HomeMy WebLinkAboutMCMAHON #2 BLK 10 LT 5McMahon
Block IO
Lot 5
#017-362-28
O
Municipality of Anchorage *¢'~,~:
Development Services Department
Building Safety Division ~ y
On-Site Water and Wastewater Program, 4700 Elmore St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page of
www. ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: .5~OqOi-I-G PID Number: 0i~ -3gZ- Z8
Name: Jcl'erg ~,'~,~iirle,, WastewaterSystem: [] New [] Upgrade
AddreSs:Phone: it~[ '"~ Number of Bedrooms:
3¢01 it e,~ i/.r,a~ ABSORPTION FIELD
3 [] Deep Trench [] Shallow Trench [] Bed [] Mound [] Other:
Soil Rating: Total Depth from original grade:
LEGAL DESCRIPTION GPDIFt:~ Ft.
Block: Lot: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe:
i0 .5 ~ l~l~h~.~ *2. Ft. Ft.
Township: Range: Section: Fill added above original grade: Gravel Length:
Ft. Ft.
Well: (¢.~;~'~ii~ [] New [] Upgrade Gravelwidth: Ft. Numberoflines: Distance between lines:Ft.
Classification (PrivateCA, B, C): Total Depth: i Cased to: Total absorption area: Pipe Material:
Ft. Ft. Ft~
Driller: Date Ddlled: Static Water Level: installer: ,,l ~ Date Installed: q/~ /
Ft. &a l Co,, t,'t' ts
Yield: GPM Pump Set at: Ft. Casing Height Above Ground:
Ft. TANK
SEPARATION DISTANCES CSeptic [] Holding [] S.T.E.P. [] Other:
TFmm~ Septic Absorption Lift Holding ~ublic/Private Manufacturer: ~ Capacity:
Tank Field Station Tank SewerLine A,&.r;;¢ 1,4~' k Ga,.
l t Material: / Number of Compartments:
we, iO0 * '25,' S/-¢~1
SurfaoeWater 10¢ 't' LIFT STATION
[ Size: Manufacturer:
Lot Line --'~' "~' Gal.
Foundation .,..~'r"4, "Pump 9n" level at:in."Pump off' level at: in. High water alarm at: in.
Pump Make & Model Electrical Inspections performed by:
Curtain Drain
R .... ks: E~i'~] ~,~t'z ,4b,~o., i;)~4 I:~,/~ BENCH MARK
Location and Description:
Assumed Elevation:
Inspections performed by: ~..~ ~ ~ Dates: 1st r~I 20i0
Development Services Department Approva~ ~ °~"49~'Y~, ~..., j'...
Conditional Approval Date: t. '~:~fi'E/. ~F URK~'I~D.'i'_'cc
Reviewed and approved ~ *¢¢¢~/P'~'/~/"/ Date: ~/'¢/t(
(Rev. 04/06) [ ('
//// S e p-I;ic_~-
ABANDONED EXISTING
SEPTIC TANK PER MOA
CODE REOUIREMENTS
Lo~: ~
I
I
(D
INSTALLEO NEPt l~r.-.~ GALLON STEEL SEPTIC
TANK I00+ FEET FROM EXISTING WELLS
AND 5+ FEET FROM EX/STING TRENCH
Lot 5
t
t
Lot 4
LEYDEN RDAD
N
/~ 4 FEET C£VER
DBUBLE
CLEANBUT$ ~ - ~
CI1NNECT TO ~ 1888 GALLI1N SEPTIC TANK
EXIST BRAINFIELD '
'"",~ FlYUNDA TI£N
CLEANllUT
25 $8 75 188
SCALE: 1' = 50 FL
OF
_- ~.."' A
~ ~/ 49th
.......... .
~..n'.
