HomeMy WebLinkAboutMEADOW BROOK BLK 3 LT 15AMunicipality of Anchorage
On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP221129 PID Number: 0507192-59
Dwelling: R Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade
Name
Steven and Mary Hansen
ABSORPTION FIELD
El Deep Trench El Wide Trench El Bed ❑ nd
Site Address
18008 Sanctuary Dr Eagle River
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth fro riginal grade
3
GPD/SF
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from originalgrade
Ft.
ravel depth beneath pipe
Ft.
Subdivision Block Lot
Meadow Brook 3 15A
Fill added above original gra
Ft.
Gravel length
Ft.
Township Range Section
Gravel width
Ft.
Beds: Number of Lines
Distance between lines
FL
SEPARATION DISTANCES
To
Septic
Absorption
I
Lift Station
Holding
I
Sewer
Total orption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
Ftz
Ft.
Well
>100'
NA
NA
NA
NA
TANK ®❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Capacity
Surface Water
>100'
NA
I NA
NA
greer
1000 Gal.
Material
Number of compartments
Lot Line
>10'
NA
NA
NA
NA
plastic
2
Foundation
>10' I
NA
NA
NA
LIFT _S_rATQN
Manufacturer
Capacity
Remarks
Gal.
Alarm location
Electrical i d by
Installer
PIPE MATERIAL House to tank 3034 drainfield Tank to
3034
JRS Septic
Drainfield CO/MT3034
Inspector Curtis Townsend
BENCH MARK (Assumed elevation) 100 ft
Inspection ection 1st 6/14/2022 2"d 6/24/2022
Location and description
3'" 4'h
bottom of siding by FCO
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval: Date
�L � .AL 411 �
.. a . Gattis L'i vmyend
a
s'
Septic System
Approved /&YC('-�' �Z� Date`7 6 X02
FC, No.C1t9�,•L�
4d�TFRoPRatESs\��'���
����������
Note: this approval does not include well permit requirements.
rrzP�� nFm�i� n�
LOT 1 64
WASTEWATER PROVIDED
BY AWWU
LOT 50
WASTEWATER PROVIDED
BY AWWU
THIS PROPERTY AND SURROUNDING PROPERTIES ARE
STRVED BY A PUBLIC WATER SYSTEIil AND THERE ARE
NO WELLS WITHIN 2OO'. WATER LINE IS SHOWN AS
APPROXIIV ATI
.E0n
\LA ?,
?,u
4
c
\ar
LOT 1
--->
NEIGHBORING SEPTIC IS >
1 O' FROM PROPIRTY LINE
SCOPE OF WORK1. PLACED NEW l,OOO GALLON TWO_CON/PARTMENT
SEPTIC TANK AND TIED INTO EXISTING
ABSORPTION SYSTEM. TANK WAS PROVIDED WITH
A N/INIMUM 20,, DIA RISTR SERVING THE FIRST
CON/PARTMENT. PROVIDED DOUBLE CLEANOUTS
DOWNSTREAN/ OF THE TANK.
2 ALL CONSTRUCTION WAS IN ACCORDANCE WITH
ALL REQUIREMINTS SPECIFIED IN ANCHORAGE
MUNICIPAL CODT CHAPTERS 15.55 AND 15 65.
4
,fr
JOX..
DEPTH t',
T/ T A\.
SL
\.0
BEDROOM
Septic Record Drowing Prepored for
Steven and Mary Hansen
18008 Sanctuary Dr Eagle River, Alaska 99577
MEADOW BROOK BLOCK 3 LOT 15A
osP221129
DATE: 612712022
DRAWN: CLT
SCALE: 1" = 30'
PID: 050-192-59 SHEET 2OF 3
T.KLUTNA INGINtIRING, LLC
19162 N/OUNTAIN ROAD
CHUGIAK, ALASKA 99567
(e07) 406- 1 058
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- Lr-l N L-Li
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lnnna| , L,,/ \J \J \-,
P LASTIC TAN Ki rLrlJttL
97 .3'
MARK A B
sTl 34'-6'1g'-1"
sT2 37'-fi"l5'-7"
DCO 41'-2"t6'-1"
Septic Record Drowing Prepored for
Steven and Mary Hansen
18008 Sanctuary Dr Eagle River, Alaska 99577
MEADOW BROOK BLOCK 3 LOT 15A
osP221129
TKLUTNA INGINIIRING, LLC
19162 MOUNTAIN ROAD
CHUGIAK, ALASKA 99567
(907) 406- 1 058
DATE: 612712022
DRAWN: CLT
SCALE: 1" = 5'
PID: 050-192-59 SHEET 3 OF 3
LOT 16A
LOT 30
ms's O
41
2.7 off
.�, 7
O� �'.
