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Municipality of Anchorage ...;
Development Services Department
Building Safety Division
On-S~te Water and Wastewater Program. 4700 Bragaw SL
P.O. Box 196650 Ancha'age. AK 99519P3650 Page of
www ct.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION P, EPORT
Pen'~it Number. $w070258
PID Number. 051-323-18
Name
Henry Warren Wastewater System: O-I New I-] Upgrade
P.O. Box 770848 Eagle ~ver. AK 99577 ABSORPTION FIELD
696-2294
3 OD~T~r~n OSae~,vTmnch 1:3~ Oa~n~ IDO.v*-
LEGAL DESCRIPTION s~.~w
~10 ~4 s-- ~, Lakel~dgeTen-ace o~w~g,n~g~
Well: [] New [] Upgrade c~,,~
Existing R. Ft
FI Stua~ Gilbmt Construction 9/23/2007
~. n,,,,.~., n. lc'~""~""'""'"'~' - ' TANK
SEPARATION DISTANCES [] septic r-I H(~dJng [] S.T.E.P. [] Othe~
Tank Field Stetmn Tank Se~er Line Anchorage Tank 1
w,~ 92' >100' N/A N/A >25' Steel Two
s,,~.w,., >1o0. >10o' N~A N/A ~ / LIFT STATION
I >10']~ ~,~
~n~ >5' N/A N/A
See Waiver From Well to Septic Tank. 2' Insu~alion Placed "~, BENCH MARK
Over Sepllc Tank. Exla~ing Sep§c Tank Pumped and R~moved Garage Slab
From $i~e. Tank and 2 Post Tank Dieanouts Placed Under
This Permit. '/
Inspections perforated by: ~- Harala Dates: 1= 0/23/2007 I
2 9/23/2007 ' '; ~, ~'~,.- '.u, ·
,, ,,,r.~. ~ .-~-;
Development Services Department Appro,~al
co,, tio,a App ova --
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK, 99519-6655 - 343-7904
On-Site Wastewater Disposal System or Well InspeclJon Report
Permit Number:. SW070258
'1.000 Ga,on ~
Seplic Tank ~94.95
NOTE: Tank Only Replaced UnderThis Perm[ Existing Tank
Removed From Site, Two Post Tank Cleano~ts $eL
PROFILE AS-BUILT
No Scale
Page 3 of 3
PID No. 051-323-18
Municipality of Anchorage
Office: (?~17) ,']]4l-SJll')l * l:a.~ (,q07) ~S,'~-8~00 htll)://,,~'wv~munl.org
3layor Mark Begich
1)cvclopmcnt Scrrlccs Dcp,-u~ncnt
Department
December 13, 2007
Michael E. Anderson
Anderson Engineering
P.O. Box 240773
Anchorage, AK 99524
Subject: Waiver Request for Lake Ridge Terrace Block I0 Lot 4
Waiver Request WRg: 070069
Parcel ID # 051-323-18
PERMIT # SW070258
Dear Michael E. Anderson:
Your request for a waiver of the required 100 feet horizontal separation from the
septic tank to the private well has been approved. The approved separation distance is
92.0 feet.
This waiver approval applies to the existing septic tank to private well separation only.
Any future upgrade to the on-site wastewater disposal system will require all separation
distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
On-Site Water & Wastewater Program
Community, Security, Prosperity
State of Alaska:
Separation Distance Waiver Guidelines for S.C.R.O.
(State of Alaska Memorandum to District Office Englneers dated January 3, t985)
Waiver Request for: Lake Ridge Terrace Block I0 Lot 4
Parcel ID#: 051-323-18
Waiver Request Number WR#: 070069
Waiver Requested: s2 foot horizontal separation from well on4ot to septic tank
Engineer: Michael E. Anderson
PERMIT # S~V070258
Septic Tank Data
The existing tank was abandoned and replaced by a new 1000 gallon
septic tank. The old septic tank was installed in 1972 and already
had a 90 foot encroachment to the well on-lot. The septic tank
bottom depth was assumed to be 10 feet from original grade for
calculating points.
