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HomeMy WebLinkAboutBRUIN PARK BLK 5 LT 13Bruin Pork Lot 13 Block #016-111-33 Municipality of Anchorage On-Site Water and Wastewater Section - (907) 343-7904 Page *1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP191286 . PID Number: 016-111-33 Dwelling: W Single Family (SF) El with ADU n Duplex (D) El Two Single Family Project: n New n1i Upgrade Name LESLIE RAO ABSORPTION FIELD 71 Deep Trench n Wide Trench 0 Bedound Site Address 11321 POLAR DRIVE *ANCHORAGE, AK 99516 El Other .";Z Phone Number of Bedrooms Soil Rating Total d� original grade 1-803-722-3534 14 GPD/SF FL LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. 71 Gravel depth beneath pipe Ft. Subdivision Block Lot BRUIN PARK; BLOCK 5, LOT 13 Fill added above original gr Ft. Gravel length Ft. Township Range Section Gravel ,width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES Tol Septic !Absorption l Holding I Sewer Lift Station Total rption area Number of trenches trenches From Tank Field , Tank Line Ftl Ft. Well 1100,+ 1 TANK 9 Septic El S.T.E.P. 0 Holding [I Other Manufacturer INFILTRATOR Capacity 1060 Gal. Surface \/%later 1100,+1 Material Number of compartments Lot Line 5'+ NA HDPE �2 Foundation '1 10'+ LIFT STATION Manufacturer Capacity Remarks Gal. Alarm location Electrical installed by Installer PIPE MATERIAL House to tank D3034 dTanfiek 'o D3034raind WILCO EXCAVATION Drainfield MC�4,!EX;STING CO/MTD3034 inspector DAVID GARNESS, PE AND TIM ECKLUND BENCHMARK (Assumed elevation) 101.56 ft Inspection 3120/2020 Location and de cription dates: OF MH 3ra 4"' ITOP ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's �Stajp Conditional Approval: Date tA IL .... . ..... ... . . .......... Septic System Approved Y, ) �)z ifl - Date 6 ..--7- Note: this approval does not include well permit requirements. OAECCCvt CA) ti PERMIT NUMBER: PARCEL ID NUMBER: OSP191286 RECORD DRAWING 016-111-33 A 6 C DBLI 11.6 16.0 20.2 bBL2 12.1 17.0 21.1 MH 14,0 191 22.8 ST1 17.3 18.9 19.5 DSL3 19.4 22.0 22.5 DBI -4 19.6 22,8 23.5 O100' WELL RADIUS DRIVEWAY FBRUIN PARK: SLO K 5!LOT 12 SHED, NEW 1060 TWO COMPARTMENT INFILTRATOR SEPTIC TANK 0 BRUIN PARK: BLOCK, 5, LOT 14 CONTRACTOR COI - 1-1.1-0 THAT THE INTERIOR BAFFLES OF INTERIOR TANK WERE FUNCTIONAL (NOTED THAT THEY WERE PLASTIC) EXISTING 4 BEDROOM HOUSE DECK SHED sc )4 GARNESS ENGINEERING GROUP, Ltd .. ................ ENGINEERING SALES CONSULTING AV, S,517 KQ. 4 tW, IV,6M*PAX PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0re mess LESLIE RAO 1-803-722-3534 2 OF 3 A C�2��795 LEGAL DESCRIPTION: DRAM BY: BRUIN PARK: BLOCK 5, LOT 13 DJG. TYPE OF WORK, DATE: LICENSE 14 ,, SEPTIC TANK RECORD DRAWINGS 3126/20 #AECC TA Vk lt PERMIT PdUMBER: RECORD DRAWINGPARCEL. ID NUMBER: OSP191286 016-111-33 TOP OF MANHOLE = 101.56 MH ST FINAL GRADE = 101.3-101.4 TOP OF TANK AT INLET = 98.59 TOP OF TANK AT OUTLET = 98,61 2" INSULATION PER k CONTRACTOR INLET OUTLET INVERT OF BUNG / 111 AT INLET = 97,98 INVERT OF BUNG = . IM-1060 2•COMPA2-COMPARTMENT} AT OUTLET 9777 INFILTRATOR SEPTIC TANK t. (a � OF ,* GARNESS 10 ENGINEERING........................ ,.... ...� ENGINEERING SALES CONSULTING 371ZI TUTZRRCADs �E101•AsC� E.r�*.u.�,z•c,, v30,3s v95 x,.3at18-3za- •✓ E r ..�.,�s�� a care ... .. _+........ .. 0 PREPARED FOR: PHONE NUMBER: PAGE NUMBER:mess' ., LESLIE RAO 1-803-722-3534 3 OF 3 • •. � E 79 + LEGAL DESCRIPTION. DRAU14i BY: BRUIN PARI{; BLOCK 5, LOT 13 D.J.G. �``���� ���•*;��� TYPE OF ARK: DATE: LICENSE ; IKOFESS uEPTIG YiTE RECORD }RAVf1IdGS 3%2612020 AAEGC854 JN1VAUt)O MUNICIPALITY OF ANCHORAGE III n1 / \ On-Site Water&Wastewater Program PO Box 196650 4700 Elmore Road Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 ,� h K http://www.muni.org/onsite ' Department 44' Hona6t. On-Site Wastewater Disposal System Permit Permit Number: OSP191286 Effective Date: 7/11/2019 Work Type: SepticTank Upgrade Expiration Date: 7/10/2020 Tax Code Number: 01611133000 Site Legal Address: BRUIN PARK BLK 5 LT 13 G:2633 Site Mailing Address: 11321 POLAR DR, Anchorage Owner: HARDIES LESLIE G & Lot Size in Sq Ft: 20000 Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 4 This permit is for the construction of: ❑ Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Received By: 7-- Y `^ j--- Date: 7//Z" / 4r Issued By: A)e,�p- Nce,/,--2-7-7,z.--- Date: /ii,/I1 6 7 8 A O w MUNICIPALITY OF ANCHORA Ju` 0 X019 Community Development Department Phone: - 7904 ti Development Services Fax: 90 ='!;P: z97 '1 On-Site Water & Wastewater Program On-Site Sewer/Well Permit Application For A Single Family Dwelling Parcel I.D. 016-111-33 Property owner(s) Leslie Rao Day phone 716-388-2074 Mailing address 11321 Polar Drive*Anchorage, AK 99516 Site address 11321 Polar Drive *Anchorage, AK 99516 Legal description (Sub'd, Block & Lot) Bruin Park; Block 5, Lot 13 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 4 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: (®all that apply) Initial ❑ Single Family (SF) Absorption Field ❑ (w/wo ADU) Septic Tank ® Upgrade Duplex (D) ❑ Renewal ❑ Holding Tank Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR: Distance: - I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: 4 asG5 `�� Waiver Fees: ✓ Date of Payment: l I ,DP' Date of Payment: Receipt Number: 0 9 3-L O( Receipt Number: Permit No. 05P1611g8 Waiver No. (Rev.01;11) GARNESS ENGINEERING GROUP, Ltd ENGINEERING SALES CONSULTING June 25, 2019 Municipality of Anchorage Development Service Department On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 Ref: Proposed Septic Tank Upgrade for Bruin Park; Block 5, Lot 13 To whom it may concern: The existing home is currently under renovation and per the homeowner the final bedroom count will be 4. The house is served by onsite wastewater and a private well. Due to the renovation and the change in bedroom count, the owner wants/needs to upgrade the septic system to serve 4 bedrooms. The existing drainfield is oversized and is currently already sized to serve 4 bedrooms (soil rating 0.7gpd/ft2, required feet2 858 (600/0.7), and actual feet2 is 894). Instead of showing an alternate site due to the increase in bedrooms, we are propoing to re-build the drainfield if /when the drainfield fails. There is already an existing 1,000-gallon concrete septic tank in place, we are proposing to install a new IM 1,060 two-compartment Infiltrator septic tank after the existing tank to provide adequate tankage. Double cleanouts will be installed after each of the two tanks. We are unaware of any adverse impacts this installation will have on adjacent wells or septic systems. If y.0 have any questions, please contact us at 337-6179. Thank you for your assistan e ince ely,/ 1 re yp f ' ar • -ss, P.:., M.S. Presid 3701 East Tudor Road, Suite 101 *Anchorage,Alaska 99507-1259 Phone: (907)337-6179*Fax: (907)338-3246*Website: www.garnessengineering.com • 0 Ci) PARK. :••• 4,LOT 17 BRU PARK. BLO 4,LOT 16 •� 100' US • BRUIN PARK; BLOCK 5,LOT 9 I (34400. BRUI •A• � •DIU� LOCK 4, OT BRUIN PARK, .. AtiAir. :LOCK 5,LOT 10�100'WELLRAa S O. • RK7111111111r, �� BRUIN'•RK; •. oT Q� BLO LOT 11 4LLRAD D UIUS 111.1(krtillillil ` :RUI PA'K1ST 100'WELL' •P ' •`a BLO• 5, .411‘. BRUIN•ARK, 'V I'T a OCK 40 13 = „�;LOCK5,LOT12.• IL ,`,`-WELL-•• BRUI PARK 1'• ��'WELL RA.. �. ADI;BLOC 4011.11BRUIN PARK; p7, �� . II 41.14 BLOCK 5,LOT 14 v O .' gRU.,�'3... �P LO ILL' Z US1111111114fr . w, . tifp ,N.44 �u �� LL RYiO . •'O 'K 1S BRUIN PARK 1• �S'j •t PROXIM ; A:a : OCK 5, ADD.BLOCK• LsT 17 TRACT A NW Op. �� Q� QIlltip CORNER POSSIBLE WELL LOCATION S R LOT • �/ ' \ �O PROPERTY IS NOW SERVED: •WWU ', a .DIUS •••\.4y 0'L�Q ■ WATER BUT RDS OF BEING DECOMMISSIONED SIIONED . ,40E `� c) . BRU T ADD - •CK 5 4�� 15 II BRUIN PARK 1ST \Ns. ADD;BLOCK 9, TRACT A LESS NW � CORNER S 1111 VACANT 1”=100' 1 1•16:.\\\ I4 ••�E OF . tt . � Ar al N. t ar • I , q GARNESS ENGINEERING GROUP, •Ltd ( 4 .1•••• ENGINEERING SALES CONSULTING Azar maw= • • 3701 E.TUDOR ROAD.SUITE 101•ANCHORAGE,AK 99507•PHONE(907)337-6179'FAX(907)338-3246•WEBSITE:mm.gamessen nexing.mm ��•:� .. . a ess c�= PREPARED FOR: PHONE NUMBER: PAGE NUMBER 0- Y • LESLIE RAO 907-388-2074 1 OF 2 0���J,' 4 C 7953 •'�� PROJECT/LEGAL DESCRIPTION: DRAWN BY •. j IL},,.•'•C` � BRUIN PARK; BLOCK 5, LOT 13 PNB . c0 ." ••j••"'' Q�- •• TYPE OF WORK: DATE LICENSE ,■PROFESS `C4•• SITE PLAN 6/25/19 #AECC884 ����� i. N\ ` // \ GEG,Ltd.HAS AN 8 PAGE SPECIFICATION LETTER THAT PERTAINS TO THIS DESIGN.BY PROCEEDING NOTE:CONTRACTOR MUST HAVE ALL 100'WELL 1 / 'RADII SHOWN FLAGGED BY A PROFESSIONAL FORWARD WITH THIS INSTALLATION,THE / LA SURVEYOR PRIOR TO CONSTRUCTION AND • ENGINEER,WELL DRILLER,CONTRACTOR AND ENGINEERS LAYOUT. PROPERTY OWNER AGREE THAT THEY HAVE BRUIN PARK;B ,LOT 11 READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND CONDITIONS OUTLINED. THE DECK WALKWAY WILL NEED TO BE REMOVED TO INSTALL THE PROPOSED TANK AND WHEN THE WALKWAY IS RE-BUILT THE CONTRACTOR WILL HAVE TO ENSURE THAT THERE ARE NO STRUCTURAL SUPPORTS WITHIN 5 FEET OF THE NEW TANK. BRUIN PARK;: • 'ik LOT 14 100'WELL RADIUS ••' . LL Rm US 4(:,- '•'"'--.... )10. 'A 1�1 \. r.. .� •�:�. "' 114 Q� :a•. BRUIN PARK;BL01 K 5,LOT 12 I �•.• �• �• 'XISTING 1000 \ LLON CONCRETE / / PROPOSED IM 1060-TWO SEPTIC TANK COMPARTMENT EXISTING 4 11111 INFI = OR SEPTIC TANK / �j BEDROOM ������ HOUSE it �r , EXISTING DRAINFIELD S MTS+\`\\ , ' (PROPOSED TO BE RE-BUILT TO SERVE AS RESERVE SITE) '111111Thl 1/4111'.. INSTALL DBL C/O" BRUIN PARK;BLOCK 5,LOT 14 i/ i i i i�� AQ ='UIN PARK 1ST ADD; O : •CK 5,LOT 17 O 100' LL RADI 1111166. r O �y �Q� OSSIBLE WELL L� ATION F• .•T 16. �0„0 S ALE: pQ ROPERTY IS NOW' RVED BY* , � QQ` WATER BUT NOREC•'•SOFWEL• s�O 1"=40' BEING DECOMMIS •NED. I W 'Qj� 100'WELL RADIUS F ' APPROXIMATE BRUT PARK 1ST ADD;BLOCK 5,L•T • 4. ��\ \\111 ..sE OF 44 • .....,..„,„.„6,Awilliktoom.,,,...„.. ,,.._... .• GARNESS ENGINEERING GROUP Ltd ; * .•• t 49 � � � • dimessiffts ENGINEERING SALES;CONSULTING • I 3701 E.TUDOR ROAD,SUITE 101•ANCHORAGE,AK 99507'PHONE(907)337-6179'FAX(907)338-3246'WEBSITE:www.gameuengineai g.com •• ••• •• ••• • PREPARED FOR: PHONE NUMBER: PAGE NUMBER: J; '1- A. Ga • LESLIE RAO 907-388-2074 2 OF 2 ••��J, I E-79 PROJECT/LEGAL DESCRIPTION: DRAWN BY: IA .