HomeMy WebLinkAboutLITTLE TINY LT 1
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
Pump Installation Log
Well Drilling Permit Number: _______________ Date of Issue: ____-____-____
Parcel Identification Number: ____-____-____
Legal Description Block Lot Property Owner Name & Address:
Pump Installation Date: _____-_____-_____
Pump Intake Depth Below Top of Well Casing: __________ feet
Pump Manufacturer’s Name: ___________________________ Pump
Model: _____________________________________
Pump Size: ____________hp
Pitless Adapter Burial Depth: _________ feet
Pitless Adapter Manufacturer’s Name: ________________________
Pitless Adapter Installer: ____________________________
Well Disinfected Upon Completion? XX Yes No
Method of Disinfection: _____________________________
Comments:
Pump Installer Name: __________________________________
Company: ___________________________________________
Mailing Address: ______________________________________
City: ___________________ State: __________Zip: _________
Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation.
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP231328 PID Number: 015-053-30
Dwelling: NO Single Family (SF) ❑ with ADU ❑ D Duplex p (D) El Two Single Family Project: ❑New ❑Upgrade
Name 6:--,a-id F t '1
C/O JORDAN ANDERSON (A.C.E.S.) I Z#- ABSORPTION FIELD
Site Address ❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound
9600 CARLSON ROAD *ANCHORAGE, AK ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
1-907-223-2305 7 n a _ _ I a f%
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Lf I IZ12Y c1d,
LEGAL DESCRIPTION
�-•�- vrvtor i v
Depth to pipe invert from original grade
SEE DWG. Ft.
Ft.
Gravel depth beneath pipe
6 Ft.
Subdivision Block Lot
LITTLE TINY; LOT 1
Fill added above original grade
SEE DWG. Ft.
Gravel length
110
Township Range Section
NIA
Ft.
Gravel width
2.5
Beds: Number of Lines
-
Distance between lines
SEPARATION
DISTANCES
To
Septic
Absorption Holding Sewer
Lift Station
Ft.
Total absorption area
Number of trenches
- Ft.
Dist. between trenches
From
TankField
Tank Line
1320 Ft2
1
15+ Ft.
Well
100'+
100'+
_
_
G
25'+
TANK 9 Septic [:1S.T.E.P. F-01Holding El Other
Manufacturer Capacity
Surface Water
100'+
100'+
_
_
GREEK 1500/1000 Gal.
Material
Number of compartments
Lot Line
10'+
10'+
-
-
NA
PLASTIC
1/2
Foundation
10'+
10'+
_
_
LIFT STATION
_
Manufacturer Capacity
Remarks PER CONTRACTOR OLD TANK WAS HAULED OFFSITE
Gal.
Alarm loc�atio'n,, Electrical installed by
Installer
PIPE MATERIAL House to tank EXISTIN Tank to D3034
drainfield
A.C.E.S.
Drainfield D3034 CO/MTD3034
Inspector GEG AND M.O.A.
BENCH MARK (Assumed elevation) 97.49 ft
Inspection ection 1s` 10/4/2023 2"d 10/4/2023
Location and description
3rd 10/5/202 0' _
TOP OF MANHOLE
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
064
Conditional Approval: Date
OF
ov ��• .-�/s,��
�......... ... ............�
�. .. ...... ............�
rey ASG rness•- t!?Septic
VQQ
Sys te
Approved `�� -��- Date J� t'
s CE-7953
Note: this approval d not include well permit requirements.
V�dp° p,ofess-wn°oma
#AEC M4
(Rev 05/09/1 R1
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PERMIT NUMBER:
OSP231328
RECORDDRAWING PARCEL A NUMBER:
015-053-30
DRIVEWAY ,
E ISTI G +
IL
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o r,
r
/ EXISTING HOUSE
I
I
I
SVS
2j2�
NEW 1500 GALLON SINGLE
COMPARTMENT GREER TANK-\
NEW 1500 GALLON SINGLE /
COMPARTMENT GREER TANK
PIPE LOCATIONS ARE
SHOWN PER AS -BUILT
SURVEY BY SHANE
HOLT, PLS (SIGNED
\ .PDF ATTACHED).
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L\ \
EXISTING DRAINFIELD
-------------------
10' TELE. & ELEC. ESM'T.