.Well Data
There was no well log in record however the engineer did provide 2
well logs on adjascent lots for soil strata information. Aarow pump
and well services recorded the depth of the well at 124 feet from
ground surface. And casing at 71 feet with a static water level at 50
feet. The soil strata from the bottom of the septic tank to the static
water level is silt and gravel. The water sample results show the
water well to be with-in municipal standards.
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastcwatcr Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchoragc.ak.us
(907) 343-7904
Waiver Review Worksheet
WR#: 070069 PID#: 051-323-18
Dale Received: December t3, 2007
HAJPermil~ PERMIT # SW070258
Legal Description: Lake Ridge Terrace Block 10 Lot 4
Engineer:
Michael E. Anderson
Anderson Engineering
P.O. Box 240773
Anchorage, AK 99524
Applicant: Henry Warren
Waiver Requested: 92 foot horizontal eeparation from well on4ot to septic tank
Cdteria: Geology Points:
A. Water Table
5.00
B. Soil Sorption 3.50
C. Permeability 2.00
D. WaterTable Gradient
4.50
E. Hodzon~lSepambon 2.68
Toml:[ ............ I~'6801
Waiveris Gmn~d: X WaiverisnotGmn~
List Condilions or Reasons fo~ above:
Date: 10/3t/07 By: Joe Goodall
Name of Reviewer
Rec#: 91111 Amount: $920 Date Paid: 12/13/2007
State of Alaska:
Separation Distance Waiver Guidelines for S.C.R.O.
(State of Alaska Memorandum to District Office Engineers dated January 3. 1985)
Waiver Request for: Lake Ridge Terrace Block 10 Lot 4
Parcel ID#: 051-323-18
Waiver Request Number WR#: 070069
1
Waiver Requested: 92 foot horizontal separauon trom well on-lot to septic tank
Engineer: Michael E. Anderson
PERMIT # SW070258
Water Table
Depth of well: 50
Depth of septic system: 10
I
IDistance from the bottom
of the system to the highest
water table In feet
40;
Point I
Value
0 0
8 1
17 2
24 3
3O 4
40 5
85 6
100 7
290 8
1000 9
10
* Straight line Interpolation Is permitted between any two values
Soll Sorbtlon
Polnts
5.00
Points
3.50
CleanS°il l'¥PeGravel , Point Value ,0 ,'"~-J 140 13'5 +[%]0+ [ 4...~00
Fractured Rock 1
.i olO .[+olo .[ olO
Sand wi Small Amt of Clay 2.5
Silt 3.5
Clay and Sand Equal 4.5 3.5 + 0 + 0
Clay 6 0 + 0 + 0
*Use the predominant soll type but values can be averaged for a mixture
permeability Points
2.00
Clay(will channel) 0 L 40 J
Silt and Sandy Clay 2
Fine Sand 1.5
Sandy Gravel 1
Fractured Rock 0.9 2.00 + 0.00 + 0.00 + 0.00
Course Sand (30 grit) 0.4 0.00 + 0.00 + 0.00 + 0.00
Clean Gravel 0
*Use the predominant soil type but values can be averaged for a mixture
Gradient
J % Slope J Points Value J
-60% 0.031
-30%
-20% 0~27.~ slopes toward well
-10%
-5%
0% 2.9 ~- flat
4.5
10% slopes away from well
60%
*If the gradient Is unknown, assume the worst case
~olnts
4.50
.Horizontal
I 02 ]
Horizontal Point
Separation Value
In Feet
0 0
25 0.7
5O 1
75 2
100 3
150 5
200 6
300 7
points
2.68
*Linear Interpolation between two point value Is acceptable. Horizontally means
straight line distance to the well not the contaminate travel distance to water table
which may be greater.
Conclusion: Grant Waiver Total Points:! J 17,6801
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
October 30, 2007
Municipality of Anchomge
Development Services Department
Building Safety Division
4700 Bragaw Street
Anchorage, AK 99507
Subject:
Lot 4, Block l 0, Lake Ridge Terrace Subdivision
Well to Septic Tank Waiver
Dear On Site Engineer:
The existing well on Lot 4, Block I0, Lake Ridge Terrace Subdivision is slightly more than 92'
from the septic tank recently placed on the lot. The new tank was placed as far as possible from
the well without encroaching into the existing absorption crib. The exact location of the crib
could not be determined, but is outside the limits of the tank.