BENCH MARK BOSOM SIDING NW HOUSE CORNER
ASSU~EO ~FATION I00'
SPUNK/AND ENGINEERING
203 W 15TH. AVENUE
ANCH. AK. 99501
(9OX,) 279-$916
McMAHON //2 BLOCK 10 £OT 5
STEVE AUGUST/NE
360! LEYDEN ROAD
SEPTIC SYSTEM AS~U/LT
DATE: SEPL 28, 2009
SHEET: 1/1 GRID: 2835
PERMIT # SW090176 PID # 017-$62-28 McMohon#2BlOL5Bl. dwg
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
Upgrade
Date Issued: Sep 11, 2009
Expiration Date: Sep 11, 2010
Permit Number: SW090176
Legal Description: MCMAHON f~2 BLK 10 LT 5
Design Engineer: 0007 SPURKLAND ENGINEERING
Owner Name: STEVE AUGUSTINE
Owner Address: 3601 LEYDEN RD
ANCHORAGE, AK 90516-2812
Parcel ID: 017-362-28
Site Address: 003601 LEYDEN RD
Lot Size: 40153 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
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,
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 EImore Road
P.O. Box 196650
Anchorage, Alaska 99507
www. munLorg/onsite
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. OI 7 - ~'_~ 6'~," ~.~
Propertyowner(s) ~'~,~e. /~,,~,~ttit~
Site address -- fi,~6 --
Legal description (Sub'd., Block & Lot) F'l~_~a~o,,
Legal description (Township, Range & Section)
Lot Size H 0,. ~_.~'~ Sq. Ft.
13[~c~ to
Day phone
Zip Code
Zip Code
Lo½ 5
Number of Bedrooms
THIS APPLICATION IS FOR ([~ all that apply): THIS APPLICATION IS AN:
Absorption Field [] Initial []
Septic Tank [] Upgrade []
Holding Tank [] Renewal []
Priw []
Private Well []
Water Storage []
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/Rush Fees: ~'~O
Date of Payment:
Receipt Number: O~, ~ ff~,~
(Rev.
Waiver Fees:
Date of Payment:
Receipt Number:.
Environmental Consulting and Design
I
Municipality of Anchorage
Development Services Department
Building Services Division
On-site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
I
September 4, 2009
Subject:
SEPTIC TANK PERMIT APPLICATION
McMAtION//2 BLOCK 10 LOT 5
Ladies and Gentlemen:
We are submitting an application to upgrade the septic lank for this lot. The existing septic tank serving the
above referenced property is 33 years old and the owner would like to replace it. The submittal consists of
one (I) drawing showing the present improvements on the lot and the proposed improvements of the lol, of
which only the septic tank is subject to this permit application.
There are no wells within one hundred feet oflhe proposed replacement site. The installation of this septic
tank will not prevent wells and septic systems from being installed on the adjacent lots. There are no
developed or natural surface / sub surface drainage courses within 100 feet of the proposed septic tank
location. The proposed septic tank will not change the general slope ofthe area. Ponding and/or
concentration of surface runoffwill not result from this installation.
Ifyou have any questions or are in need of addilional information please contact me at 279-3916.
203 West 15'h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (907) 276-6013, SpurklandEng~gcJ.net
Lot ,I
, /~LEY~ENROA~
FEET COVE£
SCALE, 1' = 50 FI'.
SPURKLAND ENGINEERING
203 FI 15ZN. AVENUE
ANCH. Al(. 99501
(90Z) 2~9-39~6
] McMAHON J2 BLOCK 10 LOT 5
STEYE AUGUSTINE
$601 LEYDEN ROAD
] SEPTIC SYSTEM ASBUILT ]
DATE:.SEPT. $, 2009 ]
SNEEI~ 1/I GRID: 2835
HcHohon#23IOLSfll. dw~
] PERMI[ # svogoxxx PI~ # 017-362-28
SubJect Property:
Date:
Environmental Consulting and Design
I
Single Family On-site Wastewater Disposal System
Construction and Material Specifications
McMAHON #2 BLOCK 10 LOT 5
September 3, 2009
General:
1.
e
5.
6.
7.
The owner shall contract with a contractor to perform the work outlined In these
specifications and plans in accordance with the attached MOA permit. There is not
contractual arrangement between the contractor and the Engineer. The Engineer shall be
the owner's representative and will inspect the work to document the contractors
activities. Final acceptance of the contractors work rests with the owner and the MOA.
