HomeMy WebLinkAboutBRUIN PARK BLK 4 LT 4O/G
MUNICIPALITY OF ANCHORAGE
DE :ITMENT OF HEALTH AND HUMAN SER ES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
DISTANCES
"'r"l .,?~, '-'r"cz~,. lot.-, ~ SEPTIC ABSORPTION
ess '--, TANK FIELD WELL
P~one(s) - -' IPerm,t NO. [No. of Bedrooms WELL ¢7' ~ Lo~ q
LOT
LINE
LEGAL DESCRIPTION
I Subdiwsion
Lot q Blockq ~ r'~lt,/ po.. c/'r FOUNDATION
Township, Range, Section
AS-BUILT DIAGRAM {Show Iocahon of well, septic system, property lines, founeahon,
~ ~0 ~N ~ 3 ~ driveway, water bodies, etc.)
TANKS
~ SEPTIC ~ HOLDING
Manufacturer Capacity in gallons
'~'ateri~l No. of Compa~ments
~FeTtC TaS~O~YPE OF SYSTEM (N, 6.}
~TRENCH ~ BED ~ W. DRAIN ~ OTHER
Depth to pipe bottom from Total depth from original grade
or.~,,.~ ~ra~ CO r ~'
FT FT 3
~i1~ added above ongmm gra~e Gravel depth beneath p~pe
FT FT
Total ~bsorp:lO~ area D~stance between tines
Number of hnesIl Soil raUnggQ FT P~pe materia~
I Installer Date Installed / ~ -- ~ ~ ........
WELLS (N,~)
Class*ficabon (A,B,C) Total Depth ] Cased to
.
REMARKS: ~ (~r Co~ (i~ ;~ ~a~ 0--/ J
~,~/~ r~¢~t ~l~ ~ ~' ~Or~b, tnspectionsPedormedby}
6"ls - -' , ....................... ...
Municipal and State guidelines in effect on this date: ~/d'/~
HeallhDepadmentApproval: ¢O'~~ ~' '~~ Date: *'~--~C
72-013 (3/85)
DEi:F:'AF(TMt~.i:I',I. OF' H[~Al_'lq"i AND EI',IV
I.~];(?.5 t .... Sq"I::;:Ei:Ei:T ~, F.:ff'.l[::H[)F;,'~:~[i')li.::: :, rql< ~?':~50.1.
~ii),50 t,-,.t.
CC)N'I"(:~[]T F:'H[:iF.11~.!::
SM ]: ).':)T [:[)I',IS'I"F;.'UCTT' I
F::' ,, []. E~O X '7 ?'::5'7 ~?.
I.:Z~:..V::JL..E:.' I::;; ]: VE!:R ~, r:~'~l':::
5~:.~ :1.- 16.1. '7
L..[)'I' S I ZE:
:[ c:ert, if'y t. hat:
!,, I am f'ami].iar wi't'..l'"~ 'Lhe r'eqL.tirem(.:.-'.~n~..;-.'; Fop (::)rq-~;it(.~) ~;;ewel"~;; and wel].s as set.
For'Lb I::)y the Mt..u"~:tc::i.p~:tl:ti:.y oF ~.~rlchc]page (M[)P~) ;au'~d 'k.h~,:? State
aar'i(::l :i. Fl c:C)ml:) 1 ianc[.:.:, ~,~i'Ll"~ 'k. hte ;:l~.]s~;:kgl'~ c:r' :i.'Ler' :[a oF Ch is l:)er'rait.,,
¥, I {,~:i.}.l ;;;~clh(.~:.)r'a? 'Lo ;al.I. I'qOg~ ;and S4:.at~;e of [qli;~sk;~;~ r.¢:~)quipem~.:.)nt.s for' the ~;~::;:,4'.. l::)ac:k
(::l:i. st;~ri(::es from &uny existing ~,~e:l.l~, ~a~stewat~ep dispose:t], system of pt..d::)].i(::
"t"t-.ll~lxl ( 1 ) f~lxl E~:L.E~:C'T'F~ I Cf~I_ F:'ERM I T P~KID Z NSF'ECT I ON PILIST BE: OB"I'¥:~ I NE}:D ~ (~) F.~S.-I~)LI I L. TS
E~]_E:CTF~ I CF.~L.. ktOl::~l< MUST BE I:)(]NIE: 13Y f.t L.. I CENSE~:D E:I.._E:C'T'f~ I C I fqlq,
Fq:::'F:'I.... ! C~:qxlT' ~ SM I D'I" L, ON~:~ I f.d.][,, I I ON
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEAl.TH & E:NVI,qOI~,I,rdEt~ITA$, PROTEC, TION
ENVIRONMENTAl. ENGINEERING DIVISIOF, I
825 [. Street- Anchorage, Alaska 99501 Telenhone 26~-47~0
ON-SITE SEWAGE DISPOSAl.. SYSTEM AND/OR WEI.t. iNSPECTION REPORT
[PHONE
~_~ NEW
~UPGRADE
NAME
MAILING ADDRESS.-
-~-~-~ A L DESCRIPTION
,qk: qt., o-a 7.
LOCATION
I we,
,~ I DISTANCE TO:
~- ~ I Manufacturer
Liq, capacity in gallons I
Well
I D~STANOETO: I
~O ~__ ~ Manufacturer
r~ I I Well
¢-r I DISTANCE TO: I
~, '~ ~ 1 No. of ,nes I Le.gth of each ~jne
g I- Top of tile to finish grade
Lu / Length Width
~ I- I Type of cri~ Crib diamete~
DISTANCE TO:
~, /Class Depth
~ [ Building foundation
DISTANCE
TO:
I
IAbsorption area
Inside length
Dwelling
Dwelling
Material
Width
Material
NO. OFBEDROOMS
PERMIT NO.
~oo ~o /
No, of compartmen7
Liquid depth
PERMIT NQ.
Liquid capacity in gallons
Foundation Nearest ~1~e PERMI~(~i~ ~ ~
Distance between lines
Total length of lines
Material bene~tl~ tile
Trench width.
~ ~ ~/~ inches
~/~Z inches
Total effective absorption area
~ '-/1f-z7/
Depth PERMIT NO.
Crib depth Total effective absorption area
Building foundation
Nearest lot line
Driller Distance to lot line PERMIT NO.
Sewer line Septic tank Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
REMARKS
APPROVED
LEGAL
72-013 (Rev. 3/78)
PERMIT NO.
~,11_!~-~ I C I PAL_ I TY mDF Rr-lm]HCIF.'F~L]E
[:,EPRRTMENT ~'" HERLTH AND ENVIRONMEI'~tTRL '"T'TE'-:I'IOI"~
825 "' L. STREET., I~INCHOF..H.~E., RE. '..~.'.~ ....
264-4720
CII"-,i--S I TE SEP-IER LIP']RFI[:,E PEAr'1 I T
( 8E~0601 )
APPLICANT
LOCATION
LEGAL
RAY BARRETT
FOREST DR.
SRR BX 1777
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
LOT SIZE
~44-7804
20000 SQUARE FEET
MAXIMUM NUMBER OF BEDROOMS = 5
SOIL RATING (SQ FT?BR)=
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
E:"EF"TH= ;~ LEr'~GTH: 82 ,3RR~..'EL DEPTH= 4
~/~TH~''/~,' ~I! ~N~~' -A~'
E LENGTH MENSION IS THE LE H (IN FEET) OF THE TRENCH OR D~ FIEL[:'.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE E×CAVRTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
F."EC-!IJ I REE, SEPT I 12: TAr-J~{ S I ZE= .5~30 GRLL. m]I"~;
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.
