HomeMy WebLinkAboutNORTH WOODS UNIT 3 BLK 11 LT 30 n,,AK Ua7,as Z Municipality of Anchorage Development Services DepartmentBuilding Safety Division 0�*�R On -Site Water & Wastewater Program, 4700 South Bragaw St. $A , , I' P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number. SW030361 PID Number. 051-732-03 Name: KATHLEEN &RONALD ANDREE Wastewater System: ❑ New ■ Upgrade Address: P.O. BOX 672528 * CHUGIAK, AK * 99567 ABSORPTION FIELD Phone: No. of Bedrooms:**Mother (907) 243-4313 4 O Deep Trench O Shallow Trench O Bed O Uound Sol Rating: Total Depth from original grade: LEGAL DESCRIPTION 2.0 cPD/sc. R SEE DWG. Ft Block: lot: Subdivision: Dept: to Pepe bottom from original grade: Grovel dept, beneath pipe: 0.3 11 3 NORTHWOODS #3 SEE DWG. FL n. Township: Range: — Section: — FBI added above original grade: Grovel wvft 20 — SEE DWG In. in. Gravel wkRh: Numbs of Ornee: Dletanee bet~ Ines: 3 WELL: O New [I Upgrade 18 rt 6 It Clossificatlon Private, A.B.0 : Tote/ Coved To: Total obsorptlon ono: 360 Pipe Mato": SCH 40 PVC ``e,` FL Driller. v,v\ Date DrIIW: R so. Ft. static Water Level: Installer A+ HOME SERVICES Date k:etalled: 10/15-17/2003 GpMM Ft Yield:Pump Set AL Coo" Height Above Ground: TANK CPM R FL SEPARATION DISTANCES OSeptic ❑Holding OS.T.E.P. Other Manufacturer EXIS�tNG To Septic Absorption Uft Holding Publc/Prlvats From Tank Field Station Tank Sewer Un" Material: Number of comportmwrds: Well 200'+ 200'+ 200'+ — 25'+ Surface Water 100'+ 100'+ 100'+ - - LIFT STATION Size In gallons: Manufacturer. Lot Une 5'+ 10'+ 25'+ — — 500 JANCHORAGE TANK ORENCO SYSTEMS Pump on Isvel at:"Pump air W.* at High water alarm at: Foundation 5'+ 10'+ 10'+ — — TIMER I TIMER 1 34" Pump Mold t Model: Deelrlcol kopeotions performed by. Curtain Drain NONE KNOWN 120 OSI 05 HHF BENCH MARK Remarks: **REBUILD OF ISF *LIMITED TO REMOVAL AND RE—INSTALLATION OF Loeaton and Description: TOP OF OLD MANHOLE = 100.00 (REMOVED) SAND FILTER. SEE PREVIOUS AS—BUILT PACKAGE. PATIO DOOR THRESHOLD Resumed lDewtion: 102.92 AIR COMPRESSOR PRESSURE 3.2 PSI UPON n. ENGINEERS SEAL COMPLETION OF INSTALLATION. _ooOF INC. Inspections performed by: AKWWC, Dates: 1st 10/15/2003 *�0 ......... .. ............D 2nd 10/16/2003 3rd 10/17/2003 4th 10/18/2003 J r y Garne s� 0 'ces m as c 7 a Development Se Department Approval \foo Reviewed and approved by: IM Date:1a/1/./o— 04pd/'rofessto(,G\ (Rev. 12/01) J PERMrTNUMBER: AS -BUILT DRAWING PARCEL ID NUMBER: SWO SW030361 051-732-03 APPROXIMATE LOCATION OF WATER UNE_ APPROXIMATE LOCATION OF KEYBOX—\ NEW pt1 ROOM 4 Hp SE V 500 GALLON STATION DBL2 DBL1 u •: •f ------ i.. 10' UTILITY EASEMENT I A I R I ST1 43.61 11.67 ST2 46.83 14.75 DBL1 49.84 18.29 DBL2 50.72 19.21 ST3 52.61 20.91 MH 54.58 22.71 MT1 89.34 68.67 MT2 104.77 78.78 MT3 114.64 93.22 MT4 100.6 84.99 I- _ _ _ _ _ _ SHELTERING SPRUCE AVENUE 10/22/2003 QF OppT 0 _i Y> _!.:. - -. DRAWN BY: 0 • ... ... Sv�O ALAS «ATI✓R & WASTE «'ATER SCALE. A.J.G. Q � 7*��o +-—+H---+��- CONSULTANTS, INC.1+• _ 40'}701 F ttACP ROAD S•;ITF 101 ANCHORAGE A4 99507 PHONF (907)357-6179 • FAX (907)338-32L6 - D PREPARED FOR: PHONE NUMBER: PACE NUMBER: RONALD & KATHLEEN ANDREE 688-8011 2 OF 3 QO '•, of e A Corn ss: LEGAL DESCRIPTION: 00 9. -79 oe 0 TYPE OF RW0HW00DS SUBDIVISION #3; LOT 3, BLOCK 11, 0440 edProfesa.oc3� A`�v AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE ��Op0006o PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER SW030361 051-732-03 FINAL GRADETOP MANHOLE 99.43 � g9.9. 83 (AVC.) ST3 MH TOP OF TANK AT INLET - 95.63 TOP OF TANK AT OUTLET - 95.58 INVERT OF BUNG AT INLET - 95.10 — 'LIMITED TO REMOVAL OF CONTAMINATED SAND AND RE—INSTALLATION FLUSHING VALVE AND COVER -1 ORIGINAL M.O.A. ISF SAND FlLTE TUBE FABRIC NEW 500 GALLON UFT STATION MONITORING TUBE - GRADE — 103.92 (AVG) BOTTOM OF SAND- - 98.30 (AVC) PER 1998 INSP. REPT. RT OF DISTRIBUTION LINE - 101.34 10/22/2003 DRAWN BY: ALASKA WATER & WASTENVATER SCALE. A.J.G. -•^^^^---^^•^-- CONSULTANTS, INC. 3701 E. TUDOR ROAD. SUITE 101 - ANCHORAGE, AK 99507 - PHONE (907)137.6t79 - FAX (907)119-326 I" = 40' PREPARED FOR: PHONE NUMBER: PAGE NUMBER: KATHLEEN & RONALD ANDREE (907) 243-4313 1 3 OF 3 LEGAL DESCRIPTION: NORTHWOODS #3 SUBDIVISION; LOT 3, BLOCK 11 TYPE OF WORK: PROFILE AS—BUILT DRAWING OF SEPTIC SYSTEM UPGRADE TOP OF SAND FILTER - 101.04 (AVG) AIR UNE (EXISTING) ORIGINAL GRADE I ffi '.Je fre t GO ne s: OD C 7953 d'OQ 4�0cd o f e sslot\ O�ODO�Ddd r..�- /b./C-153 & f o_�,o MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program _ 7 O 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Permit Number: SW030361 Legal Description:' NORTH WOODS UNIT 3 BILK 11 LT 3 Design Engineer: 0041 AK Water & Wastewater Consultarn Owner Name: Kathleen & Ronald Andree Owner Address: P.O. Box 672528 Chugiak , AK 99567-0000 .1 : o 0 3 • 0 ° Date Issued: Sep 08, 2003 Expiration Date: Sep 07, 2004 Parcel ID: 051-732-03 Site Address: 023103 SHELTERING SPRUCE AVE Lot Size: 27006 SO. FT. Total Bedrooms: 4 Permit Bedrooms: 4 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. t Received By: Issued By: Date: 9-F-03 Date: 8 03 Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water & 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 ASINGLE FAMILY DWELLING Parcel I.D. �1 \ 1` ?) CQ— t /J� Permit Number SWQ3o�6� Property owner(s) KATHLEEN & RONALD ANDREE Day phone Mailing address (1) P.O. BOX 672528 * CHUGIAK AK Mailing address (2) Zip Code 99567 Legal description (Lot, Block & Sub'd.) -NBR _J3 SUBDNISION• LOT 3. BLOCK 11 Legal description (Section, Township & Range) N/A _� 1 03 Lot Size CT) I on (P Acres/Sq.Ft. Number of Bedrooms THIS APPLICATION IS FOR: 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. ALASKA WATER & WASTEWATER CONSULTANTS INC. Permit Fees:4LA00 Date of Payment: Receipt Number:401io Waiver Fees: Date of Payment: Receipt Number: VU ALASKA WATER & WASTEWATl:�iz .,,,...