°Q5
oo N2 rage rn
(5) Nouse O G°'
4.5
ger
Manhot ram desk ° N
N 9a 2�' 5 -'
O O. �
N I o_
° I -Wood fence (typ)
O
O
O I
O I d
� I
5"e LOT 15A
00 I eptic vent (typ)
o /S
O
�s
7351 G
Anchorage Recording Precinct, Alaska, and that the
improvements situated thereon are within the property lines
and do not overlap or encroach on the property lying
adjacent thereto, that no improvements on the property lying
adjacent thereto encroach on the premises in question and
that there are no roadways, transmission lines or other
SCALE: 1 "= 40' visible easements on said property except as indicated
hereon.
Dated at Anchorage, Alaska
this 20th day of MAY , 2008.
EASEMENTS OF RECORD, OTHER THAN FRED WALATKA & ASSOCIATES, L.L.C.
THOSE SHOWN ON THE RECORDED Engineers En and Surveyors
PLAT ARE NOT SHOWN HEREON Fb 22-1, pg 33 BE 9 Y
UNLESS OTHERWISE NOTED. Fb 08-3, pg 19-20 907-248-1666
This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary
survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to
establish any fence. structure or othe} improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original
client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered,
the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product.
LOT 14
2 ((?
OF q
A/ /
(0 m
0� 49th
�1
�.,
°
00.
00
lizabeth L. Walatka : 2 00
,� • • 8030 - LS • §7 AW
AW
� • •
ARoF `� �P� �
% `\`
RECERTIFIED 6-21-22 CS 4 ) r_�
AS -BUILT NO CORNERS SET THIS DATE
I hereby certify that I have performed a Mortgagee's inspection
in accordance with ASPLS Standards of the following
1
described property: LOT 15A, BLOCK 3,
MEADOW BROOK SUBDIVISION
Anchorage Recording Precinct, Alaska, and that the
improvements situated thereon are within the property lines
and do not overlap or encroach on the property lying
adjacent thereto, that no improvements on the property lying
adjacent thereto encroach on the premises in question and
that there are no roadways, transmission lines or other
SCALE: 1 "= 40' visible easements on said property except as indicated
hereon.
Dated at Anchorage, Alaska
this 20th day of MAY , 2008.
EASEMENTS OF RECORD, OTHER THAN FRED WALATKA & ASSOCIATES, L.L.C.
THOSE SHOWN ON THE RECORDED Engineers En and Surveyors
PLAT ARE NOT SHOWN HEREON Fb 22-1, pg 33 BE 9 Y
UNLESS OTHERWISE NOTED. Fb 08-3, pg 19-20 907-248-1666
This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary
survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to
establish any fence. structure or othe} improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original
client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered,
the liability extent of the preparer is limited to the amount of fees collected for services in preparation of this product.
MUNICIPALITY OF ANCHORAGE
On-Site Water & Wastewater program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 995'1 96650 phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
l)ilrtmetrt
On'Site Wastewater Disposal System permit
Permit Number: O5P221129
Work Type: SepticTank Upgrade
Tax Gode Number: 05019259000
Site LegalAddress: MEADOW BROOK BLK 3 LT 15A G:0153
Site Mailing Address: 18008 SANCTUARy DR, Eagte River
Owner: HANSEN STEVEN L & MARY E
Design Engineer: EKLUTNA ENGINEERING, LLC*
This permit is for the construction of:
fl Disposal Field M Septic Tank E Hotding Tank E privy E Private Well E Water Siorage
Allconstruction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Munic
Wastewater Disposal Regulations (18AACZ2)
3. The wastewater code requires inspections duri
Services Department per AMC 15.65. provide
4. From October 15 to April 15, a subsurface soilabsor
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
512012022
512012023
21921
2
Received By:
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 050-192-59
Property owner(s) HANSEN STEVEN & MARY Day phone
Mailing address 18008 SANCTUARY DR EAGLE RIVER, AK 99577
Site address 18008 SANCTUARY DR EAGLE RIVER, AK 99577
Legal description (Sub'd., Block & Lot) MEADOW BROOK
Legal description (Township, Range & Section)
Lot Size 21,921 Sq. Ft. Number of Bedrooms 3
BLK 3 LT 15A
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(® all that apply)
Absorption Field ❑ Initial ❑ Single Family (SF) El
Septic Tank Q Upgrade Q (w/wo ADU)
❑
Holding Tank ❑ Renewal ElDuplex (D)
Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable unicipal Codes.
(Signature of property owner or authoriz d agdnt)
Permit/Rush Fees:_ -2 -
Date of Payment: 5 l y1,2, o2
Receipt Number: 86 q (o qb
Permit No. 0S,0 ZZ l / Z 9
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment ServiceslBuilding Safety\On Site Water and WastewaterTormsUient FormsTermit Application.doc
Eklutna Engineering, LLC
cu rtistownsend @gma il.com
May 72,2022
Subject: Meadow Brook Block 3 Lot 15A
New Septic Tank Permit Request
osP22t729
I am writing to request a septic system installation permit for the above referenced propefi. The
proposed system willserve a 3-bedroom single-family residence. An engineering site plan is enclosed for
your review. A new septic tank will be provided. The 1993 trench is holding 0" of water as measured in
May 2022.lt will not be replaced at this time.
t. Soils. A test hole was dug during the month of August to a depth of 16' and groundwater was
not discovered. Soils in this area are silty sandy gravel.