The well has been on the property since 1972 and originally produced in excess of 10 gallons per
minute. The production rote dropped dramatically when the neighboring well was drilled and
fractured. The well now produces only cloudy water when it is not completely dry. The owner
of the property, Mr. tlank Warren, wants to keep the well in service for future use if the
production rate increases. Water from the well is currently used only for landscaping and Mr.
Warren hauls water for personal use. The water is stored in a bladder in his crawlspace.
An inspection of the well was recently completed by Aarow Pump and Well Service. They
determined the well is 124' deep with casing to 71' with no perforations. Bedrock was found
from 71' to the bottom. The static water level in the well is currentl,, at 5
The ground elevation at" ...... · ~ ,, ~,~,~, u~e sunace.
me well ncaa Is approximately 6' higher than the ground at the septic
tank indicating a hydraulic gradient of 6% away from the well.
The soil beneath the septic tank is dense silty gravel (GM) with average absorptive
characteristics. The rate was estimated at 185 square feet per bedroom in 1972 when the septic
system was originally installed. Bedrock is found on the lot between 60' and 80' below the
surface. Penetration of the bedrock with septic effluent is not possible. It is unlikely leakage
from the septic tank could ever penetrate the aquifer serving the well We therefore recommend
a waiver be issued allowing the new septic tank to remain at its current location.
Sincerely,
Michael E. Anderson
Attachments
LAKE RIDGE TERRACE SUBDIVISION
BLOCK 10, LOT ~-
53'
71'
WELL TO SEPTIC TANK
No ,~ale
Froa:LIPS STORE EAGLE RZVL~ ALASKA To:67777S6
AaROw Pump & Well Service, LLC
P.O. Box 110496
Anchorage, AK 99511
Office: (907) 346-9355 · Fax (907) 333-8976
Eagle River: (907) 622-9335
CUSTOMER
10/04/20D7 14:49
JOB si"rE
Iq.. ~l ~
11587 P. 002/002
No o7854
LABOR HOURS RATE AMOUNT
TOTAL M~TEF
TOTAL
BY DATE COM~ TOTAL
LABOR
PAY THIS' AMOUNT
Hereby Acknow~e the Satlsfactop/Completion ot the Above Described Work and agree that If above work is not paid tot Irt 90 days I agree th a~ow Am'ow
Pump & Werl Sm'vice, LLC. the right to remove unpaid for e~lulpment and charge for labor a~ready performed & labor to remove unpaid for equipment.)
TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOIl. OWING PURCHASE.
SERVICE CHARGE AT RATE OF 1.5% PER MONTH WV_L BE CHARGED ON OVERDUE ACCOUNTS.
,~1~. CT&E E:~vlrmlmenta! Set'viC, la
P.OI/~2 F-3?S
Nit.,ate-N
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EPA
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0 cot/lOOmL SMt{ 9222rl
(<10) C&'Z.I~! SCL
From:UPS STORE EAGLE RZVER ALASKA
ADDRESS _ ~O O ~o ~
DATE- Su~ed_
PE~ ~MBER
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From
To:677776G 09/21/2007 09:14
SULLIVAN WATER WELLS
P. o. BOX 272, CHUGS/AK. ALASKA 99567 · TELEPHONE 688-2759
DE~r, or WELL ~
STATIC LEVEL OF WATER FT. _
DRAW DOWN Fr. _
"GAL~. PER HR _
KIND OF CASING
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......... From_. -
DRILLER'S NAME
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
Initial
Date Issued: Sep 21, 2007
Expiration Date: Sep 20, 2008
Permit Number: SW070258 Parcel ID: 051-323-18
LegalDescription: LAKERID,,GE'[F,..R_F~CE, E)LK 10LT 4A. .
Design Engineer' J~o ~ ~L~~y~~-~-~-'~ite Address
· : 014215 HAROLD LP
Owner Name: HENRY WARREN Lot Size: 15902 SQ. FT.