TP~O (2) I F~SPE,]TIC~F~S ARE REQLIIRE[)
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
i00 FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROM R PUBLIC WELL. DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM R PRIVATE WELL TO 8 PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F'EF~:r-1 I T E×P I RES C, EC:EI'-IBER
I CERTIFY THAT
l: I RM FRMIL. IRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET'
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 5 BEDROOMS.
V4. 0
~' SOILS LOG
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
5
6
7
/
10
11
12
13
14
15
16
17
18
19
2O
COMMENTS
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6-650o An¢horage, Alaska 99502 276-2221~
SOILS LOG - PERCOLATION TEST
PERCOLATION
TEST
DATE PERFORMED:
G,14
SLOPE
WAS GROUND WATER~'~
ENCOUNTERED? ~
DEPTH?IF YES, AT WHAT /b'" /
SITE PLAN
Gross Net Depth to Net
Reading Date Time Time Water Drop
/ ~/-¢o I¢_: ~ / t:;, ~. ~ ~ ' ~>
-Z. /Z: $~ ~-- Z~ ~ ?' J ~..¢Z
Y ..~. ¥¢ 5" z, r~ ~.~
PERCOLATION RATE ~--- ~"~#~AI'I'~-'~z ' (minutes/inch)
72-008 (7/76)
GRE
"ER ANCHORAGE AREA BO'
Department of Environmental Quality
3330 C Street
Anchorage, Alaska ggS03
UGH
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME '~O/L)/%LD ~:~. /-_~q. aPC MAILING ADDRESS
PHONE
LOCATION
SEPTIC TANK:
DISTANCE
FROM WELL ~--~ ! MANUFACTURER ~' ~'L~'
INSIDE LENGTH INSIDE WIDTH
NUMBER OF
MAT E R IAL/~t~,~-r~ ~ a.~7~OM pA RTM ENTS
LIQUID DEPTH ~C"//O #LIQUID CAPACITY /~2_~ GALLONS.
SEEPAGE PIT:
NUMBER OF PITS / DIAMETER __
LINING MATERIAL/-O~~ v'~t~ERiB SIZE:
BUILDING FOUNDATION ~,
ADDITIONAL ABSORPTION
OR WIDTH_
D I AM ETE R
NEAREST LOT LINE
LENGTH , DEPTH
DEPTH__ DISTANCE FROM: WELL
TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA)
SQ. FT.
WELL:
TYPE
CONSTRUCTION
DEPTH ~/~0'! DISTANCE FROM:
BU I LDI NG N EAR EST NEA REST
FOUNDATION__, LOT LINE , SEWER LINE
SEPTIC SEEPAGE
TANK ~J?! SYSTEM
CESSPOOL , OTHER SOURCES.
APPROVED DISAPPROVED ~
REMARKS
DISTANCES:
INSTALLED BY: ..~ ~-L. ~'
PiPE MATERIAL:
(~ 4-f~r' /
LOT SLOPE:
REMARKS: ~--~ ST~/4J~ /~ / 2-
Form No. EQ-031
DIAGRAM OF SYSTEM
DATE
/o- /- '7.B
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO,
3.500 TL) L'~O¢~ ROAD 'POUCH ,3-650
ANCHORAGE. Al'At~KA 99502
T F. L E p~l DiN ~' 279.06(~6
SEWAGE DISPOSAL SYSTEM APPLICATION AND PERMIT
LEGAL DESCRIPTION , '~ ~
~ / ~lq['., BRAIN FIELD OTHER
TYPE AND S~ZE OF FACiLiTY TO BE S[RWU ~ ¢*~'~ ~' ~ ¢
BOIL TEST RESULTS
pFRHTT VAI ~D ~NE YFAR
24 HOUR NOTI~ REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY TH=
FINAL INSPECTIONs
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
BEPTIC TANK SIZE ypE~tR~]
MINIMUM DISTANCES. REQUIREMENTS
FOUNDATION TO SEPTIC TANK
~OU.D~T~O. TO S~eA~E
C~)I'I~'~teSEEPAGE AREA SIZE
DIAGRAM OF SYSTE:M
CAST IRON SIPIION
PHONE
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
OR
LICENSED
SE.TIC TANK, 25 fi:., SEEPAGE PIT 100 fi:. , DRAIN FIELD 50 fi:,, ,
TO RIVER. LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION $ FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
TO Fl'r- 120'
4o'-gq'
CAS~ IR0/I
I.
'¥0 7A¢~F,- 200'
C ] r~qu~t'¢,d ~vhenever line crosses (CRIB ~' FilNI~UH ABOV[' '~A.TER:
under dr ~ ve~'a.v. TABLE)
4 ]/~CH SE:tLR LINC.
CONSI DfR A~E~, ~ELLS.
SOIl. T~T.
CAST l ~11II ~ .,'1
PiP[ 5' \.-'"' '
Ir:TO U~L I
SOIL
-1%,..j
O~de: ~'.per !63[
or 1/4" p r foo~
except 10' prec~dSn
~nk & tha. should
HOUSE not exceed ?~.
6' per lOG on flat
SEPTIC .
f
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF (~REATER ANCHORAGE ,~REA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE, //'
ii IPr I,*1111 AIRTIGHT CRIB
SEPTIC TANK ~ ~e , SEEPAGE PIT . DRAIN FIELD ~ '-' ,'~ ......
TO NEAREST LOT LINE. ~ ,. / CA~";;
SEEPAGE PIT ----- ' % , CASt IrO~
WELL TO SEPTIC TANK
__ ALSO CONSIDER AREA WELLB. . UItDI$T~R8ED SOIL
~,~] N I ~L ;- ' ti] ~1 t~u~ :L:'.:":;:';. - -- ~ -,'
DRAIN FIELD [0 ¢~. I I I
MUNICIPALITY OF ANCHORAGE
MEMORANDUM
DATE:
TO:
FROM:
SUBJECT:
August 10, 1989
John Klinger, Private Development and Assessments
Supervisor, Engineering & Planning Division, AWWU.
John Smith, P.E., Program Manager, On-site Services~7
Environmental Services Division, DHHS.
Lot 4, Block 4, Bruin Park Subdivision
It is our understanding that the property owner of the subject
lot has requested that AWWU extend water and sewer service to
his lot. Further, it is our understanding that the property
owner has placed some urgency in this request based on an
assertion that domestic water wells within the Bruin Park
Subdivision have shown evidence of fecal coliform bacteria
contamination.
Please be advised that DHHS is not aware of any evidence that
would suggest bacterial contamination of domestic water wells in
the subject subdivision.
Please call me at 343-4360 if you require further information on
this subdivision.
"Kids Are Our Future"
Tom Fink,
Mayor
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
June 23, 1989
Bob Shafer, P.E.
