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HomeMy WebLinkAboutWELLMAN LT 1Wellman
Lot 1
#018-281-23
Municipality of Anchorage
Community Development Department Page 1 of 2
On -Site Water and Wastewater Program
4700 Elmore St. - P.O. Box 196650 Anchorage, AK 99519-6650 - http://www.muni.org/onsite - (907+343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP171114 PID Number: 018-281-23❑ New Z Upgrade
Name:
ALEXANDER GREGORY & CANDY PAVELLAS
ABSORPTION FIELD
❑ Deep Trench R Shallow Trench R Bed R Mound
Address
3500 TWILIGHT LANE
El Other
Phone
Number of Bedrooms
Soil Rating
depth from ori - arc rade
1 3
ITotal
GPD/SF
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
Ft.
Ft.
GfeQ depth beneath pipe
Ft.
Subdivision Block Lot
WELLMAN 1
Fill added above origi at g d --
7� Ft.
length
Ft.
-_
Township Range Section
Gravel width
:1� Ft.
Beds: Number of Lines
Distance between lines
FL
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station Holding
Sewer
Total sorption area
Number of trenches —
Dist, between trenches
From
Tank
Field
Tank
Line
Ft2
Ft.
Well
112.5
N/A
N/A N/A
111.5
TANK El Septic ED S.T.E.P. r_1 Holding 171 Other
Manufacturer
ANCHORAGE TANK
Capacity
I 2000G,I.
Surface Water
100+
N/A
N/A N/A
Material
Number of compartments
Lot Line
16.3
N/A
N/A j N/A
STEEL
2
NA
Foundation
5.0
N/A
N/A N/A
LIFT STATION
Manufacturer
Capacity
-
Curtain Drain
50+
s N/A
N/A N/A
ORENCO
250 Gal.
Remarks TANK REPLACE ONLY
Pump on level at
TIMED in.
Pump off level at
in.
High water alarm at
45 in.
Pump make and model
P2005
Electrical Inspections performed by
MOA BUILDING SAFETY
Installer
PIPE MATERIAL Housetotank 3034 Tank to 3034
drainfield
A+ HOME SERVICES
Drainfield CO1MT 3034
inspector PANNONE ENGINEERING
BENCH MARK (Assumed elevation) 668.Oft
Inspection
dates: 6/9/17 2" 11/16/18
Location and description
3d41"
NE BOTTOM HOUSE TRIM
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
Engineer's Stamp
OF. A
Conditional Approval: Date
—tieve
Approved Date
i4o L
C
AV'
inspection Kepon— j- tiz.00c
NOTES:
RECORD DRAWING
DRAWN
/ |
-----\W -- `
_---- __-
�
FC 6.1
279
Z)
c�
T2 16.7
33.3
LS 19.6
34.6
NOTES:
RECORD DRAWING
DRAWN
/ |
-----\W -- `
_---- __-
�
Date
0 D
Z)
c�
o � <
-J
V)
u � ��F�
� �
|| n 65ti0
nr--
E.P.
TANK
CONNECT
TO MIDDLE
OF FIELD
�"I" RODFILE
SCALENTS
PANNONE ENG SVC, LLC
P.O. BOX 102954 4NCHORkG[. AK 88510
PHONE /807\ 272-8218 FAX (907) 272-8211
WELLMAN LOT l
ALEXANDER GREGORY /k
*c, CANDY PAVELLAS
| 3500 TWILIGHT LANE
| ANCHORAGE. AK 99516
r)
/
Date
11/19/2018
v
Scale
018-281-23
OSP 171114
Sheet
PAL r MUNICIPALITY OF ANCHORAGE
o c n t
On-Site Water&Wastewater Program �� 'S.;
PO Box 196650 4700 Elmore Road
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997
http:llwww.muni.org/onsite
I)cl ,ir1!t1 ni
,hcNOR AVE
On-Site Wastewater Disposal System Permit
Permit Number: OSP171114 Effective Date: 6/2/2017
Work Type: SepticTank Upgrade Expiration Date: 6/2/2018
Tax Code Number: 01828123000
Site Legal Address: WELLMAN LT 1 G:3135
Site Mailing Address: 3500 TWILIGHT LN, Anchorage
Owner: PAVELLAS CANDY & Lot Size in Sq Ft: 49479
Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 3
This permit is for the construction of:
❑ Disposal Field EI Septic Tank El Holding Tank 0 Privy LI Private Well ❑ Water Storage
All construction shall 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 shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Received By: 0( �,� Date: 0/5//Y
Issued By: ,G`l.('rr� Date: 6/a/20 17
MUNICIPALITY OF ANCHORAGE
Community Development Departments Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On-Site Water& Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I,D. 018-281-23
Property owner(s) Candy Pavellas & Alexander Gregory Day phone
Mailing address 3500 Twilight Lane Anchorage, AK 99516
Site address 3500 Twilight Lane
Legal description (Sub'd., Block & Lot) Wellman Lot 1
Legal description (Township, Range & Section)
Lot Size 49,479 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(El all that apply)
Absorption Field ❑ Initial ❑ Single Family (SF) 0
(w/wo ADU)
Septic Tank 0 Upgrade
Duplex (D) ❑
Holding Tank ❑ Renewal ❑
Multiple Dwellings El
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
oa
Permit/Rush Fees `II S Waiver Fees:
Date of Payment: q' Date of Payment:
Receipt Number: Ods Receipt Number:
Permit No. ('t P � - `L I L Waiver No.
Permit App_-• . •c
Pannone Engineering Services ac
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail:steve@panengak.com
May 31, 2017
Subject: Wellman Lot 1
Tank Replace Permit Request
Design Narrative
This is a design narrative for a permit to install an upgrade 2,000g STEP Tank to replace an existing 1,250g
STEP tank to be issued for this property. The existing tank is failing. It will be decommissioned per code.
Currently the lot is developed. The proposed system will utilize a replacement 2,000g STEP tank that will
be connected to the existing drain field. The existing tank is located approximately 100'+ from the well.
The proposed tank will be placed outside the existing well radius. All required separation distances will be
met.
1. Upgrade Tank Design.
A foundation clean out installed if needed.
The tank will be located: 5'+ from any property line or building foundation
10'+ from any water line
100'+ from any surface water
100'+ from any private wells
200'+ from any public wells
The proposed installation will not affect the future development of the surrounding or existing lots.
If you have any questions or concerns, please contact me at 907.272.8218.
Sincerely,
.•'qfc 1b
It
r
r
1t Steven R Pannone
Steven R. Pannone, P.E.
Owner/Civil Engineer
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
Municipality of Anchorage
On -Site Water and Wastewater Program • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP141143 PID Number: 018-281-23
Dwelling:RN Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New FN1 Upgrade
Name:
TED WELLMAN
ABSORPTION FIELD
❑ Deep Trench Q Shallow Trench El Bed El Mound
Address
3500 TWILIGHT LANE, ANCHORAGE AK 99516
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
3
1.2 GPDISF
6.9 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
2.6 Ft.
Gravel depth beneath pipe
4.1 Ft.
Subdivision Block Lot
W ELLMAN 1
Fill added above original grade
0-1.0 Ft.
Gravel length
80 Ft.
Township Range Section
Gravel width
5 Ft.
Beds: Number of Lines
Distance between lines
I Ft.
SEPARATION DISTANCES
TO
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
1
From
Tank
Field
Tank
Line
800 FLT
1
NA Ft.
Well
>100'
>25'
TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Capacity
Surface Water
>100'
Gal.
Material
Number of compartments
Lot Line
>10'
NA
Foundation
>10'
LIFT STATION
Manufacturer
Capacity
Curtain Drain
>50'
Gal.
Remarks EXISTING DRAIN FIELD CONNECTED VIA
Pump on level at
in.
Pump off level at
in.
High water alarm at
in.
DIVERTER VALVE IN STEP TANK.