Owner Address: PO BOX 770848 Total Bedrooms: 3 Permit Bedrooms: 3
EAGLE RIVER, AK 99577-0848
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well [] Water Storage
Ail 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.
5. The following special provisions.
THIS PERMIT APPLICATION WAS DISCUSSED BETWEEN MIKE ANDERSON AND DAN ROTH (ONSlTE
MANAGER). I HAVE BEEN AUTHORIZED BY DAN ROTH TO ISSUE THIS PERMIT FOR A SEPTIC TANK
UPGRADE.
Issued By: ,.~ Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
~',~ On-Site Water and Wastewater Program
~'~ P.O. Box 196650
Anchorage, Alaska 99519-6650
www.muni, org/onsite ,~'
(907) 343-7904
ON-SITE SEWER/VVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D..051-323-18
Property owner(s) Henry N. Warren
Mailing address P.O. Box 770848 Eagle River, AK
Site address. 14215 Harold Loop Eagle River, AK
Day phone 696-2294
Zip Code 99577
Zip Code 99577
Legal description (Sub'd., Block & Lot) Lat4, Block 10. Lake Riddle Terrace Subdivision
Legal description (Township, Range & Section)
Lot Size 15,902 Sq. Ft. Number of Bedrooms Three (3)
THIS APPLICATION IS FOR ([] all that apply):
Absorption Field []
Septic Tank []
Holding Tank []
P~vy []
Pdvate Well []
Water Storage []
THIS APPLICATION IS AN:
Initial []
Upgrade []
Renewal []
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.
(S'gnatura of property owner or authorized agent)
Permit~ush Fees: _
Date of Payment:
Receipt Number, _
(Rev, 11/05)
Waiver Fees:
Date of Payment:
{~ ~ ~Receipt Number,
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 {FAX}
September 21, 2007
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Su~e~:
Lot 4, Block 10, Lake Ridge Terrace Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:.
The septic tank on Lot 4, Block 3, Lake Ridge Terrace Subdivision has collapsed and
the resident of the house is currently using rest room facilities at other locations. We
are proposing to replace the tank with a new 1,000-gallon steel tank to serve the three-
bedroom home on the lot. The existing tank is only 82' from the well on the lot. The
new tank will be placed as far as possible from the well, but it is not possible to place it
outside the 100' protective radius due to the location of the absorption pit. A waiver will
be requested in the near future once additional information is assembled pertaining to
the well. At present the well is only used for landscaping purposes and the resident of
the house has a water storage bladder in his crawlspace for personal use.
We are hereby requesting a permit be issued on an emergency basis for the
construction of a new septic tank to serve the home. The attached Site Plan and
backup documentation identify the location and configuration of the existing septic
system and the location of the new tank. Also identified on the plans is the existing well
on the lot. The existing tank will be properly disposed on the property or removed from
site. The existing surface drainage pattems will be maintained after construction.
The existing well is cased to bedrock and is 134' deep. The ground surface at the well
head is more than 6' higher than the location of the septic tank with a ground slope to
the north and away from the well. The new tank will be nearly 90' from the well. The
static water level in the well is currently 50' below the surface. A waiver will be
submitted once all characteristics of the well and underlying soils are determined. In
the event a waiver cannot be issued for the reduced separation distance the owner will
decommission the well in accordance with State and Municipal requirements.
Lot 14, Block 10, Lake Ridge Terrace
September 21, 2007
Page 2 of 2
The ground surface on the lot slopes at an approximate 6% grade to the north. The
new septic tank will be constructed near the location of the existing tank and as parallel
with the slope of the land as possible in conformance with Municipal requirements.
If the system is constructed in accordance with our design the following statements
apply:
1. The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
4. The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
Michael E. Anderson, P.E.
