HomeMy WebLinkAboutTHE LANDINGS BLK 2 LT 4
Municipality of Anchorage Page ! of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P,O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
(:)n-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: .5"l/~ ¢2~4'0~0~ PIDNumber:_ 0~00~'/0~/
Name:
G-c.l~n ~e~ Wastewater System: ~ New ~ Upgrade
Address:
~8oo o/~ 5~ ~7~ ~ 9¢m~ ABSORPTION FIELD
Phone:
~ qC - IP~ [No
[
~ ~ Deep Trench ~ Shallow Trench ~Bed ~ Mound ~Other
LEGAL DESCRIPTION soi,.~,i~: o,~ ~o~sq.~ la '
township: ~ Rango: ~ Section: Fill added ahove original grade: Gravel length:
I
I
WELL: E~4 ~ ~ New ~ Upgrade O~aw~lwidm 8.¢' Ft Number ofllnes:l [Oislanceb~me,Hines:
GPM[PUmp Set at: Fl[ _ Fl TANK
SEPARATION DISTANCES ~ Septic U Holding ~ S.T.E.P.
From Tank Field Stal .... Tank ;ewer Li .... ~ ~ ~ I
Surface
Wa~ >~' >,¢¢ - LIFT STATION
Foundation ~O' 7~1 -. _ o,"Pump°n'leve~at:l"Pump°ff"levelat:lHighwater~larmat:
Remarks: ¢¢,¢m~( ~¢~/;6 /a~ f~, BENCH MARK
ENGINEER'S SEAL
Inspections performed by: ~l~h~/. ~ec4, ~ Dates: 1st /o{/~(95- ~ ~ , ~,~,,I ,..~, ., ,,
2nd w{t~ {5C ~ ,
Department of Health a.n~Hum ices approval ~,.., .~,,~o,.~ ~ :,;~... ,
72-013 (Rev. 9/91) MOA 25
PERMIT NO: SW950309
PID NO: 02006104
ORIGINAL "D"
SEEPAGE PIT
FtUN"
DIV. VALVE
,' NEW 32' LONG
SOIL ABS. TRENCH
WITH 9' GRAVEL
t
t
PAGE 2 OF 3
NEW 1250 GALLON
SEPTIC TANK
"A" 4 BDRM
HOUSE
SWING TIES
FROM: OOR.. "A" COR. "B"
TO:
S.T.C.O, "C" 25' 60'
S.T. C,O, "D" 31' 63'
DBL, C.O. "E" 34' 64'
DIV. VALVE "F" 42' 69'
TR. C.O. "G" 80' 82'
TR. M.T. "H" 82' 72'
TR. C.O. "1" 86' 72'
LOT 4, BLK, 2~ THE LANDINGS S/D
SEPTIC SYSTEM UPGRADE
AS-BUILT INSPECTION REPORT
FLATTOP TECHNICAL SERVICES
14530 ECHO STREET
ANCHORAGE, ALASKA 99516
SCALE: 1" = 30'
DRAWN BY TFM
OCTOBER, 1995
PERMIT NO: SW950309 PAGE 3 OF 3
PID NO: 02006104
FINAL. GRADE 94.6'
2" INSULATION
INV.
92.0'
1250 GAL
SEPTIC TANK
INV.
91.7'
"BULL RUN"
DIVERTER VALVE
FINAL GRADE 73,8'
INVERTS
(BOTH ENDS
32' LONG SOIL
BOTTOM OF TRENCH ELEV. 61,3
TEST HOLE #1 ~'
BOT. ELEV. 55.3 (DRY)
LOT 4, BLK, 2, THE LANDINGS S/D
SEPTIC SYSTEM UPGRADE
AS-BUILT PROFILE
FLATTOP TECHNICAL SERVICES
14530 ECHO STREET
ANCHORAGE, ALASKA 99516
NOT TO SCALE
DRAWN BY TFM
OCTOBER, 1995
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 1
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW950309
DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES
OWNER NAME:HANSEN GALEN R
OWNER ADDRESS:16200 OLD SEWARD HWY
ANCHORAGE, AK 99516
DATE ISSUED:10/03/95
EXPIRATION DATE:10/03/96
PARCEL ID:02006104
LEGAL DESCRIPTION:
THE LANDINGS BLK
2 LT 4
LOT SIZE: 60944 (SQ. FT.)
HUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80) .
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343 4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION 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:
NO PORTION OF THE ABSORPTION FIELD MAY BE CLOSER THAN 30
FEET FROM THE STEEP SLOPE.
RECEIVED BY: ,7~'~ ~t:~ '~-?
DATE:
? .SER¥ICES
CIVIL & ENVIRONMENTAL ENGINEERING * ENERGY CONSERVATION & ANALYSIS
TIIEODORE F. MOORE, P.E. 14530 ECHO ST.
PH: (907) 345-1355 September 20, 1995
ANCHORAGE, ALASKA 99516
M.O.A. DHHS
P.O. Box 19-6650
Anchorage, AK 99519
Dem' Sks:
The purpose of this letter is to provide the required design nma'ative in support of our application for a
permit to upgrade the wastewater disposal facilities on Lot 4, Block 2, The Landings S/D, located at 16200
Old Seward Highway. The present seepage pit is no longer able to accept the effluent generated by a tlu'ee
bech'oom residence. We ale also requesting a waiver allowing the proposed soil absorption trench to be 25
feet from the top of a bluff sloping downwm'ds at 70% instead of the normally requh'ed 50 feet. Soils
logs, perc test results, a site plan, design drawbgs and specifications are enclosed for your review.
The proposed system will be constructed between test holes #1 and #2. As can be seen from the soil
lo.gs, the native material below 2 feet is a somewhat silty stmdy gravel with a measm'ed perc rate of 3
m~nutes per inch. Using a conse~wafive soil application rate of 0.8 gpd/sq, ft., this 3 bedroom residence
requh'es a total absorption m'ea of (3 x 150)/0.8 = 562.5 square feet. The proposed 31.5 foot long trench
design with 9 feet of sewer gravel beneath the horizontal distribution pipe has a total absorption m'ea of
567 square feet.
The topography of the lot in the ama of the proposed consU'uction slopes down towm'ds the southwest
at approximately 10%, however 25' west of the north end of the proposed u'ench is the top of a bluff
which slopes down towm'ds Potter Mm'sh at 70%. The location of the proposed trench has been selected
to maximize the horizontal separation from the top of the bluff, while maintaining the required 100 foot
separation from a private well on Lot 5. This location is considerably further from the bluff thau is the
present seepage pit which has shown no sign of daylighting tlu'ough the bluff. The excellent pern~eability
of the deep soils in this m'ea mem~ that effluent coming from the U'ench will be able to easily percolate
downwards, and there should not be cause for concern that effluent will daylight out the side of the bluff.
The proposed project will have no significant impact on present or future water supply aud wastewater
disposal systems serving adjacent properties, nor will it have any significant impact on reserved space-
surface and subsurface, or on drainage.
Please give me a cail at 345-1355 if you have any questions ou this submittal.
MUNICIPALITY OF ANCHORAGE
ENVIRONMENTAL SERVICES DIVISION
RECEIVED
Sincerely,
Ted Moore, P.E.
LOT 3
(VACANT)
EXISTING
SEEPAGE PIT
LOT 4, BLOCK 2
THE LANDINGS S/D
70%j
CONSTRUCT NEW 31.5' LONG
SOIL ABSORPTION TRENCH
W. (f' SEWER GVL. BELOW PIPF_
ABANDON
EXISTING
SEPTIC
TANK
INSTALL
VALVE
#2
70%/
INSTALL NEW
SEPTIC TANK
4BDRM
HOUSE
WEL
60%
,'
.. ~/~WELL
LOT 5
LOT 4, BLK. 2, THE LANDINGS S/D
WELL AND SEPTIC SYSTEM
SITE PLAN
FLATTOP TECHNICAL SERVICES / 1 INCH = 50 FEET
14530 ECHO STREET ~ DRAWN BY TFM
ANCHORAGE, ALASKA 99516 SEPT., 1995
NOTE: THIS IS NOT A SURVEYED PLAT.
