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HomeMy WebLinkAboutSUNSET HILLS BLK B LT 19 Municipality of Anchorage Page J 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; _~' ~ $} 6"0 130 PI D Number: C} t~ ~ O I ~ ~ ~ame:L~y ~ ~ro~ ~1~ Wastewater System: D New ~ Upgrade ~r~.: I~ OO~ S~ ~,e~ O% ~., 4~ ~ ABSORPTION FIELD I No, of fledrooms: Phone: ~ ~ --~ I ~ ~ Deep Trench D Shallow Trench D Bed D Mound ~ Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: O* Y~ GPO/Sq. Ft. 12, 2 ' Subdiv~ion: Deplh to pipe bottom ~tom original grade: Gravel depth beneath pipe LOt: ~ Block: ~ ~(~Ef /~1~ ~, 0 Ft. E, ~ F~ Township: I Range: I Section: Fill added above original grade: Gravel length: I I ~ Ft. ~'~ WELL: EX~ ~' D New ~ Upgrade Gravel width: Number of lines: I DisUnce ~tween lines ~ Fh I Ft Classification (Private, A,B,C): Totei Depth: Cased TO: Total absorption area: Pipe material: ~-~ P~v ~ ~t. ~. 105'V SQ. ~h D-~O] ~/ N~ "~_ Driller: Date Dri,]ed: S,atlc Water Level:Ft. ,~a~r~ ~EA6~ Date i~/stailed:~ 7 / Yield: GPM PumpSelst: Ft. Casing Heighl Above Ground; ~L TANK SEPARATION DISTANCES ~ Septic D Holding ~ S.T.E.P. To Septic Absorption Mh Holding Public/Privet( Manufacturer: Capacity in gallons: From Tank Field 8t~l{on Tank SewerLInes Anc~or~¢ ~ n ~ I Number of Compartmenls: Weft I~' ltl -- . ~ ~ Material: ~ ~ ~/ Surface w~t~ > w~' > wo' LIFT STATION LineL°t ~ ~ ~ ~ -- ~ Size tn gallons:~ Manufacturer: I Foend6tion ~ ~' + "Pump on' level at: "Pump off" level at: ~ High weter alarm at: I Curtain Pump Make & Model ~ Electrical Inspections pedormed by: Drain -- -- -- I Remarks: T~j ~p~~ ~ m~ll~ p~ BENCH MARK ~p ~ ~ ~. ~E ~t~A~ ~ .~/, ~ Location and Description: ~PIO~I C ~t ~ ~/~ ~n ~ ~ ~ Assumed Elevation: ~n~ ~e pee-~q~W .rod ~b~o~h~ be~. I0O, 0 ~ ~lo~ ~I~6 ~lo~q ~f ~S~de o[ ~eOl~e~r~ ~y, ENGINEER'SSEAL Inspections performed by: ~/mA~ ?'~c4 ~ Dates: 1st ~/2[/2~- =~'~t ~,~m Department of He..~ H~~vices approval. ~ .;., ....... .~. Reviewed and approved b Date' ~ . 72-013 (Rev. 0/91) MOA 25 PFRMIT NO: SW950130 PAGE 2 OF 2 PID NO: 01820154 TH~OOORB F. MOORE CE-3589 SWING TIES FROM COR.: "A .... B ....C .... D" TO: S.T.C.C. "E" 41' 47' S.T.C.C. "F" 47' 51' DBL. C.C. "G" 49' 52' VALVE "H" 57' 55' TR.C.O. 'T' 67' 70' 94' 'I'R.M.T. "J" 79' 54' 81' 'I'R. C.C. "K" 69' 62.5' NEW 85' LONG SOIL ABS. TRENCH WITH 6.2' GVL. BELOW DIST PIPE PI.AN VIEW SCALE: 1" = 30' - 0" CLASS "B" WELL LOT 16A, BLOCK B PRIVATE WELL LOT 19 BLK. B DRIVE NEW 1000 GAL. · .'.,,,,SEPTIC TANK DOUBLE I © EXISTING I o t_l 18'x35'BED o --DIVERTER VALVE fii~ INV%'.-.' ii :85 LONG SOIL ABS TRENCH~iii~ ii!ilNV. .................. :::: :::::*:; .................................................................................................... ~.0 , /93.6' BOTTOM OF EXCAVATION 85.6' / LOT 19, BLK. B, SUNSET HILLS SEPTIC SYSTEM UPGRADE AS-BUILT INSPECTION REPORT PROFILE VIEW FLA~OP ~CHNICAL SERVICES SCALE: AS-SHOWN T.H, ¢1 NO SCALE ~4~o ~CHO STREET DRAWN BY TFM DRY ~ 81.3' ANCHO]~OE, ~AS~A 995~6 JUNE, 1995 TONY KNOWLE$~ GOVERNOR DEPT. OF EN¥1DONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 555 CORDOVA STREET ANCHORAGE, ALASKA 99501 June 21, 1995 (907) 269-7520 Ted Moore, Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 SUBJECT: Well Waiver, Lot 19, Bk B, Sunset Hills 9521-WV-163-044 Dear Mr. Moore: We have carefully reviewed your June 12, 1995, request for waiver of separation distance to 150 feet for the septic system serving a three bedroom single family residence on Lot 19 from a Class "B" well on Lot 16A. Our review was abbreviated in light of the fact that the property (Lot 19) received a waiver on Jauuary 6, 1988, for a leaching bed essentially adjacent to the proposed leach trench. In completing our review, we also examined the well monitoring data on file for the