
SEPARATION DISTANCES
0 Septic ❑ Holding ❑ S.T.E.P. ❑ Other:
To
Septic
Absorption
Lift
Holding
ublic/Private
Manufacturer.
Capacity in Gallons:
From
Tank
Field
Station
Tank
Sewer Line
Anchorage Tank
1,250
Material:
Number of Compartments:
Well
>100'
>100'
N/A
N/A
>25'
5teel
Two 2
Surface Water
>100'
>100'
N/A
N/A
LIFT STATION — NONE ON LOT
Size:
Manufacturer:
Lot Line
>5'
>10'
N/A
N/A
Gal.
>5'
>10'
N/A
N/A
"Pump on" level at:
"Pump off' level at:
High water alarm at:
Foundation
in.
in.
in.
None
Noted
Pump Make & Model
Electrical Inspections performed by:
Curtain Drain
Remarks'
BENCH MARK
Diverter Valve Flaced and Existing Absorption Trench Tied in
Location and Description:
for Fossible Service in the Future. 2" of Insulation Over Both
Bottom Floor Door Jamb Front Yard.
Septic Tank and New Trench. Existing Septic Tank Fumped
Assumed Elevation:
100.0 Ft.
Crushed and Buried On Site.
Engineer's Stamp
OF
49th
Inspections performed by: MEA Dates: list 7/2/2003
i
•'•�'�
.Lud -i
''MICHAEL E. ANDERSON
•�♦ i•%
Department of Hea t and Human Services approval
NO. CE-4381 ••••��/
O�TF '��`4r
Reviewed and approved by: Date: ��(ReV. 10/99)
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PLAN AS -BUILT Q�
SCALE 1" = 40'
LOT 6, BLOCK 2, PARK HILLS NO. 1
Municipality of Anchorage
Page 2 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655
- 343-7904
On -Site Wastewater Disposal System or Well
Inspection Report
Permit Number:
SW030169
PID No. 017-142-23
Setb acK
A
B
Creek
100'
S1 30.0
20.8
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s S2 38.0
28.5
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PLAN AS -BUILT Q�
SCALE 1" = 40'
LOT 6, BLOCK 2, PARK HILLS NO. 1
Municipality of Anchorage Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number: SW030169 PID No. 017-142-23
L
N
41 N
96.5 L >
N (U(7 > 6
(4 N UU L7 >
IU To Existing
Septic Tnnk
1,250 Gallon Absorption Trench
LD i c
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PROFILE AS -BUILT
Scale: 1"= 10'
r
MUNICIPALITY OF ANCHORAGE 1 I L 3 Cj
Development Services Department l
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SW030169
Legal Description: PARK HILLS #1 BLK 2 LT 6
Date Issued: Jun 04, 2003
Expiration Date: Jun 03, 2004
Parcel ID: 017-142-23
Design Engineer: 0014 Anderson Engineering Site Address: 014720 PARK HILLS CIR
Owner Name: MARC AND CATHY BOND Lot Size: 50571 SQ. FT.
Owner Address: 14720 PARK HILLS CIRCLE Total Bedrooms: 4 Permit Bedrooms: 4
ANCHORAGE, AK 99516 -
This permit is for the construction of:
❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All 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 DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 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.
ONLY, POSED ABSORPTION; FIELD. WHICH THIS PERMIT IS ISSUED TO CONSTRUCT IS APPROVED'
AND ADEQUATE FOR FOUR:(4):BEDROOMS
Received By:
Issued By:
1 Date: U (1
Date: 1 41ky
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 017-142.23 Permit Number SWO30/69
Property owner(s) Marc and Cathy Bond Day phone 345.6078
Mailing address (1) 14720 Park Hills Circle Anchorage, AK 99516
Mailing address (2) Zip Code
Legal description (Lot, Block & Sub'd.) Lot 6 Block 2 Park Hills Subdivision No.1
Legal description (Section, Township & Range)
Lot Size 5,052/ Acres q.F .
