HomeMy WebLinkAboutTHUNDERBIRD HEIGHTS #3A BLK 6 LT 2Thund
rbird
Heights
lock 6
Lot 2
051 - 582
-47
Municipality of Anchorage
Development Services Department i~ltf~ [.l12d~
Building Safety Division
On-Site Water and Wastewater Program, 4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99507 Page of
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL iNSPECTION REPORT
Permit Number: 0sP101104 PID Number: 051-582-47
Name:
Barry and Terri Schimmack Wastewater System: [] New [] Upgrade
Address:
24888 Teal Loop Chugiak, AK 99567 ABSORPTION FIELD
Phone: Number of Bedrooms:
4 [] DeepTrench ~ Shallow Trench [] Bed [] Mound [] Other:
LEGAL DESCRIPTION Sci, Rating: Total Depth from odginal grade:
1.2 GPD/Ft2 4 Ft.
Block: 6 Lot: 2 Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe:
Thunderbird Hts. No. 3A 1 Ft. 3 Ft.
Township: Range: Section: Fill added above original grade: Gravel Length:
2.7 Ft. 65 Ft.
Well: [] New [] Upgrade Gravelwidth: 5 Ft. Numberofiines:l Distance between lines:_ Ft.
Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material:
AVVVVU Ft. Ft. 560 Ft2 ASTM D3034 PVC
Ddller: Date Drilled: Static Water Level: installer: Date Installed:
Ft, Royce Martin 10/13-15/2010
Yield: GPM PumpSetat: Ft. CasingHeightAboveGround:
Ft. TAN K
SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other:
T~To Septic Absorption Lift Holding ~ublic/Private Manufacturer: Capacity:
From~
Tank Field Station Tank Sewer Line Anchorage Tank 1,250 Gal.
Material: Number of Compartments:
Well N/A N/A N/A N/A >25' Steel Two (2)
k ·
surface water >100' >100' N/A N/A ~ ~ LIFT STATION
Size: Manufacturer:
Lot Line >5' 1 .... N/A N/A Gal.
"Pump on" level at: "Pump off" level at: in. High water alarm at:
Foundation >5' > 10' N/A N/A in. in.
Curtain Drain None Noted Pump Make & Model Electrical Inspections performed by:
Remarks:
· **See Lot Line Waiver. BENCH MARK
Location and Description:
Exterior Deck.
Assumed Elevation:
100.0 Et,
Inspections performed by: A. Harala Dates: 1't 10/13-14/10
2nd
10/15/2010
Development Services Department Approval
Conditional Approval Date:
Reviewed and approved by: ~:~.~ 9 fi:;~,'///~/, ate: .;,~. ' /
Permit Number: OSP101104
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904
THUNDERBIRD HEIGHTS SUBDIVISION NO. 5A
LOT 2, BLOCK 6
22,369 S.F.
Page 2 of 3
PID No.: 051-582-47
S2 48.4123.1
S1 18.8121.5
C5 57.9148'9
M1 80.0 63.0
M2 65.7 52.9
Existing 24' x 40'
Absorption .Bed.
Existing Tank Decommissioned
In Accordance With Municipol Code.
M2
e(~room
~ome
LEGEND
Sl - Septic Vent
C4 - Cleon Out
M1 - Monitor Tube
FCO - Foundotion Cleon Out
FDV - Flow Diverter Velve
[] - Existing
[] - Proposed
NOTE:
Subdivision Served by Community
W(~ter System. No Conflicts with
Adjacent Septic Systems.
PLAN
AS
SCALE 1" = 40'
BUILT
NOTE: Drawing Not Completed from
Surveyor As Built. Locot~ons Mey Not Be Ex(~ct.
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 EImore Road Anchorage, AK. 99519-6655 - 343-7904
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number: OSP101104
Page 3 of 3
PID No. 051-582-47
94.8
Final ~de
92.1
ound
Original 2' s t n
...................... nuao
Geotext e FabTic
Geotextile Fabric _ _
~~ 91.2
91.2- --~ Drainfield Rock
88.1--/
88.1
~ 82.1
I 65' (Trench Length) I
PROFILE AS-BUILT
No Scale
On-Site Wastewater Disposal System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 EImore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP101104
Tax Code Number: 05158247000
Work Type: Septic Upgrade
Permit Effective Dates: July 09, 2010 to July 09, 2011
Design Engineer: ANDERSON ENGINEERING
Subdivision: THUNDERBIRD HEIGHTS #3A
Site Legal Address: THUNDERBIRD HEIGHTS #3A BLK
Owner/Address: SCHIMMACK BARRY & TERRI A
24888 TEAL LOOP CHUGIAK AK 995675114
6 LT 2 G:1865
/.2.:
Site Mailing Address: 24888 TEAL LOOP, Chugiak
Lot Size in Sq Ft: 22369
Total Bedrooms: 4
This permit is for the construction of:
Y Disposal Field Y SepticTank 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 Murticipal 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.
Special Provisions: Permit includes waiver OSP101105 allowing the drainfield to be 1 foot from the
property line.
Munica of Anchorage
ip lity
P.O. Box 196650 · 4700 Elmore Road
Anchorage, Alaska 99519-6650 · (907) 343-7904 · Fax (907) 343-7997
http:llwww.muni.orglOnsite
Development Services Department
On-Site Water and Waste~vater Program
**** VARIANCE/WAIVER REVIEW ****
WR#: OSP101105 HA#: Permit: OSP101104
PID#: 051-582-47
Legal Description: Thunderbird Heights #3A, Block 6, Lot 2
Engineer: Anderson En,qineerin,q
Applicant: Barry Schimmack
.Your request for a waiver of the required 10 feet horizontal separation from the absorption field
to the property line has been approved. The approved separation distance is 1.0 foot.
This waiver approval applies to the existing absorption field to property line separation only.
Any future upgrade to the on-site wastewater disposal system will require all separation
distances be met or another approval from this department.
Waiver is Granted: X Waiver is not Granted:
Date: ..... 9/29/2010 Approved b~~~~
~,,fN~me of Reviewer '
Rec~: 04596C Amount: $200.00 Date Paid: 6/30/2010
**** VARIANCE/VVAIVER REVIEW ****
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
Permit Number: OSP101104
Tax Code Number: 05158247000
Work Type: Septic
Permit Effective Dates: July 09, 2010
Design Engineer: STEVE ENG
Subdivision: THUNDERBIRD HEIGHTS #3A
Upgrade
to July 09, 2011
Site Legal Address: THUNDERBIRD HEIGHTS #3A BLK 6 LT 2 G:1865
Owner/Address: SCHIMMACK BARRY & TERRI A
24888 TEAL LOOP CHUGIAK AK 995675114
Site Mailing Address: 24888 TEAL LOOP, Chugiak
Lot Size in Sq Ft: 22369
Total Bedrooms: 4
This permit is for the construction of:
Y Disposal Field Y SepticTank 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.