The scope of the work Includes the installation of a new 1.250 gallon septic tank. The
location of the drain field is shown on the attached site plan drawings. All components of
the proposed septic system must be constructed a minimum of 1.00 feet from any surface
water or water wells in the area. A minimum of 4 feet of earthen cover is required over
the septic tank. If less than 4 feet of cover is available, 2-inch thick, 40 psi, direct bury
board foam shall be Installed directly over the septic tank and all installed piping.
Construction shall be in accordance with the approved site plan and design drawings and
any special provisions noted on the Municipal well and/or septic permit. All materials,
components, workmanship and construction practices shall comply with the Munidpality of
Anchorage's latest ordinances regarding wells and septic systems, as well as MOA,
Development Services Department, On-site Water and Wastewater Program (DSD)
policies.
The contractor is responsible for obtaining all underground utility locates, layout of the
proposed system, and verifying and maintaining all required separation distances to lot
lines, surface water, wells, steep slopes, etc.
The property owner shall be responsible for final grading any depressions formed from
settlement of backfill material. The property owner is also responsible for vegetation of all
areas disturbed by septic system installation activities.
Contractors installing wastewater disposal systems must be certified to do so by the MOA
DSD, On-site Water Wastewater Program. Property owners installing their own systems
must receive advanced approval from MOA DSD prior to system Installation activities.
The contractor shall ensure that ALL materials being used are in compliance with the most
current guidelines established by the Municipality of Anchorage. Refer to "Standards and
Specifications for Component Parts and Materials Used in the Construction of On"site
Wastewater Dispesal Systems", Dated December 2000, as provided by MOA DSD, On"site
Water and Wastewater Program.
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: {866) 354-1597, Lspurkland~gci.net
Environmental Consulting and Design
I
Septic Tank Znstallatlon:
l. A new septic tank, of the size specified in the design drawings, shall be procured from a
qualified manufacture/supplier if the existing septic tank is found to be defective.
Constructicx~ shall include two 4" diameter cleanouts for pumping access.
2. The burial rating of the tank shall be adequate for the actual burial depth encountered.
3. The tank shall be level and suffidently bedded to prevent settling of shifting of the tank.
4. All standpipes o~ the tank shall extend a minimum of !2inches above the final grade.
5. Tanks installed with less than ,t feet of cover shall be insulated.
6. The sewer service line from the ho(Jse to the tank shall have a minimum slope of 2%
unless prior approval is obtained from the engineer.
7. The inlet and outlet lines from the tank shall be bedded in drain rock or the soil shall be
sufficiently compacted to prevent future settlement of the soil
8. Septic tank inlets, outlets and cleanouts shall be f'~ed with water tight couplings.
9. A cleanout shall be installed ! to ,t feet from the foundation.
10. Post tank cleanouts shall be installed per MOA requirements. Does not apply to
pressurized lines.
ll. In areas with high ground water, the septic tank shall be suff'~ently anchored to resist
buoyancy forces when there is not adequate soil cover to resist upl~ force. The
contractor shall refer to the engineer for direction regarding this matter.
22. The tank backfill shall be graded sufficiently to ensure positive drainage away from the
tank.
13. All holding tank and lift stations shall have an audible and visible alarm inside the
residence being served.
24. All lift stations shall be wired in compliance with all HOA guidelines and the Uniform
Electrical Code. A municipal electrical permit and inspections must be obtained where
required by the MOA.
15. The contractor shall verify that the septic tank/lift station is a minimum of 100 feet from
any residential water well, !50' from any dass 'C' well and 200 feet from any community
water wells. Additional separation distances must also be maintained.
16. The contractor shall remove or abandon the existing tank in compliance with the Unform
Plumbing Code.
Znspections:
2.
3.
4.
A minimum of c~e inspection is required by the Municipality of Anchorage. These
inspections must be conducted under the supervision of a Professional Engineer licensed
to practice in the State of Alaska.