KRANICH SID;
LOT 74A
KRANICH S/D;
GROUP, Ltd
LOT 79A
3701E TUDOR ROAD. SUITE 101 ' ANCHORAGE, AK 99507 - PHONE (907) 337-6179' FAX (907) 33&3246 - WEBSITE: mvr.gamessenglneerinp.cam
SCALE:
PHONE NUMBER:
0
1" = 40'
PAGE NUMBER:
E
907-223-2305
2 OF 4
GARly SS E GINEE ING
GROUP, Ltd
ma ENGINEERING & SALES - CONSULTING
3701E TUDOR ROAD. SUITE 101 ' ANCHORAGE, AK 99507 - PHONE (907) 337-6179' FAX (907) 33&3246 - WEBSITE: mvr.gamessenglneerinp.cam
PREPARED FOR:
PHONE NUMBER:
PAGE NUMBER:
C/O JORDAN ANDERSON (A.C.E.S.)
907-223-2305
2 OF 4
LEGAL DESCRIPTION:
DRAWN BY:
LITTLE TINY; LOT 1
D.J.G.
TYPE OF WORK:
DATE:
SITE PLAN RECORD DRAWING
10/16/2023
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Veffrpy A. arness : Q i
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LICENSSOPROF\S\\ ••`••
#AECC884
PERMIT NUMBER: PARCEL ID NUMBER:
OSP231328 RECORD DRAWING 015-053-30
MH1
TOP OF TANK AT INTLET = 92.56
INVERT OF BUNG AT INLET = 91.92
TOP OF MANHOLE = 97.49
FINAL GRADE = 97.16
TOP OF TANK AT OUTLET = 92.55
INVERT OF BUNG AT OUTLET = 91.69
NEW 1500 GALLON H.D.P.E. SEPTIC TANK- SINGLE COMPARTMENT
TOP OF TANK AT INTLET = 92.25
INVERT OF BUNG AT INLET = 91
GRADE = 97.25
TOP OF TANK AT OUTLET = 92.24
INVERT OF BUNG AT OUTLET = 91.36
NEW 1000 GALLON H.D.P.E. SEPTIC TANK - SINGLE COMPARTMENT
E NGINES IJ
9 Ltd
ENGINEERING a SATES �- CONSULiiNG
3701 E. TUDOR ROAD. SUITE 101 ' ANCHORAGE. AK 99507' PHONE (907) 337-6179' FAX (907) 33&3246' WEBSITE: x
.garnessengineermg.com
PREPARED FOR:
C/O A.C.E.S.
PHONE NUMBER:
PAGE NUMBER:
907-223-2305
3 OF 4
LEGAL DESCRIPTION:
DRAWN BY:
LITTLE TINY; LOT 1
D.J.G.
TYPE OF WORK:
DATE:
SEPTIC TANK PROFILE
4/12/2024
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#AECC884
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PERSPIT NUMBER:
2OE31328RECORD LRSVtl PARCEL ID NUMBER:
-30
TH
MT COFINAL GRADE = 94.9-95.6
ORIGINAL GRADE AT
HIGHEST POINT = 94.60
FILTER FABRIC
0
e
g INVERT OF PIPE = 90.60
0
0
o°
6,0-FEET °
BOTTOM OF TRENCH = 84.60
0
00
RELATIVE ELEVATION AT BOTTOM OF T.H. = 78.60
(T.H. DRY ON 6/23/2005)
OF£ �®
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ENGINEERING,) SALES, CONSULTING
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3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE. AK 99507 -PHONE (907) 337.6179 -FAX (907) 338-3746 - WEBSITE: eww, mese
ga Lneenng.com �-f4 c .� � ... •..•••....••.. .0
PREPARED FOR. PHONE NUMBER: PAGE NUMBER: d 1 0
d Cn : J ffrey A,]Earness 4,r v
C/O JORDAN ANDERSON (A.C.E.S.) 907-223-2305 4 OF 4 d C)AeLEGAL DESCRIPTION:C�,-72,3
DRAWN BY: ®� J DLITTLE TINY; LOT 1 D.J.G.��F�'••.•��.\\• �F,®
TYPE OF WORK: DATE: LICENS��O�Pf?nc- SS,v``*141
SEPTIC TANK PROFILE 10/13/2023 #AECC884 ®11YA,&jka®®,q'
OF At 0
s4
CYD. 49 TH`
SHANE A. HOLT
I&,LS-6914
°fession3, Lsoa
N8951'04"E28044
MUNICIPALITY OF ANCHORAGE ivcnr S
On -Site Water & Wastewater Program �o
PO Box 196650 4700 Elmore Road .� i
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
L�Ch8rtillC nt
On -Site Wastewater Disposal System Permit
Permit Number: OSP231328 Effective Date: 9/27/2023
Work Type: Septic Upgrade Expiration Date: 9/26/2024
Tax Code Number: 01505330000
Site Legal Address: LITTLE TINY LT 1 G:2436
Site Mailing Address: 9600 CARLSON RD, Anchorage
Owner: REED GAVIN E & TERRY E & Lot Size in Sq Ft: 90219
Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 7
This permit is for the construction of:
