HomeMy WebLinkAboutKIMBERLY MANOR #2 BLK 3 LT 5Kimberly Manor #2 Block 3 Lot 5 #017-073-51 Municipality of Anchorage Page 1 or 3 Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 9951&6650 www.ci.anchorage.ak.us (907) 343-7904 ON7WASTEWATERDISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW040269 PID Number: 017-073-51 Name: Robert Stevens Wastewater System: New 754Atldreas: 1 Our Own Lane Anch., AK 99516 ABSORPTION FIELD Phone: Number of Bedrooms: 727-1366 Four 4 Sand Filter Bed LEGAL DESCRIPTION Soil Ra ng: Total Depthfrom�ginalgratle : Bleck: Lot:Subtlivision: 3 5 Kimberly Manor #2 2.0 GPD/Ftp Depth to pipe bottom from original grade: 2.0 Ft. Gravel depth beneath pipe: Township: Range: Section: .5 FL Fill added above original grade: .5 Ft. Gravel Length: 3-4 Ft. 30 Ft. Well: Existing Gravel width Numberoflines: Distance between lines: Classification (Private, A, S. C): Total Depth: Casad to: 12 Ft. Total absorption area: 5 2.5 Ft. Pipe Material: Ft. Ft. 360 FP ASTM 3034 PVC Driller: Date Drilled: Static Water Level: installer: Date Installed: Ft. A Plus Home Svcs. 8/23-25/04 Yield: Pump Set at: Casing eight Above Ground: GPM Ft. Ft. TANK SEPARATION DISTANCES STEP Frnk tic AbsorptionE&La,'ftion, Field anufacturer: Anchorage Tank apaary in eons: 1,500 We0' > 100' Material: Number of Compartments:Steel Three Su00' &Dmm>20' >100' EN/Al LIFT STATION Lot' >10' ca; 250 Gal. an a arer: Anchorage Tank/Orenco rr'Pump >10 on° level at: "Pump oR" level at: Hi hFou g water alarm at: 42 in. 42 n. 44 in. Cur0' >20' >20 Pump Make & Model Electrical Inspections Parronned by: Orenco Municipality of Anchorage Remarks: 2"Insula-ti-on Over Tank, Distribution Line BENCH MARK and Sand Filter Bed. Location and Description: Garage Slab Existing Septic Tank Pumped, Crushed and Assumed Elevation: ac l e is ing sore ion a Place.Abandoned an 100.0 Ft. Engineer's Stamp 0-F.•' gS�O Inspections performed by: MEA Dates: let 8/24/2004 i•� ' 49th ' J.. r 2"d 8/25/2004 i• MICHAEL E ANDERSON f Department of ealth and Human Services approval ♦♦ s'. No CE-4381 ♦♦ Reviewed and approved b : PP y Date: q11q 0 o ♦� �/ ��iii�a::�•�•. Municipality of Anchorage Page 2 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: SW040269 PID No. 017-073-51 KIMBERLY MANOR SUBDIVISION LOT 5, BLOCK 3 29,705 S.F. O Iq 00 N N O O N O O O 14 N 90'00'00"E 130.00' 10' UTIL. ESMT. -------------------- A B S 1 40.8 30.7 S2 44.4 35.9 MH 46.4 38.1 M 1 40.3 135.9 M2 24.2 30.8 e 4 B cc,,,,99 o T® I M2 n n ^nCb'oosor Pour M1 z WELL A.C. M '.. >}•0 • .`; MH, S1 DRIVE ' ....49th ♦ """" 12.2' x 16.2' .... ••" s N 90'00'00' E 130.00' SHED MICHAEL E, ANDERSON j Oa °.� A O NO. LE -4381 p•......• OUR N DRIVE PLAN A -BUILT SCALE I' = 40' _Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: SWO40269 PID No. 017-073-51 5. N / y f 1,500 Gallon STEP Tank 100.6 i � E PROFILE AS -BUILT scale: 1"=10' UG-27-2004,05:12P�FROM:A+ HOME SERVICES, IN 907-868-6770 T0:5226779 LWJ I.N N _Ila JJJII IOJD �LJI In 'p0 •V1 W[SC+ P:1 1 •bF716C-iC-J: II „RightFBX $727/2004 S:17 1111PAGE Ilt RightFax* Municipality Of Anchi 4700 INSPECTION; VOICE 345-8300 ED'S ELECTRIC 7541 OUR OWN 8K3LT5 KIMBERLY M%IN( Name Address Legal Subdivision Comments or Directions AM CALL B4 FOR Inspection Retro Electrical: NO NONCOMPLIANCE OBSERVED ❑ CORRECTIONS ESSENTIAL AS EXPLAINED SEX ❑ WILL RE-EXAMINE AT NEXT C INSPECTION �COMMENTS: (for Inspector use only) i Inspector Page 1 of 1 Report Building safety Divislon Bragaw AX (907)249-7777 INFO. 343-7982 Permit 04-8700 Phone 272-4591 inspectiOn Date 8/27/2004 E MTG Reinspection N b NOT CONCEAL UNTIL REINSPECTION I6YEr� Date: Q fir/ G file;ltC : YAngtan:'%2Utikeslltigli$'x�c\C)algoin3l[yi00035 t 812712004 AUG -27-2004 FRI 12:5,3PM 10:r1+ HOME SERVICES, INC PAGE:1 MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Permit Number: SW040269 Legal Description: ZIA?I,BCY M1ijXKW#2 B_L "_3'LT 5` Design Engineer: 0014 Anderson Engineering Owner Name: ROBERT STEVENS Owner Address: 7541 OUR OWN LANE ANCHORAGE AK 99516-3820 pADO �� Date Issued: Jul 16, 2004 Expiration Date: Jul 16, 2005 Parcel ID: 017-073-51 Site Address: 007541 OUR OWN LN Lot Size: 28600 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By Issued By Date: Date: 7- / J Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 017-073.61 Permit Number SW Property owner(s) Bob Stevens Day phone 727.1366 Mailing address (1) 7541 Our Own Lane Anchorage, AK 99516 Mailing address Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) Lot Size_ - lobd Acreq.�. THIS APPLICATION IS FOR: Code Number of Bedrooms Four ( 4) Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: I q10 0 "- Date of Payment: �%' %' 0Y Receipt Number. cr � (Rev. 12/00) Waiver Fees: Date of Payment: Receipt Number: ANDERSON-MIN'EERM(' .._H. ". P.O. BOX 240773 ANCHORAGE, AK 99624'' ` 522-7773 522.67M9 F_ July 5, 2004 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 5, Block 3, Kimberly Manor Subdivision No. 2 Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The existing septic system on Lot 5, Block 3, Kimberly Manor Subdivision No. 2 will no longer support the four-bedroom home on the lot and must be upgraded to obtain a Certificate of Health Authority Approval for the sale of the house. We are therefore requesting a permit be issued for the construction of a new septic system to serve the home. The attached Site Plan and backup documentation identify the location and configuration of the existing well and the existing and proposed septic systems. Also identified on the plans are the locations of the existing well locations on the surrounding properties. Drainage arrows are shown indicating the current patterns. The drainage patterns will be maintained after construction. Test holes placed on the lot indicate silty gravel with some sand in the area of the new absorption bed. The percolation rate for this lense is between 1 and 5 minutes per inch. During our field investigation groundwater was found at approximately 6' below the surface and remained at that elevation during the monitoring period. We are therefore proposing to place a new 1,500 -gallon STEP tank along with a 30' long by 15' wide intermittent bottomless sand filter. The elevation of the distribution line in the absorption bed will be at the existing ground surface. The separation from the highest measured groundwater will then be 6'. A minimum of 2' of coarse graded sand will be placed to raise the bed above the groundwater elevation. The ground surface on the lot slopes at minor grades from the east to west and north to south. The new absorption bed will be constructed parallel with the slope as much as possible in conformance with Municipal requirements. The location of the existing well will dictate the actual alignment of the new bed. The new septic system will be Lot 5, Block 3, Kimberly Manor No. 2 July 5, 2004 Page Two constructed a minimum of 100' from the existing well on this and adjacent lots. It will also be constructed a minimum of 100' from any surface water in the area. If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments .' 