The URL can be used to link to this page

Home My WebLink AboutNORTH WOODS UNIT 4 BLK 15 LT 11i Municipality of Anchorage Page I 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: "~l,~J ~'1~:2~ PIDNumber: ~1c:2~¢,-'~,.¢,~'~. Name: ~~ ~~ ~ ~ Wastewater System: ~ New ~pgrade ~q~ ~¢ ABSORPTION FIELD Phone: ~ ,~ ~ NO. of Bedrooms: ~ Deep Trench ~ ShalfowTrench ~Bed ~ Mound ~ Other LEGAL DESCRIPTION so~, Rating: Total Depth from original grad~ , ~.~GPD/Sq. Ft. ~, Lot: ~ Block: j~ ~Subdivisi°n:~~ Depth to pipe bottom from original~.~grade: Ft. Gravel depth beneath pipe~¢~ ~ Ft. Township: J Range: J Section: Fdl added above original grade: Gravel length: /Ft WELL: U New ~ Upg rede G~a~e~ width: ~ lFt. Number~of lines: ] Distance~be~ween~ lines:Ft. Classification (Private, A,B,C)~ Total Depth: Cased To: Total absorption are Pipe material: ~ ~ Driller: Date Drilled: Static Water Level: Installer: Date installed: Yield: [ Pump Set at: I Casing Height Above Ground: OPM] Ft.I Ft. TANK SEPARATION DISTANCES ~eptic ~ Holding ~ S.T.E.P. To Septic Absorption Lift Holding ~ubHc/Privat~ Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~ ~~ ~ t~ Well ~'~ ~ ~ ~ ~1 Material:~~ Number~of Compartments: Surface Water ~ I¢'¢ -- -- ~ LIFT STATION Line ~ ~ I ~ ~ ~ Size in gallons: Manufacturer: ~ ~ ~ ~ p off" level at: High water alarm at: CurtainDrain ~ ~ ~ ~ ~ ~ Pump Make'del ~ Electrical Inspections performed by: I Remarks: ~ '[~ 0¢ ~¢ ,S BENCH MARK ~ ~ ~ ~ Location and Description: ~ AssumedElevati°n: [~[, ENGINEER'S SEAL S & S ENGINEERING ~ ~~*' % ,' , 17034 Eagle River L~ R~d, Ho, ~.. ~/..J~ ~ ~ '*'"~ ' '~ Inspections performed by: ~~~ Ea~ie ~iwr, Ai~k~ ~5~ ua[es: ] s~ i~1~~~ ~ Reviewed and approved by: / Date: ~-~%-~ ~ *~%'*~'~~ ~,- n°¢E~s~ ,~ ) MOA 25 Permit No... of 2 S'~930070 Page 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 Description: NORTH WOODS #4, BLOCK 18, LOT 11 PID No.: 051o84o2 COl CO1 ! zi,~r~ I \ 9o,eo X 91,1, N.T.S. A 84.6! NO WATER FOUND DIVERTER T.B.M. (BOTT01v DOOR) sc~z l" = 40 72-013 A (Rev. 9/91) MOA 25 ENGIN A. 4o. 1457.1~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW930070 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:SEWARD DUANE MARK & OWNER ADDRESS:21640 SHELTERING SPRUCE LOOP CHUGIAK, AK 995687 PAGE 1 OF DATE ISSUED: 4/23/93 EXPIRATION DATE: 4/23/94 PARCEL ID:05106402 LEGAL DESCRIPTION: NORTH WOODS UNIT IV BLK 15 LT 11 LOT SIZE: 27987 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: THE ATTACHED APPROVED DESIGN. 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 (iSAACS0). THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 OR 343-4681 AFTER BUSINESS HOURS 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 THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVE ISSUED BY: I April 15, 1993 ROBERT SHAFER, P.E ROGERSHAFER. PE CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 11, Block 15, North Woods Subdivision IV Request you issue a permit to upgrade the septic system serving the referenced property. An adequacy test performed on the existing system found the absorption capacity to be inadequate for Health Authority Approval. A soil test was performed in the location shown on the attached design/site plan. Monitoring found no groundwater within 15 ft. of the ground surface. For