Q Disposal Field Q 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: 5-5 uC-J�) �� I = C Date:
a
Issued By: Date: 2 z�z
� �
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. 015-053-30
Property owner(s) C/O JORDAN ANDERSON (A.C.E.S.) Day phone 1-907-223-2305
Mailing address 9600 CARLSON ROAD *ANCHORAGE, AK
Site address 9600 CARLSON ROAD *ANCHORAGE, AK
Legal description (Sub'd., Block & Lot) LITTLE TINY; LOT 1
Legal description (Township, Range & Section)
Lot Size Sq. Ft. Number of Bedrooms 7
APPLICATION IS FOR: APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field R Initial ❑
Single Family (SF)
(w/wo AD U)
Septic Tank 1fl Upgrade nX
(D) ❑
Holding Tank ❑ RenewalDuplex
❑
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 Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: �� 5� Waiver Fees:
Date of Payment: Z 6 Zo Z Date of Payment:
Receipt Number: Com- Receipt Number:
Permit No. Waiver No.
GADevelopment Services\Building Safety\On Site Water and WastewaterTorms\Client FormsTermit Application.doc
n)1
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231328, Curtis Townsend, 09/27/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231328, Curtis Townsend, 09/27/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231328, Curtis Townsend, 09/27/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231328, Curtis Townsend, 09/27/23
OF At 0
s4
CYD. 49 TH`
SHANE A. HOLT
I&,LS-6914
°fession3, Lsoa
N8951'04"E28044
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
http://www.muni.org/onsite
On -Site Water System Permit
Permit Number: OSP221459
Work Type: Well Upgrade
Tax Code Number: 01505330000
Site Legal Address: LITTLE TINY LT 1 G:2436
Site Mailing Address: 9600 CARLSON RD, Anchorage
Owner: REED GAVIN E & TERRY E &
Design Engineer: ANCHORAGE WELL & PUMP SERVICE
This permit is for the construction of:
Effective Date:
Expiration Date
Lot Size in Sq Ft:
Total Bedrooms:
l�vent
c,
WL f
Department
11/17/2022
11/17/2023
90219
❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well Q 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: ` SSv�,�(� 1 J Date:
Issued By: Date: 2 Z
5
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. 01505330000
Property owner(S) REED GAVIN E & TERRY E & LAMAR GARY T & ROXANN R Day phone 907-529-5833 OR 907-632.0409
Mailing address 9600 CARLSON RD, ANCHORAGE, AK 99507-4326
Site address 9600 CARLSON RD, ANCHORAGE, AK 99507-4326
Legal description (Sub'd., Block & Lot) LITTLE TINY, LT 1
Legal description (Township, Range & Section)
Lot Size 96,219 Sq. Ft. Number of Bedrooms 5
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑
Initial EJ
Single Family (SF) ❑
(w/wo ADU)
Septic Tank
❑
Upgrade El
Duplex (D) Q
Holding Tank
❑
Renewal ❑
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
0
THIS APPLICATION INCLUDES
A WAIVER REQUEST FOR:
Distance:
I certify that the above inf
applicable Munic' odes.
A�
is correct. I further certify that this is in accordance with
V I
(Sign fU of property owner or
Permit/Rush Fees: I �w—
Date of Payment: ((
agent) 1 `
Waiver Fees:
Date of Payment:
Receipt Number: OSS lob � v Receipt Number:
Permit No. OS��a I`15�1 Waiver No.
G:\Development Services\Building Safety\On Site Wafer and Wastewater\Forms\client Forms\Permit Application.doc
ANCHORAGE WELL & PUMPS Sl
6901 Tanaina Drive
ANCHORAGE, ALASKA 99502
(907) 243.0740
SHEET NO. I OF
CALCULATED BY
DATE
CHECKED BY DATE
SCALE
J-
. . . . . ....... ....
T
1 A
........ ....
