HomeMy WebLinkAboutBRUIN PARK BLK 2 LT 7Bruin Park
Lot 7
Block 2
#016-102-14
z }.
I
DEC d
Municipality of Anchorage
Community Development Department Page 1 of 3
On -Site Water and Wastewater Program
4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP171167 PID Number: 016-102-14 ❑ New Upgrade
Name:
TRAVIS & HEATHER REIER
ABSORPTION FIELD
❑ Deep Trench El Shallow Trench El Bed ❑Mound
Address
11026 FOREST DRIVE
✓❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
5
1.0 GPD/SF
5.0 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
1.5 Ft.
Gravel depth beneath pipe
3.5 Ft.
Subdivision Block Lot
BRUIN PARK 2 7
Fill added above original grade
2.5 Ft.
Gravel length
2@51 Ft.
Township Range Section
Gravel width
5.OFt.
Beds: Number of Lines
N/A
Distance between lines
N/A Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
944 z
Ft
2
10 Ft.
Well
100.2
121.9
113.5
N/A
83.5
TANK El Septic r❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
ANCHORAGE TANK
Capacity
2000Gal.
Surface Water
100+
100+
100+I
N/A
Material
Number of compartments
Lot Line
57.5
20.0
68.8
N/A
STEEL
2
NA
Foundation
17.8
r28.3
37.4
N/A
LIFT STATION
Manufacturer
Capacity
Curtain Drain
50+
50+
50+
N/A
ORENCO
500 Gal.
Remarks
Pump on level at
TIMED in.
Pump off level at
in.
High water alarm at
45in.
Pump make and model
P2005
Electrical Inspections performed by
MOA BUILDING SAFETY
Installer
PIPE MATERIAL House to tank 3034 Tank to 3034
drainfield
BEEKS CONTRACTING
Drainfield 3034 CO/MT 3034
Inspector PANNONE ENGINEERING SERVICES
BENCH MARK (Assumed elevation) 105.0 ft
Inspection��' 12/19/17 nd
dates: 2 12/21 /17
Location and description
3rd 12/21/17 4`h 12/4/18
BOTTOM TRIM AT POINT B
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engineer's Stamp
rG OF �4L,Qll��
Conditional Approval: Date
-=
,o c�
Steven ° °�annone
Approved61Date110ff
f CE 814c
.•
... Vp
4
m6pecuon nepor[_ i- i- i t.coc
Q. LES. I Q N PARAMETERS Z\
PRIMARY SEPTIC SYSTEM
P
0 T 7
FC
37.1
24.3
L
38.5
NO. BEDROOM: 5 '750 gpd)
TANK SIZE: 2,000g S.T,E.P.
Ci
36.4
REM6VED TANK (E)
PERC RATE: <1 MPI
GRADE BREAK/ TOP OF SLOPE
48.1
R MOA CODE.
STALLED 20OOg S.T.E.P. TANK
/P
SOIL RATING: 1 GPD/SF
AREA ROD: 750 SF
59.1
SHED'
W/ FC BEFORE CONNECTED TO
END OF EACH FIELD
SYS. TYPE: WIDE TRENCH— 3.5 ED
RF:0.54
cl
MIN LENGTH: 81 LF
INSTALLED DRAIN FIELD
USED: (2EA) 51 LF x 5.0'W x 3,5'ED x5T
(2 EA) 51 LFx5'Wx3.5' E.D., 5.0' TD W/ 1,25"0 PIPE W/ HOI ES
TOTAL AREA: 944 SF DRILLED 30" O.C. INSTALLED MT
AT EACH END I 12.1\\
105.2 J
U
LEE REID 1989 •/
WELL (E)
RESERVE DRAIN FIELD
REUSE EXISTING (BASED ON CAT 111)
38LF x 5'W x 35ED x 6*TD
DRAIN FIELD
DRAIN FIELD
EXISTING GRADE 10%
2.5
15
Qt
FILTER FABRIC
0
. - /ID
RAI N
ROCK
0 ABOVE
INV
025 n,125, DRAIN I
—
O.G. TRENCH 1:100.0
TRENCH 2:
98,0
20009 S.T.E.P,3.5' DRAIN ROCK
TANK I I \ 11
"I UtArNmur- I '>
7T5BR DRIVEWAY
HOUSE
(E)
DRIVEWAY
00.2
0
1—
z
0
F.G. TRENCH 1.5
102
TRENCH 2 100.5
TRENCH 2: 96.5 TRENCH 2: 96.5
TH PES
(SOIL CONFIRMATION
—T:T E-7
SP
10
11
12 � SOH
DATE PERFORMED: I 9DECI 7
NOTES: PNE ENG SVC, LLC Date
RECORD DRAWING P.O. BOX 102954 ANCHORAGE, AK 99510 12/12/18
PHONE (907) 272-8218 FAX (907) 272-8211Scale
1 60'
BRUIN PARK B2 L7 P.I.D. NO
TRAVIS & HEATHER REIER PERMIT NO.
DRAWN ACP
11026 FOREST DRIVE A!.. CE 8149 OSP 17116 7
ANCHROAGE, AK 99516 Sheet
2 OF 3
A
B
FC
37.1
24.3
TI
38.5
35.1
T2
36.4
46.0
LS
36.2
48.1
M 1
45.8
59.1
24
83.6
50.6
M3
rM
58.1
72,5
M4
91,0
I 65.3
U
LEE REID 1989 •/
WELL (E)
RESERVE DRAIN FIELD
REUSE EXISTING (BASED ON CAT 111)
38LF x 5'W x 35ED x 6*TD
DRAIN FIELD
DRAIN FIELD
EXISTING GRADE 10%
2.5
15
Qt
FILTER FABRIC
0
. - /ID
RAI N
ROCK
0 ABOVE
INV
025 n,125, DRAIN I
—
O.G. TRENCH 1:100.0
TRENCH 2:
98,0
20009 S.T.E.P,3.5' DRAIN ROCK
TANK I I \ 11
"I UtArNmur- I '>
7T5BR DRIVEWAY
HOUSE
(E)
DRIVEWAY
00.2
0
1—
z
0
F.G. TRENCH 1.5
102
TRENCH 2 100.5
TRENCH 2: 96.5 TRENCH 2: 96.5
TH PES
(SOIL CONFIRMATION
—T:T E-7
SP
10
11
12 � SOH
DATE PERFORMED: I 9DECI 7
NOTES: PNE ENG SVC, LLC Date
RECORD DRAWING P.O. BOX 102954 ANCHORAGE, AK 99510 12/12/18
PHONE (907) 272-8218 FAX (907) 272-8211Scale
1 60'
BRUIN PARK B2 L7 P.I.D. NO
TRAVIS & HEATHER REIER PERMIT NO.
