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Home My WebLink AboutLA FORET LT 2 Municipality of Anchorage 'Page _l of '3 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: c)~ O.~)~ PID Number: .. ~l'7-3' 9' ~ ~ Deep Trench U Shallow Trench ~Bed QMound ~Other LEGAL DESCRIPTION Soil Rating:o , ~ GPD/Sq. Ft. Total.,, Depth from original grade:j, O ' Lot: ~ Block:NO~ Subdivision:~¢ F¢~¢ Deplh to pipeo,~bottom from original grade: Fl, Gravel depth beneatho~pipe Township: J~ ~ Range: ~ ~ So~ti;~ Fitl added above original grade: Gravellenglh: WELL:~¢W ~m ~New ~ Upgrade Grave~ width: Number of lines: Distance belween lines: Classification (Private, A,B,C): Total Depth: Cased TO: Tolal absorption area: Pipe material: ~ ~O~ ~ ~¢[t Driller: Date Orilted: Static Waler Level: Installer: Date installed: Yield: GPM ~ Pump Set at:,,.~ Casing Height Above Ground:Ft. ~ SEPARATION DISTANCES [~Septic O Holding O S.T.E.P. TO Septic Absorption LiH Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field ,Station, Tank S ...... Li .... A~ ~¢¢¢ ~n ~ I Material: N~mber of Com~artmoRIS: Surface LIFT STATION ~,~ "Pump on" level at: ] "Pump ofF' level at: High water alarm Foundation I ' Electrical Curtain Pump Make & Model Inspections performed by: Drain 9u e~l~ i~1~o~. ~ IZ~O ~O1 S~t'g [ Assumed Elevation: P/~lop TechnDol Services ~ 69 .' ¢ ~ ? u "¢;< Inspections performed by~ ' ..... 14530 Echo ~t Dates:lst I~ /19/cZ '~w: q.~ ~"% Department of Health and Human Services approval "¢,,:~,..' ' ce-3s~9' .,~," Reviewed and approved by: J~,~_ ~CP Date: m~ -~ ~-e~ ..... ¢,~ 72-013 (Rev. 9191) MOA 25 Permit No. ~ ;~ 0 .~' ~('j _ Page 9_ of ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report LegalDescription: /~.O7' 8, {,-,4 I~OF~7- .ElD . PIDNo.: OtT~q~o~ I ----F PI-.AN Vl~k/ I" = qOr-O" 5 ~/N~- Tle£ Flcttto~ Technical Se~[ce "' 14530 Echo Street %¢: ~O~N~'s i .... ~ '" * ............ ~. ......... e~e~, ,,,, ,,, 72-013 A (Rev. 9/91) MOA 25 Permit No. G ~ o ~, ¢ O Page ~ of ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report LegalDescription: /~o~' ~., Ac,- F~re/' -ff /D PIDNo.: 0/'7~ ~8o~_ ~lattS'i5 Technical Services 14530 Echo Street Anchorage, Alaska 99516 72-013 A (Rev. 9191) MOA 25 5 ~Z P7-tC ENGINEER'S SEAL EODOR~ F, MOORE ~I0,0' BC, O ' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 1 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920390 DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES OWNER NAME:DENNING JOHN H & OWNER ADDRESS:13250 GINPOLE CIR ANCHORAGE AK 99516 DATE ISSUED:il/17/92 EXPIRATION DATE:il/17/93 PARCEL ID:01734202 LEGAL DESCRIPTION: LA FORET LT 2 LOT SIZE: 50224 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAACS0). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. RECEIVED BY:_ ~-~~ ISSUED BY: DATE: DATE: CW~L & ENVBtONMENTAL ENG~EER~G · ENERGY CONSERVA~ON & ~YS~ THEODORE F. MOORE, P.E. 14~30 ECHO ST. PH: (907) $4~-~3~ ~ov¢~bCr $, ~ ~CHO~GE, ~KA M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dem' Sirs: The purpose of this letter is to provide the required design narrative in support of our application for a permit to upgrade the wastewater disposal facilities on Lot 2 of La Foret S/D, located at 13250 Ginpole Circle. The reason for the upgrade is that the existing soil absorption trench is operating in a sumharged condition. Soils logs, perc test results, a site plan, design ch'awings and specifications are enclosed for your review. The proposed soil absorption system