HomeMy WebLinkAboutPARK PLACE LT 1
Municipality of Anchorage Page
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~,~ q"'~OZl~'(~ PID Number: 0~-~ -- Oq~--
Name: ~0 ~T/~. Wastewater System: O New ~Upgrade
Address:~[ ~' ~ P~ ~& ABSORPTION FIELD
Phone: ~Z ~l~ ~ J NO. of Bedrooms: S'WlOE
~ 0 Deep Trench ~ShallowTrench D Bed D Mound ~Other
G~"'~ [~o~F ~.~, ~ro~ o~ig~na~ ~e:
LEGAL DESCRIPTION so, Rating: ~ GPD/Sq. Ft. ~ ~ W/~' ~R~O
Lot: ~ BIock:~ ~ Subdi~ion:~ ~ Depth to pipe bosom from orig~nalO~~grade: Ft. Gravel depth beneath pipe~, ~ ~ Ft.
~°w"~"~: ~/~ J"~'~:~ ~s~"o,:~ Fill added above original grade: Gravellength:
~ Ft. Ft.
WELL: ~t~T~W D Upgrade Gravelwidth: , Numberoflines: Distance~nlin~:
Classification (Pri~A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: ~H
Driller: Date Drilled:
Static Water Level: Installer: Date i~stalled: '
Yield: J Pump Set at: ~ Casing Height Above Ground:
GPu ~o~ ~t.I ~t. '~.~.~,P TANK ~'~
SEPARATION DISTANCES n Septic n Holding ~ S.T.E.P.
TO Septic Absorption Lift Holding Public/Privet Manufacturer: ~ ~ Capacityin gallons:
From Tank Field Station Tank Sewer Lines ~ ~, ~ ~
Number of Compa~ments:
Welh' /O0~ /0~ ~00~ ~ ~'~ Material: ~L
Sudace
Water /00'+ /00'+ ~m~ ~ -- LiFT STATION :
Lot
Line /~'+ ~0'+ /0 '~ __ ~ Manufacturer: ~C[4.
~ ~ ~ "Pump on" level at: ~ "Pump off" level at: ~ High water.~larm at:
Foundation /0 · /0'~ ~0 ~ ~t--~ ~V~ ~
Cu~ain
Drain ~O~ B [(~GW~ ~- ~ ~ ~ Pump~Make & Model ~ Electrical~lnspections, O, A pedormed by:
Remarks: O~D ~tgTl~ ~y~ BENCHMARK
Location and Description:
~ = I0~. ?& ~,..,~ .....
Inspections pedormed by'. ~;~ ~'~'~;a k'~> ~ Dates'. 1st II/~a/~> ~le~": .... -21;~'~'yl;~ ~ [-'~ ~:"a~
Depa~ment of Health and Human Se~ices approval ¢ ~,,,,,
Reviewed and approved by:~~ C /~ Date: ,/>~ ~77 a~.<<>~. '~'.,~s<~-",',',,'" ........
__1
A TO F,C,O, = 1,0
) B TI] F.C,O, = 23,0
A TO MH1 = 18,0
~ B TO MH1 = 15,5
· B TO NH2 -
I B TI] ~;ANPLE POET
A TI COl = 57,5
I B TO COl = 584
~ A TO MT = 72,7
~ B TO MT = 67,8
t
x ,
"
,
PREPAEED BY~ ALASKA ~ATER & ~ASTE~ATER
18/4/97
'GROUND OVER FILTER = 101.?