�i. .7• 1( ( Jo 4, BRUIN PARK; BLOCK 5, LOT 13 PNB ♦ ♦ • +''�T�, • P TYPE OF WC)RK: DATE: LICENSE,',11�„\\+s... SEPTIC TANK UPGRADE DESIGN 6/25/19 LICENSE / / Caw COR AV 4 :.... J�j WHLO .,, O�liv I o //D / V / \ �s �a77 �'o .4 '9l rma 44 Yx s/Nc`4;c. /(y,4 k,4-4, 44,,/ • • N. •:'''''.::-.,..„.....11- .,./ / / i CcxvD COR 1 / // 1 ' ) RAD YPC AOTNEID / • / / 1 / s - •/ / 'em / / �y •• // j i, MOTE `n� // Mt.9�ffRGY/f gmoo THROUGHOUT ff WITH vl. K/ GillxREGARD TO FOUNDPROaERTYCO HERS 9 //7--,. VS RECORD PIAT DATA SONE WORN l170TWERE Fp'D AFOT THSSGWFYWERE ye // / ` USED AS S#+OWNTT ;OTHERS WERE AOT HELD ‹PSR CF TIEYDD NOT PROVIDEA 0000 RT WEN J QP EN COMPARED TO OTHER COMAS \' �/ 4PA Rx''ROIV THE SLODIS SON THSN.RYFY \4 ./ REPRESENTSNNEREST FIT ANDRESULTS // e\ POSSARf WITH H7IA7WAS F0MA(MD A MORE N. EXTENSIVE RETRACEMENTYRESULT IN \ /� ��. AFFEAENTRESI/LTS N. .�// rho ASBU /LTSURVEY /" =30' N ,/ wo COPIERS SET THIS DATE 000000pp o�i OF A t N I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY p� .411 IND VP( OF THE FOLLOWING DESCRIBED PROPERTY ff.:2 :' �1� V- o00 LOT 13,BLOCKS,BRUIN PARK F/RSTADD V OV,•' TH /AN p• : 49 - Op THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE 0 O' 'V CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN S `7 //40 NOT TO BE USED FOR POSITIONIING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES. THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS ✓* EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOWN EXIST OTHER THAN NOTED. O e o HEREON ( UNLESS INDICATED) DATED AT ANCHORAGE,ALASKA THIS 215T _ DAY OF 00: ' SHANE A.HOLT �0 NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE JUNE , 2919 040, LS43914 .•''yj'0 PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS. 4 o* -. d o ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE. HOLT LARD SURVEYING D p'O T•s Siona�`'per 93M 0009 RAE,AK R DRIVE �OpOoo4pa 14285,FB 197-60 345•5513 Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: .~'bc~ 9~/ Ol~/ PIDNumber: 01~/11 ~ Name: ITt,,., E:?.~/~i~ Wastewater System: D New ~ Upgrade Address: 1~3~/ Pol~ ~A~/ ~ ~1~ ABSORPTION FIELD Phone: No. of Bedrooms: ~ ~ Deep Trench ~ Shallow Trench ~ Bed D Mound ~ Other LEGAL DESCRIPTION so, Rating: Total Depth from original grade: Lot: Block: Subdivision: Depth lo pipe bottom from original grade: Gravel depth beneath pipe Township: ~ Range: ~ Section: Fill added above original grade: Gravel length: I I Gravel width: Number of lines: Distance between lines: Classification (Private, A,B,C): Total Depth; Cased To: Total absorption area: Pipe material: Driller: Date Drilled: Static Water Lever: Installer: Date installed: Yield'. GPM IPump set at: F,. Icasing Height Ab°ve Gr°und:R. TANK SEPARATION DISTANCES ~ Septic ~ g Holding g S.T.E.P. To Septic Absorption Lift Holding 3ublic/Private Manufacturer: Capacity in gallons: From Tank Fi'eld Station Tank Sewer Lines Material: Number of Compartments; Surface Water ~' ~, - - - LIFT STATION LineL°t ~t ~ ~ -- -- . Size in gallons:IJ Manufacturer: Foundation ~1 j~, _ . _ "Pump on"levelat: J"Pump elf"level at: JHigh water alarm at: Curtain Pump Make & Model Electrical Inspections performed by: Remarks: ~¢COr.~ c~ ~ ~ BENCH MARK Inspections performed by: ~/~ ?~ [~c Dates: 1st ~/~19¢ '_ w. ' Department of Health and Human Services approval ~%." c~-~58a' 72-013 (Rev, 9/91) MOA 25 100' LOT 13 BLOCK 5 COR TBM - ASPHALT WALK BASE OF STEPS ~ M.T. NEW 18'x 45' ', SOIL ABSORPTION BE W. 10' x 12' EXTENSION LOT 14 WELL COR COR."A" COR."B" COR."C" SWING TIES FROM: TO: , ,' " "WELL-~) M.T. "D" 18.5' 25' ,' C.O. "E" 33' 51' ' LOT 12 COR EXISTING CONC ;EPTIC TANK WITH ,~ = = NEW INLET AND OUTLET --c BA ,FF-L- E S- ......... ~--, ,' ' LOT 16 LOT 13, BLOCK 5, BRUIN PARK SEPTIC SYSTEM UPGRADE AS-BUILT INSP. REPORT PERMIT # SW 940131 PAGE 2 OF 3 FLATTOP TECHNICAL SERVICES 1 INCH = 30 FEET 14530 ECHO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 DATE: JUNE, 1994 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. PERMIT NO: SW 940131 PAGE 3 OF 3 PID NO: 0161 1 133 ORIGINAL GROUND BACKFILL (MOUNDED 1'+) DIST. PIPE INV. O,O, TYP. EXISTING CONCRETE SEPTIC TANK W. NEW BAFFLES AND 2" RIGID INSULATION SM SP 12' IMPORTED SP (QUALITY S & G' ii2' IMPORTED SP (LAKE OTIS PIT)ii SP NATIVE SM PERC RATE 18 - 80 MIN/IN. NO GROUNDWATER TO 15.5' B.G.L. , MEASURED 6/91 INV 100.8' .FILTER FABRIC 12" SEWER GRAVEL --ELEV. 95.7 BOTTOM OF EXC. ELEV 91.7 CROSS SECTION VIEW NOT TO SCALE NOTES: ELEVATIONS ARE BASED ON A TBM OF 1'00' ON ASPHALT WALK AT FOOT OF STEPS, WHICH IS ALSO THE ORIGINAL GROUND ELEVATION ON THE NORTH SIDE OF THE BED. 4.0 FEET OF CLEAN SAND WAS PUT UNDER SEWER GRAVEL TO REPLACE THE NATIVE SAND STRATUM WHICH WAS PARTIALLY REMOVED DURING EXCAVATION OF THE OLD SYSTEM AND TO PROVIDE ADDITIONAL CLEAN FILTER MATERIAL PRIOR TO CONSTRUCTION TWO PERO TESTS WERE CONDUCTED IN THE SM MATERIAL UNDERLYING THE BED AND THE MEASURED PERC RATES OF THIS MATERIAL WERE 18 MIN/IN AND 80 MIN/IN LOT 13, BLOCK 5, BRUIN PARK S/D SEPTIC SYSTEM UPGRADE AS-BUILT INSPECTION REPORT FLATTOP TECHNICAL SERVICES 14530 ECHO STREET ANCHORAGE, ALASKA 99516 DRAWN BY TFM JUNE, 6, 1994 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NLTMBER:SW940131 DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES OWNER NAME:EPSTEIN KIM B OWNER ADDRESS:il321 POLAR DR ANCHORAGE, ALASKA 99516 DATE ISSUED: 5/17/94 EXPIRATION DATE: 5/17/95 PARCEL ID:01611133 LEGAL DESCRIPTION: BRUIN PARK BLK 5 LT 13 LOT SIZE: 20000 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS RECEIVED BY :.~~~..~~~-~ ATE:/ 7- CIVIL & ENVIRONMENTAL ENGINEERING · ENERGY CONSERVATION & ANALYSIS IHEODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345-1355 May 12, 1994 ANCHORAGE, ALASKA 99516 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: The purpose of this letter is to provide the required design narrative in support of our application for a permit to upgrade the wastewater disposal facilities on Lot 13, Block 5, Bruin Park S/D, located at 11321 Polar Drive. The present soil absorption bed was installed in 1991, however a recent adequacy test showed that it is already operating in a surcharged condition, apparently due to the formation of a clogging mat at the interface between the sewer gravel and the native receiving soils. As I discussed with John Smith, it appears that the best option for upgrade on this lot (with its severe space constraints due to the proximity of nearby wells) is to remove the existing contaminated material and reconstruct the bed in the same location with the addition of a 2.5 foot thick layer of coarse gravelly sand beneath the sewer gravel. This should provide the best opportunity for the septic tank effluent to be thoroughly filtered before it encounters the finer grained receiving soils. The original soils logs and perc test results, as well as a new site plan, design ch'awings and specifications are enclosed for your review. The original bed was sized using 0.7 gpd/sq, ft., based on the measured perc rate of slightly less than 1 minute per inch for the 2.5 foot thick sand stratum encountered below 6.5 feet in each of the test holes. The proposed method of upgrading the bed is to re-excavate the cover material and sewer gravel, as well as remove all contaminated soil underneath the bed and around the edges to expose the undisturbed native slightly silty sand. Once this is done, 2.5 feet of"Lake Otis Gravel", a coarse gravelly sand, will be placed in the excavation to replace any excess native receiving soil which was removed and to create a good filter for the septic tank effluent prior to its encountering the native soil. Because of this extra excavation, the final dimensions of the bed will be approximately 16' by 46', which gives an effective absorption area of 736 square feet, which will be larger than the 643 square feet required by the wastewater ordinance for soils with a measured perc rate between 1 and 5 minutes per inch. A lot line waiver was issued on July 18, 1994 allowing the original bed to be located within 5 feet of the common lot line between lots 13 and 14. Since the proposed upgrade will be in the same location, we are requesting yom' concurrence in the continued validity of that waiver for the proposed upgrade. The topography in the immediate area of the upgrade slopes towards the southwest at approximately 3%. The house and septic tank are on a higher knoll, which still enables gravity flow of effluent into the proposed upgrade. The proposed project will have no impact on present or future water supply and wastewater disposal systems serving adjacent properties, nor will it have any impact on reserved space/surface and subsurface, or on drainage. Please give me a call at 345-1355 if you have any questions on this submittal. Sincerely, Ted Moore, P.E. LOT 13 BLOCK 5 EXISTING 15' x 43' SOIL ABS. BED TO BE RECONSTRUCTED AS 16'x 46' BED IN SAME LOCATION LOT 14 WELL~"' ' EXISTING 1000 GAL. CONCRETE SEPTIC TANK ,' (UNDER DECK) CONTRACTOR ,,' SHALL VERIFY INTEGRITY OF OUTLET BAFFLE, OR REPAIR ', ,' LOT 15 LOT 18 · , LOT 17', ' R 100' ' LOT 16 LOT 13, BLOCK 5, BRUIN PARK SEPTIC SYSTEM UPGRADE SITE PLAN FLATTOP TECHNICAL SERVICES 1 INCH = 40 FEET 14530 ECHO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 DATE: MAY, 1994 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. FROM SEPTIC TANK-- ~  .~D-3034) ~-- C.C. 3' ~._~. 4 DIA. PERFORATED PIPE /l .... (ASTM D-3034) // 5' ~.~. .............. :::::::::::::::::::::::::: ::::~ ~.o. 46 1" OUTER LIMITS OF EXCAVATION PLAN VIEW .~.~~ SCALE: 1" = 10'- 0" e~ ~ .,, ,...~;.- / :. "**~~*~': ~ i C.C. MOUND COVER MATER AL ~,,.., :. ~ ~ ~3 12'' ABOVE ORIGINAL GROUND BACKFILL RIGINAL GROUND  ~ ......... :. ............................. ~, - . ~:~:~:~:~:~ ..................... F LTER FABR C ' ~ 16 ~ '1'~ ' 4'' PERF DISTRIBUTION PIPE * .O TOM O..XO*VAT,ON ON UNCONTAMINATED SOIL LOT 13, BLK. 5, BRUIN PARK S/D SEPTIC SYSTEM UPGRADE PLAN AND CROSS-SECTION FLATTOP TECHNICAL SERVICES SCALE: AS SHOWN 14530 ECHO STREET DRAWN BY: TFM ANCHORAGE, AK, 99516 DATE: MAY, 1994 SECTION "A - A" SCALE: 1"= 5'- 0" Flattop Techn~al Serv~es 14530 Echo Street, Anchorage, AK99516 Phone (907) 345-1355 Lot 13, Block 5, Bruin Park S/D 11321 Polar Drive Wastewater disposal system upgrade Specifications 1.0 General: 1.1 The scope of the project consists of excavating the cover material, sewer gravel and underlying contaminated soil from a 15' wide by 43' long soil absorption bed and reconstructing the bed in the same location with an additional 2.5 feet of coarse filter sand placed beneath the sewer gravel. The contractor should also verify the presence of a functional baffle at the outlet of the septic tank and repair if necessary. