HomeMy WebLinkAboutT15N R1W SEC 5 LT 119TI
N
IW
C ·
Lot 119
051-082
-29
Permit Number:
Tax Code Number:
Work Type:
Permit Effective Dates:
Design Engineer:
Subdivision:
Site Legal Address:
Owner/Address:
On-Site Wastewater Disposal System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
OSPll 1199
05108229000
Septic Upgrade
August 19, 2011 to
SPURKLAND ENGINEERING
T15N R1WSEC 5
T15N R1WSEC 5 LT 119 G:1457
GAY ERIC P & VICKIE L
August 18, 2012
PO BOX 670447 CHUGIAK AK 995670447
Site Mailing Address:
21236 SUNSET BLVD, Chugiak
Lot Size in Sq Ft:
Total Bedrooms:
108900
3
This permit is for the construction of:
Y Disposal Field Y Septic Tank
N Holding Tank N Privy N Private Well N Water Storage
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 wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By: :'i" ~' '~ ~ -v'~
Date:
Date:
UNICIPALITY
Community Development Department
Development Services Division
On-Site Water & Wastewater Program
Mayor Dan Sullivan
OF ANCHORAGE
Phone: 907-343-7904
Fax: 907-343-7997
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. OBI- o~z- ~.~
Property owner(s)
Mailing address FO 6oX (,"]-O ,4,~-~. ~ £k~,~,~k / AK
Legal description (Sub'd., Block & Lot)
Legal description (Township, Range & Section)
Lot Size Sq. Ft. Number of Bedrooms
Day phone
THIS APPLICATION
([~ all that apply)
Absorption Field
Septic Tank
Holding Tank
Privy
Private Well
Water Storage
IS FOR:
THIS APPLICATION IS AN:
Initial []
Upgrade []
Renewal []
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
I certify that the above information is correct. I further certify that this application is being made
for a Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
~ Permit/.Rush Fees:
k'---'"'"/' '%)ate of Payment:
Receipt Number:
Permit No.
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
G:\Building\On Site\Forms\Client Forms\Permit App_010411 .doc (Rev. 1/11)
Environmental Consulting and Design
SEPTIC SYSTEM DESIGN
T15N R1W SEC 5 LOT 119
Municipality of Anchorage
Development Services Department
On Site Water and Wastewater Program
4700 Elmore Rd.
Anchorage, Alaska 99519
Augustl8,2011
Subject:
Septic System Installation Permit
Ladies and Gentlemen:
I am writing to request a permit to upgrade the septic system for the above referenced property.
The proposed system will serve a 3-bedroom single-family residence. The existing septic system
was installed in 1975 and in no longer functioning adequately. Soil logs, design calculations, a
site plan, design drawings and construction specifications are enclosed for your review.
Design Calcs:
Groundwater observed at a depth of 10.5 feet below ground surface
(8/5/2011)
Soil Rating. From Testhole7/29/11
<1 min/in = 1.0 gal per sq.ft/day
No. of Bedrooms 3
Required Area per Bedroom: 150/1.0 =150 sq.ft.
Total area required: 150 x 3 =450 sqft
System: We are proposing a 1000 gallon septic tank, and a shallow trench absorption field.
The absorption field will be 90 feet long and 5 feet wide and contain 0.5 feet (450 sq.ft.
effective) of sewer rock. A two foot layer of filter sand will be installed directly beneath the
sewer rock.
Soils: Two test holes were excavated on July 29th, 2011. See the attached soil logs. Ground
water was observed at 10.5 feet in test hole #1 and at 12 feet in test hole #2.
Surface Water: No surface waters were observed within one hundred feet of the proposed
septic system.
Topography: The lot is generally level. The ground surface elevation varies by +/- 1 foot over
the length of the proposed trench.
203 West 15 Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci.net
Environmental Consulting and Design
I
Waivers: None required.
The installation of this septic system will not prevent wells and septic systems from being
installed on the adjacent lots. The proposed septic system will not change the general slope of
the area. Ponding and/or concentration of surface nmoff will not result from this installation.
If you have any questions or concerns, please contact me at 279-3916.
Sincerely,
/ {. ',:.,~ i~,~ ~, ~,
Lars SpOrkland, P.E.