Special Provisions: Permit includes waiver OSP101105 allowing the drainfield to be 1 foot from
the property line.
Issued By: ...~53 ~.///~o¢ ~ [/~/~¢-'¢~
Date:
Date:
Municipality of Anchorage
P.O. Box 196650 ® 4700 Elmore Road
Anchorage, Alaska 99519-6650 · (907)' 343-7904 · Fax (907) 343-7997
.h.ttp:!lwww.m u ni.or.qlOnsite
Develor~ment Services Department
On-Site Water and Wastewater Program
**** VARIANCEFWAIVER REVIEW ****
WF~: OSP101105 HA#: Permit~: OSP101104
PID~: 051-582-47
Legal Description: Thunderbird. Heights #3A, Block 6, Lot 2
Engineer: North Rim En,qineedn,q
Applicant: Barry Schick
Your request for a waiver of the required 10 feet hOrizontal separation from the absorption field
to the property line has been approved. The approved separation distance is 1.0 foot.
This waiver approval applies to the existing absorption field to property line separation only.
Any future upgrade to the on-site wastewater disposal system will require all separation
distances be met or another approval 'from this.department.
Waiver is Granted: X Waiver is not GranteAJ: .~
Da : 7/9/2010 ApProved [ /Yl~ameof'Revi~wer v
Recg: 04596C Amount: $200.00 Date Paid: 6/3012010
**** VARIA~NC,E~AIVER ,REVIEW ****
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, Alaska 99507
www. muni.org/onsite
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
'F~,'~'o-v~c~: O-CPl¢l( ~.~,~ FOR A SINGLE FAMILY DWELLING
Parcel I.D. 4~'/- '~c'(JC'Z'~'/' "~--<3oo
Property owner(s)/~ ~'¢'r~'
Mailing address~/--/' 0
Day phone
Zip Code
Site address '~r.+~ ~_ Zip Code
Legal description (Sub'd., Block & Lot)
Legal description (Township, Range & Section)
Lot Size 2 2/ ..~ ~"7 Sq. Ft.
Number of Bedrooms
THIS
APPLICATION IS FOR ([~ all that apply):
Absorption Field
Septic Tank
Holding Tank
Privy
Private Well
Water Storage
THIS APPLICATION IS AN:
Initial []
Upgrade ~'-
Renewal []
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: ,,~-- 3 ~ Waiver Fees:
Date of Payment: ~ - ~ C'~ - //~; Date of Payment:
Receipt Number: ~ ~ ~ ~ ~ Receipt Number:
(Rev. 11/05)
ANDERSON ENGINEERING
P.O* BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
September 25, 2010
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
4700 Elmore Road
Anchorage, AK 99519-6650
Subject:
Lot 2, Block 6, Thunderbird Hts. Subdivision, Addn. 3A
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The existing absorption system on the subject lot has failed and must be upgraded to
prevent a health hazard. We are therefore requesting a permit be issued for the
upgrade of the septic system to accommodate the four-bedroom home on the lot. The
attached Site Plan and backup documentation identify the location and configuration of
the existing and proposed septic system. The existing 1,250 Gallon septic tank will be
pumped, crushed and backfilled on site. The existing absorption bed system will be
tied in to the new system with a flow diverter valve. The new septic tank and absorption
trenches will be placed as shown. Also identified on the plans are the locations of the
existing water service on this lot and adjacent septic systems. No conflicts exist
between the proposed septic system and the water service on this or adjacent lots. The
subdivision is served by a community water system. Drainage arrows are shown
indicating the current drainage patterns. The drainage patterns will be maintained after
construction.
The test holes recently placed on the lot indicated sand with some silt (SW). The
percolation rate was determined to be 1 to 5 minutes per inch. We have designed the
system to an application rate of 1.2 gallons per day per square foot. We are proposing
to place a 1,250 gallon septic tank and 2 - 30' long trench by 5' wide trenches with a 3'
effective depth. The total depth of the system will be 4'. A flow splitter valve will be
placed to assure even flow to each trench. A flow diverter valve will also be placed to
tie in the old absorption bed.
The ground surface on the lot slopes to the northwest in the area of the absorption
trench at a slight grade. The trench will be placed parallel to the contours of the ground
Lot 2, Block 6, Thunderbird Hts. No. 3A
September 25, 2010
Page Two
as much as possible and in conformance with design criteria. A minimum of 100' will
be maintained between all components of the septic system and any surface water in
the area.
If the system is constructed in accordance with our design the following statements
apply:
The system, if constructed as designed, will have no adverse impact on the wells
in the area or those to be constructed in the future.
The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
The system, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
Michael E. Anderson, P.E.
Attachments
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (F~)
September 29, 2010
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject:
Lot 2, Block 6, Thunderbird Heights Subdivision No. 3A
Separation Distance Waiver
Absorption Trench to Lot Line
Dear On Site Services Engineer:
Lot 2, Block 6, Thunderbird Heights Subdivision No. 3A is a small lot with only 22,369
square feet of surface area. The existing septic system has failed and must be
replaced with a new four bedroom system. A test hole recently placed at the southeast
corner indicates sandy soils which will support a new absorption system. This area,
however, encroaches into the 10' setback from the property line on the east side.
Placement of the absorption trench within 1' of the eastern lot line will not adversely
affect neighboring lots. The subdivision is served by a public water system and all
service lines are more than 10' from the septic system as designed. We hereby
recommend a lot line waiver be issued allowing placement of the absorption system
within 1' of the eastern lot line.
Sincerely,
Michael E. Anderson, P.E.
~ 12
NOTE: No Conflicts with Wells or Septic Systems in the Area.
Surrounding Lots Served by Public Water System.
No Slopes Greater than 25% Within 50' of the New Absorption Trenches.
~..~~:~ A R E A M AP
ee_~x_;.~_~_~.~..~,~ ~ ~--SCALE = 100'
THUNDERBIRD
LOT
HEIGHTS
2, BLOCK
22,569 S.F.
SUBDIVISION'
6
NO. 3A
/
/
/
/
/
/
Existing 24' x 40'
Absorption Bed.
Dispose of Existing Ta?k
In Accordance With
Municipal Code.
