HomeMy WebLinkAboutHIGHLAND TERRACE #2 LT 14
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 Wastewater Disposal System Permit
'LAI Cnt s
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Department
Permit Number: OSP231264 Effective Date:
Work Type: SepticTank Upgrade Expiration Date:
Tax Code Number: 05031203000
Site Legal Address: HIGHLAND TERRACE #2 LT 14 G:0155
Site Mailing Address: 10900 CORRIE WAY, Eagle River
Owner: FRANK MICHAEL & LINDA G Lot Size in Sq Ft:
Design Engineer: ARC TERRA CONSULTING INC Total Bedrooms:
This permit is for the construction of:
8/16/2023
8/15/2024
38160
❑ 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: /"T (LCC T.i 12- rUi- Date:
Issued By: Date: Ily / -Zoz-_3
4
MUNICIPALITY OF ANCHORAGE
q o's vi
. t
Development Services Department ` r Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 050-312-03
Property owner(s) Linda Frank
Day phone
Mailing address 10900 Corrie Way, Eagle River, AK
Site address 10900 Corrie Way, Eagle River, AK
Legal description (Sub'd., Block & Lot) Highland Terrace #2 Lot Lot 14
Legal description (Township, Range & Section)
Lot Size 38,160 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑
Initial ❑
Single Family (SF) IN
(w/wo ADU)
Septic Tank
❑X
Upgrade ❑
(D) El
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.
Dea Duffus
(Signature of property owner or authorized agent)
Permit/Rush Fees: coWaiver Fees:
Date of Payment: /$ 2o2 3 Date of Payment:
Receipt Number: �� U -z -3 Receipt Number:
Permit No. D S P Waiver No.
G:\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231264, Curtis Townsend, 08/16/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231264, Curtis Townsend, 08/16/23
Municipality of Anchorage Page ~of
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 Inspection Report
Permit Number: S~')¢[~0~'~0c~ PIDNumber: ~ ~/~ O~
N~.:Wastewaler System: ~ New ~ Upgrade
· ~d,.,,: ABSORPTION FIELD
NO. ol Bedrooms:
Phone: ~¢~ '~52~ ~ ~ Deep Trench ~ Shallow Trench UBed ~ Mound ~Other
LEGAL D ES C R I PTI O N sci, Rating~ '6 Total O~lh from original grade:
GPD/Sq. Ft.
Block: Subdivision: Depth lo ~ipe bollom Irom original grsde: Gravel depth benealh pipe
I
' Gr¢~el ~ Number of Ilne~; Oi~l~n~ ~e~ libel:
WELL: ~ New Q Upgrade ~1~ ~' Ft. ~ N/A F~.
Classillcadonp~(Privale. A.B.C): l'ola~Oe~lh: FL Cased~To:~ Ft. Tolat absorptlon~area: SQ. Ft. PIpe~material:
Driller: Dale ~rilled: Static Walet Level: Inetaller: Dale inslalled:
m Y e d: /0GPM Pump Sel ~ FL Casing Hemghl~*,o,, o,o,.0:~,. TANK
SEPARATION DISTANCES ~Septtc [: Holding a S.T.E.P.
To Se~llc Absorpllon LIfl Holding ~u~ll¢~riva[~ Manutacturer: Capacity in gallons: ~
From Tank Field S~,,,on Tank Sew,r LIne, ~N~H. ¢~ ~
¢~O
S~r,.~, W~ I I LIFT STATION
Water
I
Lot ¢ ~OI 4 ~ + ~O f Size in gallons: Manufaclurer:
Line - ~5 -
Foundation ~ ~ ~ ~OI ~/~ "Pump on" level al: "Pump oH" level at: High wa tr alarm
Pump Ma~e & M~el I Electrical Inspections performed by:
Curtain ~/& d~ /
Drain
Remarks: CM~ ~%l~G ~% ~E [x¢6~b BENCH MARK
' ~; '- '
ENGINEER's SE~''~ ~
z...,- . ~o~'~.~z ;% ,' ~.,
InspeCtions performed by: ~~% Dates: 1st II-ol- qq , .~,,~ _
2nd ~l-Ol-q~ ' "" '
Department of Health and ~uman Services approval ~,,'o,,~.~ . , ..... ~..~,,.,..~,., .~. .....