�.......�.++�..�+,.�.. CONSULTANTS, INC.I August 28, 2003 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragraw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic System Upgrade for Lot 3, Block 11, Northwoods Subdivision #3 (Bottomless Intermittent Sand Filter - ISF) To whom it may concern: The existing 3 bedroom house is served by a community water system and a private septic system. The existing septic system consists of a 1300 gallon septic tank, an Orenco pump vault and an ISF type drainfield that were installed in 1998. The air compressor was never plugged in on the existing system. As a result the ISF bed failed is surcharged and daylighting. We are proposing to rebuild the existing ISF to the original elevations noted in the 1998 inspection report prepared by S&S engineering. In addition we are proposing to replace the orenco pump vault with a 500 gallon lift station. 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. Thank you for your .E., M.S. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com I / / / / /if / if if if / / / / / / / / / / / / / / / / / / / / / of % / CSE �C / / / `D / / / if RAMSEY S/D; j �\ / / if / TRACT A. / \ if / / / if of /if / / / j PROPOSED SEPTIC UPGRADE \ / if (SEE DESIGN PACE 2 OF3)� \\ I t0if 0' N+FlI RADIUS / if / / / / / /if if J, if // ifif (n -r / / y�" NORTHWOODS S/D %3; II a) j� LOT 4, BLOCK 11, ev if //Iff II I I NU O� // / h- EXISTING ERVED BY PUBLIC WATER SYSTEM Z I I I I =oq 4 BEDROOM gm II HOUSE -------------------- ---------- - - - - - - - - - -------- z SHELTERING SPRUCE AVENUE / �- / II in II NOTE: ALL PROPERTIES SHOWNN NU O� II ERVED BY PUBLIC WATER SYSTEM g gm II Z $S z 11 II DATE: 8/29/2003 kl DRAWN BY: C.J.G. �. ._ x M M ,'� "9S ALASKA WATER & WASTE«'ATER , �,: v++, SGALE .— CONSULTANTS. INC. 1+• = 100+ :.......... .. •"' """....t 3701 F TUDOR ROAD. SUTF 101 - ANOMORAGF. AK 99307 - PMONF (907)317-649 - FAX (907)33R-371.6 �0 PREPARED FOR PHONE NUMBER: [PAGEIAUMBER: RONALD & KATHLEEN ANDREE 688-8011 1 OF 2 y). % of Garn ss: y)1) o �� '•. —%9 LEGAL DESCRIPTION: NORTHWOODS SUBDIVISION #3; LOT 3, BLOCK 119 ti, +i�.upro(ess\o�o:"� TYPE OF WORK: SITE PLAN FOR PROPOSED SEPTIC UPGRADE �`';z I c' —' PROPOSED REBUILDING OF EXISTING BOTTOMLESS INTERMITTENT SAND FILTER BED. THE EXISTING BED IS A 18 FEET WIDE BY 20 FEET LONG WITH 0.3 FEET OF EFFECTIVE DEPTH. WE ARE PROPOSIN THAT THE BED BE EXCAVATED AND THAT `kLL CONTAMINATED MATERIAL BE REM AFTER ALL CONTAMINATED MATERIAL IS ' REMOVED. REBUILD THE ISF TO THE ORIGINAL DIMENSIONS AND ELEVATIONS. EXISTING AIR LINE (SEE NOTE) n 8'+/ EXISTING ORENCO PUMP 0 VAULT TO BE REPLACED WITH NEW 500 GALLON UFT STATION. EXISTING NR vavS BEDROOM COMMPRESSOR 4 SE (SEE NOTE) EXISTING 1300 GALLON 'PREMIER PLASTIC' SEPTI TANK APPROXIMATE LOCATION OF / WATER UNE APPROXIMATE LOCATION OF •� KEYBOX I 10' UTILITY EASEMENT SHELTERING SPRUCE AVENUE 8/28/2003 o DRAWN BY: C.J.G. vpp ALASKA NVATKR & �VASTK�'�A1'LR ��� o*. -•7*0 SCALE CONSULTANTS, INC.1 �� = 40' Q 3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE, AK 99507 • PHONE (907)337.6179 • FAX (907)338.3246 0... .. ..... •••� PREPARED FOR: PHONE NUMBER: PAGE NUMBER: RONALD & KATHLEEN ANDREE 688-8011 2 OF 2 of a erne �O o44°pJ •• C 795 4�Odp�ofessio�oo� DOOOOo�d LEGAL DESCRIPTION: NORTHWOODS SUBDIVISION #3; LOT 3, BLOCK 110 ME OF WORK: DESIGN DRAWING OF PROPOSED SEPTIC UPGRADE Municipality of Anchorage Development Services Department Building Safety Division *A� •n-Site Water and Wastewater Program4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL SUBMITTAL COMMENT SHEET To: ALASKA WATER do WASTEWATER CONSULTANTS. INC. ;Legal description: NORTHWOODS #3 SUBDIVISION BLOCK 11 LOT 3 ,The attached paperwork has been reviewed and is being returned for the following reasons: ❑ Original signature or stamp missing on ❑ Calculation error in design. ❑ Additional soils information needed. ❑ Water monitoring results inadequate. ❑ Discrepancy in information submitted. ❑ Topographic information missing' or inadequate. ❑ Incomplete; missing ❑ Incomplete; missing ❑ Additional adequacy test information needed. ❑ Water sample unacceptable. ❑ Measured/proposed distances/dimensions missing. ❑ Locations of all soils, percolation and water monitoring tests not shown. ❑ Proposed system too deep for soils information submitted. ❑ Well log required. ❑ Omission in narrative.' ❑ Insufficient fill over tank or field. ® Other. 