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HomeMy WebLinkAboutT15N R1W SEC 9 LT 47C 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: ~',/,Jq~o'5["7 PID Number: ~1 to'~ Name: (J~iLL. IAt~ ~'"J. ~&FPO~ Wastewater System: D New ~ Upgrade Address: ~H~ A~ ABSORPTION FIELD Phone: ~5~ ~N~.ofBedrooms:~ ~ Deep Trench ~ShailowTre.ch ~Bed ~Mound ~Other LEGAL DESCRIPTION sog Ratl,g: Total Depth fro~olriginal grade: O. ~ G PD/Sq. Ft. Lot: ~ ~ Block: Subdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe  ~ Fill added above original grade: Gravel length: Township:~[~ Range: ~~Secti°n: ~ ~ Ft. ~ Ft. WELL:~xtsT~ New ~ Upgrade ~ravelwidth: ~ Number of lines: I ~Distancebetween[ines: ( ~ Ft. 5 ~ .5 Ft. Classification (Private. A,B.C): Total Depth: C~ Total absorption area: Pipe material: ~l~A~ ~ Ft. ~ SQ. Ft, ~tO/SC~ ~ed: StaticWaterLevek InstaHer~ EO~%~iO~ Date installed: Yield: Pump Set .t: TAN K SEPARATION DISTANCES ~ Septic ~ Holding ~ S.T.E.P. To Septic AbsorDtlon L~ft Holding Public/Pr~vat~ Manufacturer: Capacity in gallons: Well- iO~~ ~(~ tO~I ~ ~t+ Material: ~T~~ Number °f C°mpartments: Surface ~ ~ LIFT STATION Water .~OO ~ ~oO ~ ~oO ~ ~ Lot ~ ¢ ¢ Size in gallons: Manufacturer: ~ ~ "Pump on" level at: ~ "Pump off" level at: I High water alarm at: Curtain Remarks: BENCH MARK 17034 Eagle River Loop Road, No. 2~ InspectJoRs performe~le givar~ Alaaka 99577 Dates: 1 st_ lo - ~0 ~ ,,;", ~~.~,,...' .............. . ~. .... Department of He'and Hu~ Services approval ,-~'*,~',, .... Reviewed and approved~~~ - Date: .~- ~.~ -~ 72-013 (Rev 9/91) MOA 25 Perml! No SW950317 Page 2 of 2 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 LOT 47C, SEC 9, T15N R1W 0511045,3 Legal Description: PID No · $T2 MH GRADE FI INSU] ~MT1 4AL GRADE~ ATION--._~__ 101.1'~ · 9~ 6' WATER FO[ 9-26-95 MT4 \ 2' LEVELING DURSE LOT 47C EXI ;TING SYSTEI EW 1500 GRAVEL DRIVE XW NEW ABSOR[ SCALE t" = 40' ROBERT (:. COWAN CE-8801 72-013 A (Rev. 9/91 ) MOA 25 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 NUMBER:SW950317 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:SPAFFORD WILLIAM N JR & OWNER ADDRESS:20833 BOWERY LN CHUGIAK, AK 99567 DATE ISSUED:10/05/gs EXPIRATION DATE:10/05/96 PARCEL ID:05110453 LEGAL DESCRIPTION: T1SN R1W SEC 9 LT 47C LOT SIZE: 30114 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: l. 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 (iSAACS0) . 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 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: HEALTH AUTHOR115' APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER &WATER INSPECTION ENGINEERING STUDIES ANO REPORTS WELL INSPECTION & FLOWTEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL iNSPECTIONS ROBERTC. COWAN, RE. ROBERTA. SHAFER, RE. September 27, 1995 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 47C, Section 9, T15N, R1W, S.M., Alaska Request you issue a permit to upgrade the septic system serving the four bedroom house on the referenced property. A test hole was excavated and a percolation test performed in the area of the proposed upgrade. The approximate location of the test hole is located on the attached site plan. At the time of excavation no water was encountered in the test hole and after seven day ground water monitoring, water was found at 4 feet. Attached is the proposed upgrade design. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the instal].ation of the proposed septic system. If you require additional information, please contact us. Sincerely, RCC/gk Enclosure 17034 NORTH EAGLE RIVER LOOP ' SUITE 204 ' EAGLE RIVER, ALASKA 99577 F EXISTING FOUR BEDROOM HOUSE m m-,~o m 0 oc~© -~o N.T.S. 0 Q C) DETAIL PROFII_E °~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: '~ ~,~..,,[/~'v'.~ LEGAL DESCRIPTION: ~.~1" ~'~ ~.~ S ¢_..(.~, C~ .-~1~.~ Township, Range, Section: 1 4 5 6 7 8 9 SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? ,F YES, AT WHAT DEPTH? Depth to Waler After ~ ~ Monitoring? ~ Date: Gross Net Depth to Net Reading Date Time Time Water Drop 10 11 12 13 14 15 16- 17 18 19- 20- PERCOLATION RATE '~ (minutesdnch) PERC HOLE DIAMETER TEST RUN BETWEEN '~' FT AND ¢z.p FT COMMENTS ENGINEERING ~"~,~'~'~_¢~ ~ % CERTIFY THAT THIS TEST WAS PERFORMED IN PERFORMED BY: , I , ,~;'4 ~ ~91e River L~p Road NO, 204 ACCORDANCE WITH AL~,T,~'[~,~I~I~t~J~I~I~,]~EiUIDELINES IN EFFECT ON THIS DATE, DATE: ~'~ ~'~-~ --c1~' 72-008 (Rev. 4/85) HEALTH AUTHORITY APPROVALS SEWER &WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SiTE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN ROBERTC. COWAN, RE. ROBERTA. SHAFER, RE. ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 47C, Section 9, T15N, R1W, S.M., Alaska September 26, 1995 [ENERAL: 1. e The scope of this project includes the installation of a 1500 gallon wastewater S.T.E.P. system (septic tank) and a pressurized absorption bed to serve the four bedroom residence located on the referenced property. The existing 1250 gallon septic tank is to be excavated, pumped, crushed, and abandoned completely. The existing leachfield is to be abandoned in place. Construction shall be in accordance with the approved site plan and design drawings; Municipal permit with any special provisions or conditions; and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wast·water disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 Page Two Lot 47C, Section 9, September 26, 1995 T15N, R1W, S.M., Alaska 3. 4. 5. 6w The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. LEACHFIELD BED INSTALLATION: Excavate the proposed Bed Area to the depth shown on the design. The bottom of the excavation shall be within 2 inches of level. If the bottom of the excavation becomes smeared, it must be raked or scratched (ruffed-up) before gravel or sand placement. If a sand layer is required, place sand over entire excavation to the required depth shown on the design. The top of the sand layer must be within 2 inches of level. Sewer rock shall be placed uniformly throughout the entire bed. The distribution piping is to be of PVC (ASTM D3034 or equal). All joints are to be solvent cemented. Gravel depth below the distribution pipes shall be a minimum of six (6) inches. Gravel depth above the perforated pipe shall be a minimum of two (2) inches. The distribution piping must be as shown on the design. The distance between the outermost perforated distribution pipes and the sidewall of the absorption bed must be no more than three feet. Page Three Lot 47C, Section 9, September 26, 1995 T15N, R1W, S.M., Alaska Se 7e Silt barrier material must be installed between the final gravel layer and the native soil backfill, unless insulation is used, then the silt barrier should be installed over the insulation. Ensure the silt barrier covers the entire gravel surface before placing baokfill. Monitor tubes shall be of four (4) inch diameter, installed at the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel depth shall be perforated six (6) inches below the bottom of the horizontal distribution lines. The monitoring tube should not extend below the bottom of the gravel surface. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finished grade over the bed must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal}. 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). Page Four Lot 47C, Section 9, September 26, 1995 T15N, R1W, S.M., Alaska A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the %200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. INSPECTIONS= Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditch~s, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. Page Five Lot 47C, Section 9, T15N, R1W, September 26, 1995 S.M., Alaska The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LOCATION inside length [Width IF HOMEMADE: Well PERMIT NO. DISTANCE TO: Manufacturer Material Liquid capacity in gallons Well Foundation Nearest lot line PERMIT NO. DISTANCE TO: Length of each line Trench No. of lines Total length of lines width Distance between lines inches Top of tile to finish grade Materia) beneath tile Total effective absorption area inches Length Width Depth PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO', ~lass Depth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorpt on area(s) NO. OF BED OOMS Liquid depth OTHER PIPE MATERIALS SOIL TEST RATING DATE LEGAL PERMIT NO. 1'1 L! 1.4 Z []: I ' DEPRRTMENT b, 825 "L" ( 790460 ) rIP F'[.. I Cf:INT LOC:FIT I ON L. EGE~L L. OMfq'.:5 ,?.: NETTLETON CO. L. 47C S9 TiSN R:I.N SM 444:9 BUSINESS PK BLVD LOT SIZE ;;:/74 7'661 3:2670 SQURFdE FEE"F TYPE OF SOIl_ ABSORBTION SYSTEM IS: DRAINFIELD MAXIMUM NUMBER OF BEDROOMS = 4 SOIL. RRTING (SQ FT/BR)= 0 l"i,-li,E RE[.".!UIRED SIZE OF 'fF.li,~; SOIl.. r=~BSORPTION SYSTEM IS: 'THE LENGTH DIMENSION IS THE LENGTI,q (IN FEET) OF THE TRENCH OR [)RAINFIEL. I.::,. THE [:,EPTH Oi,=' R TRENCH OR PIT IS THE DISTRNCE BETNEEN THE SURI,=RCE [)F THE GROUND RND THE BOTTOM OF THE ENCRVRTION (IN FEE'T). "['HE GRRVEL DEPTH IS THE f'IINIMUM DEF'TH OF GRRVEL. BETWEEN THE OUTFRL. L.. PIF'I,E FINE:, Ti.Hi.