~ ~-M.IN CDVER: 2.75 FEET, /---- SLOTTED PVC PIPE. INVERT = 98,G
' / GROUND OVER TANK = 99,9
]~---4 INCHES OF BLUE~D~R3 / NIN COVER = 4,6 FEET,
/~DVER TOP ~F FILTER. / DRAINROCK FROM TOP OF BL~CK PEA, TO
2 INCHE~ OVER T~P DF 3LDTTE~ PVC PIPE.
~ ~ FILTER. PER ANCHORAGE TANK DESIGN,
~INFILTRATDR CHAMBER (18 INCHES TALL> / ' TANK SET LEVEL WITHIN 01 FEE FOUNDATION C/D
ON 30TTDM DF TANK I~ COVERED WITH / INV E~r~ - o~g= , T, INV, = 95,85
NIN. DF 8 INCHES DF 3RAINRDCK, BOTTDM / ' ~' - ~'~d
OF BOX TO BUTTON DF BLOCK PEA IS / , ,
APPROX. 15 INCHES,
~~ 1,85 INCH PVC PRESSURE LIN~
NOTE, THE UPFLOW CHAMBER IS INSULATED WITH 8 INCHES FROM STEP TANK. CHECK VALVE THE LINE IS BURIED 4 FEET BEEP
DF SPRAYED URETHANE, BY ANCHORAGE TANK, IN STEP TANK PREVENTS BACK- · COVERED WITH INSULATION BOARD,
FLOW TO TANK.
GROUND COVER OVER TRENCH = 100.7 TD 101,0
MINIMUM COVER = 8,45 FEET.
TDP~DIL ~ RESEEDING / FOR LOCATIDN DF N,T SEE PLAN DRAWING
~; '~', A, TRENCH LENGTH 30+ FEET
LAYER BF LAKE BTIS C, ORIGINAL GRADE = 9~,4
GR~VEL, ~, ~QTTOH ~XCAVATION = 95,4
5,0 , TOTAL DEPTH = S FEET TB ~OTT~ ~F SAND
~ ~~ E, TOP ~K SAND = 9%4
F. INVERT OF DRAINPIPE = 97.9
SEPTIC UPGRADE, L~T I, PARK PLACE S/~, ~'~,~r~/t~
.... ........
/O;~x~'. J C~-7953 ."
ALASKA ~ATER & ~ASTE~ATER ~h:~ '..... . ...._~
DATE: 12/4/97 DWN, GARNESS SCALE, NTS
P?t-ltTM brand fax tmnsmi?_._el memo 76/~
· i :
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
PERMIT NUMBER:SW970400
DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES
OWNER NAME:~T~ FRED MARTIN
OWNER ADDRESS:16411 ST JAMES CIR
ANCHORAGE, AK 99516
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
DATE ISSUED:il/19/97
EXPIRATION DATE:il/19/98
PARCEL ID:02009247
LEGAL'DESCRIPTION:
PARK PLACE LT 1
LOT SIZE: 43401 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
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 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 IS ISSUED FOR THE CONSTRUCTION OF AN INNOVATIVE
RECURCULATING TRICKLING UPFLOW SYSTEM. AS A CONDITION OF
THIS PERMIT, THE OWNER SHALL MAKE ARRANGEMENTS FORTHE SYSTEM
TO BE SAMPLED A MAXIMUM OF ONCE A MONTH FOR 12 MONTHS AFTER
Rick Mystrom,
Mayor
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
Dear Homeowner/Prospective Buyer:
The on-site wastewater disposal system you are purchasing/installing is an "alternative" wastewater
disposal system. This system, known as a "Recirculating/Upflow Filter Septic System", is undergoing
testing within the Municipality of Anchorage under the Alternative System section of the Wastewater
Disposal Regulations (AMC 15.65). There are certain risks involved with the ownership of one of these
systems:
1. The technology used in this system has been shown to be effective in other areas. The system is
currently undergoing a two year testing period in Anchorage under the guidance of the Department of
Health and Human Services (DHHS) and the State of Alaska Department of Environmental Conservation
(ADEC) to determine its effectiveness in a subarctic environment.
2. Changes to the Wastewater Disposal Regulations (AMC 15.65) through Mtmicipal Assembly action
will be necessary prior to this system being approved as a standard system.
3. The system for this property received a vertical separation distance waiver from both State of Alaska
and Anchorage Municipal Codes to ground water. This waiver was granted due to the system's expected
performance within the site conditions on this property.