THIS APPLICATION IS FOR:
Number of Bedrooms Four (4)
Sewer Only ® Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
el
(Signature of property owner or authorized agent)
Permit Fees:
Waiver Fees:
Date of Payment: JU��� (p �, Date of Payment:
Receipt Number: 36C17b Receipt Number:
(Rev. 12/00)
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522.7773 522-6779 (FAX)
May 27, 2003
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 6, Block 2, Park Hills Subdivision No. 1
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The existing septic system on Lot 6, Block 2, Park Hills Subdivision No. 1 has failed
and must be replaced. We are therefore requesting a permit be issued for the
construction of a new septic system to serve the four-bedroom home on the lot. The
attached Site Plan and backup documentation identify the location of and configuration
of the new septic system and the parameters used in the design. Also identified on the
plans are the existing septic system, test hole location and the existing well on the lot.
Drainage arrows are shown indicating the current drainage patterns. The drainage
patterns will be maintained after construction.
The test hole placed near the location of the proposed absorption trench indicated
clean sand with some gravel and varying amounts of silt with a percolation rates
approximating 5 minutes per inch in the upper 5'. Material below this level became
siltier and tighter and the percolation rate dropped to 30 minutes per inch. We are
therefore proposing a blended application rate of .8 gallons per day per square foot for
the design of the new absorption trench. Ground water was found at 12' during
placement of the test hole and did not vary from that level during the monitoring period.
We are therefore proposing to replace the existing septic tank with a new 1,250 -gallon
septic tank and a 75' long x 5' wide x 4' effective depth absorption trench. The
distribution pipe will be placed 2' below the existing surface and the total depth will be
6'. Sufficient fill will be placed over the septic tank and 2" of insulation will be placed
atop the absorption trench to prevent freezing. A flow diverter valve will be installed to
tie in the existing absorption trench for possible future use.
Lot 6, Block 2, Park Hills No. 1
May 27, 2003
Page Two
The ground surface on the lot slopes as shown on the site plan from north to south at
varying slopes. The absorption trench will be constructed at the front of the existing
decorative retaining wall on the lot parallel with the slope as much as possible in
conformance with Municipal requirements. All components of the new septic system
will be constructed a minimum of 100' from any surface water and 100' from all wells in
the area.
If the system is constructed in accordance with our design the following statements
apply:
1. The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
4. The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
nla-t-1 cato"J�
Michael E. Anderson, P.E.
Attachments
49th ; 1
MICHAEL E. ANDERSON
No. CE -4381
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,1► m MICHAEL E. ANDERSON
.....................................MAEL� AREA
MAP
♦C� '• NO. CE-4381 _�
♦s
♦♦�•••
)Ns . • SCALE 1"
'NOFESSICN
= 100'
�,-
100'
Place Diverter Valve Ar''
Tie In Existing Trench `���
t° �ti
Replace Existing Tank �J
With New 1,250 Gallon `��,,
Septic Tank (99
75' L
ng
x 5' Wide
x 4' E
ffec
tive Depth
Absorption
Trench -
3% 3
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3016
4
MICHAEL E. ANDERSON
NO. CE -4381
peft- ESS\OPi
6 3d
F ur
Bedroom
Home
Existing Well
SITE PLAN
SCALE 1" = 40'
t
LOT 6, BLOCK 2, PARK HILLS SUBDIVISION NO. 1
DESIGN FACTORS:
Four Bedroom House
Perc. Rate: 5 Min./Inch
Application Rate: .8 GPD/SF (Average)
SYSTEM REQUIREMENTS:
5' Wide Trench System
1,250 Gallon Septic Tank
4' Drainfield Rock
4 Bedrooms X 150 GPD/1.2 GPD/SF (Appplication Rate) = 750 SF Absorption Area
750 SF/5 LF (Width)* .5 (Red. Factor) = 75 LF Trench Length
THEREFORE: Construct a 75' Long x 5' Wide x 4' Effective Depth Absorption Trench.
Flow Line Elevation in Trench to be 2' Below Original Ground Surface. Total Depth to be
6' Below Existing Ground. Maintain 100' Separation From Well on Lot. Place 2' of Direct
Bury Insulation and 2' of Fill Over Absorption Trench or Provide Minimum 3' of Cover to
Prevent Freezing. Place 4' of Cover Over Septic Tank. Tie In Existing Absorption Trench
With Flow Diverter Valve.
Natural
Backfill
1'6"
Geotextile
Fabric
6" 4" Perforated
PVC (Holes Down)
4'0" I I / I— Drainfield Rock
5'
TYPICAL 5' WIDE TRENCH SECTION
(NO SCALE)
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Groundwater.
Minimum 100' Separation From Wells in the Area.