Attachments
TRACT B
11
18
13
7
8
10
1
9
ml~,u
8
8
3
49'th
6
5
.4
3
8
No. c¢-438! ~
AREA MAP
SCALE 1' = i00'
ON-SITE WASTE'WATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 4, BLOCK 10, LAKE RIDGE TERRACE SUBDIVISION
GENERAL:
1. The scope of this project includes the pumping and removal of the existing
septic tank on the property and the procurement and placement of a new
.1,000-gallon septic tank at the location shown on the S te Plan. Work also
includes the placement of a foundation cieanout and tieing the new tank into
the existing post tank cleanouts and absorption crib. The new septic tank
must be placed as far as possible from the existing well on the lot and 100'
from all private wells and any surface water in the area and 10' from the
water service line from the well A minimum of 4' of cover is required over the
septic tank. The foundation cleanout must be replaced if one is not found on
the property.
2. Construction shall be in accordance with the approved site plan, design
drawings, Municipal Permit with any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal Regulations.
3. The Contractor shall be responsible for obtaining all underground utility
locates and for the layout of the septic system and verification of the location
of all lot lines. The Contractor must also verify the location of wells in the
area and assure that the separation distances are met.
4. Unless specifically agreed otherwise, the contractor shall be responsible for
final grading areas subsequently depressed from soil settling. Property
owner shall be responsible for revegetation of affected areas unless
specifically agreed otherwise.
5. Contractors installing wastewater disposal systems must be certified by the
Municipal Development Services Department Building Safety Division On-Site
Water and Wastewater Program for system installations. Owners installing
their own systems must receive prior approval from the On-Site Water and
Wastewater Program before beginning system installation.
SEPTIC TANK INSTALLATION
1. A new 1,000-gallon septic tank must be procured from an approved source
and installed at the location shown.
2. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
Lot 4, Block 10, Lake Ridge Terrace
September 21, 2007
Page 2 of 3
3. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
4. All standpipes on the septic tank shall extend a minimum of 12 inches above
final grade.
5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial
insulation.
6. A foundation cleanout shall be installed one to four feet from the building
foundation. Two cleanouts are required between the tank and the drainfield.
7, Final grading over the tank shall be such that a positive slope exists away
from the septic tank.
DRAINFIELD CONSTRUCTION: _ EXISTING ABSORPTION PIT TO REMAIN IN
SERVICE
1. The drainfield shall be constructed to the dimensions shown on the design.
The bottom of the trench shall be within 2" of level.
2. Distribution piping must be placed level with perforations down atop a level
bed of drainfield rock. Rock should then be placed over the pipe to provide a
minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the drainfield rock
and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations shown on
the design. The portion below ground must be perforated.
5. Contractor shall verify the septic tank and drainfield are a minimum 100' away
from any private water wells in the area, 150' from a Class "C" Well or 200'
from any community well.
Direct bu~y insulation must be placed over the distribution system if less than
6. 3' of backfill depth is available. Finish grade over the trench must be
mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trench to drain away.
8. A minimum 2' of accepting soil is required below the drainfield rock for a 5'
wide trench. All pockets of unacceptable materials must be removed and
replaced.
Lot 4, Block 10, Lake Ridge Terrace
September 21, 2007
Page 3 of 3
MATERIAL SPECIFICATIONS:
1. Septic tanks must be constructed by a municipally approved septic tank
manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (Perforated and
solid), ASTM F810 or H.D.P.E. (Perforated, but not solid) and ASTM D2662
or A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow
Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Femco, or equal).
5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed
between the final drain rock layer and the native soil layer.
6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the
#200 sieve.
INSPECTIONS:
Municipal Ordinance requires a minimum of two inspections. These inspections
must be conducted under the supervision of a professional engineer registered
in the State of Alaska. The first inspection must be conducted after the
excavation of trenches, beds or pits and before the installation of any gravel. A
septic tank may be set in place, but may not be backfilled.
The second inspection must be conducted after the placement of the geotextile
fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No
backfill should be in place at the time of inspection.
Contractor shall provide a copy of all field survey layout and construction notes
for use in preparing the certified as-built of the completed system.