2. Wells. This lot and the surrounding lots are served by AWWU. There are no wells within 100' of
the proposed septic system.
Neighboring Wastewater systems. lmmediate neighboring septic systems are all +10' distant
from the property lines. The properties to the west of the subject property have wastewater
services provided by AWWU.
Surface Water: There is no surface water within 100 feet of the proposed septic tank.
Topography: This property in the immediate area of the tank replacement slopes downhill
towards the southwest at a slope of 1%.
The proposed installation will not affect the future development of this or the surrounding lots.
Sincerely,
Curtis L. Townsend, P.E.
3.
4.
5.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221129, Rebecca Carroll, 05/20/22
LOT 1 64
WASTEWATER PROVIDED
BY AWWU
LOT 30
WASTEWATER PROVIDED
BY AWWU
THIS PROPERTY AND SURROUNDING PROPERTIES ARE
SERVED BY A PUBLIC WATER SYSTEM AND THERE ARE
NO WELLS WITHIN 200,. WATER LINE IS SHOWN AS
APPROXIM ATE.
/rl ------\
LOT
---r>
NEIGHBORING SIPTIC IS >
10, FROM PROPTRTY LINE
SCOPE OF WORK1. PLACE NEW 1,OOO GALLON TWO_COMPARTMENT
SEPTIC TANK AND TIE INTO EXISTING
ABSORP"TION SYSTIM. TANK IS TO BE PROVIDID
WITH A MINIIV1UM 20,, DIA RISIR SERVING THE
FIRST CON/PARTMTNT. PROVIDE DOUBLT
CLEANOUTS DOWNSTREAM OF THE TANK.2, ALL CONSTRUCTION TO BE IN ACCORDANCI WITH
ALL REQUIREMENTS SPECIFIED IN ANCHORAGT
MUNICIPAL CODT CHAPTERS 15.55 AND 15.65.
4/
sQ,O
14107
OPE L/
,i;^,
36' x u1
DEPTH t'.
\
lr/ T.",
"co
-^
\*\\r'r\\5\r.r t\<\\rrt \\2,\
t4
BEDROOM
HOME
Septic Design Prepored for
Steven and Mary Hansen
18008 Sanctuary Dr Eagle River, Alaska 99577
MEADOW BROOK BLOCK 3 LOT 15A
osP221129
DATE: 511212022
DRAWN:CLT
SCALE: 1"= 30'
PID: 050-192-59 SHEET 1 OF 1
EKLUTNA ING/NEIR/NG, LLC
19162 N/OUNTAIN ROAD
CHUGIAK, ALASKA 99567
(e07) 406- 1 OsB
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221129, Rebecca Carroll, 05/20/22
LOT 16A
Found bent rebar,
7011
N
O
O
O
CO
.A
0
0
Found %" rebar
with 2" aluminum can,
LOT 30
R AGO
ire
fence
ramp
/ .., o
Set 5/" re
wood 9
fence--
Z C - OV 2.7 OH
77) Y
SCALE: 1"= 30'
\ 7351 G
� C•\e9 636, liO
Found %" rebar
with 2" aluminum cap\
�S
32-o
2 gtoN N
> Ftaroe o
rn House
�
d ck over N
aZ�e
1�0
I
��000d fence �S \
I
I �
shed Found 5/e" rebar
I LOT 15A with 2" aluminum cap
I
OFA4,1 lJ
r
49TH'
m1 /� /
o �
Fred Walaka /
No. 3255-S
tl���Sa��4���0�
01 11
Found 5/" rebar
with 2" aluminum caD
EASEMENTS OF RECORD, OTHER THAN
THOSE SHOWN ON THE RECORDED
PLAT ARE NOT SHOWN HEREON. Fb 08-3, pg 19-20
AS -BUILT NO CORNERS SET THIS DATE
I hereby certify that I have performed a Mortgagee's inspection
of the following described property: LOT 15A BLOCK 3,
MEADOW BROOK SUBDIVISION
Anchorage Recording Precinct, Alaska, and that the
improvements situated thereon are within the property lines
and do not overlap or encroach on the property lying
adjacent thereto, that no improvements on the property lying
adjacent thereto encroach on the premises in question and
that there are no roadways, transmission lines or other
visible easements on said property except as indicated
hereon.