Place New 1,250 Gallon
Septic Tank, Two Post
Tank Cleanouts, Flow
Diverter Valve, Flow
Splitter Valve and Two
,30' Long x 5' Wide x
Effective Depth Absorption
Trenches.
-1'
ec~roorn
Borne
LEGEND
SV - Septic Vent
CO Clean Out
MT - Monitor Tube
FCO - Foundation Cleon Out
FDV - Flow Diverter Valve
FSV - Flow Splitter Valve
[] - Existing
[] - Proposed
o*; ~. ......... ~,
~,,~xY..: ...... ~%, NOTE: NOTE:
~ ~2 q ~ ~ ~ ~ to be Located by Registered Land
~'~,,~;~:.'.;--~,,,~,,,,~..~ Suweyor Prior to Construction.
~2(nX No CE-4381 Z ~
SI TE PLAN
'~~ SCALE 1" = 40'
Subdivision Served by Community
Water System. No Conflicts with
Adjacent Septic Systems.
LOT 2, BLOCK 6, THUNDERBIRD
HEIGHTS SUBDIVISION, ADDN. 3A
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Four Bedroom Home 5' Wide Trench System
Perc. Rate: 1-5 Min./Inch 1,250 Gallon Septic Tank
Application Rate: 1.2 GPD/SF 3' Drainfield Rock
4 Bedrooms X 150 GPD/1.2 GPD/SF (Application Rate) = 500 SF Absorption Area
500 SF/5 SF/LF*.58 (Red. Factor) = 58 LF Trench Length
THEREFORE: Construct 2-30' Long x 5' Wide x 3' Effective Depth Absorption Trenches at the
Location Shown. Flow Line Elevation in Trench to be 1'0" Below Original Ground Surface. Total Depth
to be 4' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption
Trench. Place a Flow Diverter Valve to Tie in Existing Trench and a Flow Splitter Valve to Insure
Even Flow to Each New Trench.
~ N'~tural~'~'"~
Backfill ~
6" Geotextile
~-- Fabric
6" ~('~ 4" Perforated
PVC (Holes Down)
Drainfield Rock
TYPICAL 5' WIDE TRENCH SECTION - - --(~-b--~c~ ....
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation FromSeparati°n From Bedrock._~'~""'/"'"'~' ~~.. ~ ................... , .....
Minimum 4' Groundwater.
Minimum 100' Separation From Wells in the Area.
Minimum 100' Separation From Su¢ace Water or Streams. .
&700
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT
ELMORE ROAD ANCHORAGE, AK c)c)51c9-6650
SOILS LOG - PERCOLATION TEST
LOT 2, BLOCK 6, THUNDERBIRD HTS. 3A
BARRY SCHIHMACK
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE: 9/23/10
PARCEL ID#:
TEMP: 55°
DEPTH
(feet)
1 0B/OG
2
3
4
5
SW
6
7
8
9
PROJECT No.:
05 I-582-47 TECHNICIAN:
TEST HOLE A
LOOSE, WELL GRADED, DRY
SAND, BLACK
SUART GILBERT
SLOPE
SITE PLAN
SEE SITE PLAN
20
BEDROCK
WAS GROUND WATER ENCOUNTERED? No
IF YES ~ WHAT DEPTH? ! ]
DEPTH OF WATER AFTER MONITORING: NON~
DATE OF MONITORING: 9/30/I0
DEPTH OF
DATE READING GROSS TIME NET TIME WATER NET DROP
(MINUTES) (MINUTES) (INCHES) (INCHES)
9/23/10 TEST HOLE PRESOAKED PRIOR TO TESTING:
1 4:08/4:18 l0 10.75/1.75 9.00
2 1140/1150 10 10.50/1.63 8.87
3 1150/1200 10 10.75/1.75 9.00
4 1200/1210 10 10.63/1.63 9.00
5 1210/1220 10 ,10.50/1.50 9.00
6 1220/1230 10 10.75/1.75 9.00
PERCOLATION RATE: I. I ,(MIN/INCH) PERC. HOLE DIA. 6 (iNCHES)
TEST RUN BETWEEN: 3 FT. and h ,FT.
COMMENTS: TEST CAVITY PRE SOAKED PRIOR TO PERCOLATION TEST.
TEST PERFORMED BY ANDERSON ENGINEERING. I, MICHAEL E. ANDERSON CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS
DATE:
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 2, BLOCK 6, THUNDERBIRD HEIGHTS SUBDIVISION, ADDN. 3A
GENERAL:
The scope of this project includes the pumping, crushing and backfilling of
the existing septic tank currently on site. Work also includes the furnishing
and placement of a new 1,250 gallon steel septic tank and the construction of
2 new 30' long X 5' wide X 3' effective depth absorption trenches at the
location also shown on the Site Plan. The distribution line in the trenches will
be placed at 1' below the existing ground surface. Total depth of the
trenches will be 4' below the existing ground surface. The new absorption
trenches must be placed a minimum of 100' from any surface water in the
area and 10' from the water service line on this and adjacent lots. A
minimum of 3' of cover is required over the absorption trench and 4' over the
septic tank. A flow diverter valve must be placed to tie in the existing
absorption bed for future use. A flow splitter valve must be placed to insure
even flow to each new trench.
Construction shall be in accordance with the approved site plan, 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 all underground utility
locates and for the layout of the septic system and verification of the location
of all lot lines. The Contractor must also verify the location of wells in the
area and assure that the separation distances are met.
Unless specifically agreed otherwise, the contractor shall be responsible for
final grading areas subsequently depressed from soil settling. Property
owner shall be responsible for revegetation of affected areas unless
specifically agreed otherwise.
Contractors installing wastewater disposal systems must be certified by the
Municipal Development Services Department Building Safety Division On Site
Water and Wastewater Program for system installations. Owners installing
their own systems must receive prior approval from the On Site Water and
Wastewater Program before beginning system installation.
SEPTIC TANK INSTALLATION
1. A new 1,250-gallon septic tank must be procured from an approved source
and installed at the location shown.
Lot 2, Block 6, Thunderbird Heights No. 3A
September 25, 2010
Page 2 of 3
2. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
3. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
4. All standpipes on the septic tank shall extend a minimum of 12 inches above
final grade.
5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial
insulation.
6. A foundation cleanout shall be installed one to four feet from the building
foundation. Two cleanouts are required between the tank and the drainfield.
7. Final grading over the tank shall be such that a positive slope exists away
from the septic tank.
DRAINFIELD CONSTRUCTION:
1. The drainfield shall be constructed to the dimensions shown on the design.
The bottom of the trench shall be within 2" of level.