I (we) certify that I (we) have read the above statements and am (are) aware of the risks outlined. I (we)
also certify that I (we) am (are) in the process of purchasing (property legal description):
~,Purchaser Name) ,,/ O (Purchaser Name) -
(~urchas~i~re) ~ ~ - ~h~a~re)
Notarize Here
State of Alaska
On this 19th day of November, 1997 Nancy Klingenmeyer personally
appeared before me whose identity i proved on the basis of
V ~otary Public
My commission expires
7320 East Chester Heights Circle - Anchorage - Alaska 9950'~'WIRONMENTAL ~E~VlCES
Phone (907) 33%6179 ~ Fax (907) 338-3246 NOV 0 7 1991
Consulting Engineers
RECEIVED
November 6, 1997
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref.' Septic System Upgrade for Lot 1, Park Place S/D. RECIRCULATING UPFLOW
FII,TER (RUF) SYSTEM
To whom it may concern:
1. GENERAL: The existing 3 bedroom home is served by a private well and septic system. The
drainfield is surcharged and must be upgraded at this thne. Given the location of the structure,
the old bed, the protective well radius', the area available for the new septic system is very
limited. Test holes to the east of the existing bed, and near the driveway (TH #2 & #3) revealed
unsuitable conditions for an onsite septic system. It appears that a portion of this area was used in
the pas~ for burying stumps, wood, organics, eot. The area to the northwest of the bed was ruled
· out because of the amount of trapped (ponded water) in the drainage ditch (east side of St. James
Circle), Based upon the information we have at this time, the only suitable site appears to be near
the southwest portion of the lot (TH #1). Attached is a copy of the soils logs. Because of the
space constraints, and the soil/groundwater conditions, we are proposing to install a
Recirculating Upflow Filter (RUF) system, designed by Orenco Systems, Inc., and marketed by
Anchorage Tank.
There is a drainage ditch, and a culvert under the road, immediately downhill from the proposed
trench site. On 10/8/97 there was no running water in the ditch. On 11/6/97 there was water
running in the ditch, and daylighting from the culvert on the other side of the road. On 11/5/97 a
"chinook" Wind, accompanied with rain, resulted in extremely wet conditions. It is reasonable to
assume that this ditch will have water in it during spring break-up, and during/after ."significant"
rainfall events: The new trench will be roughly the same distance from the ditch as the existing
bed system is. Does DHHS have any historical data on this ditch, and has it ever been defined as
a surface water? IfDHHS defines this as a surface water, the only other possible sit6 would be to
the east of the driveway, and between the protective well radius' for Lots 1 & 2. The useable
area at this location is very limited also. Given that fact that we found suitable soils in TH #1, we
would prefer to install the system in that vicinity. Please provide direction from your department.
The specifics regarding the design are summarized as follows:
2. SOIL CONDITIONS (TH #1): A test hole was dug to a depth of 9 feet. Below a depth of
approximately 5 feet, the soil appeared to be tight, wet, silt. At a depth of 3-4 feet, the soil
perked at 15 minutes per inch. On 10/16/97 groundwater was encountered at a depth of 5 feet
below grade.
3. DllABIFIELD: The intent is to install a Recirculating Upflow Filter (RUF) system that will
allow the use ora small drainfield in the area of the TH. The size of the drainfield will be based
upon the previously established criteria for the RUF systems, which dictates that soils percolating
between 1 & 30 minutes per inch have an allowable application rate of 4 gpd/fi2. Given this
at2plication rate, the system (3 bedroom house, 450 gpd) will require a dralnfield area of 112.5
ft~. This corresponds to a 5 foot wide trench that is 22.5 feet long. To be conservative, we are
going to install a 5 foot wide trench that is 30 feet long (150 fi2).
4. ORENCO PACKAGE SYSTEM: The STEP tank with the trickling and upflow filters will
be manufactured by Anchorage Tank & Welding to meet the latest design criteria established by
Orenco Systems, Inc. The point of contact at Anchorage Tank is Lowell McNutt. Since you are
familiar with the operation of the system I won't elaborate. As with their standard STEP tank, it
is equipped with a high water alarm per M.O.A requirements.