Civil Engineer
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland~gci. net
LOT 2
LOT i08
-~ Well
LOT llBA
LOT llBB
N
Well
LOT 119
LOT 4
I O MEA ELEC ESMT
Well
NOTE: THIS IS NOT A SURVEYED PLAT. WELL ~ SEPTIC
LOCATIONS TAKEN F~OM ON-SITE WATER ANO WASTE WATER
OEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE
APPROXIMATE.
:50 0 :5O
100 1:50 200
S£ALE; 1' = 100 FE
250 300
SPURKLAND ENGINEERING
205 HI 15TH. AVENUE
ANCH. AK. 99501
(907,) 279-$916
H SN Big SECTION fi LOT 119
ERIC GAY
1256 SUNSET BLVD., CHUGIAK, AK 99567
SEPTIC SYSTEM DESIGN
DATE: OCT. 2, 2008
SHEET: 1/$ GRID: NHI1457
PERMIT #OSPlllXXX Piti # 051-082-29 H5NRllVSSLllgfll, fllVG
LLTT IIBA
LOT 119
LDT II8.~
N
ABANDON EXISTING SEPTIC
TANK PER UPC REOUIREI~ENTS ]
[INSTALL BULL RUN DIVERTER
INSTALL S-BEDROOM SEPTIC SYSTEI~
1000 GALLON STEP TANK
LENGTH 90 FEET
P~IDTH 5.0 FEET
t~AX DEPTH 6.5 FEET
I~OA APPROVED SAND 2 FEET
SEWER ROCK 0.5 FOOT
COVER 4.0 FEET
£LM£ A V£
NOTE: THIS IS NOT A SURVEYED PLAT. WELL & SEPTIC
LOCATIONS TAKEN FRO~ ON-SITE WATER AND WASTE WATER
DEPARTI~ENT DOCUI~ENTATION. ALL LOCATIONS SHOWN ARE
APPROXIMATE.
,Ii~i~ ~
25 0 25 50 75 100 125 150
SCALE: I' = 50 FT.
SPURKLAND ENGINEERING
205 1¢ 15TX. AVENUE
ARCH. AK. 99501
(907) 2zg-ag~
L] H 5N Rig SECTION 5 LOT 119
ERIC GAY
21256 SUNSET BLVD., CHUG/AK, AK 9956?
SEPTIC SYSTEbl DESIGN
DATE: AUGUST 5, 2011
SHEET: 2/$ GRID: NW1457
PERMIT #I]SPlllXXX PID # 051-082-29 TISNR1WSSLllgD2.BWG
To Existin9 Brain Field
Shallo~ Trench:
5' Wide
90' Long
6.5' Max Deep
2' Filter Sand
0,5'
1000 gal Septic tank
4' Cover
Silt Barrier
0,5 £t o£ Sept/c RocA
Effective
Cleanouts
// / 4' Cover
2,0 Feet MOA Filter Sand
1000 9al. septic tank
NO SCALE
0
::3
SPURKLAND ENGINEERING
803 ~/15th Ave
Anchorage Ak 99501
879-3916
T15N RI $ SEC 5 LOT 119
ERIC GAY
21236 SUNSET BLVD., CHUG/AK, AK 99567
L I SEPTIC SYSTEM DESIGN
DATE: AUGUST 5, £011
SHEET, 3/3 GRID, NV1457
PERMIT // OSPXXXXXX PARCEL ID itt 051-082-29 TI5NRIWS5LIIgD$.DWG
Performed For:
Legal Description:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99507
www.ci.anchorafie.ak.us
(907) 343-7904
Soils Log - Percolation Test
-['lEN &l~/ 5ecs
Date Performed: ~f'7 ~Jl~'~"~<
L Jr 11~ Township, Range, Section:
Slope Site Plan
4-
5-
6-
7-
9-
11-
13-
14-
15-
16-
17-
19-
20-
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT DEPTH?
Depth to Water After
Monitoring?
