HomeMy WebLinkAboutMCMAHON BLK 1 LT 3McMahon
Block 1
Lot 3
#017-041-44
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 1
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP241388 PID Number: 017-041-44
Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑■ Upgrade
Name
Timothy & Sharon McLaughlin
ABSORPTION FIELD
❑■ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound
Site Address
3700 Huffman Road
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
3
0.8 GPD/SF
11.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
3.9 Ft.
Gravel depth beneath pipe
7.1 Ft.
Subdivision Block Lot
McMahon 1 3
Fill added above original grade
0.6-1.6 Ft.
Gravel length
45 Ft.
Township Range Section
Gravel width
2.5 Ft.
Beds: Number of Lines
n/a
Distance between lines
n/a Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
HoldingSewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank Line
630 Ftz
1
n/a Ft.
Well
100'+
100'+
NA
NA 25'+
TANK p Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Greer (Deep Burial)
Capacity
1000 Gal.
Surface water
100'+
100'+
NA
NA
Material
Number of compartments
Lot Line
5'+
10'+
NA
NA NA
HDPE
2
Foundation
10'+
10'+
NA
NA
LIFT STATION
Manufacturer
Capacity
Remarks
Gal.
Alarm location
Electrical installed by
PIPE MATERIAL House to tank D3034 Tank to
drainfield D3034
Installer
Beeks Contracting, LLC.
Drainfield D3034 caMTD3034
Inspector PES
BENCH MARK (Assumed elevation) 100.0 ft
Inspdectiones: vt 12/30/24 12/30/24
Location and description
2nd
3r1 01/02/25 4'h 01/09/25
See Site Plan, Bottom of Window Trim
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval: Date
s�P.��
- -- -- -- --- -
% * 49 TH V *r+r
....
�� .. CG.Ven R. NCln.nol�@
Septic Syst
CL 8140 -
i``°Approved
Approved Date
,l;F`�FnnoFFsio��`�=
ffte: this approval does not include well permit requirements.
(Rev 05/02//187
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1000GAL GREER
POLY TANK
PROFILE
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MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
hftp://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP241388
Work Type: Septic Upgrade
Tax Code Number: 01704144000
Site Legal Address: MCMAHON BLK 1 LT 3 G:2835
Site Mailing Address: 3700 HUFFMAN RD, Anchorage
Owner: MCLAUGHLIN TIMOTHY B &
Design Engineer: PANNONE ENGINEERING SERVICES
This permit is for the construction of:
Effective Date
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
12/4/2024
12/4/2025
33925
Q Disposal Field Cif Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Received By: `°Pj` -S Date:
Issued By: Date: z' V Z") 2 `�
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. 01 7-041-4,Lf
Property owner(s) Timothy McLaughlin
Mailing address
Site address 3700 Huffman Road
Day phone
Legal description (Sub'd., Block & Lot) McMahon, Block 1, Lot 3
Legal description (Township, Range & Section)
Lot Size 33,925 _Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN: TYPE OF DWELLING:
(N all that apply)
Absorption Field
F-xl
Initial ❑ Single Family (SF) 5XI
(w/wo ADU)
Septic Tank
FX
Upgrade 0
Duplex (D) F
Holding Tank
F
Renewal F
Multiple Dwellings F
Privy
F
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
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:
Date of Payment: -Z' 2-
Receipt Number:
Permit No.
Permit App_-'- .' - I
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E‐mail: steve@panengak.com
Mailing: P.O.Box 1807, Palmer, AK 99645
Telephone: (907) 745‐8200 FAX: (907) 745‐8201
Municipality of Anchorage
Development Services Department
On‐Site Water & Wastewater Program
4700 Elmore Road
Anchorage, Alaska
Subject: McMahon, Block 1, Lot 3
System Permit Request
This is a design narrative for a permit to install an upgrade septic system on the subject property. The systems will
serve an existing three (3) bedroom house. This lot and surrounding lots are served by private wells. Currently there
are no wells within 100ft of the proposed installation.
1. Soils: A test hole were performed on this lot by Pannone Engineering Services, LLC on 10/15/2024. The soils log
is attached, and approximate locations are shown on the site plan. Groundwater was not observed during the
excavation of the test hole, and bedrock was not encountered. Groundwater was not observed in the test hole
monitor tube after 7‐days. Based on the results of the percolation test and overall soils appearance an
application rate of 0.8 gpd/SF was used for the design of a conventional wastewater treatment system in the
area of the test hole.