Dated at Anchorage, Alaska
this 20th day of MAY 2008
FRED WALATKA & ASSOCIATES
Engineers and Surveyors
BE (907-248-1666)
Municipality of Anchorage Page
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 e Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: '~/'~~,~r~- ____ PID Number: /2 ~'~:P
LEGAL DESCRIPTION
Lot: ~ ~,~.. BIo C k:/.~....~ Subdivision:
New Upgrade
Wastewater System: [] ~~
ABSORPTION FIELD
~'Deep Trench E] Shallow Trench
oil Rating: ~' ~GPD/S(
Depth to pipe bottom from original
Bed [] Mound [3Other
original grade: ,,
ID'
depth beneath pipe ~ / Ft,
Township: I Range: / Section: Fill added above original th:
~ ~ravel width: / Number of lines:
"'~ELL: [] New LI Upgrade ~ Ft. I
ydal Deplh Cased To: otal absorption area: / Pipe material:
'iold: ~ al: Casing Hmght Ab°vd Gr°u / TANK
SEPARATION ~TANCES /~SepticL¢~ ~HPding ~S.%EP.
To Sepuc
Well
Surface
Water
Lot
Line
Foundation
Curtain
Drain
Remarks:
LIFT STATION
Size in gallons: Manufacturer:
"Pump on" level at: level at: ~ water alarm at:
,ections performed by:
BENCH MARK
Location and Description:
Assumed Elevation:
ENGI
$ & S EiNGIN££RING
Inspections performed by: ~7~r--L°eP~~a~oe~: 1st
Eagle River, Alaska 995? 2nd~
Department of Health and Human Services approval
Reviewed and approved by: ._~O¢~ ~ ~ Date:
72-913 (Rear 9191) MOA 25
Permit No. SW9-3031-4~-- Page 2 of 2
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O, Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well ~nspection Report
Legal Description:MEAdow BROOK SUBDIVISION. BLOCK 3. LOT 15A PID No.: 05019259
CO1
1000 GAL
SEPTIC
TANK
;O2
/F1NAL
GRADE MT C04
100.3'~
96'
N.T.S.
84' NO WATER FOUND ·
/UNDERGROUND UTILITIES
'ENCE
FC0 32.5 615 --
COl [ !9.5 I 35.5[ - /
C02 / 16.5 [ 4-0.5 - l
COS [ i6.5 / 48.o/ 43.5 I
c04 / 62.5 / - [ 67.51
SCAL~ t" : 40'
72-013 A (2/91) MOA 25
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW930314
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:EZELLE EDWARD M &
OWNER ADDRESS:HC01 BOX 6185 "D"
PALMER, AK 99645
PAGE 1 OF
DATE ISSUE : 8/23/93
EXPIRATION DATE: 8/23/94
PARCEL ID:05019259
LEGAL DESCRIPTION: MEADOW BROOK BLK
3 LT 15A
LOT SIZE: 21921 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD 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 (18AACS0).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS
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:
RECEIVED BY:
ISSUED BY:
DATE:
DATE:
HEALTH AU1 HORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER &WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPFCTION
& ~LOW TEST
SITE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAt SYSTEM
DESIGN
ROBERT SHAFER, P,E.
ROGER SHAFER, P.E.
August 12, 1993
CIVIL ENGINEERS
(907) 694-2979
FAX 694 1211
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
Ancherage, Alaska 99501
REFERENCE: Meadow Brook Subdivision, Block 3, Lot 15A
Request you expedite the issuance of a permit to upgrade the
septic system serving the three bedroom house on the
referenced property.
An adequacy test was to be performed on the existing system
serving the referenced property for Health Authority Approval
purposes. During the process of performing an adequacy test
we observed the system to be completely saturated including
the area above the effective depth. Although there was no
sewage surfacing at the time of the inspection, it would
appear there had been sewage surfacing in the area of the
existing septic system.
A test hole was excavated and percolation test performed in
the area of the proposed upgrade. Attached is the proposed
upgrade design.
We do not anticipate any adverse effects on neighboring
properties by the installation of the proposed septic
upgrade.
/If you have any questiens er require additienal informatien
for you~ please contact us.
/~. Shafer, P.E.
LSU/lsu
17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577
1" =40'
SCALE
0
0--I0
~ rtl '-~
0 7J I-fl
mcD_~
CD-<
~3 Fq i-fl
O'
-<2:
·
Frl
0--0 Zm--I
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Z~
ogB
o~
O~
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
WAS GROUND WATER
ENCOUNTERED?
SLOPE SITE PLAN
IF YES, ATWHAT
DEPTH?