Minimum 100' Separation From Surface Water or Streams.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 L STREET, ANCHORAGE, AK 99502-0605
SOILS LOG - PERCOLATION TEST
PROJECT #:
PERFORMED FOR: Marc Bond DATE PERFORMED: 5/7/2003
LEGAL DESCRIPTION: Lot 6 Block 2 Park HIRs Subdivision Addn. No. 1
TEST HOLE # 1 SLOPE SITE PLAN
OG/Organics I 1 I
E
3
4
5
6
7
8
9
14
15
16
17
Silty Sand
with Gravel
SM
Sandy Silt
with Gravel
ML
WAS GROUNDWATER
5%
ENCOUNTERED?
Yes
s
N
NET
DROP
L
IF YES, WHAT DEPTH?
12
0
1
P
DEPTH OF WATER
12'
s
AFTER MONITORING:
4:41
4�7
..�_ DATE:
5/25/2003
Q7
ENCOUNTERED?
Yes
s
DEPTH OF
WATER
NET
DROP
L
IF YES, WHAT DEPTH?
12
0
1
P
DEPTH OF WATER
12'
6.5"
AFTER MONITORING:
4:41
E
..�_ DATE:
5/25/2003
2
4.° 4
MICHAEL E. ANDERSON
No CE -4381
BOHINIb ROFES5I�N��
V.
3%-5
READING DATE
GROSS
TIME
NET
TIME
DEPTH OF
WATER
NET
DROP
Start 5/7/03
4:10
9.0"
1
4:40
30
2.5"
6.5"
Recharge
4:41
9.25"
2
1 5:11
30
2.88"
6.37"
Recharge
5:12
9.17"
3
5:42
30
2.75"
6.42"
PERC RATE: 5 MIN./INCH PERC. HOLE DIAMETER: 6"
TEST RUN BETWEEN 2.5 FT. AND—LS—FT.
COMMENTS: Test Hole Presoaked Prior to Test. Material Below 5' Percolates at 30 Min./Inch.
Average Applicaton Rate of .8 GPD/SF.
TEST PERFORMED BY: MEA I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 5/26/2003
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 6, BLOCK 2, PARK HILLS SUBDIVISION NO. 1
GENERAL:
The scope of this project includes the removal and proper disposal of
the existing septic tank and the procurement and placement of a new
1,250 -gallon tank at the location shown on the site plan. Work also
includes the construction of a new absorption trench 75' long by 5'
wide by 4' effective depth also at the location shown on the Site Plan.
The total depth of the trench will be 6' below existing ground and the
distribution pipe will be placed at 2' below the surface. All components
of the new absorption trench and septic tank must be constructed a
minimum of 100' from any surface water or 100' from all wells on the
lot and in the area. A flow diverter valve must be installed to tie in the
existing absorption trench for possible future use. A minimum of 4' of
cover is required over the septic tank and 3' over the absorption
trench. In lieu of cover 2" of direct bury insulation and 2' of cover may
be placed.
2. Construction shall be in accordance with the approved site plan,
design drawings, Municipal Permit with any special provisions or
conditions, and all applicable State and Municipal Wastewater
Disposal Regulations.
3. The Contractor shall be responsible for obtaining all underground utility
locates and for the layout of the septic system and verification of the
location of all lot lines.
4. Unless specifically agreed otherwise, the contractor shall be
responsible for final grading areas subsequently depressed from soil
settling. Property owner shall be responsible for revegetation of
affected areas unless specifically agreed otherwise.
5. Contractors installing wastewater disposal systems must be certified
by the Municipal Department of Health and Human Services for
system installations. Owners installing their own systems must receive
prior approval from D.H.H.S. before beginning system installation.
SEPTIC TANK INSTALLATION
A new 1,250 -gallon septic tank must be procured from a certified
septic tank manufacturer if the existing tank is found to be defective.
2. A septic tank is to be constructed by a certified septic tank
manufacturer. Construction shall include two 4" cleanouts for pumping
access.
Lot 6, Block 2, Park Hills No. 1
May 27, 2003
Page 2 of 3
3. The septic tank shall be sufficiently bedded to prevent settling or
shifting of the tank.
4. All standpipes on the septic tank shall extend a minimum of 12 inches
above final grade.
5. Tanks installed without 4' of cover shall have a minimum of 2" of direct
burial insulation.