2. Soil Absorption System Design: See Sheet 1 of the design package.
3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field.
4. Topography: See attached site plan for area topography.
5. Drawing Markings: The Drawings are marked “For MOA Review Only”. When written notification that the
review is complete and no further comments are received from MoA On‐Site Department, the note will be removed
and “For Construction” drawings will be issued.
The proposed installation will not affect the future development of this or the surrounding lots.
If you have any questions or concerns, please contact me at (907) 745‐8200.
Sincerely,
SRP
Steven R. Pannone, P.E. F. ASCE
Owner/Civil Engineer
18 November 2024
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241388, Curtis Townsend, 12/04/24
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241388, Curtis Townsend, 12/04/24
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241388, Curtis Townsend, 12/04/24
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241388, Curtis Townsend, 12/04/24
CD 0
HUFFMAN ROAD
S 89'55'18" E 147.50'
IL(o) it 3,
Block, ]l
o �
Lot 4
o Deck 00
0
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NRogow—
.l; n 22.8'
Lot 2 - •-' a; S�un�we,wiuniF
00
�® d' 100' M - Ot1Se Ld'
C well RQd zo
3� ;s 2.1 o
® o0 23.3, r. 0 0 20 40
V)
Shed ® 28.3'
Gm
® US SURVEY
Hse ® FEET
TH 49 TH
10
— — — — — r Jeremy A: Hurst
10' Utility Ease. �s c'. LS 116 .•A_�'
- — — — — — S 89'55'18" E 147.50' F9F�P 05°=
l �;,'�IOFES
SIONAI.`�4�
NOTES Lot 12 Lot 13 Lot 14
-All dimensions shown are grid bearings and ground distances, record boundaries are per Plat No. 65-86
-49th Star has conducted a physical survey of the property and all details shown on this Asbuilt Survey are correct. Under no
circumstances should any data hereon be used for establishment of property lines.
-It is the owners responsibility to determine the existence of any easements, covenants, or restrictions; no title research performed.
AS BUILT SURVEY LEGEND 49th Star Surveying
Lot 3, Block 1, Power Pole PO Box 738
7-0738
9958
McMahon Subdivision, Tele-comet Pedestal Girdwood, (907)-6111 AK AK 9958
Anchorage, AK \ Water Valve (D Septic Lid Jeremy@49th5tarSurveying.com
TH Perc Test Hole 0 Clean Out/Vent w-O. 2477 DATE: 11/14/24
SCALE: 1 "-40'
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
'~ ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME PHONE ' ~;~_N E W
MAI LING ADDRESS
LEGAL DESCRIPTION
LOCATION ~'~ O~1 ~' ' NO' OF BEDROOMSd
Well Absorptionarea~ ~ Dwelling PERMITNO. ,
~ ManufacturerG ~e.e~ Material,x ,~, e.-- I N°' °f c°mpartmentsz
~ Liq. capa~ ~lons IF HOMEMADE: Inside length Width Liquid depth
~ ~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
O ~ ~ Manufacturer Material Liquid capacity in gallons
O Well Foundation ~ / Nearest lot line PERMIT NO
~ ~ Top of tile ,o finish graded, Material beneath tile~ Total effective ab:~p¢~r~_ =
Length Width Depth PERMIT NO.
< H T~pe of cFib Crib diameter CFib depth Total effective absorption area
m Well Building foundation Nearest lot line
~ DISTANCE TO:
'~ Class Depth Driller Distance to lot line PERMIT NO.
Building foundation Sewer line Septic t~nk Absorption area(s)
~ DISTANCE TO:
PIPE MATERIAL8
'PVC
8OI L TEST RATING
INSTALLER
~EMARK8
APPROVED DATE LEGAL
72-013 (Rev. 3/78)
KEN'S COMPANY
WATER WELL DRILLING
PUMP SALES & SERVICE
(907) 243-7893
KEN JOHNSON
ROBERT A. FOREMAN ( Vk# — y i
HUFFMAN A AVION
Lot 3 Blk i XCMAHON SUBD.