The septic tank may be set In place, but may not be bad(filled.
The contractor shall provide a legible copy of all field notes relating to system layout and
construction to the engineer for the use in preparing the record drawings.
The contractor shall coordinate all inspections with the Engineer. A minimum of 24 hours
notice is required prior to the start of construction. If necessary, a preconstruction
meeting will be held o~-site.
203 West 15~h Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866)354-1597, Lspurkland~gci.net
~,~ MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage. Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME IPHONE ~EW
~<~ Z Manufacturer~ ~ ~ Materia~;5~ No. of~rtment'
~ Liq. ~gallons IF HOMEMADE: Inside length Width Liquid depth
~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
~ ~ ~ Manufacturer Material Liquid capacity in gallons
~" ~ DISTANCE TO: Wall /~e /~ F°undation~a' ( Nearest lot linT~ ( PERMIT NO~ OO ¢¢
Tot a lie ,,'.*s ~¢ inches
"~ Top of tile to finish grade~ y, Material beneath tile ¢6 inches motaleff,~orptionarea
Length Width Depth PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
~ DISTANCE TO:
~ Class Depth Driller Distance to lot line PERMIT NO.
~ Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
PIPE MATERIALS
SOIL TEST RATING
REMARKS
/
APPR~ DATE LEGAL
72-013 v. 3/78)
Static Water Level
Dr~w Down
WELL LOG
feet
feet
Gallons Per Minute
Total Feet of Casing
Type Material Drilled:
0 feet to
to
to
Hefty Drilling
S.R.A. Box 1553 H
Anchorage,Alaska
99507
[:E:!P~ST'MENT OF HERLTH RF-ID Ei',IVIF,'Oi'.,!.HEF,iTFiL.. I:::'F~;Cr!"ECT~OF.!
264.-472E~
R i:::' P L ! C: FI i'-,I T
L_ '3C:i::i T )' O
!- E~::, ,
'T'HE F;;:['EQUiF;i:~[::, '}:'F;:>FZ DF THE SOIL.. eE'.::;"~'F"TIOi',t 'Z:V'::;TEM t:5-
THE LENGTH D!MENSiON iS THE LEN(.:YTH (lin FEET) OF: 'THE TF:ENCH OF.:: DRI::IIiqF'!ELD.
THE DEPTN OF' !:::I TF.:ENCFI OF;: PIT Z':Z, THE r.:,!S'r~h,lCE EJETi.,.IEEN Tt-lff !SURF'RE:E OF THE
GF:C~LIf'.,I[> FiI',![::, THE [3CrTTOM OF' THEi E',:.::CR',,,'FITiOi',! ,;:SN FEET).
THiEI;?E }:S NO SET ~,.ilDTH FOF: TP. ENCHES.
THE (3F.:RVEt_ DEPTH Z'.-'~.; THE MZNIMUH DEPTH OF GRRVEL E~ETHEEN THE OLr'rFFILL. F:'IF'E
Fff-,i[) THE E:OT'TOM OF THE EHCRVFITZO!',I (IN FrEET).
F'EF:M.[] CF'F'LIi:F!i'.H' HFIS "FFiE F~tF25F'OH?:;18ZL.~T',' -r'-~ iNFi. F:P', THIS il E.",,,.:~,,.t::.¢-,r'i" 12,UF?Ii'.,IG THE
:!: NSTF!LLFN' ~ ON I h,'Z F'E:C T I i I'..'~ OF' FIN'.? .,!ELL '~ ,a!:,.)'B i E.'.iT TO TH I S F'~;' :~PE:F:'T'.r' FIND THE:
'-'~" .... ~-~' HiL. L. SEi~'.',,,'E.
i,.~.HSEF, OF ~.,.:..:.[E.~- -I ~-' THFIT THE ~'~'
H l l'q ! MUH E:, l STFtNCE.' E:ETNEEN Ff i.,]EL.L FIND Fi!".-I'.? ON-'S I TE SEi4FiGE D I SF'OSRL Sh.'STEM t S
i!~:H3 FEET FO!:~: i::i F'~:!',,,'STE HELL OK: !!5!3 TO 2E~IZ~ FE:ET Fi:itOH R PLIE~L.I(i: i.,.iE:LL rJ, EPEF,!DING
L.1POi'.,! THE 'TMPE OF:' PL![3L.!C HELL.