ALL LOCATIONS SHOWN ARE APPROXIMATE.
LINE FROM HOUSE
NEW 1000 GALLON
D-3O34 PiPE
TO ORIGINAL
SEEPAGE PIT
"BULL RUN"
"A" [-~.'- / MONITOR TUBE
VALVE _1 312 /
'A' ~-I~" ~ 31.5' LONG SOIL ABSORPTION TRENCH
WITH 9' SEWER GVL BELOW DIST PIPE
PLAN VIEW
SCALE: 1" = 10'- 0"
· MONITOR TUBE
.CLEANOUT
3
1
COVER MATERIAL6"
,LGRADE
-FILTER FABRIC
ASTM F-810 PERF PIPE
1/2"-2 1/2" SEWER GRAVEL
BOTTOM OF TRENCH
SECTION "A - A"
SCALE: 1" = 5' - 0"
L4, BLK. 2, THE LANDINGS S/D
SEPTIC SYSTEM UPGRADE
PLAN AND CROSS-SECTION
FLATFOP TECHNICAL SERVICES
14530 ECHO STREET
ANCHORAGE, AK, 99516
SCALE: AS SHOWN
DRAWN BY: TFM
SEPTEMBER, 1995
Flattop Technical Services
14530 Echo Street, Anchorage, AK99516
Phone (907) 345-1355
Lot 4, Block 2, The Landings S/D
16,200 Old Seward Highway
Wastewater disposal system installation
Specifications
1.0 General:
1.1 The scope of tile project consists of abandonment of an existing septic tank m~d installation of a
new 1000 gallon septic tank followed by 31.5 lineal feet of soil absorption trench containing 9 feet of
sewer gravel beneath the horizontal distributioa pipe. A diversion valve is also to be installed allowing
futura mconnection to the original seepage pit, if desired.
1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor
deviations from these di'awings may be allowed or required by the engineer conducting the inspections.
All consU'uction procedm'es and material specifications shall conform with Municipal and State
requirements. All separation distances shall be in conformance with Municipal requirements, unless
specifically waived.
1.3 The contractor shall be responsible to obtain any necessmy utility locates, and to work m'ound any
bm'ied utilities. The homeowner is making m'rangements allowing the contractor to access the bench
where the soil absorption trench is to be constructed via an old roadway on Lot 5.
1.4 oThe contractor shall provide adequate cover material and rough grading over ail system
components to ensm'e that propel' di'ainage is achieved after settlement and that them m'e no residual
depressions. Insofm' as possible the contractor shall minimize damage to trees and existing lawn areas.
1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after
the soil is compacted, as well as placement of topsoil and reseeding~all areas disturbed by the consu'uction.
2.0 Septic Tank:
2.1 The existing septic tank must be properly abandoned by thoroughly pumping, removing the top
and backfilling with soil.
2.2 The new 1000 gallon, 2 compm'tment septic tank shall be Manicipally approved and shall be set
level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4"
cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial type,
rigid insulation.
2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The
waste lille from tile residence to the septic tank shall have a minimum slope of 1/4'" per foot, and the waste
line between the tank and the soil absorption system shall have a minimmn slope of 1/8" per foot. A
double cleaaout shall be installed within 5 feet downstream of the septic tank. A "Bull Run" diverter
valve shall be installed downstream of the double cleanout allowing future reconnection to the original
seepage pit, if desired.
3.0 Soil absorption system:
3.1 The soil absorption system shall be constructed by excavatiug a 31.5 foot long trench to a depth of
12 feet below ground level in the approximate location shown on the site plan. The axis of the U'ench
sh~dl pm'allel the contom' of the original ground, and the closest point of the trench shall be no closer than
25 feet from the top of the bluff which drops down towm'ds Potter Mm'sh.
3.2 The bottom of the excavation shall be level. Any compacted or smem'ed surfaces shall be raked to
allow proper infiltration.