ANCHORAGES ALASKA
0ftto2ft
2 ft to 4 ft
4 ft to 12 ft
12 ft to 25 ft
25 ft to 36 ft
36 ft to 42 ft
42 ft to 52 ft
52 ft to 81 ft
81 ft to 86 ft
86 ft to 97 ft
97 ft
WATER WELL LOGS
d9�
3163 LINDEN DRIVE
ANCHORAGE, ALASKA 99502
JUNE 1, 1982
A'd;:;iC IFALITY OF ANCHORAGE
L` -FT. OF HEALTH &
ENVIRO.'41ENTAL PROTECTION
FE r) I7
RECEi VE 'D
Fill
Large slap 4ngravel
Silty sand wfine gravel
Fine gravel
Silty sand
Fine gravel itfiled. gravel ilt
Course graveilt ( hardpanClean med. sel (HZo } 10 ft head
low yield
Hardpaneeecourse gravel and gray silt
Clean fine gravel and med. sand ( water bearing }
Static water level 72 ft. ( 25 fte head }
Teat bailed at 10 GPM
12 ft* drawdown ( good recovery }
Bottom stable
Set pump at 93 ft from top of casing.
clfsi,vy 9' 7 -- 9
(907) 243-7893
KEN JOHNSON
I N'S COMPANY
WATER WELL DRILLING
PUMP SALES & SERVICE
3163 LINDEN DRIVE
ANCHORAGE, ALASKA 99502
JUNE 1, 1982
ROBERT A. FORE~DkN ( 248-1527 )
HUFFMAN & AVION
Lot 3 Blk 1 ~v'ICIvlAHON SUBD.
ANCHORAGE, ALASKA
MUNICIPALITY OF ANCHORAGE
I~NVII,: .il I. ~.: .O F I
0 ft to 2 ft Fill
WATER WELL LOG
R[C[IVED
2 ft to 4 ft
4 ft to 12 ft
12 ft to 25 ft
25 ft to 36 ft
36 ft to 42 ft
42 ft to 52 ft
52 ft to 81 ft
81 ft to 86 ft
86 ft to 97 ft
97 ft
Large slab rock
Silty sand with trace of fine gravel
Fine gravel and sand
Silty sand
Fine gravel and brown silt
Med. gravel and ~ brown silt
Course gravel and gray silt ( hardpan )
Clean med. sand and gravel ( H2o ) 10 ft head
low yield
Hardpan...course gravel ~d gray
Clean fine gravel and med. ssmd ( wate~
Static water level 72 ft. ( 25 ft, head )
Test bailed at 10 GPM
12 ft. drawdown ( good recovery )
Bottom stable
Set pump at 9~ ft from top of casing.
F%Ri',!I T NO.
i.,.OC P,T I ON
L. EGf:4..
LC:iT ~ :.r ZE
FEET
THE LENGTH DIMENE;ZEd'.-,.' ZE; THE L.E:NGTH <iN FEET) OF THE TRENC:k.~ !~i?. DRRZNFZEL[::,.
THE DEPTH OF R TRENCH OR F'ZT Z5 THE DZ~;TRNCE BETb.!EEN THE SUFE:FFiE:E OF THE
'THE[~fE :!:f6; NO ~5[ET 1.4ID'TH FOR TRENCHES.
THE C~RR'v'EL DEPTFi :[E; THE HiNZMUM DEPTH OF GRRVEL. E~E'T'NEEN THE OUTFRL. L. PIF'E
FINE:, THE BOTTOM OF 'Tide EXCRVRTiON KIN FEET).
M:[NZMLi?,! [:,!:::;TRNCE E:E'TNEEN R NELL. RNB, FIN'./ ON-E;I]"E SE:!.,.IRGE D!E;F'OSRL E;'¢STEH
::L66 FEET FOR R PR:[VRTE: F]ELL OR iSE~ TO ;;~:E~E~ F'EET FF'.OH F~ F'UE:L. IC [4ELL DEPENE:,];NG
UPON THE T'¢F'E OF F'UE&.iC NELL.