DRAWN ACP
11026 FOREST DRIVE A!.. CE 8149 OSP 17116 7
ANCHROAGE, AK 99516 Sheet
2 OF 3
2
3
4
5
6
7
8
9
10
12
13
14
15
16
17
18
19
TEST HOLE PES
OR I ORGANICS
BOH
DATE PERFORMED: 12/19/17
SOILS LOG PERCOLATION TEST
SLOPE SITE PLAN
SHED
TH —PES
TH
WAS GROUND WATER
ENCOUNTERED? y
IF YES, AT WHAT
DEPTH? 12.0'
DEPTH TO WATER AFTER
MONITORING?
DATE.
SLOPE
I
u
TH
/ 5BR
HOUSE
(E) /
READING
DATE
CLOCK
TIME
WATER
NET TIME LEVEL
READING
NET DROP
1
12/19/1-/
10:40
- 5.900
-
2
0:44:304.5
MIN 10.900
5.00
3
10:45
5-900
-
4
10: 49: 5C
4.8 MIN 10.900
5.00
5
10:50
- 5.900
6 I
10:55:015.02
MIN 10.900
5.00
PEROLATION RATE 1.02 inch —JrnLin �P
�
TEST RUN BETWEEN 3 FT AND 4 FT
COMMENTS: Test hole excavated by BEEKS CONTRACTING. Prec hole was presoaked.
Test run for at least one hour. Last 3 readings reported,
PERFORMED BY: DAN MORAN, I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDLINES IN EFFECT ON THE DATE OF THIS TEST.
NOTES:
PANNONE ENG SVC, LLC
P.O. BOX 102954 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
... . .... .. ......
........ .
. annon
CE 8149
Dote
12/12/18
RECORD DRAWING
Scale NTS
BRUIN PARK B2 L7
TRAVIS & HEATHER REIER
11026 FOREST DRIVE
ANCHROAGE, AK 99516
P.I.D. NO
016-102-14
DRAWN ACP
PERMIT NO.
OSP1 71167
Sheet
3 OF 3
%, "'` MUNICIPALITY OF ANCHORAGE
°. ° �r,cnt
On-Site Water&Wastewater Program ca' s;
PO Box 196650 4700 Elmore Road .f-
Anchorage,Alaska 99519-6650 Phone.(907)343.7904 Fax:(907)343-7997
http.//www.muni.orgionsite
epartmen1
44cwoaa6a
On-Site Wastewater Disposal System Permit
Permit Number: OSP171167 Effective Date: 8/8/2017
Work Type: Septic Upgrade Expiration Date: 8/8/2018
Tax Code Number: 01610214000
Site Legal Address: BRUIN PARK BLK 2 LT 7 G:2633
Site Mailing Address: 11026 FOREST DR, Anchorage
Owner: REIER GERALD T & HEATHER D Lot Size in Sq Ft: 41600
Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 5
This permit is for the construction of:
0 Disposal Field El Septic Tank ❑ Holding Tank 0 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
Special Provisions: A percolation test is to be completed at time of construction of the septic field to confirm the
design percolation rate. Location of test hole shall be as shown on permitted site plan. If percolation rate is <1
mpi, a sieve analysis shall be done on the soil to confirm 51% or more passes a #4 sieve. If the results require a
design change, construction of the system shall stop pending On-site review and approval of a change order.
Please submit stamped and signed results of the percolation test, as well as the sieve analysis if required, with
the inspection report/record drawings.
/ � w /� ?
Received By: r4.— �iN Date: /
Issued By: 6,tx.'
av: c Date: cF/c5/7 0 I
MunichaNty off Arachoraue
u,p,1 �Lh.1�,
P.O. Box 196650 G 4700 Elmore Road
Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997
http:llwww.muni.orglOnsite
Development Services Division
On-Site Water and Wastewater Program
**** VARIANCE/WAIVER REVIEW ** **
Waiver#: OSV171065 COSA#: Permit#: OSP171167
PID#: 016-102-14
Legal Description: Bruin Park Block 2 Lot 7
Engineer: Pannone Engineering Services
Applicant: Travis & Heather Reier
Your request for a waiver of the required 50 feet horizontal separation from the absorption field
to the excessive slope has been approved. The approved separation distance is 10.0 feet. See
engineer's waiver request and profile drawing for justifications.
This waiver approval applies to the proposed absorption field only. Any future upgrade to the
on-site wastewater disposal system will require all separation distances be met or another
approval from this department.
[] The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
❑ Notarized letter(s) of nonobjection have been received from the owner(s) of the affected
adjacent property.
® Adjacent properties are not affected by this waiver.
Waiver is Granted: X Waiver is not Granted:
Date: 0! 0/ 0 1 Approved by:
Name of Reviewer
**** VARIANCE/WAIVER REVIEW ****
MUNICIPALITY OF ANCHORAGE
/ ti". ) ---___i
Community Development Department �: ,�/, Pho-� 0 -34
Development Services Division `'� • ' ' 4,
On-Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION a
30\1 L 9 2.017I
c.
Parcel I.D. 016-102-14 it o 6 Q 9�
Property owner(s) Travis & Heather Reier Day phone
Mailing address 11026 Forest Park Drive, Anchorage, AK 99516
Site address 11026 Forest Park Drive
Legal description (Sub'd., Block & Lot) Bruin Park, Block 2, Lot 7
Legal description (Township, Range & Section)
Lot Size 41,600 Sq. Ft. Number of Bedrooms 5
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
lE all that apply)
Absorption Field El Initial ❑ Single Family (SF) El
(w/wo ADU)
Septic Tank ❑x Upgrade ❑X Duplex (D) ❑
Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Separation from slope Distance: 10.0
I certify that the above information is correct. I further certify that this is in accordance with
applicable Munici•al Codes.
1 -
(Signature of property owner or authorized agent)
Permit/Rush Fees: Jr I— Waiver Fees: 915-
Dateof Payment: {,!?JOIN Date of Payment: Ip1 30)17
Receipt Number: 05b'31 Receipt Number: DZ 145 t 6
Permit No. C(Den I1 Jo/ Waiver No. 05N/111066
Permit App_ - .:. .C:
Pannone Engineering Services ac
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail:steve@panengak.com
June 28, 2017
Subject: Bruin Park, Block 2, Lot 7
Septic System Permit Request
Design Narrative
This is a design narrative for a permit to install an upgrade septic system to be issued for this property.
The proposed system will serve an existing five (5) bedroom house. Currently the lot is developed. The
system will utilize a new 2000g S.T.E.P. tank. This lot and the surrounding lots are served by private wells.
There are no wells within 100' of the proposed septic system.
1. Soils. One test holes was conducted in the area by Leroy C. Reid Jr. in 1989. Bedrock was not
encountered in those test holes. Ground water was encountered at a depth of 10 feet in November of
1989. The test hole for the existing system on the subject property rated the soil at 150sf/br. An
additional test hole will be performed at the time of construction. The upgrade design is based upon
the original design absorption rate using 1 g/sf/d (150 sf/br)
2. Soil Absorption System Design.
a. See Sheet 1 of the design package.