3.3 A total of 9.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with
the perforated disu'ibution pipes laid level such that the pipe inverts m'e no less than 9.0 feet above the
bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing
the #200 sieve.
3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on
the design ch'awings. The portion of the monitor tube extending through the sewer gravel shall be
perforated.
3.5 Approved filter fabric shall be placed over the eutire top sm'face of the sewer gravel. A minimum
of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less than 3 feet,
two inches of rigid, burial type insulation is to be placed over the entire top surface of the gravel, in
addition to the filter fabric.
3.6 The top surface of the cover material shall be raised a n'dnimum of 6 inches higher than the
surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill
slopes shall be no steeper thau 3:1.
3.7 Unless specifically agreed otherwise the homeowner shall be responsible for re'ranging to have the
site fini~sh graded after the backfill material has stabilized, and for placement of adequate topsoil and seed
to promote rapid revegetation of ali m'eas disturbed by the construction.
4.0 Inspections:
4.1 A minimum of 4 engineering inspections will be required during the eom'se of the project: (1)
initial stakeout with the contractor to establish the location of the system and to discuss the plans,
specifications and construction procedures, (2) after the native material has been excavated to expose the
infdtrative surface to ensm'e that it is level and at the right elevation, and conforrns with the soil test
information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected
up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and
grading is complete. The septic tank requh'es one inspection after it is set level and the piping connected,
but prior to backfill. This inspection may be incorporated with any of the above iuspections.
4.2 The installer shall coordinate the timing of the iuspections with the engineer sufficiently fro' in
advm~ce to ensure the availability of the engineer.
TEST HOLE fi I
LEGAL DESCRIPTION:
DATE PERFORMED:
PERFORMED FOR:
DEPTH
(feet)
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
SOILS LOG -- PERCOLATION TEST
COMMENTS:
Lot 4, Block 2, The~Lanr~litD sLS/D
September 8, 1995
Galen Hansen
Pt
SM l~,eddish sandy loam
GP/GM Soarewbat silty sandy gravel
lenses of clean sandy gravel
damp in areas of higher silt content
sidewalls stable
B,H,
SLOPE
SiTE PLAN
', ',, 60%J
" 10%J
T.H.~
#1
Depth to Groundwater Date
No ~roundwater 9/8/95
Moaitor tube dry 9/15/95
o,
! ! ! SEE SLOPE ARROWS
Clock
Reading Time
12" Presoak
Add water aad st~t 3:23:30
3:28:3U
Add water 3:29
#2 3:34
Add water 3:35
#3 3:40
Add water 3:40:30
#4 3:45:30
Net Time Percometer
(minutes) Reading
23 3/8
- 5 21 3/8
23 1/2
5 21 3/8
23 7/16
5 21 1/4
23 1/2
5 21 3/8
Net Drop
(inches)
2
PERCOLATION RATE _ _3~ (minutes/inch) PERC NOLE DIAMETER 6" - g"
TEST RUN BETWEEN 6.?5' FTAND ?.25 FT
PERFORMED BY FLA'Iq-OP TECHNICAL SERVICES. I ,~",.~,~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ¢ ,/~¢/ /'¢ ~
TEST HOLE"
LEGAL DESCRIPTION:
DATE PERFORMED:
PERFORMED FOR:
DEPTH
(feet)
1
COMMENTS:
FLATTOP TECHNICAL SERVICES
14530 ECHO ST
ANCHORAGE, ALASKA 99516
SOILS LOG -- PERCOLATION TEST
Lot 4, Block 2, The Landings S/D
September 8, 1995 _____
Pt
SM Reddish saady loare
GP/GM Somewhat silty sandy gravel
Tightly structured above 9'
Softer digging below
SLOPE
SITE PLAN
Depth to Groundwater Date
No grouudwaler 9/8/95 __
Monitor It]be dry _ 9/15[95
!!!SEESLOPEARKOW8
Clock
Date Reading Time
Net Time Percometer Net Drop
(minutes) Reading (inches)
PERCOLATION RATE
(minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
PERFORMED BY FLA'FrOP TECHNICAL SERVICES. I_,¢~",~_ ~ CERTIFY THAT THIS TEST WAS PERFORMED Ii',
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
GREt
'--R ANCHORAGE AREA BOR' 'IGH
Department of Environment Quality
3500 Tudor Road
Anchorage, Alask~ 99§07
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME
LOCATION
SEPTIC TANK:
DISTANCE
FROM WELL
MAILING ADDR,ESS (~o~ JO/~ i(I/!F?