Date:
S
0
P
Reading Date Gross Time Net Time Depth to Water Net Drop
PERCOLATION RATE / ~ (minutes/inch) PERC HOLE DIAMETER (.o ~1 '/'
TEST RUN BETWEEN ~ FT AND ~ FT
~1'~ 5,
PERFORMED IN ACCORDANCE ~ITH ALL STATE AND MUNICIPAL ~UIOE~INES IN EFFECT ON THIS DATE. DATE: ~Z///
11
Development Department ~
Building Safety Division ~_,~_~. ·" ' T_T_T~H , ,~.~. ~" ' -~ !~//,I',
On-Site Water and Wastewater Program '
4700 ElmoreRoad 49 .. .
P.O. Box 196650 Anchorage, AK 99507 ''
www.ci.anchorafle.ak.us
Soils Log - Percolation Test [~t · . .-',
Pe.o~ed For: ~ &A7 Date Pefformed:~
Legal Description: TIE~ ~ ~ ~ ~ ~e~ t t~ Township, Range, Section:
Slope Site Plan
Depth
(Feetl,
/iJiiJ/~ o ~..~'A ~, ¢5
' "o~
~o'
:.:.';.
..~
, IF
&o.u
2-
3-
4-
5-
6-
7-
8-
WAS GROUND WATER
9- ENCOUNTERED? ¥¢5
1 0- ES, AT WHAT DEPTH? II ~ SL
o
Depth to Water After t p
11- Monitoring? lOtS E
12- Date: (~/~/~\ ~,~,
13-
Reading Date Gross Time Net Time Depth to Water Net Drop
14-
15-
16-
17-
18-
19-
20-
PERCOLATION RATE ~-~ (minutes/inch) PERC HOLE DIAMETER ~ I(
TEST RUN BETWEEN ,~ FT AND (.~ FT
COMMENTS ?~"o[~'io,, T~t 14ot~ F,'lt~ ~ A a¢~ 4 ~". O~;~,~.t ~y ;~ h~ t~,, 2~,'~.
PERFORMED BY: S~ r~ ~.--,~ ' [~/~ CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WI~H ALL STATE AND MUNICIPAL GUI~ES IN EFFECT ON THIS DATE. DATE:
GRE .
[E IANCHORAGE AREA B0r '~U-'1
Department of Environmental Quality
3330 C Street
~ Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
N A M E _(..,p, tA FLLe,~
LOCATION
MAI'LING ADDRESS P, 0,~O~' ~0%- A/a~..H L~(/'~¢/0 PHONE
, LEGAL DESCR,PT,ON [..-//~ S~.,.fs- ~-,v £/~u
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH.
I IJQUID CAPACITY_/~-~]~
INSIDE WlDTFIi LIQUID DEPTH GALLONS,
NUMBER OF PITS --
LINING MATERIAL
BUILDING FOUNDATION__
ADDITIONAL ABSORPTION
DIAMETER_ I OR WIDTH
CRIB SIZE: DIAMETER
NEARESTi LOT LINE__
LENGTH DEPTH
DEPTH DISTANCE FROM: WELL
TOTAL EFFECTIVE
ABSORPTION AREA (WALL AREA)
SQ, FT,
WELL:
T,'PE ;P,,,/f4 C ONSTRUCT,O,N
BUILDING NEAREST
FOUNDATION- LOT LINE.
CESSPOOL . , OTHER SOURCES
APPROVED _ DISAPPROVE[} __
DEPTH '~" DISTANCE FROM:
NEAREST SEPTIC SEEPAGE
SEWER LINE TANK ///~ SYSTEM
REMARKS
DISTANCES:
INSTAl-LED BY:
PIPE MATERIAL'
REMARKS:
Form No, EQ~031
DIAGRAM OF SYSTEM
DATE
APPROVED.~-~/~"~.A/' j'~-//~-E~L_
/G,A.A.B,
GREATERi ANCHORAGE AREA ]BOROUGH
SI:'WAGE DISPOSb~L SYSI'EM -- APPLICATION AND PERMIT
INSTALLATION Of: SEPTIC TANK
TYPE AND S[ZE Of FACILITY TO BE SERVED
FINANCED THROUGH --
SOIL TEST RESULTS
COMPLETION DATE ANTICIPATED
TO BE INSTALLED BY
. OTHER
NOTE= TI'liS PERMIT IS NOT VALID WITHOUT SOIL TES'I'
SEPTIC TANK SIZE /eO0
SEPTIC TANK TO SEEPAGE PiT WALL
WELL TO SEPTIC TANK ///0(~ ' ,SEEPAGE PIT
/oo' :
EXCAVATION 5 FEET INTO UNDISTURBED SOIL,
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
Well Owner_ Wa~y_no Stowers'
M "W DRILLING, Inc.