reasons which are not apparent, the existing septic tank was buried very deep with 8 ft. of cover on the tank. Due to the age of the tank and the depth of bury, we propose the installation of a new 1000 gallon septic tank installed at a lesser depth. We also propose the installation of a diverter valve so that once the existing leachfield is rejuvenated by dormancy, it can be placed into use in the event the new leachfield becomes inadequate. The properties in this subdivision are fair in size and are served by a community water system. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed upgrade. If you have any questions or require additional information for your review, please contact us. Sincerely, ROGER J. SHAFER, P.E. 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 1" -- 4-0' SCALE m 0 0 UPGRADE DESIGN -- L /'~T ~ 5°\ ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 11, Block 15, Northwoods Subdivision IV 21640 Sheltering Spruce GENERAL: 1. The scope of this project includes the installation of a 1000 gallon septic tank and a leachfield bed to serve the 3 bedroom house located on the referenced property. The existing septic tank is to be excavated, pumped, crushed, and abandoned in place. A diverter valve is to be installed after the septic tank so the flow of effluent can be diverted to either the existing leachfield or the new leachfield. Construction shall be in accordance with the approved site plan and design drawings; Municipal permit with any special provisions or conditions; and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: mo A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. page 2 Lot 11, Block 15, North Woods IV Septic tanks installed with less than 4 ft. of cover shall be insulated. Se A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. LEACHFIELD BED INSTALLATION: mo Excavate the proposed Bed Area to the depth shown on the design. The bottom of the excavation shall be within 2 inches of level. If the bottom of the excavation becomes smeared, it must be raked or scratched (ruffed-up) before gravel or sand placement. If a sand layer is required, place sand over entire excavation to the required depth shown on the design. The top of the sand layer must be within 2 inches of level. 3e Sewer rock shall be placed uniformly throughout the entire bed. Perforated distribution pipe must be installed level with perforations down. Gravel depth below the perforated pipe shall be a minimum of six (6) inches. Gravel depth above the perforated pipe shall be a minimum of two (2) inches. The total gravel depth throughout the entire bed shall be a minimum of twelve (12) inches. e The perforated distribution pipes must be no more than six feet apart. The distance between the outermost perforated distribution pipes and the sidewall of the absorption bed must be no more than three feet. Silt barrier material must be installed between the final gravel layer and the native soil backfill. Ensure the sil% barrier covers the entire gravel surface before placing backfill. page 3 Lot 11, Block 15, North Woods IV 6e e Monitor tubes shall be of four (4) inch diameter and installed at the locations shown on the design. The portion of the monitor tube extending through the gravel depth shall be perforated six (6) inches below the bottom of the horizontal distribution lines. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finished grade over the bed must be mounded to prevent the formation of a depression after settling. INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre- construction meeting will take place on-site. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. page 4 Lot 11, Block 15, North Woods IV The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of PiDe Perforated Solid Cast Iron ASTM D3034 (PVC) ASTM FS10 (HDPE) ASTM D2662 (ABS) Yes Yes Yes Yes Yes No Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. When sand is being used as a filter material, it s gradation specifications must conform to AMC 15.65. 060D. 16 17 18 19 20~ SITE PLAN A I- N Net Depth to Net Time Water Drop ~ ~-.~ ~ ~,, ~1~,, PERCOLATION RATE I''2'~'''2'~ (minutes/inch)PFI~CH~EDJAME~ER TEST RUN BETWEEN ~ FT AND ~' FT COMMENTS PERFORMED BY: iZOd* Eagie ~iYer Loop ~oa~ ~io. ~ ~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WI~[[~A~t~L GUiDELiNEs IN EFFECT ON ~HIS DATE. DATE: ~' [~ 72-008 (Rev. 4/85) uni p lity of Department of Health and Human Services Tom Fink. 825 "L" Street Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 May 25, 1993 Robert A. Shafer, P.E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 11 Block 15 North Woods #4 Waiver Request #WR930026, PID #051-064-02, HA930239 Dear Mr. Shafer: Your request for waiver of the required 10 foot separation between a septic system and a lot line has .been approved. The waived distance is 1 foot from the existing absorption bed to west 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 Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR~ WR930026 PID~ 051-064-02 HA# Ha930239 Date Received: May 13, 1993 Legal Description: Lot 11 Block 15 North Woods #4 Engineer: Applicant: Permit Robert A. Shafer~ P. E.~ S & S Enqineerinq 17034 Eaqle River Loop Road, Suite 204, EAqle River, Alaska Mark Seward 99577 Waiver Requested: Lot line waiver - existinq absorption bed and the west property line. Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: ~ Waiver is NOT Granted: List Conditions or Reasons for above: ~ E/~/~Ff ~CI~ Date: ~of Reviewer Rec ~: 24679/7861 Amount: $ 70.00 Date Paid: May 13~ 1993 HEALTH AUTHORITY APPROVALS SEWER & WATER MA~N EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST ~ PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN May 12, 1993 ROBERT SHAFER, P E ROGER SHAFER, P.E. CIVIL ENGINEERS (9071694-2979 FAX 694-1211 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, Alaska 99501 MUNI¢IP^I.I'I'y OF ANCHORAGE ENVIRONt,~N]'AL SERVICES DIVISION RE( EIVE, D REFERENCE: North Woods Subdivision Addn. #4, Block 15, Lot 11 Request you issue a Z foot property line waiver from the existing absorption bed, which has been temporarily abandoned with a diverter valve, to the West property line. An adequacy test performed on the existing system found the absorption capacity to be inadequate for a Health Authority Approval. A diverter valve was installed so that once the existing leachfield is rejuvenated by dormancy, it can be placed into use in the event the new leachfield becomes inadequate. This property is served by a Community water system. There are no protective well radii