49th MICHAEL E. ANDERSON N0. CE -4381 • 101Utp E t . • evaert wean lUIUU Cs t 130 'n "� dr. ___ KIMBE LY �R 1 SUB y A D 3 4 2 8 y aav fin. u 130.00 130. ~a '� ~� 1 Our Ow Lane IOIUt. Esat 7 6 N 5 acs 4 3 RABBIT CREEK 195 52. 152. s 0 I RabbitCreek Road 152,95 152.96 6 152.95 7 pt►rrrq� . r' ::° AREA MAP �Ap • { .. 49th V •� ............... .. .... SCALE V = 100'f't�'• A E. aNBERSON g° i •• r ' No. LE -4391 �I ANDERSON ENGINEERING P.O. BOX 240773' MEMO DATE: 7/15/2004 TO: Joe Goodall WITH: MoA/On-Site Water and Wastewater FROM: Mike Anderson SUBJECT: Lot 5, Block 3, Kimberly Manor Subdivision No. 2 Septic System Design Revision We have modified the cross section for the intermittent sand filter for the septic system to be constructed on the subject lot. The distribution pipe will now be placed at the surface. This elevation will provide 6.5' of separation from the highest measured groundwater on the lot. NOTES: KIMBERLY MANOR SUBDIVISION LOT 5, BLOCK 3 29,705 S.F. N 90'00'00"E 130.00' 10' UTIL. ESMT. -------------------- Pump, Crush and Backfill Exng Septic Tank. Abandon Existing Absorption Trench in Place. Place Foundation Cleanout if Required. O M OUR OWN DRIVE Air Line Shall Be 1/2" HDPE w/1/2" Foam Pipe Wrap Inside a Schedule 40 PVC Jacket Buried a Minimum of 3'. Air Compressor Shall Be Located in the Garage. Distribution Line From Tank to Field Shall Be 1.25" HDPE Sloped to Drain to Lift Station. All Connections to be Stainless Steel. Air Pressure Gauge Shall Be Mounted Inside the House. All Surface Water Must Be 100' From Both The Septic Tank and Intermittent Sand Filter. SITE PLAN SCALE V = 40' 0 0 15r/ C6NNp 3 O p NOOO OO`NNONO Z Z T®1 F 57. 12' x 30' Intermittent Sand Four Bedroom 2Filter ® TH Home -e 500 Gallon Tank 15'si LJ-- � L I A.C. RIVE SHED N 90'00'00"E 130.00' O M OUR OWN DRIVE Air Line Shall Be 1/2" HDPE w/1/2" Foam Pipe Wrap Inside a Schedule 40 PVC Jacket Buried a Minimum of 3'. Air Compressor Shall Be Located in the Garage. Distribution Line From Tank to Field Shall Be 1.25" HDPE Sloped to Drain to Lift Station. All Connections to be Stainless Steel. Air Pressure Gauge Shall Be Mounted Inside the House. All Surface Water Must Be 100' From Both The Septic Tank and Intermittent Sand Filter. SITE PLAN SCALE V = 40' LOT 5, BLOCK 3, KIMBERLY MANOR SUBDIVISION NO. 2 DESIGN FACTORS: SYSTEM REQUIREMENTS Four Bedroom House Bottomless Intermittent Sand Filter Perc. Rate: 15-30 Min./Inch 1,250 Gallon STEP Tank Application Rate: 2 GPD/SF 2' Coarse Sand (See Spec.) Air Supply Line (Anch. Tank) 6" of 3/8" Pea Gravel 4 Bedrooms X 150 GPD/2 GPD/SF (Application Rate) = 300 SF Absorption Area 300 SF/12 LF (Width) = 25 LF Bed Length THEREFORE: Construct a 30' Long x 12' Wide Bottomless Sand Filter Bed as Shown Below. Place Distribution Piping at Original Ground Surface. Provide 2" of Insulation and 2' of Cover Over Bed. Maintain 100' Separation From All Wells in the Area. 4 1 F 2" Insulation & 2' Cover 5'1 1 OII O O ;' ... :.,..:".2' jlter:Sand`..:'>:. 