Class "B" well on Lot 16A and determined that the well water quality is within acceptable limits. Based on the available information from 1988 and your recent submittal, your request for a waiver to approximately 150 feet is hereby approved in accordance with provisions of 18 AAC 80.030. This waiver will remain valid until any further upgrades to the system become necessary or the use of the property changes. At that time, a new waiver reque3t would need to be submitted. This approval does not imply granting of any additional authorization, nor obligate any state, federal, or local regulatory body to grant any required authorizations. Please contact me if you have any questions on this. Cordially, ' 3 rk Enviromnental Engineer cc: MOA Health Dept. DS/pt MTJNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PAGE 1 OF PERMIT PERMIT NUMBER:SW950130 DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES OWNER NAME:WALLS LARRY W & SHARON L OWNER ADDRESS:14001 SUNVIEW DR ANCHORAGE, AK 99515-4131 DATE ISSUED: 6/22/95 EXPIRATION DATE: 6/22/96 PARCEL ID:01820154 LEGAL DESCRIPTION: SUNSET HILLS BLK BLT 19 LOT SIZE: 19000 (SQ. FT.) NUI~BER OF BEDROOMS: 3 THIS PERMIT: 3 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 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEMUNDER 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: ISSUED BY: ~~~ / CIVIL & ENVIRONMENTAL ENGINEERING * ENERGY CONSERVATION & ANALYSIS TIfEODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345-1355 June 12, 1995 ANCHORAGE, ALASKA 99516 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dem' Sh's: The purpose of this letter is to provide the requh'ed design narrative in support of our application for a permit to upgrade the wastewater disposal facilities on Lot 19, Block B, Sunset Hills S/D, located at 14001Sunview Drive. The existing 7 yem' old soil absorption bed falled to pass a reeent adequacy test. Soils logs, perc test results, a site plan, design drawings and specifications are enclosed for your review. The proposed upgrade will be constructed in the vicinity of test hole #1. As can be seen from the soil log, the native material between 4.5 feet and 16.5 feet is a silty sand with a measured perc rate of 60 minutes per inch. Using the soll application rate of 0.45 gpd/sq, ft. specified in the wastewater ordinance, this 3 bedi'oom residence requires a total absorption m'ea of (3 x 150)/0.45 = 1000 square feet. The proposed 84' long trench design with 6 feet of sewer gravel beneath the horizontal distribution pipe has a total absorption area of 1008 square feet. In order to enhance the longevity of the proposed upgrade, the existing soil absorption bed will be retained in place with a diversion valve installed to allow subsequent temporm'y reconnection as appropriate to give the upgrade trench a chance to rest and diy out. The existing soil absorption bed has a waiver allowing it to be approximately 150 feet from the Class "B" well serving the church on Lot 16A. Because vh'tually no portion of Lot 19 is over 200 feet from the Class B well on Lot 16A, we are simultaneously requesting an updated waiver kom DEC allowing the proposed upgrade to also be within 150 feet of the Class "B well on Lot 16A. The general topography of the lot slopes towm'ds the south and west at approximately 1%, with a short steeper slope between the edges of the existing bed and adjacent roadways. The proposed project should uot have any significant impact on present or future water supply and wastewater disposal systems se~wing adjacent properties, nor will it have any significant impact on rese~wed space-surface and subsurface, or on th'aiuage. Please give me a call at 345-1355 if yon have any questious on this submittal. Sincerely, Ted Moore, P.E. '~2oo' /'LOT 19 : ; WELL LOT 3A - X % -- BLK. 1 REPLACEMENT SOIL ABS. TRENCH (84' LONG W. 6' GVL.) LOT 5 BLK. 1 WELL CHURCH _-- ;---~-'------ ~ ..... ''-, LOT 16A .." ." BLOCK B ' ,' ,.