3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and drain field.
The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage
ditches.
4. Topography: The existing topography on the lot generally slopes from east to west, with a slope
of approximately 10% in the area of the drain field, and a slope of approximately 50% as close as 10'
downslope of the proposed drain field. See waiver request.
5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that
the review is complete and that there are no further comments is received from MoA On-Site
Department, the note will be removed and "Issued for Construction" drawings will be issued.
The proposed installation will not affect the future development of this or the surrounding lots.
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
Pannone Engineering Services iic
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail:steve@panenaak.com
June 28, 2017
Municipality of Anchorage
Development Services Department
On-Site Water&Wastewater Program
4700 Elmore Road
P. 0. Box 196650
Anchorage, Alaska 99519
Subject: Bruin Park, Block 2, Lot 7
Septic System to Steep Slope
Waiver Request
Ladies and Gentlemen:
I am writing to request a separation distance waiver between the proposed septic system and a slope of
greater than 25%to ten feet (10').
The soils in this area are typically Hydrologic Soils Group A which contains organics underlain by
poorly graded sand (SP), as shown on the soils log.
Due to the nature of and drainage capacity of the soils found in the area (HSG A) the designed
infiltration line of 45% for septic system installation on steep slopes should be used instead of
the assumed/worst case soil classification infiltration line of 25%. The slopes and soil types
enable installation of any conventional system without the system effluent "daylighting"
further down the slope of the hill provided bury depth requirements are met.
Granting this waiver will not pose a threat to the safety of this lot or the surrounding lots.
Mailing: P.O. Box 100217, Anchorage. AK 99510-0217
Physical: 332 East Manor Ave, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
Page 2 of 2
Please contact me if you have any comments or concerns.
Sincerely,
•
I �
11 Steven R.P. none
4.4 136gS041 .1P4P
Steven R. Pannone, P.E.
Owner/Civil Engineer
Attachments:
-Site Plan
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor Ave, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
f
CN<
•
N /
0 /
,POS" 11 1
06
�0 /� OPS • / / / / • LL
�C / ' f r §
W J
\ U
DECOMMISSION EXISTING TANK PER CODE
AND INSTALL 2000g S.T.E.P. TANK / n.
/ INSTALL FOUNDATION CLEAN OUT SHED
•
GRADE BREAK/ TOP OF SLOPE-L ; TH-1 (P) SH LOT 7
•
DRAIN FIELD (P) 1 GARAGE N
(2EA) 51 LF x 5'W x 3.5'ED x 5'TD 1 70
WITH 1.25" PIPE WITH ,Ah ‘'% 12 '
Ya" HOLES DRILLED 30" O.C. ��. I� 6 . ` M ------..,,,:----
/.
�
INSTALL MT AT EACH END 4i ; // `
•
ci,
a' 1114
NI �4 ,;, • -4 5BR DRIVEWAY
r/ , •
rHOUSE
7/i ,•- 1;
N10.0 \O (E)
`2i) 101.7 t•
/1.-
- / TH-1
Alife
/ :6% LEE REID 1989 101.0 J<v
r WELL (E)
E. `" •
7i �O
/ WELL (E) • Qc
, , N /• k
•
\�. ��
N /
' RESERVE DRAIN FIELD V M-------- -----M
REUSE EXISTING (BASED ON CAT III) s�
38LF x 5'W x 3.5'ED x 6'TD '
, / \42\ /\
DESIGN PARAMETERS
PRIMARY SEPTIC SYSTEM
NO. BEDROOM: 5 (750 gpd) LEGEND
TANK SIZE: 2,000g S.T.E.P. W WATER LINE/
PERC RATE: <1 MPI WELL RADIUS ABBREVIATIONS
SOIL RATING: 1 GPD/SF TH TEST HOLE
AREA RQD: 750 SF SS NEW SEPTIC
SYS. TYPE: WIDE TRENCH- 3.5'ED (P) PROPOSED
RF:0.54 _ - _�B_ - — GRADE BREAK (E) EXISTING
MIN LENGTH: 81 LF CO CLEAN OUT NO.
USE: - 0 0 RETAINING WALL MT MONITOR TUBE NO.
(2EA) 51LFx5'Wx3.5' E.D., 5.0' TD TYP TYPICAL
TOTAL AREA: 944 SF
NOTES: >>>����\v Dote
PANNONE ENG SVC, LLC of A� �1 8�4�2017
FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 ..-�� qs ll
PHONE (907) 272-8218 FAX (907) 272-8211 "ea,:' �� 1;7I scale
DRAWN BY: If*; •• 1- • * 1"=50'
DRM rild •.,410���,. \. - I.D. NO
BRUIN PARK, BLOCK 2, LOT 7 / 016-112-14
- TRAVIS & HEATHER REIER 'teven'F�. F'onnorae PERMIT NO.
0 -v•, CE 8149 e Ai
— 11026 FOREST DRIVE #+ rJ. ., • '�. 0SP171167
PLAN ANCHORAGE, AK 99516 ll T404; ••. 1 f SheetOF 3
A\vV%-
DRAIN FIELD
DRAIN FIELD
EXISTING GRADE 10% - -
2.5
_._
3.5
50.0
SECTION
NOTES: PANNONE ENG SVC, LLC cf.A�`gs�1 8%4/2017
FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 r
PHONE (907) 272-8218 FAX (907) 272-8211 ecb.• �i� 91To Scale
DRAWN BY: ;or:
•
*.'49 1. /\ *1, NTS
/ ...'��� .. =. .D. NO
DRM BRUIN PARK, BLOCK 2, LOT 7 �, W / 016-102-14
TRAVIS & HEATHER REIER -- Steven R. Pannone' PERMIT NO.
CE 8149 4 J OSP171167
11026 FOREST DRIVE fe cs . �
DESIGN DETAILS ANCHORAGE, AK 99516 4k .iEp•• '*... Sheet
`` N\\NO■-t 2 OF 3
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON-SITE WASTEWATER DISPOSAL SYSTEMS AND AND IN ACCORDANCE WITH AMC 15.65 AND 15.55.
2. SCOPE OF WORK: INSTALL NEW TANK AND DRAIN FIELD.
3. GROUNDWATER WAS ENCOUNTERED AT A DEPTH OF 10.0 FEET BELOW EXISTING GRADE AS EVIDENCED BY THE SOIL
TEST HOLE. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 10.0 FEET BELOW
EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY.
4. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION AND SEPTIC
LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN 30 FEET OF THE PROPOSED
SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE WORK.
5. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE ATTACHED.
6. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES.
7. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK. ALL SURVEYING
AND LOCATES SHALL BE IN PLACE PRIOR TO NOTIFYING THE ENGINEER.
8. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED DRAWINGS AND SITE
CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE DESIGN.
9. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED-LINE AS-BUILT DRAWINGS TO THE
ENGINEER. THE RED-LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS, PIPE ELEVATIONS, AND
TANK ELEVATIONS.
10. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE BOTTOM OF
EXCAVATION, TOP OF PIPE WITH CLEAN-OUTS AND MONITOR TUBES INSTALLED, INSTALLED TANK AND FINAL GRADING.
11. THE CONTRACTOR PROVIDED DATA (UPON WHICH THIS RECORD DRAWING IS BASED) APPEARS TO REPRESENT THE
PROJECT AS CONSTRUCTED. THIS DATA IN CONJUNCTION WITH THE PERIODIC FIELD OBSERVATIONS BY THE
ENGINEER (OR HIS DESIGNEE) AS REQUIRED BY AMC 15.65 DOES NOT GUARANTEE THAT THERE ARE NO HIDDEN
DEFECTS BY THE CONTRACTOR.
12. THE CONTRACTOR SHALL SIGN THE FOLLOWING:
I CERTIFY THAT ALL WORK WAS PERFORMED IN ACCORDANCE WITH THE APPEND PERMIT, AND ANY AND ALL CHANGE
ORDERS, AND THAT THE AS-BUILT REDLINES ARE TRUE AND ACCURATE REPRESENTATION OF THE PROJECT AS
CONSTRUCTED.
CONTRACTOR:
BY: , TITLE: •
DATE:
DESIGN PARAMETERS
RESERVE SEPTIC SYSTEM
NO. BEDROOM: 5 (750 gpd)
TANK SIZE: 2,500g ADVANTEX
W/ 2 AX20 PODS AND AUX PUMP VAULT
PERC RATE: <1 MPI
SOIL RATING: 6 GPD/SF
AREA ROD: 125 SF
SYS. TYPE: WIDE TRENCH- 3.5'ED
RF:0.54
MIN LENGTH: 13.5 LF
USE:
EXISTING 38LFx5'Wx3.5' E.D., 6,0' TD
TOTAL AREA: 352 SF
NOTES: PANNONE ENG SVC LLC _—„oz.-x.1% Date
OF AL l 8/4/201 7
FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, AK 99510 P'��'' 'QS
PHONE (907) 272-8218 FAX (907) 272-8211RAGE, 49%
DRAWN BY: pi' *' I ."� * NTS
BRUIN PARK, BLOCK 2, LOT 7 . • +2-14
TRAVIS & HEATHER REIER t'te en f . 'ann•pe PERMIT NO.
CE 8149 •ck-
0SP171167
11026 FOREST DRIVE r •
DESIGN DETAILS ANCHORAGE, AK 99516 +�k�`o�iPo►TSs�o�'� Sheet
3
\���
MUNICIPALITY OF ANCHORAGE ~)1~--/~)~'-//7
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name , DISTANCES
Z:~5'/?'~ '~' /'f//,~.r,¢14~J,..., ~¢~e~ ~ SEPTIC ABSORPTION WELL
Addres~ ~ TANK FIELD
~ - 2~ ~ ~ r ~ WELL
LEGAL OESCRIPTION LOT LINE
I Subdivision
,cDt ~ e,o~k ~ I ~ ~ FOUNDATION ~'~ ~ ~.~
Township, Range, S~tion
~ / ~ ~ ~ ;'~O/ ~ ~, / ~/~ --/~ --/~ driveway,AS'BUILT DIAGRAM (Show location of well, septic system, prope~y lines, foundatiOn,water bodies, etc,)
TANKS
Manufacturer Capacity in gallons ~
Material No. of Compa~ments ~
TYPE OF SYSTEM ~
~ TRENCH ~ BED ~ W. DRAIN ~ OTHER ~ ~
Depth to pipe bottom from Total depth from original grade
or~ai.a, ar~de ~,3~ FT ~ FT
Gravel depth beneath pipe
Fill adde~ above origi~ai grade ~'~ ~ FT ~,~ FT
Gravel length ~ /FT Gravel width ~/ FT
Total absorption area Distance between lines
~ so ~T ~/~ FT
Number of lines Soil rating Pipe material ~ ~
Date Installed
Installer . ~/~ ~ ~
, ,,
WELLS
~ PRIVATE ~ OTHER (Identilv)
oassification (A,e,C) Tota~ Depth ~ Cased to
~,~ /~ / ~TI /~ / FT '~ ~'~ ~.. . ..~,'
~/d,.~ ~;,//. ~ ;-/~-;?
REMARKS:
~ale: ~ ~ ~ ENGINEER'S SEAL
~.~ ~ ~a/~ ~a= ~ ~..~/~. ,.s,ec,o~s~e~orme~:
,- ,.
I ~ ~ /~e ¢ ~ ~'//e d cedily that this inspe~ion was pedormed according to all
Municipal and State guidelines in effect on this date: ~f~ ~ ~/~ '
Health Depadmenl Approval: _ ~ ~ . Date:
72-013 (3/85)
ALASKA E[1UIRO[lmEI1TAL CONTROL $ERUICE$, IFIC.
o I~nqince~'in§ ~ Enuironmenlal Studies
1200 LUest 33rd Auenue. Suite [~. Anchoraq¢. Alosko 99503.[907) 561-5040
TO
~A~.
S U B J E CT ,....~.~,,,~.,,-..Z..,...,...,.~'~r/,~l,:.:..~
...................................................................................................................................................... //~,~,.~, ~...~:.~,~.~ .................................
MUNICIPALITY OF ANCHORAGE
D ~t~?,. ,. OF,....HE~L:[:H &
ENVIRONMENTAL PROTECTION
INSPECTION REPORT
MUNICIPALITY OF ANCHORAGE,3500 EAST TUDOR BUILDING ROAD SAFETY DIVISION
NSPECTIONS (907) 563-3464 INFORMATION (907) 786-821
FOOTING [] ELEC. TEMP.
FOUNDATION [] ELEC. SERVICE 0-;:-
BOND BEAM [] ELEC. ROUGH
FRAMING [] ELEC. FINAL
INSULATION - [] OTHER
SHEETROCK []
STRUCT. FINAL [] FIRE FINAL
OTHER [] ZONING
[] PLBG. UNDGR. []
[] PLBG. ROUGH []
"~ GAS TEMP. []
[] GAS []
[] MECHANICAL []
MECH. FINAL []
[] PLBG. FINAL []
[] OTHER []
[] NO NONCOMPLIANCE OBSERVED
[] WILL REEXAMINE AT NEXT INSPECTION
[] CORRECTIONS ESSENTIAL AS
EXPLAINED BELOW
[] DO NOT CONCEAL UNTIL REINSPECTED
INSPECTOR DATE
WHEN CORRECTIONS ARE MADE, PLEASE CALL FOR INSPECTION
~ DO NOT REMOVE THIS NOTICE
84-002 [Rev,~l 1/87)
:Dliii:~J :1; A'T :[ EIN l:::'l::~[::)l"t ¢~F:'I;::I::~:E)VIE)',:)
1:::'1::;: :~: Cfi:;; "I"C! CE]f",IEi'T'I::;..'UCT'
V¢~'T']:[31q::ii~ klU~ilYl" ]:fie C)I::'ENIE:[:)/C:L,,E)St:ii:):.~
N]:C']H'T', "t"H:t:~ii~ F:'E:I::;:I"f]:T'
I:;:' ]: ~:;i:l."!!:t!!i; Ot",1 :1. 2/::!!; :I.