HINIMUH [:,~:~;TF~I',iCE FROM F~ F'R!VFITE NELL TO R PRiV~'I"E E;EF!ER LiNE
'T'O ~ COHMUNiT'?' SE!.,.!ER L.~NE ZS 7D FEET.
b.!EL.L LOGE; FIRE RECtUZREE:, RND MUST 8E F;:ETT'URNE:E:, TO T'HE DEPFIF:THENT !.,.IZTH~N
OF THE NELL. COHPLET!
O'TFIER REC:¢JiF?E?IENTE; FIR? FIFIpL'?'. SF'EE:!FICRTZONS i:~ND C:ONS'FRUCTtON [:,)~f~l]l:~:F:!h!E; RRE
Ft'v'FI! LFiBLE "FO tFiSI...iREE F'ROPER I NSTFILL. FIT ION.
:[ CER'TI F"¢ "r'.HFrr
FOR"!'H B'./ "f'HE i'!UNI C~F'RL.I T¥ OF' RNCHORRE~E.
2: Z b.ilL. L !?'~.STFE..L. THE E;'?'E;TEi'"t Zh.! f:iCC:ORE:,F!NCEE b.iZTH THE CODES.
2:':: Z .UNDERE;TFINE:, 7'HFFF Title ON-L:'..ZTE E;EE!.,.!ER SYS'TEH HF!? RE:C!LiZRE ENLF:~RGEHENT ZF THE
F:E:S!DESNCE i:E; REHODELELt', ]"Ei iNC:LUE:,E MEiRE ]"HRN 3 BEDR!JJiE)I"i:'~:].
6
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5-
6-
7
8
9
10
11
12
13
14
15-
16
17,
18-
19-
20-
COMMENTS
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, AlasEa 99501 264;4720
SOILS LOG - PERCOLATION TEST
SOILS LOG
PERCOLATION
TEST
SLOPE
PLAN
I'
P
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
I 4 ;~'( 30 ,, J fl .3'7
% ~:~7 iD ."t3 ,, i?
~F ~:os ~ , Co
PERCOLATION RATE
TEST RUN BETWEEN
(minutes/inch)
AND 7 FT
,?,,,~.d / 5~ /
PERFORMED BY:
72-008 (6/79)
CERTIFIED BY:
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: (907)343-7904
On -Site Water & Wastewater Section Fax: (907)343-7997
Certificate of On -Site Systems Approval
OSC251016
Parcel ID 017 -041-44
Legal description MCMAHON BLK 1 LT 3
Site address 3700 HUFFMAN RD
Expiration Date: 10/22/2025
Current property owner(s) MCLAUGHLIN TIMOTHY B &
X The On-site system(s) is/are approved for 3 bedrooms
By:
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
Original Certificate Date:
2/7/2025
This,Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
System(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage,
Development Service Department (DSD) issues COSAs based upon representations provided by an
independent professional engineer. The Municipality of Anchorage is not responsible for errors or
omissions in the professional engineer's submittal.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
MUNICIPALITY OF ANCHORAGE
I�
Development Services Department \ ; Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 017-041-44
Complete legal description McMahon Block 1 Lot 3
Location (site address) 3700 Huffman Road
Current property owner(s) Timothy & Sharon McLaughlin Day phone
2. ON-SITE SYSTEMS SIZED FOR 3 BEDROOMS
3. TYPE OF WATER SUPPLY: ❑■ Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
❑ Water Storage
4. TYPE OF WASTEWATER DISPOSAL:❑ Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: ❑ Steel ❑■ Plastic ❑ Concrete ❑ Fiberglass
Age <1 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: ❑ AWWTS ❑ Bed 0 Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ 2 250
Date of Payment 2 Z S
COSA# OSG 251016
Waiver Fee $
Date of Payment
Waiver #
COSA Applicationjune 2022
COSA Checklist_June 2022
COSA Checklist
Legal Description: Parcel ID:
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system ____
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled Total depth ft
Cased to ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test? Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date
Comments __________________________________________________________________________________
B. TANK DATA
Measured operating fluid level in septic tank
Date of pumping
Required maintenance completed, if AWWTS
Comments:
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed)
ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade ft (min)
N/A – pressurized field.
Per record drawings, field is insulated.
Monitor tubes go to bottom of effective.
