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HomeMy WebLinkAboutROLLINS LT AOnsite File Lot A � Municipality of Anchorage Community Development Department Page 1 of 2 On -Site Water and Wastewater Program 4700 Elmore St. - P.O. Box 196650 Anchorage, AK 99519-6650 - http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP181428 PID Number: 051-312-42 ❑ New 0 Upgrade Name: BRIGGHAM & SARA CHILDRESS ABSORPTION FIELD ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 15509 HUSKY STREET ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot ROLLINS A Fill added above original grade Ft. Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 92.1 N/A N/A N/A (E) TANK El Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer ANCHORAGE TANK Capacity 1250G,1. Surface Water 100+ N/A N/A N/A Material Number of compartments Lot Line 5+ N/A N/A N/A STEEL 2 NA Foundation 10+ N/A N/A N/A LIFT STATION Manufacturer Capacity Curtain Drain50+ N/A N/A N/A Gal. Remarks* SEE WAIVER REQUEST Pump on level at in. Pump off level at in. High water alarm at in. Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL House to tank3034 Tank to drainfield 3034 JR'S SEPTIC SERVICES Drainfield CO/MT 3034 Inspector Pannone Engineering Services BENCH MARK (Assumed elevation) 365.5ft Inspections, dates: 1 12/4/18 2"' 1/9/19 Location and description 3"' 41h SE BOTTOM HOUSE TRIM COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date AQ TH t'teven R: '15annone Approved (����U Date CE 8149 90, Inspection Keport_1-1-12.doc i O I I \NEI._.—(_E,) \ \ \ \ L '•;_.:m: AUE NORTH SCALE t"=,50' tai ! p' WELL E \ \ - `° ' W BDR \ \ \! 1 \ SFD REMOVED COLLAPSED 92.11 12508 SEPTIC TANK (E) ( PER MOA CODE _ �\ ii \ 11 EXISTING DRAIN FIELD —2 3615 r \ \ 365 360 � INSTALLED 1250a SEPTIC TANK \ 355 350 W/ DCO AFTER CONNECTED TO DCO \ \ \ EXISTING DISCHARGE UNE' / V �\ !/ �Y �. _ \ I \ 2 i 6.4 8 2_1.8 � 5 24.4 ! \ r� A T1 42. (P) T2 45. (E) DCO i 47. CO — w w — WATER LINE / WELL RADIUS — SS — SS — NEW SEPTIC TH TEST HOLE (P) PROPOSED (E) EXISTING CO CLEAN OUT NO. MT MONITOR TUBE NO. TYP TYPICAL NOTES: RECORD DRAWING I DRAWN I ACP I SITE PLAN z -C O � PD r- D f - O F <0 oz O Z O Z O O DW W W w Z 0U U U O.G. E.C. � v PAMONE ENG SVC, LLC P.O. BOX 102954 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 ROLLINS LOT A BRIGGHAM & SARA CHILDRESS 15509 HUSKY STREET - EAGLE RIVER, AK 99577 PROFILE SCALE: NTS Date 2./8/2019 Scale i' = 50' P.I.D. NO 051-312-42 PERMIT NO. OSP181428 Sheet 2OF2 Municipality of Anchorage P.O. Box 196650 0 4700 Elmore Road Anchorage. Alaska 99519-6650 a (907) 343-7904 0 Fax (907) 343-7997 http://www.muni.org/Onsite Develo2ment Services Department On -Site Water and Wastewater Section Waiver#: WR050013 COSA#: Permit#:OSP181428 PID#: 051-312-42 Legal Description: Rollins Lot A Engineer: Pannone Engineering Services Applicant: Briggham & Sara Childress Your request for a renewal of the waiver of the required 100 feet horizontal separation from the septic tank on this lot to the private well on this lot has been approved. The approved separation distance is 90.0 feet. Renewal of the waiver is being granted because the original 1974 steel tank was 90 feet from the well and water samples taken in 2005 showed no contamination. This waiver approval applies to the septic tank installed under permit OSP181428 only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. a a a a as a a a a. a avasaaaasaaaaasaaay.aaaaaaaa.vaaaa.aaaaaa.a.aaaaaaaaaa0aaa20Ma.aaaI Waiver is Granted: X Waiver is not Granted: Date: 3 oc 9 � / Approved by: ' ' Name of Reviewer ...................................................aa.....a....a....a.....aaa81 Pannone noar 4 si eag ? t Steven R. Pannone, Principal Registered Professional Engineer E-mail: steve@panengak.com February 12, 2019 Subject: ROLLINS LOT A Request for Well Waiver Design Narrative This is a request for a separation distance waiver for a septic system upgrade for the subject property. Due to existing conditions and available space on the property, the plan needed to be modified to enable it to confirm with a majority of the required separation distances. 