O. Box 4-1728 o 2811 Da~vson
A C 907-279-1741
ANCHORAGE, ALASKA 99509
DRILLING LOG
Use of Well_~BL
Location (address of: lownsh~p,I Range, Section, if known; or distance main road Bowery Lane '-i 200 yards South of Peters Cr~elc
Size of casing (~ Depth of Hole ~0 feet Cased to.__.5_0 ____feet
Statie ~vater ]evel_~ fL. (s~)l (below) land surface. Finish of ~vell (check one) open end ( X
Screen ( ); Perforated ( iX ).
Describe screen or perforation__ Mills Knife S19ta~/~ft0_z'_..~hm~_Q ft. depth level
(minute)
Well pumping test at__2 gallons per
of drawdown from static level.
Date of completion _~$ July
WE~L I. OG
Deplh in feel froln
ground surface Give details of fomnations penetrated, size of material, color and hardness
Bur fag~ O~ganics
);
hours ' v .
w~th.__ ] O0 ,,~ - ft,
2 _ TO
1 7 _TO 28
28 _.TO_ ~7
JiF_To.._5~ __
_TO
.TO
...... 20.
..... TO
TO.
..... TO
....... TO.
....... TO.
Oobblo~Oravol
Blue Clay
Small Oravol: siltff/aandyo
Bluo Clay
bayno is.. ,Vostbor~/
CUSTOMER
MUNICIPALITY OF ANCHORAGE
Del~artment of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSpEcTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D. # ¢.2--'/ 0~2 ~- ~' HAA# ~-/~-~'}L/Li(.c'
1. GFNERAL INFORMATION (Must be Completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
_ not 119, Sect±on 5~ T15N¢ R1Wt S.H.
Location (address or directions)
(b) Property owner _~'~*~r] Fowler
Mailing Address ~O, J~O~(
~ Telephone
(c) Lending Institution
Mailing Address ' ·
Telephone: (home) 688-2013 Business
(d) Real Estate Company and Agent R¢,/Mm~ nC Bag] ~- River:- Carolyn McPhee
Address !66n0 Centerf~e~. n~. ~a]~ p~z~r, ALaska 99577
Telephone 69-4=4200
(e) Mail the HAA to the following address: (or check here E~ if hold for pick up.)
List contact person and day phorle number below:
$ & $ ENGINEERING
l~,'nA-~ Ee~lo ~'~er L_-,~,,*c4~a~ N=. 204
Eagle River, Alaska 99577
2. TYPE OF RESIDENCE
Single-Family ~ Number of bedrooms
WATER SUPPLY
individual Well ~ Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality ,and status.
SEWAGE DISPOSAL
On-site ~ Public [] Commumty [] Holding Tank []
Note: if community well system, mdst have written confirmation from the State Department of Environmental
Conservation attesting to the legailh/and status.
72-025 (Rev. 7/88)
Page 1 of 2
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA ANt) INFORMATION '
As certified by my seal affixed hereto ahd as of the validation date shown below, I verify that my investigation of th is
Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe,
functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and
nspect on, the on-rote water supp y and/or wastewater ¢ ~sposal 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 S & $ ENGiNEERiNg'
17034 Eagte i-;;v~,r Lo'~? Eoad No. 204
Date . Eagle Rivet*, Alaska 99577
6. DHHS APPROVAL
Approved for .~
Approved_ -~
Telephone
bedrooms by _~~ / ~'~ate /~:~-/~-~:~
Disapproved : Conditional
Terms of Conditional Approval _
The Mun'cipahty of Anchorage Departmegt of Health and Human Services (DHHS) issues Health Authority Approval
cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the State of Alaska, The DHHS does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections
or analyze data before a certificate is issue¢. The Mun c pa ity of Anchorage is not responsible for errors or omissions
in the professional engineer's work.