6. A foundation cleanout shall be installed one to four feet from the
building foundation. Two cleanouts are required between the tank and
the drainfield.
7. Final grading over the tank shall be such that a positive slope exists
away from the septic tank.
DRAINFIELD CONSTRUCTION:
1. The drainfield shall be constructed to the dimensions shown on the
design. The bottom of the trench shall be within 2" of level.
2. Distribution piping must be placed level with perforations down atop a
level bed of drainfield rock. Rock should then be placed over the pipe
to provide a minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the drainfield
rock and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations
shown on the design. The portion below ground must be perforated.
5. Contractor shall verify the septic tank and drainfield are a minimum
100' away from any private water wells in the area, 150' from a Class
"C" Well or 200' from any community well.
6. Direct bury insulation must be placed over the distribution system if
less than 3' of backfill depth is available. Finish grade over the trench
must be mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trench to drain away.
8. A minimum 2' of accepting soil is required below the drainfield rock for
a 5' wide trench. Contractor shall verify this condition prior to
placement of the rock. All pockets of unacceptable materials must be
removed and replaced.
MATERIAL SPECIFICATIONS:
Lot 6, Block 2, Park Hills No. 1
May 27, 2003
Page 3 of 3
1. Septic tanks must be constructed by a municipally approved septic
tank manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated
and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and
ASTM D2662 or A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene
(Dow Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Fernco, or equal).
5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed
between the final drain rock layer and the native soil layer.
6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing
the #200 sieve.
INSPECTIONS:
Municipal Ordinance requires a minimum of two inspections. These
inspections must be conducted under the supervision of a professional
engineer registered in the State of Alaska. The first inspection must be
conducted after the excavation of trenches, beds or pits and before the
installation of any gravel. A septic tank may be set in place, but may not
be backfilled.
The second inspection must be conducted after the placement of the
geotextile fabric, gravel, distribution piping, standpipes, cleanouts and
insulation. No backfill should be in place at the time of inspection.
Contractor shall provide a copy of all field survey layout and construction
notes for use in preparing the certified as -built of the completed system.
M1, MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
II ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
'
1-1 V-
Manufacturer
1-55J -'
-
LJ UPGRADE
MAILING ADDRESS
=
DISTANCE TO:
Well a !� r
id
Foundation
Foundation 1
D
PERMIT NO.
nt
No. of lines
Length of each line ,
LEGAL DES.0ION
Trench width
inches
Distance between lines
��-
i
Top of tile to fini h grade
q.z r l
ip to Jnlak?
Material beneath the
q8 inches
Rk
14; ILi'T) -
Length
',
�'� t� �-
Depth
PERMIT NO.
LOCATION
%r
„„
Crib diameter
NO. OF BEDROOMS
Total effective absorption area
DISTANCE TO:
Wall
Building foundation
Nearest lot line
DISTANCE TO:
U Y
Well /Q-� -L( �q&sorption area
r Dwelling Z5 r
PERMIT NO.
q
PERMIT NO.
DISTANCE TO:
Building foundation
J
1- Z Manufacturer
Absorption area(s)
Material
-�
No. of compartments
W
H Liq. capacity in gallons Inside len th
IF HOMEMADE: g
Width
Liquid depth
c� I-'
DISTANCE TO:
Well
Dwelling
i
PERMIT NO.
V
= Z FQ-
Manufacturer
Material
-
Liquid capacity in gallons
=
DISTANCE TO:
Well a !� r
id
Foundation
Foundation 1
Nearest lot line
17 ,
PERMIT NO.
LL z
Z w
~
No. of lines
Length of each line ,
Total length of lines
Trench width
inches
Distance between lines
��-
F
Top of tile to fini h grade
q.z r l
ip to Jnlak?
Material beneath the
q8 inches
Total effective absorption ar a y
SIM A
LU
C7
Length
Width
Depth
PERMIT NO.
i F
wa
W
Type of crib
Crib diameter
Crib depth.
Total effective absorption area
DISTANCE TO:
Wall
Building foundation
Nearest lot line
J
W
Class
Depth
Driller
Distance to lot line
PERMIT NO.