FIELD OVERSIZED FOR 5 BDRM
Pump make and model
Electrical Inspections performed by
PIPE MATERIAL House to tank rank to
drainfield SCH40
Installer
DEAN CONSTRUCTION
DrainfieldSCH40 CO/MTF810
Inspector ANSON MOXNESS
BENCH MARK (Assumed elevation)100 It
Inspdatio 1st 6/13/14 6/13/14
Location and description
: Zm
3itl Orn
BOTTOM SIDING SE HOUSE CORNER
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
'`QKa ' Stamp
OF gC gs l�►
Conditional Approval: Date
TH9
S E. SPURKLAND.%
��15
Approved
,��
Date l�
10:
Inspection Report_9-1-12. o
SWING TIES A B
D.F. M.T. C 43' 94'
D.F. M.T. D 58' 48'
1
H
3 BORM '4
SFR INSTALLED 5 -BEDROOM ORAINnELD
INSTALLED DIVERTER VALVE IN STEP TANK
TRENCH LENGTH 80 FEET
TRENCH WIDTH 5 FEETB
D MAX EXCAVA ON DEPTH 7 FEET
ROCK DEPTH 4.0 FEET
I COVER 3 FEET (MIN)
LOT 1
LOT /2
1 S U
I11
L M Areo, Cp
II 1 / I Area
W
4 CONTOUR /NE
WITHIN 50 FEET DOWN GRADIENT OF THE PROPOSED
ON-SITE WATER AND WASTE WAT£I
TION. ALL LOCATIONS SHOWN ARE
zs o 25 SCALSO 7,5E, 1' = 50 FT r00 res 1.50�� ; ;'i":
SPURKLAND ENGINEERING WELLMAN LOT I SEPTIC SYSTEM ASBUILT
203 W 15TH. AVENUE
ANCH. AK 99501 TED WELLMAN BA 7E JUNE 13 2014
(907) 279-3916 3500 TWILIGHT LANE, ANCHORAGE AK 99516 SHEET, 2/3 GRID, 3135
PERMIT # OSP141143 PID It 018-281-23 WELLMANLLSC50-ASB.DVG
TH
fS. nfl:=lOf.3'
T0.° PAF FlEY�B.r
BUN cfEVkM'
fisc nn:xxr
Shallow Trench+
5' Wide
80' Long
7' Max. Depth
4' Sewer Rock
3' Cover
3/16' hole 36' on Center
NO SCALE
Trench Elevation (TyP)
/-- Monitor
TO EXISTING FIELD
EXISTING
1250 GALLON STEP TANK
4 ft of' Septic Rock
BENCH NARK FRONT DOOR JAM
ASSUMED ELEVATION 100 FEET
TANK
ISPURKLAND ENGINEERING I I IYELLMAN LOT 1 (I SEPTIC SYSTEM ASBUILT
203 W 15TH. AVENUE TED VELLMAN DAT£, JUNE 13 2014
ANCH. AK, 99501
(907) 279-3916 3500 TWILIGHT LANE, ANCHORAGE AK 99516 SHEET, 373 GRO, 3135
PERMIT # OSP141143 PID # 018-281-23 WELLMANLLD3-ASRBV.-
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: OSP141143
Tax Code Number: 01828123000
Work Type: Septic Upgrade
Permit Effective Dates: June 05, 2014 to June 05, 2015
Design Engineer: SPURKLAND ENGINEERING
Subdivision: WELLMAN
Site Legal Address: WELLMAN LT 1 G:3135
Owner/Address: WELLMAN TED & CYNTHIA M
3500 TWILIGHT LANE ANCHORAGE AK 995164020
Site Mailing Address: 3500 TWILIGHT LN, Anchorage
This permit is for the construction of:
Lot Size in Sq Ft: 49479
Total Bedrooms: 3
Y Disposal Field N Septic Tank N Holding Tank N Privy N Private Well N Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received
Issued By:
MUNICIPALITY OF
Community Development Department
Development Services Division
On -Site Water & Wastewater Program
ANCHORAGUMITTA
MAY h2 9 2014
90 -
Phone: T4t6IA94StUIler
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 018-281-23
Property owner(s) TED WELLMAN
Mailing address
Site address 3500 TWILIGHT LANE, ANCHORAGE, AK 99516
Legal description (Sub'd., Block & Lot) WELLMAN LOT 1
Legal description (Township, Range & Section)
Lot Size Sq. Ft.
APPLICATION IS FOR:
(® all that apply)
Absorption Field
Fx]
Septic Tank
❑
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
Fax: 907-343-7997
Day phone
Number of Bedrooms 3
APPLICATION IS AN: TYPE OF DWELLING:
Initial ❑ Single Family (SF) El
Upgrade 0 (w/wo ADU)
El F1 Duplex (D)
Multiple Dwellings ❑
(SF and/or D)
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
J►�►ir
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
Permit/Rush Fees: '$ 51A
Date of Payment: 5)aq 114
Receipt Number: 015414
Permit No. QSplu11113
Permit App_94-12.doc
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
MINNA& Spurk[and Engineering
Environmental Consulting and Design
SEPTIC SYSTEM DESIGN
WELLMAN LOT 1
Municipality of Anchorage June 4, 2014
Development Services Department
On Site Water and Wastewater Program
4700 Elmore Road
Anchorage, Alaska 99519
Subject: Septic System Installation Permit
3500 Twilight Lane
Ladies and Gentlemen:
I am writing to request a septic system installation permit for the above referenced property. The
existing septic system did not meet COSA operational requirements. The proposed system will
serve a 3 -bedroom single-family residence. The drain field is designed for 5 bedrooms. Should
the new owner of the house decide to upgrade in the future, only a new tank is required. Soil
logs, design calculations, a site plan, design drawings and construction specifications are
enclosed for your review.
Design Cates: Groundwater observed at 15.5 feet.
(5/20/2014).
Soil Rating. From Test hole 5/13/14
2 min/in =1.2 gal per sq.ft./day
No. of Bedrooms 5
Required Area per Bedroom: 150/ 1.2 =125 sq.ft.
Total area required: 125 x 5 = 625 sq.ft.
Use shallow trench with 4 feet effective
Minimum trench length: 62.5 ft.
System: We are proposing adding a new trench with a diverter valve in the lift station of the
existing STEP tank. The absorption field will be 80 feet long and 5 feet wide and contain 4.0 feet
(800 sq.ft. effective) of sewer rock. The existing tank appears to be in working condition and
does not need to be replaced. The required absorption area is within a 30 foot radius of the test
hole. We are adding an additional 17.5 feet of trench outside of the test hole radius for an extra
safety factor.
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland@gci.net
Spurkland Engineering
Environmental Consulting and Design
Soils: A test hole was excavated on May 13th, 2014. See the attached soil logs. Ground water
monitoring will continue through construction of the septic system. Groundwater was observed
at 15.5 feet on May 20, 2014. A small pocket of water was encountered at 8' during test hole
excavation but does not appear to be groundwater. Due to the soil appearance we are adding
additional square footage to the absorption area. The design was based upon a percolation test
conducted in the least permeable soil stratum that will be used for absorption.
Surface Water: There are no surface waters within one hundred feet of the proposed septic
system upgrade.
Topography: The ground level is generally flat or slopes down towards the west at a 5% slope.
Waivers: None
The installation of this septic system will not prevent wells and septic systems from being
installed on the adjacent lots. The proposed septic system will not change the general slope of
the area. Ponding and/or concentration of surface runoff will not result from this installation.
If you have any questions or concerns, please contact me at 279-3916.
203 West 15th Avenue Suite 203, Anchorage, AK 99501, Phone: (907) 279-3916
Fax: (866) 354-1597, Lspurkland@gci.net
I
I I LOT 1
II M
- -LOT 121 - - - - I i j
MIGHT LANE
LOT J
I
evtknr o
E
SNS S 0 �D—
HILL
LOT 2
VACANT
I
LOT 154
®1
S/I D
AN
Gd�e
T13N IR3W SECTION 33
LOT 155
NOTE., THIS 6 NOT A SURVEYED PLAT. WELL A' SEPTIC
LOCATIONS TAKEN FROM ON -SIT£ WATER AND WASTE WATER
DEPARTMENT DOCUMENTATION. ALL LOCATIONS SHOWN ARE
APPROMMATE..
50 0 50 100 150 200 250 300
SCALE,• 1' = 100 FT
i
I
)2(;Aectl�� I LOT 123
Cel
LOT 2
s/DI
LOT 134
— — I
LOT 156
I
I
SPURKLAND ENGINEERING WELLMAN LOT 1 SEPTIC SYSTEM DESIGN
203 V 15TH AVENUE TED VELLMAN BATE MAY 27, 2013
ANCH, AK. 99501
(907) 279-3916 3500 TVILIGHT LANE, ANCHORAGE AK 99516 SHEEP 1/3 GRID: SV3135
PERMIT # OSP1110XX PID # 018-281-23 VELMANLLSCIOO.DVG
50 FEET DOWN GRADIENT OF THE PROPOSED
'WN MO LOCATIGN.
LOT I
ON -SIT£ WATER AND WASTE WAT£F
TION. ALL LOCATIONS SHOWN ARE
❑PJ
ILL DIV£RTER VALVE IN UFT STATION
CH LENGTH 80 FEET
CH WIDTH 5 FEET
EXCAVATION DEPTH 7 FEET
' DEPTH 4.0 FEET
R 3 FEET (MIN)
LOT
I S
M Sept!