S & S Engineering
17034 Eagle River Loop Rd., No. 204
Eagle River, Alaska 99577
Re: Lot 4, Bk 4 Bruin Park Subdivision, PID No. 016-102-05
Dear Mr. Shafer:
On March 15, 1989, a Health Authority Approval (HAA) for the
subject lot was submitted by your office and subsequently
approved by this department. In part, the HAA was approved
based on the existence of a waiver of separation between the
septic tank on the subject lot and the~well on adjacent lot 3.
It has recently been brought to our attention that the well on
Lot 3 is a class "C" well which serves a residential duplex~ As
you are aware this department does not have authority to grant
waivers of separation for on-site water systems which serve
multi-family structures. Therefore the existing waiver is
invalid.
S & S Engineering performed.the most recent evaluation and
verification of adequacy for the on-site water supply and
wastewater disposal system'on t.ot 4. We are informing you of
this waiver discrepancy so that you may have the opportunity to
assist the new property owner is acquiring the appropriate
waiver from the Alaska Department of Environmental Conservation.
The new property owner is:
Peter R. Michael
11021 Forest Drive
Anchorage, Alaska 99516
"Kids Are Our Future"
Mr. Robert Shafer
S & S Engineering
June 23, 1989
Page Two
We recognize that the information contained in our files, which
served as the basis for preparation of the HAA, was incorrect.
However, this department views the HAA process as an opportunity
to correct errors within our system based on field verified
information that is submitted as part of the HAA.
If you have any questions or concerns please contact me at
343-4360.
Sincerely, ~ -
J~~i~h, P.E.
Program Manager
On-site Services
Municipality of"Anchora e
Department of Health and Human Services
Tom Fink, 625 "L" Street
Mayor P.O. BOX 196650 Anchorage, Alaska 99519-6650
June 22, 1989
Peter R. Michael
11021 Forest Drive
Anchorage, Alaska 99516
Re: Lot 4, Bk 4 Bruin Park Subdivision, PID No. 016-102-05
Waivers of Separation
Dear Mr. Michael:
In 1985 and 1986 waivers of separation for the well and
wastewater disposal system on your lot were issued by this
department. Based on information provided by an engineer
retained by the previous owner, this department granted the
following waivers:
- The distance between the well and the absorption fie~d on
your lot was waived to 90 feet.
- The distance between your well and the wastewater
absorption field on adjacent Lot 3 was waived to 80 feet.
- The distance between your septic tank and the well on
adjacent Lot 3 was waived to 93 feet.
It has been brought to our attention that the well on adjacent
Lot 3 is a Class "C" well which serves a residential duplex.
This department does not have authority to grant waivers of
separation for on-site water and wastewater disposal systems
which serve multi-family structures. Therefore, please be
advised that waivers of separation pertaining to the well and
wastewater disposal system located on Lot 3 are invalid. To
ensure that your well and septic system are in compliance with
State Regulations we recommend that you pursue acquisition of
appropriate waivers from the Alaska Department of Environmental
Conservation.
"Kids Are Our Future"
Peter R. Michael
June 22, 1989
Page Two
We recognize that these discrepancies have occurred through no
fault of yours. If you have any questions or concerns please
contact either myself or Dan Bolles at 343-4744.
Jo~n Smith, P.E.
Program Manager, On-site Services
cc: Dan Bolles, On-site Services
File
"Kids Are Our Future"
Municipality of Anchorage
Department of Health and Human Services
Torn Fink, 825 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
June 20, 1989
Mr. Theodore F. Moore, P.E.
Flattop Technical Services
14530 Echo Street
Anchorage, Alaska 99516
Re: Lot 4, Bk 4 Bruin Park Subdivision, PID No. 016-102-05
Waivers of Separation
Dear Mr. Moore:
In 1985 and 1986, you requested waivers of separation for the
well and wastewater disposal system on, the subject lot. Based
on the information which you provided, this department granted
the following waivers:
- The distance ~etween the well and the absorption field on
the subject lot was waived to 90 feet.
- The distance between the well on the subject lot and
absorption field on adjacent Lot 3 was waived to 80 feet.
- The distance between the septic tank on the subject lot
and the well on adjacent Lot 3 was waived to 93 feet.
It has been brought to our attention that the well on adjacent
Lot 3 is a Class "C" well which serves a residential duplex.
The building, which was originally constructed as a single
family house, has functioned as a duplex since approximately
1977.
As you are aware, this department does not have authority to
grant waivers of separation for on-site water and wastewater
disposal systems which serve multi-family structures.
Therefore, please be advised that waivers of separation
pertaining to the well and wastewater disposal system located on
Lot 3 are invalid. We are notifying the owners of Lot 4 that
the waivers are invalid and recommending that they pursue
aquisition of appropriate waivers from the Alaska Department of
Environmental ConseDvation.
"Kids Are Our Future"
Mr. Theodore F. Moore, P.E.
June 20, 1989
Page Two
Should you have any questions, please contact either myself or
Dan Bolles at 343-4744.
Si nee r e ]'y ,~~
hn~Smi t h, P.E. ~
Program Manager, On-site Services
cc: Dan Bolles, On-site Services
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)
Lot 4, Block 4, Bruin Park
Location(address ordirections)
11021 Forest Drive
(b) Property owner
Mailing Address
(c) Lending Institution
Mailing Address
H.U.D. ~111-031'787-703 Telephone:(home)
605 West 4th Ave., Anchorage, Alaska 99501
Telephone
Business
(d) Real Estate Company and Agent Associated Brokers- Sandy
Address 640 W. 36th, Suite 1, Anchorage, Alaska 99503
Telephone 563-3333
(e) Mail the HAA to the following address: (or check here,~, if hold for pick up.)
List contact person and day phone number below:
S & S ENGINEERING
17034 Eagle RWer Loop Road
Eagle River, Alaska 99577
2. TYPE OF RESIDENCE
Single-Family ~ Number of bedrooms 5
3. 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.
4. SEWAGE DISPOSAL
On-siteD 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 with all Municipal and
State codes, ordinances, and regulations in effect on the date of this inspection.
Telephone
S & S ENGINEERING
17034 Eagle Ri~er Loop Road No. 204
Eagle River, Alaska 9,)577
Name of Firm
Address
Date
6. DHHS APPROVAL
Approved for
Approved
bedrooms by
Disapproved
Terms of Conditional Approval
Conditional
Date
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 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.
72-025 (Rev, 7/88) Back Page 2 of 2
A. WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
CHECKLIST- FEBRUARY 1984
NICIPALITY OF ANCHo~A3G4E3'4744
ENVIRONMENTAL SERViCES DiVi$1ONLegal Description: ~
If A, B, C, D.E.C. Approved (Y/N)
,-x..-\ ,~ -'] 7...-- Yield ~ .~ ~-'~¥"~
Well Classification
Well Log Present~li~ ~ Date Completed
Total Depth"~\'~~ Cased to ,d~. Depth of Grouting '--'-"'
Static Water Level ~ Pump Set At
Casing Height Above Ground '~'~¢~ Sanitary Seal on Casing~N)
Electrical Wiring in Conduitd~N) y Depression Around Wellhead (YLI~.