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
i
PIPE MATERIALS
SOIL TEST RATIfV
i b
o
INSTALLER
PC EX V 4-- -- 12 -4 -
REMARKS II fI
Ul0.i _' C
r ,
Meir
APPROVED DATE LEGAL
l
72-013 (Rev .1/7R) L /
Block Z
V
Well
.0. Box 10-378 • 10300 Old Seward Highway.
f (907) 349-8535
ANCHORAGE, ALASKA 99511
DRILLING LOG
Mark Bond
Location (address of: Township, Range, Section, if kn
Lot 6 Block 2 Park Hills Subdivision
; or distance main
Size of casing bit Depth of Hole 161 feet Cased to---161----feet
of WellDomestic
Static water level 69 ft. lrae"oW (below) land surface. Finish of well (check one) open end ( xxx ) ;
Screen ( ); Perforated ( ).
Describe screen or perforation None
Well pumping test at 15 gallons per (minute) for 1 hours with 100% x3ft'c
of drawdown from static level.
Date of completion June 27, 1984
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of mate610lcciv1gnjtrdi Y Doss
-Ef Or HET— FILTH gn°A-9c
ENVIROi�MENTAL P;Z07F( ile{�_
0 TO 2 Casing stickup
2
TO
6
6
TO
10
10
TO
13
13
TO
20
20
TO
28
28 TO 57
57 TO 6o
60 TO L52
1� 2 .rte 161
T0-
TO-
TO-
T0-
Organics
OTOTOTO
Organics NOV �/�- I0@4
Silty gravel (wet) _
Hard -pan
Silty gravel
Sil
1°i ..e
cafe Aro, ��f 9tr?ctor
1 —CUSTOMER
^'
^ /
MUNICIPALITY OF ANCHORAGE
' ~ ^
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
� 825 L STREET/ ANCHORAGE., AK 9950:1
1 264-4720
0«"—:E3 1~rF= :s F=-wUEF? a
PERMIT NO: 840209
DATE ISSUED: 05/07/84
APPLICANT: WINTER MISE INC.
ADDRESS: 7400 E. 20TH
ANCHORAGE.- HK 99504
CONTACT PHONE: 223-5877
LEGAL DESCR%P
LOT SIZE:
MAX BEDROOMS
SUBDIVISION: PARK HILLS
SECTION: 34 TOWNSHIP: 12N
50571 (SQ.FT. OR ACRES)
LOT: 6 BLOCK:2
RANGE: 3W
LISTED BELOW ARE THE OPTIONS AVAILABLE TO
YOU IN DESIGNING
YOUR SEPTIC
SYSTEM. CHOOSE THE OPTION
_-____-~-__--~-___~.-~--..~-~_~.~._~..~---_-~.-~.~__
THAT BEST FITS
YOUR SITE.
'
-Ir FR FE t-4 f--.
E� E: E -s
L.A.
DEPTH TO PIPE BOTTOM (FT.)
5.0
6.0
5.0
GRAVEL DEPTH (FT.)
4.0
0.5
3.0
TOTAL DEPTH'(FT. )
9. 0l
6. 5
8.0
13RA9EL WIDTH (FT. )
2.5
21.0
5�0
GRAVEL LENGTH (FT.)
69.0
40.0
65.0
GRAVEL VOLUME (CU.YDS. )
28.7
31. 1
42.1
TANK SIZE (GALS)
1-1.-000.0 *#
1/000. 0
000. 0 **
SOIL RATING (SQ. FIT. -�GR)
183
18]
182%
** TANK MUST HAVE AT LEAST TWO COMPARTMENTS
____-~-__~__~____- -__-_~-__~__-_- -__-___
I- CERTIFY THAT:
1. I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE (MOA) AND THE STATE OF ALASKA.
2. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH ALL MOR CODES AND -REGULATIONS,
AND IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PERMIT.
3. 1 WILL ADHERE TO ALL MOA AND STATE OF ALASKA REQUIREMENTS FOR THE SET BACK
DISTANCES FROM ANY EXISTING WELL/ WASTEWATER DISPOSAL SYSTEM OR PUBLIC
SEWERAGE SYSTEM ON THIS OR ANY ADJACENT OR NEARBY LOT.
4. I UNDERSTAND THAT THIS PERMIT IS VALID FOR A MAXIMUM OF 3 BEDROOMS AND
ANY ENLARGEMENT WILL REQUIRE AN ADDITIONAL PERMIT.
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY II0H BUILDINGCODES,
THEN (1> AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED.: (2) AS-BUILT5
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT/ AND (I) THE
ELECTRICAL WORK MUST BE DONE BY 8 LICENSED ELECTRICIAN.