1E THE 'ORENCO'PUMPING SYSTEM' IS A 500 GALLON LIFT STATION THE ALASKA WATER F� W.AST'J= W1V J1 r�l-c CONSULTANTS, INC. August 19, 2003 Municipality of Anchorage Development Service Department Building Safety Division On -Site Water & Wastewater Program 4700 South Bragraw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref: Septic System Upgrade for Lot 3, Block 11, Northwood Subdivision (Bottomless Intermittent Sand Filter - ISF) To whom it may concern: The existing 3 bedroom house is served by a community water system and a private septic system. The existing septic system consists of a 1300 gallon septic tank, an Orenco pump vault and an ISF type drainfield that were installed in 1998. The air compressor was never installed on the existing system. As a result the ISF bed failed is surcharged and daylighting. We are proposing to rebuild the existing ISF to the original elevations noted in the 1998 inspection report prepared by S&S engineering. I am unaware of any adverse impacts this installation would have on adjacent wells or septic systems. If you ive any questions, please contact me at 337-6179. Thank you for your assistance. / I .E., M.S. 3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com / Municipality of Anchorage Page —/Of 3 DEPARTMENT OF HEALTH AND HUMAN SE VICES ENVIRONMENTAL SERVICES DIVISI P.O. Box 196650 • Anchorage, Alaska 99519-6650 • T lephone: 343-4744 On -Site Wastewater Disposal System and/or We Inspection Report PIDNumbe DS/' 73-03 Permit Number. ,SCtJ9�Dl�.Z Name: l�✓C. Wastewater Sy tem: $ New o Upgrade /VORi� DODS Address: C, ABS RPTION FIELD Phone: No. of Bed oms: O Deep Trench O Sha ow Trench i Bed XMound O Other LEGAL DESCRIPTION Soil Rating: 019 GPDS .Ft. Total Dep trorf. 0 nal gratia: / ivlai 00 s'�`3 2 Lot: Block: II p � �j,3�'vr7pipe�0YA45 bottom from6zaCE e. y Greveldept�•eath 3 pipe Ft. O.e? Township: Range: Section: �-r Fill added above orjginat grade: (�• Gravel length: 9� Ft. Gravel width: d s: DieZbet even tk'.es: WELL: O New ❑ Upgrade / o F.J! Classification )Private, A,e,C): Totat De Cased Te: Total absorptlo s a: O SO.FSGfiDriller. 303 KIns OMMudJITY FL FL Date Drilled: Static water Level: Installer/G rn L &1 L/ �J�� -��FL Yield: Pump Set at:CaemgHeightAboveGround: TANK GPM FL Ft' SEPARATION DISTANCES Xseptic O Holding O S. . . To Septic Absorption Lift Hokling bllc/PrNale Manufacture o�M/g'n Capacity In tore: /3 �i From Tank Fletd Station Tank Sewer Linty F /� Material: &YEl//YL£,JE Number Of p mantas well Wea re /00' /OD'+ /o0'f. LIFT STATION Lot /� / .3 / / "/ � Sks ln,g�ons: Manufacturer. OlWeo Li JlG7 ✓✓ �� d Line el at: High water a� 0rr�yet• / / / ...► "Pump on' level at_'Pump oft" level Foundation �w � 7 '� Y 7 Curtain -. ./O�� �D�� Pump Make Model Ele rlcel Inspect io Darlotmed0' /V O OSl OWN F/i ,JLY /GiifS LF/r+�L O� Drain BENCH MARK Remarks: gomomLcs7s .SAdo Location and Description: 3/ '� flrR Gi,✓� /S /e%SuLA�EO //�D On/ L/'i ur1P Assumed Elevation: Ft �L RvTEc; io�l.S q �- or A!,,�itf Dates: Inspections performed by: p ••• -' •• •��✓ 9O eQ �Q 2n r� of ROSERT C. COWAN 1l#`�g $ �. ce-snot �`••',�'' Health and Human Services approval 1tdt,�`DF� Department of a c.... Date: /2 g Reviewed and approved by: 72-013 (om'• "I) MCA 2s Municipality of Anchorage Page of 3 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: SO ��lz PID Number: 0-5�l - 73z - 03 Name: /YOI�r ®00.5 Ln��'. . Wastewater System: New ❑ Upgrade Address: ABSORPTION FIELD Phone: No. of Bedr oms: �( ❑ Deep Trench ❑ Shallow Trench i Bed XMound ❑ Other LEGAL DESCRIPTION Soil Rating: 0.9 Total Dept4rorP0gi.algrade: GPD/Sq. Ft. Lot: Block: Subdivisi n: �L � lei 3 De th to pipe bottom from original grade: j3'AS�d� Gravel depth beneath pipe J� l oo S G aD€ Ft 0.3 Ft. Township: Range: Section: Fill added above or trial grade: Gravel length: 20 Ft. Ft. WELL: ❑New ❑Upgrade ' Gravel width: Number Hines: between lines: ?� ,f Ft. -/ Classification (Private, A,B,C): Total De Cased To: Total absorptio ar e: Pipe material: L>_5034 f tlC 40 0/%✓�41 l6'j Ft. Ft. SQ. Ft. .S'G1V Driller: Date Drilled: Static Water Level: Installer _ I �!� Date installed: % "' s /0 Ft. iq%CC�D - Yield:Pump Set at: I Casing Height Above Ground: TANK GPM Ft, Ft. SEPARATION DISTANCES XSeptic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: n� /� Capacity in gallons'1300 % /�T� From Tank Field Station Tank Sewer Lines �G/ - • yE.K / w Welh Material: �L ✓�ri>�Yt &-,/,C Number of Comp ments: Surfac /00 H /00+ /00`+ — LIFT STATION Watere Lot , J �� �l 2 j , 74J �y �� Size in, lions: 77,4 Manufacturer: O��Aleo Line Foundation i 7 /� tP� j J 7 / r--- --- "Pump on:' level at: 2 /r "Pump off' level at: 3Z d High water alarm/at: Curtain Drain �// n�O�F �It�GJA� Pump Make BModel 20051 Dom// Ele tricallnspectlon performed by�_ FAdE�/L)� jGNTS' LCL"j�PI6/IG O� Remarks: . o^ro/n1cs5' SAA),LrER BENCH MARK Ys,�l+1 ;Al'I' 91nI i r clJi ®5ix/U Location and Description: /vP of /)'1X✓t/oZ&_ -31q /l 1419 /5� J�ijt,9 i FD /-JVD OA/ Z11-1 FaM P �, 7 aeED iWVPev LI p3 roR Assumed Elevation: /�� PRO % 5_d i /Uh% prt `rE O�N 9-17- 9 9 Fi Inspections performed by: Dates: 1st 2nd - 2R1 -Pr^ ROBERT C. COWAN r �� 1�G',ste CE -8801 f�wgr� a4� Department of Health and Human Services approval8 ..........J;J\s��b M Reviewed by: Date: 12-9-06 and approved 72-013 (Rev. 9/91) MOA 25 PERMIT NO. SW9801 42 PAGE 2 OF 3 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,G. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 3, BLOCK 1 1 , NORTH WOODS S/D NO. 3 P.I.D. NO. 051 -732-03 EXISTING �DRAINFIELD I I I _J P" ALT, SITE MT3 TH I I MT46 • \\ \\ , T2 - i_C�T �� TH NEW 18' X 20 BOTTOMLESS 3/4" AIRLINSANDFILTERNEW LIFT STATION TBM=TOP OF MH ON ORENCONEW 1300 GAL.PUMPING SYSTEMPOLY. SEPTIC TANkGrin, (INSULATED) A 7 `-IIVJ VLHI IVIV TH A NEW TH 4 BR KoUSE TH / o 15' UTILITY ESMT. SHELTERING SPRUCE AVE. EXISTING DRAINFIELD F_ I I I I I I L___J i N SCALE I" = 40' W PERMIT NO.SW980142 PAGE 3 OF 3 DEPARTMENT OF ANDhHUKAN SERVICES ENVIRONMENTAL SERVICES DIVISION PA. Box 196650 • Anchorage, Alaska 99519-6650 a Telephones 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 3, BLK 11, NORTH WOODS S/D UNIT III P.I.D. NO. 051-732-03 FINAL GRADE 99.5' 99.5' STL ST2 INSULATION 96.2'_XNEW 1300 GAL. POLY. TANK 95.9' N.T.S. MT1=103.3MT1 MT 2 FINAL GRADE MT3 MT3=103.3' MT4 MT4=103.2' MT2=103.5' ORIGINAL GRADE INStLAN PEA GRAVEL 3' IINDBR u�cRALs 1/2" AIR LINE'.�S9ND MT1=100.3' MT3 =100.3' MT2=100.3' MT4=100.2' BOTTOM OF SAND=98.3' DIST. LINE=100.6' A N.T.S. GROUNDWATER AT 96.0' 91.0' B.O.H. FCO sLI4 sPA S��l$d ST1 43.5 11.0 c. ST2 46.5 14.0 """ 9 LIFT MH 50.0 18.0 = nil. x ;...,« MT1 88.5 68.0A&, ,....,. ;e>" MT2 104.5 78.0 .... MT3 .114.0 MT4 1100.0 93.0 84.0 ROBERT C. COWAN �Q dOd G ,'•.� CE 8801 - ..' ����a I I 1 NOV-18-98 WED 15:28 HEAVENLY LIGHTS ELECT CO 373 3894 P.O3 96aiw,4 1�64,re, %&a am 491 Willow Street • Wasilla, Alaska 99654 Phone# (907) 373,3893 • F; -x# 373-3894 1, v RECEIVED DEC 4 1998 Municipality of Ancnotarge Dept. Health & Human 8er!(- PROPERTY OWNER AGREEMENT FOR THE MAINTENANCE OF AN ON-SITE WASTEWATER DISPOSAL SYSTEM This agreement, dated 1991 is made between the Municipality of Anchorage Department of Health and Human Services (DHHS) and the property owner(s) of: This agreement is made for the purpose of maintaining an on-site wastewater disposal system on the subject property. The property owners agree to the following: Submit to the Municipality of Anchorage, on an annual basis, an inspection and operation statement from a registered professional engineer. This inspection and operation statement shall verify that the engineer has inspected all effluent and air pumps, timers, and alarms, and that any deficiencies have been repaired and that the system is functioning as designed. (Signature) M W. (Printed Name) (Notarize Here) Subscribed and sworn to before ma thIS^Ggda�y 0f /1,./la�s���, Notary Public My Commission Fxoires Y (Signature) (Printed Name) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 r (� c. 9 -lb --16 I�wv PAGE 1 OF 1 9 Z IA qoc> ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW980142 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:NORTHWOODS INC OWNER ADDRESS:3111 C STREET, #555 ANCHORAGE, ALASKA 99503 PARCEL ID:05173203 LEGAL DESCRIPTION: NORTH WOODS UNIT III BLK 11 LT 3 LOT SIZE: 26006 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 6/01/98 EXPIRATION DATE: 6/01/99 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 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. SPECIAL PROVISIONS: THIS PERMIT ISSUED FOR THE CONSTRUCTION OF AN ALTERNATIVE INTERMITTENT DOSING SAND FILTER W EWATER SYSTEM. THE ATTACHED PROPERTY OWNER AGREEMENT TO HAVE THE SYSTEM CHECKED ANNUALLY BY A PROFESSION ENGIN R SHALL BECOME A PART OF THIS PERMIT PACKAGE. Zj RECEIVED BY: ISSUED BY: DATE: 6- Z fp DATE: / P91 HEALTHAUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN ROBERT C. COWAN, P.E. CIVIL ENGINEERS May 19, 1998 (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 3; Block 11; North Woods Subdivision Unit 3 Request you issue a permit to construct a Bottomless Intermittent Sand Filter System on the referenced property. This system will include a 1500 gallon STEP tank and will be adequate to serve the proposed four bedroom home. The construction of the wastewater disposal system will not adversely effect the adjacent properties. The construction will be in accordance with the attached drawings sheets 1 - 4. This home will be connected to an existing key box on the Municipal Public Water System. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. 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Ow III III a� o O � d v z W c x Q U0 I .i :' a vi F -4o �o z w a o I owo H Ln .5V W Lo 0-4 cv I� h W I --H O�o s NS Q /c V1 m0�o >m a ado x�A � of o Umq ��W s E-4 r�� 98� s€ Co Jo$� NN Q L dq W0 E-, Ofm :" N M 1=IIMr, aN Y •'< oFoa —III—ISI ii r' -..m 00, fy <p avi °"S III—III= ZaQ�0.y 01 p Yqm^ as —III—I VQ1 V�iG 4 WNN F III— $4a Z �IIIIII. w W Wv� O III -I_ �rc=x zW —IIIA III_ aca4 f0 n 3�H�S l VIM 311JOdd 'STN 0 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: l l`� W `k,�- 0W, DATE PERF( LEGAL DESCRIPTION: V�'i 7 ✓�� �, �b.Ii.