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform with Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.4 The contractor shall provide adequate cover material and rough grading over all system components to ensm'e that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 2.0 Septic Tank: 2.1 The existing concrete septic tank may be retained in service provided the contractor verifies that the tank is equipped with a functional baffle at the outlet. The outlet baffle verification is to be done by disconnecting the waste line downstream of the tank and then running a probe back up the line to determine if there is an intact ban'ier at the outlet of the tank. Special care shall be taken to ensure that the probe itself does not damage an existing baffle in the com'se of verifying its presence. 2.2 If the original baffle is determined to be not functional, then a new baffle shall be created by removing the present discharge pipe and installing a new ASTM D-3034 discharge pipe with a sweep ell on the end which points down inside the tank. A one inch diameter hole shall be drilled in the top of the discharge line just inside the tank to prevent siphoning of septic tank effluent into the soil absorption bed. The new discharge line with internal baffle shall be secm'ely grouted into place. Some dismantling and repair of a wooden walkway which crosses over the septic tank may be necessary in order to repair the outlet baffle. 2.3 A double cleanout shall be installed in the waste line between the septic tank and the soil absorption bed. 3.0 Soil absorption system: 3.1 The existing 15' wide by 43' long soil absorption bed shall be completely excavated as follows: First a pump truck shall pump all possible liquid out of the bed from the existing monitor tubes located at either end. Second the contractor shall excavate a small pit down through the cover material and sewer gravel to a depth below the bottom of the existing bed. Any additional liquid which flows out of the bed into this hole shall also be removed by a septic pumper. Next, the contractor shall excavate all the uncontaminated cover material to expose the existing sewer gravel. Finally the contractor shall remove all the existing sewer gravel and that portion of the underlying silty sand which has been contaminated by septic tank effluent, to expose clean, undisturbed native soil on the bottom and sides of the bed. Contaminated soil shall be segregated from uncontaminated soil to the extent possible. The contractor or homeowner shall be responsible for obtaining permission from the homeowner of the lot to the south before stockpiling any excavated material on his side of the lot line. The final dimensions of the excavation should be at least 46 feet long by approximately 16 feet wide. 3.2 The bottom of the excavation should be approximately level. Any compacted or smeared surfaces shall be raked to allow proper infiltration. A total of 2.5 feet of coarse gravelly sand ("Lake Otis Gravel", or equal) shall be placed in the bottom of the excavation to create a filter. 3.3 A total of 1.0 feet of approved sewer gravel shall be placed on top of the filter sand, with the 4" diameter perforated distribution pipes laid level such that the pipe inverts are no less than 0.5 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" washed gravel, as supplied by Anchorage Sand and Gravel, with less than 3% passing the #200 sieve. Pm'ticular cm'e shall be taken to ensure that the sewer gravel is kept clean. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel before backfilling with cover material. Contaminated soil from the excavation may be used in any but the top 12 inches of the backfill. 3.6 The top surface of the cover material shall be raised a minimum of 12 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and seed to promote rapidrevegetation of all areas disturbed by the construCtion. 4.0 Inspections: 4.1 A total of 5 engineering inspections are anticipated during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the existing bed has been excavated to expose the uncontaminated infiltrative surface to ensure that it is level and at the fight elevation, (3) after the sand filter material has been placed, (4) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of filter fabric, and (5) after rough backfill and grading is complete. The septic tank baffle verification is to be approved by the inspecting engineer. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. It is anticipated that construction inspections and as- built inspection report will be performed by Gilfillian Engineering (ph. 277-20210. PERFORMED FOR: Flattop Technical Services 14530 Echo Street A]acho]:aae, Alaska 99516 Mun,cJpality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG-- PERCOLATION TEST -... .... . ~ * T}'IEODOI~E F '~O0~E ~i ~;~..'% CE DATE PERFORMED: LEGAL DESCRIPTION: 9 10 11 12. 13 14 15 16 17 18 19 20 PT SM 2 3 SM 7 8 sP COMMENTS J- 13 ~,~' BRUIN '~/~/~4" Township, Range, Section: REDDISH sANby LoAM SLOPE 6RA"I SILTY SAND SOME CoB. BLE S SITE PLAN F'tNE ~LI6HTL Y sA Nb 6PAVELLy SANb CAV£b ~ILT'¥ SA ~4b WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT L DEPTH? O P E Oeplh to Water AFter I 2' I" I~ ¢-? L. Monitoring7 troy Dale: ~//~'/ql Reading Date Gross Net Depth to Net Time Time Water Drop PRE$o/tk (o/lo 12:q7:','~' 27 .V~, ~r H~ o ~2:go -~:~: ~o 21% -2? Yt +~=0 i2:~: 3o 2g Y~ 5VARr ~2:5~:2s 2'~ l:ol:oo 2 21 - 2 ~/~ H~o J: 02: J~ 2~ p~r ce~ PERCOLATION RATE · '7~' TEST RUN BETWEEN 7 (minules/inch) PERC HOLE DIAMETER .. ,~ -- FTAND '7,~'~ _FT ACCORDANCE WITH ALL STA~rE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: ~'/~ Y/g / PERFORMED FOR: Flattop Techn[ca! Services 14530 Echo Street Anchorage, ,Alasl~c~ 99516 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST '1'. I~. ~Z g LEGAL DESCRIPTION: 9 10 11 13 14 15 16 17 18 19 20 PT 4 5 6 7 5P 8 REbDISH SILTY SANI~ FINE $~lNb COMMENTS 5LIGI-IT LY SILTY Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? NO SITE PLAN IF YES, AT WHAT DEPTH? p Oeplh Io Waler Alter Monitoring? D~¥ Date: fo/18/~11 Reading Dato Gross Net Depth to Net Time Time Water Drop I PERCOLATION RATE .-~ (minutes/inch) PERC HOLE DIAMETER I'EST t:{UN BETWEEN . . FTAND . _FT CERTIFY THAT THIS TEST WAS PERFORMED iN ACCORDANCE WITH ALL ST,~rE AND MUNiCiPAL GUiDELiNES iN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) '~' Municipality of Anchorage Page t of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: 5k/ cji0 18fo PID Number: Ot/~, Name: JAHE~ LANE Wastewater System: D New ~Upgrade Address: 70~ ~. iN~ A~PoRT RD. ~2o~ ANcN.~qge ABSORPTION FIELD Phone~ of Bedrooms: ~ ~ Deep Trench ~ Shallow Trench ~Bed ~ Mound D Other LEGAL DESCRIPTION so, Rating: Total Depth from original grade: 0,7 GPD/Sq. Ft. Lot: J ~ Block: Subdivision: Depth to pipe botto~ from original grade: Gravel depth beneath pipe ] Section: Fill added above original grade: Gravel length: Township: 12 ~ Range: ~ ~I ~O O, ~ Ft. ~ Ft. WELL: ~New D Upgrade Grave~ depth: Number of lines: Distance between lines: {,O Ft. 3 ~, Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: ~ - Dat~ Drilled: Static Water Level: Installer: Date installed: ~ Driller: ~LPINE ~H21ql flZ Ft. Yield: J Pump Set at: ]Casing Height Above Ground: ~,J GPM, .178 Ft.I J,O Et, TANK SEPARATION DISTANCES ~Septic~jSTJN~ ~ Holding ~ S.T.E.P. To Septic Absorption Lift Holding ~f~;/Priwte Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines J O O O Well j I0' JO2' ~ IO~l Material:CoNCRETE Number of Compartments: Sudace t Water >[O0 >~oo' - >/oo' LIFT STATION ~ Lot , ~ -- Line ~ ~ ~ / Size in gallons: Manufacturer: I F°undatl°n' ~~ 15' - ~ O "Pump °n"level at" I"Pump °ff" level at: I High water alarm at: Cu~aln Pump Make & Model ~ Electrical Inspections performed by: Drain .... -- I emarKs:~ r~'~ ~f~ ~ m~p¢c~-~ BENCH MARK u J ~laffop Technical Servic~ ~j..'.."' ENGINEER'S SEAL Inspections performed by: FLA~OP TEc~ ~vc~ Dates: 1st ~/~z/e~ ,~P~.'A~H';:":,;;' "~ · THEODORE F ~AOORE Department of Healt~d ~m~n Servi~ approval '),~,,,..' c~. ~" ." ~G~' ' Reviewed and approved by: ate: ................. , ~,~~. Permit No. ~W' ~lO ]~(o Page ~ of ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report LegalDescription: L 13, BS' BRU~N PARK PIDNo.: 016 11133 NORTH C.o.,f I~,T. DOVi~LE C.O, S~>~. ABS. Bgb ~lattop Technical i4530 Echo Street Anchorage, Alaska ' 995] EN( SEAL CE- 3589 .,' 72-013 A (2/91) MOA 25 Permit No, of ~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: L 13, ]~5 ~EUI~( P~iRK PID No.: O1~ ill 33 GRouch L~VEL lO0 r AT AB~o~PTJoJ~ t'4.T. IN bI$'TR~ BuTIo Iq LINE ELEVAT/o~ ...... VEg? !CAL, 5CAL£: i% S' T.B.14.: CONCW~=TE 5;LAB AT So~rrN k/EST CORNER OF ~AiqAGE ELEI/~ IOo.o Flattop Techn~ca! Services 14530 Echo. Street AnChorage, Alasi<a 99518 72-013 A (2/91) MOA 25 DRY ENGINEER'S SEAL _.-.~.~ ¥............~1 ~ ~ ,'. CE- 3589 'C%2:.. ...... RECEIV'ED AUG ~O_~CA~.X..ON' _0~ WZLL . Mu, ii BOROU(~ & 6 1991 DEI~A/~T~NT OF NATURAL ~8OI~CES DIVISION OF GE0/,0GXCAL AND GEOPHYSICAL ~URV1 WATER WELL I%F;CORD TOWNSHIP RANGE MERIDIAN U N~ P0~NT: g]9~uund surface BOREROL~ DATA:  top of other Deptl) WELL DEPTH: i DATE OF oe th oze:J. t METItOD OF'DRILLING: ~at, r rotary ~cabl~ tOO]. ~other:' L.Jpublic supply [] other: CASING: Stick-up..,.__~__ ft. Diam: d in WELL INTAKE; ~ open end []so~e~ned · perforated []'open hole Depths of openings:__ to ..... ft SCR~;EN T~E: , Diam: .in Slot/Mes~h~~ Length: ft Set Betwe(~n and ft Volum~ uzed~. Depth to top: GROUT ~E ~ Volume: Duratio~: CONT~CTOR I~FO~TZON: j .... ~:" · "; .... 2 ................ , ........ ___ · ~ ~ , ~, __ __ . J WA~RR O~Ei4XSTRM ~PL~ TAKEN9 ~ yua - /~~ DAYS ~0' DGGS _.7~/V' 9/.., PO BOX 77-P~6 Date '" .,~r, RIVER, AN. 99577 A'A6 .... PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW910186 DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES OWNER NAME:LANE JAMES J & OWNER ADDRESS:709 W. INT'L AIRPORT RD., SUITE 204 ANCHORAGE, ALASKA 99518 PARCEL ID:01611133 DATE ISSUED: 7/09/91 EXPIRATION DATE: 7/09/92 LEGAL DESCRIPTION: BRUIN PARK BLK 5 LT 13 LOT SIZE: 20000 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ~_~'~_ DATE: DATE: unicipality of Anchorage Department of Health and Human Services Tom Fink, 825 "L" Street Mayor P.O. BOX 196650 Anchorage, Alaska 99519-6650 343-4744 July 18, 1991 Ted Moore, P. E. Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 Subject: Waiver Request for Lot 13 BLock 5 Bruin Park S/D Waiver Request #WR910024, PID ~016-111-33 Permit #SW910186 Dear Mr. Moore: Your request for waiver of the required 10 foot separation between a septic system and a lot line has been approved. waived distance is 5 feet to the common lot line of Lot 14 and Lot 13 Block 5 Bruin Park Subdivision. The This approval applies to the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services DJR/ljm #7 CIVIL & ENVIRONMENTAL ENGINEERING * ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. June 24, 1991 14530 ECHO ST. PH: (907) 345-1355 ANCHORAGE, ALASKA 99516 M.O.A. DHHS P.O. Box 196650 Anchorage, AK 99519 Dear Sirs: The purpose of this letter is to provide the required design narrative in support of our application for a permit to upgrade the water supply and wastewater disposal facilities serving the residence on Lot 13, Block 5, Bruin Park S/D. These upgrades are necessary because a recent adequacy test showed that the existing wastewater disposal system is not performing adequately for a three bedroom residence, and the required separation criteria were not being met. Copies of the soils logs and proposed site plan,,design drawings, and specifications are enclosed for your review. As can be seen from the soils logs, the prefered soil absorption stratum consists of fine, slightly silty, poorly graded sand between the depths of 6.5 and 9 feet. Although the measured perc rate was slightly faster than 1 minute per inch, it is our opinion that this material is entirely comparable to filter sand, and thus we do not propose to incorporate additional filter sand in the design, except as may be necessary to provide a leveling course for the bottom of the bed. A small sample of this sand material collected from test hole #1 is attached for your evaluation. In light of the measured perc rate, the bed design is conservatively based on the applicable rate for filter sand, which is 0.7 gpd/sq, ft. The required basal area for a three bedroom system is (3 x 150)/0.7 = 643 square feet, which is accomplished by a 15' wide by 43 foot long soil absorption bed. Once the well is relocated, this seepage bed area can just be accommodated outside the 100 foot radii from all wells. A waiver is hereby requested to allow the soil absorption bed to be within 5 feet of the lot line, as opposed to the normally required 10 feet. The topography of the lot will necessitate a comer of the seepage bed being within approximately 5 feet of the lot line separating the subject lot from Lot 14. Granting the waiver will have no impact on the ability to develop soil absorption systems on Lot 14, both because the area across the lot line is within the 100 foot radius from the well and because the proposed bed type construction would be entirely compatible with a similar bed a like distance away on the other side of the lot line. The topography in the proposed construction area is generally level. The land between the proposed construction site and the residence is generally higher, with slopes of up to 20% leading downwards to the southwest and southeast. The site plan shows the locations of all known wells and septic systems within 200 feet of the proposed construction site. Aside from eliminating some presently non-conforming separation distances and replacement of an inadequate septic system, the proposed project will have no impact on existing or future water supply and wastewater disposal facilities on adjoining lots, or on reserved space/surface and subsurface. Please give me a call if you have any questions on this permit request. ~Sincerel~~<- Ted Moore, P.E. 3 BPR H LoT Iq ~L~,~ ~' ~ouSE eeeeeeeeeee~eeeeee~eee~. THEODORE F. ,e/iOORE ~, CE - 3589 LOT i.~ LoT I~ ~atto~5 TeCT~filC~! Sa~ric~ :[4530 Echo Street Anc;horage, Alaska 995 L l3, B$ BRuiN PARK SEPTI, C S¥$'~E~4 UPGRADE ,SITE PLAN SC~tL£ DATE' NOTE: THiS ALL LoCATmN 5 ARE APPRoX~ PLAN $¢^L~ t $£c~o~ A-A ~' bElaTI4 o~ ~RAV£L ~c[ttop Technicc~! Services ..... 14530 Echo Street Anchor(:zge, Alc~skcc 9951~ ! SOIL A b.so R PT iON SCALE: AS SHO~,~ ~DATE ' G / c~ l Flattop Technical Services 14530 Echo Street, Anchorage, AK 99516 Phone (907) 345-1355 Lot 13, Block 5, Bruin Park S/D 11321 Polar Drive Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project includes abandonment of the existing well and drilling a new well in the northernmost comer of the lot in the location shown on the site plan. The structural integrity of the existing septic tank is to be verified and the tank replaced if found to be not sound. The existing seepage pit is to be pumped and abandoned by filling with clean soil. A new 15' wide by 43" long soil absorption bed is to be constructed in the location shown on the site plan. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and matefifl specifications shall conform with Municipal and State requirements. 1.3 All separation distances shall be in conformance with Municipal requirements, unless specifically waived. A lot line waiver is required from the Municipality, allowing construction of the soil absorption bed.within 5 feet of the southwest property line. Special care will be necessary to ensure that impacts of the construction activities do not infringe onto the adjoining lot. 1.4 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. 1.5 The property owner shall arrange for a surveyor to locate both the northernmost property comer and the property boundaries within 10 feet of this corner, and also stake the entire southwestern property line at 50 foot intervals. 2.0 Septic Tank: 2.1 The existing septic tank may be retained in service only if it's structural integrity can be verified, and if it has functional cleanout pipes wiyh airtight caps, allowing pumping access to each compartment. To allow the engineer to make this determination, the contractor sha~l remove portions of the boardwalk as necessary and expose the top of the tank and the sides down to a point below the working fluid level. 2.2 If the existing septic tank is determined to be not sound, the contractor shall install a new 1000 gallon, two compartment, Municipally approved tank. The new tank shall be set level on undisturbed soil and the old tank properly abandoned by pumping, crushing and burying on site. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried leSs than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. 2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4'" per foot, and the waste line between the tank and the soil absorption system shall have a minimum slor>e of 1/8" per foot. A ¢leanout shall be installed within 5 feet of the building foundation, and a doubl[ cleanout shall be installed within 5 feet downstream of the septic tank. 3.0 ~Soil absorption system: 3.1 The existing seepage pit is to be properly abandoned by pumping, removing the top and filling with clean soil. The remains of a second, unused, log crib cess pool located just east of test hole #2 are to be properly abandoned by removing the top of the crib and filling it with clean sand. 3.2 The 15' x 43' soil absorption bed shall be constructed in the approximate location shown, no closer than 100 feet from any well and 5 feet from the southwest property line. If any soil is encountered which shows signs of contamination from the old cess pool, the boundaries of the new soil absorption bed shall be adjusted to provide an equivalent area in uncontaminated soil. 3.3 The bottom surface of the soil absorption bed shall be constructed by removing the peat and overlying soils to a depth of approximately 6.75 feet below natural ground level at test hole #1 to expose the top of a fine sand stratum. The bottom surface of the bed shall be level, however this may be achieved, if necessary, by placement of a sand leveling course in the bottom of the excavation. Any leveling sand shall comply with Municipal specifications for falter sand. 3.4 A total of 12 inches of sewer gravel shall be placed in the bottom of the bed. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. Four inch diameter perforated and non-perforated distribution pipes shall be configured as shown, with the bottom of the pipes laid level no less than 6 inches above the bottom of the sewer gravel. 3.5 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.6 Approved filter fabric shall be placed over the entire top surface of the sewer gravel before backfill with unclassified soil. 3.7 The top surface of the cover material shall be raised a minimum of 6 inches higher than the surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill slopes shall be no steeper than 3:1. 3.8 Any topsoil and reseeding of disturbed areas shall be accomplished by the owners under a separate contract. 5.0 Inspections: 5.1 A total of 4 engineering inspections will be required during-the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of filter fabric, and (4) after final backfill and grading is complete. The septic tank requires one inspection to determine it's suitability, and if it needs to be replaced, another inspection after it is set level and the piping connected, but prior to backfill. These inspections may be incorporated with any of the above inspections. 5.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. _?