SEPARATION DISTANCES FROM WELL: i.~ ~/~~="~ ~~-"~'
To Septic/Holding Tank on Lot ~"7''~ ; On Adjoining Lots
I
To Nearest Edge of Absorption Fieldl.~7~Lot '~ ~--, ~" ; On Adjoining Lots
TO Nearest Public Sewer Line
To Near~st Public Sewer Cleanout/Manhoie
To Nearest Sewer Service Line on Lot '~'~"
Water Sample Collected by ~'~---~ _~"~_ ~--~[~:~f-~ ;Date "~-~"~'"~'=:~
Water Sample Test Results
Comments'5~.~_~,~,, l r~ (/.~.~~--~_ ~-----,~'~-~1 ~ ~
B. SEPTIC/HOLDING TANK DA._I'A~,j
StandPipes~/N) '7' Air-tight Caps~N)
Depression over Tank (Y~ I'~
Pumping/Maintenance Contact on File (Y/Nf~//~
Holding Tank High-Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water, Supp y Well ~--~"~' ~ ~ To Building Foundation
To Property Line ~' ,,~r TO Disposal Field ~'
To Water Main/Service Line \
To Stream, Pond, Lake or Major Drainage Course
...... /, / ! '
No. of Compartments ~--
Foundation Cleanout~f~tN) '7'
Date Last Pumped '"~ -' ~::~ ~
;for
72-026 (Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Str/~ta
Date Installed ~, ~/~o
!
Width of Field ~-~
~///~¢'~-'~ Type of System Design
(_~ ~ Length of Field
Depth of Field
Gravel Bed Thickness
Statndpipes Present ~N)
Date of Last Adequacy Test
System on
Square Feet of Absortion Area
Depression over Field (Y/~
Results of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIELD:
t
To Water-Supply Well /]-~-~
To Building Foundation "~ ~
!
Lot ~ '5~
To Water Main/Service Line \ '-~
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments h_/~)'4,' ~/.u.'/.-~ ,~'..,~t,,~¢~
!
To Property Line 'Z-,'~
To Existin~ or Abandoned
; On Adjoining Lots
To Cutback (if present) r~ /~
D. LIFT STATION ~/,/~
D,,~ Installed I '
Size"i~.G~lons ____
"Pump
High Water Alarm L~
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Tested for ~
Meets MOA Electrical Codes (Y/N)
Comments
Vent (Y/N)
Pumping Cycles during Adequacy Test.
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this
inspection.
Signed
Company
Date
MOA No.
! 7034 Eagle River L~p Road No. 2~
Eagle River, Alaska 99577
Receipt No. 0
Date of Payment
Amount: $
72-026 (Rev. 7/88) Back
Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
<Client Sample ID:L4, B4 BRUI~ PARK
PWSID,~UA
Rs~slved SD'L 25 88 t 14:00 lus
Preserved with :COOL
STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907)'562-2343 ,
5633
B
FEDERAL TAX ID # 92-0040440
ANALYSIS REPORT BY SAMdLE for Wozk Orde~ # 8102
Date Beport Printed: JUL 28 88 ! 11:15
Client Ma]me : S & S ENGI~gI{IN~
Client Acer : SNSENGP
P. O. { NONE REC' D
O~dored By :
Send lieports to:
Laboz&~o~y'$~pe~vlso~$YE~HBNC. EDE
/
~ecial . ~-" ~ ~ ''.
I~ C~ab ~ef $: 1943 Lab Smpl ID: 3 ~atrlx: Wate~
Allowable
'' ~,~]:Pa~t'e~ Tested Result/~mts Nethod Ll~ta
~IT~TE-N ND(O.~0) ~g/1 EPA ~53.2 i0
~ampls ROUTI~ SAMPLE
Ren~s~ks: SAMPLE COLLECYED BY R.P,
1 Tests Pezfo~ed ' See Special Instructions lbove UA=Unavailable
ND- None Detected "See Sample Rema~k~ Abow
NA- Not Analyzed LT-Le~ Than, GI-Craate~ Than
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4744
Application Date July 22, 1988
GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 4; Block 4; Bruin Park Subdivision
Location (address or directions)
11021 Forest Drive
(b) Property Owner
Mailing Address
(c) Lending Institution
Mailing Address
(d)
HUD Telephone: Home
#111-031787-703
Business
Telephone
RealEstate Companyand Agent MARSTON PROPERTIES/Ed Tolle¥
Address 4105 Turnagain, Anchorage, Alaska
Telephone 248-1717
Mailthe HAAtothefollowino address:or:Check here [],ifholdforpick up.
Listcontactperson and day phone numberbelow.
S & S ENGINEERING/694-2979
17034 Eagle River Loop Road, Suite 204
Eagle River, Alaska 99577 ,
ordered by Ed Tolley
(e)
TYPE OF RESIDENCE'.
Single-Family Ik'l
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 the legality and status.
SEWAGE DISPOSAL
Onsite [~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 fRev 8/86~ Front
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 Heatth
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 with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm Telephone
$ & S ENGINEERING
Address 17o;ii4 Eagle R;.,~i-Lc.,c.~ Rc.a~ ,N~. 264
Date ~__~.la River, Alaska 99577
Approved for "~ bedrooms by
Approved ./~. Disapproved
Terms of Conditional Approval
~-- ~'~ate
Conditional
8-2
CAUTION
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.
Page 2 of 2 72-025 (Rev 8/86) Back
MUNICIPAUTY OF ANCHORAGE (MOA)
~H AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4744
Legal Description: ~
WELL DATA
Well Classification \ ~ ~ \~ ~ ~ If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (Y~g~ T'''b Date Completed "~ ~ "J 7,--- Yield
Total Depth '"~'"1''~%'' Cased to ~d~c~l'~ Depth of Grouting '-'-----'
Static Water Level ~ Pump Set At L..)
Casing Height Above Ground ~__~.~/ Sanitary Seal on Casing~C~)'N) y
Electrical Wiring in Conduit~'N) '7 ~ ~TM '~ Depression Around Wellhead (v.~) I--
Separation Distances from Well: ..~-~,"~.~'~ t.,0,¢~//.~ (~::~,,..5~1::~''~
To Septic,~fol~l~g Tank on Lot ///"~-7 '~//~__.~ ;On Adjoining Lots
To Nearest Edge of Absorption Field on~,~'~'~; On Adjoining Lots
To Nearest Public Sewer Line r~ ( }~ To Nearest Public Sewer
Cleanout/Manhole J¢~ To Nearest Sewer Service Line on Lot "~
Water Sample Collected by ~'~-'~ ~ ~~-~&~- ;Date q ~'Z.~
Water Sample Test Results ~/"~"'3'-~c-~ ~')~--~[-O..~ --~ ~ .~ ~ ~---~'~--~
Comments t~ ~ ~ ~:~~~
SEPTIC/HOLDING TANK DATA
Date Installed g Size No. of Compartments
Standpipes~N) y Air-tight Capsd~Z~J) ~ Foundation Cleanout(J~g:N)
Depression over Tank (Y/(~ ~ / Date Last Pumped q -"~
/'"~//~'-~ ;for '"--'--
Pu mping/Maintenance C°ntract °n File (Y/N)i~///~ t,
Holding Tank High-Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N)
Separation Distances fromp~' ' '
To Water-Supply Well Se~ ~.~.%_~ To Building Foundation ~--~
I
To Property Line ('~ ~ ~./2 To Disposal Field
To water'Main/Service Line~ ~.c~ I-Jr
TO Stream, Pond, Lake, or Major Drainage
Course ~, 4:>~::~
Page 1 of 2
72-026 (Rev 8/86~ Front
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Str)ta
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/I~
Results of Last Adequacy Test
Separation Distance from Abs~-'-----.,,
· o
To Building Foun~
Lot //'
To Water Main/~
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking 'A'rea, or Vehicle Storage Area
Type of System Design
Length of Field 4::3f', Z~.f
Depth of Field
Gravel Bed Thickness
'"7 ~ ~ ''~ Standpipes Present ([~N) y
r'"3 Date of Last Adequacy Test
To Property Line
To Existing] or Abandoned System on
· On Adjoining Lots
To Cutbank (if present) ~-~//~
Comments
Date Installed
High Water Alarm Level at ~
Tested for
Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
~---~ Pumping Cycles during Adequacy Test. Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all ~1. OA~d HAA guidelines in effect on the date of this inspection.