ANC..ORA E
Building Safety DIwsion
MEMORANDUM
DATE: September 21, 2007
TO: FILE
FROM: Joe Goodall
Engineer II, On-Site Water Wastewater Program
SUB J: LAKE RIDGE TERRACE BLOCK 10 LOT4
THIS PERMIT APPLICATION WAS DISCUSSED BETWEEN MIKE
ANDERSON AND DAN ROTH (ONSITE MANAGER). I HAVE BEEN
AUTHORIZED BY DAN ROTH TO ISSUE THIS PERMIT FOR A SEPTIC
TANK UPGRADE.
Rick Mystrom,
Mayor
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
September 11, 1997
Henry N & Ingeborg Warren
PO Box 770848
Eagle River, Alaska 99577 0484
Subject: Lot 4 Block 10 Lake Ridge Terrace Subdivision
Permit #SW960291, PID #05~-323-18
The subject permit, issued September i1, 1996 by this office for a
single family well and/or on-site wastewater system, has
expired as of September 11, 1997.
A new permit must be obtained from this office for a well
and/or on-site wastewater system NOT installed by the
expiration date.
If you have drilled the well, a well log must be sent to
this office for documentation of the installation and to
close the permit.
If a licensed Professional Engineer has inspected the
installation of the on-site wastewater system, the original
as-built inspection report must be sent to this office for
review, approval and documentation. All inspection reports
must be submitted within 30 days of construction completion.
When applying for a new permit, the fees are: $320.00 for an
on-site wastewater permit; $120.00 for a well permit and
$440.00 for a combined on-site wastewater and well permit.
If you have any questions, please call this office at 343-4744.
S,i~r e 1 y, ~
On-site Services
enc: Copy of Permit
MUNICIPALITY OF A~CHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
PAGE
1 OF
ON-SITE WELL SYSTEM PERMIT
PERMIT NUMBER:SW960291
DESIGN ENGINEER:DUMMY COMPANY
OWNER NAME:WARREN HENRY N & INGEBORG
OWNER ADDRESS:P.O.BOX 770845
EAGLE RIVER, AK 99577
DATE ISSUED: 9/11/96
EXPIRATION DATE: 9/11/97
PARCEL ID:05132318
LEGAL DESCRIPTION:
LAKE RIDGE TERRACE BLK 10 LT
LOT SIZE: 16515 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONSTRUCTION OF:
WATER STORAGE 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 (18AAC80) .
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
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 PROVISIONS:
.~%~THIS pERMIT IS FOR THE INSTALLATION AND OPERATION OF A
TABLE wATER STORAGE TANK WHICH MUST CONFORM TO AMC
AMC 15.55.070i
2.~ WATER DELIVERY MUST BE BY A WATER HAULER CERTIFIED BY THE
S,T'ATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
RECEIVED
ISSUED BY:
PAGE
2 OF
This is a request for installation of a Burch Kolaps-a Tank
for storage of household water. The tank would be installed
in our basement which has a concrete slab floor. The tank
to be installed would be model no FDA 712 MT which holds
1140 gallons and is described more fully on the enclosed
specification sheet, Installation to be accomplished by
R and S Plumbing in Ea~le River, and would require a one-
half horsepower jet pump,a pressure switch and a pressure
tank, in addition to the water storage tank.
MANUFACTURING COMPANY, INC.
The Easy, Economical Way
to Store or Haul Liquids
Multiple Uses. Ideal for
feeding livestock, crop
spraying, mixing fertilizer,
pesticides or herbicides, the
Butch Kolaps-A-Tank is at
home on the farm or ranch.
For parks, nurseries -- anywhere water
sources are scarce, the Kolaps-A-Tank
provides a mobile, reliable source of water.
Plus it's FDA approved for drinking water for
human consumption.
Unmatched Economy. The Kolaps-A-Tank is
the least expensive means devised to haul'
liquids on virtually any vehicle you have
available. Initial cost is substantially lower
than any comparable fiberglass or poly tank
on the market. For value, you can't beat the
Kolaps-A-Tank. The first tanks made are still
in the field after years of outstanding service.
kol Es
l ' tank
Superior Strength. Made
of rugged PVC (polyvinyl
chloride) coated nylon, the
Kolaps-A-Tank resists chem-
ical contamination, mildew,
rot, and solar heat exposure.