MiNIML!M DiSTRNCE F'F:OM R PF::IVF!TE: i4EI....L TO F! F'.~'.!VRT'E SEF.tEP. Li!'.,!E ti:.; ;;it:ii FEET FIND
TO R COHi','iI..!F:i~T'=' SEi.,.iE:F4: L. INE iS '7~:~ F'EE'!".
HELL LOI3S FiF?.E: ~:E(;!UII~:ED FIND HUST BE
(.'iF' THE HELl,. COHF!_ETiON.
OTHER F-.::EQLI!K:EME:NTS !','IFi'Y FIPPL?. :::;PECiF!C:..q. TIONS
RVF~IL.F~BL_E TO iNSLIF.:E: PF~'.OF'EF: !NSTFiL.M::YF!ON.
! CE:FNi" :[ F'"r' TF.F."."
J..: I I::iM FF!MtL.T. FiF;.: i.!!'H THE F:EQLI!F:E.:.:.h![N'.,!TS F'OF:: 'it~.,-<:::.T."[E. S.E'REF:S R!'-,iE:, f.,.!ELI_S FiS SET
.......... .I. lf,:t... ~ t.. [~.., ,
FORTH B"r' THE i'-!! ?-,I T f": )i F'F!L..'r'''-'-'.~, ~ IitF - -'~'~,"c~,'
. H~ COt'::,ES.
2 i !.,.iiM_ iNSTFtLi_. T~.',~:DFff',!CE NITH T
3:' I !...ti'-,I[:,ii!i?.ST~N[;~~ER: S?STEM MFI"? R:EQUII'--::iZ ENLI'::iRGEHE!qT !F THE
F',;:F:i S , 'r ,, -," ,'
S I GN El!
'.,~ F: iei F;~.
January 4, 1982
Robert Milby
P.O. Box 3114
Palmer, AK 99645
Permit ~ 810887
Subject: L5 B10 MC MAHON ~2
A permit issued by this department for a well and/or sewer
system has expired as of December 31, 1981.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log should be sent to
this department to document the installation date.
If an engineer inspected the installation of the on-site
sewer system, please have them send us the as-builts for our
files.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
Sewer and Water Program
Enclosure: Copy of Permit
FIPF'L ! CRNT F.'OBERT MILB?
L. OCFIT Z ON LE'~'E:,EN DRIVE
LEGFIL L 5 8 ie~ MO MRHON ~2
T'¢PE OF SOIL. RBSORPTION SYSTEM
MF!XIMLIH HUMBER OF BEDROOMS = 4
THE REQUIRED SIZE OF THE SO~L ~BSORPTZON SYSTEM iS:
DEPFIF.:'f'MENT ,..r' HEF!LTH FIN[:, ENVIRONHENT'FI.L rROTECTIOH
825 "L" STREET., FINCHOF:FIGE, FIK. 995Ef±
254-4720
( 8!.C~887" )
PO BO',:.~ S:I.!4 PFILMER 5.'~'.~645
LOT SIZE 6(.~iEiEtE1 SQOFIF..'E FEET
!S: TRENCH
SOIL RFI'T I NG
THE LENGTH DIMENSION IS THE LENGTH ,.'.'iN FEET::, OF THE TRENCH OR DRFIINFIELD.
THE DEPTH OF' FI TRENCH OR PIT IS THE DISTFINCE BETNEEN THE SURFRCE OF THE
GROUND FIND THE BOTTOM OF THE EXCFiVFITION (!N FEET).
THERE IS NO SET P.tIDTH FOR TRENCHES.
THE GRF!VEL DEPTH IS THE MIN!MLtM DEPTH OF GRFIVEL. E:ETI,.!EEN THE OUTFFIL. L PIPE
FIN[:, THE BOTTOM OF THE EXC:RVRTION (if.,! FEET).