If not, state depth into effective
Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months)
If yes, enter date
Adequacy test date
Results Pass
Fluid depth prior to test in
Water added gal
New fluid depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
FIELD STATUS – POST RECOVERY
Effective depth (per record drawings) in
Effective depth used in
Effective depth remaining in
Comments/Deficiencies:
COSA Checklist_June 2022
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’ Yes if No ft
Absorption Field on Lot > 100’ Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’ Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’ Yes if No ft
Holding Tank > 100’ Yes if No ft
Animal Containment > 50’ Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
N/A – Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10’ Yes if No ft
Tank to Property Line > 5’ Yes if No ft
Field to Property Line > 10’ Yes if No ft
Water Main > 10’ Yes if No ft
Water Service Line > 10’ Yes if No ft
Surface Water > 100’ Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100’ Yes if No ft
Community Wells > 200’ Yes if No ft
If tank or field is under driveway comment below
F.ENGINEER’S COMMENTS
G.CERTIFICATION & 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 Certificate of On-Site Systems Approval Guidelines, indicates that the on-site water supply
and/or wastewater disposal system appears to comply with applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation, unless noted otherwise.
In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in
accordance with ADEC & MOA guidelines and regulations. The reported results describe the performance of the system
under the conditions encountered at the time of the test, and separation distances measured to readily identifiable
features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that
may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside
the control of the evaluator of this system. All systems eventually fail, and satisfactory test results do not guarantee future
performance of the system, nor do they guarantee that there are no hidden defects or encroachments. Therefore, we
cannot provide any warranty for future performance, nor can we estimate remaining life of the system. The content of this
report is for the sole benefit of the owner listed above.
Name of Firm
Phone
Engineer’s Printed Name
Date
00
HUFFMAN ROAD
S 89"55'18" E 147.50'
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_ /
10' Utility Ease.�)j.. L -11 6tA)
S 89°55'18" E 147.50' `0 F • •
- 1l Fop ... • a�oS�
NOTES Lot 12 Lot 13 Lot 14
-All dimensions shown are grid bearings and ground distances, record boundaries are per Plat No. 65-86
-49th Star has conducted a physical survey of the property and all details shown on this Asbuilt Survey are correct. Under no
circumstances should any data hereon be used for establishment of property lines.
-It is the owners responsibility to determine the existence of any easements, covenants, or restrictions; no title research performed.
AS BUILT SURVEY LEGEND 49th Star Surveying
Lot 3, Block 1, (_Q,� Power Pole PO Box 738
/L, Tele-comm Pedestal Girdwood, AK 99587-0738
McMahon Subdivision, (907)891-6111
Anchorage, AK Water Valve 0 Septic Lid Jeremy@49thStarSurveying.com
O Perc Test Hole 0 Clean Out/Vent W.O. 2477 1 DATE: 1/9/25
SCALE. 1"-40'
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information Application Date
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
(b) Applicants Name
Applicants Address
Telephone - Homel3q~-~fgBusiness
(c) Applicant_is (check one) Lending Institution
Buyer ~ ; Other ~-] (explain);
(d) Lending Institution
~-~ ; Owner/builder ~ ;
Telephone
Address
(e) Real Estate Co. & Agent
Address
Telephone
(f) Mail the HAA to the following address:
2. Type of Residence
Single-Family~
Number of Bedrooms
3. Water Supply
Individual Well [~
Multi-Family~--~
Other (describe)
Community~ Public~--~
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
Sewage Disposal
O site 0o=u i. olding
Note: If community well system, must have written confirmation from the State
Departmeng of Envi=onmental Conservation attesting to the legality and status.
[Page 1 of 2]
e
Engineering Firm Providing Inspections, Tests, File Search, Data and Information
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 shows that the on-site
water supply and/or wastewater disposal system is safe, functional and adequate for
the number of bedrooms and type of structure indicated herein. I further verify that,
based on the information obtained from the Municipality of Anchorage files and from my
investigation and inspection, the on-site water supply and/or wastewater disposal
system is in compliance with all Municipal and State codes, ordinances, and regula-
tions in effect on the date of this inspection.