/a~oP TechnlcaI Services 14530 Echo Street Anchorage, Alaska 9951 n Flattop Technical Services 14530 Echo Street, Anchorage, AK 99516 Phone (907) 345-1355 Lot 13, Block 5, Bruin Park S/D 11321 Polar Drive Well Modifications Specifications The existing well is to be properly abandoned by removing the pump and cutting the casing off 4 feet below grade and filling the casing with concrete or bentonite grout. A new well is to be drilled in the extreme northern comer of the property, approximately 2 feet from the property lines which will be marked by a surveyor. The well shall have a 6" steel casing extending at least 12 inches above ground level, and be constructed to Municipal standards including a proper well seal and conduit to protect the pump wires. The well shall be fitted with a pitless adaptor and a new waterline which is to be spliced into the original waterline serving the old well. The pump from the original well may be reinstalled in the new well, so long as it is in good condition. Once the new well is connected to the residence and is fully operational, the installer shall collect water samples and have them tested for total coliform and nitrate-N at an approved testing laboratory. The installer shall provide satisfactory water test results and the driller's log to the engineer at the above address, along with a statement describing the procedure used to abandon the original well. PERFORMED FOR: Flattop Technical Services 14530 Echo Street A ho a , Alaska 99516 Z~aCuZnl)c~p'~'i?~ of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG:-- PERCOLATION TEST LEGAL DESCRIPTION: PT 1 2 3 4 5 6 7 5P 8 5P 9 10 11 12. 13 14 15~ 16 17 18 19 2O J. IS ~' BRc'~N REDDISH SANDY LoAM GRA~ .SILTY SAND SOME CoB. BLE S SAND ~f?I~V~.LL¥ ,SA Nb CAI(£b SA COMMENTS Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? NO SITE PLAN IF YES, AT WHAT L DEPTH? O P E Depth to Water Alter 12 Monitoring? D R ¥ Dale: (o ]1~/~ 1 Reading Date Gross Net Depth to Net Time Time Water Drop 5VART 12:5~:2~ 2'~ t H~o 1:o2~ ~ 23 v= PERCOLATION RATE · ~ (minutes/inch) PERC HOLE DIAMETER ,, TEST RUN BETWEEN 7 FT AND '7.~" . FT ACCORDANCE WITH ALL STA~E AND MUNICIPAL GUIDELINES tN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN' DATE: ,,~"/ ~' Y 19 [ PERFORMED FOR: l~lattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG-- PERCOLATION TEST 'l'. N. ~Z LEGAL DESCRIPTION: 9 10 11 12. 13 14 15 16 17 18 19 20 PT 2 3 4 5 6 7 ~P 8 L I~ ~ BRuiN PA~k' REbDISH SANb~/ z. o4~ SILTY SAND FINE 5ANb Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? ~0 SITE PLAN S L IF YES, AT WHAT O DEPTH? p E Depth lo Water Alter i,~' '(~ n ~. ~ · &, Monitoring? DRY Date: (~/18/91 Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN __ FTAND FT COMMENTS ..~t~.~' )~.'~./~..~'~ ~'.~'' ¢*~.,,.~' ~"C~'/'~ C2./' ~,~r-~"(,~:~ ~ '7~'. j~. ~'.~ ACCORDANCE WITH ALL STA'LFE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE:., (~/"//2 ~//~/ G~'~ATER ANCHORAGE AREA BORO""~H HEALTH DEPARTMENT 327 EAGLE ST. ANCHORAGE, ALASKA 99501 2~'9-25! 1 N°. 322 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LOCATION SEPTIC TANK: DISTANCE FROM WELL LIQUID CAPACITY ADDRESS , PHONE MATERIAL NUMBER OF COMPARTMENTS INSIDE LENGTH LIQUID INSIDE WIDTH DEPTH_ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS OUTSIDE DIAMETER OR WIDTH J'~- //O' LINING MATERIAL DISTANCE FROM WELL NEAREST LOT LINE /~.-I TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) LENGTH ~"~ ! ~ ! , DEPTH BUILDING FOUNDATION~ SQ. FT. TILE DRAIN FIELD: DISTANCE F,R/OM WELL F~ ,NEAREST LOT LINE DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGTH , OF LINES IN. ABOVE TILE ~'//~ '//~Z DISTANCE FROM WATER WELL: TYPE ! DEPTH , BUILDING FOUNDATION. SAMPLE. , NEAREST NEAREST SEPTIC SEEPAGE '~ OTHER LOT LINE SEWER LINE , TANK ~-~-' SYSTEM ///0 , CESSPOOL , SOURCES~ DISTANCES: DATE DIAGRAM OF SYSTEM APPROVE HEALTH AUTHORITY GR.E. ATET , NCHORAG E AREA 'OROUGH ~~~-----'~- ' flEALTH DEPAR~'i~MENT ISPOSAL SYSTEM - AP ATION & PERMIT APPLICATION TO INSTALL: SEPTIC TANK ~' ,, SEEPAGE PIT ~ ,, DRAIN FIELD , OTHEr'_ Cas. THIS IS TO SERVE AS f- , PERMIT TO INSTALL A AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED .. SEPTIC TANK SIZE TYPE .SEEPAGE AREA .TYPE -~ DIAGRAM OF SYSTEM DISTANCES: HEALTH AUTHORITY OR LICENSED DESIGNER I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the above described system is in accordance with said code. ~ DATE , f.. ~ ' ' r APP LI CA NTS ' De?th .......... t ,' s Location Sketch Was Ground Water Encounter'ed? If Yes, At ~.,i?.at Depth Readl.n~', Da'te G'r, cc.s ?ime ~e'~ 7i~,e Depth Tc, _ ' ~-'V~ Net Drop Municipality of Anchorage On-site Water and Wastewater Program (907) 343-7904 s T Y Certificate of On -Site Systems Approval Parcel I. D. 016-111-33 1. GENERAL INFORMATION: Expiration Date: Complete legal description Bruin Park; Block 5, Lot 13 Location (site address) 11321 Polar Dr. *Anchorage, AK 99516 Current Property owner(s) Leslie Rao Day phone 716-388-2074 Mailing address 11321 Polar Dr. *Anchorage, AK 99516 Real Estate Agent Day phone 2. TYPE OF DWELLING: © Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ® Individual Individual Water Storage ❑ Holding Tank 0 Community Class Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ WaiverNariance request for: Received by: COSA to be released to the bngineer, unless otherwise requested by the engineer. COSA Fee $ 9 12,50 CQ U, 0 Date of Payment 1©13 0 I �C')�D Receipt Number o ?g G COSA # 05CW 1605 Date: Waiver Fee $ Date of Payment Receipt Number Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm: _Garness Engineering Group, Ltd (GEG) Phone: 907-337-6179 Address: 3701 East Tudor Road, Suite 101- Anchorage Alaska 99507__ Engineer's Printed Name: Jeffrey A. Garness Date: io In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in accordance with the guidelines and regulations established by the Municipality of Anchorage and industry practices. The reported results describe the condition of the systemis on the date/s of the evaluation. separation distances were measured to readily identifiable features. Hidden defects or encroachments may exist that were not identified during the evaluation. The operational life of all wells and septic systems depend upon a variety of variables, including but not limited to, soil conditions, groundwater levels (that may fluctuate during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing the systemis: These conditions can vary, and are outside the control of GEG. Satisfactory test results do not guarantee future performance of the systemis; therefore, GEG makes no warranty (express or implied) regarding the future performance of the well or septic system. GEG makes no representation whether an alternative well or septic system can be installed on the property in the event either of the current systems fail to perform adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG to perform the evaluation. Reliance upon the information provided in this report by any other person or party (including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever. 6. DSD SIGNATURE System #1 Approved for 41 bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, �Q Fa , �a 4 f rey . orness q9. CE -795 V4Rr •�..�JJI dCp v��npr0 r e s sior�Oo� #AECC.884 OF �r `1'�e,�-CE with the followin,��tpula � 4 WPTE'��A-��R a iffic'' 1 0 0; 1,, Original Certificate Date: The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work, 7. ATTACHMENTS: / COSA Checklist -Nitrate Advisory Septic System Advisory Arsenic Advisory Well Flow Advisory Other COSA blue sheet 10-10-12.doc COSA Checklist Legal Description: Bruin Park; Block 5, Lot 13 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 7/12/91 Total depth 181 ft Cased to 181 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 18+ in. Date of flow test for COSA 9/4/19 Static water level at beginning of test 91.5 ft. Comments B. TANK DATA Age of tank(s) 50/New years _ Tank type/material septic Concrete/HDPE Measured operating fluid level in septic tank 22 /New FE -1 Standpipes/foundation cleanout per record drawing Date of pumping 10/23/20 D. ABSORPTION FIELD DATA Parcel ID: 016-111-33 Structure served by this system Well production at time of test 5.7+ gpm Water storage tank volume n/a gallons Well disinfected for coliform test? ❑ Yes ❑ No ❑Q Coliform bacteria is Negative Nitrate mg/L Nitrate less than MRL (ND) Arsenic ug/L Arsenic less than MRL (ND) Collected by GEG, LTD. Date of Sample 10/6/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments Which system tested (date installed) 1994 Adequacy test date *9/4/19 Al ALL standpipes present per record drawing Results ❑✓ Pass For 4 bedrooms Total measured depth from grade **4.5 ft (max) Fluid depth prior to test 0 in Measured depth to pipe invert from grade 3.58+ ft (min) Water added 649 gal ❑ N/A — pressurized field New depth 1 in ❑ Monitor tubes go to bottom of effective. If not, state Elapsed time 15 min depth into effective ***4.s ❑� Code -required soil cover over field Final fluid depth 0 in System presoaked Absorption rate 600+ gpd (Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) No date of test) Gallons introduced 2,414 gallons _ If yes, enter date Comments/Deficiencies: *Pre-soaked on 9/3/19 - Drainfield is sized for 4 bedrooms **At monitoring tube ***West monitoring tube COSA Checklist yellow sheet E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community well) Septic Tank/Lift Station on Lot > 100' ❑ Yes if No *3 Community Sewer Manhole/Cleanout > 100' E✓ Yes if No ft Q Yes if No ft Neighboring Tank > 100' Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft Absorption Field on Lot > 100' Yes if No ft Holding Tank > 100' R Yes if No ft Neighboring Absorption Fields > 100' Water Main > 10' ✓1 Animal Containment > 50' �✓ Yes if No ft ✓❑ Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' Fv Yes if No ft E] Yes if No ft From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundations > 10' ❑ Yes if No *3 ft Surface Water > 100' Yes if No ft Property Line > 5' Yes if No ft Wells on Adjacent Lots: Absorption Field > 5'[]✓ Yes if No ft Private Wells > 100'✓C] Yes if No ft Water Main > 10' ✓1 Yes if No ft Community Wells > 200' [Z] Yes if No ft Water Service Line > 10' ❑✓ Yes if No ft If septic tank is under driveway comment below From Absorption Field on Lot to: (Please enter distances if less than required) Building Foundation > 10' 121 Yes if No ft If absorption field is under driveway comment below Property Line > 10' ❑ Yes if No ft Wells on Adjacent Lots: Water Main > 10' 0 Yes if No ft Private Wells > 100' Yes if No ft Water Service Line > 10' F71 Yes if No ft Community Wells > 200' ❑✓ Yes if No ft Surface Water > 100' 0 Yes if No ft F. ENGINEER'S COMMENTS *Approved on 1994 Inspection Report **Per Ted Moore, P.E. 1994 inspection report. ***Per Ted Moore, P.E. 1994 inspection report in regards to well on 135, 1_14. G. ENGINEER'S CERTIFICATION l certify that / have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. COSA Checklist yellow sheet ...... ............. ........ _;,def r A. Gor ess: 9 . CE -7 �D�a pro fiession°G� #AECC884 October 29th, 2020 Municipality of Anchorage On -Site Water & Wastewater Program 4700 Elmore Road Anchorage, Alaska 99519-6650 REFERENCE: Bruin Park: Block 5, Lot 13 — Leak Test on Concrete Septic Tank To whom it may concern: During the investigative process we noted that there was only 22 inches of liquid in the single - compartment concrete septic tank (installed in 1970). It is our understanding that the home had been vacant for an extended period of time, and we had no documentation as to when the tank had last been pumped. It is possible that the tank was pumped in the time -frame when the house was vacated and that there had been some water use after it was vacated, resulting in 22 inches of liquid in the tank. The other possibility was that the tank had not been pumped and was leaking. We decided to run a "leak test". On (or about) 10/23/20 the concrete septic tank was pumped. On 10/28/20 we measured 2 inches of liquid in the tank. Over a period of 162 minutes we introduced 929 gallons into the tank at which point water was observed flowing in the post -tank double-cleanouts. The liquid depth in the tank was measured to be 39 inches, which corresponds to a rise of 37 inches. Based upon this data, the volume of the septic tank is approximately 980 gallons, which is consistent with the documents prepared by Ted Moore, P.E stating the tank volume is 1000 gallons. We returned to the property 1190 minutes later and the water level in the septic tank was still 39 inches. Based upon this limited investigation, the septic tank appears to be "watertight". If you have any question, please contact me. Best Jeffroy/lA Garnessj.E., M.S. 3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259 Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com Municipality of Anchorage DepartmeD is :n feEani namnendtaTSUe sn Se, ,ices On-Site Services Section 825 "L" Street Room 502 P.O, Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak, us (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 0t6-111-33 1. GENERAL INFORMATION Complete legal description Lot 13, Block 5 Bruin Park Expiration Date: Location (site address or directions) 1i321 Polar Drive Current Property owner(s) Sue Sick Day phone 344-6466 Mailing address 11321 Polar Drive, Anch AK 99516 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Un/ess otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: [] Individual On-site [] Individual Holding tank [] Community On-site Public Sewer The Municipality of Anchorage Department of Health and Human Services (DHHS) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval ere required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS aisc issues HAAs upon request to home owners. Certificates of Health Authority Approval ere valid for 90 days from the date of issue for properties served by a private or Class C weil and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year rot properties served ;3y Class A or B wells or a pubiic water system. The Municipality or Anchorage is not :asponsible for errors or omissions in the professional engineer's work. 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation based on procedures outlined in the Health Authority Approval Guidelines for this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone En.q. Svc. Address P.O. Box 102954, Anch, AK 99510 Engineer's Printed Name Steven R. Pannone, P.E. Phone 272-8218 Date 8/11/2000 DHHS SIGNATURE ~ Approved for ~ Disapproved. Conditional approval for ~.....~ ,_,: ............... , -. ..... ~ .,.~ bedrooms. *.> ~ ....~ [ [ ,,,, -:~ bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist X Seotic System Advisory Weil Flow Advisory /I- ~. q-cc Maintenance Agreements Supplemental Engineer's Report Other Original Certificate Dale: x Legal Description: A. WELL DATA RECEIVED Municipality of Anchorage~H 2 1 ~000 Department of Health and Human Services-G Division of Environment,a,I Services ~umtOP^Lr~ O~ ^NCHO~G~ On-S te Serv ces Sect on 825 "L' Street Room 502iRONMENTAI.$E£VICE$ DIVI$ P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak, us (907) 343-4744 HEALTH AUTHORITY APPROVAL CHECKLIST Lot 13, Block 5 Bruin Park S/D Well type Private Date completed 711411991 Total depth 181 ft FROM WELL LOG Date of test 7/'14/'1991 Parcel I.D.: 016-t11-33 Static water level Well production WATER SAMPLE RESULTS: Coliform (~ colonies/100 mi Date of sample: 8/17/2000 SEPTIC/HOLDING TANK DATA Tank Type/Material Concrete IfA, B, or C provide PWSID # __ Sanitary seal v Cased to 181 ft 178 ft 5.1 g.p.m Nitrate ¢-,~ D mg/I Collected by: Well Log y Wires properly protected v Casing height (above ground) 12 AT INSPECTION 8~4~2000 80 ft 6.1 g.p.m Other bacteria O colonies/100 mi S.R.PANNONE Date installed 1011911970 Tank size 1250 gal Number of Compartments _2 Cleanouts v Foundation cleanout v Depression over tank _n High water alarm n/a Date of pumping 6/15/2000 Pumper Northland Pumping C. ABSORPTION FIELD DATA Date installed 6/6/1994 Soil rating (g.p.d./ft2 or ft2/bdrm) 0.7 System type bed Length 45 ft Width 18 ft Gravel below pipe 0.5 ft Total depth 4.._.~2 ft Effective absorption area 894 ft2 Monitoring tube y Depression over field L Date of adequacy test 8~4~2000 Results (Pass/Fail) pass For 3 bedrooms Fluid depth in absorption field before test dry in Water added600 gal. New depthdrv in. Elapsed Time: _0 mJn Final fluid depth dry in Absorption rate >= 600+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date Rev. 11/99) D. LIFT STATION Date installed "Pump on" level at __ Datum Size in gallons in"Pump off" level at Cycles tested Manhole/Access High water alarm level at __ in Meets alarm & circuit requirements? __ SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 110 On adjacent lots 100+ Absorption field on lot 103 On adjacent lots 100+ Public sewer main n/a Public sewer manhole/cleanout Sewer/septic service line 110 Holding tank 100+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 3 Water main n/a Drainage 100+ Property line 45 Water service line $0 Wells on adjacent lots 100+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 6 Water Service line 50 Curtain drain 100+ F. COMMENTS G. ENGINEER'S CERTIFICATION Building foundation 18 Surface water 100+ Wells on adjacent lots 101 I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone, P.E. Date 8-11-00 n/a Absorption field 15 Surface water 100+ Water main n/a Driveway, parking/vehicle storage 25 HAA Fee $ Date of Payment Receipt Number (Rev. 11/99) Waiver Fee $ Date of Payment Receipt Number Pannone Engineering Services, LLC Consulting Engineer SEPTIC SYSTEM ADEQUACY TEST Legal: Owner: Residence: No. of Bedrooms: Septic System: Lot 13, Block 5 Buin Park S/D, Sue Siok 11321 Polar Drive, Anch. AK 99516 Three (3) Tank Size: 1250 gallons. Absorption System Type: Bed Absorption System Size: l 8x45x0.5 Date of Pumping: Date of Test: D.O. Box 102954 Aa~chorage, Alaska 99510 (907) 272-8218 ......................... Absorption Area: 894 s.£ Installation Date: 6-6-94 Soil Rating: 188 sfPor 6-15-00 By: Northland Pumping 8-4-00 Test Procedure: System was inspected visually and measured. The tank was found to have 4 fbet of cover. Liquid depth was measured to be 50 inches. The drain field was found to have 42 inches of cover and a total depth of 48 inches. There was no liquid measured in the field's monitor tube. Water was added from the well at a rate of six point one (6.1) gallons per minute (GPM) into the drain fields monitor clean- out. Liquid depths were measured in the monitor tubes. The liquid levels did not rise in the monitor tube with the induction of 600 gallons of water into the drain field. This system is able to absorb greater than 600 gallons per day. The well was tested in conjunction with the septic system. The static water level in the well was measured to be 80 feet below the top of the casing. The water level in the well was drawn down to 135 feet below the top of casing while the pump produced 6.1 GPM. The water was tested Ibr bacteria and nitrates. The test results were not available at the time of this writing, but will be forwarded when received. TEST RESULTS: This system meets the code and operational requirements of Municipality of Anchorage, Department of Health and Social Services for a three (3) bedroom house. In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DHHS Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil condition, ground water levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. PES can therefore not provide any warranty for future performance nor give any estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DHHS. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized nor will it confer any legal right whatsoever. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Location (site address or directions) I I 3' ~1 ?,~ (c<~- ~'~_ Property owner Mailing address Lending agency Mailing address Day phone Day phone Agent No~e~ Address Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: NOTE: Individual well ,--'"' Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 {Rev, 1/91) Front MOA #21 5. STATEMENT OF INSPECTION BY ENGINEER Se As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I 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 Address / ¥~ 0 J Engineer's signature ~'~ Phone Date DHHS SIGNATURE X Approved for -.~ Disapproved. bedrooms. Conditional approval for bedrooms, with the following stipulations: Additional Comments , / Date { - ,2 ?- ~" ~:: 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. 