[ BOTTOM Oi,-"' TNE EXCRVRTION (IN FEET). I,::'ERMIT IRPPLICF:INT HFIS THE RESPONSIBILITY 'TO INFORM THIS [:,EPFtR'TMENT DURING INSTALLATION INSPECTIONS OF RNY NEL. LS ADJACENT TO THIS PROF'ERTY FIND TF.IE: NUMBER OF RESI[)ENCES THAT THE NELL 1.4ILL. SERVE. THE ................... -F L..! ,.'.) ,:: 2 ::, I 1.-.0 L'?=; F' Ed C: "T' I (=, I%1E-~; FA BRC::I<FILL. ING L]F F:INY SYSTEM WITHOI.JT F'INRL INSPECTION RND RPPROVRL BY THIS DE;I,Z'RRTMENT MILL. BE SUBJECT 7'0 PF..'OSECUTION. i'qlNIMIJM DISTANCE BETWEEN R NELL FIND RNY ON-SITE SENRI,3E DISF'OSRL. SYSTEM IS 100 I,=EET FOR R F'RIVRTE NE[...[..~ OR ±50 TO 200 FEET FROM R PUBLIC: WELL DEPENDING UI,:'ON 'T'FIE TYPE Oi,= F'UBL. IC NEL. L.. EFI'HER REQLIIREMENTS MRY RPF'L.Y. SPECIFICFITIONS RN[:, CONS"FRUCTION L'.,IF~GRRMS FIRE RVFIILFIBLI,F TO INSLIRI,E I,:'ROPER INSTRL. LFITION I CERTIF'Y THRT l: I AM FRMIL. II,qR WITH THE REQUIREMENTS FOR ON-SITE SENERS F:IND NEL. LS RS SET i,=OR"rH BY THE MUNICIPRLI'TY OF ANCHORRGE. 2: I NIL. L INSTFILL TNE SYSTEM IN RCC:ORDRNCE NITN THI,.:: CODES. ;;ii:: I UNDI,.-:RSTFIND THAT "FHE ON-SITE .'=.-.,EWER SYL:]TEM MRY RE~;!LIIRE ENLARGEMEN'T IF: TFIE RESIDENCE IS; REMO['.,ELED TO INCLUDE MORI,:E. THRN 4 BEDROOMS. S I GNED: ................................................................... RPI,:'LICRNT L. OMRS & NETTI,_E'rON V:3. 2 PERMIT RPF'LICRNT /-.--0~?)~ .% LOCFIT I ON LEGRL /--0 ('- L_/. "? (7'- MLIr-4 I C ?RL ][ T'~' ~3F DEPRRTMEN~ OF HERLTH RHD ENVIRONMENTAL PRDTEOTIOH 825 'L' STREET., RNuHORH~E., 264-4720 NEL_L R¢-4B, C~P4--S I TE LSEbJEE: F'EE:Pl I T ( , ;~ 7 "/~ 7~. ~1 , - LOT SIZE -') ¢ fil~* , /c? S..]UBRE FE q "- IS: TYF'E OF SOIL FIBSORBTIOH _%_',TEM MRXIMUM NUMBER OF BEDROOMS = SOIL RRTIf4G (SQ FTCE, R.- THE REQUIRED SIZE OF THE SOIL RBSORPTIC~N S'¢STK~ [-; E F" T H = b EI'4~] T H ~ ~S~ [)EPTH= THE L. ENGTH DIMENSION IS THE LENGTH (Iii FEET) OF THE TRENCH OR DRRINFIEED. THE DEPTH OF Fi TREHCH. OR PIT IS THE DISTRNE:E 8ETHEEN THE SURFACE OF THE GROLIND RND THE BOTTOM, OF THE EXCFi',,,'RTION (IH FEET). THERE ~S NO SET NIDTH FOR TRENCHES. THE GRFiVEL DEPTH IS THE MIHIMUM DEPTH OF GRR',,,'EL E:ETbJEEH THE OLITFRLL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET). F-: ELT!LI I RE[:., --C, EF'T I ~3 T RI'-.II-< '---1 I ZE= ~3FILLC~[-4 - ' ' P- ' i:'/~}- , / F'ERM~T tdFFLI..HNT HRS THE RESF'ONSIBILIT',r' Ti IHFORM THIS DEPRRTMENT OURZNG THE HSTFiLLFITION INSPECTIOH$ OF RH%' 14ELLS FiDJRCEI'4T TO THIS FR_FERT~r' r~ , "Fir-~E:, THE HUMBER OF RESIDENCES THRT THE NELL 14ILL SERVE. TI,J,] < 2 ) I b4SPE~DT I iii[-4'_-] RRE F-:E t;!LI I F.: E ~., E,~L&.FILLINb OF RN9 S'¢STEM NITHOUT FIHBL IH_,~EL. TIuN RND RF'PF.:O',/RL E','¢ THIS [~_PMRTMENT NILL BE SLISJEC:T TCi PROSECUTION. ~ HIHIMOM DISTFINCE BETWEEN R WELL FIND RNY OH-SITE SEI4~qGE [:,ISPOSFIL S'¢STEM IS :LDO FEET FOR R PRIVRTE NELL: OR ±50 TO 200 FEET FROM R PLIBLIC NELL DEPENDIHG UPON THE TS'PE OF PUE',LIC NELL HELL LOGS RRE REQUIRED BND MUST BE RETURNED TO THE [:,EPRRTMEHT NITHIN OF THE NELL COMPLETION. ,]THER REL~UIREMENTS MRY RF'F'L%'. SF'EC:IFICFITIONS Fff.K:, cr~HSTRUi]:TICiN DIRGRRMS FIRE RVFIILFIBLE TO IHSURE PROPER IHSTRLL. FiTION. F'E RI',1 I T E><F' I F4ES B'EL~-E PlE:E F.: ]:::L .. I t: FORTH B'¢ THE MUNICIF'RLIT¥ OF RNCHORFiGE. ':': I NILL INSTFiLL THE _¢_,TEM IN RCr:ORDRt'IC:E HITH THE CCIC, ES. -<: I I.IHDER'~TRND THBT THE ON-SITE '~ , - z, EHER -~=,TEM MR'¢ REQUIRE ENLRRGEMENT RE_,IDEHuE I~ REMODELED TO If~LLUDE MURE THRN SI SHE[:~¢- , .~ , A~plicant //~ ~E~ T I THRT I ~Pl FRr,1ILIBR NITH THE RE]~LIIREMENTS F}R ON-SITE SENERS RND HELLS RS :SET I F TH[{ GRE^,LR ANCHORAGE AREA BOR~,~GH Department of Environmental Quality 3330 C Street Anchorage, Alaska gg§03 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM SEPTIC TANK: DISTANCE FROM WELL ~0 INSIDE LENGTH MANUFACTURER INSIDE WIDTH MATERIAL NUMBER OF COMPARTMENTS LIQUID DEPTH LIQUID CAPACITY¢'~d~g'o GALLONS. TILE DRAIN FIELD: D~STANCE FROM WELL ! NUMBER OF LINES .~'¢~ DISTANCE BETWEEN LINES ABSORPTION AREA / ~'~O (~ Sq. FT. LENGTH OF EACH LINE ~¢.