P~I",':h'.':~lql:)C)lxll!!i::[:), ¢":~ 1,,., :1: I:::'1"
'°,/ ALASKA 6FIUIROFImI FITAL CORTROL $ERUICI $, IRC.
.,~ I~nclincerinq ~, I~nuironm~nlal Studies
SPECIFICATIONS FOR A FIVE-WIDE WASTEWATER TREATMENT SYSTEM
LEGAL DESCRIPTION: LOT 7, BLOCK 2, BRUIN PARK SUBDIVISION.
1.0 GENERAL
1.1
The Drawings, sheets 1 thru 5, shall be a part of
this specification.
1.2 All materials and workmanship shall meet the
requirements of the Municipality of Anchorage,
Department of Health & Human Services (DHHS), the
conditions of the permit, and all applicable rules
and regulations currently in effect.
1.3
All elevations and depths are advisory and are to
be verified or modified in the field by a DHHS
approved inspector.
1.4
It is the responsibility of the property owner or
installer to adhere to approved designs for
installation, maintain the specified separation
distances, and have the appropriate inspections.
1.5
It is the responsibility of the property owner or
installer to report to the engineer any observed
conditions which would put the system in violation
of state or Municipal regulations.
1.6
If the installation is not inspected by an AECS
engineer, AECS will not be responsible for the
installed system. An engineer at AECS should be
consulted prior to construction, to determine the
number of inspections that will be required and to
explain what these inspections will involve.
2.0
SEPTIC SYSTEM
2.1
The existing septic tank may be used, if it meets
the capacity requirements for the residence and
the approval of DHHS. Older systems may need tank
integrity verified. If not, then specifications
2.2 through 2.6 apply.
2.2
The septic tank shall be a UPC-approved
two-compartment tank, constructed of 12 gauge
steel with bitumastic coating, set level on
undisturbed soil and insulated with overlying
layer of 2 inch burial type polystyrene.
2.3 The septic tank shall be a minimum of 5 feet from
1412 We, St 33Rb c~v6nu6 · ,kncho~ac~6, Alaska 99503 · (907) 279-5553
2.4
2.,5
2.6
2.7
the house foundation, and a minimum of 5 feet from
the absorption area.
The septic tank and drainfield shall be a minimum
of 100 feet from any private well or body of
water, 150 feet from Class "C" wells, and 200 feet
from Class "A" or "B" wells, unless otherwise
specified. Less than the required separation
distance must have prior approval or waiver by
Alaska Department of Environmental Conservation
(ADEC).
Piping shall be fitted with a mechanical
watertight calder coupling of the inlet and outlet
of the septic tank. Piping shall be 4 inch ASTM
D-3054 or cast iron, sloped a minimum of 1/4 inch
per foot from the house to the tank and 1/8 inch
per foot from the tank to the trench.
Cleanouts shall be installed as designated, capped
with air-tight rain caps (Jim Caps or equivalent),
and extend a minimum of 2 feet above ground level.
If a lift station is required, it shall be a
combination lift station septic tank per Anchorage
Tank and Welding, Inc. design. Specifications and
design drawings are on file with the Municipality
and the engineer,
3.0
DRAINFIELD
3.1
The gravel for the drainfield shall be 0.5 to 2.5
inch, screened rock with less than 3 percent
passing the No. 200 sieve. All substitutes must
have prior DHHS approval.
3.2
The bottom and side of the excavation shall be
raked with the backhoe blade to ensure that it has
not been compacted during excavation. The bottom
elevation shall be level.
3.3 Monitor standpipes(s) shall be placed as shown in
the drawings, and shall be rigid PVC ASTM D-8034,
or 4 inch cast iron. The section shown with holes
may be drilled 0.5 inch holes on the 6 inch
centers on opposite sides of the pipe, or a
regular section of perforated sewer pipe, clamped
to a solid section, with either a no-hub coupling
or a solvent joint. The perforated section of the
monitor tube shall be located in gravel only. A
3.4
3.5
3.6
3.7
rubber rain cap (Jim Cap or equivalent) shall be
placed over the top of the pipe.
The distribution pipe shall be 4 inch rigid PVC
with a minimum crush strength of 1500 pounds or
equal. All distribution pipes shall be laid
level.
If the final grade of the drainfield is less than
4 feet from the gravel, insulation is required
using burial type polystyrene rigid board
insulation. There shall be 1 inch of insulation
for every foot of soil less than the required 4
feet of cover, but there must be at least 18
inches of soil cover even though insulation is
used. The solid pipe extending from the septic
tank or lift station to the drainfield shall also
have a minimum of 4 feet of cover or an equivalent
layer of insulation to prevent freezing of the
line.
Filter fabric is required on top of rock.
It is recommended that the area excavated and the
area in the vicinity of the drainfield shall be
planted with a white clover, red rescue mix, or
with Kentucky bluegrass.
4.0
INSPECTIONS
4.1
A minimum of three inspections are required for
installation of the trench. The first inspection
will be of the excavation to verify that the
installation will be in the proper soil.
4.2
The second inspection will be after placement of
the gravel, monitor standpipe(s) and distribution
pipe to verify proper installation before
backfill.
4.3
The third inspection will be after final backfill,
grading and seeding to ensure that adequate soil
cover has been proved over the drainfield.
4.4
The inspection of the septic tank can be
incorporated with any one of the above listed
inspections.
4.5
The lift station will require either an MOA
electrical inspection or certification by a
licensed electrician depending on whether the
building code applies to this part of the city.
ALASKA ENVIRONMENTAL
CONTROL SERVICES, INC.
JOB
SHEET NO
CALCULATEO,V /,
CHECKED BY DATE
SCALE
PRODUCT 21)4-1 ~ Inc., Groton, Mas~. 01471
0
Z
Iii
J
H
X o
Z ·
LI
hi n
ri H
c
o
0
L
0
C
$
.J
J
H
0
> o
Z 0 mo
.0 fl'
ZU ~
0~ "~
>~;
<OZ m
z gram
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
,, SOILS LOG -- PERCOLATION TEST
PERFORMED FOR: ~/~
LEGAL DESCRIPTION:
1
2
3
4
5
WAS GROUND WATER
ENCOUNTERED?
S
IF YES, AT WHAT / ~)
DEPTH? /'~ p
E,
SLOPE SITE PLAN
Depth to Water Alter/~,, /,8/~o/1~'~,
Monitoring? Date:
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE __
(minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~ FT AND FT
COMMENTS
PERFORMED
ACCORDANCE WITH ALL STATE'AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE.