Area �J�/
25 0 25 50 75 100 125 150
SCALE, I' = 50 FT
CONTOUR
5PURKLAND ENGINEERING(I NUMAN LOT I I ( SEPTIC SYSTEM DESIGN
203 V 15TH. AVENUE BATE., MAY 27 2014
ANCH. AK. 99501 TED WELLMAN
(907) 279-3916 3500 TVIL16HT LANE, ANCHORAGE AK 99,516 SHEETS 2/3 6RID, 3135
PERMIT # USP141XXX PID # 018-281-23 VELLMANLIS00..DI✓6
Shallow Trench:
5' Wide
80' Long
7' Max. Depth
4' Sewer Rock
3' Cover
3/16' hole 36' on Center
NO SCALE
Trench Elevation (TyP)
Monitor -
EXISTING
1250 64LL17N STEP TANK
4 ft of Septic Rock
TANK
ISPURKLAND ENGINEERINGI I WELLM" LOT I (I SEPTIC SYSTEM DESIGN
203 W K. 99507 TH, AVENUE
ANCH. AK. TED WELLMAN DATE, MAY 27 2014
(907) 279-3916 3500 TWILIGHT LAN£, ANCHURAGE AK 99516 SHEET.• 3/3 GRID: 3135
PERMIT # DSP141XXX PID # 018-281-23 WELL14ANLI.D3.DW6
Spurkland Englneering
203 W.1SthAve. Ste. 202A
Anchorage, AK99501
TEST HOLE I _ I
DEPTH
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
SOIL LOG AND PERCOLATION TEST
'ZnIL DESCRIPTION DATE: Ski 14
anics WAS GROUNDWATER OBSERVED: YES, SEEPS
IF YES, AT WHAT DEPTH: 8'
AFTER MONITORING PERIOD: 15.5 — _
DATE OBSERVED: 5/20/14
dy Silt PERCOLATION TEST:
1ML)
y Sand
LEVEL
FILL
DATE I GROSS TIME
NET TIME
DISTANCE
I DROP
9.250
5 15 14 12.18 PM
0 min.
9.125
12.28 PM
f0 min
14750
5500
9.438
12:38 PM
10 min
14188
5.063
9.063
12:48 PM
10 min
14250
4.813
9.125'
12.•58 PM
f0 min
13375'
4688'
9.125
1:08 PM
10 min
1, 188
4938'
1:18 M
m n
13.250
4875
PERCOLATION RATE: 1 minutes/ inch
P£RC HOLE DIAMETER: 6 inches
TEST RUN BETWEEN 4.5 FT AND 5 FT
SITE PLAN:
NOTES: PRE SOAK CONDUCTED
PERFORMED BY.• Anson Moxness. G Lars Spurkland P.E. CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE.
SPURKLAND ENGINEERINGI I JYEHMAN LOT 1 I I SOIL LOG PERCOLATION TEST
203 W K 99501 TH. AVENUE
ANCH. AK. TED WELLMAN BATE, MAY 20 2014
(907) 279-3916 3500 TWILIGHT LANE, ANCHORAGE AK 99516 GRID #% 3135
PERMIT # DSP 141XXX PID # 18-281-23
Municipality of Anchorage Page —I of?
72-013
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: sWR400li PID Number: O/Sz8lz3
Name:
Wastewater System: ❑ New 19Upgrade
TEV 1nr'%ELLWI AN
Address:
ABSORPTION FIELD
3500 TW / G,4.uE
_P4 n1 •
No. of Bedrooms:
1 3
Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound '❑ Other
A1jCH0P_AC,T K 99s/Cp
LEGAL DESCRIPTION
Soil Rating: /-
D.
Total Depth from original grade: r
VJGPD/S . Ft.
Lot: .Bleak: Subdivision:
SZ
Depth to pipe bottom from original grad9:
Gravel depth beneath pipe /
iu)ELLM16)
Ft.
Ft.
Township:
Range:
Section:
Fill added above original grade:
Gravel length: �r /
Ft
Ft.
WELL: ❑New 11 Upgrade
Gravel width: /
Number of lines:
'
Distance between lines:
Ft.
id Ft.
Classification (Private, A,B,C) p(/ST.
Total Depth:
Cased To:
Total absorption area:
��SD.
Pipe material: 1,610 rrep-
AS77-1 -0
P IVA E
Driller:
Ft.
Date Drilled:
Ft.
Static Water Level-
Ft.
installer:
D?
Ft./�/
Linstalled:
am/
Yield:
Pump Set at:
Casing Height Above Ground:
TANK
GPM
Ft.
Ft.
f�
SEPARATION
DISTANCES
Septic ❑ Holding S.T.E.P.
To
Septic
Absorption
Lift
Holding
Public/Private
M anuffaactuJerlJ �
capacity galloons:
From
Tank
Field
Station
Tank
Sewer Lines
T�j`/v F—
O50
Welt'
I
Material:
Number of Compartments:
Im'I"
--
LIFT STATION
Watere
Ick
Lot
+
Size
t-.2
Macturer;
?,,. rps G E -Fp-,-,
Line
Foundation
_
"Pump on" level at:
42 n
'Pump off" level at:
� 12-1
High water alarm at:
Curtain
Pati5p i akjyodpl
Electrical nspe tiops performed by:
Drain
Yom_•
�y
Remarks: G}" I�ISUt—ATIa�
BENCH MARK
Location and Description:
�p 2A l: tS-�-/2 �.�
Assumed Elevation: p
Ft
ENGW.r2Ep54}S A,L
<,i
` a F egi
f eon+} �Iv
S $ 5 ENGINEERING
Inspections performed by: 17094 Eagle River 16601 Road, Q : 1St
`
1 eoo o� h
Eagle River, Alaska 99S77 2nd ��
Yo ha6a
Department of Health a d uman Ices appro al
.cmc/Dat-
Reviewed and approved by: Date
]2-013 (Rev. 9/91) MOA 25
Permit No. SW940011 Page 2 of 2
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 * Anchorage, Alaska 99519-6650 9 Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Legal Descriptioffl-LIMAN SUBDIVISION, LOT I PID No.: 01828123
72-013A(1/93)-
CO1 CO2:
107`4 MTI
100.0.1
MH
................... . ......... ........... - ......
SR
J&Z
NEW
95.1':
1250 G AL
S. T.E.P.
S
94.9'
SYSTEM YSTEM
.......... ........
... . ..... ........................
95 7
................. .....................................
A
B;
A 89.7' NO WATER FOUND
FCO
40.0
2.0
COI
40.5
6.0
CO2
41.0
1M.H.41.5
1210
M5
MT1
MT
56.0
80.0
M MT
T2 54.5 9410
NEW PRESSURE
----------
N
DIST. DRAINFIEL)
INSULATION
DRIVE
...........
..
MH
...... ............... ....... .............. .. . .................. ..................
............ ............. -
W
CO2
MT2
A NEW. 1250 GAL.
o
S.T.E.P.
----- --- - - - ----------
3 BDRM
NA,4,
HOUSM
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1-1 -A
... ........ .1 "PP
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I.,
40''
72-013A(1/93)-
INSPECTION REPORT
MUNICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION
3500 EAST TUDOR ROAD
INSPECTIONS (907)563-•3464 INFORMATION (907)786-821I.
NAME: ED'S ELECT PERMIT fir: 907805
`` PHONE 0: 272 4`i91.
ADDRESS: 3500 TWLIGHT.S �2j ?
LOT, I BLOCK, SURD: W,F.LMAN DATE: 7/22/1994
COMMENT: SEWER LIFT HOOKUP
+ C
- ---- -----------------.._.----
TYPE 09 INSPECTION: ELECTRICAL SERVILE
0 0
0 0
_-__---_--_._._.--_.__-_.---__.----_.-----,.-_._ _
I: 3 NO NONCOMPLIANCE OBSERVED C I CORRECTIONS ESSENTIALAS
/ EXPLAINED BELOW
C 7 WILL REEXAMINE AT NEXT INSPECTION C 1 DO NOT CONCEAL UNTIL REINSPECTED
COMMENTS:
1
%l
INSPECTOR: DATE."
_.ji��-:�111�____.__.__.-----._..____________--.--_------____-____._
MEN CORRECTIONS ARE MADE, PLEASE CALL FOR INSPECTION
DO NOT REMOVETHIS NOT"
JUN -21-94 TUE 1541 S,0, A. DIV, OF WATER FAX NO, 9075K1384 Pr 01
- -i36�.5
Anr tri'"±cr,T— tvOtSh l.ika 1tK2 d 2101 illi^0321' \
V .A T E; v E L L P E C 0 H C
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1OU715H OF WELL `— Pleeze crimple to ei V,er la lb, tr 111 (n, Permit No. -- ----� .--
r ...— — _ Cf Ic,
4. &5fOW9h PJtIdIVlF ton Lc[ NI^„r Ib, Frart lo^ S-r-"-"—„-�-
t cel ion Ha. To�mhla .9a ere --
12n@
(ersett l0nf L O -NCA OF'WELL,
Tei 100— 1 1 L,ar)
AdCrca [:
Strut i.itaua
2. WLLL LOG
4. WELL OCPTN; I:4mal r, c:li Ser face E1 t•e-
prface _ I lien matt of
M`^tCYlal Type TJP13
PO['�m �t Cpr,pl e(ipn
5. hlcaoia F:nl cear.