Reviewed and approved by: ~ ~ ~Date: ~ - 7- ~
DEC-22--95 ~RI 10:48 SEW~R~ ~ ASSC)C LA~D SURV 9~? 6940~30 Po~I
RECE{VED
J,:.., . 2
{vumi<:;pWJty of Anchorage
f)ept, fler. dth & Human Services
HEREBY CERTIFY .THAT I HAVE SURVEYED THE
~Wl~ D~CRIBED PROP~:
I~iCA~. IT 18 THE RES~N~BILI~ O~ ~E
~1~ ~ N~ ~R ON THE ~ ~J- ~.
VISI~ P~T. U~ NO ~RCUM~AN~ S~ F~ ~-, 1~-4~ ."m~
December 22, 1995
Jim Williams
On-Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Louis Butera, P.E.
Registered Civil Engineer
DEO 2 2 1995
Municipality of Anchora
Dept. Hei]!fh & Human Ser~/gices
Re: Highland Terrace//2, Lot 14
Dear Mr. Williams:
We are addressing the location of a septic leachfield installed in 1994 and previously approved
which is now located under a driving surface and the property is in the process of Health
Approval.
After consulting with tile owner we can provide for posts to be installed around the tank location
to prevent any vehicle traffic over the tank. These will have to be installed in the spring and a
conditional approval is acceptable with money escrowed if necessary for this construction which
the owner intends to perform. It is expected that there will be 3 all weather wood posts on either
side of the tank extending 4' above ground level.
The leachfield is located in a position where eliminating vehicle traffic entirely is not practical.
The position of the field is diagramed on the attached survey asbuilt. As shown, vehicle traffic is
limited to a snow removal vehicle stored under the canopy. Vehicles are not parked directly over
the leachfield. Private vehicle traffic to the house and shop does not pass over the leachfield area.
There would be no reason for heavy vehicle traffic over this area. We are requesting the use of
code chapter 15.65.030 H in the evaluation of our request for Health Approval as we are certain
that this leachfietd system will function as effectively as a system located outside a parking
surface.
This is based on the following Engineering data:
1. The Leachfield has a depth of cover of 6' of soil material. The depth of cover was
measured by use of a level and is shown on a revised asbuilt, which is attached. This cover depth
would effectively protect the system from any expected vehicle loading.
\G:\WPDOCS\1994\94-072A.NAR
P.O. Box 773294 . Ea~le River. Alaska 99577 · '¥elar~hone (9071 694-5195 · P;~,~ f9(}71 R94-Fv~q7
2. The entire system is insulated with burial foam providing an effective burial depth of
8' of em'th cover. This provides protection from the only other detriment which is frost. We could
perform a detailed frost penetration calculation but instead defer to the MOA AWWU design
Criteria Manual (copy attached) which states that the standard depth of cover to prevent freezing
is 8'.
3. This is a deep trench system which is the type of leachfield least affected by deep burial
under a driven surface.
4. All clem~outs are provide with steel flush covers to allow location and accessibility. The
end of field cleanout and monitor tubes are located in a fenced area outside the parking site. All
cleanouts have been swing tied on the revised asbuilt.
5. Reserve area outside the driving surface is adequate and shown on the attached asbuilt.
Soil conditions and ground slope are consistent thru this area providing suitable reserve leachfield.
If you have any questions please call our office at 694-5195.
Sincerely,
Louis Butera, P.E.