which encroach upon the property. We do not anticipate any adverse effects on the neighboring properties due to a 1 foot property line waiver being granted. If you have any questions or require additional information for your review, please contact us. .n t RAS/RLS/LSU/lsu 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 ~~) NIUNICIPALITY OF ANCHORAGE '~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PRoTECTioN ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 NAME -- ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MAILING ADDRESS /~ -Z,~l~ [] UPGRADt LEGAL DESCRIPT, I~)N . NO. OF BEDROOM8 PEP~MIT NO. area I($' ~1- ~~'~ Mat e ri~.,~L,( N°, of compi]rtments ~Z' q. capacity in gallons ............ ns de length ~ 1(~)0 ~r rlUlVl~lVl/~gl:. Liquid depth 6 v DISTANCE TO: 2 PERMIT NO. _j O ~ Well Dwelling ~ ~ Liquid capacity in gallons ~u · DISTANCE TO: I- -' o inish g'r~_.~ ~ Material beneath tile Top of tile to fin~ -- ....... ~ ,~u, . Distance between lines ~ ~ Tot~effective absorp/i/en area ~1 Length Width ~~ Dep t"~"~--'~ inches <~ I- Type of crib Crib diameter Crib depth [u ~- Total effective absorption area u~ u~ DISTANCE TO: Well Building foundation Nearest lot line .a Class Depth Driller -~ Distance to lot line PERMIT NO. u~ ~ DISTANCE TO: Building foundation 8ewer line Septic tank J Absorption area(s) OTHER PIPE MATERIALS T~ $OI L TEST ,NSTALLE 3 J fO--O/ APPROVE D~--'~~ DATE LEGAL 72-013 (Rev. 3/78) Permit ~ App 1 ic an t :~'. ~7 ~ Location: Phone Number: ~& Legal Description: X~~ // ~/~ /~-- ~~o~ Size: Type of Soil Absorption System Is: Trench: Drainfield: Seepage Bed: ~ Holding Tank: Maximum Number of Bedrooms: ~ Soil Rating (sq. ft/br) ..... / The Required Size of the Soil Absorption System Is:~ _ . GRAVEL DEPTH WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). REQUIRED SEPTIC(HOLDING) TANK SIZE = /~ GALLONS ~ Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED ~ ~ ~ Backfilling of any system without final inspection and approval by this department will be subject to prosecution. D ~UNICIPALITY OF ANCHORAGE~. epartment,' ~ Health and Environmenta? ~rotection 825 ~ Street, Anchorage, AK. ~9501 264-4720 HANDWRITTEN PERMIT * * * WELL AND/OR ON-SITE SEWER PERMIT Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, ! 98~* I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes, (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to ,~ ~ .~ include mor~ 3 bedrooms. Applicant SWP/024 (1/81) o MUNICIPALITY OF ANCHORAGE Department~-~ Health and Environmenta3~-~rotection - ' 825 ~ Street, Anchorage, AK. _9501 264-4720 Permit ~ ~/°~{# '* * * HANDWRITTEN PERMIT * * * W~ ON-SITE SEWER PERMIT Legal Description: a~ i ~ ~~3~LOt Size: ' -- Type of Soil ~sorption System Is: Trench: Drainfield: ~ Seepage Bed: Holding Tank: Maximum N~ber of Bedrooms: ~ Soil Rating(sq.ft/br) ~ ,, , The Required Size of the Soil ~sorption System Is: ' The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minim~ depth of gravel between the outfall pipe and the bottom of the excavation(in feet). REQUIRED SEPTIC(HOLDING) TANK SIZE = /OO~ GA~LONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences'that the well will serve. · * * TWO(2) INSPECTIONS ARE REQUIRED * * * Backfilling of any system without final inspection.and approval by this