will be constructed between test holes #1 & ~2. As can be seen from the soil log for test hole #1, the native material between 0.5' and 2.5' below ground surface is a sandy loam overlying a loose sandy silt with a measured perc rate of 1 - 3 minutes per inch. The proposed design concept is to build a soil absorption bed on top of the sandy loam, with coat'se filter sand added as a leveling course. Using the soil application rate of 0.7 gpd/sq, ft. specified in the wastewater ordinance for filter sand, tlfis 4 bedroom residence mquh'es a total absorption area of (4 x 150)/0.7 = 858 squat'e feet. The proposed 25' x' 35' bed design has a total absorption at'ea of 875 square feet. The topography of the lot in the vicinity of the proposed const~'uction slopes the west at approximately 5%. The proposed project is not anticipated to have any impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it impact reserved space/surface and subsurface, or at'eawide di'ainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. / / t I PLA IV VIEW ~ '~" _~CT IOtq "A -A" Flattop Technical Servicea 14530 Echo Street Anchorage, Alaskct 99516 Flattop Technical Services 14530 Echo Street, Anchorage, AK99516 Phone (907) 345-1355 Lot 2, La Foret S/D 13250 Ginpole Circle Wastewater disposal system upgrade Specifications 1.0 General: 1.1 The scope of the project consists of construction of a 25' wide by 35' long shallow soil absorption bed, using fiker sand as a leveling com'se. The integrity of the existing 1250 gallon septic tank is to be verified, and the tank replaced if necessary. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these ch'awings may be allowed or requh'ed by the engineer conducting the inspections. All construction procedures and material specifications shall coufmTn with Municipal and State requirements. All sepm'ation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around m~y bm'led utilities. Telephone and cable TV lines are known to traverse the proposed bed area. 1.4 At the time of installation the conu'actor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofm' as possible the cont,'actor shall minimize damage to trees. 1.5 The contractor's bid shall include topsoil and seeding of the final surface to prevent erosion. 2.0 Septic Tank: 2.1 The existing 1250 gallon septic tank may be retained in service if it's structural integrity has been verified, and if it has functional cleanout pipes with airtight caps, allowing pumping access to each compartment. 2.2 If the existing septic tank is no longer watertight, it shall be properly abandoned and replaced with a new 1250 gallon, 2-compartment Municipally approved septic tank set level on undisturbed soil. Each compartment shall be equippexl with a watertight manhole cover tu~d a 4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. 2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4"' per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A double cleanout shall be installed within 5 feet downstream of the septic tank. 2.4 The waste line from the tank to the soil absorption bed shall have a minimum soil cover depth of 2 feet. If the soil cover depth is less than 3 feet, the line shall be insulated with 2" of rigid insulation. 3.0 Soil absorption system: 3.1 The soil absorption bed shall be consU'ucted by stripping the black peat material only (approximately 6" thick) off the 25' x 35' bed area to expose the top of a reddish sandy loam stratum. The bed shall be located away fi'om the test holes. Cat'e shall be taken not to drive equipment on the loam surface...