7
. . . . . . . . . . A
...........
"J
A
.
..... ...... . . ..... _j
. ......... . . . ...... . . . . . . .... . ..... ------
'A -,"P A.
Date Received
STATE OF ALASKA.
DEPARTMENT OF ENVIRONMENTAL CONSERVATION
DOCUMENTATION OF CONSTRUCTION
LITTLE TINY S/D• LOT 1 ❑ Certified Installer
❑ Approved Homeowner
Installer Name: a Registered Engineer
A+ HOME SERVICES Onsite Wastewater System Serves:
Mailing Address Single Family. Number of Bedrooms 7
7501 E. 140fh AVE. ❑ Duplex. Number of Bedrooms
ANCHORAGE AK 99516 ❑ Small Commercial Facility With Estimated
Design Flow of less than 500 GPD.
II. WATER SUPPLY SYSTEM (SECTION 11 IS OPTIONAL)
rce of water and Containment (Check all that Apply) Type of Water Supply System Treatment of Water (Check ail that Apply)
) ❑ Surface (Iderrr fy) ❑ SF/Duplex
❑ Roof hment ❑ None ❑ Chlorination
❑ Holding Tan ❑Other (!dent fy) 11Filtration E3 Mineral Remova
We Data
❑ Public ❑ Other.
Is the hei ht o e well casing more than 12" above the --Al
Is a sanitaryseal or we a installed on the well casing? ❑ Yes ❑ No
es ❑ No
Is drains a directed awa from around the casing within a radius of 10 feet of the well casing? ❑ Yes
Is well wires enclosed in conduit? ❑ No
)ate Drille Depth of Well (Feet)Yes ElNo
Static Water Level (Feet) Yield(f I available
eparation Distance hom the We Casing to eac o the Fo owing o
eptic/Hoing Ta • on Loi es o 'ontammatron ) Pump Rate (IfavailableJ
Sewer Lines Lot A sorption Area on Lot
osest Septtc/Ho mg Tan on Adjacent Lot Feet Feet
osest E ge o
C osest Sewer Lines on ent Lot Fcet
Feet an A sorption Area on
dicate separation distance from toxic material including fuel tanks, paints, lu ' ants and other Feet Adjacent Lot
otroleum based materials, pesticides, fungicides or herbicides to well cas• On Lot I_Feet
On Adiacent �r
❑ Buyer ❑ Engineer
Water Sample Results: ❑ Banker ❑ Government Official
Attach Co ❑ Satisfacto - Date
COmments/RecOnlrnendatio ❑ Unsatisfacto - to
"r
l�certifv that the 'I E! information and that rov
signature ided in our attached drawing . is correct:
r/
Typed/Printed Name Title
JEFFREY A. GAR ESS, Date
P.E. PROFESSIONAL ENGINEER 10/19/2005
ole. 1. This s c,"tion shoul e signed b a Certified Installer•, Professional Engineer, DEC staff, or Owner/Builder /
�. Alli )bile voter syster •eeeive ADEC plan approval prior to construction. See 18 AAC 80 State of Alaska Drinking Water
Re latiabl for specific requirements.
h I
III. WASTEWATER DISPOSAL Legal Description:
Type of Wastewater System:
10 Septic Tank with Conventional Soil Absorption System
❑ Package Treatment Plant (requires engineered design)
❑ Holding Tank: Material Type: Size in Gallons:
Manufacturer:
EJ Other - Specify Type: ❑ Alternate Onsite (requires engineered design)
❑ Small Commercial System (<500 GPD) With Estimated Daily Wastewater Flow of:
Criteria Used to Estimate Daily Wastewater Quantity: Gallons Per Day (GPD)
NEW SYSTEM ❑ REPAIR TO EXISTING SYSTEM
Certified Installer Installation Notification Date:
Name of Installer: A+ HOME SERVICES
Date Installed: 10/6/2005
System Installed: ❑ By a Registered Engineer IN With Inspection by a Registered Engineer
❑ By Approved Homeowner (attach copy of approval letter) ❑ By a Certified Installer/Installer Number
Septic Tank: Material: Manufacturer: SizeGallons
STEEL ( ) Number of Compartments:
ANCHORAGE TANK 2000 2
Type of Soil Absorption System: Deep Trench ❑ Shallow Trench
❑ Seepage Pit ❑ Bed
❑ Mound ❑ Other, Specify
Soil Classification: SM Soil Rating: 0.5 Dimensions/Size of Absorption Area: 2,5' X 1 10
Grading/Size of Distribution Rock: 3/4" TO 2 1/2" Thickness/Depth of Distribution Rock: g
Percolation Test Results, Attach Copy of Report:
Percolation Test Performed by:
7.5 Minutes per Inch N/A Sq, ft. per bedroom GEG Ltd.
percolation test results must be sealed/signed by a registered engineer.