~ 150 , 20' ALLEY '~ PRIVATE WELL LOT 6 BLK. 1 LOT 20 BLK. B HOUSE ,' PERC TEST UNDER BED 18' x 35' BED SUNVIEW DRIVE LOT9, BLK. A (VACANT) LOT 19, BLK. B, SUNSET HILLS S/D SEPTIC SYSTEM UPGRADE SITE PLAN FLAI~OP TECHNICAL SERVICES 1 INCH = 50 FEET 14530 ECHO STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 JUNE, 1995 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. WASTE LINE FROM HOUSE INSTALL NEW 84' LONG SOIL ABSORPTION TRENCH · WITH 6' SEWER GRAVEL BELOW HORIZ DIST PIPE (TOTAL DEPTH OF TRENCH IS APPROX 10.5') INSPECT EXISTING 1250 GALLON SEPTIC TANK REPLACE, IF NECESSARY, W. NEW 1000 GAL. S,T. INSTALL "BULL RUN" DIVERSION VALVE DOUBLE CLEANOUT TO EXISTING SOIL ABS. PLAN VIEW SCALE: 1" = 10' - 0" PERF. DIST. PIPE 1/2" - 2 1/2" SEWER GRAVEL SECTION "A - A" SCALE: 1" = 5'- 0" LOT 19, BLK, B, SUNSET HILLS S/D SEPTIC SYSTEM UPGRADE PLAN AND CROSS-SECTION FLATTOP TECHNICAL SERVICES 14530 ECHO STREET ANCHORAGE, AK, 99516 SCALE: AS SHOWN DRAWN BY: TFM JUNE, 1995 Flattop Techn~al Serv~es 14530 Echo Street, Anchorage, AK99516 Phone (907) 345-1355 Lot 19, Block B, Sunset Hills S/D 14001 Sunview Drive Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project consists installation of 84 lineal feet of soil absorption Wench with 6 feet of sewer gravel beneath the horizontal disu'ibufion pipe. The condition of the existing 1250 gallon septic tank is to be determh~ed at the time of construction, and if the existing tank is found not to be in good condition it is to be replaced by a new 1000 gallon septic tank. A diversion valve is also to be installed to allow switching of effluent between the original absorption bed and the new trench. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these di'awings may be allowed or requh'ed by the engineer conducting the inspections. All construction procedm'es and material specifications shall conform with Municipal and State requh'ements. All sepm'ation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.3 The conU'actor 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 m'e no residual depressions. Insofar as possible the contractor shall miltimize 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 distm'bed by the construction. 2.0 Septic Tank: 2.1 The existing 1250 gallon septic tank may be retained in service, only if it's structural integ~ity has been verified by the inspecting engineer, and if it has functional cleanout pipes with ah'tight caps, allowing pumping access to each compm'tment. Any existing septic tank or seepage pit which is not retained in service must be properly abandoned by thoroughly pumping, removing the top and backfilling with soil. 2.2 If the existing tank is found to not be in acceptable condition, a new 1000 gallon, two compartment, septic tank shall be set level on undisturbed soil. Each compm'tment 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 nfinimum slope of 1/8" per foot. A double cleanout shall be installed within 5 feet downstream of the septic tank. 2.4 A "Bull Run" diversion valve shall be installed downstream of the double cleanout allowing future switching of the effluent back to the original soil absorption bed. 3.0Soil absorption system: 3.1 The soil absorption system shall be constructed by excavating an 84 foot long trench in the approximate location shown on the design drawings to a depth of approximately 10.5 feet below the original ground elevation at the north end of the trench 3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to allow proper infilta'ation. 3.3 A total of 6.