1. Waivers: We would like to request a waiver for separation distance for the septic tank to the well located on the lot with the details specified below. a. Septic Tank (E): A separation distance waiver between existing well on Lot A and the replacement septic tank on the same lot. The distance between the septic tank and well is 92.0±, the well head is also at a higher elevation than that of the septic tank so it is not likely that effluent would travel toward the well head. We are requesting a waiver for the septic tank to the existing well for a distance of 90' on Lot A. L DEC Criteria: The well on Lot A is a private well and was drilled in 1974. The data is summarized as follows: LOT # WELL STATIC YIELD Well Data H2O Test Soil Well Nitrate 2.68 DEPTH WATER Date Date Characteristics Log Level LEVEL Data Lot A 12S' 45' 0.5-1 gpm 02/14/1974 03/01/2005 Y Y <0.145 mg/L The ground water in this area typically flows from the north to south. The soil cross-sections are similar across the area and a homogenous cross-section was used to calculate the DEC criteria for all components. As outlined under 18 AAC 80.020 and 18 AAC 72.021(a), I have calculated the following points: Lot A Septic Tank to Well: Distance from sewer system bottom to groundwater 5.70 Soil sorption below sewage system 1.81 Soil permeability below the system 2.00 Water table gradient 4.50 Horizontal separation 2.68 Total Points 16.69 "The sum of the above values could equate to the following conditions: 16-24 Almost sure to be free from any form of contamination from household sewage." In my opinion, this waiver request meets the above criteria for Page 2 of 2 approval and does not constitute risk to health. I hope the above information will assist you in determining that the waiver should be granted. Granting this waiver will not affect the future development of the surrounding or existing lots. If you have any questions or concerns, please contact me at 754-8200. Sincerely, Q�ycanaa p 4 OF Steven R. Pannone, P.E. Owner/Civil Engineer 4.i I V&�-'f- W bs nd J 3 cn ;Om a xg ozo o g -�-<—n Z—ver m N• zcZi��`�vm�A�� v rn m ss � o -1 � � -Z -< �r-:c z G n ►� _ m mZ m � n •••� � a; v , roc OM z� m -4 Om W>>m-I cp -� � z . x n' orn o�c�nim3 ® D v0 mmz -v gowmmm—x o CrnCA �25 t(A 0 D 3��—imm m < m ro-ic„Z0°�—n � cn CAR czn z ;u m v— ��NBdo�0 o m n LOpmom �* -4 cn z n -n a z0 qNz-� -� ®� �mcn = m M N ~_ n b !r a rn rn co m I 0 r MUNICIPALITY {]FANCHORAGE On -Site Water & Wastewater Program POBox 19GGsn 470DElmore Road Anchorage, Alaska 99519-885O Phone: (3O7)343'78O4 Fax: (9U7)343-7997 Permit Number: O8P181428 Work Type: SepticTankUpgoada Tax Code Number: 05131242000 Site Legal Address: R[)LL/NSLT A G:0653 Site Mailing Address: 1550gHUSKY ST, Eagle River Owner: CH|LDRESSBR|GGHAMK8&SARA Design Engineer: PANNONEENGINEERING SERVICES This permit iafor the construction of: El Disposal Field 0 Septic Tank Holding Tank Privy Effective Date Expiration Date LotSize inSq Ft Total Bedrooms: 12/4/2O18 12/4/20iS El Private Well El Water Storage All construction shall beinaccordance 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 (18AAC8O) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.G5.Provide notification bycalling (SO7)343-7QO4(24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall beeither: o. Opened