Signed S & S EN~INe.~.~iN~ Date
CompanY17054 E~,le River Loop l~oaa r~MOA No. t'~ ~ ~ C2,~ ._~
Eagle River, Alaska 99577 ~.~ 0
Receipt No.
Date of Payment ~--' [ i~'~?~y
Amount: $ / ? O '"----"
Page 2 of 2
72-026 fRev 8/86/ Back
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 4 Block 4 Bruin Park Subdivision
Location (address or directions)
11021 Forest Drive
(b) Applicant Name Timothy F. Taylor Telephone: Home 345-2197 Business 279-1441
Applicant Address
(c) Applicant is (check one): Lending Institution [] · Owner/builder []; Buyer []; Other [] (explain);
(d) Lending Institution Telephone
Address
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family ~ Multi-Family []
Number of Bedrooms
Other
WATER SUPPLY
Individual Well []x×Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsite ~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 (11/84)
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 with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm Telephone
Address
Date
Engineer's Seal
This department has received written confirmation from the engineer
regarding the Conditional Approval of November 21, 1985.
The corrections have been accomplished and an inspection has been
completed by the engineer. The subject property meets with Municipal
standards and is now approved.
DHEP APPROVAL
Approved for f.~ bedrooms by
×XXXXXXXX
Approved Disapproved
Terms of Conditional Approval
Date July 25~ 1986
Conditional
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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,
Page 2 of 2
72-025 (11/84)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
GENE~RAL INFORMATION
(a)
(b)
(c)
Cegal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
Applicant Name~VV~% ~-~~ Telephone: Home -zlq7
Applicant Address
Applicant is (check one): Lending Institution ~; Owner/builder~; Buyer ~; Other ~ (explain);
Business
(d) Lending Institution
Address
Telephone
(e) Real Estate Company and Agent
Address
Telephone
(f)
Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family Ci~ Multi-Family []
Number of Bedrooms ~
Other
WATER SUPPLY
Individual Well ~ Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite [] Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 (11/84)
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
was~ewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection. ~['
Name of Firm 1~[44 ~'/~f -[-~¢/~(af ~'~,f~'~C~' Telephone ~ Y~'
Address I~O ~ ~ ~ ~or~/ ~tc
Engineer's Seal
DHEP APPROVAL
Approved for "~'~" =~edroomsby /~P.~43¢,.~ ,4~. '~'~'~ Date
App~ved ' Disap~ved Conditional
Tei'ms of Conditional App"oval ...~jo.~,'c. ~/c,~ ,,~.*.~S.("' ~
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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.
Page 2 of 2
72-025 (11/84)
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA) 0~'r"~
CHECKLIST- FEBRUARY 1984
~64-4720 J IEf(:EIIVED
Legal Description:
~J~ICIPALITY OF ANC3'IOI~AG~-
DEFT, OF HEALTH &
J~NVII~ONMt~NTAL PROTECTION
WELL DATA
Well Classification ~V'~'~ If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (Y/N) /~/ Date Completed ~ I~"/' ~- Yield
Total Depth ~ 13'6' ' Cased to ~' ¥O ' Depth of Grouting
Static Water Level S*/' Pump Set At ~//
i'~" Sanitary Seal on Casing (Y/N)
1'
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
Depression Around Wellhead (Y/N)
To Septic/I-t~l~l~ Tank on Lot
To Nearest Edge of Absorption Field on Lot /o~,~' · On Adjoining Lots
To Nearest Public Sewer Line I~/
Cleanout/Manhole
Water Sample Collected by '"r'~
water sample Test Results
Comments ~e~ (~lf~r
~-7' '~ ¢.0~ , On Adjoining Lots ~'3' ¢ P¥'
eS+' ¢ P'/+'
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
;Date l~ /
B. SEPTIC/HOLDING TANK DATA
~o /73
Date Installed I~/~0 Size
Standpipes (Y/N) ~ Air-tight Caps (Y/N)
Depression over Tank (Y/N) N
Pumping/Maintenance Contract on File (Y/N) )~,/~.
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well y,~' ~' ~'7'
To Property Line ~'7 t
To Water Main/Service Line
Course ~' !og ~
No. of Compartments I
Foundation Cleanout (Y/N)
Date Last Pumped
; for /~/J'.
Temporary Holding Tank Permit (Y/N) ~'
To Building Foundation ~,O'- '
To Disposal Field ~'7 ~
To Stream, Pond, Lake, or Major Drainage
Comments ~"ee I~H--e~' d~,~ lo,/Z~lS.C r'e w~er ,'~?.~
Page I of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed /'g/~O
Width of Field 3 /
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
N
~'/~¢~"~ Type of System Design
Length of Field /l//j i
Depth of Field ~ ~
Gravel Bed Thickness ~'~' ~
Standpipes Present (Y/N)
Date of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation ~ ~'O'
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments .~'~' {¢¢"~C
c 4
To Property Line '~, ~ ~
To Existing or Abandoned System on
; On Adjoining Lots ~ 3'0 ~
To Cutbank (if present)
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed ~J'-~ ~. ~ Date
Company ~'~l~/-~'
Receipt No. ~
Date of Payment
Amount: $
Page '2 of 2
72-026 (11/84)
Engineer's Seal
unicipality
of
Anchorage
P.O. BOX 6650
ANCHORAGE, ALASKA 99502-0650
(907) 264-4111
TONY KNOWLES,
MA YOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
July 25, 1986
Theodore F. Moore, P.E.
Flattop Technical Services
14530 Echo Street
Anchorage, Alaska 99516
Subject: Lot 4 Block 4 Bruin Park Subdivision
Waiver Request, WR86-058
Dear Mr. Moore:
Your request for waivers of the 100 foot separation distance required
between the septic tank on the subject lot and well on the subject lot
and the well on the adjacent lot (Lot 3) have been granted. This septic
tank has been placed in a position as to maximize the separation distance
to adjoining wells.
The property owner of Lot 3 has been notified and has not voiced an
objection to this waiver.
This waiver is valid for the existing septic system only.. Future approvals
of this system may require tests to verify septic tank integrity and/or tests
verify that chemical/bacteriological contamination has not occurred in
either well.
Sincerely,
Stephen S.
Civil Engineer
On-site Services
SSM/lJw
TECHNICAL
CIVIL & ENVIRONMENTAL ENGINEERING · ENERGY CONSERVATION & ANALYSIS
THEODORE F. MOORE, P.E. June 1 6, 1986 14530 ECHO ST.