RECEIVED
\G:\WPDO CS\1994\94-072A.NAR
36 inch 0.046 11.28 R [~ C ~ iV [~ D
42 inch 0.037 15.27
48 inch 0.031 19.95 b[~0 2 2. 1935
54 inch 0.028 25.48
60 inch 0.027 31.10 ~vlu~:c,pah.'.y Ol Anchorage
Oept, Health & t-luman Service
Slopes slightly less than those required for the 2.0 feet per second velocity when
flowing at peak capacity, will be permitted only with written approval from
ADEC. Such decreased slopes will only be considered where the depth of flow
will be 0.3 of the diameter or greater for design average flow. Whenever such
decreased slopes are selected, the design engineer must furnish with his report
his computations of the antic!pated flow velocities of average and daily or
weekly peak flow rates. The pipe diameter and slope shall be selected to obtain
the greatest practical velocities to minimize settling problems.
Where soil conditions so warrant, sewer on slopes in excess of twenty (20)
percent shall be secured through the use of concrete anchor walls or other
anchor protection.
Minimum Anchor Spacing
Slope Center to Center
20 - 34% 35 feet
35 - 50% 25 feet
51 + 15 feet or concrete encasement
~ZP,_I~pth of Cover
In general, sewers shall be sufficiently deep to receive sewage from basements and
to prevent freezing. The standard depth of cover for lateral sewers is eight (8) feet.
This depth is to be maintained providing the system will still flow by gravity. If
eight (8) feet is unattainable, exception will be considered by AW*WU Planning
Section. On profile, show elevation of origi,n, al ground, finish grade and sewer
inverts at each manhole. Sewer mains less than five and one-half (5 1/2) feet deep
require an arctic protected pipe approved by the Manager of the AVvAVU
Engineering and Planning Division.
31.02.01 Miniraum Depth of Cover
Minimum depth of cover for gravity sewer is three and one-half (3 1/2) feet. If
this standard cannot be maintained, a lift station shall be designed.
31.02.02 Maximum Depth of Cover
The mathematical formulas are given by pipe manufacturers for determining
the necessary pipe thickness for a given combination of internal pressure and
external load. Also included are homographs for the quick determination of
pipe thickness for various combinations of standard conditions.
31.02.03 Deep Service Risers
Deep service risers shall be installed where the sewer is in excess of twelve (12)
feet deep (see MASS, "Standard Details"). If a deep service riser is used, it shall
be designed to a height such that a service connection to the lowest elevation on
the lot being serviced shall have eight (8) feet of cover. This elevation shall be
shown in the profile.
-21-
AXIzWU DESIGN CRITERIA
f
Municipality of Anchorage pa~e / of ~'
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 Inspection Report
Permit Number: "~1"'3~O¢'~O~ PIDNumber: ~ ~/~ ~
N~: Wastewater Syslem: ~New ~ Upgrade
~ / ~/~ F~.~I~
Address:
~ ~/~ ABSORPTION FIELD
No. el Bedrooms:
Phone: ~ '~--~ --.,r~C ~ ~ Deep Trench ~ Shallow Trench ~ Bed g Mound ~ Other
LE GAL D ESC RI PTI O N so,, Ratingb -S Total O~h from original grade:
GPO/Sq. FL __
Lot: Block: Subdivision: Oepth lo pips boltom from original grads: Gravel depth beneath pipe
Township: /¢~ Range: /~ Section:7 Fill added above original grade: Grnvel length:
Gravel 6op~h; Number of lines: Distance belween lines:
WELL: Z New ~ Upgrade ~1>~ ¢ Ft. ~ I N/A Ft~
Classification (Private, A,B,C): Tota~ Oepth: Cased To: Total absorption area: Pipe material:
Driller: Date ~ril[ed: SlaticWaler Level: Installer: Date installed:
Casing Heighl Above Ground:
Pump SoI~ TANK
SEPARATION DISTANCES ~Septic O Holding O S.T.EP.