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with the perforated distribution pipes laid level such that the pipe invells are no less than 6.0 feet above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.4 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 enth'e top surface of the sewer gravel. A minimum of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thicla~ess is less than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the gravel, in addition to the filtur fabric. 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 urranging to have the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and seed to promote rapid revegetation of ail areas disturbed by the construction. 4.0 Inspections: 4. I A minimum of 4 engineering inspections will be requked 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 inffitrative sat'face 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 insulation or filter fabric, and (4) after rough backfill and grading is complete. The new septic tank, ff one is needed, requkes one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently fat' in advance to ensure the availability of the engineer. TEST HOLE LEGAL DESCRIPTION: DATE PERFORMED: PERFORMED FOR: DEPTH -- (feet) FLATTOP TECHNICAL SERVICES 14530 ECHO s'r. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST Lot 19, Block B, Sunset Hills June 1, 1995 Larry and Sharon Walls Pt GM/SM Previously disturbed soil GP Brown sandy gravel ML Light gray sandy silt SM Gray silty saad Some gravel & cobbles SLOPE Depth to Groundwater Date No grouadwater __ 6/1/95 SITE pLAN WELL PERC COMMENTS: Clock Net Time Percometer Net Drop Date Reading Time (minutes) Reading (inches) I 6/1 Presoak 4:26 26 1/2 6/2 Re-soak 1:52 26 1/8 Start 3:10___ 24 3/16 #1 3:40 30 __ 23 11/16 1/2 #2 4:10 __ 30 23 3/16 1/2 Add water 4:11 24 1/2 #3 4:41 ____ 30 23 15/16- -- 9/16 PERCOLATION RATE 60 (minutes/inch) PERC HOLE DIAMETER 6 TEST RUN BETWEEN 7.75 FT AND 8.25 FT PERFORMED BY FLATrOP TECHNICAL SERVICES. I_~/..~.~'(~m__ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 0/'' ITEST HOLE LEGAL DESCRIPTION; DATE PERFORMED: PERFORMED FOR: DEPTH ---- 9- 10- 12- 13- FLATTOP TFCHNICAL SERVICES 14530 ECHO ST. ANCHO RAG E, ALASKA 99516 SOILS LOG -- PERCOLATION TEST Lot 19, Block B, Sunset Hills Sune 1, 1995 Larryand SlmronWalls Pt SM/ML Brown silty sand many cobbles and boulders SP/SM Silty gravelly sand Wet w. effluent leaching from bed SM Brown silty sand Sbnilar to T,H. #1 SLOPE Depth to Groundwater Date Seeps ia SP/SM slratm 6~793 SITE PLAN V~LL ® 14- 16- 17- 18- 19- COMMENTS: NOTE: THIS PERC TEST WAS CONDUCTED IN THE IMPORTED SAND STRATUM DIRECTLY UNDER THE FAILING BED Clock Net Time Percometer Net Drop Date Reading Time (mlnules) Reading (inches) 6/1 12" presoak 2:47 27 1/2 2:51_ 25 I/2 ....... Add water 2:58:45 23 3/8 #1 3:01:45 3 21 3/8 2 Add water 3:02:10 23 5/16 #2 3:05:10 3 21 5/16 2 Add water 3:05:30 23 3/8 #3 3:08:30 3 21 3/8 2----- PERCOLATION RATE 2 (minutes/inch) PERC HOLE DIAMETER 7" TEST RUN BETWEEN 0.75 FTAND 1,25 FT below sewer gravel in failing bed No monitor tube set in this test hole. Thc pert test sllowr, on this sheet was conducted under the failing bed. { '~..~_~'~/~ CERTIFY THAT THIS TEST WAS PERFORMED IN PERFORMED BY FLATTOP TECHNIOAL SERVICES. AOCORDANCE WITH ALL STATE AND MUNIOIPAL GUIDELINES iN EFFECT ON THiS DATE, DATE: 0'""/'/,~ / ~,jc- DEPT. OF ENVIRONMENiTAL CONSEI[VATION TONY KNOWL~S, GOVERNOr~ ANCHORAGE/WESTERN DISTRICT OFFICE 555 CORDOVA STREET ANCHORAGE, ALASKA 99501 June 21, 1995 (907) 269-7520 Ted Moore, Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 SUBJECT: Well Waiver, Lot 19, Bk B, Sunset Hills 9521-WV- 163 -044 RECEIVED JUN 2 2 1995 Mumc,pahty ol Anchorage Dept, Health & Human Services Dear Mr. Moore: We have carefully reviewed your June 12, 1995, request for waiver of separation distance to 150 feet for the septic system serving a three