�oO®S�V41SOW.ShIF, Range, Section: J SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT DEPTH? G O P E Depth to Water After 3t (ltd S� Monitoring? Date: "► ==Mmm� ... VIA 2 L + ct 3 4 v J 5- 6- 67 7 � D 8- 9- 91011 10- 11 12 13- 3141516171819 14- 15- 16- 17- 18- '91 20 WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT DEPTH? G O P E Depth to Water After 3t (ltd S� Monitoring? Date: "► ==Mmm� .. PERCOLATION RATE '5- (minutes/inch) PERC HOLE DIAMETER L TEST RUN BETWEEN Z FT AND a FT COMMENTS �� % 4— LL966 e31SOW"AIN 81be3 PERFORMED BY:1��68p3�q1�0C MA CERTIFY THAT THIS/TEST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND tv�INKNUVM17ELI A IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) S&S May 20, 1998 ROBERT C. COWAN, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 BOTTOMLESS INTERMITTENT SAND FILTER SPECIFICATIONS HEALTH AUTHORITY APPROVALS Lot 3, Block 11, North Woods Subdivision, Unit III GENERAL STATEMENT OF WORK SEWER&WATER MAIN EXTENSIONS The work covered by these specifications and the plans consist of furnishing all labor, materials, tools, transportation, and equipment necessary to complete an intermittent sand filter system as described herein and on the attached drawings. SEWER&WATER INSPECTION All work under this project shall comply with the latest edition and addendum to all applicable codes, ordinances and standards including Municipality of Anchorage -Dept. of Health and ENGINEERING STUDIES Human Services (MOA)-(DHHS) septic installation guidelines and On -Site Waste Water AND REPORTS Disposal Systems permits. 4 Bedroom single family home = 600 GPD WELL INSPECTION Use 2.0 GPD/SF for polished effluent &FLOW TEST 300 S.F. required 18' X 20' sand filter and absorption area Sand filter to be constructed on accepting soil SITE PLANS SITE INVESTIGATION ROAD DESIGN The Contractor who proposes to complete this project must carefully examine the project documents, have full knowledge thereof, have investigated the site, and be satisfied with the conditions affecting the work. Conditions include, but are not limited to those bearing upon SOILTEST transportation, disposal, handling and storage of materials, availability of labor, water, electric power, roads, and uncertainties of weather, physical conditions at the site including all underground utilities, the conformation and condition of the ground, the character of equipment and facilities needed preliminary to and during prosecution of the work. The Contractor must PERCOLATION TEST be satisfied with the character, quality and quantity of surface and subsurface materials or obstacles to be encountered insofar as this information is reasonably ascertainable from an inspection of the site, including all prior exploratory work, as well as from information presented by the plans and specifications made a part of this project. Any failure by the STRUCTURAL& MECHANICAL Contractor to become acquainted with the available information will not relieve him/her from INSPECTIONS responsibility for performing the work as stated in these specifications and drawings. ON SITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577 Page 2 Lot 3, Block 11 North Woods Subdivision, Unit III May 20, 1998 Location of utilities will be the contractor's responsibility. At least forty-eight (48) hours prior to commencing work, the Contractor shall contract all local utility companies to obtain underground utility locates. The Contractor shall exert due care to prevent damage to utilities. Should a utility be damaged, the Contractor shall notify the utility company and shall have repaired at his own expense any damage resulting from failure of the Contractor to request an underground utility locate or to exert due care. If any utility company determines that a utility has to be temporarily raised, lowered, moved, guyed, shored, braced or otherwise protected during construction, it shall be done at the expense of the Contractor to the satisfaction of the utility company. INSPECTIONS Typically, there will be a minimum of four (4) inspections required during the installation of the waste water disposal system. These inspections will occur as follow: Inspection of work in progress may be made by the Engineer and MOA-DHHS at any time. The following schedule of required inspections is to be adhered to. Twenty-four (24) hours notice is required prior to each inspection. Inspections can only be arranged during weekdays and during normal working hours. The following inspection schedule is to be strictly adhered to: Septic tank/lift station is in place, but not backfilled. Sewer piping from building to tank is complete and properly bedded. Sand filter location is excavated and prepared for filter construction. 2. Engineer to be notified with Contractor's schedule during actual construction of the sand filter to allow spot inspection during construction. Any deviation from reported schedule is to be reported to the Engineer. 3. Final inspection of the sand filter with all pressure piping in place, but prior to placement of cover material. Test pressure piping to ensure adequate flow and pressure, (requires completion of lift station wiring and piping prior to this inspection). 