TO Seplio AbsoCption Lill Holding ~ubfic/Private I Manufacturer: Capacity in gallons:
From Tank Field Station Tan, S .... Lines ANcH. ¢~N~ I,~
w,, ¢ I~' 111 ' ¢/~ W4 ~, Materlah5%6~¢ Number of Compartments:
SurfaCewater N/A I ¢' LIFT STATION
LineL°t ~ ~Ot 4_ ~ ~ ~ ~O~ Size in gallons: { Manufacturer:
Foundation ~ ' ~ ~OI ~/~ "P~mP on', level al: "Pump off" level at: High wai ~r alarm at:
Curtain ~/, ~ Pump Make & Model ~ Eleclrical Inspections performed by:
Drain'~ ~ ~ ~ /
Remarks: ~ ~%~ ~ ~g ~~ BENCH MARK
location and Description:
:ENGINEeR's sEAE:*' :,
Inspections performed by: ~[~5 . Dates: 1st II-O!- qq . ..,, . ..
2nd II-OI- q"~ ~" %" ?:_', ',.. :x,:, m
Department of Health and ~uman Services approval
Reviewed and approved by: , Date: /Z- 7'-
72-013 (1/91) MOA 25
Page
ECEIVED
Municipality of Anchorage
o6r\
DEPARTMENT OF HEALTH AND HUMAN SER~fe~§~aitha Human~"""
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
PIE) No.: o2-o- 3/o - 03'
N 89°58'0" E
Z
APPROX EX1ST1NG
GARAGE FOUND.
LOCATION
50' X 32'
]250 GAL /'4
SEPTIC
B-D 72.2 '¢'0+~%
~_ DETAIL
ELEVATIUNS
(NOT TO SCALE)
~40.00
~U~D ~v . ioo.oo
APPRBX
PROPOSED
3 BR HOUSE
LOCATION
36' X 38'
LOT ]4
PROPOSED
WATER LINE
/
WELL SITE
840.00 /
SCALE 1" = 40'
/ · MONITOR TUBE
o SEWER CLEANOUT
~ O- - WELL
LEACNFIELD
EASEMENT
SULLIVAN WATER WELLS
P.O. BOX 870272, CHUGIAK, ALASFJ~g9667 · TEL~HONEe66.2;5~
, /
. , " DRAW DOWN ~.
DATE-
S(arted
KIND OF FORMATION:
F, om D
From__.Fl. to Fl',
-Ft. 1o. _~Ft,
Ft. to_~Ft._.
Ft. to_ _
__~Fl. to_~
.Ft, lo,
FI. lo__
From,~FI. to.
From__ , Fl-lo____Ft.
From__Ft. to Fl.__
FrOm ~Ft, to_~Ft.
From , ~Ft, to_ Ft
From~ FI. ~o- -Fl,
From. Ft. to Ft
From Fl, lO _Ft.
From. Pi', ~'o...-. Ft.
Frolla _,Ft. to_ _Ft._
From Ft, lo~.-~-~ Ft,_
From___.Fr. to_ -Fl,
From~Ft. to Ft._
From~FL to Ft,
From~Ft, to~ Ft.
From FI. to Ft,
From Ft, to Ft.
From Ft.~o_ _Ft__
MI~CL,. INFOI~'AATION:
DRILLER~ NAME ~~
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH ~ HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHOPJtGE, ALASKA 99519-6650
PAGE 1 OF 1
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW940409
DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES
OWNER NAME:FRANK MICHAEL & LINDA G
OWNER ADDRESS:10900 CORRIE WAY
ANCHORAGE, ALASKA 99577
DATE ISSUED:10/25/94
EXPIRATION DATE:10/25/95
PARCEL ID:05031203
LEGAL DESCRIPTION: HIGHLAND TERRACE #2 LT 14
LOT SIZE: 38160 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL 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 (iSAAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 (24 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 PROVIS IONSj~ ~7
RECEIVED BY: (~-~,~ / ~
Louis Butera, P.E.
Registered Civil Engineer
October 13, 1994
Jim Cross, P.E.
Manager, On-Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: Highland Terrace//2, Lot 14
Narrative & Permit Application
Dear Mr. Cross:
The proposed well and septic installation will have very limited impact on adjacent properties for
the following reasons:
2.