PERMIT FiPPLICRNT FIFIS THE RESF'ONSIBIL. IT'~? TO INFORM THIS DEPF!RTMEN]- [:,LIRiNG THE
!NSTFIL. L.RTION IN:SPEC:TIONS; OF' FIN'?' P.IEL. LS Fi[)JF!CENT TO THIL=., PF:OF.'ERT'¢ FIN[) THE
NUHBER OF RE:E;IE:`ENC:ES THRT THE !.,JELL !.4ILL. SERVE.
BRCKFILL. iNG OF FIN? S'¢STEM 1.4ITHOUT FiNFIL I.NSPECT!ON RND FIPPROVFIL B'¢ 'THIS
DEPFIRTHENT WILL. BE: SUBJECT 'TO PROSECUTION.
MINIMUM DISTRNC:E E',ETNEEN .[:I !,.!ELL FIND Fi!",!Y ON-SITE SE.NFIGE D!SPOSFIL SYSTEM iS
i8~:.~ FEE'f' FOR F! PRIVRTE NELL OR :L5,C'~ TO :..'..~E'~E~ FEET FROM FI PUBLIC NELL [:,EPENDING
UPON THE TYPE OF' PUBLIC NELL.
MINIMUM DIST'RN. CE FROM FI PRIVRTE NELL 'f'O FI PR!'VRTE SENER LINE IS 25 FEE']" FIND
'TO FI COMMUNiT'¢ SENER LINE IS i:'5 FEE'.['.
1.4ELL LOGS FI.F..'E RE)]:!LIIF.:E[:, RND HLtST BE RETURNE[> TO THE DEPRRTMENT NITHtN ]:E~ DR'¢S
OF THE P.iELL E:OMPLETION.
OTHER F.'.EQU!REMENTS P!FI'.'r' FIPPL".,". SPECIFICRT!ONS RN[:, CONSTRUCTION [)IRGRRHS FIRE
RVB !LRBLE TO iNSURE PROPEF.: INSTRLL. RT!ON.
I CERTIF'?' THFIT
i: I lam FFIMiLIFIR P.!ITN THE RE(.-:!UIREMENTS FOR ON-SITE SEWERS; FIND NELLS FiS SET
FORTH 8V THE: MUNtC:IPRL. I'rV OF RNCHORRGE.
2: i WiLL INSTRLL T::-!E S'¢STEM IN RCC:ORDRNCE WITH THE CC~DES;,.
2:: I U.NDERSTFtND THFI'F THE ON-SITE SENER S'?'STEM MW'r' REQUIRE ENLFfRGEMENT IF THE
RE:BIC, ENC:E IS REMODEL. ED TO INCLUDE MORE THFIN 4 BEDF.:CK)MS.
~ ,:~'~UNICIPALITY OF ANCHORAGE/~",
.: ~ ~ Department~ z Health and Environmenta. ;rotection
825 L Street, Anchorage, AK. 99501
· . 264-4720
" * * * HANDWRITTEN PERMIT * * *
WELL AND/~ ON-SITE SEWER PERMIT
Location: ~¢y~¢,~ ~'~%. Phone Number:
Type of Soil Absorption System Is: ' ~'
Trench: k/. Drainfield: Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: ,,. ~ Soil Rating (sq. ft/br)
The Required Size of the Soil Absorption System~Is:
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
· * REQUIRED SEPTIC(~) TANK SIZE = I~3 GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
· * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection.and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
· * * PERMIT EXPIRES DECEMBER 31~ 1 9 8 1 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the residence is/remo~el~x~to include more that ~ bedrooms.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAl- PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG- PERCOLATION TEST
~ SOILS"LOG
[] PERCOLATION
TEST
PERFORMED FOR: ~-~.,~'~ '"~,~'~'~' ~-'-~" *
,.E~AL DESCR,PT,ON: LO "/- :--,"dl,,,~/_ /O
SLOPE
12
13
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
SITE PLAN
fooz.~
14-
15-
16-
17-
18
19
20
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN
PERFORMED B~: ,4
(minutes/inch)
CERTIFIED BY:
FT AND ~ FT
72-008 (6/79)
A. WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description:
Well Classification /~)/¢/,~-/7~__ If A, B, C, D.E.C. Approved (Y/N)
Well Log Preser~l) Date Completed .~//~'~/~ ~- - Yield
Total Depth 7-1 / Cased to -.~/ /' Depth of Grouting ,/~'"/~
Static Water Level ~,.~ /,~ /' t~ ' Pump Set At /~-~--//~-'~'-¢'~
Casing Height Above Ground
~¢¢-Electrical Wiring in ConduitO/N)
Separation Distances from Well:
Sanitary Seal on CasinO,S4) '.4
Depression Around Wellhead (Y~ '-4