4. Inspection of final grading and adequate cover. The Owner shall contract with the Contractor to perform the work outlined in these specifications, plans and in accordance with the attached MOA permit. There will be no contractual arrangement existing between the Contractor and S&S Engineering. S&S Engineering shall be the Owners' representative and will inspect the work as stated above to document the Contractor's activities. Final acceptance of the Contractor's work rests with the Owner and the MOA. S&S Engineering shall have no liability to the Owner or to others for acts or omissions of the Contractor or any other persons performing work on this project or the failure of the Contractor to carry out the work in accordance with these construction documents. S&S Engineering's inspecting Engineer will not be Page 3 Lot 3, Block 11 North Woods Subdivision, Unit III May 20, 1998 responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. All landscaping, fences, sidewalks, paving, driveways, utility markers and other improvements, removed to facilitate the Contractor's operations shall be fully restored to their original condition and location by the Contractor unless otherwise directed by the Engineer. Items damaged by the Contractor during removal, storage, or restoration, shall be repaired or replaced in kind by the Contractor. This work shall be considered incidental to the project. MINIMUM MATERIAL SPECIFICATIONS 1. Any septic tank proposed for installation 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: Type of Pipe Perforate olid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes ASTM D2241 Yes Yes ASTM D2239-74 Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting Engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with water tight couplings (Caulder, Femco, or equal). SEPTIC TANK/LIFT STATION A. General The work under this section consists of the performance of all operations pertaining to furnishing and installing the septic tank/lift station and piping to the sand filter. Page 4 Lot 3, Block 11 North Woods Subdivision, Unit III May 20, 1998 B. Materials 1. Tank for Lift Systems a. Septic tank shall be a 1500 gallon two compartment tank specifically for use with Orenco Systems, Inc. patented lift station assembly Orenco No. 4200, or approved equal. b. The tanks shall be designed for adequate burial depth as required by MOA and State regulations. The design or analysis shall be in accordance with accepted engineering practice and local regulatory agencies. c. In areas with high ground water, the tank shall be adequately weighted or anchored to prevent flotation if the tank is pumped. 2. Risers a. First compartment shall have a separate 4" pump out riser. The second compartment shall have a separate 4" pump out riser. b. An additional second compartment manhole riser shall extend above surface grade, shall have a minimum nominal diameter of 24", and shall be capable of being equipped with the following: 1. A junction (Nema 4x) box or equal, bonded or attached to the riser. 2. UL listed electrical cord grips, installed in the J -box. c. A lid - shall be furnished with the riser. It shall be constructed to meet H-10 loading requirements and have a latching mechanism. d. Riser installation - each riser shall be sealed or welded to the top of the tank in such a manner as to prevent infiltration of ground water. e. Lid insulation - 4" rigid extruded polystyrene shall be placed inside and attached to the lid. f. Riser insulation - 2" sprayed shop applied urethane on circumference of riser with 46465 Tnemec coating. Page 5 Lot 3, Block 11 North Woods Subdivision, Unit III May 20, 1998 3. Effluent Pumping Assembly a. Effluent pumping assembly shall be Orenco systems (TM) Model 20- OSI-05-HHF series, or approved equal consisting of the following: 1. 1/2 H.P. 110/120 volt or equal U.L. Listed effluent pump. 2. Screened pump vault (U.S. patent No. 4439323) 59" deep, 3/16" thick high-density PVC cylinder houses the pump, level controls and screen and serves as a baffle to prevent the screen from clogging. 3. Fifteen 1 1/2" diameter holes are drilled in the vault at a level that places them at about the midway point of the depth in the septic tank. 4. Flap check: Allows the vault to drain when removing the tank. Screen: 15" diameter cylinder of high-density polyethylene 1/8" mesh. 5. All piping shall be PVC or other non -corroding material. b. Pump controls and alarm system shall be Orenco systems SICTETMRO 110 volt with the following options consisting of: 1. Event counter 2. Elapsed time meter 3. Program timer 4. 10 watt heater 5. Remote alarm panel option with a minimum of 80 DB sound pressure at 24", operating temperature 30°C to 65°C, continuous sound to be located inside the home. 6. Oil -tight visual alarm with push -to -silence feature. Automatic audio -alarm reset. 7. 15 amp motor rated toggle switch, double pole, double throw with three positions; manual (man), automatic (auto) and center (off) (H.O.A.). Page 6 Lot 3, Block 11 North Woods Subdivision, Unit III May 20, 1998 8. Nema 4x -rated, fiberglass, or equal, enclosure with hinged cover. 9. All controls to be installed as per manufacturer's recommendations. 