15' NOTE: Remove Organic Layer and Construct Sand Filter at That Level. Minimum 2' Separation From Bottom of Filter to Groundwater. TYPICAL BED SECTION Geotex"abric Over Pea Grave 3/4" PVC Laterals 4 Each) Existing Ground 3/8" Pea Gravel Air Line 18" Below Top of Sand NOTE: Grade Area Surrounding Bed to Drain Away. Minimum 6' Separation From Bedrock. ■;.•. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells in the Area. i'A+ Minimum 100' Separation From Surface Water or Streams. 1 0 Minimum 10' Separation From Water Service Line. 11.d Lv. 49th * ... MICHAEL E. ANDERSON No. CE -0351 1 2 4 5 6 7 8 9 I( I It 1: 14 15 16 17 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 SOUTH BRAGAW STREET ANCHORAGE, ALASKA 99519-6650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: Bob Stevens DATE PERFORMED: 6/22/2004 LEGAL DESCRIPTION: Lot 5, Block 3, Kimberly Manor No. 2 �j�jj�Tj TEST HOLE # 1 SLOPE SITE PLAN II I I I I I II OG/OLPROJECT # v Silty Sand W/Some Gravel SM n a Cobbles to 10" A d BOH @ 10.5' 4 WAS GROUNDWATER ENCOUNTERED? IF YES, WHAT DEPTH? DEPTH OF WATER AFTER MONITORING: DATE: MICR EI. E. ANDERSON No. CE4381 Yes S NET TIME L 7' 0 12:15 P 6' 1 E 7/5/2004 3.75" SEE SITE PLAN FOR TEST HOLE LOCATION READING DATE GROSS TIME NET TIME DEPTH TO WATER NET DROP Start 6/22 12:15 8.5" 1 12:45 30 3.75" 4.75" Recharge 12:46 8.5" 2 1:16 30 4" 4.5" Recharge 1:17 8.5" 3 1:47 30 4" 4.5" PERC RATE: 7 MIN./INCH PERC. HOLE DIAMETER: 8_ TEST RUN BETWEEN 2.0 FT. AND 3.0 T. COMMENTS: Test Hole Pre Soaked Prior to Test. TEST PERFORMED. BY: MEA I, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 7/6/2004 MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 SOUTH BRAGAW STREET ANCHORAGE, ALASKA 99519-6650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: Bob Stevens DATE PERFORMED: 6/22/2004 LEGAL DESCRIPTION: Lot 5, Block 3, Kimberly Manor No. 2 j� TEST HOLE # 2 SLOPE SITE PLAN II I I I I I II OG/OLPROJECT # I 2 d 3 a .. 4 Start 6/22 10:02 a 5 6 ° a 7 ° 8 G 9 n d 15 16 17 Silty Sand W/Some Gravel SM Cobbles to 10" BOH @ 10.5' 4t WAS GROUNDWATER ENCOUNTERED? IF YES, WHAT DEPTH? DEPTH OF WATER AFTER MONITORING: DATE: MICHAEL E. ANDERSON No. cEC3si Yes 7- 6. 7/5/2004 S L 0 P E SEE SITE PLAN FOR TEST HOLE LOCATION READING DATE GROSS TIME NET TIME DEPTH TO WATER NET DROP Start 6/22 10:02 8.5 1 10:32 30 3.25' 5.25' Recharge 10:33 8.5" 2 11:03 30 3.5" 5" Recharge 1 1 11:34 1 1 8.5' 3 12:04 30 3.5' 5" PERC RATE: 6 MIN./INCH PERC. HOLE DIAMETER:8.._ TEST RUN BETWEEN 2.0 FT. AND 3.0 T. COMMENTS: Test Hole Pre Soaked Prior to Test. TEST PERFORMED BY: MEA 1, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE' WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE: 7/6/2004 August 31 1977 *76475 Robert Stevens Stir RotLtL A. Boas 407RA Anchorage, Alaska 99501 Sub3 ect e icer i t xp4 ration Dear !'21+s F3 LeY eFL rJ{ peLrlit issued by this department for well as/Or lY ora4sita sewer installation an �,tt 5 the 3 �.e ate Subdivision has eApired since the issue data seeds ane (1) year. :fin the event You still �la�istreguirall iand/ore well � ed * The original site sewer system, a new permit soil test may be used to obtain a currentPermit- :[f the well has beendrilled, a well log should be sent to this department to docual}ent the installation date- please If you have r3Tly questi�as regarding the above matter at y ple9- do not hesitate o cont ct this Office 'Mmediately 2511, ext S incea: ely a Las No BUCI aolz, ReSr sanitarian ZzIBoljh 276-2221 � PERMIT NO ( 76475 ) BOX 407H APPLICHN| xu LOCHTION UU� uwm �mvc LEGHL 125 B] KIMBERELY MHNOR #2 MINIMUM DISTHNCE BETWEEN H WELL AND HNY � 100 FEET FOR H PRIVHTE WELL OR 200 FEET WELL LOGS HRE R�QUIRED HNDTUP� OF THE WELL COMPLETION SPECIFICHTIQNS HND CONSTRUCTION D1MuR INSTHLLHTION LOT SIZE 44000 SQUHRE FEET SEWHGE DISPOSHL SYSTEM IS UBLIC WELL ~/THE DEPART�ENT WITHIN ]0 DH-r"S HVHILABLE TO INSURE PROPER I CEFX.