and Closed onthe same day, or b. Covered, sealed, and heated to prevent freezing Received By: ]jn� a 111 Issued By: J / 7'/�// S/ Date: Date: I / M MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 051-312-42 Property owner(s) Briggham & Sara Childress Mailing address 15509 Husky Street Eagle River, AK 99577 Site address 15509 Husky Street Day phone Legal description (Sub'd., Block & Lot) Rollins Lot A Legal description (Township, Range & Section) Lot Size 40,598 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: (® all that apply) Absorption Field ❑ Septic Tank ❑X Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage ❑ APPLICATION IS AN: Initial ❑ Upgrade ❑x Renewal ❑ TYPE OF DWELLING: Single Family (SF) ❑X (w/wo ADU) Duplex (D) ❑ Multiple Dwellings ❑ (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Dis tance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: '/S Waiver Fees: Date of Payment: 12-LZZ2 Date of Payment: Receipt Number: 0 T q36? Receipt Number: Permit No. 615,0012 ILIA --9 Waiver No. Permit App_:•:•._. c: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181428, Rebecca Carroll, 12/04/18 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP181428, Rebecca Carroll, 12/04/18 ?~---, MUNICIPALITY OF ANCHORAGE DE~ .;ITMENT OF HEALTH AND HUMAN SERL .ES ,~ Environmenlal Health Division ~ 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 'ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Na~.e DISTANCES Nddress , TANK FIELD WELL LEGAL DESCRIPTION ~ ~ // Township, Range, Section AS-BUiLT DIAGRA~ tShow Jocation of well, septic system, property hnes, foundabon, ~ I~ ) ~'~ ~J~ j ~X~ driveway, wa,erboOies, etc.) TANKS i ~ SEPTIC ~ HOLDING ¢~ ~ ~ Compa~nts ' Material No. of ' . TYPE OF SYSTEM Cl. ~ TRENCH ~ BED ~W. DRAIN ~ OTHER r ~ Dept~ to p~pe bottom from Total depth from original grade ~ / orlginalgrade ¢,¢ FT q,~ FT T, ~ FIJI added above original grade Gravel depth beneath pipe ~J / ~" Total~absorptlon&~+. ¢ ~area ~QFT Distance between ii.es ~ FT ~ ~ PRIVATE ~ OTHER ddentifvl , SR B 196X cedily that this inspection was pedormed according to all Municipal and Health Depadment Approval: · .['~IEI:::'ARTt"'tli:NT L., HEALTH AND E]',IVIF;.:OhlMEf',IT~L , ,q[)]"ECT~ON ;:~. I I":E:.k:. I ANCHORAGE, AK '::;~;)'::'"" 1 825 L. " ..................... , · .... ¢ - ,:,:.~: 4 ~ 4. 7,..-..(.) ....... t.,::./86 DON ROI..A..INS P,,O,, BOX 140210 ANC]"tORAGIE .,, Al< 995 :L 4 688 '"" 928 9 t....L:!i:GFd... DESCR l F': SUBD I V I S I ON: NA LOT: 124 BLOCI<: NA SEC"I'ION: 25 'fOWNSHIP: ;L5N RANGE: 2W LO'I S i ZE:: 9()0:5? (SC,!. F"F,, OR ACRES) I cer. t:Lfy that= :J. ,,]. am ~ ami ]. iar v,]:J.'Lh thE, r(.::~,qLtii"em,:::.~r'Y[.s ~ or' ¢.:)n'""sit~e s~9~er's al~d t4E,~. ].!~ a~ set f'cH-i:.h by the Munic.::i. pal&ty of An:borage (MOA) and the State af Alaska, ;2, i will ins:tall the ~:ystem in acc:cH"dance ~gi't:.h a].l MOA,cc:)des and r, egu].at~c)ns~ and :i.n compliance w:i. tl"~ the design triter:La oF 't'..h:~: perm:i.i:., :%, ]: w:i.$1 adher'e 'Lo alJ. MOA and State of Alaska Pequirements for the set d:i.~'LarH::;es frc:)m ar'ly exist:i.r]g wel'.L~, wastewater' di~pos~], system or pub].:i.c sewer'age system (:H"~ th:i.s of any ad:ac:e)nt or nearby ].ot,, IF A I....IF:'T SI"ATION IS INSTAL..L..ED iN AN AREA COVERED BY MOA BUILDING CODES~ 'l'HE]'q (1) AN ELECTR];CAL. PERMIT AND ZhISPEC'/T'I[)N MUST BE OBTAI. NED~' (2) AS-BLIII...TS WILL. NO'f BE AF'PROVED WI'I"HOLYT' AN ELECTF;'.ZCAt... INSF'EC'T'ION RE]::q]R'T'; AND C:5) THE ELECTRICAL WORK MUST BE: DONE BY A L. IC',ENSED ELEC]:RICtAN,, , ......... .......................... 0 D[]NAL..D J ~ F;~[]L..L,]iNS EAE,iL,Jiii: I;R I VE]:R !, A!< 9x95 77 t,...OT ~ :1. ;~4-B ~(EIt,...OCI..'