It's electronically heat sealed and capable of
withstanding severe outdoor exposure,
including -40° temperatures!
Versatile Capacity. The Burch Kolaps-A-Tank
can be handled easily by one man and yet
holds from 525 to 1340 gallons! It can be filled
and emptied in minutes with a centrifugal
force pump or drained by gravity flow. Seven
sizes are available to fit pickups and many
standard wagon boxes. On hayracks, the
Kolaps~A-Tank is self-supporting. Just thread
rope over tank, through D-ring guides, and tie
down.
Convenient to Fill, Dralr~ Quality 11/2" gate
valve is mounted on 8" PVC extension pipe for
easy draining. Big 10" diameter flexible sleeve
on top makes tank simple to fill.
_~.'
Compact, Easy to Store Even the largest
Kolaps-A-Tank can be folded up and stored in
an 18" x 18" x 18" carton.
SPECIFICATIONS
Approx.
Shipping Wt.
Model No. Approximate Size Gals. Liters Lbs. KG
FDA 50MT 40" x 50"x 12" (102cm x 127cm x 30em) 73 276 11 5
FDA 73MT 80" x 73" x 16" (203em x 185cm x 41cra) 275 1040 23 10.4
FDA 98MT 65" x 98" x 18" (165cm x 249cm x 46cm) 525 1987 33 15
FDA 610MT 6' x 10' x 2' (1.83m x 3.05m x .61m) 800 3028 42 19.1
FDA 712MT 7'x12'x2'(2.13mx3.66mx.61m) 1140 4315 58 26.3
FDA 714MT 7' x 14' x2' (2.13m x 4.27m x .61m) 1340 5072 64 29
FDA-approved models meet Food and Drug Administration 21CFR121.2514 of subpart F of the Food Additive
Regulation, making it safe £or drinking water used for human consumption.
From covered wagons to
turkey saddles...
Butch Manufacturing has been making
quality textile products for agriculture,
industry, and more for almost 100 years. If a
product you need can be made of canvas or
vinyl coated nylon -- chances are we can
sew it, heat seal it, or silkscreen it. Send us
your specifications and we'll be happy to
provide you with a free estimate.
Sales and Service:
360 E. International Airport Rd., Ste 9
Anchorage, Alaska 99518
AGKT 81
(907) 563-3770 Ph (907) 563-5502 Fax
Manufacturers of canvas and sunthetic textile tgroducts since 1882.
olazoq~ '~uao~.fpe ~u!&[
ou :leq.a, 2o~,oaoq~. ~uaa~[pu
--~-~-~
:,ilzado:d paq[zosop
::::..;'. :?': ':N~,:./,'.;:;.'-:-: ' "-:' :~-.
~[':Y9 i · ' V'';~ "' '
'; ~:_ ,:[,':.~;;;: :,7 f.:,. :..:7~? :..=' ' . ~." . .
[¢,-$i>~:-..-.: --. _:.; '., . .
a
t /
ANCHORAGE AREA BOROI,~"~
GAAB-HD-I
DErARTMENT OF ENVIRONMENTAL OUALtL ~'
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SiTE SEWAGE DISPOSAL SYSTEM
NAME
LOCATION
MAILING
ADDRESS
LEGAL DESCRIPTION
PHONE
SEPTIC TANK:
DISTANCE FROM WELL
LIQUID CAPACITY /'~-~
GALLONS.
NUMBER OF
MATERIAL ,.~'/"'-~'-.~'"Z...-. COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH
LIQUID
DEPTH____
SEEPAGE SYSTEM:
NUMBER OF PiTS
LINING MATERIAL
NEAREST LOT LINE
SEEPAGE PiT:
OUTSIDE DIAMETER
OR WIDTH
DISTANCE FROM WELL
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
, LENGTH2~'~ ,~-7 , DEPTH
BUILDING FOUNDATION
?