bedroom single family residence on Lot 19 from a Class "B" well on Lot 16A. Our review was abbreviated in light of the fact that the property (Lot 19) received a waiver on January 6, 1988, for a leaching bed essentially adjacent to the proposed leach trench. In completing our review, we also examined the well monitoring data on file for the Class "B" well on Lot 16A and determined that the well water quality is within acceptable limits. Based on the available information from 1988 and your recent submittal, your request for a waiver to approximately 150 feet is hereby approved in accordance with provisions of 18 AAC 80.030. This waiver will remain valid until any further upgrades to the system become necessary or the use of the property changes. At that time, a new waiver request would need to be submitted. This approval does not imply granting of any additional authorization, nor obligate any state, federal, or local regulatory body to grant any required authorizations. Please contact me if you have any questions on this. Cordially, Environmental Engineer cc: MOA Health Dept. DS/pt MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 'L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELl.. INSPECTION REPORT TANKS SEPTIC [] HOLDING TYPE OF SYSTEM ~I'RENCH ~[,BED ~ W. DRAIN [] OTHER Depth to pipe bottom rom lolal deplh Irom orlglnel grede .? WELLS ~ PRIVAT~ ~ OTHER (Idenlitv) DISTANCES ~0 SEPTIC ABSORPTION - TANK FIELD WELL WELL /0~-- //~-~ LOT LINE ~.'~ --}-- /~.,) ,/~ O-- FOUNDATION ZS-~ ~ ,~ -~L ~-~ ET REMARKS: --4- :' ::? l~ =~7l'~- [) (~ ~' ~,~ Scale: I ~2 013 (3/85) I%)rmi'L Number. M U Iq I C; i[ F' ~3 L Dep c~.l' 'L mere, t <:if' 8;;Y, 5 L S'Lr'e(?t, Arlchot,age, Alasl::a 9950:1. N .... S I T E S E W E R & W E L I .... 880 :t 20 07/()8/E~8 IEngineeP Designed ]' Y 0 I:::' A N C I'1 0 R A G IL I.l~!!alt'.l'~ & I...lumarl SePvic:e!~ :54:3 .... 4 '72 () P Iii] R M I T Owne)r' Namcc,:: I"l]l:l<]l}}i BU[3KIqlZR 995 Day Phcmen :345',...50 Par' ce I I i::l: 0 :t. 8'"-20 J.-'L'i4 ~ I...ot I...ega].,", Subd:i. visiorl: SUNSET HII..L~:i ,SIIJBD. I....crL,~ Sc:,,c::t:Lon~ 32 'rowr~shil::~: :I,~N I::~angce: 3W I.,c:xL S:i.~'.e~ 2:',42.(~I() (sq,, fL,, or ac:r,e~) Max Bedr'.ooms~ ]his Per'm:i.'L: 3 'l'c~'t. al CapacJ. t.y: 3 19 Blocl<: B DEF'T I D 'T'ANK :~ M :i. n :i. mum to'La I sep'L J. c: t an k capac: ;i. ,IL,/, ~: 1 ~ 000 ga ]. :1. on s ,, 3'ee't'. Pe!qu:i, Pes :i. rH'.4~t].atic)n over' 'l:.anl.:: (s) ,, IEac::l'~ 'Lank (si '.:: 4,, 0 WI!:L,.I....,".. I_.c!g In~,ls'L be subm:i,'Lted t.o Mur'l:(C:[l:)a].i'Ly of' Arlc:hl:)Page DepaP'LmerrL I:){' f,l~aZI, tl", and I..h.unarl !3er'v:i.c:~:..,~ wi't..h:i.r~ 30 days o," we].], cl::)mpl, eticm,, INF:'OF:;:M D. H,, H,, ,*3. F'RIOFi: TO 1S-I- & 2ND Ilqf3F:'I~:CTIDNS BY I:BxlGINI~':E:R~, AF:'TIEF? CIF:'F' ]: CE HOURS, CALl,.. 343-zI'6D1 AND L..EAVE A MESSAGE. CONSTI::~'UCT PER I~:NGINEI~ERS ATTACHISD AF:'F~RDVED DES]:GN. THIS PERMIT EXF:'IRI~':S 'IH:IS PIERM I'f VAL ]: D F:OI:? ~ S]:NGL.E F'(~M II....Y RE]~31DIENCE: ONLY,, ]: C[i:I::;~T!F:'Y I!"h~'l"~ ].,, ]: alii {' i.:'dll :i. ]. J, al" ~;['[,l"l '1',l"/~? r'(~.iqLtJ, r't~)fTl~::!l']t!~ '~'(:)r' E)I],..~;;J,'~,6~ ~(3~w(~r'~i[~ al'iCI fc:)r"Lh I:)y the Nur~ic:i. pal:i, ty ~:~I' Arlc::hoPage (ME]A) and the S'La'Le of' Alasl::a. :~?,, ]: W:i.].]. :i.l'Hi3'La].]. '['.h(~) ~By!13'~.Dfll ii'] a(zE:Ol',Clal"l[::[.~ with all M[IA C::[:)C:I6Hi~; alqd al"iCJ ~l-I E:C)I~I:I I. :J. aI'H]¢2 ~ J. th '~,,l'IC~) de)[!~ i grl (:: p :i. 'LI~H" :J, a [) [' 't.h :[ !~3 1:)6~p iff:i,'['. ,, 3,, ]: ~J]J. a(:ll'~ei'e '1'..o a].]. M[)A and StaLe o{' A:!.~:~ska PeC:lLCLPem~,::~rrLs f'or' 'Ll"~e set back d:[!XF[.aT]c::IL, Si~ [r'Oifl any exist:[ng we],],r, wast. l~:~atep disposal, system of i::~ubl:i.c:: 4. I urlder'stal~c:l t,.ha'[ Lh:i.s pi:eH'mit is valJ. d ~'(::)r' ~:~ ilia).