Depth to Waler A~[~c, ....~ _ / ...eJI .~_ I.~ .-~_
Monitoring? ~--~ Dale: ~'~
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE J ~, ~ (m,nutes/,nch) PERC HOLE DIAMETER
TEST RUN BETWEEN .~ '/~ FT
COMMENTS 0,?~ ~-<D,(-gt '~ JCl' '~r ~(~~/ ~~ /~' ~,
'l ~ 034 ~ag~c- [.i.¢eF ...oop,l~g~¢ lvo 204 ~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN
72-~8 (Rev. 4/~)
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
REFERENCE: Meadow Brook Subdivision, Block 3, Lot 15A
GENERAL:
1.
o
o
o
o
The scope of this project includes the installation of a
leachfield trench to serve the three bedroom residence
located on the referenced property and excavation of the
existing 1000 gal septic tank to verify its integrity and
location in reference to the Northwest property line. If
the integrity of the existing septic tank is poor the
existing septic tank is to be excavated, pumped, crushed,
and abandoned in place and a new 1000 gal septic tank
installed.
Construction shall be in accordance with the approved
site plan and design drawings; Municipal permit with any
special provisions or conditions; and all applicable
State and Municipal Wastewater Disposal Regulations.
The contractor shall be responsible for obtaining any
necessary underground utility locates.
Unless specifically agreed otherwise, the property owner
shall be responsible for final grading areas subsequently
depressed from soil settling.
Contractors installing wastewater disposal systems must
be certified by the Municipal Health Department for
system installations. Owners installing their own
systems must also receive prior approval from the
Municipal Health Department.
SEPTIC TANK INSTALLATION:
A septic tank is to be constructed by a certified septic
tank manufacturer. Construction shall include two 4"
cleanouts for pumping access.
The septic tank shall be sufficiently bedded to prevent
settling or shifting of the tank.
o
Ail standpipes on the septic tank shall extend a minimum
of 12 inches above final grade.
Page Two
Meadow Brook Subdivision, Block 3, Lot 15A
August 12, 1993
o
o
Septic tanks installed with less than 4 ft. of cover
shall be insulated.
A foundation cleanout shall be installed one to four feet
from the building foundation. In the line between the
tank and the leachfield there shall be two adjacent
cleanouts (unless an effluent pumping system exists
within the septic tank). These cleanouts shall be
located on undisturbed soil not more than 10 ft. from the
tank. The first cleanout, in line, shall be to clean
toward the leachfield. The second cleanout shall be to
clean toward the septic tank.
Final grading over the septic tank shall be such that a
positive slope exists away from the septic tank.
ABSORPTION TRENCH/DP~AINFIELD INSTALLATION:
Excavate the proposed trench to the dimensions shown on
the design. The bottom of the excavation shall be within
2 inches of level. If the sidewalls of the excavation
become smeared, they must be raked or scratched ruffed-
up) before gravel (sewer rock) placement.
o
Once the gravel is installed, the distribution pmpe is to
be installed level with the perforations faced downward.
Gravel is then to be placed over the distribution pipe to
provide a minimum of 2 inches of cover over the pipe.
A silt barrier must be installed between the final gravel
layer and the native soil backfill. Ensure the silt
barrier covers the entire gravel surface before placing
backfill.
°
Monitor tubes shall be of four (4) inch diameter and
installed approximately in the locations shown on the
design. The portion of the monitoring tube extending
through the gravel shall be perforated from the bottom of
the trench to the invert of the distribution pipe. This
is equivalent to the effective depth of the gravel as
noted on the design.
Page Four
Meadow Brook Subdivision, Block 3, Lot 15A
August 12, 1993
]iNSPECTIONS:
Typically there will be a minimum of three (3) inspections
required during the installation of the wastewater disposal
system. These inspections will occur as follows:
The first inspection must be conducted after the
excavation of ditches, pits, trenches, or beds and before
the installation of any gravel. A septic tank may be set
in place, but may not be backfilled before this
inspection.
The second inspection must be conducted after the
placement of the silt barrier, gravel, distribution
lines, standpipes, cleanouts, and insulation, but
before the placement of any other backfill.
The final inspection is to occur upon final grading
of the property.
Often there will be more than these 3 inspections required.
Especially with the installation of multiple trenches, sand
filters, pressurized distribution systems, etc. Thus, the
inspecting engineer is to be contacted at least 24 hours prior
to the start of construction. If necessary, a pre-
construction meeting will take place on-site.
~ GREA _R ANCHORAGE AREA BORL
· ~ Department of Environmental Quality
~ 3330 C Street
Anchorage, Alaska 99503
,GH
NAME
SEPTIC TANK'.
DISTANCE c.% !--
FROM WELL
MANUFACTURER . .,.,b,k,'L~_ ¢2 MATERIAL
INSIDE LENGTH__~') INSIDE WIDTH LIQUID DEPTH
NUMBER OF .~__
COMPARTMENTS
LIQUID CAPAC ITY_i ¢'¢"~ GALLONS.