72-008 (Rev, 4/85)
CERTIFY THAT THIS TEST WAS PERFORMED IN
DATE: /~-/'/~'?
ALASKA ENVIRONMENTAL'
CONTROL SERVICES, INC.
!200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
JOB
SHEET NO.
CALCULATED BY
o~ .4-
DATE
REID, JR~
i'¢E~2251
4¢'*"
Me ~o poe
./
,N
9'.
EAS~,M~NTS OF RECORD, 'OTHER THAN THOSE SHOWN O~ THE
RECORDED PLAT ARE NOT SHOWN HEREON.
The-information hereon 'is for the use of lending
institut'ions.-showing-the ,relationship of existing*
structures and platted easements and lot lines.
It is not to be used for positioning additional''
structures or fencelines.
DRAWN: DMS" IFB ] 6RID: 10-20-89
:. ~ .......... [ .,DATE ....
SCALE: : . :
1"=30! 9-53 2633 ·
AS-BUILT/No oorners set this date
I hereby certify that l' have performed a ~;ortagec'~ ~-
spe.ction of the lollowEng described property:
Bruin Park Subd..,L,ot 7,Blk. 2 ,,.
Ancho~rage }l~cording ~ecinct, Alaska, and that the
men~ ~ituat~ th~aon ~e wi~ the pro~2 ~ne~ and do
"'not'overlap or'end.ch on the pro~ty lying adjacent ~er~
~, that no ~p~vemen~ on pro~ lying adjacent ~ereto
e~t~oach on the pre~as ~ question ~d that ~ are
roadway,, W~sm~ion lines or other visible e~man~ on
said ~roperty except ~ lndica~d
Dated at ~orage, ~uka ·
~j~ 2Q, day of, Oct. ,, 1989
~ 688.4565
t
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
RECEIVED
,N
EASEMEN"i'8 OF RECORD, 'OTHER THAN THOSE SHOWN.O~ THE
RECORDED PLAT ARE NOT SHOWN HEREON.
The~-information hereon 'is for the use of lending
instit~'i'Ons-sho~ing-the .relationship of existing'
structures and platted easments and lot lines.
It is not to be used for positioning additional
structure~ or fencelines.
DRAWN:_ '.. DMS ,'
SCALE: . " ' 10-20-89
FB: ' ' '
!"=30', , 9-53 2633 -
AS-BUILT"No' oorners ,se~ ~his date
hereby certify that 1' have par/ormed a ~orlagee'~
spectlon 0% the following described property: , ~
Bruin Park Subd. ,Lp.t ~,Blk.... 2
Anchorage P~cording Precinct, Alaska, and that the improve-
masts situated thereon are within the pro~ert¥ lines and do
'not'overlap or'encroach on the property lying adjacent there~
to, that,no im. provements on property lying adjacent thereto
encroach on t~e premises in question and that there are no
roadways, ~ansmi~s/on lines or other visible ea.~ment~ on
said property except as indicated he.i-eon~
Dated at Anchorage, A~ask& .
m!: 20 da3, or.,, Oct.
· . - 688-4566
.SEWA.RI.).&.. A...SS.OCIATES LAND SURVEYING
WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of ISeologicol 8~ Geophysicel Surveys
Drilling Permit No.
LOCATION OF WELL (Please complete either ia, lb or lc.) A.D.L. No.
~a~.lBorough Subdivision Lot Block I-'~.I '/4qlrs. Secfion No. TownshiPN0 Range E['-J Meridian
~.,~,,~ 7 "Z- _o,_o,_of_ sn wn
DISTANCE ~ND ~' '~ ROAD INTERSECTIONS ~. OWNER OF WELL:
DIRECTION FROM
,,
Address'. ~ ~.-~-~4: .~ ,,1 ~c~.
Feet Below 4. WELL DEPTH: (final) 5. DITE~F CO~PLETIO~
Material Type Top Bottom ·-
'' '~ ' ' ~ ~,,,. ~ ,~. ,al'd/,,. o.,,~ w.,~,, 17 ,~,.I,,.
,
diem. in. to__ fl. Depth Stlckup .
9. FINISH OF WELL:~.
Type: ~ /- - Dlomefer:
~ Slot/M Size: Length
..'~ .~- Set between ft. and ft.
.~ Backfillin~ Gr~vel pock
" / t'i
/
~ . .~,' I0. STATIC WATER LEVEL: .~'~_
'~ ........... /'~ ~ AbOve or ~:Below land surface Dote
~, ,~,::, /~ ' fl. ,flor hrs. pumping~g.p.m.
Materiel: ~ Neat Oenent ~ Other:
't, I~.PUMP: (If available) HP
Length of Drop Pipe ft. ~apacily g.p.m.
14. REMARKS:
16. WATER WELL CONTRACTOR'S CERTIFICATION:
15. Water Temperature ~o ~ F ~ C
This well was drilled ~r ~sdlction and this ~eport is true fo the~est of my knowledge and belief;
/r~i~F~r~'a Busi.~s No~ ' ' Conlract' Licen~ Number
~,,,,,~ ~, Z~.~ //~2/~ ,~..~~ /~'~>~'~. -,': //'
m...... ~ dt ~ori'z~d ~present, five
Form O~-WWR (Il/81) C~y~isiri~tio~.;'"WHl~E~ -~t~fe ~6~S, PINK-Driller, CANAEY-CusIomer
MUNICIPALITY Of ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Sita Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
(907) 343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILLY DWELLING
Parcel I.D. #
016-102-14
HAA # ,,~/'q ( i(' ?(2:'/ I ~
1. GENERAL INFORMATION
Complete legal description BRUIN PARK SUBDIVISION: LOT 7. BLOCK 2.
Location (site address or directions) 11026 FOREST DRIVE
Property owner
Mailing address
Lending agency
Mailing address
LARRY DONAHUE Dayphone 244-5568./5447-5150
11026 FOREST DRIVE ANCHORAGE. ALASKA 99516
Day phone
Agent TAMMY KELLY w./ REMAX PROPERTIES
Address 2600 CORDOVA STREET ANCHORAGE. ALASKA
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 2
TYPE OF WATER SUPPLY:
Individual well xx
Community well
Public water
Day phone (907~ 276-2761
99505
NOTE: ff community well system, provide written confirmation from State ADEC attest-
lng to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding Tank
Community on-site
Public sewer
XX
NOTE: If community wastewater system, provide written confirmation from State ADEC
lng to the legality and status of system.