(:i, rflLU'll Df' ::',~; Municipality ol Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: VICTOR SMITH DATE PERF(~MED: LEGAL DESCRIPTION: L19, BLK B SUNSET HILLtDwnship, Range, Section: 1 2 3 4 5 6 7 8 9 11 14- 15- 16- 17- 18- 19- 20- DISTURBED MIXED SAND AND SILTS WITH ORGANICS COMMENTS GRAVEL GRAVELLY SAND ( CLEAN ) GRAVELLY SAND GRADING INTO SANDY GRAVEL ? DENSE SANDY SILTY GRAVLL this strata percs @ 45 to 60 minutes per inch --B~'tom of hole WAS GROUND WATER NO ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth lo Water Alter Monitoring? _N on 0 I00 Gross Net Depth to Net Reading Date Time Time Water Drop 1 6/1~ 9;50 0 0 0 2 6/12 J0:05 15 12 12 1 6/12__ 10:06 0 0 0 2 6/12 10:17 11 9~ 9~ $ 6/12 10:22 5 11~ ~ PERCOLATION RATE 2 5 (minutes/inch) PERC HOLE DIAMETER 6" TEST RUN BETWEEN 4 FIAND 5 _FI GRAVELLY SAND STRATA NOTED IN TWO TEST PITS APPROX. 15' apart S~ra~a three feet to four feet lower tested on previous occation note above PERFORMED BY: BRUCE FL PAT~LERSDL I -~T~J~S~]IFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES iN EFFECT ON THIS DATE. DATE: 7/5/~ \% LoT ICl I~,LOCK ~ 14ILLS SUt~D. /Al ,, fett · TYPICAL., BED INSTALLATION t%ndallo.. ' Septl:l.,, [ cleanouts. C eanout between septic Solid pipe. t.nk ~nd bed. ~O~OSED SYSTE~ TO B~:~ INSTALLED AS SHO~ EXCEPT WILL ~VE ONLY THREE PERFO~TED PIPES. D= 6 feet ~D=d= 3 feet D = 3' to 6' between inside perloraled pipes· TYPICAL BED DESIGN (END VIEW) Surlace mounded Io insure ~ // / NATiVE S~OIL BACKFILL/ I I / ,, // [24" Minimum - must~ b~ insulated, if less !hah 36' ] ./ / fi.. -' // /,//~171~ // · 4" Perforaled pipe (perfs down) / / Grave 8ed' ' ' '. ' ~EVEL~ fit b~rrier or P~sulation if equired. Accepting Soil SIr,~a (Minimum of 2 teet below bed bollom) Seasor~lly Higb Static Groundwater Table Bed Rock or other Impermeable ' B~rrier ~G* (S~ F~ROOM) X NO. BE~OMS X 1.5: TOTAL AREA ~~~DTH ~NGTH /~ ~?~ soil r~. See reverse s~ sheet, EXAMPLE: 4~oms Soil~= 175 sq, ft,/bedroom ~5 x 4 x 175 = l?~ff. G~K AREA: 23 x ~1~8 SQ. FT, ~' ~_. NOTE'. For area~lation, only b~tto~re~used witl~:~idewell~flect. MUNICIPALITY DP ANCHOP, AGE DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION 'AU6 3 1988 RECEIVED Orillin9 Permit No. LOCATION OF WELL (Please complete either la~ lb or lc.) A.D.L. No. WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NA'rURAL RESOURES Division of Geological 8~ Geophysical Surveys I-[~..IGorough Subdivision got Block ~ I/4qtrs. Section No. TownshiPNO Range Er--1 Meridian Address: Feet Se[ow 4, WELL DEPTH: (finol) 5. DATE OF COMPLETION -- ' ~ ~ Jetted ~ Bored ~ Other: / / // Set between ft. and ft. ~ Above or ~ Below land lurface Date II. PUMPING LEVEL below lend surface and YIELD 12.GROUTING Well Grouted: ~ Yes ~ NO I~, PUMP: (Jr available) HP Length of Orop Pipe /~ft. capoclty 14.REMARKS: lC. WATER WELL CONTRACTOR'S CERTIFICATION: This well was drilled under my jurisdiction end this report is Irue to the besl of my knowledge and belief; 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 1. GENERAL INFORMATION Completelegaldescription ~.-~(' i~., ~(oc/,r Location (site address or directions) Property owner ~,~Fr~, ~-.J'/~ron (X,',~/(_f Dayphone ~-E~&~ Mailing address f~001 ~ ~ 'De~ ~n~ ~ qq~l~ Lendingage~cy~¢ D¢~¢~,~ ~(~ ~o~¢ Dayphone Mailing address. ~¢ ~ ~ee~ ~n%, ~c4~¢ ~ Agent .~ron ~(~ 8~01 ' R~I~/ Day phone' ~7~- ~0~ ' Address 8~'~0 P~,a(i~ ~,~ ~¢,~ ',4-,~c~o,-a~e.~ Unless otherwise roquested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: ~ NOTE: TYPE OF WATER SUPPLY: Individual well . ..¢ Community well Public water .. If community well system, provide written confirmation from State AD,.C attest;, lng to the legality and status of system. · .