APPLICANT:
ISSUED 09
DATE-:
DATE:
t-ISE
���_
L_� --�------------ --- ' 77
�� "
• s:
MUNICIPALITY OF ANCHORAGE
ae µ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRjI'�PTIONh: J ( c t_r,(J/�p� I" V V
.i
2
3 i�
n
4-
6
6 6—
PJ
9 im
10
11
12
13
14
15
16
17
18
19
20
PERFORMED BY:
72-008 (6/79)
DATE PERFORMED:
v[�
SOILS LOG
q4 6 D 6
PERCOLATION
TEST
b1l 'S in
SLOPE SITE PLAN
.4L
WAS GROUND WATER S
ENCOUNTERED? L
O
P
IF YES, AT WHAT E
DEPTH?
7t—
PERCOLATION RATE �' /I? (minutes/inch)
TEST RUN BETWEEN S'51S FT AND �' FT
CERTIFIED BY:
DATE:
I
�
�'
UMME
0,41
PERCOLATION RATE �' /I? (minutes/inch)
TEST RUN BETWEEN S'51S FT AND �' FT
CERTIFIED BY:
DATE:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date —Hat,,( < g
GENERAL INFORMATION .
(a) Legal Description (include lot, block, subdivision, section, township, range) r ��
& V7. '2 a,rc , As S bcl`1vlSion Aad 82 -(32
Location (address or directions)
14i2.0 Wfri iS cwcAvv,�r JL
(b) Applicant Name M p✓(C 50na Telephone: Home
45—(.9079 Business 2.7 9 _ 35 S
��t, #W+00 r�y'G� oraq� AK �j`150)
Applicant Address t 0 07 �"" ��� �e � '
(c) Applicant is (check one): Lending Institution 13; Owner/builder; Buyer 11 ;Other 11 (explain);
(d) Lending Institution
/�10.5�to� 1 uci�rlc may -_ Telephone 5 0219
AIL �`�` 10 �A�}v,: Lawrie 1-i�i e
Address 60A 100420 1,c� �+" Up orp.a. W e b6
1
(e) Real Estate Company and Agent A
Address
Telephone
(f) Mail the HAA to the following address: l70
AhcYlorc� z R q5o�
A h
2. TYPE OF RESIDENCE
Single -Family Multi -Family ❑ Other
Number of Bedrooms
3. WATER SUPPLY
Individual WelI K Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
72-025 (11/84)
Page 1 of 2
5 ENGINEERING FIRM PROVIDIN'G.SPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the va ation wastewaterhownelow,dispoI v rifythterra s safe, fun my investti do of thisand Health
Authority Approval shows that the on-site water supply
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 regulations in effect on
the date of this inspection.
Cb�ify„a,ti. E tnttr5 'fin e e Telephone
Name of Firm sn t AyC, , X1956 }
Address
Date
6. DHEP APPROVAL .
Approved for bedrooms by
Approved - t
Terms of Conditional Approval
y/o•oeo ee eeoo. �'E 4 r6 ST
WUpham,
EE���'��" - 5829 ; •.,`'p.'y
dhep
CAUTION
Date
Engineer's Seal
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-025 (11/84)
MUNICIPALITY OF ANCHORAGE (MO'AT'
HEALTH AUTHORITY APPROVAL (HAA)
MUNICIPALITY OF ANCHORAGE CHECKLIST - FEBRUARY 1984
r
DEPT. OF HEALTH & 264-4720 QQ
ENVIRONMENTAL PROTECTION Legal D scription: L, v 2 P0'A-' NI els
N'lAY 16 06
A. WELL DATA
REC�1 V`EQ
Well Classification ld4" � If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (Y/N) — Date Completed ('— 2--7"q4 Yield IS G CM
Total Depth
1 (01 Cased to �' Depth of Grouting &" <<ri ov'n
Static Water Level &.1q Pump Set At t�riknowh
Casing Height Above Ground 2' Sanitary Seal on Casing (Y/N) y
Electrical Wiring in Conduit (Y/N) z Depression Around Wellhead (Y/N)
Separation Distances from Well: '
To Septic/Holding Tank on Lot (1 On Adjoining Lots ? I CSO/
To Nearest Edge of Absorption Field on Lot i On Adjoining Lots i
To Nearest Public Sewer Line iJ To Nearest Public Sewer
Cleanout/Manhole Ni A To Nearest Sewer Service Line on Lot N
Water Sample Collected by G wry ;Date S " 14 =(o
Water Sample Test Results
> tt
Comments J n "Y vr) aA„"^ pa'nc "J�ll pA
B. SEPTIC/HOLDING TANK DATA
5-16- 4 1250 z
Date Installed Size No. of Compartments