To Septic/Holding Tank on Lot /[¢ / /%z_ ; On Adjoining Lots '/:
To Nearest Edge of Absorption Field on Lot ./.~'5 / '~; On Adjoining Lots ./L /
To Nearest Public Sewer Line ~/~'/'~ To Nearest Public Sewer
Cleanout/Manhole To Nearest Sewer Service Line on .t_~t
Water Sample Collected by '~ ¢/~'%-'/'"P~", ;Date %//:¢//?¢¢¢
Water Sample Test Results ~/--/~'% ,~/~-'~.'E~F
B. SEPTIC/HOLDING TANK DATA
Date Installed '/////~'~ Size / ~ ~-'Z~ ~ No. of Compartments ~ ~
Standpipes~/N) / / Air-tight Cap~'N) ~ Foundation Cleanou~N) ~¢
~ Depression over Tank (Y~_~l x, Date Last Pumped '~"-//~/~" .0~7'- ~
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well //'~_~ /'~
To Property Line
To Water Main/Service Line
Course ~ [OD
;for
-//~/"~-~emporary Holding Tank Permit (Y/N)
/
To Building Foundation /~/:;'(~
To Disposal Field /.,5-'"
To Stream, Pond, Lake,"or Major Drainage
Page 1 of 2
72-026(11/84)
ENGINEERING FIRE~ PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATIO~,..
As certified by my seal aff xed hereto and as of the va ~dahon date shown below, I venfy that my investigation ~..,~¢,~s Head:h:
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and acequa:e
for the number of bedrooms and type of structure indicated herein, t fudher verify that based on the informatioR ccta ned
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supp,y and
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations
the date of this inspection.
..~:
Name of Firm :/~-, .... ' Telephone
_ . .- ' ,. '~' .~/ .--". ~; ~ -
Address /~'~3/: /~.~ ~;:;c.~;/ :'.;:'/c.:~ .,~'...:('~, .-c :: ,,
Date
Engineer's Seal
DHEP APPROVAL
Approved for /t¢¢~ bedrooms by
Approved / Disapproved
Terms of Conditional Approval
Conditional
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues
Approval certificates based solely upon the representations given in paragraph 5 above by an independent
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and Ll'te~r
institutions in order' to satisfy certain federal and state requirements. Employees of DHEP do not conduct
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or
professional engineer's work.
Page 2 of 2
ABSORPTION FIELD DATA
Soils Rating in Absorption Str, ata
Date Installed ~7;~
Width of Field
Square Feet of Absorption Area
Depression over Field (~.))
Results of Last Adequacy Test
Type of System Design
Length of Field ~'~ ~
Depth of Field ~
G/
Gravel Bed Thickness
J~~) ~'"f¢ Standpipes Prese ~r~N)
Date of Last Adequacy Test
~ [~eDRoom_~
Separation Distance from Absorption Field:
To Water-Supply Well /..~'~
To Building Foundation ~-~
Lot
To Water Main/Service Line '~ ~/~
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle S~orage Ar~a
Comments ~J~¢~C~} ~C~L
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots .;/ ~::'~d¢} /
To Cutbank (if present)
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
r~ Dimensions
' " ff" Level at
~'ent (Y/N)
Tested for
Electrical Codes (Y/N~"
Comments ~
Pumping Cycles during Adequacy Test. Meets MOA
,/
'** Check Permitted Bedroom Rating Against HAA Bequest **
I certify tha~,ave chec~.,~.erified, or conformed to all Iv~OA a/I/d HA~guidelines in effect on
Signed ~~/~ Date
Receipt ~o.