~ 3.2 The contractor shall work around buried utilities including telephone and cable TV which traverse the bed area. 3.3 The bottom of the excavation is not expected to be level. Any compacted or smeared sm'faces shall be raked to encourage proper infiltration. Coarse sand meeting Municipal specifications for filter sand shall be placed in the excavation to create a level surface at the elevation of the highest point of the loam stratum. A soil "dam" may be created around the edges of the bed area to contain the leveling sand and sewer gravel. 3.4 A total of 12 inches of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level on 5' centers such that the pipe inverts are no less than 6 inches above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.5 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.6 Approved filter fabric shall be placed over the enth'e top surface of the sewer gravel, followed by 2 iuches of rigid burial type insulation. A minimum of 2 feet of imported soil cover is to be placed over the top of the insulation. 3.7 The top surface of the cover material shall be graded to smooth contours. Care shall be taken to ensure that all areas around the bed are sloped to rh'ain away from the bed, with no residual depressions. Fill slopes shall be no steeper than 3:1. 3.8 All at'eas disturbed by the construction shall be covered with topsoil and seeded to promote rapid revegetation. 4.0 Inspections: 4.1 A total of 5 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure~ that it conforms with the soil test inforlnation, (3) after the sand leveling material has been placed, (4) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of insulatiou or filter fabric, and (5) after final backfill and grading is complete. The septic tank (if it must be replaced) requkes one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently fat' in advance to ensm'e the availability of the engineer. PERFORMED FOR: LEGAL DESCRtPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 2O ~lattop Technical Serviceu 14530 Echo Street Anchorage, Alaska 995~e Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 'L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST Township, Range, Section: SLOPE t"ta~-tr te( har~er /o d'~y WAS GROUND WATER ENCOUNTERED7 N SITE PLAN IF YES, AT WHAT ~k DEPTH? -- Deplh Io Water AFter Moniloring? .]~_,~_G..~e~_ Bale: _ II /~_/~_~ . Reading Date Gross Net Depth to Net Time Time C i,-IM,) ..... Water Drop · H~o I~:~:~ ~2 '/~ ~ H~o I~,'qt:3~ ~3 vi/6 PERCOLATION RATE ,3 (m~nutes/inch) PERC HOLE DIAMETER 7 TEST RUN BETWEEN ~,tl "PT'AND PE.~ORMEDBY: Fr~f ~6~1,~( Soc, , 'U~'~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) ~¢~c[ttop Technlccd Services 14530 Echo Stree[ ~nchorage, Alaska 99~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED OR:. LEGAL DESCRIPTION: Township, Range, Section: SLOPE lO ~r~,/ .G !,1' WAS GROUND WATER ENCOUNTERED? , N ___ 5cc ~7~ 7-~ N/ R 3t, u, SITE PLAN 11 12 13 14 15 16 17 18 19- 20- COMMENTS ... '7-~'$ /~t~C PERFORMED BY; . .~'¢'4 ~ ~/'C"~4~ ACCORDANCE WITH ALL STATE AND MUNICIPAL 72-008 (Rev. 4/85) s IF YES, AT WHA'F O DEPTFI? E Oepll~ Io Waler Aller Monitoring? /"/,~' ~'~C.y~Oale: Reading {)ate Gross Net Depth to Net Time Time (¢'fl ~) Water Drop PERCOLATION RATE _~,_ ~¢' ._ (r'mnules/~nch) PERC HOLE DIAMETER ~" TEST RUN BETWEEN I ~ I~ I'=~'AND '~ 'g ' FT gO ' I ' ~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN GUIDELINES IN EFFECT ON THIS DATE. DATE: PERFORMED FOR: LEGAL DESCRIPTION: 2 3 4 5 6 /W 7 8 9 10 11 12 13'-- 14 15 16 17 18 19- 20- $"!