Ic~ LEGAL DESCRIPTION
INSIDE WIDTH_ LIQUID DEPTH
INSIDE LENGTH
p H O N E ~/4//4/'%~ 77S'-
NUMBER OF
COMPARTMENTS
LIQUID CAPACITY/¢)0° GALLONS.
? I' L---E--B R~t'N ~Pl'E L: D:
DISTANCE FROM WELl_
NEAREST LOT LINE ~/~O
TOTAL LENGTH
_OF LINES
NUMBER OF LINES £ ,DISTANCE,)3ETWEEN LINES __ TRENCH WIDTH IN. TOTAL EFFECTIVE
ABSORPTION AREA ] I ~ ~ ('d~ ' SQ. FT,
DEPTH: TOP OF 'rILE TO FINISH GRADE MATERIAL BENEATH TILE IN. ABOVE TILE IN.
WFLL: , . ~ A
BUILDING
FOUNDATION____,
CESSPOOL _
APPROVED ~
CONSTRUCTION
NEAREST ~
LOT LINF~(%)- ~
OTHER SOURCES
DISAPPROVED
NEAREST SEPTIC
SEWER I_INE~f'- /O(J__, TANK /(.}O,__
REMARKS
DEP-rH
SEEPAGE
SYSTEM__
DISTANCE FROM:
DISTANCES: ~O o DIAGRAM OF SYSTEM
Form PW,027
GREATER ANCHORAGE AREA BOROUGH
3330 "C." STREET ANCBORAGE, ALASKA 99503
TELEPHONE 274-456 I
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERMIT NO,
iNSTALLATION LOCATION --
Soil TEST resuLTs _~/~-/-7
COMPLETION DATE ANTICIPATED
· SEEPAGE PIT , DRAIN FIELD -, OTHER --
TO
INSTALLED
NOTE~ THIS PERMIT I~; NOT VALID WITHOILIT BOIL
i~--/
/
SEPTIC TANK ~'~ seePAge PIT ~-.
WELL TO SEPTIC TANK
., DRAIN FIELD
/
, AL~O CONSIDER AREA W~LL$.
/
DRAIN FIELD
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO (;RIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL·
4 INCH DIAMETEr CAST IRON SIPHON PIPES ON SEPTIC 'raNI( AND SEEPAGE PIT
FITTED WiTH AIRTIGHT F~EMOVA~LE CAPS
GRAVEL BAC:KFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
GR' ~T[:R ANCttORA(;Ii ~,Ri~iN
DEP," ,lENT OF ~TNVIRONM~;N'I'AL QUAL
3500 TUDOR ROAD
ANCItOF<AGE~ ALASKA 99502
Y CASE
Lab No. 5-SS
c o ,~ c 0 Leo Sawyer Da~,. P~r,or,rcdMa_)L7
ec~;'i '.) .sc · : t~o';' or 2~ Block 2 5u)( lvlslofl Landings
l'hi~ F t'n~ Remort~ S)]ls [oq ~x Percolation lest
Feet Soil Ct;aracteristics
i Brown Clayey Silt (ML) '
4---.I Gray Sandy Grave[ (OW)
6--.1 and Silty Grave[ (GM)
8 ..... i with Gravelly Sandy Seams below 7'
12~- . .
14~.
' : i i '
!:las Grouad Water Encountered? No
if Yos~ ?,t What Depth?
Reading
Da te
Gross
Time Net T~me
Depth to H20
~ercolation 2ate ]q'~nute
Proposed ]n!;ta'i=i-a~-~%-n-~-- Seepage Pit xx Drain
Dep'ch Of inlet Depth To Bottom
CO~'ibi~.i~TS: 165 sq. ft. 6~ge area ~red per bedroom
Field
Net Dro
Alaska Mineral & Materials '~,~b, Inc.