Name of Firm ~l'(.~.,'(yl~ ~ ff./.'!~i~?~q'~ 6 Telephone ~/
Address /5 g/ ~ ~'/. '~'-i,,¥.'.~- ;'~,./~.~.~'~l'~!'"'~... ~,"~/~C','~5'~? /~ )i
DHEP Approval
Approved for ~ bedrooms
Approved ~ Disapproved
Terms of Conditional Approval
CAIri'ION
'THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRO~,IENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED
IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO pURCHASERS OF HOMES AND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN F~DERAL ~ND STATE REQUIRE-
MENTS. F~[PLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR ~NALYZE DATA BEFORE A
CERTIFICATE IS ISSNED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS
OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK.
(DHEP SEAL)
RR4/ej/DI8
[Page 2 of 2]
7-19-84
/-'1
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
Well Classification
Well Log P~esent ~/N)
Total Depth ~7/ ~. Cased to
Static Water Level 7~/
Casing Height Above Ground
Electrical Wiring in Conduit ~/N)
Separation Distances f~am Well:
To Septic/Holding Tank on Lot //~'
To Nearest Edge of Absorption Field on Lot
To Nearest Public Se%~r Line ~/~
Cleanout/Manhole
Water Sample Collected By .~.
Water Sample Test Results
MUNICIPALITY OF ANCHOlb~'C~
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
AU6:5 1 lg84
RECEIVED
Legal Description:
If A, B, c~ C, D.E.C. Approved(Y/N)
Date C~,~)leted / ~ /~_~_ . .. Yield
~ 7 ~ Depthv of G~outing
At ?5'
Sanitary Seal on Casing
Depression A~ound Wellhead (Y~
; On Adjoining Lots ~
; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot ;~//~
$'z ? -8/'/
Cc~,~ents
B. SEPTIC/HOLDING TANK DATA
Date Installed /~-I%-~Z~ Size I(~OCb a(kl.¢ No. of Cc~,~)a~tm~nts
Standpipes ~/N) ,,~5 Air-tight Caps ~) t,AfJ Foundation Cleanout (Y_~)
Depression over Tm& (Ye) ~10 Date Last Pumpe~
pun~ping/Maintenance Contract on File (Y/N) ~/~ .; for
Holding Tank High-Water Ala~,m (Y/N) ~/~ Temporary HotdiP~3 Tank Permit (Y/N)
Separation Distances f~cm Septic/Holding Tank:
To Water-Supply Well > J00' To Building Foundation
To P~ogerty Line ~
To Water Main/Service Line
Cou=se >' / O0
To Disposal Field (~'
TO' Stream, Pond, Lake, c~ Major D~ainage
[Page 1 of 2] 2-15-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed ~ ~f~'f
Width of Field ~ i'n¢/t ~
Square Feet of Absorption A~ea
Depression over Field (Y~
Results of Last Adequacy Test
/ 60~,/~J/~!~Type of System Design
Length of Field ~/~/
Depth of Field
Gravel Bed Thickness
Standpipes P~esent (~/N)
Date of Last Adequacy Test ~/~
Separation Distance frcm Absorption Field:
To Water-Supply Well > ~0' To P~operty Line
To Building Foundation ~/ ~0 To Existing or Abandoned System
Lot ~ ; ~ ~joining ~ts >~$'
To Wate~ Main/~vi~ Line ~O} To ~t~(if ~e~nt) ~/~
To St~e~ond~ke/~ ~jo~ ~aina~ C~se >/~O;
To ~i~way, Pa~ki~ ~ea, ~ Vehicle Sto~a~ ~ea ~
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alaz~m Level at
Tested for
Electrical Codes(Y/N)
Dimensions
Manhole/Access (Y/N)
"Pur~p Off" Level at
Vent (Y/N)
Pumping Cycles dll~ing Adequacy Test.
Meets MOA
Conm~nts
** Check Permitted Bed~o<m~ Rating AGainst HAA Request **
I celrtify that I have checked, verified, o~ confc~ed to all MOA HAA Guidelines in effect
on the date of this inspection.
Si~ned ~[~d~ 0~ ~ Date ~ ~/~
Company ~,<~L~ ~ </~'~¢:3 MOA
KB1/d5/s
[Page 2 of 2]
2-15-84
CHEMICAL & Gl LOGICAL LABORATORIES ,.~£ ALASKA, INC.~.~
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
WATER SYSTEM:
Water System Name
Mailing Address
City State
MO. Day Year
I.D. NO,
Phone No.