Standpipes (Y/N) ) Air -tight Caps (Y/N) y Foundation Cleanout (Y/N)
Depression over Tank (Y/N) N Date Last Pumped <t ,
Pumping/Maintenance Contract on File (Y/N) NA ; for
N� Tem orar Holding Tank Permit Y/N N�
Holding Tank High -Water Alarm (Y/N) —Temporary 9 ( )
Separation Distances from Septic/Holding Tank:
To Water -Supply Well 115, To Building Foundation 31
To Property Line ' S f To Disposal Field 2%
1
To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage
Course
Comments
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata -15
Date Installed " ZA
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/N) N
Results of Last Adequacy Test NA
Separation Distance from Absorption Field:
To Water -Supply Well 11 3 /
1
To Building Foundation
N a
Type of System Design
Length of Field _
r
Depth of Field
Gravel Bed Thickness
t'2
Standpipes Present(Y/N) Y
Date of Last Adequacy Test Rouse WAS hew S Ib��4
1
To Property Line F 7,S
To Existing or Abandoned System on
I
Lot ; On Adjoining Lots ZW
To Water Main/Service Line N /-\ To Cutbank (if present)
To Stream/Pond/Lake/or Major Drainage Course N P\
To Driveway, Parking Area, or Vehicle Storage Area � 43 /
Comments
D. LIFT STATION
Date Installed N
Size in Gallons
"Pump On" Level at
High Water Alarm Level at .
Tested for
Electrical Codes (Y/N)
Comments
Dimensions
q1A I\
Manhole/Access (Y/N)
"Pump Off" Level at _
Vent(Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certify that ave the ke e 'fled, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed
Company CO'
Receipt No.�
Date of Paymen ` �b 0 ,v",u, a ° A' e ®0�
Amount: $ OU'°f` `'o"4�b® Engineer's Seal
a °
000e e000000eo 00 0 000®
Ad e000 000 odes ea oeeaeQ
Page 2 of 2 V a y G. Upham
7
72-026 (11/84)
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
I. General Information
Application Date
(a) Legal Description (include lot, block
r , subdivision, section, townsh
SEG p' range)
" � K
Locati�o/n address or directions)
—41%1/y fHr-K IJP l -,L-5 e,,cC Le:
(b) Applicants Name �[%,nfnr /.l nc Telephone fiome33j :i'17Business
333-.SPi77
ApplicantspOdtMit..,a
pQ
(c) Applies check.
EuY Fier
o"Od•+I�y ep tya3aut89k4•.
(d) Len 'ng Instition
a•v96J
Addr
(e) Real Estat""°Etfe• g'.9
Address
Telephone
V,
Lending Institution
explain); =1; Owner/builder � ;
.
(f) Mail the HAA to the following address:
arz s,
2. Type of Residence
Single -Family 5EI Multi -Family E�J Other (describe
Number of Bedrooms y
3. Water Supply
Tel
ne
Individual wellal Community Public
Note: If community well system,
Department of Environmental Consmust have written confirmation from the State
ervation attesting to the legality and status.
4. Sewage Disposal.
Onsite [Ha Public F=j Community 77 Holding Tank
Note: If community well system, must have written confirmation from the State
/ Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 23
5. Enineering Firm Providin Inspections Tests File Search, Data and Information
As certified by my seal affixed hereto and as of the validation date shown below, I
the
verifysupply
m invesf disposalthisasystemtity isrsafeA functionalpprovalwa-adhat adequatenforte
water supply wastewaterof structure indicated herein. I further verify that;
the number of bedrooms and typege
based on the information obtained from the Municipality Anchora
my
investigation and inspection, the on-site water Supp y
system is in compliance with all Municipal and State codes, ordinances, and regula-
tions in effect on the date of this inspection.