Date of Payment c~-%%
Amount: $ ~
Page 2 of 2
12-026 (11/84)
the date of this inspection,
I'¢IUNICIPALITY OF ANCHORAGE
DEPART~,IENT OF HEALTH AND ENVIRONIVIENTAL PROTECTION
DIVISION OF ENVIRON{~ENTAI- HEALTH
CERTIFICATE OF iNSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
GENERAL INFOR~ATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Z ¢ ? :% ,!'%. ~:c' ?,< /'~; ../~-~ . :, ';'~./?~'.,~; '~" ' '~' ~' '" -~ ~ -~
Location (address or directions)
/ ,~,. u',-',~ Telephone: ~ ....... Business
(b)
Applicant Name
. '-~, .
Applicant Address
(c) Applican~is (check one): Lending Institution ~; Owner/builder ~; Buyer ~; Other~.(explain);
(d) Lending Institution Telephone
Address
(e) Real Estate Company and Agent'
Address
Telephone
(f)
Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family~t~ Multi-Family._~ []
Number of Bedrooms ~.~
Other ~ , '
WATER SUPPLY
Individual Well Community [] Public []
Note: If corem unity well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite ¢~.'i Public [] Community El Holding Tank []
1
Note: If com munity well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 (11/84)
ALASKA E iiLIIF OFImE F1TAL COF1TROL SE!F4uIC $, IF1C.
REMAX REALTY
1000 E DIMOND SUITE 101
ANCHORAGE ALASKA
99515
SELLER-CAROL DOUFITT
JULY 23 1985
REMAX REALTY
1000 E DIMOND SUITE 101
ANCHORAGE ALASKA
99515
50406
LEGAL:MCMAHON BLOCK 10 LOT 5
ADEQUACY TEST FOR SEWER SYSTEM
ADEQUACY TEST DATE-JULY 15 1985
THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 380 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 70_.0 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
3 BEDROOM HOME.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR
THIS 3 BEDROOM HOUSE.
THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON JULY 16 1985 .
FLOW TEST ON WELL
WELL FLOW DATE-JULY 15 1985
A FLOW TEST WAS PERFORMED ON THE WELL. 700 GALLONS OF WATER WAS
PUMPED AT A RATE OF 7 GPM OVER A DURATION OF 2 HOURS.
THE DRAWDOWN WAS 1.65 ' WITH A RECOVERY TIME OF i0 MINUTES
AND THE STATIC WATER LEVEL WAS 61.9 FEET.
THE WELL IS ADEQUATE FOR THIS 3 BEDROOM HOME.
1200 Wcsl 33r(I Au~nu¢, $uii¢ B,,AncNora§¢, ^lasNo 99503,(907) 561-50/40
APPLI( " NT FILLS OUT UPPER HAt ONLY
Address Zip Code
Realty Co. & A~nt
Address Zip Code
Street Locat,~ ~ ~ y ~O~ ~r) A ~
Ty~f Resi~nce '
~Singla Family
~ ~ultiple Family No. of Bedroo~ ~
~ Other
Water Supply
~ Individual A~ACH WELL LOG. A.w~I log is required for all wells drilled since ~une
~' Community For wells drillad prior to that date, give well depth (attach log if available).
D ~ublic Utility
Sewer Disposal / ¢~ ~
lndividual Year Individual Installed:
~ Public ~ility When Connected to Public Utility:
~ 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 Inspector
( L.~[APPROVED BEDROOMS ~ *CONDITIONS OF APPROVAL
( ) DISAPPROVED
( ) CONDITIONAL APPROVAL*
Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received
~'--/-- ~ ~c__~ Well to Tank Septic Tank Size
72,023 (3182)