3.
4.
The surrounding lots are large, allowing sufficient room for septic sites.
Immediate neighboring septic systems are all +30' distm~ce.
Reserve space is adequate, due to absorption capacity.
Drainage will not be affected and is not a major consideration in our design.
Our design provides a four foot separation from the system bottom to onr highest recorded
groundwater level. The water table level was taken during a typically high water period
(October). Due to slope constraints, the leach pipe enters our 63' trench near one end.
If you have any questions please call our office at 694-5195.
Sincerely,
Louis Butera, P.E.
\C:\WPWIN60\WPDO CS\1994\94-072A.NAR
P.0. Box 7732.94 . Earle River /~laska 911577 · '['olpnhn,lp ~a71 ~q4-~lqg · Pnv/qa71 gq~1_RgQ7
LrlT 15
VACANT
N 89°58'0, E
I 240.00,
WELL +100',
/fll' LINE I
I
I PRBPOSED GARAGE_ __ -- --~ ~
I 50' x 3B'
·
1250 GAL ._~.'/~',4' ~ -- ~ PROPOSED
I SEPTIC ~57~ ~ -- HOUSE I
~NK I] / ~ 3~' x 3s' I LOT 14
I ~U ~' 35 PS NSULAT ~N / ~
Z
LOT1 ~ X
~ELL 97' CDR
~ LOT L ~ - T~S~ ~0~[
· - MONITOR TUBE
VACANT ~ o - SEWER CL~NOUT
~ - WELL
NO SURFACE WATER PROPOSED L~CHFIELD
~o x~ow~ CU~A~ ~A~S
WELL & SEPTIC S~TE PLAN
LEGAL: HIGHLAND TERRACE ~2, LOT 14
OWNER: MICHAEL ~ LINDA FRANK
CONTRACTOR: CAIL~Y ~.~gm~ '..~'~.
JOB ~ 94-0721 DATE: lo/~2/941 SCALE 1" = 40' ~.¢7~...~~.~,
A EAGLE R]'VER ENGZNEERZNG SERWCES
EAGLE RZVER, A~. 99577
(907) 694-5195 FAX: (907) 694-3297
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LEGAL: Highland Terrace//2 Lot 14
mo
1. The well and septic plan are for a single family residence and detached garage
only.
2. The drawing and or site plan shall be a part of this specification.
3. All materials and workmanship shall meet the Anchorage Department of Health
requirements.
4. All soil tests are advisory to the design and are to be verified or modified in the
field by the engineer.
5. All excavations and depths are advisory and are to be verified in the field by the
contractor to meet Municipality of Anchorage requirements.
6. It is the responsibility of the owner to obtain all necessary permits or easements
and to locate any adjacent multi-family wells.
7. The excavation is to be exactly in the area shown on the site plan, any deviation
requires engineer approval.
8. It is always recommended that a surveyor locate the nearest lot line position and
the location of any easements.
DRAINF~
1. The dminfield is to follow the natural land contour to maintain uniform total depth
of the drainfield bottom.
2. The bottom of the drainfield shall be level, plus or minus 1.5".
3. The total depth of the drainfield excavation is not to exceed 8' at any point.
4. The leach line is to be laid level, total variance 0.03'.
5. The drainfield gravel is to be covered with typar fabric material.
6. Soil or combination of soil and extruded board insulation to a depth of 3' or
equivalent is to be placed over the leachfield, mounding if necessary.
7. The area over the drainfield is to be £mish graded into the slope to prevent ponding
of surface water runoff.
8. The septic tank and leachfield must not be closer than 100' to any existing private
well, 150' to any Class "C" well, or 200 feet to any community well.
RECOMMENDED LEACHFIELD DIMENSIONS:
TOTAL DEPTH = 8' SEPTIC TANK = 1,250 gallons
DRAINFIELD LENGTH = 63' DRAINFIELD WIDTH = 3'
SOIL RATING = 0.8 GPD/ft2 BEDROOM CAPACITY = 4
GRAVEL DEPTH = 6' under pipe, 2"over pipe, total 6.5'
Twenty-four (24) hours notice required for all inspections.