department will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minim~ distance from a private well to a private sewer line is 25 feet and to a co--unity sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper.installation. · * * PERMIT EXPIRES DECEMBER ~1~ 1 9 8 3 * * * I certify that: (1) I ~ f~iliar with the requirements for on-site sewers and wells as set forth by the Municipality of ~chorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedrooms. Applicant SWP/024 (i/si) · E. EFI-IF.'."f1"IE1',I L-hr`:. HEFILTH FINC,' E1'.,IVIF?F1"JMEI",!TFL pF?FTECTIf"$1 ':"":'.~'" L"' ._..,TREET. FINCHORPlGE., FIK '- ...:,.-. · 7.":, .'; FII'-4F:H FIF'I::'~I3E E, 94-2::L~::'L ' EFIGLE R I',,,'ER PERHIT NO. 8]:t0:E6 F'HONE FIF:'PLICI::INT: SKFIGGS E>:',Ci::I',/ FIDE:,F.:ES'.E;: F'O BO;-'-:; D f':HI. IG I FtK., I:11-:::'::¢q~56'? · ' ~- - .,: BLOCK: t~ LOT: LE.:,I'h.- E:,E'.:SCF-'.IF'TI01"~' ,:;.,ItE.:f':,'i',,,'ISII"'IN: 1'.,tORTHI.4UOI"-'-, :1:1:4 - ~ ::r .... F..:FINGE: - SECT ! ON: .... L¢IT SIZE ~_..Z~ 'SI..-.!. FT. FUI..~N::,IIIF: .... ,, , ,.., ~"'1*'m'mr~ OF E:EE:,F.:O01'"IS = _.3:: Si_ilL F::FITING := i.'Z.:8 ::LE.':F': t3:8 ('..50. F'T. ,..E,R., I"IFI:qlM .I"1 ,,,.., ,i.::,. .... - ' IE: LISTED E:ELOW FIF::E THE CIF'T'r-' '- FIVf:iILI:IDLE TO "r'OU I1'4 DESIt.~1",II1"4I~ "fOUR .=,EFT ::,¥=,TEI1. L. HUI]=,E THE; F:F'TIOI',! THFIT E:EST FITS '.r'l-IIJ'~: SITE. T 'F~. E% ~""~ _..It-ii IE:*E~ ."E "} ~",~ NIDTH = "~' =' FT. LEI",IGTH = ,':;9. 0' FT. TOTFIL [:,EF"I'H = E;. 0 FT. ! NOTE ! ...... REQUIRES INSULFITION o.F...II~ ,:,,,rz',,,..L DEPTH = E.':. O FT. .~ 1",IOTE , [.x,. GF.'.FI',,,'EL ',,,'OLUME = ;-22. ~: E:U. ,_ . ~ .... · ,~ COI'"IPFtR'.TMENT TFINK TI.-"tI'.~t< ::,I~.E = l., 000. 0 IaHL. I_ui'4_, TWO t.4tDTH = ±8. O FT. LENGTH = _-'-':6. 0 FT. TOTFIL DEPTH = 5. 0 FT. GRFt',,,'EL [;,EF'TI"'I = 0. 5 FT. GF.,.i:iVEL ,,,.,i.'.iL.t.li~qE = 24. 0 CU. TFINK SIZE = /.., 000. ID GFILL,7,~4S (TWO COMPF:IF,:'.Ti"IENT t...I I [;,TH ..... 0 FT. LENGTH = ~';'... ~.,. 0 FT. TOTF:IL E:,EF'TH = E;. 0 FT. GF.:FI',,,'EL DEF'TH = 2. 0 FT. GRFt',,,'EL VOLUME = ~.,_':':. 8 CU. T Fi N 1< ) TI;:lhiJ< S;IZE ±., OO(~. I,_."1 -' I'"''1':;'; ('TI'-~1-1 I CERTIFY THFIT: - , ,,.- :.L. i Fll-'l FF-li'IILiF:iF.: kliTH THE F.'E..":JIF'E'"ENTS FOR Ed'.,I-...SITE =,EI..IEF,= F'.IN[:, WELLS FIS SET FOF.:TH E:"¢ THE I','ItJI'.,IlCIF'FiLIT'-/ EIF I::tI,,ICHOR:FIGE FINE:, THE STFITE OF i..":.tLFISI<I:I. FINE:, HFIVE F.:ECE I VE[:, '-' '-" = -- THIS ,::.. I !-,.IIL. L Il,kc, RILL THIE S'.r'~,TEM tt'4 F:IFF:OF.:[:,t::II",ICE I,tlTH THE CODES -t t~''l" - r: ~...~ Ft L-:OF'"r' OF TI'IE CO[:'E .-;,., ,r,:. l":ti',l[:' E:,IFII3F.':Fli"I F. ITTI::iCHMENTS WHICH 1:5 PI":'I'F.':T L3F PER:M I T. Z:':. I UNE:'EF;:STFIi';ID' TI...IFIT THE JN...:::,ITE ::EPt~.F. :.;,~:;,TEI1 i"lFl"r' F.:EQUIF.:E EhlLF-IF.':GEMENT IF THE ~ .... ,~ F- F.:EMODELEE:, TO IN(.':LI_I[:,E ,IU~.E THFIN Z:: E:EE:,'F.':OOMS. I .E.:, ~ [. ,_[4 _.EI ~.Z, - , .... - F'ERt"IIT ,-IFFL.,;E:F:tNT Hi:IS THE F:ESF'OI'.~SIBILZT"r' TO ZI"4FLI'RI~1 FE.F....=,E,i',INEL THE I NSTFILLFIT I E,I,I t 1'.,ISPEP:¥ I OI',tS E;F I::11'.,~"¢ WELL:5 FIE:,J'FICENT TO TH I S F'F~:OPERT"r' FINE~ ~ ~-,,-r:, CIE:: F-:.E_' ,r"'r.