Telephone S C'. 'IF
Name of Firm Cc. S d'
gap I
Address i 21,r, L. t. lc.. JCC-= i� ��
Date
®ea am see
(ENGINEER SEAL) ea jOoeo� o aM
C. it.8
" soo 2231.0 a
�F
6. DHEP Approval. �p a®.®°Daae® !.
OF �
Approved for bedrooms
Approved
Disapproved Conditional
Terms of Conditional Approval
CAUTION
J
TAL
THE iNNICIPALITY LTOF ANCHORAGE H AUTHORITY APPROVALENT OF CERTIFICATESTBASEDDSOLELY UPONTHEREPRESENT-
RED
(DHEP) ISSUES HEA
ATIONS GIVEN IN PARAGRAPHTAHE DHEP DOESNTHIS EPASDA COURTESY STOOPURCHASERS EOFRHOMESEAND
IN THE STATE OF
QUIRE -
THEIR LENDING INSTITU IONS DIN O ORDER CONDUCTTO ISINSPECT ONS OR ANALYZE DATA AE BEFORE A
BEFORE
EMPLOYEE
CERTIFICATE IS ISS PROFETHEONMUNICIPALITYAL OF ORKCHORAGE IS NOT RESPONSIBLE FOR ERROR
OR OMISSIONS IN THE
(DHEP SEAL)
RR4/ej/D18 7-19-84
(Page 2 of 2]
T G ia3
MUNICIPALITY OF ANCHORAGE (MOA)"Y'`
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
Legal Description:
A. WELL DATA Legal
lJ-/ L,L.S
Well Classification P/D U/A•t! If A, B. or C. D.E.C. Approved(Y/N) U/�
Well Log Present 1/N) Date Conpleted U'/O Yield /6 C -;PAI
Total Depth / G / Cased to J 6 / ` Depth of Grouting .art; nNac�N
Static Water Level /-> c Pump Set At
Casing Height:Above Ground 2.' Sanitary Seal on Casing (Y, )
Electrical Wiring in Conduit Depression Around bbllhead , I r)?
Separation Distances from Nbll:
To Septic/Holding Tank on Lot 1 13 On Adjoining Lots > /0o
To Nearest Edge of Absorption Field on Lot 14-o4 ; On Adjoining Lots >ioc.'
To Nearest Public Seder Line To Nearest Public Sewer
Cleanout/Manhole/, To Nearest Sewer Service Line on Lot_
Water Sample. "Collected By (,u r- ; Date %// L
Water Sample Test Results is sic !-A-
Comments;p.kAMfsif �� /n9 .
B. SEPTIC/HOLDING TANK DATA
Date Installed S 6 4 Size 17,E No. of Compartments
Standpipes %4'I) Air -tight Caps ) Foundation Cleanout ( /N)
Depression over Tank (Y } Date Last Pumped L -i t IN
Pumping/Maintenancee Contract on File (YM) ° '- for L'
Holding Tank High -Water Alarm (Y/N) Temporary Holding.Tank Permit (Y/N) rU
Separation Distances from Septic/Holding Tank:
To Water -Supply Wall cl To Building Foundation
To Property Lire S / To Disposal Field 2
To -Water Main/Service Lire t1 / To Stream, Pond, Lake, or Major Drainage
Course v
3
Conirents60VIAW
rA
(Page 1 of 21 (O/�c�'��
2-15-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata 8_s ' Type of System Design
Date Installed 5�/Gr/"'U Length of Field 7/
Width of Field 3�" Depth of Field
Gravel Bed Thickness Li
Square Feet of Absorption Area S fi'"' ! Standpipes Present 0/N)
Depression over Field (YA Date of Last Adequacy Test 4)In
Results of Last Adequacy Test ti �lq
Separation Distance from Absorption Field:
To Water -Supply Well O To Property Line
To Building Foundation Z� To Existing or Abandoned System cn
Lot , ; On Adjoining Lots 3c) _
To -Water Main/Service Line A�% _ To Cutbank(if present) 6,(4
To Stream/Pond/Lake/or Major Drainage Course-
To Driveway, Parking Area, or Vehicle Storage
Comments I/V l4 Llj &-W%~ 41.4e
D. LIFT STATION \
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Code
Comments
Dimensions
�ccess (YM)
Off" Level at
y�Vent (YM)Pumping cies during Adequacy Test. Meets MCA
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect
on the date of this inspection.
Signed Date
-n
Company (� `�. (,v _ MOA No. S r8(t- -C) -z sc
KBl/d5/s
(Page 2 of 21
2-15-84