C :\WPWIN60\WPDO CS\1994\94-072A.SPC
EAGLE RIVER
ENGINEERING SERVICES
P.O. Box 773294
EAGLE RIVER, AK 99577
(907) 694-5:195
SCALE
4 Bedroom Single Family Dwelling
4BR x i50gpd/BR = 600 gpd
Percolation rate = 6,2 min/inch~
For a 3' wide trench, use 0.8 gpd/ft2 application rate
(600 gpd) + (0.8 gpd/fP) = 750 ft2
Effective side wall area for 2' to 8' = (2) (6) = 12'
750 ft2 + 12' wide = 62~5 ft trench length
Use trench 63' long x 3' wide x 6' gravel below pipe
Tank size:
(4BR - 3) (250) + 1,000 = 1,250 gallons for 4 BR
~ \C:\WPW1N60\WPDO CS\1994\94-072A.CAL 1
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED OR:
I ~ '~ '~'~.~TH
~. ¢ ; tou,~ A. gu.era
DATE PERFORMED:
'EOAL DESCR,PT,ON: ktl( 14bANP Lol'l~Township, Range, Section:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
SLOPE
WAS GROUNDWATER
ENCOUNTERED?
S
IF YES, AT WHAT
DEPTH7 / ~ p
E
Deplh to Water After
Moniloriflg?
..Date:
Reading Date
SITE PLAN
Gross Net Depth to Net
Time Time Water Drop
lQ .0 1'.,t11~.
ft%,"/:ol I~ - g
PERCOLATION RATE
TEST RUN BETWEEN
I.tCq~l~J~MT~/Sl~ T~ ~ t6'
____. (m,nutes/mch) PERC HOLE DIAMETER __
__ FT AND 7 . FT
PERFORMED BY: (~'H/¢~''~'~ I ~"- '~'~"~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOLES LOG I PERCOLATION TEST
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
7
8
- 9
10
11
12
13
14
15
16
17
18
19
20
Depth ID Water Aiter
Monitoring? /'~_.. Date:
DATE PERFORMED:
SITE PLAN
Township, Range, Section:
Reading
Date
SLOPE
Gross
Time
PERCOLATION RATE __
TEST RUN BETWEEN
f ,....,~.
Net Depth to
Time Water
(mmutesnnch) PERC HOLE DIAMETER
FT AND ~I FT
Net
Drop
PERFORMED BY: ~'~"~"~"~S I ~ ~~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEt. INES IN EFFECT ON THIS DATE. DATE:
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. # ~'5-o -3'/..z - ¢ :~
1. GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address_.
Day phone
Agent
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: /-/
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
- lng to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 fRev 1/91~ Front MOA~21
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 furtherverifythat 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 regulations in effect on the date of this inspection.
Name of Firm ~,¢~, :.., ::::::::::::::::::::: ::?.;~'o..
I'. O B~Jx )'732ii,1
Address F-,? i;;~,~r Al': i]!!!;~:
694- 5195
Engineer's signature ~~~
Phone
Date
SIGNATURE
Approved for
Disapproved.
Conditional at- .roval for
bedrooms.
4 bedrooms, with the following stipulations:
Install 6 posts around septic tank to prevent vehicle traffic over tank.
AdditionalComments Note: The
State and Municipal Codes.
~ggested that a periodic
conttinued suitability, Nitrate
well for this property meets existing
There are nitrates present. It is
testinq be performed to insure the wells
~oncentration is 6.91 mg/1. EPA
Date
The Municipality of Anchorag~ , artment of Health and Human Services (D ~) issues Hea': ~,.ithority
Approval Certificates based c :v )on the representations given in paragraph above by an ~ pendent
professional engineer registere~ ~'- d'm 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.