---- _.. �r•el� 1P1ae - —2 7 ❑> y ❑5flven 0=p9
.—.� a,r�Pl. rT(<r• �!i 4nAn,e Clvttec �Pered r�OLher:
e V'rig3 o. USE: u:e:.+a,efe �Pic;rYy.pt1' '"II�Austry
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N.�Cx�_hJw ara,`------..,-
_ I G1.ave ❑2e 1c'v Ileo wrface
type: of
POSt-It'" brand fax transmittal memo 7671 om p;,yrs
?6z. Asx
Pex d
2�. 5-%2 t 3 9lc
IO. ?LHF16G LETEL >elp:; lane �ffacc--- _.__
-- --_� 4•c. m.
after _ _ hr, . P.,,..PIn9
I1. ':ELL HEAD CChrL ET I 6v-•-+'�4� In n:Drovca Fit
L_;pi Cleea Adap(cf-ipiLea a
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les
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13. PCtiF: (If
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Y-� 9
T9pef CI1SA„erzlble IJ Rcc ipf Otv ti ria
t,J'e1 L-f(jLPer:
IIS. JATER YELL ::IRaaC TOA'S :EFTIT t:dTICY:
tnis retd" to r
TF.i1 he('l'l''ray :n IIeC _nacr 'Y jvf'3Q i�:ion LnC IS [!oe r ( of my kne..l e9:e end bel:.l
^<^e_terea Sas nss
7 _
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r
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JUN -21-94 TUE 15,42 S, O, A, DIV, OF WATER FAX NO. 907t:621384
—ti? WATT R W _:.(.riot;
P. 02
i ,� Y: ° !A
?053 DRILLING
ig5t 08s ttt
Anchorngco, A1Rukla 99-,
c
WELLOWNER��S.� �,!�-.1��22G�.tL��. �--.
I,00ATI0)1 zjyr , r L
SIZE OF
CASING Lp
DEPTHOF
HOLE ,?T- CASED TOvFT.
.STA'TIQ
wNI'Pli Ltv�L
7 y
rl. iT f��� �AL.PRH.MII.'.
4dII'Ilr s!Z�_�
FEET AP DRAG4WNt
REMARKS
DATE COMPLETED cSt —L, " z ___PUMP TO fiL* 3EP AT
-9-t O -LG J
to1�
!fit oL�,LC/
/Y—b— t�
12-9—t ozr
/4�L C�"
1..Z r1 j-%
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JUN 21 94 TUC 15:42 S, 0. A, DIV. OF WATER
` RETURN TOt DIylllpr of Cenl pgful sic' Cccp:ryalt.l :'rats (DOGS)
)DDI POrcuple. Drive (7 a ltpgcco: 277-6615)
Anchorage. Alaska 99501
I
AN[ N0, 9075621304 P, 03
STATE OF ALASKA
DEPARTHINT OF HATUIUL RESOURCES
YY.. ysp r♦ �y�������W A. T E R W r L L R E C O R D
Orf111ng Coaoany Hand FOSS L1�J�LLt.LJ11i_- __ ti.S.G.S. Laiai No. Y ----,— --
Drilling Permit No.
LOCATION Or WILLS]
dR16e1e COMPla[a althar la, Ib. Or IS tptp t1 A.P.L. No,
-,._-__.�..._._.
la Borough lvisipn ~LoRlnc
t tb. Fr"a cn a I Ycwnahlp Aa n9r Ger id len
Ra bit Cr 13t
l
'Jae DjstjO,. and Direction from Road Intersactiens `EP DWI±LR of WELLTpd Wellman
-Adess: SRA Box 490-u
()iV, Of Geolori.l_i! S!rr�drey A_y)ohorage, AlEi&ka 99507
Street Address and Ar" of Wall Loc.06A r�T1G110tU 0
1.
WELL LOG Feel Beau,. W4^vELI DEF TIL (:an.p le[cd} 5uf fare Lirra[[on fate Of
Material
ed
I
_ Surfaceit
Top
_-----1-�
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pp Cpom�p� at on
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--5: --in. to _1�ft. napLh weight ib5/f[.
In. to ft. Depth
FINISH CF WELL:—^---..._..... ...--.._�.__..�
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Set between ft, and ft.
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Type of xeo vi na,a; _'It +�,_t�2 `a9.fuls�%r
-- -- -------_ - --- __._.._...- ----
�taY�NGry LEvtL iasow tano [arface
f t. after ..__4-, hrs. ... g.p.m.
hrs. p..rping
11. WE" vmaoLJ:Y:S7 D:k: �f )�u In A;F'Qrvcd Pit
np!tleas Adapter 24 inv,es awp . irade
------
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-- - -
ilie
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Type . L. ."merTbie ❑P.cclprocating
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___.... .....
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---�--
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11 WIMA H61 11111KIPH'1 Ii611111AM1111,
This well sees drilled under my
j1 jurlsd!ctlon and :his report Is true [e the b,
1"'ii%Dr4j)i!f Yl 1 _
s�tyre[e/red B --/as^ mess nerf- Cf
Address:` Ct -•1.E7C, r N.(-, P})-)
5igned: A—
Aut orl2tJ Rspredentat L.e
f .,y kno,.!ed,c s{d be!lef:
Da to:
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE a n(Y-\
DEPARTMENT OF HEALTH AND HUMAN SERVICES (o _Q(
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW940011
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:WELLMAN TED &
OWNER ADDRESS:3500 TWILIGHT LN
ANCHORAGE, ALASKA 99516
PARCEL ID:01828123
LEGAL DESCRIPTION: WELLMAN LT 1
LOT SIZE: 49479 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
DATE ISSUED: 1/25/94
EXPIRATION DATE: 1/25/95
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 OR 343-4681 AFTER BUSINESS HOURS
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 B
ISSUED BY:
I
DATE:
DATE: /- 2 5- -
A`
,A
HEALTHAUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITEPLANS
ROAD DESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSALSYSTEM
DESIGN
EI
January 16, 1994
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
Anchorage, Alaska 99519-6650
REFERENCE. Wellman Subdivision, Lot 1
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
We request you issue a permit to upgrade the septic system serving the
three bedroom house on the referenced property and issue a conditional
Health Authority Approval.
An adequacy test performed on the existing system for Health Authority Approval
purposes found the absorption capacity of the existing system to be inadequate.
A conditional Health Authority Approval is request until the system can be
upgraded in the Spring 1994.
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. The monitoring tube within the test hole has been checked
and found to be dry. Attached is the proposed upgrade design.
We do not anticipate any adverse effects on neighboring properties by the
installation of the proposed septic system.
If you have any questions, or require additional information for your review,
please contact us.
A. Shafer, P.E.
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
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Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
r SOILS LOG — PERCOLATION TEST
PERFORMED FOR: IED WC-W'Y(�1n�JN DATE
LEGAL DESCRIPTION: LUT WE
Z&,q/j Township, Range, Section:
DEPTH
T')
(�rtr Ntcs
A
2O2fiR1JlC CJ(x ZPN D J C ftl�
sxn
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ENCOUNTERED?
S t°
L
T WHAT O
P
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t�a��rsl� Sz.7
To A 10 c, GpQW
SAf�()
COMMENTS
Reading Date Gross
Time
IF YES,A
A,r /
DEPTH?
C SAtJL
to Wale te�YY
W
Monitoring?
t�a��rsl� Sz.7
To A 10 c, GpQW
SAf�()
COMMENTS
Reading Date Gross
Time
Net
Time
Depth toEDrop
Water
f•A%2
AtiN
30 i'3L
/0MW
3/Y"g
d
_
it
_
16AAUI
l�MR
s
to
y�g"
aig
PERCOLATION RATE 2 (minutes/inch) PERC HOLE DIAMETER 6o/
TEST RUN BETWEEN 5 FT D ` X FT
PERFORMED BYS & S ENGINEERIPfG
17034 Earr'g(��
ACCORDANCE 19ATF� AL' 5`r, Alas a 99577 �lIQ -
ag a rVer, Alaska 99577
72-008 (Rev. 4/85)
CERTIFY THAT THIS TEST WAS PERFORMED IN
ON THIS DATE. DATE:
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
REFERENCE: Wellman Subdivision, Lot 1
GENERAL:
The scope of this project includes the installation of a 500 gallon septic tank
effluent pumping (S. T. E. P.) system and a leachfield trench to serve the
three bedroom residence located on the referenced propertyand excavation
of the existing 1000 gal septic tank to verify its integrity. If the integrity of
the existing septic tank is poor the existing septic tank is to be excavated,
pumped, crushed, and abandoned in place and a new 1250 gallon septic
tank effluent pumping (S. T. E. P.) system installed.
2. 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.
3. The contractor shall be responsible for obtaining any necessary
underground utility locates.
4. Unless specifically agreed otherwise, the property owner shall be
responsible for final grading areas subsequently depressed from soil
settling.
5. Contractors installing wastewater 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.
2. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
3. All standpipes on the septic tank shall extend a minimum of 12 inches
above final grade.
Page Two
Wellman Subdivision, Lot i
January 16, 1994
4. Septic tanks installed with less than 4 ft. of cover shall be insulated.
5. 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.
6. Final grading over the septic tank shall be such that a positive slope exists
away from the septic tank.
ABSORPTION TRENCH/DRAINFIELD INSTALLATION:
Excavate the proposed trench to the dimensions shown on the design. The
bottom of the excavation shall be within 2 inches of level. If the sidewalls
of the excavation become smeared, they must be raked or scratched
(ruffed -up) before gravel (sewer rock) placement.
2. Once the gravel is installed, the distribution pipe is to be installed level with
the perforations faced downward. Gravel is then to be placed over the
distribution pipe to provide a minimum of 2 inches of cover over the pipe.