5. SURFACE WATER: See comments in paragraph one regarding the drainage ditch.
6. TOPOGRAPltY: The entire tot slopes gently downhill (approximately 4%), to the west, and
southwest. The slope transitions to a 20% slope about 25 feet below test hole #1. Fifty-two feet
downhill from the test hole, there is a steep (100% slope) cutbank. We will place the new trench
so as to maintain a 50 foot separation to the cutbank.
7. CLOSING: Clearly, this property has numerous site restrictions which limit the potential for
septic system upgrades. The suitability of this design will be limited by the soil/groundwater
conditions at the proposed trench site. It is my recommendation that the contractor install the
trench, prior to purchasing and installing the RUF system components. In short, they should
ensure that the drainfield can be installed prior to committing to the complete installation.
I am open to any suggestions from your department that would be an improvement to the
proposed system. I am unaware of any negative impacts that this installation would impose on
adjacent wells, or septic systems. If you have any questions, please call me a 33%6179, or
244-9612.
/
Sincerely,~ A ~, /
PfindiI~al u
arness, P.E., M.S.
16~-TH AVENUE
LOT 11~ PARK PLACE S/I), ~ w o |
THAN 100 FEET FROM THE ~ . \ SEF~TIC gYSTEM X OF ~DUND SYSTEM
LilT 10, PARK PLACE
PVT, ~ELL AN~ ~EPTIC S~STEN. ~L ~ "~. ~ YELL
k/ M"'--t.: "
/ ~H~ V~UVU~ UVb~~~ S/~, PVT. WELL
/ / '/ SEPTIC SYSTEM,
~. OF A~ ~
SEPTIC UPGRADE, LUT 1, PARK PLACE S/3
~F-.7,7~i7.-~ ...............
PREPARE3 FBR: FRE~ NARTIN
PREPARE9 3Y, ALASKA WATER ~ ~ASTE~ATER
,
DATE~ 1~/4/97 ORAWN, GARNESS SCALE, 1' = 100'
/ '~, '~ \ ~/~H PER ~UaT MINIMUM,
~ ~ ~ ~B FEET BY 58 FEET. / ~
', ~ ~ . / ~ ~ ULATIN6 TRICKLING FILi'ER,
t ~ % % / ~ / ~ PER ANEH~TANK DESIGN
~ k ~ % PER ANCH TANK~ ~/
~ '~ES ~ ~IS AREA ~ ~SIGN
~ ~ED ORG~ FILL ~ / FTM
o -.
~LL '.
PREPARE]] FOR: FRED HARTIN
DATE, 11/4/97 DRAWN, GARNEgS SCALE: 1' = 30'
FEET NIN OF ANCHflRAGE
~/ITH RECIRCULATING TRICKLING FROM HOUSE,
FILTER. PER ANCHORAGE TANK DESIGN.
R B SET TANK LEVEL
, I M
APPROX. i5 INCHES.
1.25 INCH PVC PRESSURE LINE
FROM STEP TANK, CHECK VALVE
NDTE~ THE UPFLDk¢ CHAMBER SHALL DE INSULATED ~AITH 8" IN STEP TANK PREVENTS BACK-
DF SPRAYED URETHANE, 3Y ANCHORAGE TANK. FLDV TD TANK. MIN BURIAL DEPTH
DF 4 FEET, AND 4 INCHES OF INSULA-
TION BOARD (2 FEET VIDE) OVER THE
TOP DF THE PIPE, FOR EFFECTIVE
~URIAL DEPTH OF B FEET.