Distribution piping must be placed level with perforations down atop a level
bed of drainfield rock. Rock should then be placed over the pipe to provide a
minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the drainfield rock
and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations shown on
the design. The portion below the distribution line must be perforated.
Contractor shall verify the septic tank and drainfield are a minimum 100' away
from any private water wells in the area, 150' from a Class "C" Well or 200'
from any community well.
Direct bury insulation must be placed over the distribution system if less than
3' of backfill depth is available. Finish grade over the trench must be
mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trench to drain away.
A minimum 2' of accepting soil is required below the drainfield rock for a 5'
wide trench. Contractor shall verify this condition prior to placement of the
rock. All pockets of unacceptable materials must be removed and replaced.
Lot 2, Block 6, Thunderbird Heights No. 3A
September 25, 2010
Page 3 of 3
MATERIAL SPECIFICATIONS:
1. Septic tanks must be constructed by a municipally approved septic tank
manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and
solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662
or A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow
Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Fernco, or equal).
5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed
between the final drain rock layer and the native soil layer.
6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the
#200 sieve.
INSPECTIONS:
Municipal Ordinance requires a minimum of two inspections. These inspections
must be conducted under the supervision of a professional engineer registered
in the State of Alaska. The first inspection must be conducted after the
excavation of trenches, beds or pits and before the installation of any gravel. A
septic tank may be set in place, but may not be backfilled.
The second inspection must be conducted after the placement of the geotextile
fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No
backfill should be in place at the time of inspection.
Contractor shall provide a copy of all field survey layout and construction notes
for use in preparing the certified as-built of the completed system.
M '!
EERING
MEMO
Steve Eng, PE, PH
P.O. Box 770724, Eagle River AK 99577
(907) 694-7028 tel
northrimeng@aol.com
Date: 6/29/10
Number of Pages:
To: MOA On-Site Services
Subject: Thunderbird Hts #3A, Block 6, Lot 2
The subject property septic tank has failed. We are replacing the entire septic system with a new
1250 gallon septic tank, followed by a parallel absorption trench. Excellent soil was evident in
the test hole.
Public water serves the area lots and are shown in drawings. The owner wishes to obtain the
permit as soon as possible, since the tank has failed. We are requesting a 1' lot line waiver due to
the tight configuration. The old leach field will be connected via a valve.
Please review the wastewater system design for the single family home. I have included design
plans & specs, design guidelines, & soil tests. If them is need for additional information or
clarification please give me a call.
Thanks-Steve
THRIM
Thunderbird Hts #3A, Block 6, Lot 2
SPECIFICATIONS & DESIGN GUIDELINES
Wastewater System Sizing: This is an existing 4-bedroom, single family home. The septic tank
has failed. Upon inspection it was found that the absorption trench was flooded. A new design is
submitted for a new trench & new septic tank. The neighboring lots are developed as indicated in
the drawing. New soil tests were conducted. A 4' deep trench will be excavated with new septic
tank. The old tank will be removed or properly abandoned in place. No water wells are in the
area. Public water serves all the neighboring lots. No adverse impacts are expected from septic
system replacement. No conflicts to the other lots will take place by this septic system
construction. The easements are located on the drawing and are not encroached upon. The soil
tests revealed a clean sand soil. A conventional septic system will be used, application rate of 1.2
GPD/FT2. Trench Length = 500 FT2/5'x 0.58 reduction factor = 58'; 2 lines ~ 29', 3' effective
depth. Old leach field will be connected via "Bull Run Valve". Due to the lack of room, a lot line
waiver is requested to 1'.
Specification Requirements: All components and work must comply with the Municipality
of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and
Wastewater Regulations.
· Two compartment, 1250 gallon septic tank. Watertight couplings on inlet & outlet.
· 5' minimum between the tank and bed. 10' to property lines.
· 3' of cover or insulation is required for trench; 1" insulation may be substituted for one foot
soil cover.
· Tank & solid pipe must be set on well compacted, stable soil.
· 4 inch diameter cleanouts with airtight caps are required 1' to 4' from foundation wall,
prior to any 90 degree bend in 4 inch line, in each tank compartment, and two adjacent
opposing cleanouts between the tank and the absorption field, not more than 10' from the
tank positioned to provide cleanout access towards the tank and towards the absorption field.
· All cleanouts must extend to at least ground level.
· In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron.
· Trench to be placed level, minimum of 4' to groundwater, 6' to bedrock from drain-rock.
· Drain rock to be ½ inch to 2 ½ inch screened. Drain rock to be distributed uniformly
throughout the trench.
· Perforated pipe to be installed level with perforations down.
· Silt barrier (filter fabric) to be installed above the drain rock.
· Smeared trench sides must be raked or scarified before drain rock placement.
· Backfill over drain rock must not be less than 36", 24" with 1" insulation.
· The finish grade must be mounded to promote drainage over the trench.
· Insulation must be placed over any pipe installed under driveways or parking areas.
· Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS
ASTM D2661,
· Sewer Service Line is minimum 2% slope.
· Septic Tank to be pumped every two years or when required.
· Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI or equal)
· Old Septic Tank to be removed or pumped, filled with sand/gravel, crushed, & buried.
DESIGN NOTES:
1. Total Depth of Trench is 4'.
Septic Site is Close To Level Slope.
2. Sewer Service Line minimum 2% slope.
5. Abandon/Decommission Old Septic Tank
4. Lots Serve,
tOld Leachfit
Line To Old Le,
11Connect To Piping
Public Water System.