List ground cover in feet over: Septic Tank: 4'+ Absorption Area: 4'+ Sewer Pipes: A'41.
Cleanout Pipes/Caps Installed: Foundation Cleanout: YES Septic Tank: YES Monitor Tubes: YES
Indicate separation distances from septic tank or absorption area, whichever is closest to, to all nearby:
Public drinking water sources within 200 feet: 200'+ Private drinking water sources within 100 feet: 150'+/100'+
Nearest water bodies (see 18 AAC 72.020(b)): 100'+ Lot Line: 10'+
Separation Distance from Onlot Sewer Lines to: Public Drinking
b Water Sources: 1001+ Private Sources: 25'+
Separation Distance from Bottom of Distribution Rock to:
Groundwater Table: 4'+ Bedrock: 6'+
Separation Distance from Absorption Area to Slope exceeding 25%: 50'+
1 certify that the above information, 11 11 1
and that provided in our attach
Signature ed drawings, is correct:
Typed/Printed Name Title, Reg./Cert No., Inst. No.
Date
JEFFREY A. GARNESS, P.E. PROFESSIONAL ENGINEER
NOTE: Must be signed by a Certified Installer, Professional Engineer, DEC staff,' or Approved Homeowner. # engineering seal bears printed name,
registration number, and is signed, those bloc!; need not be completed for engineered submittals.
SEAL
Registered Professional
Engineer
10/19/2005
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EXISTING
2 BEDROOM
i TRAILER r"
4DBL
/ DBL2 A
-4-1- NEW
2000 GALLON
SEPTIC TANK
CO DT
CO M13
CF TH#2 {{ /
{ { { { { DRA NI LD
tt
t 1 MT \ 1\ \ CFLAT
FLAT 11 \
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FbNATE SITE \ \
10' UTILITY EASEMENT
NEERING G,
ROUP, Ltd
CONSULTANTS $ GENERAL CONTRACTORS
3701 E MOOR ROAD, SLUE 101 • ANCHORAGE, AK 99507 • PHONE (907)337-6179 • FAX (907)338-3246 • WEeWE; rww.gamnananpinoarinq.00m
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
GAVIN REED 346-1370
LEGAL DESCRIPTION: 1 OF 2
LITTLE TINY S/D; LOT1 , DRAWN BY:
B.F.M.
TYPE OF WORK: DATE:
AS—BUILT FOR NEW SEPTIC SYSTEM 10/19/2005
(Rev. 01/05)
XISTING WELL
ERVES THE 5
DROOM HOUSE
AND THE 2
)ROOM TRAILER
N
SCALE: = 40'
e rey A. arness.:
�49
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Q
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A B
STI
98.89 119.34
ST2
107.10 120.10
DBL1
18.64 75.83
DBL2
19.74 76.31
DBL3
94.68 117.00
DBL4
95.90 118.10
C01
112.10 121.06
MT1
111.62 119.83
CO2
179.52 143.51
MT2
144.45 126.86
DTI
109.09 120.36
DT2
109.53 120.40
MT3 1178.561142.24
D813-
DBL4-
` Srt
EXISTING
2 BEDROOM
i TRAILER r"
4DBL
/ DBL2 A
-4-1- NEW
2000 GALLON
SEPTIC TANK
CO DT
CO M13
CF TH#2 {{ /
{ { { { { DRA NI LD
tt
t 1 MT \ 1\ \ CFLAT
FLAT 11 \
\``TH#1 ,` \
\ \\ \
CMT \\
\ \
z
FbNATE SITE \ \
10' UTILITY EASEMENT
NEERING G,
ROUP, Ltd
CONSULTANTS $ GENERAL CONTRACTORS
3701 E MOOR ROAD, SLUE 101 • ANCHORAGE, AK 99507 • PHONE (907)337-6179 • FAX (907)338-3246 • WEeWE; rww.gamnananpinoarinq.00m
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
GAVIN REED 346-1370
LEGAL DESCRIPTION: 1 OF 2
LITTLE TINY S/D; LOT1 , DRAWN BY:
B.F.M.