TOPSOIL AND RESEEDING TD BE THE RESPONSIBILITY OF THE HDNEOVNER
FOR LOCATION OF M.T SEE PLAN DRA~ING
4 INCH PVC, 6 INCHES DF DRAINRDCK BELDV PIPE,
/ ~ FILTER FABRIC OVER DRAINRD~K
/ AND 8 INCHES DF INSULATION,
~'t~'5:~z~'~ A. TRENCH LENGTH : 30 FEET
· ~ B. TOTAL ABSORPTION AREA = 150+ SQ. FT,
5,0
EXCAVATE TO DEPTH DF 3 FEET AND FILL BACK UP TO ~ITHIN
1 FOOT DF ORIGINAL GRADE ~ITH LAKE OTIS GRAVEL.
THIS ~ILL ENSURE A 4' SEPARATION TO IMPERMABLE SOILS,
ALASKA ~ATER & ~ASTE~ATER
~ro fesslO~'
DATE: 11/4/97 D~N' GARNESS SCALE~ NTS
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
2
3
4
7
8
~0
12
~3
14
17
15
20
DATE PERFORMED
Township, Range, Section:
SLOPE
WAS GROUND WATER
ENCOUNTERED?
SITE PLAN
~ ¢:..~,,q~.~ / s
ATW.AT
DEPTH?
Deplh to Water After 5"
Monitoring? Date: ]
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE /~" (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~/~_~_0 FT AND 4o_~__~O FT
~ ~ i ~[~ T~IS~ST WAS PERFORMED
72-008 (Rev, 4/85)
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17-
18-
19-
20
COMMENTS
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
DATE PERFORME~
~' ~/~ownship, Range, Section: ~ ~"
SLOPE SITE PLAN
WAS GROUND WATER ~____~
ENCOUNTERED?
,
IF YES, AT WHAT
O
DEPTH? ~ p
E
Deplh t0 Water Alter
~0~it0ring? Date:
Reading Date Gross Net Depth to Net
Time Time Water Dropsy.
TEST RUN BETWEEN
tminutes/inch) PERC HOLE DIAMETER __
FT AND __. FT
~-~ C
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: II/,~.../C/.¢/-
72-008 (Rev. 4/85)
PERFORMED FOR:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG m PERCOLATION TEST
LEGAL DESCRIPTION: [.~O"~ t .) I~,...~--~ p[.,A~-..,~
1
2
3
4
,5
6
7
8
9
10
11
12
13-
14-
15
16
17
18
19
20
COMMENTS t,d ["& S t~. t ~--'~-.~ t ~.
SITE PLAN
DATE PERFOI~I~"
Township, Range, Section:
I I
SLOPE
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Oepth Io Water After
Moniloring? Date:
Reading Date Gross Net Depth to
Time Time
Water / Drop
PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER __
TEST RUN BETWEEN FT AND __ FT
PERFORMED e,: , OERT,F, THATTH,STSTfASPERPORMEO,N
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
WATERWELL - TEST PUMP REPORT
Owner~ ~ ~ Address I(~'l I
Well Location ~ ~ ~ ~.~
Well Information: Tfl. Depth ,~0 _Depth of Casing Z~'"7' Screen From To
Casing Size __.Screen Dlam I,,~/',~ Screen Slot
Remarks
Pump Information:
Pump On:
Intake Depth ~0~ Pump Size
Static Water Level -~-~1,/~r'-J Av. Discharge
Time /..,-2:/~__'~ ~o rT~. Date ~/~{~/Q'7 Pump Off:
'7,4
Air Line Depth ~L.~_.CT'~O~J ~C_...
GPM. Max. Drawdown
Time 1: 4D prT'l Date
WATER PIEZO- FLOW WATER PIEZO- FLOW
TIME LEVEL TUBE GPM REMARKS TIME LEVEL TUBE GPM REMARKS
IAoO 0 0
i~'.b~ ~.'~ ~
I
I I ~ i
i ' ~ ~ ] I
~ i i ! ........ ~ ........ . _ ~ .....
_~,.../ MUNICIPALITY OF ANCHORAGE . ,.. ~
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME /. P /~/~ , ~ ~, . (~)~ PHONE ' ~NEW
MAILING ADDR ESS~ O
-07 7
LEGAL DESCRIPTION
LOCAT/O~ ~ ¢~ ~
W~.~, Absorption area Dwelling PERMIT NO.