�TIFY THHT FOR O�_S�TE SE�ERS HND WELLS HS SET 1 I HM FHMILIHR 1|M i�� v .~ FRTH By THE HUN:IPHLITY H RHGE.NCE WITH THE CODES. 2u I WILL INSTHL.\THE SYSTE� INl�CCORDH � HPPLICHNT � ~ GRE ER ANCNURAUt AKtA bUl -UUH a � Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME 1 b J' VFNS MAILING ADDRESS SC<A PHONE LOCATION 'Fle-ST COA1D 8brof2€ W-Ck LEGAL DESCRIPTION L S" E33 _��LAr /w SEPTIC TANK: DISTANCE () NUMBER OF ��iL¢ FROM WELL Yhu o5E0 MANUFACTURER MATERIAL COMPARTMENTS �_,� 2cP INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY jC)o0 GALLONS. SH@P*&E wr' !R0 tw-te'& _6_�_ 11 NUMBER OF PITS DIAMETER OR WIDTH_, LENGTH_, DEPTH LINING MATERIAL BUILDING FOUNDATION ADDITIONAL ABSORPTION WELL: _ CRIB SIZE: DIAMETER_DEPTH DISTANCE FROM: WELL TOTAL EFFECTIVE NEAREST LOT LINE ABSORPTION AREA (WALL AREA) SQ. FT. 13 /A- (t� TYPE CONSTRUCTION BUILDING I NEAREST FOUNDATION LOT LINE CESSPOOL OTHER SOURCES NEAREST SEWER LINE APPROVED DISAPPROVED REMARKS DEPTH SEPTIC TANK_ DISTANCE FROM: SEEPAGE SYSTEM _ DISTANCES: DIAGRAM OF SYSTEM A zD 7-yK ! d� INSTALLED BY p S in��f Al PIPE MATERIAL:Q,1LQXJ 1 LOT SLOPE: '7b Lok S 7 - REMARKS: REMARKS: ';H" .FOTO 19 DATE DATE /1 A APPROVED G.A.A.B. Form No. EQ -031 F1614=1i J O � � kCO A NAME OF APPLICANT INSTALLATION LOCATION GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT MAILING ADDRESS Z -79'--'j3 PHONE LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK SEEPAG '- DRAIN FIELD OTHER n n n TYPE AND SIZE OF FACILITY TO BE SERVED c FINANCED THROUGH (/ /, TO BE INSTALLED BY SOIL TEST RESULTS T` ZS 4 �T` NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE _/D o 04CZ!51f TYPE MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT SEPTIC TANK TO SEEPAGE PIT WALL SEPTIC TANK SEEPAGE PIT TO NEAREST LOT LINE. ` DRAIN FIELD Jo ^/ DRAIN FIELD / (� r r WELL TO SEPTIC TANK /_ SEEPAGE PIT OO , DRAIN FIELD �ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD L © SEPTIC TANK, -L, SEEPAGE PIT w DRAIN FIELD TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF 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 AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. G.A.A.B. OR LICENSED DESIGNER AREA SIZE�TJ �_ C/D,tel df � -'�/�1 Se/i /'+��LP ���Spf, DIAGRAM OF SYSTEM I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. TE 7 sZ 17'!�t APPLICANT'S SIGNATURE RM NO. EQ -01 6 Ij � C I_. L I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. TE 7 sZ 17'!