TILE DRAIN FIELD: ff '~u.~J2'
DISTANCE FRO[v1 WELL ~-- FOUNDATION
NUMBER OF LINES__
ABSORPTION AREA
DEPTH:
D~iST2NCE BETWEEN LINES
_"/- ~'*/~)~//~'~ SQ. FT. LENGTH OF EACH LINE
OEPT, OF F,LTER
-FOP OF TILE TO FINISH GRADE
NEAREST LOT LINE OF LINES ¢ /
TRENCH WIDTH~' /'IN. TOTAL EFFECTIVE
MATERIAL BENEATH TILE
IN. ABOVE TILE
IN,
WELL:
TYPE
BUILDING
FOUNDATION
CESSPOOL _._
APPROVED
CONSTRUCTION
NEAREST
LOT LINE .__ ,
OTHER SOURCES
DISAPPROVED
NEAREST
SEWER LINE__
DEPTH
SEPTIC SEEPAGE
TANK__ SYSTEM
REMARKS
DISTANCE FROM:
DISTANCES:
INSTALLED BY: ~'~ -'"~
SEWER LINE DEPTH:
PIPE MATERIAL'
LOT SLOPE:
,///c~ -/f-
DIAGRAM ~F SYSTEM
~),~.~,;/:a ~ -'
-- G.A.A.B.
Form EQ-032
T f;'::EIqCH
SOIL f[iFtTII'.,IL'~ ,::!i~Q F'T,.."[~:R:: ..... J..~:2
THE:
Tt-I[:[ L..ENG"I'I~I [:, I FIEN:5 101q I rE; 'THE I...ENG'i'H ,:: ]: N FEET :.', OF' ]'HIE: 'TRENCH E:l[::: [.',F:'.FI
THE: I]:,E{PTH C)F I:~ 'T'[:~:EiqC:I-t 01~'. P ZT I'.i:.'; 'TTiE D]:~;TFINCE E',Ii~TIqF::[.:..I'.,I 'rFHE ~;I. JF'.F::'F~C:tZ CII:::
I.~it-,~tCIUN[) FIN[> Fl.ti!i: 13C)T]"OH OF 'FHIZ. E::.::CFIVF::IT 1' ON ,.'. I N P"IZE"i"
"I'HI~:F~:F: Z5 I'.,tCI 5E:T I.,.I:[I>TH FOR Tf~.'.EhlCHE~:;.
THE GRf:I',,,'EL. I)EPTH I '.il; THE H :[ N I I'il..IFI [::,EPTFI CIF' GF'J::I~,,'I::JL IE:ETlq[i:EN THE Ot..JTFFILJ_ P
F:liql) '1'1~1[C []IC'ITTCIi-'I 01:: THE E::.::C:I':IMFIT :1: Igf.,I ':: l t",l FEET >.
I'~:FIC:I.:::F: 11: L.L. :1: NC:i (itt::' F:II'.,I'-/ ?.;'T'S'I'EH 141 'FIr-I(]IJT F l NFIL ]: F,ISF'EC'F :[ CIF,I lqlq[:' FIPI':'I>C ","FIL E:'T TH ]1
I>t":F'FIf.ltI'FI[~']q"i' kl:[I,.L. E:I!'~ 51J[!~L]'EC:T TO
ELf' "{"Hl::l"l'
I::'11'{ FrF:II'III_.IFII;~'. I.'JiTH THE
, THE HLIN :[ C .[ F ~ L, '! '~1 ~ C F' FU'qCH :: I~'.flFi~..
L.L I N~;TFILL. THE S"r'~;TEH :[ N FK::CORDF~NCE ['-IZ TH THE C:C~[:'E:5.
[:,ENC:E I :~J; REHC~DEI..ED 'FO ~ NCL.LIDE H.]F E ]"HIaN :!: E,E.[, Fi... L ~1 .....
I:;]I::'PI. I CFIIq'T' H.K.E. C:C~RF:',
GREATER ANCtiORAGE AP, EA UOROUGtl
Department of [/nvironmen~al Quality
3330 "C" Street
Anchorage, Alaska 99503
SOILS LOG - PEROI,A'_PION TEST
Legal bescri p~i on :_~o
This form reports: Soils log'. ~_ Percolation ~est
Dep th
Feet
1 -
3-
4-
5-
7-
8-
9-
lO-
ll -
12-
13-
14-
6"?0,0° r4
" D
Was ground water encountered? ___~]0 _.~ If yes, at what depth?
Reading Date Gross Time
Percolation rate
-Proposed i ns tal 1 a~'G~-n:
mi nute.
Seepage Pit
Net Time Depth to Water'
· Drain Field
Net Drop
Depth of Inlet Depth to bottom of pit or trench
COMMENTS: ~ , ~, ~-',: - - ,-~'~- '~ '
Pnrformed ~,;:'d ...... ,,,'..4 .~- ,:6~,.; Cerdfied
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage. Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # ~ ~ \o~ ~r~-~,_~ ,~ HAA # ~,~'~O~,~,q~
1. GENERAL INFORMATION
Complete legal description
Lot 15A; Block 3; Meadowbrook Subdiuision
18008 Sanctuary Drive
Location (site address ordirections)
Ea~le Rive% AK
Sheila and Ed Ezell~ Day phone-74~-4~6 "
Property owner
HOOt Box 6185 "D" Palmer, AK 99645
Mailing address --
Lending agency
Day phone
Mailing address---
Dave Sellie/HERITAGE REAL ESTATE
Agent
18850 Eagle River Road Eagle River,
694-4994
Day phone
AK 99577
Address
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WA'rER SUPPLY:
Individual well
Community well
NOTE:
Public water XXX _
If community well system, provide written confirmation from orate ADEC attest..
lng to the legality and status of system.