.'i ~ 0 :L 5N F~ANGEi ~ f'(::x"'Lh by 'LJ"m, l"h..u"~:i.c::Lpal:i.'Ly (::)f Ar'Ic::hc~I~ag(~) (PjOrr.~,) and ali"icj iiq c:,:::)mp!:i, an~::e wit..h 'Lh~:-:.) df~,~:.:i, gr'l (:::i-:L'Ler':La c::,f' t..h:i.~ t:x.:.:.:,r'mi'L. ]: t.~:i.].], ax::!l"i~:.'.~,r'(.~x, 'L.,x:, al.]. ~4C)F.~ and Ei'[:.a'L(.z.:, (::)f' lc~:J.~:':~l.::~':':~ r(.~.x::jL.t:i.r'E:,mE)['i'L~s f'ol" '['..l'~.~.) EH:E~'~.. ]:::,,:~:~(:::J.:: · d:J.~d:.,~Ed'H:::C.:~:qS fr~(::)m any E.:~,x:i.~'L:J.r'~g v,u.:.:~,].].~, wau:s'L(~,wa'E.(~:.:,r~ d:L~sl::~(:~E~a]. L.. ]: F;'T ST'A'T I E)N ]: S i NS'i'AL..L.E)~] I N ,-':.".iN Ai::RI.E:~'91 C['.)9E]:RED BY I"IOA BI..J ]i I....D I I",JG CE).OE:E~ ~, ( ii. ) ~r.tihJ E] ... Ei C 'T F;-'. i!~ C~(:d... F'l!i!]::;~!"l ]i J" F~::iI',ID Z IxI!ii~F'EZC'T l CJJ',I J"'J!.J!E~"J" ]E}J}i OEFJ"~':I ]] NED ~; (f~[:) r:':IS'"'BLJ I L.'T'S NJ3F E~Eil ~:~d:::'-F:?:R[]VE!Z[) NI'I"HEiJLJT is:.~lJ"-I Ji:/'.L...EC'T'I::~: ]i CF. d.... ]iI',IE~PECi:TIC)N I::;:EP[]I::;:T!~ rr.'.'il\lX] (::!!i) Ii:]'.L...EiX.}I l::~ Z ,{3AL.. WC}I::;'.!<i Jvj!.JS"J' iE{Ei~ ]}(].')J\JJi!!~ ~{{V {.ti J.... '.[ CE]~.tE~E:D Ii!i:L..EE;"! F;~ '.[ C :[ ~.~!1\t. DATE '0 ~Z ' 00£' Z'O0£ . '0 ..2J.'0££ '3,,2£ .91 oOO'N 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 RtSPOSAL SYSTEM z../ze ROBERT A. SHAFER December 7, 1985 CIVIL ENGINEER 694-2979 Mr. Don Rollin~ P.O. Box 140210 Anchorage, Alaska 99514A l REFERENCE: Lot 124; Section 25; TIEN; R2W Dea~ Mr. Rollins, Reference our recent t~lephone conversation concerning the on-site waste water disposal 4ystem upgrade installed on the referenced property by RaSmusson Enterprises. As I expl~ned to you on the t~ephone, the absorption area a~ installed and described by Mr. Rasmusson, and documented on Municipality inspection report dated May 17, 1985 by u~ is deficient in area to support a four bedroom residence. The following calculations show the short fall and upgrade requirements for four bedrooms. DRAINFIELD: 21 Ft. long; 10 ft. wide; 3 ft. S.R. depth 210 210 AREA = 21X 10 = -~- = 7- = 300 SF w~1+-~T x100 I0+I+2(3) 100 = 70 REQUIRED AREA FOR FOUR BEDROOM 85 X 4 = 340 SF ~ 300 SF Short 40SF UPGRAGE REQUIRED: 21X12 = 340.5 340 OK 12+5 · % depth = 12+I+2~ = 74 Add 2 ft. to the width X 21 fe~t long with 3 feet S.R.; I run of 4 inch perforated pipe; tied into the existing!u distribution system page Lot 124; Seation 25; TI5N; Anahorage and two inspection~ ~ill has b~n accepted and approved bedroom r~iden~e. If we ~a~ be of ~th~r 6erring, p~se co~a~ Department of H~lth and Human Services 'O · · ~Z * 00£ ~.' 00£ gA '0OS: -"~00' ¢ ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 NAME IPHONE Absorption~oarea t I Dwellin~ %~ex..s~%_l Material~..~~ Inside length J [ Width I~q-N EW [~UPGRADE NO. PERMIT NO, No. of compartments Liquid depth Dwelling PERMIT NO. Material Liquid capacity gallons in ILEGAL DESCRIPTION ~ ~ DISTANCE TO: ~ [ Liq'lc~gall°ns IF HOMEMADE: Well DISTANCE TO: Well DISTANCE TO: Top of tile to finish grade Total leng~o~ lilies Length Type of crib Nearesi ~lin.~ Trench v~idth /'~(~inches DISTANCE TO: Material beneath tile '~,,P inches Depth :rib diameter Well PE RialTo_ N 0~,.~ Lo, Distance between lines Total effective absorpljon area PERMIT NO. Total effective absorption area Nearest lot line Distance to lot line PERMIT NO. tank Absorption area(s) DISTANCE TO: OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS Z APPROVED DATE .,LEGAL MESSAGE REPLY SIC ~T~c~ 4S 472 SIGNED SEND PARTS 1 AND 3 INTACT - PART 3 WILL BE RETURNED WITH REPLY. DATE POLY PAK (50 SETS) 4P472 L.. E E{i,.q J. }'Z:"::i: '.ii:;C I::;'. :[ !:::' :', E;L..iii{;[]'t F;: ;[ F:?F:'L ][ []f,:~N'i' :: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONiVlENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG -- PERCOLATION TEST ~ SOILS LOG [] PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: SLOPE DATE PERFORMED: · 10 11 12 13 14 15 16 17 18 19 2O WAS GROUND WATER ~%~[ ENCOUNTERED? ' '~ ~ I~ O P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop )ERCOLATION RATE ~/~ (minutes/inch) TEST RUN BETWEEN ,/,~-- FT PERFORMED BY: ' r S'R~ 19~ ~ ~ ~ ROBERTA. SHAFER December 7, 1985 CIVIL ENGINEER 694-2979 HEALTH AUTHORITY 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 WASTE WATER DISPOSAL SYSTEM DESIGN Mr. Don Rollins P.O. Box 140210 Anchorage, Alaska 99514 REFERENCE: Lot 124; Section 25; TI5N; R2W Dear Mr. Rollins, MUNICIPALITY OF ANCHOI~ DEPT. OF HEALTH & ENVIRONMENTAL PROTECI'IOI~ BEC g'lg85 RECEIVED Reference our recent telephone conversation concerning the on-site waste water disposal system upgrade installed on the referenced property by RasmuSSon Enterprises. As I explained to you on the telephone, the absorption area as installed and described by Mr. Rasmusson, and documented on Municipality inspection report dated May 17, 1985 by us is deficient in area to support a four bedroom residence. The following calculations show the short fall and upgrade requirements for four bedrooms. DRAINFIELD: 21 Ft. long; 10 ft. wide; 3 ft. S.R. depth 210 ~ =' 300 SF AREA = 21 × 10 =7= . % ~epth = w+1+2d ×100 10+I+2(3) 100 = 70 REQUIRED AREA FOR FOUR BEDROOM 85 × 4 = 340 SF ~ 300 SF Short 40SF UPGRAGE REQUIRED: 21X12 = 340.5 340 OK .74 -- 12+2 = 74 % depth = 12+I+2(3) Add 2 ft. to the width X 21 feet long with 3 feet S.R.; run of 4 inch perforated pipe; tied into the existingi'? distribution system SRB 196X EAGLE RIVER, ALASKA 99577 Lot 124; Section 25; TISN; R2W Decem§er 7, 1985 A permit from the Municipality of Anchorage and two inspections will be required at the time this upgrade is preformed. In the meantime, your system has been accepted and approved by the Municipality of Anchorage for a three bedroom r~idence. If we may be of further service, please contact us. AS/ss - ¢~: RasmuSSon Enterprises Municipality of Anchorage Depar~ent of Health and Human Services ~G£ ER ANCHORAGE AREA Bb ~"~JGH ~/]~/ Department of Environmental Quality '~ 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME L OC^T,ON MAILING ADDRESS ~( ~-0~ ~'~)[~. /~e~ PHONE LEGAL DESCRIPTION ~ ~o~ IZc~ ~/' ~'- SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH NUMBER OF MANUFACTURER ~/-~4~¢ fTl~E¢~. MATERIAL ~-~ CO NTS ~ INSIDE WIDTH LIQUID DEPTH __.LIQUID CAPAClTY~T~ GALLONS, ( SEEPAGE PIT: NUMBER OF PITS / LINING MATERIAL BUILDING FOUNDATION ADDITIONAL ABSORPTION CRIB SIZE: DIAMETER"~? DEPTH ~?¢ DISTANCE FROM: NEAREST LOT LINE TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) -~ SQ. FT. WELL: BUILDING FOUNDATION CESSPOOL APPROVED CONSTRUCTION NEAREST LOT LINE OTHER SOURCES DISAPPROVED _ NEAREST SEWER LINE REMARKS_ DEPTH DISTANCE FROM: SEPTIC SEEPAGE TANK SYSTEM DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: PIPE MATERIAL. LOT SLOPE: R~EMARKS: (/ G.A.A.B. --  . Use of Well ' ': Location .(addze~s.,of: · To~ip, .l~mge, :Bect~o~,-L[ ~own; or di~t.a~ee mat~ road .' S~e of cas~g 6 Depth of 'H61e 12~ feet Cased to '1'~ "feet" Static wa~gr, iegel a~ : ~. ' ft. (~) (below) land surface. Fini~ of well (check one) open end ( -of drawdo~ from ata~ie level. _ . REC[IVED · ~ ~ ,'/- ..... '. - ~ . ..~......~'...' ;.:.... :' . . .TO "" ' · .... " RE'CE TO .... ~ .