PH: (907) 345-1355 ANCHORAGE, ALASKA 99516
Stephen Morris
M.O.A. DHHS
P.O. Box 6-650
Anchorage, AK 99502
~O~1o~d WIN~NO~tAN~
Dear Mr. Morris: ~mO~N¥ 40 ~l~atglN~
Enclosed is the As-Built drawing for the new septic tank
installation serving Lot 4, Block 4, Bruin Park S/D. As we have
verbally discussed, approval of this will have to be contingent
upon issuance of a waiver of the required separation distance
between this tank and the Lot 3 well down to 93 feet, in addition
to the other waivers mentioned in your letter of November 15.
During installation, an old crib was encountered immediately east
of the tank location making it preferable to orient the tank as
shown. Several factors support the granting of this waiver.
As discussed in my letter of November 13, the water table in
the vicinity of the septic tank was measured at 16.9 feet below
ground surface, or some 6 feet below the bottom of the tank.
Thus, were there to be any leakage, the effluent would have to
pass through dry soil before entering the water table. To ensure
tank integrity, calder couplings were installed on the inlet,
outlet, and on the standpipes serving each compartment.
This tank relocation was always a compromise seeking to make
the best of a less-than-ideal situation. From a practical
viewpoint the orientation of the tank shouldn't make any
significant difference, with slightly better separation being
achieved from the Lot 4 well in exchange for slightly worse
separation from the Lot 3 well. The degree of violation of state
standards has been minimized to the point where I do not believe
public health is in danger of being compromised.
Hopefully, this will allow you to lift the conditions on the
previously issued Health Authority Approval. Please give me a
call if you have any questions.
cc. Tim Taylor
Sincerely,
Ted Moore, P.E.
Municipality of AnchOrage
MEMORANDUM
DATE: November 22, 1985
TO: Steve Morris, Environmental Health Division
FF~OM: ./~.tq t~i ke Mil 1 s, Ombudsman
SUBJEGT: Waiver of separation distances for Bruin Park Subdivision,
Block 4, lot 4
Mr. Tim Taylor contacted my office concerning your refusal to grant a
waiver for the separation distances of 45 and 55 feet between the two
septic tanks and the well for lot 4, Block 4 of Bruin Park Subdivision.
Although the Health Department would waive the separatio~ distances if
Mr. Taylor moved his septic tank to a point as far as possible from the
well, this mitigation feature would cost approximately $7,000.00.
When Mr. Taylor purchased the home in 1981, it had a HAA which led him to
believe that his home had septic and water systems meeting Municipal
standards for approval. It comes as quite a shock that he must now
invest $7,000.00 in order to sell his home because the previous HAA was
issued in error.
Since the lack of separation distance was the reason for the denial of
HAA's in 1972, 1973 and 1974, there is no lack of documentation or
knowledge of the problem. How could the HAA be granted in 1981 if the
problem still existed? If the information presented is correct, will the
Health Department claim responsibility for the errors which occured when
the septic system and well permits were issued. If the burden of
insuring compliance does rest with homeowner or purchaser, then the
homeowner or the purchaser should be made aware of this so that he may
take the necessary precautions before he buys a home.
Thank you for your assistance in this matter.
mm/bm69
unicipal ty
of
POUCH 6-650
ANCHORAGE, ALASKA 99502-0650
(907) 264-4111
TONY KNOWLE,~r
MA YOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
November 21, 1985
Mr. Timothy F. Taylor
3140 Flyway Avenue
Anchorage, Alaska .99515
Subject:
Conditional Waiver (WR85-048)
Lot 4, Block 4, Bruin Park Subdivision
Dear Mr. Taylor:
This Department has issued a conditional Health Authority Approval for
the subject lot. This approval is conditional upon the requirement that
the existing septic tanks be moved or replaced to a location at least 80
feet from the well. This relocation or replacement must begin on or
before July 1, 1986.
This letter constitutes a temporary waiver of the separation distance
required between the existing well and septic tanks on the referenced
lot. This waiver is invalid after July 1, 1986.
After a new septic tank or tanks are installed 80 feet from the well, and
an as-built drawing submitted by a professional engineer is submitted to
the Department, the required 100 foot separation distance between a well
and septic tank will be considered waived to 80 feet. This waiver will
be considered valid indefinitely.
If you have questions regarding thi~ matter, please contact me at
264-4720.
Sincerely,
Stephen S. Morris
Civil Engineer
On-Site Services
P.O. BOX 6650
ANCHORAGE, ALASKA 99502-0650
(907) 264-4111
TONY KNOWLES,
MA YOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
November 15, 1985
Theodore F. Moore, P.E.
Flattop Technical Services
14520 Echo Street
Anchorage, Alaska 99516
Subject: Waiver Request WR85-048
Lot 4 Block 4 Bruin Park Subdivision
Dear Mr. Moore:
This Department has reviewed your waiver request for the subject lot
in light of the supplemental information that you provided on
November 13, 1985. Based on this information, the following waivers
to the minimum required(100 feet) separation distances have been
granted:
(1) The distance between the well and the absorption field on
the subject lot has been waived to 90 feet.
(2)
The distance between the well on the subject lot and the
absorption field on the adjacent lot(Lot 3) has been waived
to 80 feet.
The Department cannot appzove your request for waivers to 45 and 55 feet
for the two existing septic tanks on the subject lot. A waiver can be
granted, however, if a new septic tank is installed in a loctaion that
is separated as far as practically possible from the well. You have
noted that a separation distance of 80 feet could be achieved. A waiver
to 80 feet will be considered vaild when a certified as-built drawing
showing the installation of a new septic tank at least 80 feet from the
well is received and approved by this Department. A permit must be
obtained for the septic tank installation.
If you have questions regarding this matter I can be reached at 264-4720.
Sincerely,
Stephen S. Morris
Civil Engineer
On-site Services
CIVIL & ENVIRONMENTAL ENGINEERING * ENERGY CONSERVATION & ANALYSIS
THEODORE F. MOORE, P.E. 14530 ECHO ST.
PH: (907) 345-1355 November 13, 1985 ANCHORAGE, ALASKA 99516
Stephen Morris
M.O.A. Dept. of Health and Human Services
P.O. Box 6-650
Anchorage, AK 99502
Dear Mr. Morris:
The purpose of this letter is to supplement the information
provided on 10/28/85 in support of my request for a waiver of
separation distances affecting Lot 4, Block 4, Bruin Park
Subdivision. Your letter of 11/6 denied the waiver request,
however, based on subsequent discussions we have had, I have done
some additional testing and made more precise measurements which
I believe provide a stronger basis for granting the necessary
waivers. Please refer to the attached sketch which I have
prepared of the subject property and it's immediate neighbors.
Two 20 foot deep holes were drilled on November 11 at the
locations indicated on the sketch. Test hole #1 had 8 feet of
gravel underlain by a fine sand. Near the bottom of the hole a
moist silty sand was encountered, but that portion of the hole
sloughed in before a monitoring tube could be installed. When
checked one day later, there was no moisture down to 16.4 feet
deep in that hole. Test hole #2 located 15 feet north of the
existing absorption trench showed 12 feet of gravel underlain by
silty sand, the bottom portion of which was also quite moist.
Here we were able to get the monitoring tube to 2~LTf~ee.t. One day
after the hole was dug, the water table was at~16.9 ~eet below
ground surface.