TYPE OF WORK: DATE:
AS—BUILT FOR NEW SEPTIC SYSTEM 10/19/2005
(Rev. 01/05)
XISTING WELL
ERVES THE 5
DROOM HOUSE
AND THE 2
)ROOM TRAILER
N
SCALE: = 40'
e rey A. arness.:
�49
CE 795
Q'p_ 'Ofess10110,��..o
O
U)
J
Q
U
PERMIT NUMBER:
AS -BUILT DRAWING
PARCEL ID NUMBER:
TOP OF TANK A'
INLET = 97.10
INVERT OF BUNG
AT INLET = 96.54
Lk kY. /—FINAL GRADE -
ORIGINAL GRADE 100.42-101.12
— 98.56-99.56
FlLTER FABRIC
INVERT OF PIPE
95.54
BOTTOM OF
TRENCH =
89.54
rtGxARNESS ENGINE.-----"
ERINTG GROU.p, ,
CONSULTANTS & GENERAL CONTRACTORS
3701 E TUDOR ROAD, SUfiE 101 • ANCHORAGE, AX 99307 - PHONE (907)337-6179 - FAX (907)338-3246 • WEBSITE: cam
tfi
PREPAREDTOR: PHONE NUMBER: PAGE NUMBER:
GAVIN REED 346-1370 2 OF 2
LEGAL DESCRIPTION: DRAWN BY:
LITTLE TINY S./D; LOT 1, B.F.M.
TYPE OF WORK: DATE:
PROFILE FOR SEPTIC SYSTEM 10/19/2005
(Rev. 01!05)
TOP OF TANK AT
OUTLET = 97.04
INVERT OF BUNG AT
OUTLET = 96.15
ey A. Garness:
�CE-7953
• •�cQO
'��•� �.b�f3J F,°o'er
p"ofessi0fi000 /
"O -' -• -"''P - `'•1:": 907u=111c•3a L11c111UV`IO6 G(GUP: Lt0•
Stat; of Alaska
DQpaz-trnent of Environmental Conservation
CERTIFICATION OF CONSTRUCTION
FOR
DOMESTIC WASTEWATER SYSTEMS
f'10. J 4 9 5 F. 2 f*@at)7
Instructions: •
1. Within 30 days after the construction, installation, or modification of a project is completed, the owner, the
contractur(s) responsible for consrrtictin; the project, and,a registered engineer responsib t for construcl'tOU.
inspection, mull coniptete and sign dris form declaring that the project was constructed in accordance with Ut<vmost
recent Deparmtent-approved plans, or in accordtmcc with the attacried as -built drawings. "
2. tf a project is being completed in phased constniction, a map shall be attached showing that portion .of the Pro�Gfa:
being declared completed on the date stated in the Owner's Section. Completion of each phase of.1 projett roust ae i
declared as it is completed. Additional Certiftcittion of Construction forms are available. from 8ny Department of�
Environmental Conservation office.
•...............Ia...R/a.R......................0.ii/a.............Obi..................
...aa..a Ra R. a..♦.x...a............li '
Please type or print, excepffor xign aturc; SECTION A.- owner's Scction
Name and brief description of project: LA
Name or Owner; ADEC Project No. � r` 1,, i
Address:_ �ei Date Project Completed: / /:
1 certify that I am the owner of the above -referenced project: I furthcr ccrtify that this project was consinic'ted in act:oxdartce
with the latest plates submitted to and approved by the Alaska Department of Environmental Corlsrrvation.(ADEC), or in
accordance with the attached as -built drawings. 1 undersi7nd that 1 may be required to take remedial measures to corte}rraity, .
construction which was completed Will=( prior ADEC approval, whieh<departs from the approved plans.and wtticn is fhund.• .
w hhee inn^c'onnssiistent with e -a p ua i regilirements of AL)EC vrastewater disposal regulations (I S AAd iy).