3. A silt barrier must be installed between the final gravel layer and the native
soil backfill. Ensure the silt barrier covers the entire gravel surface before
placing backfill.
4. Monitor tubes shall be of four (4) inch diameter and installed approximately
in the locations shown on the design. The portion of the monitoring tube
extending through the gravel shall be perforated from the bottom of the
trench to the invert of the distribution pipe. This is equivalent to the
effective depth of the gravel as noted on the design.
5. 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 finish grade over the trench must be mounded
to prevent the formation of a depression after settling.
Page Three
Wellman Subdivision, Lot i
January 16, 1994
MINIMUM MATERIAL SPECIFICATIONS;
1. Any septic tank proposed for installation 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:
Tvpe 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.
3. 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).
5. 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.
6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with
less than 3% passing the #200 sieve.
7. When sand is being used as a filter material, it's gradation specifications
must conform to current M.O.A, or D. E. C. requirements.
Page Four
Wellman Subdivision, Lot i
January 16, 1994
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
ditches, 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.
2. 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.
3. 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.
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.
i
MUNICIPALITY OF ANCHORAGE
V
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
PHONE NEW
�J�,
C `LC J�n`r
�t5� ED UPGRADE
MAILING ADDRESS
LEGAL DESCRIPTION
! CC% �' 1 L % �'5L
\
nn�
l S it�Xrnrat�l .
LOCATIO
G'
NO. OF BED ODMS
T
r
DISTANCE TO:
Wel
Absorpti n area
r
Dwelling )
PER IT. O.
�/
UY
Y�
/�✓
F Z
Manufacture r¢_"I
eri
No. of co partments
w
Lie. ca a allons
CCJJ
a2y
IF HOMEMADE:
Inside length
Width
Liquid depth
O
DISTANCE TO:
Well
we lig
PERMIT NO.
Jt7Z
_
Manufacturer 17
Material
Liquid capacity in gallons
O
w=
DISTANCE TO:
Welld
Oro
Foundation -
Nearest to "nes
PERMS.'C� .®���
/
� a Z
Zw
No. of lines
Length of e cI I
Total length of lines
Trench wi th
.� inches
Distance be li es
/¢
Q
CQ ~
Top of rile o finish grad >
Material beneath
/
Total effectiv abs rption area
Zp
O
4;7
inches
3
Length
Width
Depth
PERMIT NO.
w
Q F-
Type of crib
Crib diameter
Crib depth
Total effective absorption area
wa
y
DISTANCE TO:
Well
Building foundation
Nearest lot line
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
w
�
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
Deo
V
OTHER
PIPE MAT IALS
A5Ti12'%'0��
us
SOIL TEST RATING
r�Q
INSTALLER
AL
OcUuE P. cv
REMARKS
�j
AT 1 '1'e> In - tS 0eDO
�-
'
PPROVDATE LEGAL
t 2, 1 %�
I� 72- (Rev. 3178)
~ �\
1-1 R -A H41 1 CC X Fn- -71 L '3: -T kv� ��� �1JR-01-o
DEPHRTMEHT O"'4EHLTH AND ENVIRONMENTHL R��TECTIO��
825 /L' STREET, ANCHORAGE, HK. 99501
264-4720
� ^ w sE. n L , Fs mA Es co m -- w x -r EE -. :S5: 0 5 EE F;-": �FE. �R.-F DE 1 -
PERMIT NO. ( 790140 .-
APPLICANT
HPPLICHNT TFD WELLMHN
LOCATION RABBIT CREEK AREA
LEGAL LT.135 BLM SM TR.
TYPE OF SOIL RBSORBTlON SYSTEM IS
490-E SRH HNCH
TRENCH
�
LOT
SIZE
54000 SQUARE
FEET
�������
������
�
-~_
THE
MAXIMUM NUMBER OF BEDROOMS = ] SOIL RATING (S8 FT/BR)� 220
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
� �
fl- lot
��������
��
�������
������
�
-~_
THE
LENGTH
DIMENSION
'_-_--'---
IS THE LENGTH
(IN
FEET) OF THE
TRENCH OR DRHINFIRLD.
WITHIN 30 DAYS
THE
DEPTH
OF R
TRENCH OR PIT
IS THE DISTANCE
BETWEEN
THE SURFACE
OF TkE
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).
141=0=3110101K>
nNEEF"-FluD
�FIF400
�cachus
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.
--- ____ -1- 1"! CD ��� �1 �IF--, ��F'."g H.J 1: F! ERE 12;
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN H WELL
AND ANY ON-SITE SEWAGE DISPOSAL
SYSTEM IS
100 FEET FOR H PRIVATE WELL/ OR
150 TO 200 FEET FROM H PUBLIC WELL
DEPENDING UPON THE
TYPE OF
PUBLIC WELL.
�WELL LOGS ARE REQUIRED AND M//ST
BE RETURNED TO THE
DEPARTMENT
WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY RPPLY� SPECIFICATIONS AND
CONSTRUCTION DIAGRAMS ARF
AVAILABLE TO INSURE PROPER INSTALLATION.
� �����El- P. :1 - F- FEE 4: lF. S"-;
ED, EF Cl FEE P1 E3 F=: Fe
f R,
`E;�n
I CERTIFY THAT
1: I HM 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 THE CODES.
Z: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN I BEDROOMS,
SlGNED:
APPLICix
ANT TED NELLMHN
ISSUED 8
h BOMHOFF & ASSOCIATES, INC.
Engineering - Planning- Surveying
i02o West International Airport Road
April 16, 1979
Dor. Ted Wellman.
SRA Box 490-E
Anchorage, Alaska
Dear Mr. Wellman
Anchorage, Alaska 99502
99507
Telephone (907)2749621
We have performed a soils investigation for an on-site
sewer system on Lot 1 of B.L.M. Lot 135. The work
consisted of a 17 foot test hole and percolation test.
The results are attached.
We recommend that a drainfield trench with washed
gravel from 4 feet to 12 feet in depth be employed. The
soil can be rated at P square feet per bedroom.
Please call if you have any questions or comments.
Sincerely,
FF $ ASSOCIATES, INC.
Paul G. Hansen, P.E.
Senior Engineer
Attachment
PGH/jh
highways • airports . drainage • planning . shopping centers • subdivisions • streets • water • sewage
I
Performed for —
Legal Description:
This form reports:
dl,-;ATER ANCHORAGE AREA BOROU--r
Department of Environmental Quality
3330 "Cr Street
Anchorage, Alaska 99503
Depth
Feet
M SANOV Sur - wrrN--
2 Gi VS L� (ML), 2," IAA.)(
3 -
10-
12-
14-
16-
18-
20 —
— PEROLATION TEST
Hyl Iver, moo Dvi�
16 DRU bF Sh-TY ""AC -4-1-.
S-A'rJ0 CSUI, aCc-ASlONl XY
SgPt A!__3'-8'�_�SC«�'/i
•✓rTMP� 4+,�?li X11.1 ltJ 6
Was groundwater encountered? LY t3 If yes, at what depth?
BY
8' -Sb P014
Reading I Date I Gross Time I Net Time I Depth to Water I Net Drop
Percolation
Proposed installation: ,� Seepage Pit hd Drain Field
Depth of .•• • bot of pit or trench
isIN
W
MUNICIPALITY OF ANCHORAGE
Development Services DepartmentPhone: 907-343-7904
^T
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D.018-281-23 Expiration Date: Zd Zo
1. GENERAL INFORMATION
Complete legal description WELLMAN LOT 1
Location (site address) 3500 TWILIGHT LANE, ANCHORAGE, AK 99516
Current property owner(s) CANDY & GREGORY PAVELLAS
Mailing address
Real estate agent
Day phone
1636 CAMPFIRE ROAD, LAKE CHARLES, LA 70611
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
5
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
®
Private Septic
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 5—y© – m-5,0
Date of Payment ,SL 2 Z/ 2.0 Z0
Receipt Number
COSA# (9 SG 2G? 2c95_
Waiver Fee $
Date of Payment
Receipt Number
Waiver #
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. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm FIRST WATER CONSULTING Phone 907-350-9566
Address 13030 SUES WAY. ANCHORAGE. AK 99516
Engineer's Printed Name CURTIS HUFFMAN, PE Date
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. The assessment of the condition of the well and septic
applies only to the conditions as of the day tested. The flow and absorption rates may change
due to subsurface conditions that may not be observed from the surface, changes in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. The operational life of all well and septic systems are subject to
these various and dynamic characteristics and are outside the control of the evaluator of the
well and septic system. Therefore, any estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by First Water Consulting &
6. DSD SIGNATURE
System #1 Approved for bedrooms
System #2 Approved for
Disapproved
Conditional approval for
bedrooms
6/19/2020
*: 49 TM ....�:*
• • Curtis Huffman
�F`• . CE 128991 • �`���
����is��R' • (/19/20 • •���',.�-
i�kF, ROFESSIONP
bedrooms. with the followina stioulatioMWM(Wr,.
'//111......1♦\\1.
By:Original Certificate Date: (o' q' 2d2 d
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.
ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory . Other
Legal Description: WELLMAN LOT 1 Parcel ID: 018-281-23
If more than 1 septic system on lot: COSA Checklist # _of . Structure served by this system
A. WELL DATA
® Well log is filed with Onsite (or attached)
Date drilled 8/1979
Total depth 182 ft
Cased to 182 ft
® Sanitary seal is functioning correctly
® Wires are properly protected
Casing height (above ground) 18+ in.
Date of flow test for COSA 5/19/2020
Static water level at beginning of test 34 ft.
Well production at time of test 4.5+ gpm
Comments
B. TANK DATA
Age of tank(s) 1.5 years
Tank type/material STEP / STEEL
Measured operating fluid level in septic tank
® Standpipes/foundation cleanout per record drawing
Date of pumping 5/19/2020
D. ABSORPTION FIELD DATA
Which system tested (date installed) 6/13/2014
® ALL standpipes present per record drawing
Total measured depth from grade 8_1 ft (max)
Measured depth to pipe invert from grade _ft (min)
® N/A — pressurized field
® Monitor tubes go to bottom of effective. If not, state
depth into effective
Water storage tank volume NA gallons
Well disinfected for coliform test? ❑ Yes ® No
® Coliform bacteria is Negative
Nitrate 0.76 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ® Arsenic less than MRL (ND)
Collected by
FW'f�S
Date of Sample 5/19/2020
C. LIFT STATION
® Required maintenance completed
Age of lift station 1.5 years
Lift station material
Comments: *STEP float setting. Maint. report attach.
Adequacy test date 6/18/2020
Results 0 Pass For 5 bedrooms
Fluid depth prior to test 0 in
Water added 770 gal
New depth 0_5 in
Elapsed time <1 min
® Code -required soil cover over field Final fluid depth 0 in
❑ System presoaked Absorption rate 750+ and-
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) N
date of test) If yes, enter date
Gallons introduced gallons FW'C5
Comments/Deficiencies: .,
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
® Yes if No ft
Wells on Adjacent Lots:
Community Sewer Manhole/Cleanout > 100'
® Yes
if No
ft
® Yes
if No
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25' ® Yes
if No
Absorption Field on Lot > 100' ® Yes
if No
ft
Holding Tank > 100' ® Yes
if No
Neighboring Absorption Fields > 100'
Surface Water > 100'
® Yes
Animal Containment > 50' ® Yes
if No
® Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ® Yes
if No
ft
® Yes
if No
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' ❑ Yes if No 5' ft Surface Water > 100'
ft
ft
ft
ft
ft
® Yes if No ft
Property Line > 5'
® Yes if No ft
Wells on Adjacent Lots:
Absorption Field > 5'
® Yes if No ft
Private Wells > 100' ® Yes if No
Water Main > 10'
® Yes if No ft
Community Wells > 200' ® Yes if No
Water Service Line > 10'
® Yes if No ft
If septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10'
® Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
® Yes
if No
_ ft
Wells on Adjacent Lots:
Water Main > 10'
® Yes
if No
ft
Private Wells > 100' ® Yes if No ft
Water Service Line > 10'
® Yes
if No
ft
Community Wells > 200' ® Yes if No
Surface Water > 100'
® Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION 4.®,a`r�►®d���Ak��
1 certify that I have determined through field inspections and review .� • �,
of Municipal records that the above systems are in conformance �j�4' • • • • '.��► ���
with MOA COSA guidelines in effect on this date. ik; • TH • • . ••: ��
.... ....�..�....
Curtis Huffman
��� �°F�,•, CE 128991 .• �� ,+'
�F9F4ROFES510��
ft
ft
(� Frontier Surveys, LLC Project No: 20-181
Ordered By: Morgan Michelsohn
tir
Scale 1" 50'
Date: 6/2/2020
Plat: 79-75 1 Grid: 3135
E TWILIGHT DRIVE -- —
nron• nn• nn^c Tae ax Dcr
HOUSE DETAIL -SCALE: 1 "=15'
Electric Meter/Outside Power r'O., Telephone Pole 4� Found Pipe
y Gas Meter ® Deck —x— Fence o- Found Rebar
$; Septic (W; Water Well 'X Elec. Ped.
General Notes: 0 25 50 100
1. This document is created for the purpose of a single property transaction and is subject to Federal Copyright Laws.
2. Excepting for gross negligence, the liability for this survey shall not exceed the cost of preparing this survey. SCoIe In Feet
3. All measurements/setbacks are to the visuaVapparent building footprint.
4. All dimensions to property lines are plus/minus 0.1fl.
` ```�*"%*'NN,ttt This survey complies with the ASPLS Mortgage Location Standards. The survey represents visible improvements and
O F Q i t I t conditions at the time of the survey. This document does not constitute a boundary survey and is subject to any
�� ( r inaccuracies that a subsequent boundary survey may reveal. It is the responsibility of the Owner to determine the
Q�. • • • • •.9S�r/V' existence of any easements, covenants, or restriction which do no appear on the record plat. Under no circumstances
•_ 9 should this document be used for construction or for establishing a boundary or fence line.
4 H � As -Built Survey of:
i ... .. .. :. .;
Lot 1 Wellman Subdivision
.................
Pier M. St gier ; Q'i
rz= I, Pierre Stragier, hereby certify that this Mortgage Inspection Survey was performed by me, or
irl.sT
06/4/ 20 under my direct supervision on June 2nd, 2020.
rrfloliRo't„ ON;; 'Pao` Frontier Surveys, LLC FRONTIER,
650 W. 58th Ave. Suite E Anchorage, Alaska 99518 SarvCys•.
907.460.1686 - info@frontiersurveys.com
PROFESSIONAL SEAL www.frontiersurveys.com
MUNICIPALITY OF ANCHORAGE
Development Services Department �'� j Phone: 907-343-7904
On -Site Water & Wastewater Section �'�,' Fax: 907-343-7997
Lift Station/Pump Vault
Owner
Septic Tank:
-Sludge level inches
Lift station:
b v
Street Address 3s -oz) T,,� � �2�'1,-�'
-Pumping: required e no
-Pump basket cleanedren
-Control floats cleaned•Operation satisfactory
Alarm System:
-Pumping completed e no
-Effluent filter cleaned es } no
-Proper float settings confirmed es no
•.s
Dedicated electrical alarm circuit es no -Audible and visual alarm inside dwelling es no
Alarm system operation sa is acto not satisfactory
Manhole Riser
-Ground water intrusion at riser to tank connection Isn•Ground water intrusion around pipe penetrations e -Weep hole functional es. no
-Manhole lid: Functional (g no Insulated es no Properly Securedes no
Other
-All manufacturer required inspections and maintenance completed yes no
Comments:
Qualified Maintenance Provider:
Technician >' lz-N4Q �-f
Company L
Signature
Date of maintenance
Date 2 Slk
• '� Municipality of Anchorage
On -Site Water and Wastewater Program
(907)343-7904 �r..
Certificate of On -Site Systems Approval r
Parcel I.D. 018-281-23 Expiration Date:
1. GENERAL INFORMATION /
Complete legal description WELLMAN LOT 1
Location (site address) 3500 TWILIGHT LANE ANCHORAGE AK 99516
Current Property owner(s) TED WELLMAN Day phone
Mailing address
Real Estate Agent Day phone
2, TYPE OF DWELLING:
x❑ Single Family (w/wo ADU) 6IVi 1 t 4 #-i g
[j Duplex L
❑ Multiple Dwellings (Single Family and/or Duplex) JUN 17 2014
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
IN
Individual
0
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
P"b—li- —te. C,M
El
Public Ccwar
❑
Waiver/Variance request for: NONE
q nis}ance- ___
Received by , ✓amu' - - --" Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ Waiver Fee $
Date of Payment blit S Date of Payment
Receipt Number ObZI6, Receipt Number
COSA # 1245 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 SPURKLAND ENGINEERING
Address 203 W. 15TH AVE.,STE.202A, ANCHORAGE, AK 99501
Engineer's Printed Name LARS SPURKLAND
6. DSD SIGNATURE
l System #1 Approved for 7 bedrooms
System #2 Approved for bedrooms
Disapproved
Conditional approval for bedrooms,
Phone 279-3916
Date 6113/14
.,r
L E. S?URKLAND.��
• .<�' ys
l�
50
� � AFD .lQ�l �'.�.•, r�,�`,�,'
with the following stipuI tions.
gy. Original Certificate Date:
They nicipal' of orage 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 Anchorageis not responsible for errors or omissions in the professional engineers work.
ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA bluesheel f _� -
If more than 1 septic system is on the lot:
COSA Checklist # 1 of 1
Structure served by this system 1
Certificate of On -Site Systems Approval Checklist
Legal Description: WELLMAN LOT 1
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID #-
Date completed 8/1979 Sanitary seal (YIN) Y
Total depth 182 ft. Cased to 182 ft
FROM WELL LOG
Date of test 8/14/1979
Static water level 42 ft.
Well production 8 g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate .133 mg/L
Arsenic NO ug/L Date of sample: 5/27/14
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC/STEEL
Tank size 1250 gal. Number of Compartments
Foundation cleanout (YIN) Y Depression over tank (YIN) N
Date of pumping 10/24/13 Pumper ISAACS PUMPING
Parcel ID -018-281-23
Well Log (YIN) Y
Wires properly protected (YIN) Y
Casing height (above ground) 12+ in.