~zttop Technlccd Services 14530 Echo Street Anchorage, Alaska 9957~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST WASGROUND WATER ENCOUNTERED? ;~A'~,~..'o, C~. 3589 DATE PERFORMED: [0 / ~ 7 Township, Range, Section: SITE PLAN IF YES, ATWHAT Water AFter Monilaring? ~ Date: Reading Date Gross Net Depth to Net Time Time Water Drop COMMENTS ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE 72-008 (Rev. 4/85) PERCOLATION RATE __ tmlnutes/mch) PERC HOLE DIAMETER TEST RUN BETWEEN ..... FTAND FT CERTIFY 7HAT THIS 7EST WAS PERFORMED IN DATE: 1113/~ CWIL & ENVIRONMENTAl. ENGINEEIUNG * ENERGY CONSERVATION & ANAI.YSIS THEODORE F. MOORE, P,E. November 17, 1992 14530 ECHO ST. PH: (907) 345-1355 ANCHORAGE, ALASKA 99516 John Smith M.O.A DHHS P.O. Box 19-6650 Anchorage, AK 99519 RE: Lot 2, LaForet upgrade permit Dear Mr. Smith: Per your request, on November 16 we conducted a perc test (see attached log) at a depth of 4' below ground level in the ML stratum underlying the proposed soil absorption bed on the subject lot. This perc test revealed the ML to have a pemolation rate of 27 minutes per inch at that location and depth. This confhvns my em'lier hypothesis that the pe~rneability of the ML gTadually decreases with increasing depth, and it also demonstrates that at least the tipper pm~ions of this stratum m'e not impermeable, which would necessitate a 6' vertical separation. Despite the reasonably fast measured perc rate at this depth, I still do not feel that installation of another deep trench in the ML stratum is an appropriate solution for this lot, based on the observed surchm'ged state of the existing deep trench, coupled with the soils test info~rnation provided at the time of its installation. Please give me a call if you have any questions on this supplemental analysis. Sincerely, Ted Moore, P.E. LEGAL DESCRIPTION:J.O¢ 2 3 4 7 8 9 10 11 12 13 14- 16 17 18 19 20 _~lcdiop Tecltn[caI Services 14530 Echo ,Street Muni~ipality of Anchorage DEPARTMENT OF HEALTI4 & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG ~ PERCOLATION TEST W~ ~oc~P Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p E Depth to Water Aller Moniloring? Dale: Gross Net Depth to Net Reading Date Time Time ( ~t;~) Water Drop PERCOLATION RATE ~ 7 (minutes/inch) PERC HOLE DIAMETER TE$I RL'N [3EIWEEN _ ,~',,~' F1 AND ~/'~ .Fl' PERFORMED BY: ~p 7~0~ _G~er~. ~ CERTIFY THAT THiS TEST WAS PERFORMED. N ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES iN EFFECT ON THiS DATE. DATE: 72-008 (Rev. 4/85) NAME MUNICIPALITY OF ANCHORAGE DEPARTMENT OF 14EALTH & ENVIRONMENTAL PROTECTION ENVlRONMENI'ALENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPOR'F IPRONE UPGRADE LEGAL DESCRIPTION LOCATION DISTANCE TO: Liq. c DISTANCE TO: Wetl Absorption ~F HOMEMADE: ~nsideiength ]Width Dwelling · Material Nearest lot tine//~) I Trench width ~-- ~' inches NO. OF BEOROOM~ PERMIT NO, No, of compart~ Liquid depth PERMIT NO, Liquid capacity in gallons PERMIT NO. DISTANCE TO: Total 'er~tf lines Materiel beneath tile Depth No. of lines . weu//¢-r-. L,.