TH
\
Gallon
Tank
Decommission
Old Tank
--Bull Run Valve
To Old Field
CB/MT
THUNDERBIRD HTS #3A
3LDCK 6 LBT 2
NEW TRENCH/TANK
SEPTIC SYSTEM
1' = 40'
WASTEWATER ~
LAYBUT i
7/9/10 ¢ 3 ~
Septic System ~ons~ruc~io~
. Does No~ Prec--~de A(
'"'l,_o~s From Sai,,rf'~a~ion
:~p\rovemen~s,
SEPTIC
SYSTEM
\
\
\
\
\
\
J
Bm[
STATI[]
=20
28.24
/
/
/
/
/
/
2
SEPTIC
SYSTEM
PRF1PDSE]
SEPTIC
NEW
,'SEPTIC
SYSTEM
SEPTIC
SYSTEM
THUNDERBIRD HTS
BLE]CK 6, LBT P
SUBDIVISIE]N LAYE]UT
AREA PLAN
50'
ISHEET:
6/29/io ~
Dote:
C
0
>
0
0 U'
'q- 0
0
0
0
_C
U
C
(~
(4-
0
C
W
0
_Q
0
0
W
THRIM
Performed For
1
3
4
5
6 -
7 -
8 -
9 -
10 -
11 -
1P -
13 -
14 -
15 -
16 -
17 -
18 -
19 -
20 -
21 -
Legal Description:
Flrgcnic
SW
w/GraveL
DEPTH
(FEET)
~////////~
,. .~ :...;. ~ :' ~
Comments: Presoaked
SOILS
LOG - PERCOLATION TEST
Date Performed: 5/19/10
3arry Schimmack
Thunderbird Hfs
~3A, BLock 6, Lot 8
T,H, Locction: See Attcched Design
~5% SLope
Groundwater? No
Depth
Water Depth
AFter Monitorinq, None Date: 5/88/10
$~ Dote Gross Time Net Time Depth Net Drop
1 5/19 0 --
8 5/19 10 10 mir, 16' 5'
3 5/19 18 11' --
4 5/19 22 10 mir, 16' 5"
5 5/19 85 -- 11'
6 5/19 35 10 mir, 16' 5'
7 5/19 37 -- 11,, __
8 5/19 47 10 Mir i~'~ 5"
9 5/19 50 -- 11,, --
10 5/19 60 10 Mir 16"
PercoLation Rate 2 min,/inch Perc HoLe Diameter
Test Run ~etween 3' ~nd 4'
PerFormed ByNorthRim Eng, I
PerFormed in Accordance with
ON THIS DATE, DATE: 5/28/10
~ CERTIFY
ALL Sro, re/MunicipaL
THAT THIS TEST WAS
GuideLines in EFFect
NOR THRIM ~,,,~,~..~
PO Box 770724 ~% ;, ~. i~ ':.~! --
TESTHOLE LOG
GEOTECHNICAL
T, H, 1
5/28/10
T RIM
SOILS
LOG - PERCF1LATIBN TEST
Dance PerFormed: 5/i9/i0
PerFormed For: Barry Schimmcck
LeDcL Description: Thunderbird H~s ~3A, BLock 6, Lo~ a
2 -
3 -
4 -
5 -
6 -
7 -
8 -
9 -
10 -
11 -
1P -
13 -
14 -
15 -
16 -
17 -
18 -
19 -
20 -
2i -
DEPTH
(FEET)
~///////~
· .:'.~. ~...::'.~
s.".".': ~'"/ ~.'.:"~.~
."~...."~",> :' 'T'::
T,H, Loca~cion: See A~c~cached Design
FIrD~nic ~5Z SLope
SW
w/Gr~veL
Perk Tes~
Groundwater? No
Depth
Wa~er Depth
AFSer Noni~orin9, None
~ Da~ce Gross Time Ne~c Time Dep~ch Ne~ Drop
1 5/19 0 -- 4,, __
2 5/19 10 10 mir 9' Sm
3 5/19 12 -- 4, __
4 5/19 22 10 mir 9~ 5~
5 5/19 P5 -- 4,, __
6 5/19 35 10 mir 9" 5"
7 5/19 37 -- 4,, __
8 5/19 47 10 mill 9,, 5·
9 5/19 50 -- 4"
10 5/19 60 10 mir 9" 5"
PercoLc~ion Ra~e 2 min,/inch Perc HoLe Dicme~er 6x
Tes~ Run Between 3' and 4'
CommenCes: Presoaked ,
PerFormed :By Nor~chRim Eng, I ~ CERTIFY THAT THIS TEST WAS
PerFormed in Accordance wi~ch At[ S~ca~ce/Municipo[ Guidelines in EFFec~c
UN THIS DATE, I)ATE: 5/;~8/10
N 01~ THI~IM
EN GINEEI~IN ~
1=0 I9o~ ?70724
Eogle River, AIosko 99577
907.694. 7028
TESTHOLE LUG
GEBTECHNICAL
T, H, 2
~ ' 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
NAME
LEGAL DESCRIPTION
LOCATION
PHONE
[] UPGRADE
Well AbsorPtion area Dwelli
Manufacturer r Mate:5 bj(.
IF HOMEMADE: Inside length
DISTANCE TO: Well Dwelling
Manufacturer
Total len g~c~nes
Material beneath tile
DIST^NCE*O= Iwe" f'OR¢~
No. of lines ~ I Lengtl~.~eacJ~}ine
Top of tile to finish grade ~ ~ I
Length Width
Material
Nearest lot line
Tre c wi t o
I ,nches
Depth
NO. OF BEDRO~/S
No. of compartment~
Liquid depth
PERMIT NO.
Liquid capacity in gallons
Distance between lines
Total effective¢~i~ ,re8
PERMIT NO.
Type of crib irib diameter Crib depth Total effective absorption area
Well Building foundation Nearest lot line
DISTANCE TO:
Class Depth Driller Distance to lot line
Building foundation Sewer line Septic tank
DISTANCE TO:
OTHER
INSTALLER
REMARKS
DATE
z I
APPROVED
72-013 (Rev, 3/78)
LEGAL
Permit ~
Applicant:
Location:
Legal Description: ~0~ ~
Type of Soil Absorption System Is:
Trench: Drainfield: ~
Maximum Number of Bedrooms: ~ .
MUNICIPALITY 0F ANCHORAGE
Department/~5 Health and Environmenta3~'¥rotection
825 ,~ Street, Anchorage, AK. ~ ~501
264-4720
* * * HANDWRITTEN PERMIT * * *
ON-SITE SEWER PERMIT Ro
Mailing Address:
Phone, Number:
Seepage Bed: Holding Tank:
Soil Rating(sq.ft/br)
The Required Size of the Soil Absorption System Is:'
DEPTH ~ LENGTH ~/
RAVEL DEPTH WIDTH
The length dimension is the length(in feet) of the ~ren~O~ or dralnfleld. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(MSC-D-t-NG) TANK SIZE = /~00 GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 3L 1
9 8 3 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the residence is remodeled to include mor~ tha~3 b~dro?2~
Signe~: ~/%~3 ~z-) Issued by. ,~__~~_
A~plica~ %~ Date: ,~7~2
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION [] PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SLOPE SITE 'P ~]'
1
2
3
4-
5-
6-
7
8
9-
10-
11
13-
14-
15-
16-
17-
18-
19-
20-
COMMENTS
PE.FORMED
72-008 (6/79)
O
P
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN FT AND -- FT
/
CERTIFIED BY: J ~/~x
(minutes/inch)
•
• Municipality of Anchor. • 6 8 9 '0 ''
,t _ - ,L . . -
On-Site Water and Wastewater Progr-• i►'�`.� ,;;, '-. IAA 1- i ,
(907) 343-7904 ` SAFETY
JUL 162.°1 1"
Certificate of On-Site Systems A 4''t w
` A
oval
051-582-47 g 020) 0201 '1
Parcel I.D. Expiration`i =:8 J�
1. GENERAL INFORMATION
Complete legal description Thunderbird Heights #3A, Block 6, Lot 2
Location (site address) 24888 Teal Loop Chugiak, AK 99567
Current Property owner(s) Barry & Terri Schimmack Day phone
• Mailing address 24888 Teal Loop Chugiak, AK 99567
Real Estate Agent Day phone
2. TYPE OF DWELLING:
O Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: Four
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ❑ Individual 0
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System 0 Public Sewer ❑
WaiverNariance request for: Distance:
•
Received by: l/, Qii'it1 I1'!i J Date: /up y
the engineer,unless otherwise requested bythe engineer.