AT INSPECTION
6/13/14
40
6.1
ft.
FI
Collected by: ANSON MOXNESS
Date installed 6/18/94
Cleanouts (YIN) Y
High water alarm (YIN) Y
C. ABSORPTION FIELD DATA
Date installed 6/13/14 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.5 System type WIDE TRENCF
Length 80 ft. Width 5 ft. Gravel below pipe 4'1 ft.
Total depth 7 ft. Eff. absorption area 800 ft2 Monitoring tube Y Depression over field N
Date of adequacy test NEW Results (Pass/Fail) For _ bedrooms
Fluid depth in absorption field before test in. Water added gal. New depth in.
Elapsed Time: min. Final fluid depth in. Absorption rate >= --- g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) If yes, give date
D. LIFT STATION
Date installed 6/18/94
"Pump on" level at 42 in.
Datum BOTTOM OF TANK
E. SEPARATION DISTANCES
WELL ON LOT TO:
Size in gallons 1250
"Pump off" level at 32
Cycles tested 2+
Septic tank/lift station on lot 100'+
Absorption field on lot 100'+
Public sewer main NA
Sewer /septic service line 25'+
Animal containment areas 50+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5'+
Water main NA
Wells on adjacent lots 100'+
Manhole/Access (Y/N) Y
in. High water alarm level at 44
Meets alarm & circuit requirements? Y
On adjacent lots 100'+
On adjacent lots 1001+
Public sewer manhole/cleanout NA
Holding tank NA
Manure/animal excrete storage areas 100'+
Water service line 10'+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10+
Water Service line 10+ Surface water 100'+(N.O.)
Curtain drain 50'+ (N.O.) Wells on adjacent lots 100'+
F. COMMENTS
izty'- Y�uly er c�y� upw�w
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name LARS SPURKLAND
Date 6/13/14
COSA brown sheet_10.10.12.doc
Absorption field 5.+
Surface water 100'+
Water main NA
Driveway, parking/vehicle storage 9
101
10
•r• ... ...�
E. SPURKJiND; C
b 0 r
k! 451LH G
B HANE A. HOLT�6
LS-
6914,'®G
.........' r
TWILIGHT LANE
EAST 164.83
" t
r I 6 e
a
V
I�
I`a
a\
4;
S!i
OwL
N 89 58' 39" E 164.82
THE INFORMATION HEREON I5 FOR THE USEIOF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY
CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS: AND IS
NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELTNES.
EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT, ARE NOT SHOWN
HEREON( UNLESS INDICATED)
NOTE: FENCELINE5 THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE
PROPERTY LINES OR POSITION ADDITIONAL LNPROVEMENTS.
ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR WE.
a
AS -BUILT SURVEY 1" =30'
NO CORNERS SET THIS DATE
JHEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY
F THE FOLLOWING DESCRIBED PROPERTY
LOT 1, WELLMAN SUB. ( PLAT 79-75)
ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE
VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN
THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS
EXIST OTHER THAN NOTED.
DATED AT ANCHORAGE,ALASKA THIS 17TH DAY OF
_]UNE , 2014.
HOLT LAND SURVEYING
MXI HIGHVIEW DRIYE
12577, FB 164-68 ANCHORAGE/,K 99515
345-5513
q0' P- L'/
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. # C) \ k - a2t� - D\1
1. GENERAL INFORMATION
Complete legal description Lot 1; OIet&an Subdiv.izion
2.
3.
4.
Location (site address or directions) 3500 Tw-iUgh# Lane
Anchorage AK
Property owner Ted WePAman Day phone 345-4654 )ti)
Mailing address 3500 TwiZighx Lane Anchoxau AK 99516
Lending agency
Mailing add
Agent —
Address —
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
XXX
Day phone
Day phone
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 XXX
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 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 in ection.
Name of Firm Phone
S & S ENGINEERI
Address 1 �7nze PanlB River Loo oa� No.2
00/
Eagle River, Alaskay/a
Engineer's signature Date
6. DHHS SIGNATURE
Approved for bedrooms.
Ll'2
Disapproved.
Conditional approval for
Additional Comments
berl A. Sbmfv:
No. 14.57.9
b� F
bedrooms, with the following stipulations:
WTIC
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. Employees of DHHSdo 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.
72025(RW.1/91) BaOk MOA021
June 20, 1994
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
HEALTHAUTHORITY
RECEIVED
APPROVALS
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
2 6 1994
825 'L' Street
,1U L
P.O. Box 196650ctpnchorage
MwRicipauiy
Anchorage, Alaska 99519-6650
g
Health &Human Services('
SEWER& WATER
Dept.
MAIN EXTENSIONS
1 0E
..��f
i.
( j
REFERENCE: Wellman Subdivision; Lot 1
SEWER & WATER
INSPECTION
A Conditional Health Authority Approval
(HAA) was issued on January 25,
1994 for the referenced property.
All work required for the
ENGINEERING STUDIES
AND REPORTS
Conditional HAA has been completed.
Attached is the On -Site Wastewater
Disposal System and/or Well
Inspection Report for your approval.
We request you issue a Final
WELL INSPECTION
Health Authority Approval for the referenced
property.
& FLOW TEST
If you have any questions or require any
additional information, please
contact us.
SITE PLANS
ely,
ROADDESIGN
®RerP.E.
U/jk
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ON SITE
WASTEWATER
DISPOSALSYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99677
Municipality of Anchorage
Department of Health and Human Services it
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: ������ �l �\ lam, L� I Parcel I.D. 2� Z�
A. Well Data
Well typd - k �P, If A, B, or C, attach ADEC letter. ADEC water system number f�
��_�� i
Log prese t (Y/ ) Date completed �—I Driller
Total depth ( 0� r Cased to SZ� Casing height Z
Sanitary s 6 ) Wires properly protecte (/N)
FROM WELL LOG AT INSPECTION
Date of test g In
Static water level
Well flow _ _ ti 8. �- o•P•m•
Pump levell_._�
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absor tion field on lot t ��
� RECEIVED
g.p.m�P
a JUL 2 6 1994Mullici, .
of Anchorage
Bect Health & Human Services
On adjacent lots
; On adjacent lots
1014—
P I
0v
Public sewer main I� (� )% Public sewer manhole/cleanout
Sewer service line
A- Petroleum tank
WATER SAMPLE RESULTS:
Coliform ZI) Nitrate b' 2/L Other bacteria
Date of sample: I - li 'q Or Collected by: -�2 t�6 e— .
B. SEPTIC/HOLDING TANK DATA
Date install - "9`r Tank size �2 044td L, Compartments ��/�
Cleano s (Y ) Foundation cleano&N) Depression (Y6p- Li
(Y
High water alar (Y N) _ Alarm teste ) ll//
11i
Date of pumping �/� Pumper
SEPARATION DISTANCES FROM SEPTIC/ ^' TANK TO:
�!
Well(s) on lot On adjacent lots I cx:� '- Foundation
I I IC�t�
To property line :Z�(o Absorption field Water main/service line
Surface water/drainage j OG
72-026(3/93)' Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed L0 - 10 I4- Manufacturer
Size in gallons 2� Manhole/Access
Ve (Y N)
"Pump on" level at
M
"Pump off" Level at
High water alarm level 44 1,
Cycles tested
Meets MOA electrical code Y( /N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot � c;� "r On adjacent lots ( C)(�:D Surface water
D. ABSORPTION FIELD DATA
32
Date installed j0 Soil rating (GPD/Ftp) C (o. System type'l�G���
Lengths Width �Jt Gravel thickness / Total depth
Total absorption area X5(0+ CIQanloe+tpresen (Y ) Depression over field (Y&�,-J
Date of adequacy test IJP Results (pass/fail) 1�-k for Bedrooms
Water level in absorption field before testI�11/P After test �In-
Peroxide/
treatment (past 12 months) (Y& ✓�-t If yes, give date -)/ A
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot ( QD ' 'j— On adjacent lots ( d o 4- Property line
i
To building foundations To existing or abandoned system on lot _
On adjacent lots �Jfl Cutank NI 0,A t�-- Water main/service line
I Z+ /
i
Surface water t00 '- Driveway, parking/vehicle storage area to -
Curtain drain tJ
E. ENGINEER'S CERTIFICATION
I certify that I have checked,
Signature
Engineer's
Date
HAA Fee $ _
Eagle fir, Alaska 99577
Date of Payment
Receipt Number
72-026 (3/93)' Back
to all MOA and HAA guidelines
Waiver Fee $
Date of Payment
Receipt Number
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 l.D. # n 1 S't R - HAA #
1. GENERAL INFORMATION "0.
Complete legal description Lot 1 • UIet&an Subdivizion
Location (site address or directions) 3500 Tw.i,Ught Lane
Anchorage, AK
Property owner Ted WeU-man Day phone 345-4654 (h)
Mailing address
3500 Twitight Lane Ancho&age, AK 99516 257-5300 (w)
Lending agency Day phone
Mailing address
Agent
AAA,l c.