Data Cer'c~f~ed ~ly: . ._~._
Date: MaN 7, 1.973
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 DWE:LLING
1. GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property Own'er
,M~P.~O ~.ddress. (~
Lending agency
Mailing address
Agent'~ ~o~j
Address ~ '- ''~ ~7"~ ~,
Day phone
Day phone
Day phone '~'¢¥ -~'/q '~
Unless otherwise requested, HAA will be held for pickup, ' .... ~ ".% '~'
2. NUMBER OF .~,'~OMS. · ......
8.'
~'-: ~ '~ 0
-~:~..,: :4 :~,Z.: ~om mu nity welt : .... _
' ,:'.Public water: :~
~ ~t
NOTE: If community well system, provide written confirmation from State ADEC ~t~s -
~ng to ~he ~gafity aq.d,.status of system. ..........
4. TYPE OF WASTI-'WATER DISPOSAL:
Individual on-site
H g t ~! ~
,: · .'::: ;,:~: oldin ank 4!:
:.., ~ ,: Community on-site
..........- "" "'""~ Publid'seWer '~'~:~ "'"'
NOTE:
If Com~nunity Wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025(Rev, l/91) Front MOA#21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm f='l,~/',l~/
Address
EngineeCs signature
6. DHHS SIGNATURE
. Approved for ,'~
/
Disapproved.
Conditional approval for
;~i ~,~ ,;,~";:' ·
bedrooms..
bedrooms, with the follow!ng st. ipuJa~-ion.s:
Additional Comments
By: .
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Em ployees 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 C HUMAN SERVICES
Environmental Services Division MUNICIPALITY OF ANCHOk;A<51;:
825"L" Street, Room 502 · Anchorage, Alaska 99501 · (SbiC'II--FetiCh-SERVICES DIVI$10
(,, 2~ 1995
Legal Dcscriptioa:
A, WELL DATA
Well type
Log present (Y/N) _
Total depth
Sanitary seal (Y/N)
Health Authority Approval Checklist I; ECEIVED
If A. B, or C. attaclt ADEC letter, ADEC water system lmmber /V,/J.,
Date completed
Cascdto '> ¥O'
FROM WELL LOG
· Casiag height (above ground)
Wires properly l)rotected (Y/N)
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform (9 col /toOm~
Date of sample:
B. SEPTIC/HOLDING TANK DATA
Date installed tO{t~/gJ-Tanksize
Foundation cleaaoat (Y/N) F . Depression (Y/N)
DateofPumping N,dr, (N.~*o~ Pumper --
C. ABSORPTION FIELD DATA
Date iostatled
Length '~ ~ ~ Width
AT INSPECTION
~ { t 197
q7
g.p.m. O'of/* g,p.m.
Nitrate tg, d~ r~j {J,_ Other bacteria None
Collectedby: l~/a/-,~,/o 7-ec~holea/ .f-erue¢'e~
Number of Compartmeuts '& Cleanouts (Y/N) Y'
N High water alarm (Y/N) Al, A,
Soil rating (g.p.d./fi2 or ft2/bdrm) 0.~ _ System type
~..-¢" Gravel thickness below pipe ~, &' Total depth
Effective absorption area 5'76' c~' Monitoring Tube present(Y/N).__
Date ofadequa~ test ~,,4. (N~oa) Resalts (Pass/Fail) P
Fluid depth in absorptioa field before test (in.);
Fluid depth - Minutes later: ~
Peroxide treaUneat (past 12 lnonths) (Y/N)
Y . Depression over field (Y/N)
For ~ bedrooms
o hnmediately after - gal. water added (in.):
. (in.) Absorption rate = - g.p.d.