While these test results do not resolve the question of the
groundwater gradient, they do confirm that the existing soil
absorption trench has adequate vertical separation from the water
table. The flat surface topography is probably reflected in the
underlying water table.
By triangulation, I have been able to determine more exactly
the horizontal distances between the well and the wastewater
facilities shown on the sketch. By plotting information from the
Lot 3 wastewater system as-built onto the sketch, it can be seen
that the closest portion of that seepage pit is approximately 80
feet from the Lot 4 well. The seepage pit on Lot 5 appears to be
just outside the 100 foot radius from the Lot 4 well. Both of
these septic tanks, while closer than 100 feet are further than
50 feet which was the requirement at the time of installation.
In order to obtain the Health Authority Approval, we are
requesting that you waive the well-to-absorption field
requirement from 100 feet down to 80 feet for the Lot 3 seepage
pit and down to 90 feet for the Lot 4 absorption trench. We are
also requesting a waiver of the well-to-septic separation down
from the pre-1973 requirement of 50 feet to 45 feet for the first
septic tank, and down from the post-1973 requirement of 100 feet
to 55 feet for the second septic tank.
In support of this request it is noted that the well, by
being located in the middle of the garage surrounded by a poured
concrete floor, is well protected from surface contamination
should one or the other of the absorption fields or septic tanks
fail and leak effluent onto the ground surface. There does
appear to be adequate separation between the bottom of the
absorption fields and the water table to provide for aerobic
diegestion of BOD and coliform bacteria in unsaturated soils.
The fine silty sands found in the saturated zone should provide
good filtration during horizontal migration of the groundwater.
Both the well logs for the nearby Lots 17 and 23 show one or more
clay layers between these surficial soils and the water bearing
strata below 100 feet in depth, which should help prevent
contamination.
Short of a total relocation of both the well and septic
system, various corrective measures could also be considered in
conjunction with limited waivers. A new 1500 gallon septic tank
could be installed near the northwest corner of Lot 4, thereby
achieving an 80 foot separation from the Lot 4 well, while still
remaining outside the 100 foot perimeter from the Lot 3 well. I
question whether the benefit of this still substandard location
would justify the disturbance and abandonment of the existing
2100 gallon two tank system.
The alternative which I would recommend is to verify the
continuity of both the existing tanks by excavating below them on
one side to check for effluent, and to verify the adequacy of the
couplings on both the inlet and the outlet of each tank. Should
there be any sign of displacement or leakage, then I would
require the installation of new watertight mechanical couplings.
In consideration of the functional adequacy of the present
system, it's "grandfather" status, and the lack of other
reasonable alternatives, I recommend granting of the necessary
waivers and Health Authority Approval contingent on the
tank verification program outlined above.
cc. Tim Taylor
septic
........
'?,,~ '. C~- 3589 .'-_~ ~
Sincerely,
Theodore F. Moore, P.E.
unicip lity
of
Anchorage
P.O. BOX 6650
ANCHORAGE, ALASKA 99502-0650
(907) 264-4111
TONY KNOWLES,
MAYOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
November 6, 1985
Theodore F. Moore, P.E.
Flattop Technical Services
14520 Echo Street
Anchorage, Alaska 99516
Subject: Waiver Request WR85-048
Lot 4 Block 4 Bruin Park Subdivision
Dear Mr. Moore:
Your request for a waiver to the required 100 foot horizontal
separation distance between the well and the septic system on
the subject lot has been denied. The information provided did
not show that required minimum separation distances were not
necessary on the subject lot.
This decision may be appealed to the Department of Environmental
Conservation.
Sincerely,
Stephen S. Morris
Civil Engineer
On-site Services
SSM/ljw
P TECHNICAL
)EPT. 0;: HEAi..T;I &
CIVIL & ENVIRONMENTAL ENGINEERING * ENERGY CONSERVATION & ANALYSIS
TItEODORE F. MOORE, P.E. 14530 ECHO ST.
PH: (907) 345-1355 October 28, 1985 ANCHORAGE, ALASKA 99516
MOA Dept. of Health and Human Services
Pouch 6-650
Anchorage, AK 99502
Dear Sirs:
By means of this letter I wish to request a waiver of the
separation distances described below affecting the on-site well
and septic system serving the residence on Lot 4, Block 4, of
Bruin Park Subdivision, which is located on Forest Drive south of
O'Malley Road. The owners of the property, Mr. and Mrs. Tim
Taylor need to obtain Health Authority Approval of the system in
order to sell the property. I am enclosing copies of relevant
documents from your files, and my completed Health Authority
Approval forms.
The earliest record of the system is a 1972 denial of Health
Authority Approval due to the unknown nature of the system and
inadequate separation distances. This was followed by a 1973
permit and inspection report for an upgrade from a previous
cesspool to a 1683 gallon septic tank and seepage pit. The
permit specified a 100 foot separation between the well and both
the septic tank and the seepage pit, however the inspection
report notes a 45 foot separation between the well and septic and
a 83 foot separation between the well and the seepage pit. A
note on the inspection report states that a state waiver is
needed on the well-tank, and well-pit distances, however there is
no record of that having been applied for or granted.
There
references
distance.
is an unsigned HAA request dated 1974 which again
the need for a state waiver of the well-seepage pit
There is no follow up to this.
The next documents are an October 1980 soils test and
upgrade permit for a system to serve a 5 bedroom residence. This
permit also references the 100 foot separation requirement
between the well and the on-site disposal system. Lee Reid at
AECS provided me with a copy of his copy of the permit containing
an unsigned reference to a 95 foot separation between the well
and trench which replaces the former seepage pit, and also a
signed note from Les Buchholz authorizing Lee to use his
judgement on soil value and dimensions during installation. The
as-built drawing indicates that an additional 500 gallon tank was
installed 58 feet from the well between the existing tank and the
new trench which is noted as being 94 feet from the well. No
reference is made to waivers of other separation distances.
MOA Health Authority Approval for this system was issued on
July 8, 1981. It referenced a well depth of 136 feet.
I conducted adequacy tests of the well and septic systems on
October 21, 1985. The static water level in the well was 54 feet
below ground, and steady pumping at 5.6 gpm brought the level
down only to 64 feet. The water sample showed no coliform or
other bacterial contamination. Despite intensive searching, no
well log has been located, but well logs for nearby lots show 154
and 179 foot total depths (see attached). The absorption trench
accepted 850 gallons over a 4 hour period and continued to absorb
at a rate of 70 gallons per hour at this level, which is
satisfactory.
Numerous shortfalls relative to required separation criteria
were noted, which will require waivers prior to issuance of HAA.
The standpipes of the two septic tanks are 48 and 57 feet
respectively from the well. The closest portion of the
absorption trench is 92.5 feet from the well. The absorption
trench passes underneath the driveway for 20 feet. The septic
tanks and soil absorption systems on adjacent lots on each side
are approximately 83 and 94 feet from the well.
In consideration of this waiver request it should be noted
that the well water has been tested numerous times over the years
without any record of contamination. While numerous violations
exist, it should be noted that they are relatively minor for the
most part, and were created at a time when enforcement was
considerably less strict than at the present. Given the well
placement almost in the dead center of this 20,000 sq. ft. lot,
it is virtually impossible to obtain the required separation
distances. With adjoining lots having their wells in front and
septic systems in back, it is even more difficult to achieve the
proper separations on this lot with reversed positions. Total
relocation of both systems would be cost prohibitive. Finally,
this subdivision is within the boundary of the Hillside area
ultimately designated for sewers, so these problems will be
resolved at the time of sewer construction.