Day phone
1.4. Y
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY: -
Individual well XXX
Community well
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 XXX
Holding tank
Community on-site
Public sewer'
NOTE: If comm unitywastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025(Rm1191) Front MOAM21
x.
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 l.D. # n 1 S't R - HAA #
1. GENERAL INFORMATION "0.
Complete legal description Lot 1 • UIet&an Subdivizion
Location (site address or directions) 3500 Tw.i,Ught Lane
Anchorage, AK
Property owner Ted WeU-man Day phone 345-4654 (h)
Mailing address
3500 Twitight Lane Ancho&age, AK 99516 257-5300 (w)
Lending agency Day phone
Mailing address
Agent
AAA,l c.
Day phone
1.4. Y
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY: -
Individual well XXX
Community well
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 XXX
Holding tank
Community on-site
Public sewer'
NOTE: If comm unitywastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025(Rm1191) Front MOAM21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, 1 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. /1
Name of Firm c u. a ENGI NEEM Phone
Address
Engineer's signature
17034 Eagley4er Loop FAnd No. 214
m952
6. DHHS SIGNATURE
Approved for bedrooms.
By;
Date
.4blu`r7 f„ ci:xl:e .
Disapproved.
X Conditional approval for 3 bedrooms, with the following stipulations:
SEF_ E v6/n.EE'RS RECD -c fS7- A e 0 L/r
To aF COMPLC-TE9 /vo L4r6R rF-i/gv /
Additional Comments
411Th
Date
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 courtesyto 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.
72-025JRev.V01) Beck MOAb21
x Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: USF r -(-u 1 46',� -S(T:::> r) f- I Parcel I.D.
A. Well Data l
Well type ` �� If A, B, or C, attach ADEC letter. ADEC water system number ��/�
Log preset ( /N) Date completed g r Driller �oSS2t C L I )moi
I I'
Total depth 1 8 Z Cased to �F O Casing height I Z l
Sanitary sea(Y N)
_Wires properly protecte (/N),-
FROM WELL LOG AT INSPECTION
Date of test I -4
Static water level
""
Well flow C��k� I , , �A //w
g.p.m. g.p.m. M4D
ev
Pump levell 6L� U M
SEPARATION DISTANCES FROM WELL TO:
r
Septic/holding tank on lot I (� r ± ; On adjacent lots w
Absorption field on lot I Z� + ; On adjacent lots D r+
Public sewer main Public sewer manhole/cleanout
Sewer service line 2G Petroleum tank V
WATER SAMPLE RESULTS:
iYI
Coliform o —Nitrate " Z� �--Other bacteria
Date of sample: % 4 -% % Collected by: �' S
B. SEPTIC/HOLDING TANK DATA 4- C q -l -1 U, -C-- �
Date installed Tank size ) Compartments Z
Cleanout6Y N) Foundation cleanout (Y/N) Depression
High water alarm (/ Alarm tested (Y/N) 0 /i�'-
Date of pumping I Pumper S
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot I On adjacent lots 10-0 1 Foundation
To property line U k Absorption field I D Water main/service line p
Surface water/drainage ) o
t
CONTINUED ON BACK PAGE
72-026 (3/93)` Front
E
Z
r
N
m
m
0
Vf
Mo
C. LIFT STATION
Date installed Manufacturer
Size in gallonsManhole ass (Y/N)
Vent (Y/N) "Pump on" level at "Pump off" Level at
High water alarm level Cycles tested
Meets MOA electrical codes (Y/N)
SEPARATION DISTANC ROM LIFT STATION TO:
Well on lot On adjacent lots Surface water
D. ABSORPTION FIELD DATA /
Date installed S -2-1 Soil rating (GPD/Ft2) System type
Length Width Gravel thickness g Total depth I'Z
Total absorption area LaCoD Cleanout presen&N) Depression over field (Y4ti
Date of adequacy test I - r—� � Results (pas fail for f7 Bedrooms
Water level in absorption field before test DY9 ' After test I U u
Peroxide treatment (past 12 months) If yes, give date I�
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot I Z I : On adjacent lots I D Property line ( D '4 -
To
To building foundation I o -f- To existing or abandoned system on lot
On adjacent lots 4- Cutbank 1J,n �\ � Water main/service line
� t
Surface water (bO Driveway, parking/vehicle storage area
Curtain drain i K__
E. ENGINEER'S CERTIFICATION
I certify that I have checked,
Signature
Engineer's
Alaska 94577
Date
conformed to all MOA and HAA guidelines in effect on the date of this inspection.
/
HAA Fee $ 306 r 6FZ) Waiver Fee $
Date of Payment
Receipt Number
72026 (3/93)' Back
Date of Payment
Receipt Number
i
5. LEGAL DESCRIPTION
L&7i
DATE RECEIVED -...._. -._
_
- y INSPECTION APPOINTMENTS -- -
<-
_.
TIME
TIME
;TIME
^
❑ Two ❑ Five
DATE /
-1
DATE
DATE
�- - � F r
❑ COMMUNITY
since June. 1975. For wells drilled prior to that date, give well-.
INSPECT
INSPECTOR
INSPECTOR
! 11G
8 INDIVIDUAL/ON-SITE**
7� YEAR ON -SITE -SYSTEM WAS INSTALLED._.
MUNICIPALITY Dc,' r,i,'ChOP.AGE
MUNICIPALITY OF ANCHORAGE �rlPT.G.-
DEPARTMENT OF HEALTH& ENVIRONMENTAL PROTECTION I -i.., /II�C �i,iECTION
825 L Street - Anchorage, Alaska 99501
• ENVIRONMENTAL SANITATION DIVISION 5H28 91 0
Telephone 264-4720 FF
Ct�'t Y E 0
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER AA
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) dans for processing.
1. PROPERTYOWNER /
PHONE
MAILING ADDRESS
��� E IS214 41UC1461e_ �6�
/? !t-/ 4j C-(/ PHONE
PROPERTY RESIDENT hf different from above) 7_4?
20-T / ✓ 3
2. BUYER
75 14
PHONE
MAILING ADDRESS
3. LENDING INSTITUTION;
PHONE
MAILING ADDRESS
1 072-"Tµ �LLp✓ LT S
4. REALTOR/AGENT
PHONE _
MAILING ADDRESS -
5. LEGAL DESCRIPTION
L&7i
^T/�
��13 /
CeJEc c �o«r✓
STREET LOCATION
Gcj1t_161 jr LIh/✓�'
/�� �
TNJ l f-913if -���r
6. TYPE OF RESIDENCE
NUMBER OF,BEDROOMS
��SINGLEFAMILY
ED One ED Four Ell Other
❑ Two ❑ Five
❑ MULTIPLE FAMILY
F& Three ❑ Six
7. WATER SUPPLY
INDIVIDUAL*
* ATTACH WELL LOG. A well log is required for all wells drilled.
❑ COMMUNITY
since June. 1975. For wells drilled prior to that date, give well-.
❑ PUBLIC UTILITY
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
- - -- ---- - - ---
8 INDIVIDUAL/ON-SITE**
7� YEAR ON -SITE -SYSTEM WAS INSTALLED._.
❑ PUBLIC UTILITY
-
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (R ev. 6/79) y�-}�
012
72-010 (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
❑ SINGLEFAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS `
❑ ONE
❑ TWO
❑ THREE ❑ FIVE ❑ OTHER
❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON -SITE
❑PUBLIC UTILITY
Connection Verified _
PERMIT NUMBER
DATEINSTALLED
c
INSTALLER
❑Septic Tank or El Holding Tank
SizeIf Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER
nn
TOTAL ABSORPTION AREA
MATERIAL
Q
4. DISTANCES
WELL T0:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption. Area to nearest Lot Line
B. COMMENTS
Q APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE
BY
012
72-010 (Rev. 6/79)
'LJ
BOMHOFF & ASSOCIATES, INC.
Engineering - Planning - Surveying
1020 West International Airport Road
May 17, 1979
Anchorage, Alaska 99502
UWCtPP�1YG ",,. ;ICY\ON
Jao
Municipality of Anchorage
Environmental Health Division (Sewer and Water)
825 L Street
Anchorage, Alaska /
ATTN: Lynn Lind u' r
-r �a. k� � �
SUBJECT: r in Drainfield Trench
Lot 1 of BLM Lot 135
(Ted Wellman - Owner)
Dear Ly
I inspected the Wellman trench today following your observing
water in the bottom. According to Mr. Al White, he excavated
the trench during the past two days. Frost was encountered
from approximately 2 to 6 feet in depth. Mr. White attributes
the several inches of water in the trench to meltwater
derived from exposed frozen ground.
We drilled a 17 ft. test hole and performed a percolation
test on April 6, 1979, at which time no water table was
encountered. In addition, a test pit last year at the same
location did not encounter a water table.
In my opinion, the trench water is attributable to thawing
frozen ground and/or soils locally saturated from breakup
conditions, not a water table.
Sincerely,
$ ASSOCIATES, INC.
PaUl'G. Hansen, P.E.
Senior Engineer
P GI -I/ j h
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