~.. ~ .... ~ .: · 2 ~ State GrEaTEr ANr~,HORAGE Area BOrOUgh 'IRONMENTAL QUALITY DEPARTMENT OF EN¥. ~, 3350 "C" STREET ANCH0.RAGE. ALASKA 99505 TELEPHONE 27~:~561 PERMIT NO. SEWAGE DISPOSAL SYSTEM -- APPLICATION. NAME OP APRLiCaNT INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED SEEPAGE Pit_ ~/ , DRAIN FIELD , OTHER NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST FINANCED THROUGH COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQU RED BACKFILLING O~' ANY sYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE Pit ~2~l DRAIN field. SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK ,SEEPAGE PIT , DRAIN FIELD TO NEAREST LOT LINE. WELL TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK ,SEEPAGE Pit DRAIN FIELD ~ SEPTIC TANK,/~/~l~./j~]{~, SEEPAGE PIT /00 ,DRAIN FIELD TO RIVER, LAKE. STREAM. CAST IRON INTO AND O[JT 0F SEPTIC TANK AND INTO CRIB CROSSING GAP OF ExcaVATION 5 FEET INTO UNDISTURBED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH ~lRTiGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO B~ REGULATIONS REGARDING INSTALLATION. OR LICENSED DESIGNER _ SEEPAGE AREA SIZE TYPE DIAGRAM OF SYSTEM [ CERTIFY THAT I AM FAMiliar WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIb SYSTEM IS iN ACCORDANCe WITH SAID CODE. 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 S'INGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Lot~, Rollins Subdivision Location (site address or directions) 15509 Husky' Property owner Mailing address Rollins Day phone 696-7089 270-3631 wk Lending agency Mailing addreSs CITY MORTGAGE Day phone Eagle River, Alaska/ATTENTION: Mark Truskett Agent Lola Pederson/JACKWHITE COMPANY Day phone 694-5500 Address 10928 Eagle River Road, Eagle River, Alaska 99577 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual well xxx Community well NOTE: Public water If community well system, provide written confirmation from State AD£C attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: if community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA ~21 Sm 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 wa[er 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 Munici pal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Phone ~/-~-~7~ $ & $ ENGINEERING Address 17034 Eagle Ri,vet' Loop Road Ne. 21)4 Fagle River, Alaska 99577 Engineer's signature Date D/~S SIGNATURE Approved for ~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments ~ (~¢~'¢~ Date By: / 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 pumhasers 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 o~ .Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91 ) Back MOA #21 Legal Description: RECEIVED Municipality of Anchorage ,~i~ )CT 1 4 1991 Department of Health & Human Services ~eCipality of Anchorage HEALTH AUTHORITY APPROVAL CHECKLIST alth & Human Services A. WELL DATA Well type ~-¢,/'~c'¢ Log present J~/N) ~ Total depth \ '/..5 ~ Sanitary seal ~)'N) if A, B, or C, attach ADEC letter. Date corn pleted Cased to ~,?-o ' FROM WELL LOG Date of test Static water level Well flow '/1~ Pump level ~-- ADEC water system number '¢' ~[ -'J ~ Driller ~/~- Xe-~ Casing height Wires properly protected {~)'N) ...YMuNICIPALITY OF ANCHORAGE AT INSPECTIONENVIRONMENTAL SERVICES DIVISION o~ - "l~ -"l ~ OCT 14 1991 '57,2 g.p.m. .[..CEIVE D SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot ~C) ~'~ Public sewer main Sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/c leanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed 1 Cleanouts (~/N) High water alarm (Y~:) Date of pumping Nitrate Collected by: Other bacteria $ & $ ENGINEERING 17034 lESlie River LOep Road Ne, ~04 Eagle River, Alaska ~$~"'/ Tank size \ '7-~'~.-~ Compartments Foundation cleanout ~)/N) ~ Depression (YXJ~ J~ Alarm tested (Y/N) '"~J~ Pumper ~..~.- ~¢~5,¢oc) ~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot \ DC> t~' On adjacent lots To property line \ o Absorption field Surface water/drainage ~ 0 C~ ~¥ Foundation Water mai n/service Ii ne Z-c) i 72-026 (Rev. 7t91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y~ .WefFon lot On adjacent lots Manufacturer Manhole/Access (Y/N) .