~,~4"/~4".,.~..~-..¢~ ~--...¢~/ $~.,.~ DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE__~ IN. ABOVE TILE TOTAL LENGTH NEAREST LOT LINE / O OF LINES '.~ / ~ TRENCH WIDTH'~/~ IN. TOTAL EFFECTIVE WELL: TYPE CONST RUCTiON ~/~/~'' DEPTH ~(~1 DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC ~,~. SEEPAGE FOUNDATION_~~ LOT LINE ~ ~ SEWER LINE__ TANK SYSTEM CESSPOOL AppROVED_.~~''~ OTHER SOURCES DISAPPROVED REMARKS ¢ DISTANCES: SEWER LINE DEPTH: PIPE MATERIAL:6'',/'~f'~ ~'~ ~L LOT SLOPE: REMARKS: I Form EQ-032 DIAGRAM OF SYSTEM DATE ¢¢/?, /APPROV E il]]]]iilli"".FJ'""'~!i]ii!;;][]""h'"lJiiiii~] :~ilil;;IJi!iiiil]l~.,,Jlflii!iJil]i]::;;i;;: IF::;"ili~Jiii:JF;;i;:lf"qJ]]t["ll 'IHE: I...E:NCii'r'H I) :1; I'"ttiii:l'.,i:!ii; ]: Ctl'-,! :!: :iii; 'I"I*IE: I....EI'.,IEiTH ,:: ]: I'.,I I::'l!!!:liiiZT ::, O1:::' '["l..ll!;i; I I:;~:l{il:lqC:H OF;i: 'i'll[i: E:,I!/:I:::'T'H OF:' FI "FF;:Ei:hlCH O1:;~: t:::':1:-I" ;1:'.:i:; 1'HE I) ]; :E;TFINC:Ii!i; Ei:lii:;"l'l.,.t[~:Ei:N "IHE ::~;I..l~;;:Fl:::tl;;;:liZ Gi:;;:OI...IF,II) FIN[:., 'l't..l£ii: E',OTTOI',I OF:' 'l'Hl:i; [il;:~.:;C:I:::I~,,,~F:IT ]Z ON ,:::1:1'.,t 'I'HE 'T'F;:E;NC:FI [,1:1:[:)"['1.1 I::'O1:;i: E)[~:F:l]:i'.!l:::':[[ii;L.[::,:i!i; ]:'_:ii; ::i::: I'I-IE; E!i[;;:[:::i~,,,'[!~l. 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'FHliilZ :~i;'T':i!i;"FE:t'"I :IN I::IC:C:OF~'.I:;,I:::IF,IC:[i:; I.,I:[TH Tt."IE: ;;:: ;~; l.tl'.,ll;;:,l~;l:;~::~;"l"l:::ll'.,ll;;:, 'i'l.'.[l:::tT THE; I;;;~1'.,I....:~;;I;"['1~: :~;IE;I,I[~:I:;;: :~;"r'~;YE:;I"I ~"IF:I¥ F;:E~X;:~I.I];I:;~:E~; l~:~',ll..l:::ll:;;:~;~il~:!"ll~;l",l~' ;[1::: ~"1'11~; / 0 ~ E GEG, Russe# Oyster 694-2774 Soils~ Foundations Performed for: Legal Description: Depth (feet) 0 :CHNICAL ~ DEVEL..PMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Earl Ellis SOIL LOG 688-2280 Lend Development Neme: ~'A~x-~- ~-~'~,~ ~,~,~%-(\~,.. Tel. No.~'~-3~ Hatllng Address: ~, ~o,~ g~ ~_~; ~.~. d{~ Sot1 Characterlstlca 6 10 15_,, 16 Ground Water Encountered: Proposed Installation: Seepage Pit Comments: "X~,~ ~,~.~ Yes / No . If yes, what depth Drain Field v// ' Performed by: Oate: ~J ~v.~ ")G 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,# O_T'! - Iow - ~--~ 1. GENERAL INFORMATION Complete legal description HAA # Lot 4 7C ~ '~.TI'5N; ~ RIW; 'S~';~. ~ Location (site address or directions) Property pwner % ~.;~, Mailinga~dr~s~. ~.0. Box 671114 Ee~d ng.agency , ~Maihng ~ddress ~.' NHN Bowery Lane Chu~iak, AK Day phone 688-5256 Chu~iak, AK 99567 Day phone Agent." - ..... Day phone Address .......... . ..- ........ U~le'~'o'~herwise r~qUe~tedl 'HAA wili be held for .... ::*'3.~::!~'TYPE OF WATER .................................. :~; I nd . · =,,,~r. Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Y,X× , ,~,~ ..... .~,,~ Hod ngtank ..... ~ , ,,:;,;,.~; ........... commun t¥'on-s te ,~;.. - -.. ~ NOTE~ ' If community wastewater system, provide written confirmation from Sta~e,'ADEC attesting to the legality and status of system. ?'~ -' 72-026 (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 S & S ENGINEERING ]7u34 ~ag~e rover Leep R0a'~ Ne. :2o~ Phone. ~z/_ 3- ~/ -7 ~ Address E~le Ri~er, Alaska,99.,q77 Engineer's signature "~//~ ~'. ~ Date ///~/'~ .c- /, ~, / 6. DHHS SIGNATURE ' ~':'AP~3;ov,.e:d for ~ .-,~/.'~..:~..:.. .~.OlSap roved .... ..... ~:'":"~:'~.' '-': ............ :'Oo'~iti~l~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 ~n paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtssy 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 & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 · Anchorage, Alaska 99501· (907) 343-4744 Health Authority Approval Checklist Legal Description: Em ~"7C~ %~acC~ q"l~hd~ ~Z, IL.'~ Parcel I.D.: A. WELL DATA Well type Log present (Y/~ Total depth q) { I~- Sanitary seal (~N) If A, B, or C, attach ADEC letter. ADEC water system omnber Date completed Cased to ~ 4- Casing height (above ground) Wires properly protected (~N) ~/¢'$ FROM WELL LOG AT INSPECTION Date of test Static water level Well production /o ,-~3 -%?- ~ g.p.m. 3-79 g.p.m WATER SAIvlPLE RESULTS: Coliform 4~- Nitntte Other bacteria Date of sample: OLDING TANK DATA Date installed Io -7.ot-et.