COSA to be released to g q g
COSA Fee $ 52-c Waiver Fee $
Date of Payment 1(418 Date of Payment
Receipt Number 014115t' Receipt Number
COSA# 03CI47 t 3'45 Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm Forge Engineering Phone (907) 522-7773
Address PO Box 240773 Anchorage, AK 99524
Engineer's Printed Name Michael E. Anderson, P.E. Date 7/15/2018
j* 49 TH /\ *��/
6. DSD
SIGNATURE e..-
System
System #1 Approved for / bedrooms . Michael E.Anderson
System #2 Approved for bedrooms �fi,�T, .l 4381-E� � �,���
Disapproved iq,P.R.OFEssok\\\\....0...
Conditional approval for bedrooms, with the following stipulations:
car ANC6.
OWS
W ATE AGER o
Wp,Roc'RPM
P
C._
•1.A,,
By: fatteA � m �c��cv1 a Original Certificate Date: (J .90� G201 8
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS: .:" •, ^,
COSA Checklist X Nitrate AdvisSr�y."_ ..
Septic System Advisory Arsenic Ad'isdry
Well Flow Advisory Other • ' j`� r •
COSA blue sheet s c
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On-Site Systems Approval Checklist
Legal Description: Thunderbird Heights #3A Block 6 Lot 2 Parcel ID:051-582-47
A. WELL DATA
Well type Public Water If A, B, or C provide PWSID# Well Log (Y/N)
Date completed Sanitary seal (Y/N) Wires properly protected (Y/N)
Total depth ft. Cased to ft. Casing height(above ground) in.
FROM WELL LOG AT INSPECTION
Date of test
Static water level ft. ft.
Well production g.p.m. g.p.m.
WATER SAMPLE RESULTS:
Coliform colonies/100 mL Nitrate mg/L
Arsenic ug/L Date of sample: Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel Date installed 02/18/2011
Tank size 1250gal. Number of Compartments 2 Cleanouts(Y/N) Y
Foundation cleanout(Y/N) Y Depression over tank(Y/N) N High water alarm (Y/N) N
Date of pumping 7/2/2018Pumper Alaska Quality Septic
C. ABSORPTION FIELD DATA
Date installed 10113 1512010 Soil rating (g.p.d./ft2 or ft2/bdrm) 1 .2 System type Shallow Trench
Length 65 ft. Width 5 ft. Gravel below pipe 3 ft.
Total depth 4 ft. Eff. absorption area 560 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 7/12/18 Results (Pass/Fail) Pass For 4 bedrooms
Fluid depth in absorption field before test 0 in. Water added 609 gal. New depth 0 in.
Elapsed Time: 0 Mia. Final Final fluid depth 0 in. Absorption rate >= 600 g p d
N
Any rejuvenation treatment(past 12 mo.) (Y/N &type) If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at in. High water alarm level at in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot On adjacent lots
Absorption field on lot On adjacent lots
Public sewer main Public sewer manhole/cleanout
Sewer/septic service line Holding tank
Animal containment areas Manure/animal excrete storage areas
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >1 0' Property line >5' Absorption field >5'
Water main Water service line >10 Surface water >100
Wells on adjacent lots >100'
ABSORPTION FIELD ON LOT TO:
'* >10'
Property line Building foundation >10' Water main
'
Water Service line 0 Surface water >100 Driveway, parking/vehicle storage >10'
Curtain drain None Noted Wells on adjacent lots >100'
F. COMMENTS
*See Lot Line Waiver OSP101105.
G. ENGINEER'S CERTIFICATION OF A/ 4
-r �A • sly
I certify that / have determined through field inspections and -C '•• 4A--'11-e0
• ,1-
review of Municipal records that the above systems are in r: • '9
/ * • 4'9TH �\ ..*�r
conformance with MOA COSA guidelines in effect on this date. r
Engineer's Printed Name Michael E. Anderson, P.E.
Date 7/15/2018 �FA �,••Michael E.Anderson •:�
. 4381-E .• (4,•-•,4%-
%
'
�k %ROFESSI��'�
COSA brown sheet 10-10-12.doc
3
•0
601 (' \ r `N ,..
TArt
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v A / .t. c_ 0. v0
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, q , A / • • • 47„
r I5 /
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.tl, ,
,i,
(X 1/11 11
•
1
ASBUILT—NO CORNERS SET THIS DATE. SEWARD & ASSOCIATES LAND SURVEYING 688-4566
I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE:
FOLLOWING DESCRIBED PROPERTY: yo .
.0-4-•-s .;
•,;,�OF A�)
yi=� -'1 -0�;� /.‹.4.f .",. )--'� - -e,i;: '4.?c'-2e2--= DATE: �v���' .'��5•
AND THAT NO ENCROACHMENTS EXIST EXCEPT AS
INDICATED. IT IS THE RESPONSIBILITY OF THE / J ,,*7. • Li
OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: .; .�. .! %•.*.4
EASEMENTS, COVENANTS, OR RESTRICTIONS : ..�/,..'6
ii
WHICH DO NOT APPEAR ON THE RECORDED SUBDI— 4'' � "$ �t
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB: • ora LS-WS Merk sewa
ANY DATA HEREON BE USED FOR CONSTRUCTION r% '�/' Q
OF FENCE LINES, OR FOR ESTABLISHING BOUND- �� � ''�� � �
ARY LINES. DRAWN ��Fh �zfa1�±,'"
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
Complete legal description
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address
Agent ~'~/YlCr~ -
Address
Day phone
Day phone
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
individual well
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA#21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my inves_ti_gation and inspection, the on-site water
sui~ply 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.
