HomeMy WebLinkAboutWILLIAMSON BLK 2 LT 11
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
PAGE i OF
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW960141
]DESIGN ENGINEER:STEVEN R. PANNONE
OWNER NAME:DEVRIES STEVEN D &
OWNER ADDRESS:5200 E 98TH AVE
ANCHORAGE , AK. 99516
DATE ISSUED: 6/25/96
EXPIRATION DATE: 6/25/97
PARCEL ID:01507314
LEGAL DESCRIPTION:
WILLIAMSON BLK 2 LT 11
LOT SIZE: 13244 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONSTRUCTION OF:
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 ) (MOT 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:
Steven R. Pannone, P.E.
Consulting Engin~or
(907) 272-8218
P.O. Box 142025
Am:borage, Alaska, 99514
/907)272-8218 Fax
June 11, 1996
Municipality of Anchorage
Dept. of Health & Human Services
On-Site Services Section
P. O. Box 196650
Pmchorage, Alaska 99519
Subject:
Lot 11, Block 2 Williamson S/D
Upgrade Permit
Gentlemen:
My firm was asked to investigate to relocation of an existing septic tank at the above property. The owner is
interested in constructing a large deck and motor home storage area. These are planned to be installed were
the existing 1250 gallon septic tank is located.
I have developed a site plan showing the original and proposed location of the septic tank. A new 1250
gallon steel septic tank would be installed approximately 15 feet down stream from the existing tank location.
New solid lines made of 3034 material will be used to connect the new tank with the existing system. This
house and subdivision is served by a community well. The new tank location will not affect the surrounding
area.
If you have any questions about the proposed installation, please contact me at 272-8218
Sincerely,
Steven R. Pammne, P.E.
C:\WORK\I I-2W1LMLTR
DESIGN 9ETAfLS
WASTEWATER ASSBRPTION SYSTEN
Lot It Stock 2
Swing-Ties
A-t=37,2'
A-2=31,0'
A-3=51,6' B-3=78,4'
NUTES'
1) Exls.t, sep1;Ic $$o,nt4 Is being
moved 1;o Ins1;o,tt o, new deck,
81) Exls1;In9 18589
will be nemoved
3) New 1250g sep1;Ic 'to,nk wilt be
Ins'to,lied In-line wi.th 'the dro,ln-'Pleld
o,nd se4; o.t; o,n elevo. 1;Ion consls1;o,ri1; I
wi.th 1;he pos1; 1;o,nk line lifo,de,
4) Two pos1;-1;0.nk deo,n-ou.ts wilt
5) Exls.t, 6' C.I. Cteo,n-ou1; will
Ioco. tedo. nd reinstalled.
House Is senve~ ?rom o.
communft;y well.
PREPARE]) FUR,
5~00 E:6s.t 9B.th Ave,
Anchoro,ge, ~K 99516
STEVEN R, PANNONE, P,E,
P, O, SOX 142025
I ANCHORAGE, ALASKA 99514
1__272-8218
I~)c~9;e~ 6-8-96 /
~ 1'=30' -~ DESIGN
Rick ivlystrom,
Mayor
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
P,O. Box 196650 Anchorage, Alaska 99519-6650
December 9, 1996
Steven R. Pannone, P.E.
PO Box 142025
Anchorage, Alaska 99514
Subject:
Waiver Request for Lot 11 Block 2 Williamson Subdivision
Waiver Request #WR960048, PID #015--073-14, SW960141
Dear Mr. Pamlone:
Yonr request for a waiver of the required 100 foot horizontal separation of an on-site
wastewater disposal system to a private well has been approved. ']?he approved separation
distance is a private well to the on-site septic tank of 97.7 feet.
This waiver approval applies to the existing on-site wastewater disposal system to we[I
separation only. Any future upgrade to either Mil require all separation distances be met
or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-4744.
fsi ly '~
ncere , /
~ / James P. Williams
'-/ Civil Engineer
On-site Services
JPW/ljm:DeVries
WR= WR960048 PIDa 015-073-14 HA~
Date Received: September 6, 1996
Legal Description: Lot 11 Block 2 Williamson
Engineer: Steven R. Pantone, P,E.
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
Permit
= SW960141
PO Box 142025, Anchorage, Alaska 9~514
Applicant: Steven D DeVries
Waiver Requested: Private well to on-site septic tank of 97.7 feet
Criteria: 1. Geology: Points:
A. Water table ~,~
B. Soil Sorp~ion
C. Permeability
D, Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3. Other:
Waiver is Granted:
List Conditions or Reasons
for
****** RECEIVED
Waiver is NOT Granted:
Date:
Rec ~: O~)\,~ Amount:
/~me of Reviewer
S 625,00 Date Paid: Sept 6,
1996
?'8, kg (.0
l'/0 ~,0
?-o .~ ,,<
8g (~.o
./0 ~_~o.~ = '/o%
Steven R. Pannone, P.E.