~ Tank size Foundation cleanm t ~q) Date of Pumping m/~ .t~a~y~rw~.. Pumper Collected by: S & $ ENGINEERING 17034 Eagle River Loop Road Eagle River, Alaska 99577 i~oo ~,c Number of Compartments ~ Cleanouts (~/N) Depression (YI~ gdo _ High water alarm (~)'N) ~-co C.' ABSORPTION FIELD DATA Date installed Length t.q ~1 ~ Width . Effective absorption area '"/b-'la Date of adequacy test ~/^ ,.,ave Soil rating ~r ft2/bdrm) O,cg System type Gravel thickness below pipe 0,~ Total depth Monitoring Tube present~',l) "/q$ Depression over field tY/~ t, Jo Results (Pass/Fail) -- For -- bedrooms Fluid depth in absorption field before test tm.); Fluid depth --- (ins./Minutes later: -- - Immediatel3 ,'tiler '~fi~.water added (in.~: Absorptmu rate = _g.p.d Peroxide treatment [past 12 months) (Y/N) ' ~ If yes, give date -- D. Lllrf STATION Date iustalled ~ 0 - ~1 - q ~' Manhole/Access ~Iq) ~, High water alarm level at* ~ 5 ~ Size in gallous }~-OO "Pump ou' level at* t.l$" "Pump off" Icvel at* ~% *Datum 'E,m-ro~, o~"~.~ Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: (~3holding tank on lot /o°1 ! Absorption field on lot I Public sewer main '"/~ Sewer/septic service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Ioo q- Lift station [Oqt SEPARATION DISTANCES FRO~OLDING TANK ON LOT TO: Building foundation % O ~ Property line ~% ~ Absorption field Water main/service line I O ~4- Surface water/drainage _ lax> ~4- . Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation t4 [ Water main/service line [ O ~ + Surface water I o o h- Driveway, parking/vehicle storage area Curtaiu drain t,.Io~ ¢:.~ot.~ Wells Oil adjacent lots Property line F. ENGINEER'S CERTIFICATION ! cert~v that I have determined thrufield inspections and review of Municipal records are in co,;?ormance with 3/10.4 HfiA ~uideline~ in effect on this date. ~o~[ ' ' ~6~ ~ ~ Co ~ ' Eugmeer s Name ~ --. ~W~ ~~'~ . . .............. ,.~x ........................................................................................................ .... HAA Fee $ ~ ~ ~ ~ Waiver Fee $ Date of Payment /[~ ~ ~ ~ Date of Payment Rev. 8/95 OSS: baa.wk,doc 10×27×95 17:14 COMMERCIAL TESTING ~ 9076941211 N0.773 P05 CT&E Environmental Services Inc Sa~pl~ Kem~k~l SPJ4PL~ COLLBCT~D 8~DAVID. ELECT TRIC ~otor 1C~#601~ Hal Kostlln P.O. BOX 771745 * EAGLE RIVER, AK 99577 To: CCC Construction PCB 770647 Eagle River AK 99577 Date: 11-1-95 Ref: On Site Sewer Disposal System Lt. 47C, Sec.9, Township 15N Bowery Rd. Chugiak RECEIVED NOV 9 1995 iv~un,<;,p,~n~ ol Anchorage Oept. Health & Human Services This is to certify that on site sewer lift station at above mentioned property has been wired in accordance with the National Electrical Code and manufactures specification. Systems were checked and performed as specified in the systems manual. Halmar Electric 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. # ~'-'-~ ~\ ~ \~r~) ~\ _ ~._~ NAA# ~'~ ~'"~ ~/'-1 ~ '-'~ c~ 1. GENERAL INFORMATION Complete legal description Lot 47C; S~c. 9, T15N, R1W, S.M. Location (site address or directions) 20833 Bowery Lan~ Property owner Mailing address Lending agency Mailing address H~4b~rt E. Gile~ Day phone 333-5574 Day phone Agent 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: XX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev, 1//)1) Front MOA #21 m, ueuJuJoo leuop,!ppv :suo!~elnd!ls BU!MOlIOJ oq), ql!M 'SLUOOJpeq 'SLUOOJpeq JoJ leAoJdde leUO!~!puoo 'pe^oJddes!a loJ poAoJdd¥ ~ '~I~n,J.VNglS sNNa .g · uo!loedsu! s!ql jo elep eql uo loc,ge u! suo!lelnBe~ pue '8eoueu!pJo 'sepoo elelS pue led!o!UnlAJ lie ql!M eoue!ldUJoo u! s! ~els~s lesods!p ~ele~else~ ~o/pue ~lddns Je~eM e~s-uo eq~ 'uo!~oedsu! pue uo!~eB!~seAU! ~w wo~; pue sel!~ eB~Joqou~ ¢o X~!led!o~un~ ~oJ¢ peu!elqo uo!~emJo~u! owl uo pes~q ~eq~ ~!JeA JeqMnj I 'u!eJeq pe~eo!pul eJn~onJ~s ~o ed~ pug s~ooJpeq jo Jeq~nu eql Joj ej~nbepe pue leUO!lounj 'e~es s! ~e~s~s lesods!p Je~eMelSeM Jo/pu~ 41ddns Je~eM e~!s-uo eql l~ql SMOWS uo!ieOlldde leAoJddv ~llJoq~nv qll~eH s!q~ jo UO!~B!~SeAUl X~ Jeq~ ~¢peA I 'MOleq UMOqS el~p UO!lep!l~A eq~ ~o se pue oledeM pex!t~e leOS X~ ~q peu!~eo sV EI:I:INI~)N:I AG NOIJ.O:adgNI dO .LN:i~:I.LV/$ 'g Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescription: ~;:::~'Y~-~ ; ~_----~7.~__~ ~.~ Parcell. D. A, WELL DATA Well type ,~..~4~, ~ If A, B, or C, attach ADEC letter. AD~C water system number Log present (Y~ ~ Date completed ~ ~[~ Total depth ~ Cased to ~1 ~ Casing height Sanitary seal ~N) ~ , ~ Wires properly protected) FROM WELL LOG AT INSPECTION ; On adjacent lots Public sewer manhole/cleanout Petroleum tank Date of test Static water level Well flow Pump level / SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot ~.