Sip Owner (Please Sign in Ink) Date
24.
certify that 1 (or} individual Under }ml direct sapervisior,) have conducted an ins t c- s c
p_�tion : t . prn;cCt r ,erenced in Section
A. or po tions orfn� projc.i Which 1 had the ki +, , {, ,
InfotlflatiOTi, rcSuti 25}'flir 1"01- C0-QMTUCti^`, ud flu,t t. is btrfr, f my k,
7 lii U....t � J .Zo L('11i3`e LtPi:
Cllr project, o, those posons, w, ;;s or wcr c constructed in accordance v+ith rhe latest plans suhn�itted to and
at l;roved by the r;l„$%3 DCi"Ja;?I2iC/]i, 0 En; irp17 I Cr,titl COnServa!iw, Or IA aCCOrd311CC Witll t17I itrjaChed 25 -bunt dr0lyln&5,
IQ
Name of Contractor Signature of Contractor (please sicn in ink)
For multiple contractors, if applicable;
Name of Contractor Signature Of Contractor (please sign in ink)
Date
Date
Name of Contractor Si. -nature ,of Contractor (please si?n in ink) jute
........... ............... ..................................... ,.....,..................... ...........
,
•� tiT C- EnginFcr''S 58Crt6J1
1 certify that i (or any individuid under my direct supervision) have conducted an inspection of the above referenced project;
and that to the- best of my knoAalcd_e and information, the project was censtructed'ln accordance with: (check orn of the
following)
the latest plans submitted to and approved by the Alaska Department of Fnvironmental Conservation
or
in aeeUrdtrnc; With the attached as -built drawings.
Sjvnaiure of Professional Engineer
Responsible for Construction )nspection
(Please Sign in Ink)
•iyjiv,^ri o7 PFi;ru:ii 1Vaic7C' 04 ;'ofessmnal Engju4Vr
`31-2100s 1,101.4 0 :53PM ID:
State of Alaska Dale
Professional Engineer
Rc`istrltion Numbi:r
Pnrr:-.
35
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 /P"ONE [ [] NEw
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION NO. OF BEDROOMS
J Well Absorption area DwelJin~o/W PERMIT NO,
2 ~ DISTANCE TO: ~/~ i /O / 8~
~ ~ Manufacturer Material No, of compartments
~ ~ Eiq. capacity in gallons inside length Width Liquid depth
/~ O IF HOMEMADE:
~ ~ DISTANCE TO: Well Dwelling PERMIT N0.
~_~O Z ~ Manufacturer Mate6al Liquid capacity in gallons
D Well ~ Foundation Nearest lot li0e PERMI~ NO.
~ ~ DISTANCE TO: /0/ G~ / ~/0' ~ 3 05-0 G
~ NO. of lin]S Length of each line Total length of lines Trench width Distance between lines
-- FO~¢ / O~/ ~ ¢inches
~ ~ ~ Top of tile to finish grade Material beneath tile Total effective absorption area
Length Width Depth PERMIT NO,
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest Jot line
~ DISTANCE TO:
~ Class . Depth Driller Distance to lot line PERMIT NO,
~ DISTANCE TO: Building foundation Sewer line ~ Septic tank [ Absorption area(s)
OTHER
PIPE MATERIALS ~50~ ~
D3o8~¢ N
SOIL TEST RATING
INSTAELER ~O ~¢ ~
REMARKS
f I / -
/
O ~ D~PT. OF EAUH
El VIR(~NM: NTA PD)TEC;'ION
] JUL
APPROVED LEGAL RECEIVED
PERMIT NL-L
DEPRRTMENT L,F HEFILTH FIND EN',,,'IRONMEIqTRL P'ROTEC:TtF'~N _,,¢-.._ '"L'"=,TF..EET.,'- ' RNCHORRGE., Rt--':.:. 9950:I.
~-~ ~-.~ .... ~ t -iF ~ .-- .
,' ;--L--.':E~506 ;:,
FIPF'L I CFiNT
LOZATI ZN
LEGFtL
HBR'¢E'T' EVFINS,, ]:60 I.::: STREET
TZ2N Ri-':H Gi-F,,,'-"T Lilt 66 ,.'::: 7t
T'¢PE OF ':;OIL RBSORF'TION:,'-'"-T'-~'T_-, . r_,', IS: TF, EN_.H-'
LOT SIZE
276-t560
999999 SL.-.!UFiRE FEET
MR::,:,'IMIJM NI,_IME:ER AF BEDROAMS = 5
SFIIL RFITING ,:iSl..-.! FT,.."BR)= '-265
'THE REQI_tlRED SIZE OF THE SOIL FtBSORF'TION :,'r=TEH IS
E:'EF"TH= 1
.- ~ E~'-,~-3TH= 1£t~.~1 ~.3 F: FI %-' E L_ [:"EF"TH=:
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF 'THE TRENCH OR DRRINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETHEEN THE SURFRCE OF THE
GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET).