�t APPLICANT'S SIGNATURE RM NO. EQ -01 6 "ATER ANCHURAUt ARtA eUKUUun Depc,--,,,ment of Environmental Quality, 3330 "C" Street Anchorage, Alaska 99503 Performed for Ste-%) eve S Date performed Legal Description: V This form reports: Soils log rI Percolation test Depth Feet Z- 3 4- 5- 6- 9 - o 10 - 11 - 12 - 13- 14 Was ground water encountered? ri n.. If yes, at what deP th. y Reading Date Gross Time ( Net Time I Depth to H2O � Net Drop Percolation rate minute. Proposed installation: Seepage Pit Drain Field Depth of Irkt Depth to bottom of pit or trench COMMENTS: Performed By: S Certified By: Date: Municipality of Anchorage V • Development Services Department Building Safety Division. On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak. us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING// II Parcel I. D. 017-073-51 HAA#�—t Expiration Date: 1. GENERAL INFORMATION Complete legal description _ Lot 5, Block 3, Kimberly Manor Subdivision No. 2 Location (site address or directions) 7541 Our Own Lane Current Property owner(s) Robert Stevens Day phone 727-1366 Mailing address 7541 Our Own Lane Anchorage, AK 99516 Lending agency Day phone Mailing address Real Estate Agent - Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Four (4) 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. 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, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 8/31/2004 4 ;fA MIClIRE� E ANDERSEN �; 5. DSD SIGNATURE:,n No cE sael'.= Approved for bedrooms. ��,aE;;t.•• Disapproved. _ Conditional approval for Ll bedrooms, with the following stipulations: At the time of title transfer, the new property owner shall sign the attached maintenance agreement whichshall be returned to this office before an unconditional approval is issued. Additional Comments Attachments: `J . ON-SITE G� , HAA Checklist X Maintenance Agreements WATER AND : M, Septic System Advisory Supplemental Engineer �2eporASTEW ATER PTS Well Flow Advisory Other ` 11'Js�0�i1?ENT ?a/y)W By. Original Certificate Date: Ca (Rev. 12100) Municipality of AnchorageE, a • Development Services Department F Building Safety Division s On -Site Water& Wastewater Program 4700 South Bragaw St P.O. Box 196650 Anchorage, AK 99519-6650 I` www.cl.anchorage.ak.us c (907)343-7904 l HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot S. Block 3. Kimberly manor No. 2 Parcel ID: 017-073-51 A. WELL DATA Well type Private If A, B, or C provide PWSID # _ Well Log (Y/N) N Date completed _ " Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y " Total depth 101 ft. Cased to >40' ft Casing height (above ground) 24 in. FROM WELL LOG AT INSPECTION Date of test 4/1/2004 Static water level ft.l3. 'a? ft. RIMI&4 r Well productiong.p.m. " 3.1 g.p.m. a WATER SAMPLE RESULTS: Coliform _-O--colonies/100 mL Nitrate x.10 mg.A. Other bacteria 0 colonies/100 ml. Date of sample: 8125/2064 Collected by: MEA B. SEPTIC/HOLDING TANK DATA Tank Type/Material STEP/Steel Date installed 8/25/2004 Tank size 1.500 gal. Number of Compartments 2 Cleanouts (Y/N) Y k Foundation cleanout (Y/N)1X Depression over tank (YIN) N High water alarm (Y/N) Y Date of pumping Pumper New Construction l C. ABSORPTION FIELD DATA Date installed 8/25/04 Soil rating (g.p.d./ft2 or fiz/bdrm) G2 PD/SF System type Sand Filter A ' Length 30 ft. Width 12 ft Gravel'below.pipe .5 ft. Total depth 2.L.0 ft. Eff. absorption area 360 a Monitoring tube Y Depression over field N Date of adequacy test Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test _ in. Water added_ gal. ! New depth_ in. Elapsed Time: min. Final fluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) IN If yes, give date A STATION Date installed 8/25/2004 Size in gallons 250 Manhole/Access (Y/N) Y "Pump on" level at 42 in. `Pump off" level at 42 in. High water alarm level at 44 in. Datum Bottom of Tank