~l Absorption field on lot Public sewer main Sewer service line WATER SAMPLE RESULTS:, Coliform O ~/'~c, ~ Nitrate Date of sample: ! (c::::>-~--~l -'-'~ Collected by: O~ther bacteria B. SEPTIC/HOLDING TANK DATA Date installed [ ~'"~"-'~ ~::~ Tank size ! ~ ~"{::) Compartments Cleanouts~.~N) y F oi~ nl~ o n c lea n o u t::~i~N )y Depression (Y~) High water alarm (Y/N) - Alarm tested (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~{~OI On adjacent lots I C:~;~I '~ Foundation ~ To property line /_~2~t ~ Absorption field ~- 1 Water main/service line Surface water/drainage 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION D%nstalled Size i n"gsl~s Vent (Y/N) ~ High water alarm level Manufacturer 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 D. ABSORPTION FIELD DATA Date installed _ Length. ~"'~ ~'~ Width Total absorption area Soil rating Depression over field (Y~ Results (pass/fail) ~ Peroxide treatment (past 12 months) (Y/N) Gravel thickness ~ Cleanouts present, N) Date of adequacy test for ~ ~-~ ~ If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wel~onlot ! (~2::>1 "~' On adjacent lots ~ ~ *~ Propertyline To building foundation .To existing or abandoned system on lot On adjacent lots ~ ~ Cutbank 4t'~ Water main/service line Surface water !&~l'"~l ~{F Driveway, parking/vehicle storage area Curtain drain ~ E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect oQ ~/a,t~ of this inspection. Signature 17034 Eaole .,~er L~....~ ~5. ~ Eagle Ri~;~, Alaska ~ Engineer's Name HAA Fee $ Date of Payment Receipt Number 72-028 (Rev. 3/31) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number o ,00 Tom Fink, Mayor unicipality of Anchorage Department of Health and Human Services 825 "L" Street P.O, Box 196650 Anchorage, Alaska 99519-6650 January 3, 1992 343-4744 Roger A. Shafer, P.E. S & S Engineering 17034 Eagle River Loop Road, Eagle River, Alaska 99577 Suite 204 Subject: Waiver Request for T15N R1W Section 9 Lot 47C Waiver Request #WR910056, PID~ 051-104-53 Dear Mr. Shafer: Your request for waiver of the required 100 foot horizontal separation of a septic system to a private well has been approved. The approved separation distance is 96 feet. This waiver approval applies 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. Roth Civil Engineer On-site Services Concur: On-site Services ljm:~6 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYST~EM DESIGN ROBERT SHAFER, P.E. ROGER SHAFER, P.E. December 2, 1991 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 Mu~icipatity of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519~6650 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL ,SERVICES DIVISION DEC O~ 1991 RECEIVED REFERENCE: Lot 47C; Sec. 9, T15N, RIW, S.M. Request you issue the attached Health Certificate and gra~ a waiver for the horizontal separation distance between the septic tank and private well serving the referenced property at 96 ft. The approximate date of installation of the well is ~965, however, no well log h~s been located. The septic tank was inst~ed in October, 1979 as part of an upgrade under permit #790460. A note on the permit had approved the inst~lation of the septic tan~ at a less than 100 ft. separation. The tank i~tallation was inspected by the Municipal Department of Health with the lesser separation distance of 96 ft. noted and approved. Circumstances which justify re-issuance of the waiver are as follows: No well log for the referenced well exists, however, a nearby we~l log shows a thick clayey soil layer between 14 ft. and 38 ft. from the ground surface. This confihin~ layer would detour the migration of septic tank effluent into the drinking water aqaifer. A flow test on the referenced w~ shows a static water level of 12 ft. with a drawndown of 30 ft. This shallow static level is further evidence of an aquifer confi~ing clay layer as stated in item #I. The topography of the ~ea shows the ground sloping away from the wetl toward the north. It is typic~ly safe to assume the underlying soil strata may slope in the same direction which would direct septic tank effluent away from the well. Water samples taken from the wall were satisfactory with a ~trate level undetectable. This is after 12 years of use on the septic tank and 15 years of use on the leachfield. 