72-025 (Rev. 7188) Back
Page 2 of 2
A. WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA) ~
=Health Authority Approval (HAA)
CHECKLIST - FEBRUARY 1984
343-4744
Legal Description: ~,-~-'¢ ~t~.,
~UI~'iCIPAI 1¥/' OF AIqCH()!RAGE
[i,~vi?ONIV'~t:NI AL 5EkViCE$ DiVIStON
Well Classification
Well Log Present ~N) ~ Dat6 Completed ~ --- "¢~ ¢ "/~
Total Depth ~';C) 'Cased to _~_~_~l__ Depth of Grouting
Static Water Level [..,¢ i, ~
i Pump Set At
Casing Height Above Ground,Il'~'~'1 "~- Sanitary Seal on Casing (d~N)
Electrical Wiring in Conduit (~-¢'N) ! '~// Depression Around Wellhead
SEPARATION DISTANCES FROM WELl..:
To Septic/Holding Tank on Lot i ¢-"1, ~.~ ; On Adjoining Lots __
To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole
To Nearest Sewer Service Line',on Lot ~
Water Sample Collected by ~"~'~ ~[~'~i'~'~[~1~ ; Date
Water Sample Test Result$ ~/¢,~, ¢- O~y,~¢,..~ ,,¢r¢
Comments ~ ,~-'t~%,~ i"'~'¢~-'7'F¢:;::~ t~:::~ ,- t~
If A, B, C, D.E.C. Approved (Y/N)
Yield "¢¢, ¢-~
B. SEPTIC/HOLDING TANK DATA
Date Installed 6¢~"5-"1¢" Size ~
Standpipes4~/N) *,¢/ _ Air-tight Caps(_C~N) _
Depression over Tank (Y,¢]:~ i-~
Pumping/Maintenance Contact on File (Y/N)
Holding Tank High-Water Alarm (Y/N) //~
SEPARATION DISTANCES FROM SEPTIC/HOLDING 'rANK:
-?
No. of Compartments
"7/ Foundation Cleanou,~/N) _"/'
Date Last Pumped ~ ~-
; for
.,._\ /
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field
To Water-Supply Well ,::::~ ~ t
To Property Line
To Water Main/oervice Line
To Stream, Pond, Lake or Major Draihage Course
72-026 (Rev. 7~88) Fronl
Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed ~ --'~ -'~
Width of Field '¢~'~
Square Feet of Absortion Area
Depression over Field (Y/~[~;,
Results of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well / ~:::~c::) t.+ To Property Line
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Statndpipes Present (Y/N)
Date of Last Adequacy Test
To Building Foundatio~
Lot r~ h, ; On Adjoining Lots
To Water Main/Service Line ~ ~o ~-¢ To Cutback (if present)
To Stream, Pond, Lake, or Major Drainage Course '~ .,:~c:, 14-
To Driveway, Parking Area, or Vehicle Storage Area ~'c:~
Comments ")('- ~-----¢~ll~ ~-~-,IV'~ ~ ,,~. ~
D, LiFT STATION/ //,~_
Date Installed ¢
Siz~ons
"Pump On" ~
High Water Alarm Level at %
To Existing or Abandoned System on
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Pumping Cycles during Adequacy Test.
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this
inspection.
Signed
Company
Date
MOA No.
17034 Eagle River Loop Road No. 204
Eagle River, Alaska/~.YS.7?/
Receipt No.
Date of Payment
Amount:
Receipt No.
Waiver Fee:
Date of Payment I~)')LI'~
Page 2 of 2
Tom Fink,
Mayor
A un ._ pahty Ancko age
Department of Health and Human Services
825 "L" Street
P,O, Box 1196650 Anchorage, Alaska 99519-6650
October 19, 1988
Robert A. Shafer,
S & S Engineering
17034 Eagle River Loop
Suite 204
Eagle River, Alaska 99577
Subject: Waiver Request
Waiver Request
Dear Mr. Shafer:
343-4744
for T15N R1W Section 5 Lot 119
~WR88-063, H88-0446
Your reques% for waiver of the required 100 foot separation of
a septic system to a private well has been approved. The
approved separation distance is 96 feet.
This waiver approval ~pplies to the existing septic system to
well separation only. Any future upgrade to either will
require all separation distances be met or another approval
from this department.~
Sincerely,
Daniel J. Ro%h
Civil Engineer
On-site Services
DJR/ljw~6
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
ROBERT A. SHAFER
October 13, 1988
CIVIL ENGINEER
694-2979
Muni~ipa~ty of AnChorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
Anchorage, Alaska i99501
REFERENCE: Lot I191; Section 5; TI5N; RIW; S.M.
Request you issue the attached Health Authority Approval (HAA) and
grant a waiver for ~he horizo~al separat~on distance between the
private well and thle septic tank located on the referenced property
at a distance of 961 feet.
The well was drilled in 1973. The septic was installed in 1975
and inspected by a Municipal inspector. A Health Certificate was
issued by the Municipality in August of 1977.