TYPE OF WASTEWA'rER DISPOSAL:
individual on-site
Holding tank
Community on-site
NOTE:
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev, l/91) Fronl MOA#2~
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 inves_ti__gation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm _. s & S ENGINEERING
Address
Engineer's signature
Phone _. ~Z'¢ r¢'--~~
DHHS SIGNATURE
_.~k Approved for ,--~ bedrooms.
DisapprOved.
Conditional approval for
bedrooms, with the following stipulations:
o H- -4
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(Rey. 1/91) Back MOA ¢f21
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
_If A, B, or C, attach ADEC letter. ADEC water system number
Date completed / Driller
Cased to ,/// Casing height
Wires properly protected (Y/N)
FROM WELL LOG ~ AT INSPECTION
Date of test
Static water level
SEPARATION DISTANCES FR L TO:
Septic/holding tank on lot / ; On adjacent lots
Absorption field on lot ¢~ ~ ; On adjacent lots ~/ ~*
A. Well Data
Well type
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Public sewer main
Sewer service line
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS:
Coliform ~Nl~te
Date of sample: __ .~'~ Collected by:
Other bacteria
B. SEPTIC/¢ TANK DATA
Date installed ~ I I¢1 ~'~./~
Cleanouts~/N) y~
High water alarm ( l~''~
Date of pumping ~/¢0,.
Tank size I ~D ~1 ,c> ~ Compartments
cleanout~N) '"'/ Depression (Y(~
Foundation
Alarm tested ('~) ~'~
Pumper t-~'~LL~ "'F'¢~C--~ ~ '
SEPARATION DISTANCES FROM SEPTIC/~TANK TO:
Well(s) on lot Y-\] ~__On adjacent
lots
Absorption field
To property line
Surface water/drainage
Foundation
Water main/service line ID
CONTINUED ON BACK PAGE
72-026 (3/93)* Fronl
C. LIFT STATION
Date installed
Size in gallons
Vent(Y/N)
"Pump on" level at
Manufacturer ~
Maj3holeoleol~ccess (Y/N)
~ "Pump off" Level at
High water alarm level
Meets MOA electrical codes (Y/N)~.~'"
SEPARATION D~OM LIFT STATION TO:
Well on lot,,--'"'/ On adjacent lots
D. ABSORPTION FIELD DATA
Date installed ~
Length (~¢(~ / Width
Total absorption area
Date of adequacy test
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y~
Cycles tested
Surface water
Soil rating (GPD/Ft2) ~. ~'
Gravel thickness ~:~ I
Cleanout present,N)
Results (pass/fail) ~ ~'~for
After test
If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
System type ~;:~.~
Total depth
Depression over field (Y~)
~ Bedrooms
Well on lot ~--~/.¢~
To building foundation
On adjacent lots ~,¢
Surface water
Curtain drain ~
On adjacent lots '~--~ ¢-'P~ Property line
To existing or abandoned system on lot
Cutbank F-~O r~ ~' Water main/service line
Driveway, parking/vehicle storage area
E. ENGINEER'S CERTIFICATION
I certify that I have checke~HAA
Signature
S & S
Engineer's Name 17034 Eagle..B, ci~er Loop Rea~l
Date Eagle Ri,ve~, Alasl~a 99~
guidefines in effect on the date of this inspection.
HAA Fee $
Date of Payment
Receipt Number
72-026 (3/93)* Back
Waiver Fee $
Date of Payment
Receipt Number
INSPECTION APPOINTMENTS ' I/'YL-(~_-C
TIME TIME TIME
DATE }ATE ~~~ DATE
NSPECTOR C INSPECTO~
J ' MUNICiPALiTY OF ANCHORAGE
MUNicIpALITY OF ANCHORAGE DEPT. OF HEALTH &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL
82~ L Street - Anehorage, Alaska 99501
ENVIRONMENTAL SANITATION DIVISION
REQUEST FOR APPROVAl OF INDIVIDUAL WATER AND SEWER
DIRECTIONS: CompJele all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing.