'¢4J.E.._.D R A I N FIELD:
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION AREA
DEPTH: TOP OF TILE TO FINISH GRADE
TOTAL LENGTH
, FOUNDATION , NEAREST LOT LINE , OF LINES
DISTANCE BETWEEN LINES~-~ TRENCH WIDTH IN. TOTAL EFFECTIVE
SQ. ET. LENGTH OF EACH LINE
.DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE~'~
WELL:
TYPE -~'/~'~ ~/~-J'~ DEPTH
~ / NEAREST
LOT LINE ~ , SEWER LINE
/.~...~.~ DISTANCE FROM ,.g/ WATER
, BU LDiNG FOUNDATION. ' SAMPLE ,'4'''/~'x/~--, NEAREST
SEPTIC / SEEPAGE / __ OTHER
., TANK '-~-~) '~'~ , SYSTEM /~ , CESSPOOL X/'~4/~--, SOURCES
DISTANCES:
~'~" C?za~5,~/~,~
DIAGRAM OF SYSTEM
GREAiER ANCHORAGE AREA BOR,..,alGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT
NAME OF APPL,C^N""
INSTALLATION LOCATION
rAAILING ADDRESS
__ PHONE .
LEGAL DESCRIPTION ~C'~ ¢
INSTALLATION OF; SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
SOIL TEST RESULTS
S~E, EPAGE PIT--X DRAI~q FIELD OTHER
TO SE INSTALLED BY
NOTE: THIS PERMIT IS NOT VALID WITHOUT
COMPLETION DATE ANTICIPATED
pfRMfT VAI.~rD ONE YFAR
FINAL INSPECTION~ 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE TYPE,~t~] O'~' {'~-t~rI~-'t~R'~RSEEPAGE AREA SIZE TYPE
MINIMUM DISTANCES, REQUIREMENTS
5 ft.
FOUNDAT}ON TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT 20 f%.
DRAIN FIELD
10 ft.
SEPTIC TANK TO SEEPAGE PIT WALL 15 ft
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
DRAIN FIELD
WATER MAIN TO SEPTIC TANK DRAIN FIELD l0
s~,c TANK. 25 f%.. SZE.ASE
TO RIVER, LAKE, STREAM.
DIAGRAM OF SYSTEM
DRAIN FIELD
SEEPAGE PIT
ALSO CONSIDER AREA WELLS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
HEALTH AUTHORITY
OR
LICENSED DESIGNER
LII:£ PI?£ S' \.--~ ~TANK
.I'I]NU~- IHSTNRCED//~ (.CAST IRON SlPIION PIPE
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN A~CORDANCE WITH SAID CODE.
DATE APPLICANT'S SIGNATURE
r, I ~.,~ 99503
3330 "C' Streei:, Anchorage, "*-'-'"- ' .....' ....
Date of "'~"'= +'; ~' ' ....
REQUEST FOR AP~OVAL
INDIVIDUAL SEWER & WATER FACILITIES
Approval requested by:
~a'iling Address:
Property Owner:
Mailing Address:
PhoT;e:
,~, L.,=gc, ~ Descriptioiq:
Location:
iypa o'r ~c,c,lii:y '80 oe
Hu. Of badpoolTs
-ca:
A. Type Drilled
C, Construction StanEard
Sewage Disposal System:
A~ installed 1972
uelJ l.,h
installer
Co Septic Tank: 1. Size .i. 000
~ Seepage Pit: i '; ...... '
., . ~OSO, ,OulO.l Area
',500 sq. '¢'
;.u. 2. Material
Disposal Fi*''':
, ~a TOtal length of lines
~ c i to:
Septic tank
50~
Absorption area I
i00~
Nearest 'tot line
20"
COR be, it n~ blO!l
40"
-. ., ..... ~ 28~
8. -ouhaau.or to septic tank
C. Absorption area to nearest lot line
Absorption area __
20:
Di s~.pprm, e~
owl J/alid TOt one year '~ om e~ s'igneci
D'~'~r?~,:~ OF SYSTEM
~.;' cartii-~y ~h~,~ the, in'Format'ion contained 'in 'Cillfi 'reo~!es'B, 'For approval, to u="r ,~. ~;;.;;~ ,.:,,..
;~c(:L!r~te represerr~tion of the subject sewer and water facilities ..... :-~ ~'-. ....
are o~erating satisfactor'ily.
Data ......................