David R. Dayton P.E, Phone ~ ' ~/,,~. -;..~././'/7
Name of Firm
Address
Engineer's signature
20210 Donalar St.
Chuglak, .~la~ka 99567
o
DHHS SIGNATURE
~,, Approved for ~'z"~/~-~/
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services {DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The D HHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72~)25(Rev. 1/91) Bsck MOA#21
Municipality of Anchorage /~
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
A. Well Data
Well type
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
7_~ ~p~,-- (~ Parcel I.D. ~ ~ / -- ~-
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed Driller
Cased to Casing height
Wires properly protected (Y/N)
FROM WELL LOG
Date of test
Static water level
Well flow
Pump level1
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
g.p.m.
ATINSPECTION
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Sewer service line
Petroleum tank
WATER SAMPLE RESULTS:
Coliform Nitrate
Other bacteria
Date of sample:
Collected by:
B. SEPTIC/HOLDING TANK DATA
Date installed ¢/
Cleanouts (Y/N)
Tank size
Foundation cleanout (Y/N)
Compartments
High water alarm (Y/N)
Date of pumping
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
On adjacent lots
Absorption field
~/ . Depression (Y/N)
Alarm tested (Y/N)
/
Pumper ~A~~ --
Well(s) on lot '~,,/,~
To property line
Surface water/drainage
Foundation
Water main/service line
72-026 (3/93)* Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
/,2/4
"Pump on" level at
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 ¢/ ~/ff ~
Length ¢~ Width
Total absorption area
Date of adequacy test '~//~./¢'~;
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y/N)
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Sudaoe water
Soil rating (GPD/FF) /'5"~ -¢~./'Z'~/~ System type
Gravel thickness (~// Total depth '~,
Cleanout present (Y/N) ¥ Depression over field (Y/N)
Results (pass/fail) /¢~,/~-¢~ for '¢- Bedrooms
~ ~ ~.Crc After test /J
Well oil lot '"~///~-/
/
To building foundation
On adjacent lots ~ '~-~-
Surface water / ~-O
Curtain drain
E, ENGINEER'S CERTIFICATION
If yes. give date
On adjacent lots .~,/% Properly line
~. / To existing or abandoned system on lot
Cutbank /L,)¢,',~'z~ Water main/service line
Driveway. parking/vehicle storage area
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in
David R, Dayton P,E,
20210 DonaJar St,
Chugiak, Alaska
Signature
Engineer's Name ,
HAA Fee $
Date of Payment
Receipt Number
72-026 (3/93)* Back
Waiver Fee $
Date of Payment
Receipt Number
D¢lvid R. Dayton
NO. 2205-E
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
GENERAL INFORMATION
Complete legal description
Lot 2; Block 6; Thunderbird H~ights #3A
Location (site address or directions) 24888 (104) T~. Loop
=
Property owner
Mailing address.
Lending agency
Gordon & Rita S~hmidt
Day phone
24888 T~l Ln~p Chugiak~ Alaska 99567
Day phone
688-4545
Mailing address
Agent Th6a
RE/MAX PROPERTIES, INC.
2600 Cordova Str6et
Address Suite, # 100
Anchorage, Alaska 99503
Unless otherw~erequeste~ HAA will be held forpickup.
Day phone
257-0125
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system; provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025(Rev, I/91) Front MOA#21
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Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:~''¢ ~-' I'~,V._.l~ "~'~O~o~.,15~/z-r'~ ~5 Parcel I.D.
A. WELL DATA
Well type /~
IfA, B, orC, attach ADEC letter. ADEC water sYstem number ~.11 I~'~,
Log present(Y/N)
Date completed Driller
Total depth Cased to
Casing height
Sanitary seal (Y/N)
Date of test
Static water level
Well flow
FROM WELL LOG
Wires properly protected (Y/N)
AT INSPECTI MuNtCtpALITY Of ANCHOP-AGE
ON.,.~.~ AL sERviCES DtVISIOt~
g.p.m.
Pump level
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot 'Z-~ ~ 4-
Absorption field on lot ?...,~ o '~'
; On adjacent lots
; On adjacent lots.
Public sewer main
Public sewer manhole/cleanout
Sewer service line
Petroleum tank
WATER SAMPLE RESULTS:
Coliform Nitrate
Other bacteria
Date of sample:
Collected by:
B. SEPTIC/HOLDING TANK DATA
Date installed °t "~
Cleanouts ~N) y
High water alarm (Y~)
Date of pumping
Tank size ~.~'~b /~,~"1.~ Compartments
Foundation cleanout (~N) ,,// Depression (Y/~
Alarm tested (Y/N)
Pumper ..-2~ ~.
Well(s) on lot ~,o~)
To property line I o
Surface water/drainage
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
On adjacent lots
Absorption field '7
Foundation
Water main/service line.
72-026 (Rev. 7/91) Front ~" " ' CONT NUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N) __ "Pump on" level at
High water alarm level
Meets MOAelectric~ ~
~NC E FRO M L' F~;~;~t 7c~;
Manufacturer
Manhole/Access (Y/N) ~
---~'~ump off" level at
~cles tested
Surface water
D. ABSORPTION FIELD DATA
Date installed o~
Length ~1 Width
Total absorption area ~,'~
Depression over field (YL4"~
Result~fail)
Peroxide treatment (past 12 months) (Y,~
Soil rating /~'(:::'~/~'¢-
Gravel thickness ~.~'
Cleanouts present ~N)
Date of adequacy test
for ,~0 ¢-.- (~)
/-./~^/(¢ /~,,&/o ~'~" If yes, give date
System type
Total depth
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot ~-~ ~ ~ ~ On adjacent lots ~J/A-' Property line
To existing or abandoned system on lot
Cutbank ,,-[' l ~,¢,* Water main/service line
Driveway, parking/vehicle storage area .~'~ ' '+
To building foundation
On adjacent lots
Surface water
Curtain drain 'U/~-
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
$ & S I~[NGINEEEING
Signature 17034 Eagle River [.oep Eo~ No. 204
Engineer's Name
Date ~--q ~ '?' : .....
,^^ Fee $
Date of Payment
.eee,ptNum er
72-026 (Rev. 3/91) B~ck MOA
Waiver Fee: $
Date of Payment
Receipt Number
D. R. DAYTON, P.E., R.L.S.
~(~x~~(~(~ ChUgiak, Alaska 99567
20210 Donalar
(so7)
696-2417
July 17, 1993
ADEQUACY TEST
Legal Description: Lot 2, Block 6, Thunderbird Heights #3A
Date of Test: July 16, 1993
Septic T~nk: 1250 gallon, 2 compartment, steel tank
Absorption System: 24' x 40~ bed
Soils Rating: 150 sq. ft. per bedroom
Requirements: 4 BR - 600 gallons per day
Test:
Water was pumped into the absorption bed while measuring
volume, time and rise in the liquid level in the bed. After pumping
was stopped, the liquid level drop was measured at regular intervals.