~ PHONE
1.' ~OPERTY OWNER
MAILING ADDRESS
t '~- . ~_ ~ PHONE
~ROPERTY RESIDENT (If differen~ fro~above)
~ ~C~ PHONE
~A~N6 ADPRES~ ~
- ' L-~- P~ONE
MAILINGA~ESS - / - ''
5. LEGAL DESg'RIPTION / ,~
-~;REET LOCATIO~ D --
NUMBER OF~BEDROOMS
~. TYPE OF RESIDENCE ~ [] One [] Four
'~ SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY ~ Three [] Six
[] Other _
7, WATER SUPPLY [] INDIVIDUAL'*
COMMUNITY
[] PUBLIC UTILITY
ATTACH WELL LOG. A well Icg is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach Icg if available.)
8, SEWAGE DISPOSAL SYSTEM
~ iNDiViDUAE/oN.siTE** /z) / //~ YEAR ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
'2-010 (Rev. 6/79,~):.~)
1. TYPE OF RESIDENCE
~ SINGLE FAMILY
[] MULTIPLE FAMILY
2. WATER SUPPLY
[] INDIVIDUAL
COMMUNITY
PUBLIC UTILITY
Connection Verified
3. SEWAGE DISPOSAL SYSTEM
[] I NDIVI DUAL/ON -SITE
[]PUBLIC UTILITY
Connection Verified
[~]Septic Tank Or [] Holding Tank
Size:_~ ~ ~'~ ~ If Tank is homemade
give dimensions:
TYPE OF TANK
TOTAL ABSORPTION AREA
4. DISTANCES
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS
THIS SIDE FOR OFFICIAL USE ONLY
NUMBER OF BEDROOMS
[] ONE ~ THREE [] FIVE
[] TWO [] FOUR [] SIX
PERMIT NUMBER
[] OTHER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
DATE INSTALLED
INSTALLER
SOILS RATING
/3 ~-
MATERIAL
Septic/Holding Tank Absorption Area
ISewer Line
INearest Lot Line
DATE
APPROVED FOR ~
BEDROOMS
CONDITIONAL APPROVAL (letter must accompany certificate)
DISAPPROVED
72-010 (Rev. 6/79)
I I1UIROFIITII Ill'AL COFITROL S FqUICI $, IFIC.
I~nqin~e~'i'~ 8- ~rm,'or~mcr, IQI Stu,:lics
MUNICIPALITY OF AN
DEPT. CF
FNVIRCh;M[:N i,' ' ~' Cf ION
7/29/81
RECEIVED
FIRST NATIONAL BANK
BOX 4-2090
ANCHORAGE AK 99509
SELLER - GABALDON
SUBDIV]BION-M EADO W BROOK BLOCK-3 LO T-15
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM ]~ A TRENCH WITH AN AREA OF 408 SQFT.
THE SYSTEM %~ CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY.
BASED UPON THE TEST DATA THE SYSTEM ]S ACCEPTABLE FOR A
3 BEDROOM HOME.
THE SEPTIC TANK WAS PUMPED ON 7/29/81 .
1220 U Jest 251h/\ucnu¢ ','/)mchorc, cj~, Alasb 99503 "(907) 276-1361
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received September
23, 1976
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
1. Approval requested by:
Mailing Address:
Property Owner:
Mailing Address:
COi1V.
Arctic First Federal Savings
701 West 4th Avenue
Robert Cousineau/James E Davis
2810 C Street
Phone: 278-9541
Phone: 276-7777
Legal Description: Lot 15 Block 3 Meadowbrook Subdivision
4. Location:
5. Type of facility to be inspected
6. Well Data:
A. Type
Single Family
Public Utility
C. Construction
7. Sewage Disposal System:
A. Installed
C. Septic Tank: 1. Size
D. Seepage Pit: 1.
E. Disposal Field:
8. Distances:
A. Well to: Septic tank
Nearest 'lot line
B. Foundation to septic tank
No. of bedrooms
B. Depth
D. Bacterial Analysis
On-site system
B. Instal ]er
2. Manufacturer
Absorption Area 2. Material
Total length of lines
, Absorption area
Other contamination
, Absorption area
._, Sewer Lines
C. Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
Page 2 of two pages - Rec ~t for Approval of Individual S ~.r & Water Facilities
Legal Description Lot 15 Block 3 Meadowbrook Subdivision
Comments
Disapproved
Date
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I 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,
Date
SIGNED
EQ-034 (1/74)
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: CM RO VA FHA ._CONY__ l----'
D~y Phone:
Mailing Address: .~
Mailing Address: Phone:_
5. Name of Realtor or Agent" --~'/~('~-~'~-~' ~//'L ~ g- /..~.._-~, (¢- - ~L,~i . _~-
Mailing Address:--~2-c~2 / ~) ?:/' ~~t - Ph°ne~
6. Legal Description:. t~~' /~ ~:~"/~'~
7. Type of Facility to be Inspected:
8. Water Supply
Type of Supply:
Public Utility~ ,)~, ~k, .Individual__
If Individual, number of dwellings presently served
If Individual, depth of well
Sewage Disposal System
Type of System: Public Utility_
If Individual, date of installation
Individual (on-site). ,
72-003(3/76)