72-025 {Rev, 1/91 } Front MOA #21 Computer Version
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verity that my
investigation of this Health Authority Approval application shows that the on-site water supply and/or
wast°water disposal system is safe, functional and adequate for the number of bedrooms and type of
structure indicated herein. I further verify that based on the information obtained from the Municipality of
investi ation and insp,~ction, the on-s te water supply and/or wast°water
Anchors efi es and from my g ' ulat OhS n effect
d sposalg~ystem is in comp ance with all Munici ,P, al/and State codes, ordinances, and reg
on the date of this inspection. , /-7/ [
^, o~,^ ,^,A'~ ~/~S/T~'~/~ITER CONSULTANTS, INC.. Phone_ (907)
Name of Firm **~-,o, ............
Address 0901 DEBAReROA.D/, ~'~L'T/E 2//¢/ANCHORAGE, ALASKA 99504 .= 3/~o
Engineer's Signature-( .... ~,,iY~- ~=' .O,~-
In conducting this .valuation. AWWC. ,n/,tfJmpt(~J to provids a th°r°Ugh' consden#ous eegtheedng
~aiysis of fhe system in accordance wffh ADEC and MOA DHHS Guidelthss & Regulations, The repotted ~:=',~ "~. ,', ? '
"dtI. tI. tI. 4, ·.
a~dsspt~ssystsrnsdepond~nth~lcca~s~tIsc~dtIi~n~r~und~t~w~$th~t~n.~y#uct~at°~sdngthe ~....," .,.. ~ . . .:....~
guaranis° future performance o! tbs system, no~' do lbeY gusranisa thst there are ~o hidden de~ect~ or ,'"
encro~chrnsnts. AVVWO, tho. can lhere~ore ~o~ provide a~y wauanty Cot future performance nor giro any ~t~._ ' tfr~ A. G~rn ess.:
sstImat~ ~ h~w ~ng ~h~ syst~rn ~ c~ntin~ ~ meet ~h~ °poratI~ns~ regulrerne~t~ ~f th~ A~ ~r M~A ~ ~ ,~-7955
OHHS, The cent°hi of this report Is rot th~ sole bene§t o! ths re'met listed ~bove, Any retis~ce upon et ss°
~Hh~ r~port by a~y ~h~r pors~n ~r Par~y ~s n~t au~;h~ri~ed~ n~r wi~ ~t c~n~r a~ ~ega~ r~gh~ wha~w~. ' · ' '
2. Alaska Wa ter a.d Wast°water Cot~sultants. thc, shall be pold $1.165.00 at, or pdor to, closing for the ~:~e~
engineering sap/Ices provided.
6, DHHS SIGNATURE
L.--'/ Approved for_ ~'- . 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 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.
72K)25 (Rev. 1/91 ) Back MOA g21 Computer Version
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVIC~R
Environmen~i Se~i~s Division
825 "L" Street, Rm 502 ~chomge, Alaska 99501 (907)
Health Authority Approval Checklist
Legal Description: BRUIN PARK SUBDIVISION; LOT 7, BLOCK 2 Parcel I.D.:
A. WELL DATA
Well Type PRIVATE
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Date of test
141'
IfA, B, or C, attach ADEC letter. ADEC water system number
Y Date completed
Cased to 141'
YES
FROM WELL LOG
12/lO/B9
12-10-89
Casing height (above ground)
Wires properly protected (Y/N)
AT INSPECTION
5/15/2000
57' 42'
17"
YES
016-102.14
Static water level
Well production
40 g.p.m. 6.5+ g.p~m.
, .~'~ %c~/~. Other bacteria ~
Collected by: A.W.W.C., INC.
Number of Compartments 2 Cleanouts (Y/N). YES
NO High water alarm (Y/N) N/A
WATER SAMPLE RESULTS:
Coliform ~ Nitrate
Date of sample: ~ c~ _[(~
B. SEPTIC/HOLDING TANK DATA
Date installed 12/8/89 Tank size 1250
Foundation cleanout (Y/N) YES (iN BASEMENT) Depression (Y/N)
Pumper. A+ HOME SERVICES
Soil rating (g.p.d./fl2 or ff2/bdrm) 150
5' Gravel thickness below pipe 3.5' Total depth
Date of Pumping 5/15/2000
C. ABSORPTION FIELD DATA
Date installed 12/8/89
Length 58' Width
Effective absorption area 552 SO.FT.
Date of adequacy test 5/15/2000
Fluid depth in absorption field before test (in.);
Fluid depth 31.5 (ins) Minutes later:
Peroxide treatment (past 12 months) (Y/N)
72-026 (Rev. 3/96)* Computer Version
Monitoring Tube present (Y/N) YES Depression overfield (Y/N)
Results (Pass/Fail) PASS For
28.5 Immediately after 461
173 Absorption rate =
NONE KNowN If yes, give date
System type SHALLOW TRENCH
6'
NO
2 Bedrooms
gal. water added (in.): 58.25
,300+ C.P.D.
D. LIFT STATION
Date installed 12/8/89
Manhole/Access (Y/N) YES
High water alarm level at*. 45"
Cycles tested ;5
Size in gallons 1250
"Pump on" level at* 43" ."Pump off" level at*
*Datum BOTTOM OF TANK
39"
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
100'+
100'+
N/A
25'+
On adjacent lots. 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Lift station N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation. 5' + Property line 5' +
Water main/service line 10'+ Surface water/drainage. 100'+
SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO:
*8'
Building foundation
100' +
10'+
NONE KNOWN
Property line
Surface water
Curtain drain
Absorption field.
Wells on adjacent lots
5'+
F. ENGINEER'S CERTIF
I certify that l/f~d~l
of Municip§[ recor~s/i
with MOA ~AA g~ic/~
Signature
Engineer's Nam/e
Date
100'+
*SEE AFFACHED WAIVER REQUEST.
.Water main/service line 10'+
Driveway, parking/vehicle storage area
Wetls on adjacent lots 100'-
field Inspections and review
systems are In conformance
)n this date.
JEFFREY A. GARNESS
>g
10'+
'4--~ ~) ¢ ,, Waiver Fee $
HA,& Fee $
Date of Payment (-~> '-- ~-?/~-- E:~ C) Date of Payment
Receipt Number ¢2'~¢z7 ~'k~(/~l/? "~,,~ , Receipt Number
72-026 (Rev. 3/96)* Computer Vemlon
AK Water & Wastewater Consultants, Inc.
ATTN: Jeffrey Garness, PE
6901 De Barr Road, Suite 2B
Anchorage, AK 99504-
March 31, 2000
Subject: Waiver Request forBRUIN PARK BLK 2 LT 7
Waiver # WR000015 Lot Line Request for Parcel ID 016-102-14
Dear Engineer:
Your request for a waiver of the required 10 feet horizontal separation of the on-site wastewater
disposal system to the lot line has been approved. The approved separation distance is 8 feet.
This waiver approval applies to the current on-site wastewater disposal system and lot line
separation only. Any future upgrade to the on-site wastewater disposal system and lot line will
require all separation distances to be met or another waiver approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office at
343-4744.