Cycles tested New Const. Meets alarm 8 circuit requirements? Y E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot >10Y On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main N/A Public sewer manhole/cleanout N/A Sewer /septic service line` >25' Holding tank N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >V Absorption field >5' Water main N/A Water service line >10' Surface water >100' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >1V Water main >10' Water Service line >10' Surface water >100' Driveway, parkingtvehicle storage >25' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and G 49th review of Municipal records that the above systems are in �............i... conformance with MOA HAA guidelines in effect on this date. �. . •....................................... MCHAEL E ANDERSON i EI Engineer's Printed Name Michael E. Anderson. P.E. �ti No, CE-4381 e� tif��7 Date 8/31104 • HAA Fee $ qm o0 Date of Payment 5- 31 -tom Receipt Number oo n -7 !b Sam (Rev. 12/00) Waiver Fee $ Date of Payment _ Receipt Number "MMIM, V T C J -2 U O 0 Q w O w 0] Y o a at a 11 9 ■I J ❑ Y c P I .n - � � m E 1� n W T � O o J EW � C7 o LL W J ; o � rnU O U O U h Q M cD W Q J z O o °M W 6 m ~ 3 P � c c .n - � � f6 E a � � U W T � 30 m T v �j maa nc�Ust N y6 a w co �w N(Lv m E N H U w C � m ~ O N E d H U) EO m cm C O m y 33 O M U U Q c W � W C W O O 16'0 COO �r-000 N MMco � I- r n W W W W co 00 co co Uv— O vagi cZ U � J' - U s Q c d a Oca�ioz UJ J'- � L C N;O d L cavi cz C6 t a C d uj c a Nt00 �lJ tO �O i0Nkk.cl a>CVCNCNMNN N N N NNc Qsu� q o o oo ogUn G d V N t N CN W) OD t00 (00 t0 fN0� � IO UO N H r U c avoo.-.=Nco.- 0q 0 0q 0 0 0 0 m w0 N�C Z) U) J OM N O� O O N O I� O NE LL d' Ol CMN v m Nf+I t0 t7 N m M O P r�O N M O �O M O N �O M E O N H P � c c .n - � � f6 E a � � U W T � 30 m T v �j maa nc�Ust N y6 a w co �w N(Lv m E O U U w Q d f6 30 U LL m Z i4 U) cm Cj O m y 33 O M IF m w H °3 0 ADVANCED WASTEWATER TREATMENT SYSTE-M MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORAGE AND Bob Stevens 1H15 MEMORANDUM OF UNL__sTtv iDuvG ulndc aiiii riiteic=1 111tU aJ Ul LI11J 7th day of July 20_04 by and between Bob Stevens herein the "OWNER, and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this iMemorandum of Understanding agree as follows: 1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as intermittent located at ,Lot 5, Block 4, Kimberly Sand Filter Manor No.2 Anchorage, Alaska. 2. Definitions. A. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to performing any alterations to an AWWTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65 B. Certificate of On -Site Systems Approval. An approval by the Municipality of existing water and wastewater disposal; systems given at the time of property sale and title transfer in accordance with ANIC Page 1 of 5 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. E. Permit (Construction). An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating). An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all requirements of this agreement, the conditions of the Operating Permit, the requirements of the On -Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65. 