Results:
There was no liquid in the bed before the test° 600 gallons
of water were pumped into the bed with no rise in the bed.
The system is currently functioning adequately for a 4 bedroom home.
DEPT. OF ENVIRONMENTAL CONSERVATION
: WALTER J. HICKEL, GOVERNOR
ANCHORAGE DISTRICT OFFICE
800 E. DIMOND BLVD., SUITE 3-470
ANCHORAGE, ALASKA 99503
(907) 349-7755
March 11, 1992
FOR: S & S Engineering
PWSID # 211156
My review of the records on file in this office reveals that the Eklutna Thunderbird Heights
Subdivision, Class "A" Public Water System, is in compliance with the routine coliform
bacteria sampling requirements listed in Table C, and with the inorganic sampling
requirements listed in Table B of 18 AAC 80.200.
Sincerely,
Byron Roys
Environmental Engineering Assistant
BR/of
MUNICIPALITY. OF ANCHORAGE
DIVISION OF ENgIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
i. General Information ./ ApplicatiOn Date Z/f! /~6~
'(a) Legal Description (include lot, block,' subdivision, section, township, range)
Location (address or directions)
(b) Applicants NameG,.L~ ~k~,~ Telephone - Home
Applicants Address
Business
(c) Applicant is (check one) Lending Institution
Buyer~; 0ther~ (explain);
(d) Lending Institution
(e) Real Estate Co. & Agent
Address
Telephone
(f) Mail the HAA to the following address:
2. Type of Residence
Single-Family~
Number of Bedrooms
3. Water Supply
Individual Well.'[
Multi-Family~-~
Other (describe)
Community~ Publtc~-~
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
Sewase 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]
5. gn$ineerin$ Firm Frovidln$ Inspections~ Test% File Search, Data and Information.
As certified by my seal affixed hereto and as of the validation date shown below, I
verify that myinvestigation of this Health Authority Approval shows that the on-site
water supply and/or wastewater disposal system is safe, functional and adequate for
the number of bedrooms and type of structure indicated herein.- I further verify that,
based on the information obtained from the Mmnicipality of Anchorage files and from my
investigation and inspection, the on-site water supply and/or wsstewater disposal
system is in compliance with 8ll Municipal and State codes, ordinances, and regula-
tions in effect on'the date of this inspection.
Name of Firm
(ENGINEER SEAL)
Approved for.~.,k bedrooms
Approved ~ Disapproved
Terms of Conditional Approval
Condi~al
CAUTION
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED
IN T~ STATE OF ALASKA. THE DHEP DOES THIS A~ A COURTESY TO PURCHASERS OF HOMES AND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
MENTS. EMPLOYEES OF DREP 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.
(DHEP SEAL)
RRd/eJ/D18
[Page 2 of 2]
7-19-84
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303
ANCHORAGE, ALASKA g9501
BILL SHEFFIELD, GOVERNOR
Telephone: (~07)
Address:
274-2533
To Whom it May Concern:
According to records on file in this office the
Water Regulations
Water System is in compliance with the State Drinking
Si ncerely,
MUN, ICIPALi.~ OF
"~ ~OTEC~IO~
RECEIVED
APPLI~'~"~IT FILLS OUT UPPER HAl.. 'ONLY
Phone
Property Owner T & D Construction
Mailing Address Rnw ~'~?f*_ Pm. IneT'. AW ZipCode 99645 745--273i
Buyer Gordon Schmidt
Address 9430 Kylie Cir Anchorage zip Code 99502
Lendi,g restitution Alaska Pacific Mortgage Corn pany Pho,e
276-3110
Address Northern Lights zip Code ~X~
Realty Co. & Agent william Schleg~l Phone
Totem Realty, Inc.
Address 724. 15th Avenue Anmhroage zip Cede 99501 272-0571
Legal Description Lot 2, Block 6 Thunderbird Heights
Street Locatio~ Raveu~iew Loop
Type of Residence
[] Multipie Family NO. of Bedroor~s 4
[] Other
E~ Individual ~,<~ ~(.~,~ '~), ~ ATTACH WELL LOG; A well log is required for all wells drilled since June 1975.
[~ Community ~'-'~ ~/~ ~ For weils drilled prior to that date, give well depth (attach log if available).
Sewer Disposal
~ Individual Year Individual Installed: 1983
[] Public Utility When Connected to Public Utility:
E] Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQOEST BEFORE PROCESSING CAN BE INITIATED,
Time Time Time Time
Date Date Date Date
Inspector Inspector Inspector Inspector
Field Notes: C'~ ~ ~, (-~ ' ~UNIClPALI~Y O~
k. ~f~J SC~.~' DEPT. OF H~i',LTH
C
ENVIRONMENTAL PROTEC[[ON
NOV ~ 6"
RECEIVED
(~) APPROVED BEDrOOm8 *GONDITION8 OF
APPROVAL
( ) DISAPPROVED
( ) CONOmONALAPP~OVAL'
Well Log Received
Well To ~sorption
Soils Rating Date ~wer Installed~
72.023(3/~)
WELL DATA
Well Classification ~' "~
Well Log Present (Y/N)
Total Depth Cased to
Static Water Level
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal DescriPtion:. ~4::~1~ ~. ~(0~ ~"
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
Comments
ff A, B, C, D.E.C. Approved (Y/N)
Date Completed Yield
Depth of Grouting
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on .Lot
; Date
PROTECTION
¢E!_V ED
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes (Y/N} Y Air-tight Caps (Y/N)
Depression ever Tank (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 Properly Line ~
To Water Main/Service Line ~
Size I P-.,..r~'o[ No. of Compaltments
Foundation Cleanout (Y/N)
Date Last Pumped
; for
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field ~, ,'O
To Stream, Pond, Lake, or Major Drainage
Course
Comments
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Length of Field
Depth of Field
Gravel Bed Thickness
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation ~ gO
Lot _ J~,
To Water Main/Service Line ~
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
CommentsF'_ A~o",,C~Op ~e',=¢¢
Type of System Design
Standpipe¢ Present (Y/N)
Date of Last Adequacy Test
To Property Line I,~
To Existing or Abandoned System on
On Adjoining Lots ~ ,~O '
To Cutbank (if present)
to '
D. LIFT STATION N,
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA and HAA g uideli nes in effect on the date of this inspection.
Company Flc~'~re~n re( ~ MOA No. ~' ~
Receipt No. ~!~ L