A risk analysis has! been performed and it appears that no bacterialogical
pollution is possible from this source. Attached for your review
are the following documents:
A. A plot ~lan showing the relative distance between the well
and septic System.
B. Risk analys~s waiver review worksheet.
C. Coliform and ~itrate analysis of water taken from the well
located on the referenced property.
D. A well log for the referenced well.
It is our opihion that the horizont~ separation distance prescribed
by 18AAC72.021 is not required in this case.
If you, re addi~onal information, please contact us.
Sin~c~rel~ ./
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
SCALE
//~.~'~, MUNICIPALITY OF ANCHORAGE
[[,~j~. DEPARTMEN 3F~ HEALTH ABD ENVIRONMEN'[ PRO'~'ECTION
~ ', / /'Date Recetvc~: ~uly 22, 1977
Time .._~.L~ZD~L__ ~2r ~e . _j~ ~/3 .t ..lee .........
, ,/
REQUEST FOR APPROVAl2 OF IND~%~AL oEWER AND WATER N ACILI%
Lendlng Institution Request: Alaska Mutual Savings Bank % Stormy {
Mailing Address: Post O]ffice Box 1120 Phone: 274-3561/245
2. Property Owner: Charles W/Linda C. Stowers Phone: 688-2029/h
Mailing Address: Post Office Box 105
276-6981
3. Legal Description: T15N R1W Section 5 Lot l[L9
4: Single Family Resi_dence:: (~
Number of Bedrooms: _._T_h_ree__
Mm].E:i. ple Family Residence:
( ) Number of Bedrooms:
5. Well System: IndJ.vJ.dual; We]'[
Permit tt ............ Depth of
Construction
6. Sewage Disposal System: On-site System (x)
Permit ,~ Installed
7.
k ) Commun~.ty/Public Sysucm ~ )
Well ~ ~) Welt l,oq on File
Bacterial Analyszs
(
Public Utility ( )
__ _ Installer ,~,-~/~.--
Sept.tc 'Iank Size /0OO Mm~Jfactuler .~_u,~j ~5
Absorption Area _~_G,SJ~ Soils Rate Mat:ariel ...............
Distances: Well to Septiic Tank
S~_wal Line ' . Nearest
I / ~i) lX, Absorption Area \ 30
Lot line Absorpt2oD Area
to Nearest Lot Line
Deparkment ~f Health and Elnvironmental Protect:ion
}'{ec{lJf.~,'4*b. fol? Approv,~l of Indiv:[dual Sewer and Water'
I.e~al Dascription: T15N R1W Section 5 Lot 119
C'.o~ent s: ~
Affadav:].t At:tached: ( ) , ],error Att:ached
Approved: ...... Date:
Disapproved: ' Date..
Det>artmen~ Worksheet: ~
MUN C PAL TY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVlRONNIENTAL PROTECTION
825 L Street,. Anchorage, Alaska 99501
279-2511, ext. 224, 225
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection:
VA FHA CONV ~X
2. Property Owner:_
STOWERS, Charles W. & I, inda C.
Mailing Ad'dress: P. O.
3. Name of Buyer: none
Mailing Address:
4. Name of Lending Institution:
Bo~ 1~5
Day Phone: 688-20_29 hm
276-6981 wk
Day Phone:.
Alaska Mutual Savings Bank
,. P. 0. Box 1120
Mailing Address ....
Narne of Realtor or Ageot: n_one
__Phone: 274-3561 ex: 245
l~t__o, rmy)
Mailing Address: Phone:
Legal Description: Lot 119, Sec. 5, T15N, R1W, S. M.
Location:
m~ Chugi~k
7. Type of Facility to be Inspected:
8. Water Supply
Type of Sbpply:
well & Septic
Public Utility
No. Bdrms.~3
Individual XXX
If Individual, number of dwellings presently served
If Individual, depth of well~4
Sewage Disposal System I
Type of System:
Public Utility,
Individual (on-site) XXX
If Individual, date of installation
72-003(3/70)
APPLI( NT FILLS OUT UPPER HAt ONLY
~SIngle Family J -)
Multiple Family No. of Bedroo~ ] ~
~dndlvidual I Year Individual Installed: _ J'? ? ~ -
Time Time Time 'rime
: ~UNICIPALIW OF ANCHORAGE
~' ~, ; DFPT O~ pE'LT:'
~ ....... ~ [NVlROiqh,zh, A. ', .O,ECTION
%' RECEIVED
i
1
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