- 4. TYPE OF WASTEWATER DISPOSAL: · ' Individual on-site :Holding tank : :{ Cornmunity ~n-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. NOTE: 72-C25(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 veritythat 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. F'/~t-~.,i~ T~cA/n~cc~/ ._Cc~'u;¢~/ Phone "~ q,5'- 125"5- Name of Firm Address I VS~ o E~c~o ..~'./-. , ~C,~ or',~f¢, ,Z~./..c Engin rssignature .ff- % Date 6. DHHS SIGNATURE ~ APpro~:.ed f~.~ ' .' ' Disapproved. Conditional approval for bedrooms, with the following stipulations: · :..q-:- .~:,~-.?,~...i ~' ' :: :~ ,~da'itional Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DH HS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ko ~ I?.., ~/~ I~., .~,,)£¢t' f);ll_f Parcel I.D. A. Well Data Well type pr'~'u~ Log present (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~'17-!/<5~' Driller Total depth I d'l' Cased to Sanitary seal (Y/N) FROM WELL LOG Date of test d' ( Static water level / Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot I co' Absorption field on lot I I I ' Public sewer main ;> ~ cc.,' Sewer service line WATER SAMPLE RESULTS: Coliform 0 co I { (o c, ~.~ Nitrate Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed 0" { ~ 7 / 9 5- .Tank size / d/' Casing height Wires properly protected (Y/N) AT INSPECTION .5-1~1 .g.p.m. '7 '~ g.p.m. ; On adjacent lots .; On adjacent lots Public sewer manhole/cleanout Petroleum tank Collected by: Other bacteria Compartments '2, Cleanouts (Y/N) Y High water alarm (Y/N) Date of pumping Foundation cleanout (Y/N) Y' Depression (Y/N) N.A. Alarm tested (Y/N) lq, ~-. (~ N~) Pumper /'4./~. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot I O o TO property line ~0' Sudace water/drainage On adjacent lots '~ ~ oo' Absorption field N Foundation '~ 8 ~ Water main/serviceline ~ AS" 72-026 (3/93)° Front CONTINUED ON BACK PAGE C. LIFT STATION N, 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 D. ABSORPTION FIELD DATA Date installed ~' / ~. 7 / 95- Length O~5-' Width Total absorption area I On adjacent lots Manufacturer Manhole/Access (Y/N) _ "Pump off" Level at .Cycles tested Soil rating (GPD/FF) O, .Gravel thickness Cleanout present (Y/N) '¢ .Results (pass/fail) Date of adequacy test N,~., (.Jrt z co,) Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: 5"0' Well on lot I To building foundation On adjacent lots_ Surface water ;> tOO' Curtain drain I'~ooe s~e4 Surface water, .System type 77'e Total depth I Depression over field (Y/N) for After test If yes, give date /"/, N Bedrooms On adjacent lots .. > IOo' _ Property line _ I O' To existing or abandoned system on lot Cutbank N, A, Water main/service line_ Driveway, parking/vehicle storage area ~ o ' E. ENGINEER'S CERTIFICATION I ce~'fy that I have checked, verified, or conformed to all MOA and HAA guidelines i date of this inspect/on. Signature Engineer's Name Date,, HAA Fee $ '~3d~O ~ Date of Payment ~o ¢).~ _c[ ~-- Receipt Number ,.. (-.~ \Cbl&'"~ I [~&~ 72-026 (3,,93) · ~ack Waiver Fee $ Date of Payment Receipt Number CE-3589 ~ ,~t~al~ CT&E Environmental Services Inc. CT&E Ref.~ 95.2337-1 Matrix WATER Client Sample ID L19 B 'B' SLrNSET HILLS S/D W HOSE BIB Client Name FI~TTOP TECHNICAL SRV WORK Order 15371 Ordered By T.F. MOORE Printed Date 06/13/95 ~ 15:01 hrs. Project Name Collected Date 06/09/95 ~ 16:45 hrs. Project~ Received Date 06/09/95 ® 17:15 hrs. PWSID UA Technical Director STEPHEN C. EDE Sample Remarks: SAMPLE COLLECTED BY~ T.F. MOORE. QC Allowable Ext. Anal Parameter Results Qual Units Method Limits Date Date Init Nitrate-N 1.48 U m~/L EPA 353.2 10. 