3. Fee. Owner shall pay to Municipality an annual fee of 0.00 (S .00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. Page 2 of 5 i 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. E. Permit (Construction). An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating). An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all requirements of this agreement, the conditions of the Operating Permit, the requirements of the On -Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65. 3. Fee. Owner shall pay to Municipality an annual fee of 0.00 (S .00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. Page 2 of 5 4. Term. The term of this Memorandum of Understanding shall be for the life of the AWWTS. The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of on site approval is issued to the new owner or transferee of the property. 5. Alterations, Installation and Removal of Additional Equipment. Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Construction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner ` during- the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, owner agrees to comply with all applicable ordinances, laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AWWTS Operating Permit is: Page 3 of 5 s C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the systems. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. G. Owner .agrees that the relevant provisions of the standard specification guidebook for AWWTS is the governing professional guidelines for the construction, . maintenance and repair of the Owner's AW WTS. 7. Nonwaiver. The failure of either party at any time to enforce. a provision of this Memorandum of Understanding shall in no way constitute a waiver ofthe provisions, nor in any way affect the validity of this Memorandum of Understanding or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, .modified or changed by a writing, executed by authorized representatives of the parties, with the same formality as this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. Page 4 of 5 R B. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: Owner: Bob Stevens Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Memorandum of Understanding. 10. Severability. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the -i Memorandum of Understanding. OWNER: MUNICIPALITY: By: By: ���� , ! Title: Date' `f Date: STATE OF ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) The foregoing instrument was ackno edged before m / day of , 2004, by f State of Alaska NOTARY PUBLIC NOT Y PUBLICL DONNA K. n�QNIEL���S Q� rw�S M AhJ. MY COMMIUIOB *xptrai Ll' :._:_31_ s ��» ». Page 5of5 My Commission expires: Rlchard\ASSIGNMENTAAACode Addendum AMC 15.65 [N00-0257]\Memomnudm or Undersmanding Version VLdoc 41- C- > C) M cn > �D T- --4 C3) -7� > CD L4 (0 0 > * > 0 M m m U) CO I j Go > > C- u) z C� > �j C) I CO r- CO > 0 Q I > - F— z cf) b cn C. K > M Cn Ln QO , Tj M fel=C> ru U) CA im m —7 7, > >I �u < 0 Z MMMMFT'', ;:D -u 0 CC) :;u 0 M 0 > 77 > K: r>p 0 cn -7 z (-) E , -< p :.-� cc) o 0 -iF = -< 0 > Z m C/) 7)K (-) F—ij m m {7 fTl 0 C/) Z �o 0 m C) r-) (f) n Tt m C) C �u m :�57 ---� n K �u m x — F,-1 m m o CJ5 m bo C/) x � :zd ---1 c �cri U-) to > p > 0 --4 > ��u 7't ci FTIGZ7 0 C) -4 o m 0 0 U� m �-D Fil 0 (-) FI x < Z =0 > CC) C)n�-O==M> cn r- — �5 m ::� 0 t < = 0 m < > F- =- > C-) > Z 0rn z -70 C/� m > m 0 m m 0 TA 0 Q T 44V agcy • AV mv IM st S, O 0 30' C -D m =j n D D 32.0' x7 u m X iu N 00*02'00"W 228.50' N 00*02'00"W 228.50' FT'l :�o F— F- 0 zLO_ > 0 o oj 0 tQ U) F- 7ri 0 Cn o cc (J� ll l 0