/ ..-~ :-:~, t '";?'7
' Zip Code
SAMPLE TYPE:
[] Routine
[] Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
[- Treated Water
[] Untreated Water
SAMPLE
NO.
I
I
I
LOCATION
"
Time Collected
Collected By
TO BE CO MPLETED BY LABORATORY
AnaNsis shows this Water SAMPLE to be:
I~atisfactory
[] Unsatisfactorv
[] Sample too ong in transit; sample should
ROt be over 48 hours old at examination
to indicate reliable .results. Please send
· n.ew sampm.
Date Received
Time Received
Analytical Method:
[] Fermentation Tube
~ Membrane Filter
Lab Ref, No. Result* Analyst
>' / .
I
a'No. of colonies/lO0 mi. or No. oJ Positive Dortions.
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
06-1220 (b)
Rev. 1978
BACTERIOLOGICAL WATER ANALYSIS RECORD
Date Collected Source
eCelve¢l Lab. No,
Presumptive 10mi 10mi 10mi - /0mi 10mi 1,0mi 0.1mi
24 Hours
48 Hours
Confirmatory .
24 Hours
48 Hours
EMB. Broth 24 hours:
Membrana Filter: Direct Count
verification: LTB.
Final Membrane Filter Results
Broth 48 hours:
Collform/100ml
BGB
Collform/100ml
CAL & GEoLoGICAL LABORATORIES'OF ALASKA,
TELEPHONE (907) 562.2343 ANCHORAGE INDUSTRIAL CENTER 5633 B Street
Drinking W ter Analysis Report for Total Coliform Bacteria
WATER SYSTEM:
Water System Name
Mailing Address
SAMPLE DATE:
TO BE COMPLETED ~Y WATER SUPPUER
J sm~ z~ ~
SAMPLE TYPE:
~ Routine
Check Sample (for routine sam 31e
with lab ref. no. )
[3 Special Purpose
SAMPLE
NO. LOCATION
I
, I
Treated Water
Untreated Water
Time Collected
Collected By
TO Bi COMPLETED BY LABORATORY
Satiysis shows this Water SAMPLE to be:
isfactory
[] unsatisfactory
[] Sa~nple too long in transit; sample should
not be over 30 hours old at examination to
inc~icate reliable results. Please send new
sample via special delivery mail.
Date:, Received ~
nm,; Rec, ,ed
Analytical Method:
~ [] Fermentation Tube
~l~Membrane Filter
4
Lab Ref. No. Result*
Analyst
064220 (b)
Re~. 1983
BACTE'RIOLOGICALWATER ANALYSIS RECORD- --
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Membrane Fillet Direct Count
Verification: LTB BOB
CollformllOOml
Final Membrane Filter Resulta ~ Collformll0Oml
TNTC = Too Numerous To Count
- APPLIC?NT FILLS OUT UPPER HAt':':'.ONLY ·
Buyer
Lending Instituti on ~ ~ ~ ~~ P h one
Address Zip Code
,e~,,~ Co. ~ *~, /~ ,~o.e
Address Zip Code
Legal Descr,ption ~ ~/ ~~
Type of Resi~nce
Single Family
Multiple Family No. of Bedroo~ . ~
~ Other
Water Supply
Individual 'P~ ~ A~ACH WELL LOG. A wall log is required for all wells drilled since June 1975,
~ CommunitYPublic Utility ~ ~ ~ ~ ~ For wells drilled prior to that date. give well depth (attach log if available).
Sewer Disposal
~ Individual ~ ~ ~ 5 ~ Year Individual Installed:
Public Utility When Connected to Public ~ti~ity~
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Time Time Time Time
Date Date Date Date
Inspector Inspector ~'~, .,Inspector In s ' act ° r ~(.d~,~~
~ ~ ' ' ~?T C
RECEIVED
(~ ) APPROVED BEDROOMS *OONDITIONS OF APPROVAL
( ) DISAP~OVED
( ) OONDITIONAL APPROVAL'
gATE ~ ~" ~ ~
Soils R~ling Date ~wer InBtalled Well To ~sorption Are8 Well Log Received
/
'. ~ ~ Well to Tank Septio T~k Size
72-023