N If yes, give date lq,
D. LIFt STATION /9,
Date installed
Mauhole/Access (Y/N)
High water alarm level at*
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot I Oo""
Absorption field on lot
Public sewer main ~ 75
Sewer/septic service line > i~ ~' '
Size iii gallous
"Pump on" level at*
*Datum
: On adjacent lots
; On adjaceut lots
_"Pnmp off" level at*
Public sewer mmdiole/cleanout
Lift station
I certify that i have detemnined thrufield inspections and review of Municipal records that ~h~,~q.~oye aya'tems are
guidelines in effect on this date.
in
MOA
ItAA
Date ~C~e~ t~, lgq~
~Fee $ ~0 Waver Fee $
Date of Payment /S/~J~/~-- Date of Payment
ReceiptNumber /~t~K,~~
Rev. 8/95 OSS: haa,wk.doc
Receipt Nnmber
Water mailffservice line 1> ~ OO' '
Driveway, parking/vehicle storage area _ ;> too '
Wells on adjacent lots I t O ~
?r'a?ert7 i-;,,e 60~
Building foundation 70 '
Surface water 2~ roO '
Cur[an drain N, A,
F. ENGINEER'S CERTIFICATION
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundatiou '~ O ' Property line ;~ ¥ ' Absorption field too '
Water main/service line ';>~'~ Surface water/drainage ;> (oo' Wells 0u adjaceut lots ~. t t O '
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
W__AYER wSnn ADVISORY_
HEALTH AUTHORITY APPROVAL NO. 7~/
During a recent Health Authority Approval on-s~e inspection and
test of the potable water supply well on Lot ~-~ Block ~
of 2-~ ~v~t~<~ Subdivision, the well's productivity
was de~ermined to be ~, ~ gallons per minute. The minimum well
productivity required by this department (AMC 15.55) for
a ~ bedroom residence is ~,.~/ gallons per minute.
Although the subject well currently exceeds this minimum
requirement, all parties concerned are advised that the
production capacity of the well may fluctuate. Restriction of
noncritical water uses such as washing cars and watering lawns
and gardens may be required.
This advisory must be attached to all copies of t~e subject
Health Authority Approval..
~-_~_~.~'~,, CT&E Environmental Services Inc.
CT&E Ref.~ 95.4510-3
Matrix WATER
Client Sample ID L4 BLK2 THE LANDING S/D
Client Name FLATTOP TECHNICAL SRV WORK Order 18779
Ordered By TED MOORE Printed Date 10/13/95 @ 09:22 hrs.
Project Name Collected Date 10/10/95 ~ 15:00 hrs.
Project~ Received Date 10/10/95 ~ 16:30 hrs.
PWEID UA
Technical Director STEPHEN C. EDE
Released y ~,~ ~ ..... ~ ..~ ~.~'- ~,~.~...~
Sample Remarks: SAMPLE COLLECTED BY: T.F. MOORE.
QC Allowable Ext. Anal
Parameter Results Qual Units Method Limits Date Date Init
Nitrate-N 0.62 mg/L EPA 353.2 10. 10/11/95 CMR
See Special Instructions Above UA = Unavailable
** See Sample Remarks Above NA = Not Analyzed
U ~ Undetected, Reported value is the practical quantification limit. LT = Les~ Than
D - Secondary dilution. GT = Greater Than
FLATTOP TECHNICAL SERVICES
14530 Echo St., Aachorage, AK 99516
PA. (907) 345-1355
ADEQUACY TEST DATA SHEET
Street Address:
Client Name:
Test Date: 9/! /93-
Initial Conditions:
Float #1 in
Float #2 inr
Float #3 in
Float #4 in-"
Water added through:
TAKEN
TIME H20 ME'FI
Tested By:_
__set____
set
set
set
NET.
" b.t.o. " pipe w. " fluid
"b.t.Oo'___~--:i pipe w.' --" fluid
" b.t.Oo -- pipa w.--"
" i .... : fluid
"b.t.Oo .~--.R Pg,,,,W,· "fluid
WELL
LEVEL
o ~7
6~
~:o9 ~oo 77
~:oo q q ~o ePg
Measured Well Yield = O,b'* ~/;m Adequate for 3 Bdrms
Unit Abso. Eption Capacity = · .- Surge Capacity = . .