Sincerely,
jeffPoet~ ~a'~'7~
Engineering Technician III
On-Site Water Quality Program
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
On-Site Services
Waiver Review Worksheet
WR#000015 PID# 016-102-14 HA#: HA000113 Permit~
Date Received: Mamh 24, 2000
Legal Description: Bruin Park Subdivision, Lot 7, Block 2
Engineer: Alaska Water & Wastewater Consultants
6901 Debarr Road, Suite 2-B, Anchorage, AK 99503
Applicant: ~.F~,~ /'~E)~'/'?~ ..........
Waiver Requested: Property line wiaver on the subject property for the separation distance between
the leachfield and the southwest property line at 8 feet.
Criteria: 1.
Geology
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
2. Special Conditions:
3. Other:
Points:
Total:
WaiverisGranted: ~
List Conditions or Reasonsfor above:
Waiver is not Granted:
Date: ~-3)'~o
l~j~e of Reviewer
Rec.~: 05795 Amount: $115.00 Date Paid: March 24, 2000
ALASKA WATER & WASTEWATER
October 21, 1999
Municipality of Anchorage
Department of Health & Human Services
On-Site Services Section
P.O. Box 196650
· Anchorage, Alaska 99519-6650
Subject: Lot Line Waiver for Lot 7 Block 2; Brain Park S/D
To whom it may concern:
Request you issue a property line waiver on the subject property for the separation distance
between the leachfield and the southwest property line at eight (8) feet. Enclosed is a copy of a
recent asbuilt survey by Shane Holt, Land Surveyor. The clean-out at the end of the leachfield is
located approximately 8 feet from the southwest property line. We measured the distance
between this cleanout and the neighhoring well (Lot 8; Blk 2). It meets the 100 fi separation
distance requirement. We do not anticipate any adverse effects by issuance of this waiver.
If you have any questio~
Sincerely, ~
, please contact us at 337-6179, or 244-9612.
JAG/gd
6901 Debarr Road, Suite 2-B * Anchorage, Alaska 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 * email: awws~alaska.net
03/21/2000 18:52 9072589701 TAMERA KELLY PAGE 82
8 38°03'00"W 160.00'
N 38~03'00"E 160.00'
MUNICIPALITY OF ANCHORAGE ~ '
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
Parcel I.D. #
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF'
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lOt, block, subdivision, section, township, range)
(b) Prop~pwner ~ d~ ~ Telephone : (home)
Mailin~es~)~~ ~ o~/~
~'~'"*"*"~"' - '" Tele hone
(c) Lending I~stitution '..~ ' P
Business
Mailing Address
(d) Real Estate Company and Agent
Address
Telephone
(e) Mail the HAA to the following address: (or check hereJZ, if hold for pick up.)
List contact person and day phone number below:
TYPE OF RESIDENCE
Single-Family,S.. Number of bedrooms
WATER SUPPLY
Individual Well)~ Community [] Public []
Note: If community well system, must have written confirmation from the State DePartment of Environmental
Conservation attesting to th legality and status.
SEWAGE DISPOSAL
On-site,S[. Public [] Community [] Holding Tank
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legailty and status.
72-025 (Rev. 7/88) Page 1 of 2
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
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 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 further verify that
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 witl~ all Municipal and
State codes, ordinances, and regulations in effect on the date of this inspection.
Name of Firm
Address
Date
Telephone 03. ~ ~'--.J-'Y-J'"J~
6. DHHS APPROVAL
Approved for //
bedrooms by
Conditional
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the 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 DH HS 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.
72-025 (Rev. 7/88) Back Page 2 of 2
MUNICIPALITY OF ANCHORAGE (MOA)
H.ealth~ Au~'~'0HtY Approval (HAA)
~":~ :if~,",, .CHECK,~t~~. ~FEi~RUARY 1984
...... = 343-4744
A. WELL DATA
Well Classification
Well Log Present CH)
Total Depth/~ / ~ Cased to /~/
Static Water Level -.~;~
Casing Height Above Ground /~,~
Electrical Wiring in Conduit(~,,~)
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
To Nearest Sewer Service Line on Lot
Water Sample Collected by ~'
Water Sample Test Results ~c'/'.'
Comments
Legal Description:
__ Date Completed
_ Depth of Grouting //',~ ·
Pump Set At ~',,/:,,o~ ~ .
Sanitary Seal on Casing ~N)
Depression Around Wellhead (Y/~
If A, B, C, D.E.C. Approved (Y/N)
Yield /'~)'~'/ /'~ ~''
; On Adjoining Lots
/OZ- / ; On Adjoining Lots /~d ¢ '
To Nearest Public Sewer Cleanout/Manhole
; Date /2-/x ~-/~' ?'
B. SEPTIC/HOLDING TANK DATA
Date Installed /~/~,~/~'~,,' Size
Standpipes~)'N)
Depression over Tank (Y/~
/,2.¢-o No. of Compartments
Air-tight Caps~)N) Foundation Cleanout (Y/(~
Date Last Pumped
Pumping/Maintenance Ool~tadt.'Dn ,~jle (Y/N) ~J/,~. ; for X J/,4
Holding Tank H~g~-Wate'f.AJarm (.~),~_ ~/4 Temporary Holding Tank Permit (Y/N)
SEPARATION D~.STA. R c~S:F~u-~ r~ ~.E~HOLDi NG TANK:
To Water Su Well /~/ To Bu~l
- p~y ..... ~ d~ng Foundation
To Property Li~~
~ To Disposal Field ~ /
To Water Main/Su~e~Lin~ ~ ~'
To Stream, Pond, Lake or Major Drainage Course ~/o~ /
Comments
72-026 (Rev, 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absortion Area
Depression over Field (Y~)
Type of System Design
Length of Field ~'¢ /
Depth of Field ¢' ~'
Gravel Bed Thickness 3 5- '
Statndpipes Present ~N)
Date of Last Adequacy Test
Results of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well /0~/
To Building Foundation
Lot /~ /
To Water Main/Service Line ,~.
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots -~ ¢ /
To Cutback (if present)
Comments
D. LIFT STATION ._.~_,~ _~'e.~¢7c
Date Installed {~-/7'js'?' Dimensions 5 22
Size in Gallons ~[~/'~5~ ~,& 7~ Manhole/Access~)
"Pump On" Level at ~~/~ ~4 h~t "Pump Off" Level at
,,
High Water Alarm Level at ~t¢~¢'~ ~ ~ Vent ~N)
Tested for ~ Pumping Cycles during Adequacy Test.
Meets MOA Electrical Codes ~) ~ ~ ~
Comments
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to all MOA and H
inspection. ~
Signed ~~'"'"~
Company
Date / 2-/~-~//~' ?
MOA NO. ~ -'~'~-~/
Receipt No.
Date of Payment
Amount: $
,~&~u~[ir~,~i~,~a~fect on the date of this
~ ~~ t Engineer's Seal
Receipt No.
Waiver Fee: $
Date of Payment
72-026 (Rev. 7/88) Back Page 2 of 2