06/12/95 DJS * See Special Instructions Above UA ~ Unavailable ** See Sample Remarks Above NA = Not Analyzed U = Undetected, Reported value is the practical quantification limit. LT ~ Less Than D = Secondary dilution. GT ~ Greater Than MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES DIVISION OF ENVIRONMENTAL SERVICES CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4744 Application Date GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL) (a) Legal Description (include lot, block, subdivision, section, township, range) Location(addre~sordirections) - /'~'(~[ 5f"L'I~Xl/~c'L~,P~/V ~ (b) Prope,y Owner .~l)~ ]~IT~P Telephone: Home ~---~OJ ~ BusJness _ ~ MailingAddress /~[ 5~I~I¢CU ,[~1~ /~Ck~ ~/~ (C) Le.dinglnstitutio~ .~¢./ ~~ Telepho.e (d) Real Estate Oompany and Agent '~ I~ ~,~ ~ ~ (e) Mail the HA~to the followina address: or: Check here ~if hold for pick up. List contac~erson and day phone number below. TYPE OF RESIDENCE Single~Family~ Number of Bedroom§ WATER SUPPLY Individual Well ~ Community [] Public [] Note: If corn munity well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite'~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 fRev 81861 Front ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION ,As certified by my seal affixed hereto and ~s of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the un-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 ~---".~' / DHHS APPROVAL Approved for ~ bedrooms by Approved /~X~ Disapproved Terms of Conditional Approval __ Conditional __ CAUTION The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DH HS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Page 2 of 2 72-025 fray 8/86) Back ~:¢.c'AO%~\O~' A. WELL DATA Well Classification MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) ~ C.ECK'.ST- FE..UA.Y.984 - Y 264-4744 Legal De (iption: /~,0"~- /(~ /'~/(..~ ~ If A, B, C, D.E.C. Approved (Y/N) Well Log Present (Y/N) ~ Date Completed ~ -~(-~) _¢O)~ l Total Depth /~'~/ Cased to /~2 / Depth of Grouting Static Water Level /(~.~ ~ Pump Set At Casing Height Above Ground //~/ ../~ .~ * Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Eot Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ;On Adjoining Lots O~ ~-~'~ /('~O ~ To Nearest Edge of Absorption Field on Lot {/;~//~; On Adjoin ng Lots To Nearest Public Sewer Line /'¢~//~/ To Nearest Public Sewer Cleanout/Manhole ~J/~ .. To Nearest Sewer Service Line Water Sample Collected by J~ ~ ~¢~ ~ O !~ ; Date ~ Water Sample Test Results ,~~ O ~ ~,~/~ SEPTIC/HOLDING TANK DATA SDt:~l~PSi~: (//e~)Tank'(~y/N) Ai~h, Caps (Y/N) Pumping/Maintenance Contract on File (Y/N) Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: TO Water-Supply Well /('~.~ To Property Line (~)~P-~_- No. of Compartments Foundation Cleanout (Y/N) Date Last Pumped ; for Temporary Holding Tank Permit (Y/N) To Building Foundation '~-~"~/~ To Disposal Field 8 / '~- To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026 fray 8/861 Front C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed d 0~'*¢ /. Width of Field /% Square Feet of Absorption Area ~)--~'~) Depression over Field (Y/N) Type of System Design Length of Field ~ ~" ~ Depth of Field ~//~'~ ~ Gravel Bed Thickness Z Standpipes Present (Y/N) Date of Last Adequacy Test Results of Last Adequacy Test Comments To Property Line __ /O f~¢' To Existing or Abandoned System on Separation Distance from Absorption Field: To Water-Supply Well //~'~ To Building Found?))n ~ ,'~(~) ~> Lot / V~ ; on Adjoining Lots __ TO Water Main/Service Line ~//C)_ To Cutba~k (if present) To Stream/Pond/Lake/or Major Drainage Course ,]~C)¢,5~ (2,D !']'~}/"} To Driveway, Parking Area, or Vehicle Storage Area C~./¢'~--./~-. ~:~.~ /.Vs" " /-- D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Ch rmitted Bedn I certify th Signed Date Company /~-~--~--/% MOA No. Receipt No. n'~ ~:2 ~ ~/ Date of Payment ~:2~__ /TZ~.~ Amount:$ . /20 O..._~O Page 2 of 2 72-026 IRev 8/861 Back ,m Rating Against HAA Request ** II MOA and HAA guidelines in effect on the date of this inspection. Engineer's Seal 2 C~: 50'3,; ~,,:~