~E::ENCES THFtT THE L,c. LL'"' ;4.T. LL "-=,Et;.,;' E'". THE .... ~ TF' Fi LIFT £;'Tt=ITIEfi'4 IS 'fNSTI""'tLLED., FIN ELE'.":'f'RtC:::IL F'EI~t"IZT FINE:' INSPECTION MU"-'-',T I-'" ' '"" ' I"" ~"::'~'r"T BE: I:IF'F'F.;'.OVED I...IITHOIJT FIN ELE~"tR~E:F'IL IN.:.FE_.rlnN DE JE," ""1 ["*' Ii',IEC.~ l:':tS-';Ed_l ] L-f'S..r",',~ ~'~n'-.'~'o F'-~ ' F"" ~'C'~::~-.l"=~D ELECTF.':ICIFIN. t;~:EF'ORT. THE ~:.~.~.-;. ..... ,..I_.lq*.-I...IOF:K I'IL.::,F E:E DONE E:'¢ FI L .ONICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVlRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST SLOPE 1 2- 10--- 11 12 13 14 16 17 18- 19- 20 co..,,,s SITE PLAN WAS GROUND WATER S ENCOUNTERED? /~) (~ P IF YES, AT WHAT E DEPTH? [ Reading Date Gress Net Depth to Net Time Time Water Drop / ~ ;,/5 /o ¢?.¢7 ~,~(~ ~H~ : 4~ ~ ~. ;fro lo ~.~ff (minutes/inch) ~, ~ to lo -F~ef, PERFORMED BY: 72-008 (6/79) CERTIFIED BY: 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. # ¢¢- /-~'6¥ -0% 1. GENERAL INFORMATION Complete legal description Lot ti; Block North Woods ~ '=~ ' ' ~ ou~,.vls~on ~ Location (site address or directions) Property owner Mailing address Lending agency Mailing address Ted Bryant 21540 Sheltering Chugiak, 21640 Shelter~nq Spr~]ce Spruce Day phone Chuqiak, AK Day phone 68¢-7050 995S7 Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~ TYPE OF WATER SUPPLY: Individual well Community well ...... Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: I! community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Fronl MOA #21 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 ail Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm S & $ ENGiNEERiNG 17034 Eagle River Loop Road Add ress Ea~lle River, AJas~,a 9957_Z Engineer's signature Phone ~''q ~'' - ~_cl -z ~ Date DHHS SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: By: 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 courtesy to 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. 72-O25 (Rev. 1/91 ) 8ac~ MOA Legal Description: A. WELL DATA Well pe.. A Log present (Y/N) Total Sanitary seal (Y/N) Date of test Static water Heait~ Auth If A, B. orlC, attach ADEC letter AT INSPECTION g.p.m . B. SEPTIC/HOLDING TANK DATA ' Date installed .-~ -25 -*1~ Tank size; J oo~ Number of Compartments '~. CleanOuts Foun~tion clementS): ~ ) Depression (~ ~ High water.alarm (Y~ ~enCh N -: ' Width' Gravel thic~eS~ below pi e O' ~ ~ Effectiv, ' M~ni/ofi~g Tube preSe"t~) Y Depressionovet field Date of adequacy test ~ ~ Fluid depth in abso~tion field before test fin ); ¢ I~ediately ~er &a~g~: .Water added .(in Fluid depth 3 ~ '(ins.) Minutes lat~: ]¢ ~¢. Absoeti0,'r~te 2 J; q'~O'* '~' g Peroxide tiea~ent (past 12 months) (Y~ Se Public sewer main Building foundation · Water main~service line Building foundation Surface water . I O° ~ Curtain drain Iq'//~ ~'. est;I~t,s C~,~XI~IC~TIOS :~ ON 'LOT TO: Signature Date HKA ReceiPt Numbei Rev. 8795 DSS: haa;wk.doc 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Lot 111 Block 15~ Northwood Subdivision Phas~ #4 Location (site address or directions) 21640 Sheltering Spruc~ Peters Er~k, aK Property owner Mailing address Lending agency Mailing address. Mark S~ward 21640 Sh~tcrin~ spruc~ Day phone 688-4566 P~t~rs Cr~k, AK Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: $ TYPE OF WATER SUPPLY: Individual well Community well XXx Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: XXX 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 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 Municipalit~ 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. ~ ~, := ENGINEERING ~-~O, Phone ~:~' Name of Firm ~?034 Eagle River L~ep---7" Address ~agle River, Ala ~ 99577/ Engineer's signatur~ ~,~~ Date ~4-//3/~ _,,i!, . .... / / DHHS SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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 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. 72-025 (Rev. 1/91) Back MOA ~Y21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description:~'c~.~ ~A~v_~' ~A_'~c>.~ '~ Parcel .D. A. WELL DATA Well type A Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level If A, B, or C, attach ADEC letter. ADEC water system number Date corn pleted Driller Cased to Casing height .-.--- ~ Wires p~ FROM WELL LOG ~.~'~ AT INSPECTION Septic/holding tank on lot Absorption field on lot Public sewer main SEPARATION DISTANCES FROM WELL TO: ~ c~ ; On adjacent lots ~/.-~o c, ~ ~' ; On adjacent lots Sewer service line ...-.PetrEleum tank WATER SAMPLE R~ Coliform ~ Nitrate Other bacteria D~: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ~"~ ~'-'°t~ Cleanouts ~)'N) ~ High water alarm (Y~ Date of pumping Tank size \~c~c~ Compartments Foundation cleanout ~..~N) ~ DeP~essio .n~.(Y~'~). ~'~ Alarmtested (Y/N) ~r~/ JX~ Pumper Well(s) on lot To property line \ c> Surface water/drainage SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: On adjacent lots /~- Foundation Absorption field ~, c, · ._Water main/service line 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) ~ Vent (Y/N) "Pump on" level at ' - ~ _ ~at ;,::tsWaMt;rAale:~t rliecVa:,c o d es (y/N )~s tested ____ SEPA~T~n lot _ On a~lc~2t Tc~i Surface water D. ABSORPTION FIELD DATA Date installed ~'- ~ ~-- ...c~.-~ Soil rating O,5" /'~'¢~-T-~- System type L~.~ Length 't~o ' Width ~. 4. ' Gravel thickness ~,-~'- Total depth ¢' Total absorption area ~' / ~ ~ Cleanouts present ~)'N) ~ Depression over field (Y~ ~ Date of adequacy test ~L Results (pass/fail) I'[[/~' for bedrooms Peroxide treatment (past 12 months) (Y~ ~ If yes, give date ~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot -2... c~ z~ ~'~ On adjacent lots '~/~ Property line ~,°~ ~ To building foundation ~ ~' ~ To existing or abandoned system on lot \ c, ~ ~ On adjacent lots '~ c~ Cutbank Water main/service line Surface water ~, o z~ Driveway, parking/vehicle storage area Curtain drain '~[ l~' E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidefines in effect on the S & S ENGINEERING Signature ~?h~z ~--,-., . /'/_~z ....... ~ .....~-r ~-u~O~Ci NO, 204 , Eagle River, Alaska Engineers Name Date c>~'///~'~/¢'-~ ' HAA Fee $ ( -/LO, ,~"~'-~ Waiver Fee: $ Date of Paymen~ ~ f 13 / ~/3 Date of Payment Receipt Number 2~ Z ¢~7~/~ Receipt Number DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 800 E. DIMOND BLVD., SUITE 3-470 ANCHORAGE, ALASKA 99515 April 5, 1993 WALTER J. HICKEL, GOVERNOR (907) 349-7755 Mr. Ray Shafer S & S Engineering SUBJECT: Northwoods Subdivision Class "A" Public Water System, PWSID 213001 Dear Mr. Shafer: Ihave completed a review of this office's files concerning the monitoring status of the above-referenced Class "A" Public Water System and found the following: The last satisfactory Total Coliform Bacteria Sample results was submitted to this Department on March 4, 1993. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. The last inorganic Chemical Contaminants Sample results were submitted to this Department on April 21, 1992. This does meet the provisions of 18 AAC 80.200(a), of the State Drinking Water Regulations. The last Radioactive Contaminants Sample results were submitted to the Department on July 1, 1992. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. The last Organic Chemical Contaminants/Volatile Organic Chemical (VOC) were submitted to this Department on June 2, 1992. Based on analysis of the previous VOC samples results have been satisfactory. This does meet the provisions of 18 AAC 80.200(a), State Drinking Water Regulations. Issuance of this letter does not imply that the above-referenced Class "A" Public Water System is in compliance with other provisions of the State Drinking Regulations. ~.¢~} prir~tt~(~ ()r~ recyclecJ paf)e~ h y C, [; APPLIC?'%I, T FILLS OUT UPPER HAI.'"%,ONLY · "') ') ~ "~ ~ Zip Code ~'" ~.,, Mailing ~dre~ t,~ ~ ~.~ ,~ %) ~-,", .... , : V ', , t .)~-, Buyer ~> --. ~¢ / >) Address Zip Code " " , Phone Lending Institution '~*,,,~ k, ~I, ~:~ ,-1~ ;~; ., ~. ,,:~ ,,, ,~ Address .,> _, '"'"; Zip Code Realty Co. & A~nt ¢~ ,%'i ,' '' ' ~,., .: Phone Legal Description ~ ~ ~ ~ .~,~ ....... ~ ~ Street Locat'i~ ~ ~ ~'% ",,.~'~ Type of Resi~nce ¢ '~ Single Family ~ Multiple Family No. of Bedroo~ ~ ~ Other . ,,; Water Supply ' ' ~ ." ~ Individual /' A~CH~,WELL LOG. A'W~I ~o~ is required for all wells drilled since June 1975. ~ Community ~ ~ ~ ~" ' : ' ' / ' For wells drilled prior to that 8ate,/ give well depth (attach Icg if available). ~ Public Utility ~ .... T~*., / Sewer Disposal " ~ ' -, -"' ~ Individual ; Year Individual Insialled: _ ~ Public Utility ~ ' When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE-MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Date Date Date Inspector Inspector Inspector Field Notes: ¢~¢2~x. U~,"~ ~ ~ ~ (~,~APPROVED BEDROOMS ) DISAPPROVED ) CONDITIONAL APPROVAL* DATE / ' ~ ~''- ~4¢' *CONDITIONS OF APPROVAL Date Sewer Installed Well To Absorption Ares / ~" ~ ~--~¢" ¢ Well to Tank Well Log Received Septic Tank Size Soils Ratting /3? 72-023 (3182) APPLI NT FILLS OUT UPPER HAT ONLY Pr, gperty Qwner [-~ (~ ~'~-;: _ 'ii~) (: ~ ~' ~C.'~ ~'~} ~:~> -~ ~ ~ ~ ~J~ / ~ ~.. Phone Buyer ~ Real~y Co. & A~nt ~ t: ' / Phone Street Locati~ kJ H ~-~ %~((:L ~ '- ~ '; ¢ ''~ Type of Resi~nce ~ Single Family ~ Multiple Family N0. of Bedrooms ~ Other Water Supply ~ Individual A~ACH WELL LOG. A wall Icg is required for all wells drilled since June 1975. Community For wells drilled prier to that date, give well depth (attach Icg if available). , Public Utility Sewer Disposal ~ Public Utility When Connected to Public Utility: ~ Holding Tank NOT~ THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Mt, iNICIPALII'Y OF ANCHORAGE Field Notes: DEPT. OF h.l,~,l L~ ENViRONM:NTAL PROTECTION RECEIVED, ( ) APPBOVED BEDROOMS 'OONDITIONS OF APPROVAL ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* DATE BY: Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received Well to Tank Septic Tank Size ?2.023 (3182) RAMsIzY