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 Page Two Lot 47C; Sec. 9; T15N, RIW, S.M. Dec~ber 2, 1991 If you have any questions please contact us. or require additional information for your review, Sincerely, ROGER J. SHAFER, P.E. RJS/gm ASSUILT-NO CORNERS SET THIS DATE. SEWARD & ASSOCIATES LAND SURVEYING 688-4566 SCALE' I HERESY CERTIFY .THAT I HAVE SURVEYED THE0 FOLLOWING DESCRIBED PRO'PERTY: 1"=3 ' Lot 47C,Sec. 9,T15N,R1W.S.M. ,~. DATE, AND ~AT NO EN~OACHMENTS ~IST ~CE~ AS 10-6-91 INDICA~D. IT IS THE RES~NSIBILITY OF THE ,,, OWN~ ~ D~ER.INE THE EX STENCE OF ANY GRID, E~EMENTS, COVENANTS, OR RESTRICTIONS WHICH DO NOT ~PEAR ON THE RE~D~ ~BDI- VISION PLAT. UNDER NO CIRCUMSTANCES S~ FB~ ~Y DATA H~EON SE USED FOR CONSTRUCTION 24-39 OF FENCE LINES, OR FOR EST~LISHING ~ND- DRAWN, ARY LINES. DMS . 11054 £~1e I~er Loop FIo~I ~flOJtOf~ ' . ~ ~At~ I ,flOBtflTA.$HAF~fl C,I~L~flGIH£~fl OLOOK EIJ~$llO TIIdlE 8IHCE D£PTItIO D~WDOWHI PUMPING PUMPING STARTED/ TIME 8TOP~[~ ~IN. WAIE~. fltOOVt~Y ~:~ ,,~0,, ~' ~' ~,o ,, " '... ,,,' ~: ......., &~' ,,,~' ....... I ~0 {~ ~ours) ..... 'ito RE~OYtRY ... I 0 0 t~. . ........ ..... · ~ ,,. ,, , 8~ .... Subsequent Variations Can Oc~r. FA?ER WELL gECORO DEPARTMENT or NATURAL RESOURES Drv~ttofl oJGeolo~*col ~ GeophysicelSuevo~ Hr, H;irry ~hlte SR I Bux 2672 ChuRlak, Ak, gqSb7 Of'"" , O"'"' Oo'~'t' ~[,, o.,,, ..,,,, ~ 7 ,h,./,, a,oeled: [']Vee r'lNe ) HP Il. sled at 15 GPP{ :,.: ,,_-'_. ~.L___~.t 17~, IVfl2 .......... WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geological ~ Geophysical SurveTs I~J, aarough,, ~' Subdivision Lot Block ~ I/4c11,'$, Section No. Township N~ Ran{Ia E[~ Meridian ..... ~, 48 --of--of--of-- 9 15 S~ 1 ~ Seward ROAO INTERSECTIONS 3. OWNER OF WELL: DISTANCE AND O~RECTION FROM ~ Te~t Well ~ Other; 8. CAStNG: ~ Threa~ed ,j~ Welded bc~ ~ i i982 '" '""'" '" """ ". ~t*~::?~;e~ pred_:~tion of 2 15. W~ter Temperature o ~ P ~ C f DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME INSPECTOR INSPECTOR INSPECT~:I MUNICIPALITY OF ANCHORAGE ·  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~iINICIPALITY OF ANCHORAGE 825 L Street- Anchorage, Alaska 99501 DEPT. OF [' M',! & ENVIRONMEN I>'. ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWE~I~,IE~I~I~Ii~~D DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing. PROPERTY RESIDENT (if different from above) PHONE 2. BUYER ~/~ PHONE MAILING ADDRESS 3, LENDING INSTITUTION MAILING ADDRESS MAILING ADDRESS 5. LEGAL DESCRIPTION 6, TYPE OF RESIDENCE ! NUMBER OF~BEDROOMS ~ SINGLE FAMILY ~ '~[] FiveF°Ur [] [] MULTIPLE FAMILY ~ Three [] Six Other 7. WATER SUPPLY  I NDIVIDUAL' COMMUNITY [] PUBLIC UTI LITY 8. SEWAGE DISPOSAL SYSTEM INDIVIDUAL/ON-SITE** [] PUBLIC UTILITY ATTACH WELL LOG. A wel log is required for all wells drilled since June 197,5. For wells drilled prior to that date, give well depth (attach log if available.) ~YEAR ON-SITE SYSTEM WAS INSTALLED, NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, 82.~ L SFRE~I' ANCHONA(H-~, Al ASI<A 99501 (90'1) 264 4111 Pebruary 25, ]981 Bill I,ong Lomas a:nd Nettleton 4449 Business Park Boulevard Anchorage, Alaska 99503 Subject: 9PISN RIW Section 9 Lot 47C NW¼ Approval for the individual sewer and water facilities eannoL be granted until the following items h.~vc~ :, been c om p ]. e t e d: (2) 3) The water analysis report:, needs to be delivered this oEfiee from the Chem Lab, 5633 B Street, for otlr roview~ The septic tank pumped with a receipt submitted ho this offfioe. An adequacy test needs to be performed on the exi. sting leaching area. This test will determine if the system is adequate according 'to National Standards. A listing of private fi. tins performing the test is enclosed. This report_ needs to be submitted to this office for our review. If there are any fuFther questions, please call this office! at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw DAVID A. SLENKAMP ROBERT A. SHAFER MECHANICAL ENGINEER 694-9055 March 10,, 1981 CIVIL ENGINEER 694-2979 Bill Long o/o Lomas and Nettleton 4449 Business Park Boulevard Ahchorage, Alaska 99503 Dear Mr. Long, Reference: Lot 47C; Section 9; T15N; RiW A sewer system adequscey test was performed on the system located on the referenced property st your request. The septic tank was verified to hsve a capacity of 1250 