~0 · Lengt, of~e~ac), line Top of tile to finish grade Width Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: DISTANCE TO: Distance to lot line Depth Driller Building foundation Sewel line Septic tank Distance between lines Total effective aj~.sorption area PERMIT NO. PERMIT NO. /~n a-rea(s) OTHER SOIL TEST RATING INSTALLER REMARKS I APPROVED .4 DATE LEGAL F'EF~ff'I I T NO. ( 6d..13,::1.27 FIF'PL. I C F:II'.EI' L 0 Iii I::1T ]', (3 N LEEGFIL 51...IN CON5TRUC"['Z ON., LOT .2." [...FI FOF.".ET E;,-"'D I_O'F 5IZE 5E~E~E~3 5C!URFi:E FE.'_'ET T'.r'F'E OF 50:IL f:IE:5ORP'T' :[ ON 5'T'5'T'Et'I I5: TF:EI'.,tC':H E;OIL F...'I:::tTIt"4G ,::5L.-.! P';T,."EI[(::: .... THE F::EC!UIF:E[)512'.E OF 'THE SOIl_ RE:E;OF.:F'TION E;'¢STEI"I I5: 'TH[F. L.[.ZI'.4GTH DIP1ENSIEIN I5 TFIE LENGTH (IN FEE"r) OF "['FIE TF:ENC'H OF¢. [:,F:FiINF'ZELD. THE E:,E'F'TH OF:' FI 'T'RENCH OR F']:T I5 THE [::,I5TFtNCE BETHEEN TFIE SUF4.':FFtC:E OF' THE:.' GF:OUNI:) FIN[) THE E:OTTOFI OF THE E'?,',CFI'v'FI'f'ICff.~ ,:: IN FEET::,. 'THERE I2:; NO :BET HI[::,TFI FC)F,?. TF:ENCHES. THE GF.".FI',/E:L. DEEF'TH ]: 5 TFIE P1 ]: N Z HUH DEPTH OF GF,?.FI'v'EL. BETHEEN THE: OUTF:'FIL. L F' I F::'E: FiNI3, THE BOTTOH Eft:' THE E::.:',C:R',,,'I:~TICfl'.4 (IN FEET). PEf?J','I I T FIF'F:'L. I C:FINT HF:I5 THE R:E~.SPONE: I E: I L I '1""¢ TO :[ f-,IF'Cl[;::['l 'TH ]: 5 [)EF'I:~F.:THEN'T' [)lJl:;;: ]: NG THE!: ZN2.:,TFtL.LFtTION IN5F'[-]C:TZONE; OF' F:IN'T' HELLE; FtD...TRCENT TO "I~I'"I.T. 5 PROPEF?.T'¢ FIN[::, THE I'.,ll. JHE',ER OF: F.:EE;tE:,ENC:E5 'T'FII::IT THE I.,]EL.L HILL 5EF.?v'E. ................ -r B,.I CD ,:: ~: ::, Z [~.q '_:..7, F' [£ i:::: 'T % CE, ~'-,~ f2; IF::I~ E;L" EE fR?. EE l:;::~ IL..J~ :E IF:L" IE E:: ...................... i:3FIC:KF Z LL Z IqG OF FtN'¢ 'L-:;'¢51"IEH I.,.! ].' 'I-HOIJT F Z NI~I... ].' N'E,F'ECT E ON F:li'.,ll::, PIPF'f4%P,,,'FIL B"r' TFI I E; [::,IE[:'FII:;;~'f'I'"IEi'.,I'I" I.,.I Z L.L. DE 5LIEh3ECT TO F'FE:O5ECLIT ]: ON. .... "'"' '"""" :' .f. 5 t"'1 :[ 1'.,I I i"ILIH [_':, ]: :~!;TFINCE E:E'I"HEEN FI HE:LL RI',,ID FIN"r' ON"-5 1 TE E;EHFIGE I.'.:, I ':;F'FPSFIL .:, r ::, l EP1 :I..OE~ F:'EET FOI~: R F'F..'].",/FITE HEL.L OR :LSE~ TO 2E~E~ F'E:E-I' F'F.':OH FI F'UBL]:C 14ELL. DEF'END]ZNG UF"ON THE 'T"¢PE Eft: F'UBLIC HEL. L.. i'"IIN:[I"ILW1 DISTFtI",IE:E F:'ROH FI F'F:i',,,'FYi'E HEL. L. TO R F'RZ',/I::ITE 5EHER LINE :[5 ;2:5 FEE'T FINE:' TO FI COHHIJNZT"r' E;E:I.,~EF:: L]:NE :[::5 75 FEET. HELL L. OG5 FIF.':E F.:E6!UIRED RI",t[.':, I"IUE;T BE RETUF?I",IEE:' TO THE E:,EF'FIF.'.]'HEN'I' HI'THTN OF THE HEL..L E:OHPLETi'OI",I. O'FI."IIEf4: f:?.EC!I.JTRE:HENT:~ ftFI'T' FIF'PL'T'. SF'EE:IF.I:CFtTTON"-E; FIND COI'.,15TRUC:I-ICflq E:,]:RGRRH5 RRE F't',,,'FI I L. FIE,'LE TO Z NSUF:E F'F?.OPEF:: 11'45TRL. LFIT :[ ON. I C::ERT I I:'T' ]'FIFIT ::L: ]: Fff'l FF:IHIL.:[f::IR FI ITH THE: I;::E:C!UIF.:EP1EI"4T5 FO[;.': Ot",I'~E;iTE SEt.qERE; FII",tE:, I.,.IE:L.I_5 FI5 SE:"I" FOI;:TFI E',"r' THE I'IU1'.4 2: Z I.,.I:[LL. INSTtal....L THE :E;'T':i!~,TIEI"I ZN FIE:COF.".E:,FINCE 14ITH THE CODES. :}i:' ]: .NE~E~.F%:Tf::IN[> TFIFIT THE OI",I-"':i:;:[TE :~;EHEF'. 5h"%TEH i"lFl"r' F.:EC!LIIF.:E ENLRRGEHEN'T' IF' T'HE: RE:::.E; I E:,ENCE T :5 REI"IEC':,ELEE:' TO INCLUDE I'IOF.!E TI'"IFIN 4. BEDF:.'OOH'::;. L::'; I EiI'..IED: RPF'L ICFtNT E;UN CON~STI:;?.IJCTION., INC 'UNICIPALITY OF ANCHORAGE Department ~£ Health and Environmental ,,rotection 825 L Street, Anchorage, AK. 99501 264-4720 ~ * ~ HANDWRITTEN PERMIT * ~ ~ ~./ :~ WELL. AND/~ ON-SITE SEWER PERMIT 5/ Appllcan%:::z ~L/[/ t.. :~! 'J.~?' ~' ? Mailing Address :-,F~F~z~ Z/ / ~[' Location: :~'L'bt ~ I~U/JL ~'?' Phone Number: A ,/- ~'~ / ~ ~f~ Lot Size: .... v. Legal Description: L.~:7 ~.