10. Control panel to be installed on outside wall of home within sight of septic tank/lift station. c. Piping from the septic tank to the sand filter is to be 1 1/4" PVC schedule 40 solvent weld piping properly bedded and sloped to drain back to the septic tank. Insulation board 2" thick and 2' wide centered over pipe is to be placed where soil cover is less than 4' depth over pipe. CONSTRUCTION SEQUENCE In order to ensure proper installation, the system is to be installed in the following order: 1. Sewer line from house to tank 2. Septic tank/lift station 3. Sand filter 4. Final grading CONSTRUCTION Pipe Grade and Alignment Variance of individual pipe sections from established line and grade shall not be greater than 0.05 feet, providing that such variance does not result in a level or reverse sloping invert. During the progress of the work, the Contractor shall provide instruments such as transits, or levels, for transferring grades from offset hubs or other construction guides from the control points and bench marks provided to the Contractor by the Engineer. The Contractor shall provide qualified personnel to use such instruments and who shall have the duty and responsibility for placing and maintaining such construction guides. 2. Pipe Laying All pipe shall be laid with Class C bedding, free of large stones and organic matter. Page 7 Lot 3, Block 11 North Woods Subdivision, Unit III May 20, 1998 Each section of pipe shall be handled carefully and placed accurately, the spigot end shall be fully inserted pointing in the direction of flow and glued in place to make a water tight seal. Each section of pipe shall be properly supported to ensure true alignment and an invert which is smooth and free from roughness or irregularity. At all times, when work is not in progress, open ends of pipe and fittings shall be securely and satisfactorily closed so that no undesirable substance will enter the end of the pipe or fittings. 3. Bedding of Pipe for Sewer Lines The pipe should be bedded with Class C bedding materials, compacted to 95%. Native materials may be used as back fill material above the pipe, provided it is free of large stones and organic matter to a point one (1) foot above the top of the pipe. All pumping services shall be installed in accordance with the manufacturer's recommendations and standards. Electrical installation is to be to code by a licensed electrical contractor, with Municipality inspection where required. If MOA inspection is not required, a licensed electrician is to provide a letter to the Engineer stating that the system meets or exceeds all applicable codes. 4. Tank Installation Excavate to proper depth to allow gravity flow, install tank level, tolerance 0.1 foot, end to end, on undisturbed or compacted to 95% classified sand fill material. Line excavated tank pit walls with 2" +35 PSI burial foam full depth of tank. Back fill between tank and foam and compact in a manner to prevent damage to tank surface coating. Create a level sand surface over the tank and add 2" burial foam +35 PSI directly over tank. Mound unclassified soil over tank location to a depth of 2' above finished grade to allow positive drainage away from tank and counteract buoyancy. 5. Connections All connections to be as per MOA-DHHS and UPS requirements PVC 3034 piping with Caulder or equivalent couplings for inlet riser pipes. All tank connections are to be completely water tight. Page 8 Lot 3, Block 11 North Woods Subdivision, Unit III May 20, 1998 SAND FILTER The work under this section consists of materials and construction/installation of the sand filter. A. Materials The Contractor shall provide a washed sand to meet ASTM C-33 Concrete Sand Specifications with the additional requirement that all but 1% of the materials passing the #100 sieve be removed. A sample maybe taken from the sand bed during construction for purposes of quality control. If the sample does not meet specifications, all sand will be removed and replaced. 2. The Contractor shall provide pea gravel that shall be a washed material containing no fines (0% passing the #100 sieve) and a maximum size of 1/4" diameter. 3. The Contractor shall provide round rock that shall be washed gravel with rounded edges, well graded with maximum diameter of 1/2". 4. The Contractor shall provide the manifold assembly. The manifold assembly shall be the Orenco Model SFM 1036 or equivalent with orifice shields and flushing assembly. All drilled holes to be cleaned of burrs and pipes flushed, prior to assembly. Flushing valve to include riser to +12" above finish grade with extension handle provided to operate globe valve from the ground surface. 5. Side walls and top of the filter box to be insulated with 2" direct burial polystyrene insulation and be inside the plywood box. 6. The Contractor shall provide the filter fabric. 7. The linear air diffuser line and compressor are available from Orenco, no model number available. The feed line from the house to the filter is HDPE arctic insulated pipe 3/4"-2" SDR -11 Maskell-Robbins or equivalent. The compressor will have a gauge (0-10 psi) and be installed in a heated area, crawl space, or garage. B. Construction of Sand Filter The sand filter construction is to follow procedures as outlined in the Orenco Installation Manual as applicable to this design. Rock, pea gravel and filter sand are to be hand leveled to proper depth (tolerance within 0.05 feet) in filter, taking care not to allow mud or fine soil material into the filter or rock layers. This would include any soil material picked up by excavation machinery buckets Page 9 Lot 3, Block 11 North Woods Subdivision, Unit III May 20, 1998 while loading specified material. The