72-025 (Rev. 1/91) Back MOA ~21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: J-c,,~' I~/ 6t/o~ ~' ~ ~n.~,,~ ?/'~ Parcel I.D. A. Well Data Well type J'>r L u,~ ~-E Log present (Y/N) y' Total depth I E'/° Sanitary seal (Y/N) Date of test Static water level Well flow If A, B, or C, attach ADEC letter. ADEC water system number Date completed 7 //'z/? / Driller ~l~ Cased to I E,/' Casing height T' Wires properly protected (Y/N) ~" FROM WELL LOG 7/1~-/~/ 5"./ Pump level1 I '7 ~ g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot I I O' Absorption field on lot I 0 ,7' Public sewer main -~. I0o' Sewer service line ; On adjacent lots ~, ; On adjacent lots ;~ Public sewer manhole/cleanout Petroleum tank tVon,~ lC,O~ '~ loc)' WATER SAMPLE RESULTS: Coliform ,, ~ co//"(oo ~-~ Date of sample: 5'"rd'/' ~ Y' Nitrate m. I~_~-,~ Otherbacteria c7 col //oo ,,~ .~' Collected by: /~/~/',/o,~ B. SEPTIC/HOLDING TANK DATA Date installed Id /' 7 (? Tank size IOC~ 0 ~/ Compartments Cleanouts (Y/N) 'r' Foundation cleanout (Y/N) '7' Depression (Y/N) High water alarm (Y/N) ~, ~-. Alarm tested (Y/N) A/./~ Date of pumping ~" / ~ / '~ ~ Pumper ~_cc~,~ c £ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot I1~ ' To property line Surface water/drainage On adjacent lots Absorption field loc,' Foundation "~ ' Id' Water main/service line 72-026 (3/g3)' Front CONTINUED ON BACK PAGE C. LIFT STATION h~, A. Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot D. ABSORPTION FIELD DATA Date installed ~d' / ~" Length ~.5"' Width Total absorption area On adjacent lots Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested Surface water Soil rating (GPD/Ft2) O. '7 System type + to ~ ;z.~f.) Gravel thickness I .~' Total depth Cleanout present (Y/N) 'r' Depression over field (Y/N) Results (pass/fail) -- for - - After test -- If yes, give date Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 103' To building foundation ! On adjacent lots 'p, ,~o' Surface water ~, foo' Curtain drain No,o~ 5' ¢~"~ On adjacent lots I ~ ?- ' Property line'~ G' ' r~ ¢ ~,,.,,.t/- To existing or abandoned system on lot /,,,.~ Cutbank N, ,4. Water main/service line ';> Driveway, parking/vehicle storage area 1,5- ' E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name Date HAA Fee $ ~00 Date of Payment ~'//~/~,~- Receipt Number 72-026 (3/93)' Back '~ TH2ODO~E F. ~OORI~ .~, ~, ,. , · .:,:': % Cl:- 3589 Waiver Fee $ Date of Payment Receipt Number NORTHERN TESTING LABORATORIES, INC. 3330 INDUSTRIAL AVENUE 2505 FAIRBANKS STREET FAIRBANKS, ALASKA 99701 ANCHORAGE, ALASKA 99503 (907) 456-3116 · FAX 456-3125 (907) 277-8378 · FAX 274-9645 DRINKING WATER ANALYSIS REPORT FOR TOTAL COLIFORM BACTERIA Flattop Technical Services 14530 Echo St. Anchorage, AK 99516 Collected by: TM Sample Type: Routine Method of Analysis: Membrane Filtration Comments: Sample Sample Location Date Time Lab# Public Water System I.D.# Date Received: Date Analyzed: Date Reported: Next Sample Due: 05/06/94 Time Received: 05/06/94 Time Analyzed: 17:00 05/10/94 Time Reported: 07:48 Comments: S = Satisfactory U = Unsatisfactory POS = Positive Test Result ND = None Detected TNTC = Too Numerous To Count (>200 Colonies) CG = Confluent Growth HSM = Heavy Sediment Masking, Results May Not Be Reliable SA = Sample Age >30 Hours But <48 Hours, Results May Not Be Reliable Old = Sample Age >48 Hours, Too Old For Analysis R = Resample Required NT = No Test * # Colonies/lO0 ml ** # Colonies/mi Total* Fecal* Other* HPC** Coliform Coliform Bacteria Result Comments 1 1315 Bruin Park 05/06/94 05:45 AB2625 ND ND ND NT S E~ro~ment a-1 Anal'ys~t ' y NORTHERN TESTING LABORATORIES, INC. 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 456-3116 , FAX 456-3125 2505 FAIRBANKS STREET ANCHORAGE, ALASKA 99503 (907) 277-8378 · FAX 274-9645 Flattop Technical Services 14530 Echo St. Anchorage Ak 99516 Attn: Ted Moore Our Lab #: Location/Project: Your Sample ID: Sample Matrix: Comments: Lab Number Method A130640 1313 Bruin Pk Water Parameter Units Report Date: 05/13/94 Date Arrived: 05/11/94 Date Sampled: 05/06/94 Time Sampled: 1545 Collected By: TM * Definitions * B = Below Regulatory Min. H = Above Regulatory Max. E = Estimated Value M = Matrix Interference D = Lost to Dilution MDL = Method Detection Limit Result * MDL Date Date Prepared Analyze A130640 EPA 353.3 Nitrate-N mg/1 <MDL 0.10 05/0919 Reported By: Anthq~/J. Lange Chemistry Supervisor MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 1. GENERAL INFORMATION Complete legal description Lot 13; Block HAA # ~ i~c>t ~ ~"-) ~ Bruin Park Subdivision; Location (site address. Or ,directions) 11321 Pol~ Property owner .... ~ Lan~ Day phone Mailing"~ddre'ss "~709 W~St In~:~..~nz[tio~ Airport Road #204 Len~ing agen(~y' ' Anchorage_, A~zs/~z 99518 Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I 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 S & S ENGINEERING Address 17034 Eagle River Loop Road Ne. 204 Eagle River, Alaska 99577 Engineer's signature Phone 6.' 'DHHS SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. 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, 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lo-r )~.,~t...E:S, ~:~u,j~ ~p~p.~ &//D Parcel I.D. A. WELL DATA Well type ~[L~(~r""[ ~'-- If A, B, or C, attach ADEC letter. Log present (~N) V~-~ Total depth 181 Sanitary seal ~..)N) Y~-----~ Date completed Cased to l~l' Wires properly protected {~N) ADEC water system number Casing height /.,~. FROM WELL LOG Date of test ~C'-/~-c~ / Static water level Well flow Pump level g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holdh"rg tank on lot Absorption field on lot Public sewer main Sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank ~O~OF= AT INSPECTION ENVIRONMENTAL SERVICES DIVISION, g.p.m. RECEIVED WATER SAMPLE RESULTS: Coliform (~ Date of sample: Nitrate ~('~t~,- bE:7F'CT~D Other bacteria J~ /~'~- Collected by: ~::~ B. SEPTIC/HOLDING TANK DATA Date installed /0 _je/-~O Tank size /~0(~) ~'/~L Compartments Cleanouts (~N) Ulg~~ WM.~W~¥ Foundation cleanout (~N) ~'~E.S Depression (Y/~) High water alarm (Y/J~ /O//) Alarm tested (Y/(~) Date of pumping '~' - / ~.-? / Pumper /~)/2~J[ SEPARATION DISTANCES FROM SEPTIC~ TANK TO: I Well(s) on lot I IC) On adjacent lots //'JO To property line ~ ~ Absorption field ~01 Surface water/drainage l O0 ' + Foundation Water main/service line ~0 '+ 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION / Size in gallons ~ Vent (Y/N) ~ "Pump on" High water alarm level .~~"'""~'~.-tested Meets~MOA electrical codes ~ ' - ~'~"'~ S~ROM LIFT STATION TO: '~/Vell on lot On adjacent lots Surface water Manufacturer / Manhole/Access (Y/N)f/ ~mp off" level at D. ABSORPTION FIELD DATA Width Date installed Soil rating Length ~,~ /Co' Total absorption area Depression over field (Y/{~ Results (pass/fail) ~/.~) ~ -/~J~vv' ~.~,&?~ Peroxide treatment (past 12 months) (Y/~) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot lO~' /01 ' To building foundation On adjacent lots ~,co "~ Surface water (,00 Curtain drain E. ENGINEER'S CERTIFICATION I Gravel thickness [ Cleanouts present (6~/N) Date of adequacy test for -~ If yes, give date On adjacent lots System type Total depth Cutbank To existing or abandoned system on lot IC~O~ _ Water main/service line bedrooms Property tine Driveway, parking/vehicle storage area 3o + I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature S & S ENGINEERING 11034 Eagle RIv,r I, eep Reid Ne. Engineer's Name Date HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA Waiver Fee: $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 A, nchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Co.m. plete legal description Location (site address or directions) II 3.2t ?oLA~ ]~i~. , /iNCH., AK Property owner JAr~ /-AN¢ Day phone Mailing address ~oc[ ~, iNTI/. /~I~po~T ~'D , 5v~T'E 20/-( , Lending agency ~,A. Day phone Mailing address Agent ~M LANE /~A~'s'ro~ Day phone~ Address 2gOA/- ~. NO. LT5 ~ ~NCH ~95/7 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: NOTE: Individual well Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OFWASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1/91) Front MOA #21 STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I 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 FZ AT'FOP TE¢t¢. 5~'C S Address IHE30 EcHo ~7', ~N¢~/. Engineer's signature ¢~ ~. ~ Phone 3 utS' - Date DHHS SIGNATURE ~ Approved for 7~'~,_~') bedrooms. Disapproved. Col3ditional approval for ~ %THEODO,,E F. MOORE .- ~ bedrooms, with the following stipulations: Additional Comments By: /w'~/-~~,'~/,,-~/~/'/ Date 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. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage ~i~ Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: L 13, DS' BRuiN ~/~RK Parcel I.D. O1~ 111 3:~ A. WELL DATA Well type PR tv'A't'£ If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) ~/ Date completed 7/12/(~'~ " Driller /~/P~ NE' Total depth 18l ~ ' ' Cased to 18 { Casing height I. Sanitary seal (Y/N) ~/ Wires properly protected (Y/N) Y Date of test Static water level Well flow pump level FROM WELL LOG 5,1 178 SEPARATION DISTANCES FROM WELL TO: ! Septic/holding tank on lot I lC) ! Absorption field on lot I o~- Public sewer main g.p.m. AT INSPECTION MJINICiPAIlTY OF ANCHORAGE ENVIRONMENTAL SERVICES DIViSiON 5 1991 RECEIVED Public sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank ! '7'/oo ! '7 · '~{oo ~ WATER SAMPLE RESULTS: Coliform O/Ioo ,,( Nitrate ~O.I ~3/.~ Date of sample: '7/1~ / q t Collected by: Other bacteria lOC* ~1 B. SEPTIC/I'I~L-I~N~/~NK DATA Date installed I OTTO Tank size l00 O (~/J/_ Compartments ! Cleanouts (Y/N) ¥ Foundation cleanout (Y/N) ~ Depression (Y/N) High water alarm (Y/N) N ,A. Alarm tested (Y/N) ' ~J. ~' Date of pumping 7/12/ct I ' ' N SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot Il bi On adjacent lots I ~ro ' To property line H.5 Absorption field 20 1 Surface water/drainage >-/Dr> Foundation Water main/service line 72-026 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION j~, ,~. Date installed Manufacturer Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manhole/Access (Y/N) "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed "7/1~/~ I Length q 3 t. Width Total absorption area Depression over field (Y/N) Results (paSs/fail) 'f iA, Soil rating O.'7 Gravel thickness Cleanouts present (Y/N) Date of adequacy test for Peroxide treatment (past 12 months) (Y/N) N,4, System type BEb Total depth Y If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: I Well on lot To building foundation On adjacent lots Surface water On adjacent lots I el Property line To existing or abandoned system on lot Cutbank t,t.A. Water main/service line Driveway, parking/vehicle storage area Curtain drain N,R. E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature '~"~ ~, ~ Engineer's Name 7'~o~:~.