~ Type of Soil Absorption System Is: Trench: x/ Drainfield: Seepage Bed: __ Holding Tank: Maximum Number of Bedrooms~ ~ / Soil Rating(sq.ft/br) ~. The Required Siz~~of the Soil Absorption System Is: DEPTH .~ /L> LENGTH _ ~ GRAVEL DEPTH ~ WIDTH 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(HOLDING) TANK SIZE = / L.~ ~ 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 $ 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) Z understand that the on-site sewer system may require enlargement if the r i:ce is remodeled to include more tha 3 bedrooms. Signed ~' Issued b~'''~>'~'~:, ':~ ..... SWP/024(1181) [] SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG -- PERCOLATION TEST PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 14- 18 20 i'/ -' /¢ ] M' /HZ SLOPE SITE PLAN WAS GROUND WATER IS_ ENCOUNTERED? /"~/0 O IF YES, AT WHAT DEPTH? PoW. P Gross Net Depth to Net Reading Date Time Time Water Drop / ?~,v~,l 7: o5- 0 I,V ~z 0 PERCOLATION RATE (minutes/inch) ~'; /' TEST RUN ~ETWEEN ,X ~T AN~ ~,$~ ET 72-008 (6~79) 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Location (site address or directions Property owner Mailing address Lending agency Mailing address Agent P~¢H~.y Address goo Day phone 87~ - ~/~-0 Day phone ~ ~- ~/ 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- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1191) Fronl 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 ApproYaJ 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 furtherverifythatbased 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 ali Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm /--'(~f-/-c,,p Address 1"/5-..~ 0 ~cAo .~'/-.~ Engineer's signature 6. DHHS SIGNATURE Approved for ~c/~¢~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DH HS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72~325 (Rev. 1/91) Back MOA ~t21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. WELL DATA Well type CCH'. Log present (Y/N) ~' Total depth 3'~9' Sanitary seal (Y/N) ~.O'F' ~¢ /,-~. ~'ore¢- 5/P Parcel I.D. dpt 75 ~ :~o 2g ifA, B, orC, attach ADEC letter. ADEC water system number Date completed ~'/8~ / ~ ! Driller Cased to ~go' Casing height Wires properly protected (Y/N) Date of test Static water level Well flow FROM WELL LOG Pump level SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot / Absorption field on lot / Public sewer main Sewer service line 75-' g.p.m. AT INSPECTION m~4 ......~,, OF ANCHORAGE ~ O,.¢.NVIRONMENTAL SERVICES DIVISION ~ ~/,~ i, .... g/p.bn. ,99 ~ '* ' 'RECEiVED ;On adjacentlots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank tOO ~ I~, A. WATER SAMPLE RESULTS: Coliform 0 co! /IOO f~.~ Nitrate Date of sample: Il /5' / ¢ 8 O. (~'/--L~ Other bacteria 0 cot /~oo m-~ Collected by: I~1~ F¢'~/~ T~'c/~ _CLx c B. SEPTIC/HOLDING TANK DATA Date installed /I [' ~' [ ¢ ~ Cleanouts (Y/N) Y High water alarm (Y/N) _ Date of pumping Tank size I ~_~-(2 ,,,~! Compartments 'P~ Foundation cleanout (Y/N) Y' Depression (Y/N) ~,1, ,4-. Alarm tested (Y/N) /~. ,~. N, ,4. (_ n ~ u_~) Pumper /',/, ,4. N SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot / 0 ~I ' To property line Surface water/drainage On adjacent lots Absorption field ;~. ,~OO ' Foundation '7~' Water main/service line 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Iq, A. Date installed Size in gallons Vent (Y/N) High water alarm level Meets MOA electrical codes (Y/N) "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots D. ABSORPTION