Contractor should estimate filter material volumes such that allowance is made for wastage of material in contact with the ground at site. Work on the sand filter may be suspended at the Engineer's discretion due to inclement weather conditions, such as rainfall. The sand filter and material stockpiles will be completely covered by a tarp over night during construction until finished. Filter internal construction should be accomplished in one (1) day's time. The area over the sand filter to be finish graded with a minimum of 2 feet of cover and to prevent ponding of surface water run off. Side slopes shall not exceed 3:1. Six inches of top soil and seed are required over the entire sand filter when the side slopes approach 3:1, or at the discretion of the M.O.A. The Engineer will reject any sand, round rock or pea gravel that does not meet specifications or is contaminated in transit or while handling. If such material is placed in the filter, all soil material may be required to be removed and replaced with new material. CONTRACTOR/INSTALLER L,f MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 051-732-03 HAA #t 1. GENERAL INFORMATION Complete legal description Lot 3, Block 11, Northwoods #3 Location (site address or directions) NHN Sheltering Spruce Property owner George wilmoth Day phone Mailing address 3111 C Street, Anchorage, AK 99503 Lending agency Day phone Mailing address Agent n -;.c Target Reai+-y Day phone 694-2188 Address PO Box 774627, Eagle River, AK 99577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: = 4 3. TYPE OF WATER SUPPLY: Individual well Community well Public water XXX 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: XXX 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. 72-025 (Rev. 1/91) Front MOA #21 5. 6. STATEMENT OF INSPECTION BY ENGINEER 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 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 regulations in effect on the date of this inspection. Name of Firm S & S ENGINEERING GINEERING Phone � y " �-`1 7 I 7M4 gle River ILGOP KOad No. 204 Address Eagle River, Alaska 995777 Engineer's signature DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments NI1TIC Date ))-/ ;L l q c� .. , 4h ZIROE_9RT C. COMM i �Q 0. CE 88 bedrooms, with the following stipulations: Date/2-8-FS 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 courtesy to purchasers of homes and their lending institutions in orderto 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. 72-M (Rev.1/J1) Back MOA #21 V RECE ED DEC 03 1998 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN S[bRkfllgEV OF ANCHORAGE Environmental Services'Divisii IRONMENtAGSEI:vICEs DIVISION 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: 47/3L�(' �� N©k/_i 4J00p sli% 3 >Parcel I.D.: Q. / ' 7.3.2- r 63 A. WELL`DATA I type If A, B, or C, attach-ADEC letter. ADEC water system number Log presen /N) Date completed j j Total depth Cased to Casing height (aboveL ground) Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL,L C AT INSPECTION Date of test Static water level { Well production g.pm. g.p.m. i WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of'semple: 6611e6ted by: B. SEPTIC/HOLDING TANK DATA Date Date installed q�17 `9 Tank size X30 Number of Compartments Cleanouts (ON) Foundation cleanout @N) /y Depression (Y Vi Y High water alarm (Y)@ r-0 Date of Pumping "'�� '�"�` Pumper C. ABSORPTION FIELD DATA Q Date installed �'� 9r� Soil rating (gp.d./ftz or Ytz/bdrm) ®• g System type aED �Jo� rE2 Length 201 Width Gravel thickness below pipe 3 Total depth Effective absorption area .3?ar Z Monitoring Tube present a/N) I Depression over field (Y/Q A i/Ekj �'Y'5%6M Date of adequacy test ` Results (Pass/Fall) For bedrooms Fluid a on field before test (in.); immediately after gal. water added (in.): Fluid depth (ins) Minutes later: tion rate = g.pd. Peroxide treatment (past 12 months) (Y/N) . If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Size inallons/ Date installed_ ` g Manhole/Access (Y/N) 1/ "Pump on" level at* �1� /J ,,Pump off" level at* High water alarm level at* "r 7 *Datum /3DToM Cycles tested E. SEPARATION. DISTANCES SEPA DISTANCES FROM WELL ON LOT: TO:., Septic/holding tank on lot On adjacent lots - Absorption field on lot On adjacent lots Public sewer main Public sewer manho out Sewer /septic service line Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 7 Property line 7 Absorption field ice, Water main/service line f,/ Surface`water/drainage' 0®/ - Wellston adjacent lots �o� SEPARATION DISTANCE FROM ABSORPTION FIELD ON LL/OT TO: / !�t�A[O /' i Property line 36 Building foundation Water main/service line �, /00/-,,- surface water /00 r `t- Driveway, parking/vehicle storage area �� Curtain drain A/a,�F ri✓dId/ Wells on adjacent lots aoo + F. ENGINEER'S CERTIFICATION' I certify that I have determined thru field inspections and review of Municipal record i�h®ibfg jems are in conformance with MOA HAA 'd s in effect on this date. Signature ,,//►► � Axl a Engineer's Name /� 08 far- f! . Co � � :..» I...... Date l ��,l °l $� �% "c�,a cE -Saot ^ _ HAA Fee $ Waiver Fee $ % Lj Date of Payment L / '� / Date of Payment Receipt Number 3r � ` 3 / Receipt Number 72-626 (Rev. 3/96)*