~D~ Manufacturer ~ M~~ No. of~partments
Liq. ~a~ty in gallons Inside length Width Liquid depth
~ -- ~ Material ~city in gallons
D We]l Foundation ~ Nearest lot line PERMIT NO,
~ ~ DISTANCE TO: ~ ~0 ~/O ~
~~ Z No/of~ lines Length~¢of each~line Total length of lines ' Tr~c~width~ Distance between lin~
~= Topoftieto inis grade z Material beneath tile ......
~ ~ ~ ~ (.~ Total effective absorption area
Length Width Depth PERMIT NO.
~ ~earest lot line ~
~ ~~ Depth Briller Distance to lot line P[BUlI ~0.
~ DISTANCE TO: Building foundation Sewer line Septic 'tank Absorption area(s}
OTHER
PIPE ~TERIALS
SOl L TEST RATING~ / ~
APPROVED ~ , DATE LEGAL
72-013 (Re{
~ ':'~.'-' .~ -' ...... --"~ ,- ~, /-
PERMIT NO. ,: ::~FlP~5~: b ~ : '
RPF'LICRNT TRENT 5LR'T'MRKER PO BO:, 50-0787
TYPE OF SOIL RE:SC~RF'TION S,:,TEM IS:
MR;~IMIIM NLIMBER OF E,E[.RUUM_, = ~ SOIL RRTING
THE RE~;~UIRED SIZE OF THE SOIL RBSORPTION S'T'STEM IS:
[:,EF"TH= 6. 5 LE[-~G1-H: :..1.. :E: ~Z.l G F~ R'-..' E L [:.E F'TH:
THE LENGTH DIMENqIFIN IS THE LENGTH ,'IN FEET) OF THE TF. EN_,H ... DRRINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE
GROUND RND 'THE BOTTOM OF THE E~(CRVRTION (IN FEET:.".
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETNEEN THE OUTFFILL PIPE
~'FtND THE BOTTOM OF THE EXCRVRTION ,.'.IN FEET).
5
F-:E _F--~LI TREE-'" SEPT T C: TI-3~'-.~-=:: S
PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM TFIIS DEPRRTMENT DURING THE
INSTRLLRTION INSPECTIONS OF RNY WELLS RDJRCENT TO 'THIS PROPERTY RND THE
NUMBER OF RESIDENCES THRT THE HELL WILL SERVE.
-r~,:, (2) ~ ~SPEC:TI C,P-~S R~:E RE~:!fJIRE[:~
BRCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION RND RPPROVRL BY THIS
DEPRRTMENT WILL BE SUBJECT 'TO PROSECUTION.
MINIMUM DISTBNCE BETWEEN R WELL RND RN'~' ON-SITE SEWRGE DISPOSRL SYSTEM IS
±00 FEET FOR 8 PRIV8TE HELL OR t50 TO 20~ FEET FROM H PUBLIC HELL DEPENDING
UPON THE TYPE OF PUBLIC HELL.
MINIMUM DISTBNCE FROM 8 PRIVATE WELL TO 8 PRIV8TE SEWER LINE IS 25 FEET 8ND
TO ~ COMMUNITY SEWER LINE IS F5 FEET.
HELL LOGS 8RE REQUIRED 8ND MUST BE RETURNED TO THE DEP8RTMENT WITHIN Z~O D8YS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONS RND CONSTRUmZ:TION DIRG~RE
RVRILRBLE TI] INClLIRE F'ROF'ER INSTRLLRTION.
- - - .
F'EF:~'] ~ I E:~.F" ~ RES
~ CERTIFY THRT
· : ~ RN FRN~L~RR I.,J~TH THE REQUIREMENTS FOR ON-SZTE SEWERS fiND WELLS RS SET
KOR'~H BY' THE MUN~C~PRL~TY OF RNCHORRGE.
2: ~ H~LL ~NSTRLL THE S'~'STEM ~N RCCORDRNCE H]TH THE CODES.