- ~ ~-~ue~.~. Date 7~'0 /'2/ HAAFee$ ~ 70 or.) Date of Payment Receipt Number ,~ 27~J~"- -- ? '7 ~)~ Waiver Fee: $ Date of Payment Receipt Number 72-026 (Rev. 3/91) Back MOA 21 --. lst-ZnsPeo~i0n: Time q:~/~m inspection: ,Time ¢/,'~ ¢' · 'REQUEST FOR APPROVAL OF INDIVZDUAL SEWER ~D wATER FACILITIES ~ 1. Lending InstitUtion Request: Lomas and Nettleton Company . ' -Mailing Address: 4449 Business park Boulevard . Phone: 274-7661 ~? 2. ProPert~:~Owner: Rona!d T/Barbara V. Enlsmin~er phone': 34423844. ~ ''- LMailin9 Address; Star Route A Box t778E 99507 ' 3. Le al Descri tion- Lot 13 Block 5 Bruin Park SubdivisiOn ~ 4. -~n~le Family Residence: ~) Number of Bedrooms: -4 ' Multiple F~ily Residence: (') N~nber of Bedrooms: ....... 5. Well Data: Type _ !ndivi~pa! , Depth Well Log Filed Absorption Area to Nearest Lo% Line MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L Street, Anchorage, Alaska 99501 279-2511, ext. 224, 225 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER and WATER FACILITIES MUNICIPALITY OF ANCHoRA~ DEPT. OF HE, £NVIRONM~:,.,.,... ~LTH & ' "~'~ PROTECTION MAR 3 0 1977 RECEIVED 1. Type of Inspection: VA ~ FHA 2. Property Owner: ~ / , ¢4- ,/~</~,,~/~ ~ ~,,/ (//~ ,/~,/)?(,z.,~ Mailing Address: .~ ~/Y~- Day Phone: J O ~ ~ Mailing Address: ~J ~~/~i{c~ay Phone: 4. Name of Lending Institution: ~ ~~ ~ ~~~~ ~~~~. Mailing Address: ~~ ~~~ ~~hone: ~ 5. Name of Realtor or Agent: Mailing Address: Phone: Legal Description:/~-?~ Location: '.'~_ /~ ')( Y,'~~) .k~ ~/'3~' . 7. Type of Facility to be Inspected: 8. Water Supply Type of Supply: --.~ /~ JL~ No. Bdrms. Y Public Utility If Individual, number of dwellings presently served If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation Individual ,~'" Individual (on-site) 72-003(3/76) Legal Description: Lot 13 Block 5 Bruin Park' Subdivision comment s: !~? Affadavit Attached Ap~ Disapproved: Date ~'~partment Worksheet: - ' Date of Inspection INDIVIDUAL S~-W~-R & WATER FACILITIES i, F09 A / e GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 ../ 0 , 11--i3- ?3 Address: Phone: Prooertv O~ner: ,,, Phone. Type of Foc~tity to be Inspected: Number of Bedrooms: 5. We].] Data: A. Type~', B. Depth .., C. Construction .~~'~/ D, Bacterial Analysis · · 7. Sewage. DisPosal ^. Installed B, Installer C. Septic Tank: 1. ozze 2. Manufacturer D. Seepage Pit: 1. Size 2. Material H. Disposal Field: 8. Distances: Total. Length of Lines A. Well To: Septic Tank , Absorption Area , Sewer Lines , Nearest Lot Line · Other Contamination B. Foundation to Sentic T~nk ' ,~ Absorption Area C. Absorption Area to Nearest Lot Line F(eqJe~t for Approval of Individual Sewer & Water Facilities Page Two ,^~ro~e~.>~_ f~.~-2:,.~,~isa~.prove~ Date / Approval Va~d for One Year From Date Signed Greater Anchorage Area Borough, DeF~rtment of F-nvironmental 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 located at: Signed Date GREATER ANCHORAG,=- AREA BOR(YJGH 9,apartment of Environmental Qumltty 350,0 Tudo~ Road, Anchorage, A].ask~ 99507 279-8686 Date of Ins~ection.~ REQUEST FOR APPROVAL OF INg!VIDUAL ,qEi~ER & WATER FACILITIES Tv...~e of Faci. titv to oe Imsoected: Number of !Bedrooms: C. Construction _ 7. Sewage Dis9osal System: /qT~ D. ~acteria] Ana!ysis C. Septic Tank: ].o 3ize Instelled q. Installer 2. ~anufacturer D. Seepage Pit: !. Size 2. ~aterial ~. D~sposa] Field: Iota] ~nqth of Lines Distances: A. Well To: Sent~c Tank ~0 , Absorotion Area Sewer Lines , ,New, res% I, ot Line _ _., O~-ber Contamination Foundation 'to '.?o:~f,~.c Tank '~, Absorntion Area ~. Absorption Are~ to I-leare .... Lot Line Request for Aporoval of .dividua! Sewer & Water Facflit'~ Page Two . /~,/.. ~'/q~ ~ ~II ~,,~- _ .......... An.-¥ov~.~~ Va]id for One Y~ar From Date Siqned (]real, e? Anchoraqe Are~ 2orouqh, De~.a,~tment of EnVirons. eh.ts] QUattty D?AGi?AM OF SYSTEM I cert].f" that the information contained in this request for approval to be a true and accurst, re~re$~r~tat~,~ of the ~Ubi~ct sewer and water facilities located at: Date ..~9ned i~iarch 13, 1973 Hrs. Parks t~laska S'~a'&e bank P. U. Box Anciiorage, Alaska Subject: Lot 15, L';lock 5, i~ruin Park Liubdivision i~ear ).irs. Parks; This Depart~,'~ent conduc'ted on inspection of ~iie subjcc~ property. The sewer sys~e~,i was upgraUed iii 1970 to meet Grea~er £snchorage Are~ Borough requirer.~ents for an FIIA approval. Since the enactj'~:ent of ~he StateEEi:~er~ericy ~astewater [~ispos~l Act, however, this Bepart~en~ can no l~nger grant final approval of ~n existin~ system until a waiver is received f . ro.~: Lhe S~a~e Depart~ent of Environl~ental Conservation. This v~aiv'or is needed Lo grant a variance fror,~ tile requirel,~ent of lO0 f~et between a septic ~ank and a w~ll. Your systel~ J-~as only a 60 foot se~ar~Lion. At the presenL ti~Je, the well casing is buried. This D~part- ~en'L will require upgrading of the casing prior to approv~l. Ti~e casing i~lust be ex~ended 'Lo 12 inches above grounu level, and the ground sloped away fro~:~ i~. This Departl~ent will ~rant a te~:Jporary approval until July 1, lg/3 provided an escrow of funds is i,~ade, i~ copy of 'Lhe agreet~ent shoulu be forwarded Lo this ~epart~:~enL for our files. The water sampl~ v~as sa:is fac'tory. Air[if~hL caps on the '~ank and piL cleanou~.s need to be provided If you have any questions on tile above, please cool,acC t,~e at £74-,1561, extension 136. Sincerely, Susan £. Dickerson Sanitarian k~ FHA Form 2573 Form Approved Rev. July 1958 FEDERAL I'.'OlJSI~G'ADMINISTRATION Budget Bureau No. 63-R296.8 HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM PART I.--TO BE COMPLETED BY FHA INSURING OFFICE MORTGAGEE J SERIAL NO. Anchorage~ Alaska Alaska Mutual Savings Bank __._5/+~ 5th Ave, Anchorages Alaska 111-010692-203 MORTGAGOR OR SPONSOR PROPERTY ADDRESS Le~ Rogers Polar Drive, Anchorage, Alaska SUBDIVISION NAME BLOCK NO. L~)T NO. Rm:~n Park 5 13 TOTAL NUMBER: Con attic or ether area be made inte ~ New installation additional bedrooms? BASEMENT LIVING UNITS BEDROOMS BATHS I I (If Yes, how rnanyi~) '1 3 2. r-j Yes r~No ['-']Yes r'~No WATER SUPPLY BY: SYSTEM DESIGNED FOR D Public system r-'] Community system r-~ Individual NO. OF BDRMS. GARBAGE DISPOSAL j SEWAGE DISPOSAL BY: I IPublic system [--] Community system [] Individual 3 J~ Yes [~] No PART fl.--TO BE COMPLETED BY HEALTH DEPARTMENT HEALTH DEPARTMENT INSPECTOR'S SKETCH ..... . ..... , ~___~ ...... ~ -~_~-_-__ .... .~__ ~_ [- ~ ~ It is the opinion of the O State r-] County ~ Local Department of Health that this individual water-supply system ~ is O is not satisfactory as a domestic water supply for the subiect property. It is the opinion of the [~] State N County ~ Local Department of Health that this individual sewage-disposal sys- tem with proper maintenance: ~ Can be expected to function satisfactorily, and [~ Cannot be expected to function satisfactorily is not likely to create an insanitary condition DATE SIGNATURE ,~/~/ ~ . /'I TITLE Oct. 20, 1970 En¥iro unental Health Supervisor NOTE: The h®oFJh nu ¥ ~h~ {omplete th~ op~ro~rlote opinion ,tot.merit oboYe ond offix dot~, ,~ignoture ond tiff® in the Use o{ tho obo¥o ~ri~{or Noolth Department Inspecter's sket-h o.~ well os ~se o{ the ho~k o{ thls {orm is ot the option ot h®alth euthorit¥. PART III.~FOR USE OF ~HA O~FICE TO ?H~ ¢l'll~ UND£RINRIT£R: I have reviewed the foregoing and the pertinent FHA Compliance Inspection Report, and recommend that 'the Individual water-supply system be considered ~] Acceptable [~ Not Acceptable Sewage disposal be considered [~ Acceptable O Not Acceptable. SIGNATURE [--] CHIEF ARCHtTECT [~I DEPUTY FOR CHIEF ARCHITECT HEALTH AUTHORITY APPROVAL INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL SYSTEM FHA Form 2573 Rev. July 1958 REQUEST FOR APPROVAL OF INDIVIDUAL SEWAGE AND WATER FACILITIES ~ ~~ill out in T~iplicate) meques%ing approval 5. -Wate~3knalyeis: a. Bac~_r is_l .... . b. Detergent _ j _ d, Di~ance from well ~o closes~ existing or proposed:~ 1.- S.we~ line .... . 2. Septic ~ank ~ / . 3. Seepage Area . ~. Cesspool[__ _ 5. Property Line Other sources of possible contamination, i.e., creeks, lakes, houses, barn, drainage ditch, etc. ~ .. .. ....... · 7. Sew~g~ disposal system. a. Age of system ~ b. Septic tank capacity in gallons c. Name of septic tank manufactu.m.~ 1. If "home made" show diagram on reverse si~e of this form. Disposal field or seepage pit size and type, z~-~ .... 1. Distance to property-, line to house foundation, -e, Perco~atic~ T~s~ 'resulZs . ~ Use the reverse .s~de of this form to sh. ow dia~ram. D~agram should include ...~he following, information: p,~operty lanes; .w~ll location, house location, q~d~rtic tank location, disposal area location, location of percolation test, a~., direction of g~ound slope. 9. The ~mfxxrma~ion on this form is true and correct to the best of my knowledge. '\ -$iKnature'%f' A~'pllc~t ........ Date 'si'~ne~ T~o BE FILLED OUT BY HEALTH DEPART~,~ENT PERSONNEL -~he above described sanitary facilities are hereby approved, _subject to the owin conditions: Conditions: The above described sanitary facilities are disapproved for the following reasons: .Approval is valid for one yea~ following the date of approval. CPJ: cw p,o. Box 4~0 Sulxtl~sim, Ssrt~l No. 111-01~g2- Sirs: ~y sed found zha~ ~ ~ ~ suPPlied via a HO dfllled well. A w~r sm~pl~s ~ ~ ~ sst1 ~ms sattsf~ctor)'.' could not ds~l~LM ~ o~ no~ ~ sever syste~ c~nStsted ca the sever syste~ ~ ~ vel1 wilg~L~ ~he 100' protective could not be Siven by ~ls ~~n~ , ~~~ ~~1 wu a ct~ ~ ~ld ~~ pit ~ld h~ to ~ cawd in sinc~wel~, CLIFFORD P. JUDKINS, R.S. Administrative Di2~or JRL{~