724)25 (Rev 1/91) B8ck MOA ~21
Municipality of Anchorage
DEPARTMENT OF HEAL-I'Ft & FlUMAN SERVI
Environmental ServicesDivision C... E I",/E P
825"L" Street, Room 502 · Anchorage, Alaska 99501· (907) 343-4744
OEO I 9 199~
Legal Dcscripdou: ,~,¢/'? ¢
Mu (;qja!i[~, ol p, liotlorag8
Health Authority Approval Checklist Dept, Health & Human Services
A. WELL DATA
Well type /mr-
Log present (Y/N)
Total depth
SanitaL'y seal (Y/N)
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed
Cased to z/,9._ /
FROM WELL LOG
/o/? ¥
~.p.m.
Date of test
Static water level
Well production I
WATER SAMPLE RESULTS:
Coliform
Date of sample: / :2_ - /:7 -~--
B, SEPTIC/HOLDING TANK DATA
casiug height (above ground)
Wires properly protected (Y/N)
AT INSPECTION
g.p.m.
Nitrate
~',¢/ r,-~/'~_ Other bacteria /
/
Collected by: ~'/'"i.'~/'-/¢ ¢ "'
Date installed
Foundation cleanout (Y/N) )/ Depressioa (Y/N)
Date of Pumping t~ ~) Pmnper ~/4
C. ABSOR~ION FIELD DATA
Date installed / I- ~ ~
Lcugth ~ 3 / Width J '
Effective absorption area 7~¢ p
Date or adequacy test ~ 1~
//- ? '-/ Tank size//~,,.;-o Number of Compartn]ents R Clcanouts (Y/N) ~/
N High water alarm (Y/N) tv,ia-
Soil rating (g.p.d./ft: or-ft~Axkm)
~,~
Gravel thickness below pipe ~,
Monitoring Tube present(Y/N)
~r,,e,~.) Results (PassPFail)
System type, .F'~-~
Total depth
Fhfid depth in absorption field before test (in.);
Fhfid depth "'" (ins.) Minutes later:
Peroxide treatment (past 12 months) (Y/N)
hnmediately after -- gal. water added (in.): __
Absorption rate = ~ g.p.d.
If yes, give date '~
Depression over field (Y/N) A/
FOr ~- bedrooms
D. LIFT STATION
Date installed r,¢ ]A Size in gallons
Manhole/Access (Y/N) ~n" level at*
"Pump off' level at*
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot /.5'-
Absorption field on lot //o ·
Public sewer main ~ / 4
Sewer/septic service line 70 r
: On adjacent lots
: On adjacent lots
Public sewer manhole/cleanout
L~ station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation '7 / Property line /../'r9 / Absorption field
Water main/service line ~- t o ~ Surface water/drainage r/oo ' Wells on adjacent lots -/--~ aa /
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Bailding foundation .~ 6" Water main/service line ~- / o
Surface water
Driveway, parking/vehicle storage area ¢.o /
Curtain drain t4 [,q Wells on adjacent lots
Property line ~ /
F. ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and review
of ~lumctpal t~eCot'ds' ,that the,above sPstems are
in coJ~formance with MOA
Signature ~,.~~~,
Engineer's Name
Date /~ - ~ -
HAA Fee $ ~'/D, aa Waiver Fee $
Date of Payment
Receipt Number
Rev. 8/95 eSS: haa.wk.doc
Date of Payment
Receipt Number
12/18/95 15:15 COMMERCIal- TESTING -* 9~9 Gg~ 3'299 NO. ~? 1~2
CT&E Environmental Services Inc.
Laboratory Division ~
~s,~,~o-~ Laboratory Analysis Report
WAT~R
COllecTed Da~e 12/~3/9~ % 1~:30
QC Allowable ~=- Anal
6.91 mg/L E~A 300.0 ION 10
{~NVIRONMI~NTAL FACILITIES {N ALASKA, CALIFORNIA, FLORIOA, ILLINOIS. MARYLAND, MICHIGAN, MISSOURI. NEW JERSEY. OHIO. WEST VSRGINI