]:: ~ LINE:,ERSTRND THRT THE ON-S~TE :,EHEE. ~T_,TEM MR~ REQ_~RE ENL~RG~HE. NT ~F THE
: I bNED :LRYMRKER
PERFORMED FOR:
LEGAL DESCRIPTION:
2
3
5-
6-
7
8
9
10
12
13
14
15
16
17
18
19
20
COMMENTS
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6-650, Anchorage, Alaska 99502 276-222~
SOILS LOG- PERCOLATION TEST
[] SOILS LOG
PERCOLATION
TEST
DATE P..FOmED: /
SLOPE
SITE PLAN
~--H-H---i---,
WAS GROUND WATER
ENCOUNTERED? y~'
IF YES, AT WHAT
DEPTR? /o~ ~.
Gross Net Depth to Net
Reading Date
Time Time Water Drop
/ ~ od~o ,~."/~; o I; ~" o
PERCOLATION RATE Z O (minutes/inch)
TEST RUN BETWEEN 5'/'~-- FT AND ? /~- FT
72-008 (7/76)
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. # ~) ?-'~ - O~'Z--
1. 'GENERAL INFORMATION
Complete legal description
Mailing address "
Lending agency ~
Mailing address
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
Public water
NOTE:
lng to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site ~
Holding tank
Community on-site
Public sewer
If community well system, provide written confirmation from State ADEC attest-
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~I
5. 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
Alaska Water & Waste cater
Phone
Date
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
' r .' 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) Back MOA#21
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division
825 L Street, Room 502° Anchorage, Alaska 99501. (907) 343-~7~
Legal Description:
b- o-~- ID
Health Authority Approval Checklist
<: JP' Parcel I.D.:
A. WELL DATA
Well type
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Date of test
Static water level
Well production
IfA, B, or C, attach ADEC letter. ADEC water system number
Date completed
'~ Cased to
FROM WELL LOG
WATER SAMPLE RESULTS:
Coliform
Date ;, ;;mp,e:
B. SEPTIC/HOLDING TANK DATA
Date installed /! /c/cF
Foundation cleanout (Y/N)
Date of Pumping
Casing height (above ground)
Wires properly protected (Y/N)
AT INSPECTION
Collected by: "~'~ L~L'c4~'~t~
g.p.m, g.p.m.
Nitrate . ~"Z,~ w'~d~ Other bacteria
Tanksize '2,OOO Number of Compar/ments ~ Cleanouts (Y/N)
Depression (Y/N) /,,/'O High water alarm (Y/N)
Pumper /'"//~
C. ABSORPTION FIELD DATA
Date installed
!
Length BO * Width
Soil rating (g.p.d./fF orJ~
!
"' Gravel thickness below pipe
System type
Total depth
Effective absorption area l ~D +' Monitoring Tube present (Y/N) ~ Depression over field (Y/N) __
~Date~test. Results (Pass/Fail) For
Fluid depth in abs~ gal. water added (in.):
Fluid depth (ins) Minutes later: Absorption rate ~ g.p.d.
peroxide treatment (past 12 months) (Y/N)
bedrooms
If yes, give date
72-026 (Rev. 3/96)*
Date installed II
Manhole/Access (Y/N)
High water alarm level at*
Cycles tested /,4/~
Size in gallons
"Pump on" level at* ~ T'I~ ~-.P__ "Pump off" level at* '~
*Datum ~,. ~ o/'"~ O~
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot /~00 ¢'
Absorption field on lot /OD ~
Public sewer main /~///4
Sewer/septic service line c~o ~
/
On adjacent lots
On adjacent lots ! OD/"'r'
Public sewer manhole/cleanout
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
!
Foundation I 0 4' Property line ~_.~ /4-
- - Absorption field ~ ~
Water main/service line /0/*' Surface water/drainage /00 (-/- Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line ~ /+ Building foundation ~'~0 !
Surface water
Curtain drain
Water main/service line /0 /4.
Driveway, parking/vehicle storage area 20/4.
Wells on adjacent lots /0~0/~.
ENGINEER'S CERTIFICATION
I certify that I have detercpilCed ¢1~ ~ld inspections and review of Municipal
in conformance~Ml~//~/~k,lines in effect on this da te .