THERE IS NO SET HiDTH FOR TRENCHES.
THE GRFIVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETHEEN THE OUTFRLL PIPE
RND THE BOTTOM OF THE EXCRVRTION (IN FEET).
F-:EC-~.L~ I RE[:. SEF'T i C: TFif~[::] "_--] Z ZE-- '1 5C~ ~Z~ L-~FILLE~f-~'_-~
F'ERMIT FIF'F'LICFINT HI=IS THE RESF'ONSIBILIT'-r' TO II",tFORM THIS DEF'FIRTMENT DURING THE'
INSTFILLFITICIN II",tSPECTIFtNS OF FIN'¢ HELL'--; FIDJFiCENT TO THIS F'ROPERT"? FIND THE
NUMBER OF RESIDENCES THFIT THE .WELL HILL SEF-:',,,'E.
BBCKFILLING ElF BF,IV S'T'STEM HITHOUT FINBL IN=,F_L. TIUN'- 'F-' - BND FtPF'F.'.O',,,'FtL E"¢, THIS
DEPFtRTMENT HILL BE SUBJECT Tn PROSECUTIEIN.
MINIMUM [:,ISTFINC:E BETHEEN F! HELL FIND RN"r' ON-SITE SEHFIGE DISF'OSFIL S?S"FEi"I IS
±0C'~ FEET FOR FI PRI'v'FITE HELL OR ±5E'~ TO 2.';.:'~C'~ FEET FROH FI PUBLIC HELL DEPEN[:'II",IG
UPON THE 'T"r'PE OF PUBLIC HELL.
MINIMUH DISTFII"',ICE FROH FI PRI","RTE HELL TO FI PRI'v'RTE SEHER LINE IS 25 FEET FIND
TO R COMHUNIT"? SEHER LINE IS 75 FEET.
OTHER REQUIREMENTS I'"IFIV FIPPL",". SPECIFICFITIONS FIND CONSTRUCTION DIFIGRFIt"IS FIRE
FI","FIILFIBLE TO INSURE PROPER INSTFILLFITION.
F'F F41Pl I: T E::-::F' .][ F-:E :.~; [:, E C: E--2 I"1E: EF-: _---=:±.. ::L 9 :E:,2<
i CERTIFV THBT
l: I FIM FRMILIFIR HITH THE REQUIREMENTS FOR ON-SITE SEHERS FIND HELLS FIS SET
FORTH BV THE MUNICIPFILIT9 OF BNCHORRGE.
2: I NILL INST8LL THE SYSTEM IN BCCORDRNCE WITH THE CODES.
3: t UNDERSTFIND THRT THE ON-SITE SEWER SYSTEM MFIY REQUIRE ENLRRGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THRN 5 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:
LEGAL DESCRIPTION:
1
§
7
8
g
11
13
14
15
16
17
18
19
2O
DATE PERFORMED:
' "= -
SLOPE
COMMENTS
SITE PLAN
WAS GROUND WATER S
ENCOUNTERED? i~' ~ L
O
P
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN
~'~7/~-b (minutes/inch)
/~ FT AND ~.5 FT
DATE: 6-- ?'P'I
APPLI¢ .NT FILLS OUT UPPER HAt-'' 'ONLY
Mailinglddre~ '~. ~ ~ j~/) ~- Zip Code ~,~p
Buyer J~ ~ 5~ I/~ l / ~ ~ ~ ~
Address ,~ ~ /~/~.~. .~ ~. ' Zip Code
Realty Co. & A~nt ~]'/~: ,~/~,~ Y ~ e (~
/
Type of Resi~nce ' /
Multiple Family No. of Bedroo~
~ Other
Water Supply
Individual A~ACH WELL LOG. A w~l log is required for all wells drilled since June 1975.
Community For wells drilled prior to that date, give well depth (attach log if available).
~ Public Utility
Sewer Disposal ~.
Individual ' Year Individual Installed:
Public Utility 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
Insp~tor Insp~tor Insp~to,~¢~ ~ I Insp~tor
. _? , ~ JNICIPAb
Field Notes:~'~'~, ~'1,.;~¢22.¢~ ~ ~. ¢ /"% :'?' ~ ~ DFPT.
(~) APPROVED BEDROOMS *CONDITIONS OF APPROVAL
( ~ ) DISAPPROVED
Soils Rating Date ~wer Installed Well To Absorption Area Well Log Received
Well to Tank Septic T~k Size
72-023 (3/82)