FIELD DATA Surface water Date installed Length ~/~' ' Total absorption area Depression over field (Y/N) Results (pass/fail) Soil rating O, '7~,f~o(/jcl- ~ System type Width Gravel thickness /,o' Cleanouts present (Y/N) Date of adequacy test for /'/ Peroxide treatment (past 12 months) (Y/N) /~ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: If yes, give date Total depth /,,~ ' 1'4, A. bedrooms Well on lot I To building foundation On adjacent lots ~ too' Property line To existing or abandoned system on lot Cutbank hlo,~ ¢_ Water main/service line Driveway, parking/vehicle storage area On adjacent lots z./o' Surface water Curtain drain E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature ,¢~7~~ Engineer's Name Date ~o ~ HAA Fee $ / Date of Payment Receipt Number 72-026 (Rev, 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ANALYSIS RESULTS for INVOICE $ 60395 Chemlab Ref.# 92.6170 Sample # 1 Natrix: WATER FAX: (907) 561-5301 Client Sample ID PWSID Collected Received Preserved with L2 LA FORET FRONT NOSE BIB Client Name :FLATTOP TECHNICAL SgV UA Client Acct :FLATTOT NOV 5 92 @ 11:15 hrs. EPO~ : PO# :NONE RECEIVED NOV 5 92 @ 14:45 hrs. Req# : AS REQUIRED Ordered By Analysis Completed : NOV 6 92 Send Reports to: Laboratory Supervisor : STEPHEN C. EDE 1)FLATTOP TECHNICAL SRV Released By : (/~'~/~~'"~'-~ 2) Parameter Results Unite Method Allowable Limits NITRATE-N ND(O.IO) mg/1 EPA 353.2/300.0 10 Sample ROUTINE SA)dPLE COLLECTED BY: CHRIS. Remarks: I Tests Performed ' See Special Instructions Above UA~Unavailable ND- None Detected "See Sample Remarks Above NA- Hot Analyzed LT-Less Than, G~-Greatez Than Member of the SGS Group (Soci~t¢ G~n~rale de Surveillance) RECEIVED INSPECTION APPOINTMENTS D'--~TE DATE INSPECTOR NSPECTOR DATE INSPECTOr1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL Street- Alaska 99501 825 L Anchorage, ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SI~_~%~V~S_ DIRECTIONS: Comole'~e all parts on page 1. Incomplete requests will not be processe[~, Please allow ten (10) days for processing. c._ __10 S7- MAI LING ADDRESS -~O~TY ~NT (If different from above) IPFtON E MAI LING ADDRESS 3. LENDING INSTITUTIO~ V1AI kl '4G ADDRESS MAILING ADDRESS IPH~)N E STREET LOCATION 6. TYPI: OF RESIDENCE ~ SINGLE FAMILY [] MULTIPLE FAMILY NU'vlBER OF BEDROOMS ~ One ~ Eour _-~ Two [] Five [] Three 17~ Six [] Other WATER SUPPLY I NDIVIDUAL~ COMMUNITY ~ PUBLIC UTILITY ATTACH WELL LOG. A well log is required for al wellsdr:lled since Juno 1975, For wells drilled 'prior to that date, give wel de~th (attacl~ Io§ if available.) 8. SEWAGE DISPOSAL SYSTEIVl INDIVIDUAL/ON'SITE*~ PUBLIC UTILITY ./Be / YEAR ON-SITE SYSTEM WAS INSTALLED, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATE[). 72-010 (Rev, 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE [] SINGLE FAMILY [] MULTIPLE FAMILY 2, WATER SUPPLY [] INDIVIDUAL [] COMMUNITY [] PUBLIC UTILITY Connection Verified 3. SEWAGE DISPOSAL SYSTEM []INDIVIDUAL/ON -SITE []PUBLIC UTILITY Connection Verified []Septic Tank or ~ Holding Tank Size: /-')-.5'%) If Tank is homemade give dimensions: NUMBER OF BEDROOMS 4, DISTANCES WELL TO: Absorption Area to nearest Lot Line [] ONE [] THREE [] FIVE [] TWO [] FOUR [] SIX PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED PERMIT NUMBER DATE INSTALLED INSTALLER SOILS RATING TYPE OF TANK MANUFACTURER /~ . . TOTAL ABSORPTION AREA MATERIAL Septic/Holdi ng Tank rea [] OTHER Sewer Line I Nearest Lot Line 5. COMMENTS DATE