~ .~'"'"'~'Pump off" level at .~~Gycles tested Surface water D. ABSORPTION FIELD DATA~ Date installed Length ~-I Total absorption area Depression ove~ field (Y~J~ Results(]~/fail) Peroxide treatment (past 12 months) Soil rating ~ ~/I~_ Gravel thickness ~ ~ Cleanouts present (~)/N) Date of adequacy test for l,~e~.~-'~' '~ System type Total depth ~*d~J If yes, give date "'~l,~, bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot \~t~- On adjacent lots '~c~Ot~' Property line \~t~- To building foundation '~f~ ' To existing or abandoned system on lot On adjacent lots ~ ~ ~ Cutbank Water main/service line Surface water ~ ~ ~ ~ Driveway, parking/vehicle storage area u rtain drain ~ E. ENGINEERS CERTIFICATION '' I ce~ify that I have checked, verified, or conformed to all MOA and HAA guidelines in ef~~ate of this inspection. ~. O~~' ,A~ ~. $ & S ENGINEERING ~. , 17034 Eagle Ri~er L~p Road N~. ~,gnature ~ ' ~5~d~ ~ver, Alaska 9~7~ Engineer's Name Date /~- 1/~( ~* ~ ~;.. ..~ HAA Fee $ ' ~ Waiver Fee: Date of Payment ~ ~/~- ~ ~ Date of Payment R c i.tNu er ) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received October 12, 1976 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR 1:30 p.m. 10-15-76 Friday Pratt 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: Lomas & Nettleton 4449 Business Park Bldv. Carl A. Dashnaw Phone: 274-7661 Phone: 3. Legal Description: T15N R2W Section 25 Lot 124 4. Location: Chugiak 5. Type of facility to be inspected Single Family 6. Well Data: Individual A. Type C. Construction 7. Sewage Disposal System: A. Installed C. Septic Tank: 1. Size D. Seepage Pit: E. Disposal Field: 8. Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank No. of bedrooms 1. Absorption Area Total length of lines B. Depth D. Bacterial Analysis On-site system B. Installer 2. Manufacturer 2. Material , Absorption area , Other contamination , Absorption area , Sewer Lines __ C. Absorption area to nearest lot line F0-~34 (1/74l P~nm 1 n{ fwn n~nm¢ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES 1. Type of Inspection~-~ CMRO VA '~// 2. Property Owner: ( ~ ~e-- ~-- .~, ~~)~)/7 z~) Mailing Address: 3. Name of Buyer: c~-~, FHA CONV Day Phone: Mailing Address: ~ Day Phone: Name of Lending lnstitution: ~-~:::~,~'~/4._~ ~ Mailing Address: Phone: 5. Name of Realtor or Agent: ~'q,~O,~ (~ ~--'~ ~.,~ Mailing Address:~)~/-~, ,/~/~'~ ~ ~]~' Phone: 6. Legal Description:~O~ /~ ~ ~ ~ ~ -/ /5 ~ Locat on= 7. Type of Facility to be Inspected: No. Bdrms. Water Supply Type of Supply: ~// Public Utility. If Individual, number of dwellings presently served .Individual / If Individual, depth of well. Sewage DisPosal System Type of System: Public Utility. Individual (on-site) If Individual, date of installation 72-003(3/76) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received July" ? " 1~, 19~6 ~~0,~~ / ~ ~Z?~ c~' ~'~ '~ TD~~ ime :fi InspecTion 2-_~. m.. /~':~:~ ~~L, ~ ~ ?~/~ ate 0 . n~pect'0n 7 6 Frida~ ~ ~., ~ND~W~U~L SE~E~ ~ ~TE~ F~C~L~T~ES · ~eaZe voa. 1. Approval requested by: U, nited Bank of Alaska Mailing Address: 645 G Street 2. Property Owner: Carl A & Bonnie J. Dashnaw 4. 5. 6. % Mat Sullivan Phone: 278-9526 Phone: 688-3130 Mailing Address: Post Office Box 501, Eagle River Legal Description: Lot 124 Section 25 T15N R2W Location: See map on back Type of facility to be inspeCted Well Data: Individual A. Type Single Family B. Depth No. of bedrooms 4 C. Construction Sewage Disposal System: A. Installed C. Septic Tank: D. Seepage Pit: E. Disposal Field: D. Bacterial Analysis On-site system B. Installer 1. Size 2. Manufacturer 1. Absorption Area 2. Material Total length of lines Distances: A. Well to: Septic tank Nearest lot line B. Foundation to septic tank , Absorption area /~ Other contamination , Absorption area , Sewer Lines C. Absorption area to nearest lot line D~.