g~llons as documented in the Municipality recoCds. The absorption trench was tested by e continuous flow of approximately 700 gallons of water over a.period of 2% hours. It can be concluded from this test that the sewer system (septic t~m~and absorption trench) is currently functioning sdequstely for the four bedroom residence located on this property. If we nmy be of further service, please do not hesitate to call. or Municipality of Anchorage Department of Health and EnviornmentR1 Pr~ection SRB 196X EAGLE RIVER, ALASKA ,.iUNICIPALITY OF ANCHORAGE , //~ Department of Health and Environmental ProLect"io= Ff~ 825 L Street, Anchorage, Alaska 99501  264-4720 ~ ,~[equest for Approval of Individual Sewer and Water FaCilities Property Owner: .~ 2 o Mailing Address: Name of Buyer: ~ Mailing Address: Phone: Phone: Lending Institution: ~~ Mailing Address:~ 1~~Phone: Mailing Address: Legal Description: Street Location: Single Family Residence: ( ) Number of Bedrooms: Multiple Family Residence: (~ Number of Bedrooms:4 Water Supply: *Individual Well X Public/Community System ( ) If Individual Well, well depth ~ If Community System, name of system o Sewage Disposal System: On-site System If On-site System, date of installation: Public System ( ) *NOTE: A well log is required on ALL wells drilled since 6/75. 3/77 Paqe. Two Department of Health and Environmental Protection Request for Approval of Individual Sewer and Water Facilities Legal Description: T15N R1W Section 9 Lot 47C Comments: Affadavit Attached: ( ) Letter Attached: ( ) Approved: Q~ Disapproved: Date: Department Worksheet: GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 1. Approval requested by: Mailing Address: 2. Property Owner: Mailing Address: 3. Legal Description: 4. Location: Date Received Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR VA Selective Realty Salome Atkins Box 512 [hugiakAK Lot 47C T1SN~ RlW~ Sec 9 Birdxwood Feb. 24, 1975 Feb 24 1975 Phone: Phone: 5. Type of facility to be inspected 6. Well Data: A. Type Drilled A. Installed C. Septic Tank: D. Seepage Pit: E. Disposal Distances: A. Well to: Duplex No. of bedrooms 6 C. Construction Standard Sewage Disposal System: 1965 1. Size 1. Absorption Area Field: Total length of lines B. Depth 65' Septic tank Nearest lot line B. Foundation to septic tank D. Bacterial Analysis~ Satis£actory B. Installer 2000 sal 2. Manufacturer 2. Material , Absorption area , Other contamination ., Absorption area C. Absorption area to nearest lot line , Sewer Lines , EQ-034 (1/74) Page 1 of two pages Legal Description Lot 47C, TLS;,,~ R]Ix', ,Sec Comments Date 2/24/75 Quality DIAGRAM OF SYSTEM certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and wa~er facilities and these facilities are operating satisfactorily. SIGNED Date EQ-O34 (1/7~) } DEPARTMEN1 825 t~1: Time 10:30 a.m. Date 10-17-77 Monday Insp willis "UNICIPALITY OF ANCHORAGE F HEALTH AND ENVIRONMENTAL L Street, Anchorage. Alaska 264-4720 'ROTECTION 99501 Date Received: October 13, 1977 ~2: Time ~3: Date Insp Time Date Insp REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES Lending Institution Request: Lomas and Nettleton Company Mailing Address: 4449 Business Park Boulevard Phone: Property Owner: Raymond D. Monroe Mailing Address: Phone: 688-3238 3. Legal Description: T15N R1W Section 9 Lot 47C Single Family Residence: ( ) Number of Bedrooms: Multiple Family Residence: (~ Number of Bedrooms: Four Well System: Permit ~ Construction Individual well ( ~ Community/Public System ( ) Depth of Well Well Log on File Bacterial Analysis ( ) Sewage Disposal System: Permit ~ Septic Tank Size Absorption Area On-site System k~ Public utility Installed 1976 Installer 2,000 gallons Manufacturer 1,400 sq.' ~oils Rate Material ( ) Distances. Well to Septic Tank to Absorption Area to Sewer Line Nearest Lot line Absorption Area to Nearest Lot Line THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [] SINGLE FAMILY [] ONE [] THREE [] FiVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY [] INDIVIDUAL )EPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER []PUBLIC UTILITY Connection Verified INSTALLER [] Septic Ta~__l.~o r [] Holding Tank Size: I~,~ If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS [~APP~OVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (better must accompany certificate) [] DI~PPROVED 72-010 (Rev, 6/79)