In consideration of all of these factors, and the absence of
any demonstrated public health hazard resulting from the
continued existance of this system, I believe granting of the
necessary waivers would be the prudent course of action. Please
call me if you have any questions.
Sincerely,
Theodore F. Moore, P.E.
:' INSPECT! ON APPOI NTM E NTS D
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
D~PT. OF HEALTH & ---
MUNICIPALITY OF ANCHORAGE E~IRONMENTAL P~OTE~ION
,~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
. 825 LStreet-Anchora~,Alask, 99501 JUN ~ 3 1981
E C E i
Telephone 264-4720_ R V E D
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete reques~ will not be pr~ed. Please allow ten (10) days for processing.
1, PROPERTY OWNER I PHONE
MAILING ADDRESS '
PROPERTY RESIDENT'(If different from above) PHONE
2, BUYER PHONE
MAI LING ADDR ESS
MAILING ADDRESS
~.' REALTOR/AGENT I PHONE'
1
MAI LING ADDRESS
5. ' LEG~DESCRII~N
STREET LOCATION
B, TYPE OF RESIDENCE
/~ SINGLE FAMILY
[] MULTIPLE FAMILY
NUMBER OF~BEDROOMS
[] One [] Four
[] Two I~ Five
[] Three I'-] Six
[] Other
7. WATER SUPPLY
~]~ INDIVIDUAL*
COMMUNITY
[] PUBLIC UTILITY
8. SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
* ATTACH WELL LOG. A well Icg is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth {attach Icg if available.) !~:~ /
YEAR' ON-SITE SYSTEM WAS INSTALLED.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED,
72-010 (Rev. 6/79)
/-/~o
1. TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
2. WATER SUPPLY
[] INDIVIDUAL
[] COMMUNITY
[] PUBLIC UTILITY
Connection Verified
3. SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON -SITE
r--I PUBLIC UTILITY
Connection Verified
[]Septic Tank or [] Holding Tank
Size: I~._~-O If Tank is homemade
give dimensi?ns: ~..~ ~
THIS SIDE FOR OFFICIAL USE ONLY
NUMBER OF BEDROOMS
[] ONE [] THREE [] FIVE
[] TWO [] FOUR [] SlX
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
DATE INSTALLED
iNSTALLER
SOl LS RATING
MATERIAL
Septic/Holding Tank ~'Absorpti~)n Area
/
[] OTHER
ISewer Line
INearest Lot Line
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA
4. DISTANCES
WELL TO:
[~;~t'~APPROVED FOR --~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must acco,~7)certificate)
[]DISAPPROVED / /
Absorption Area to nearest Lot Line
5. COMMENTS
DATE
72-010 (Rev. 6/79)
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received ~-
Time of Inspection
Date of Inspection
1. Approval requested by:
Mailing Address:
2. Property Owner:
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
.1
Phone:
Phone:
0
Mailing Address:
Legal Description:
Location: ?~
Type of facility to be inspected ~,~ -:~ ]. ·
6. Well Data:
7. Sewage Disposal System:
A. Installed /.77~ '
C. Septic Tank:
D. Seepage Pit:
/~
B. Depth
D. Bacterial Analysis
B. Installer
1. Size /E-~/3~ ~.,;..~' 2. Manufacturer
1. Absorption Area ~i~ ~-~:~ . Material
e
E. Disposal Field: Total length of lines
Distances:
A. Well to: Septic tank
, Absorption area
Sewer Lines .,
Nearest lot line
, Other contamination
B. Foundation to septic tank
, Absorption area
C. Absorption area to nearest lot line
EQ-034 (1/74) Page 1 of two pages
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" St., Ancilorage, AlasKa
99.503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
I. Type of Inspection: CMRO VA ~ FHA CONV
2. Property Owner: _~-,~=~0
Mailing Address: ~ \~qS~- ~n~ ~ Day Phone
3. Name of Buyer: _~~.r)m~ ~
Mailing Address: Da~ Phone~~O~-~_]~(~_~
Name of Lending Institution:
Mailing Address:
Name of Realtor or Agent:
Mailing Address:
Phone
Phone
Legal Description:
Location:
Type of Facility to be inspected: j~.~h~ No. Bdrm~.. ~
Water Supply
Type of Supply: Public Utility
Individual
If Individual, number of dwellings presently served /
If Individual, depth of well /~(D.
Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation __~/~
Individual (on-site)
Page 2 of two pages - Req,~_st for Approval of Individual S~ Jr & Water Facilities
Legal Description
Comments
Approved
Disapproved Date
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
Date
EQ-034 (1/74)
GREATEP, AMC!iOR&GE AREA BORO,']GH
Department of Environmental Ou,~!itv
~500 Tudor Road, Anchorage, Alask~ 00507 279-8696
Date Receive4 ~-
Date of Ins oeci:i on "-~-/~/-7 ~
.'~,~:n ~r:c'r FOP APr;;*'OWA~ OF
INDIVIDUAl. SEC;ER & WATER FACILITIES
-- ,,- / ~~<_ .L/,I
Bacteria] Analvsi~
;
C. Septic Tank: 1. Size 2. Manufacturer
D. Seepage Pit: 1. Size~__ 2, Material, ~
Disposal Field: Total Length of Lines
8. Distances:
A. Well To: Septic Tank , Absorption Area
Sewer Lines
, Nearest Lot Line
, Other Contamination
B. Foundation to Sm~t~c Tank
'~ AbSorption Area
C. Absorption Area to Mearest Lot Line .
"3truest for Approval of !'
, Pa~ Two
9. Comments:
Sewer & Water Fac&]it~.e
Ap!~rova~ Va¢.ld for One Yaar F~,,:om Date
Greater Anchorage Area }~orou(~h, Depart.ment of Envi'r'o~enta] Quality
DTAG~AM OF SYSTE~
I certify that the information contained in this request for approval to be a true
and accurate representation of the ~ubiect sewer and water faci!ities located at:
Signed Date
July 28, 1972
Mrs. Lynn Forrest
4404 Garfield
Anct)orage, Alaska
Subject: Lot 4, Block 4, Bruin Park Subdivision
Dear ~Irs. Forr~st:
An inspection of the subject property was made on July 14, 1972.
This depart~,ent was u~able to determine what the sewer system
consisted of.
A well recently ~rilled and the construction of the well is
approved. A water sa~plu taken at the ti~e of 'Cne inspection
proved to be satisfactory. Before this depart~'~e~t could approve
~he sewer anJ water systemics for the subject property, a si~neO
diagram of th~ sewer syste~'~ needs to b~ sub~'.~i~te~ for evaluation.
The sewer syste)~ would need to be the proper distances fro~', the
well.
It appeared th~: the sewer syste~-~ possibly consiste~i of a
cesspool w~tch w~s ~3' from the well. If this is the case,
~he sewer systeh~ will neeu to be up~jraded with proper distances
to the well.
If you have any questions regardtn9 the above, please contact
this office.
Sincerely,
Lynn S. Coati
S~nitartan II
cc: Abbott Realty