^ I ^-¢ Page, 2 of two pages - Red st for Approval of Individual .c '-~.r & Water Facilities L~gal Description T15N R2W Section 25 Lot 124 Comments Date Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) o ~;' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 "C" Street,' Anchorage, Alaska 99503 -- ~1 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACI/LITIES VA FHA Type of Inspection:~_. Mailing AddreSs: ~"0~ '"~-'~// Name of Buyer: ~~ ~ ~~'~~' Maili(g Address; ""~~ Name of Lending In.itutio~: A r.s: Mailing Address: 6.' Legal D~scri'ption: Lo'cation: Type of Facility to be inspected: Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well . No. Bdrms. Individual / 9, Sewage Disposal System Type of System: Public Utility If Individual, date of installation Individual (on-site) , EQ-037 (1/74) GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FAC]L]T]ES FOR v.ao Date Received Time of Inspection Date of Inspection January 5, 1976 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: Spokane Mortgage Carl A. Dashnaw Post Office Box 501, Eagle River Phone: 277-0543 Phone: 688-3130 3. Legal Description: Lot 124 Section 25 T15N R2W S.m. 4o LOcation: Chugiak 5. Type of facility to be inspected Single Family No. of bedrooms 4 6. Well Data: Individual A. Type DR///~/] c. construction B. Depth A!~orox. 130' D. Bacterial Analysis e Sewage Disposal System: On-site system. A. Installed 7._~_ ~z/ B. Installer -/~/~/- C. Septic Tank: 1. Size /ZS'~) 2. Manufacturer D. Seepa§e Pit: 1. Absorption Area '~O 2, Material X ~/7~ E. Disposal Field: Total length of lines Distances: A. Well to: Septic tank ~-~ , Absorption area Nearest lot line ~// , Other contamination B. Foundation to septic tank ~ C. Absorption area to nearest l°tline __ Sewer Lines , AbsOrption area (1/74) Paae 1 of two oaqes ~age 2 of two pages - Re~ ;t for Approval of Individual ~ ir & Water Facilities ~Legal Description Lot 124 Section 25 T15N R2W Comments Approved /~ Date Approval Valid for one year from date sigq~n-e~~x~LyK// Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and ~ccurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED Date EQ-034 (1/74) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF ENVIRONMENTAL QUALITY 3330 'C" Street, Anchorage, Alaska 99503 - 274-4561 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTSCTION JAN ,5 1976 RECEIVED REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER F~CILITIES 1. Type of Inspection: CMRO VA ~/ FHA CONV 2. Property Owner: ~')~-~__~L Mailing Address: ~, ~ ~/ ~. 3. Name of Buyer: Mailing Address: ~ ~, ~/~ Day Phone 4. Name of Lending Institution: ,~O~& Mailing Address: ~~~hone 5. Name of Realtor or Agent: '~~ Mailing Address: ~~)"+~~~ 6. Legal Description: ,' Location: Type of Facility to be inspected: No. Bdrms. Water Supply Type of Supply: Public Utility If Individual, number of dwellings presently served If Individual, depth of well Individual / Sewage Disposal System Type of System: Public Utility Individual (on-site) If Individual, date of installation EQ-037 (1/74) Pgge 2 of two pages - Re st for Approval of Individual ! er & Water Facilities L~gal ~escripti0n T15N R2W Section 25 Lot 124 S.M. Comments Approved _~/,/~,,~.~m~z~%-~ Disapproved Approval Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true a'nd accurate representation of~e subject sewer and water facilities and these facilities are operating satis~actor/Jly.) t~ SIG~ED~/~//_'~/~/~?~-~---3 Da /,~ ~_ EQ-034 (1/74)