SignatUre "~-//'-~./~- k,~ ~-' -
Engineer's Name
Date
HAA Fee $ 'F
Date of Payment
Receipt
Number
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
.~ CT&E Environmental Servi=es Inc.
CT&E gef.#
Client Name
Pro,~e~t Name///
Cilcnt 5ample ID
Matrix
Ordered By
977284001
AK Water & Wastewaler
Lot 1, Park Place
Lot 1, Pa~k Place $/D
Drinking Wa~er
0
Coliform
0.4Z~
0.00
Client PO//
Priz~t~d Date/Time 12/02197 19:41
CollectedDate/Time 11/26/97 10:25
Received Date/Time 11/26/97 16:00
Technical Dlr~c$or: ~ephen C. Edt
Method
~PA 300.0
Prep
once Oete ]n{t
10 max 11t~6/97 RMV
DATE DATE DATE
INSPECTO~ INSPECTOR
MUNICIPALITY OF ANCHORAGE
D~PART~ENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 L Street - ~nchorage, ~laska
ENVIRONMENTAL SANITATION DIV~~ ~BL '~
Telephone 264-4720 ~ ~?~- ~,:~b.~
REQUEST FOR APPROVAL OF INDIVIDUAL WAT~ AND $~ER~ILITIES
1. PROPERTY OWNER ~¢~" [ PHONE
MAILING ADDRESS
PROPERTY RESIDENT (If different from above) PRONE
2. BUYER PHONE
MAILING ADDRESS
3, '[E~DING I~$TITUTION PHONE
MAILING ADDRESS
4.-- ~ ----REALTOR/AGENT I PHONE
I
MAILING ADDRESS
5. LEGAL DESCRIPTION
STREET LOCATION /
6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS
[] One [] Four
~ SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY ~ Three [] Six
[] Other
7. WATER SUPPLY
INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY
* ATTACH WELL LOG. A well tog is required for ail wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach Icg if available.)
8. SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON-SITE** /~'/' YEAR ON-SITE SYSTEM WAS INSTALLED.
[] PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. e/79)
: THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE I~ FiVE [~ OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVIDUAL/ON -SITE DATE INBTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
[~]Septic Tank or [] Holding Tank '~ ~.. ~
Size: t.,~'~ IfTank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES Septic/Holding Tank Absorption A[ea Sewer Line I Nearest Lot Lih~
1
WELL TQ:
Absorption Area to nearest Lot Line
5, COMMENTS
~PPROVED FOR '- ~,~ DROOMS
~ONDITIONAL APPROVAL (letter mF~ accompany certificate)
72-010 (Rev. 6/79)
t
82.5 "L" STREET
ANCHOR/-',G L
(907) 264-4111
GEORGE M. SULLiVAN,
MAYOR
DEPARTM[:N'.r OF ,q£!ALTH AMD ENVISONMEN'rAL
March ll, 1981
Raymond T. Slaymaker
Post office ]3ox 10-.787
Anchorage ~ Alaska 993__1
Subject: Lot 1 Block I Park Place Subdivision
Approval for your individual sewer and water facilities
cannot be granted until the following items have been
completed:
1)
The water analysis report needs .to be delivered to this
office from the Chem Lab~ 5633 B Street, for our
review~
2)
The depression or p~.,~, around the well casing needs to oe
:filled with impervious type soil so that it slopes away
from the well casing.
3)
Exposed electrical wires to the well head are z., violation
of the Municipality of Anchorage codes and must be encased
in conduit 'and buried.
Please notify this office for a reinspection when -the noted
descrepanc, ies have been corrected. If there are any further
questions, --'~¢~a call this office at 264-4'720
N.~. c:. se ·
eincerely
Robert C. Pratt~ R~S.
Associate ~ ''~' '·
opec 1. ~. ]. 1_ .~ ~
RcP/~jw
cc: Alaska Mutual Savings Bank
1503 West: 31 Avenue 99503