Average Absorption Rate = . . hde u
v V ~
Approval requested by:
Mailing Address:
Property Owner:
Mailing Address:
Legal Description:
Location:
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received July
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
Conv.
National Bank of Alaska~
630 East 5th Avenue
Nate& Luanne Wilson
% Jack White Co. 3201
Lot 4 Block
22, 1976
10:30 a.m.
7-23-76 Pratt
Friday
% Lucille Steitz
See map
Type of facility to be inspected
Well Data: Individual
A. Type
C. Construction
7. Sewage Disposal System:
A. Installed 1973
C. Septic Tank:
D. Seepage Pit:
E. Disposal
8. Distances:
A. Well to: Septic tank
Nearest lot 'line
Phone: 279-2506
Phone: 344-0541
C Street,-'~~., ~
2 The Landings Subdivision
Single Family
No. of bedrooms 3
Approx. 186'
B. Depth
D. Bacterial Analysis
On-site system
B. Installer
1. Size
1. Absorption Area
Field: Total length of lines
2. Manufacturer
, Absorption area
, Other contamination
B. Foundation to septic tank
C. Absorption area to nearest lot line __
2. Material
Sewer Lines
, Absorption area
EQ-034 (1/74) Page 1 of two pages
Page 2 of two pages ~ Re% ~st for Approval of Individual L ar & Water Facilities
Legal Description
Lot 4 Block 2 The Landings Subdivision
Comments
Approved ~ J~4~J~ Disapproved
Approval Valid for one year from (late signed
Greater Anchorage Area Borough, Department of Environmental
DIAGRAM OF SYSTEM
Quality
certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
Date
EQ-034 (1/74)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAl. PROTEI~'IONN;44 N7
2510 East Tudor Road, Anchorage, Alaska 99504 276-2221
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection: CMRO__ VA_ _FHA__ CONY_
2. Property Owner:
Mailing Address: ~-~- ~-' ~ ~: ~' Day Phone: ~ ~- ~ 7~
~..~
3. Name of Buyer: ~[~/~'~ /~- ~/~Sd
Mailing Address:~-~ ~¢,~ -/~'~ ~c~,~,~ ~f ~ ,1
Name of Lending Institution: /¢/~ z~' 'Z='~''~'''~
Mailing Address:_
6. Legal Description:
Location:
7. Type of Facility to be Inspected: ~ ~7/c~ -,/--/_.~///
No. Bdrms. ~
Water Supply
Type of Supply: ~D/'/ Public Utility
If Individual, number of dwellings presently served
If Individual, depth of well. //~(~ ~
,Individual
/
Sewage Disposal System
Type of System: Public Utility. ___,;__Individual (on-site)_
If Individual, date of ~nstallation ...... ~ ~ ,?Z ......
FIN HERNANDEZ
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99.~i03 274-4561
Date Received_,~/,9/
Time of Inspection
Date of Inspection
REOUHST FOR APPROVAL OF
INDIVIDUAL SHWER & WATHR FACILITIES
FOR
Add tess ~
2. Prooertv Owner: , -- ~,,~~
4, * .... ' .....
5. TVpe of Facility to be Inspected:
" of Bedrooms: 3
Num~ , -
6, ~ell Data~
C. Construction
Sewage Disooaal System~,~-J~
C. 1, Size
B. Depth
D. Bacterial Analysis
Septic 'rank:
Installer
Manufacturer
'7.
D. Seepage Pit~ 1. Siza 2. Material
Disposal Field: Total Length of Lines~ ...... -_
Distances:
A, Well To~ Septic Tank
Absorption Aree
, Sewer Lines
,,,, Nearest Lot Line , Other Contamination
B, Peunda~ton to Septic Tank '~ Absorotion Area
C, Abaorotion Area to Nearest Lot Line _, _~.
l[equust for Approval of ~adividual Sewer i Water Faoiliti~
- Fa_Je T~o
9'. Comments.' ~ ~0 ~-- /O-")~_
Disapproved
Approval Valid for One Year From Date Signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I certify that the information contained in this reque~t for appreVal to be a true
and accurate representation of the aubject sewer and water facilities located at:
Signed Dage