Consulting Engineer
P. O. Box 142025
Pmchorag¢, Alaska, 995 l 4
(907) 272-8218
October 9, 1996
RECEIVED
Municipality of Anchorage
Dept. of Health & Human Services
On-Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519
0CY ~ 0 19%
Murm;~pali~y o't Anchorage
Oept. Health & Human Services
Attn.: Mr. Jim Williams
Subject:
Lot 11, Block 2, Williamson Subdivision
Septic tank to well waiver
Dear Mr. Williams;
You requested additional information on how the points were derived requesting a waiver for the above
property. Attached is a site plan showing the adjacent properties, general site topography and approximate
location of wells and on-site soil absorption system on each lot.
Lot 11 is approximately 1/3 acre. The lot slopes gradually from the north to the south, with the southern end
dropping offsteeply to an undeveloped forest. The well is situated approximately 5 feet south of the
northern property line and 3 feet east of the western property line. The seepage trench is located along the
southern boundary of the property, approximately seven feet north of the southern property line and located
approximately 112 feet from the well serving this lot and approximately 120 feet from the neighboring well.
The soil absorption system was installed in 1976. The original septic tank was located approximately 88 feet
from the well and did not n~"~t~ he separation requirements at the time of installation. The sewer systems and
well on the west side of Lot 11 is si~nilarly situated. A new septic tank was installed in July of 1996 outboard
of the existing septic tank. It was discovered to be 97.72 feet from the well serving this property.
The exact date of drilling the well is unknown; we found that it is cased to over 40 feet and that the static
water level was 79 feet below ground level. Well logs for Lot 10, and 12 cannot be found in the records
maintained by your office. It is assmned that the wells were drilled by the same company during the same
time frame. A well flow test showed the static water lowered ten feet while flowing at approximately seven
G.P.M. An adequacy Investigation conducted in 1988 indicated that there was no bacteria and minimal
nitrates in the drinking water.
A soil log was found tbr Lot 11, performed in 1976. The soils on Lot 11 were logged to be sands and
gravels to sandy gravel to a depth of 10 feet. No water was encountered in this test hole. It can be assumed
that the soils are similar on Lots 10 and 12.
Mr. Jim Williams
October 9, 1996
Page 2
As outlined under 18 AAC 80.020 and 18 AAC 72.021(a), I have calculated the following points:
Distance from sewer system bottom to groundwater 5.9 5'. 5;
Soil absorption below sewage system 2.5 '? ~ ()
Soil permeability below tile system 1.3 ' . :;
Water table gradient 6.0 ~ · ·~
Horizontal separation 2.9 ~ '
Total Points 18.6 ~ , 7~
16-25 Almost sure to be fi'ce fi'om any form ofcontanfination from household sewage.
In my opi~fion, tiffs waiver request meets tile above criteria for approval and does not constitute risk to
health. Tile soil absorption system is located greater than 100 feet fi'om the well, and the septic tauk is a new
installation, using the latest in anti-corrosion technology. I hope the above information will assist you in
determining that the waiver should be granted. If you have any questions or concerns, please contact me.
Sincerely,
Steven R. Pannone, P.E.
Civil Engineer
Attachments
(-)
-4Y.
Lo-I; 12
/
Lo-b 10
Welt ~nfl septic ~re Located
10%
PREPARED F[]R,
Nr, 81~even
SRO0 E~s~ 98~ch Ave,
Anchorage, AK 99516
STEVEN R, PANNBNE, P,E,
P, B, 3DX 142025
ANCHDRAGE, ALASKA 9951,
272-8218
ca[e~ 1':30' AS-BUILT
~m~m~ CT&E Environmental Services Inc,
CT&E Ref.#
Clienl Name
['rojm Name/#
Client Sample ID
Matrix
Ordered By
PW$1D
965965001
PalmO:le 17.~ Sty.
Lkl B2 WJlliemisml
LI 1/B2 Wil time, son Kitchen
Drip,king Wuter
Client PO//
Printed Date/Time 11/12/96 13:55
Collected Date/Time 11/06/96 19:00
Received Date/Time I1/07/96 13:30
Technical Directer: Stephen C. Ede
Re eased By ~ C
Collected by: S.R.P.
P~i'er~ter
Nitre~e*N
Total Co[{fOl'm
0.660
0
Repeat Sample (for routine sample
with lab ref. no. .)
Special Purpose
T]me Collected
SAMPLE LOCAT1Ot'q' Co{leered By
Treated '~V~ tel ~"~{1 [ co .,',,D.g.C,,\nth rbks Jun []
Uncreated Water F~xed
F,tx: (907) 961.6301
Analysis shows this Water S~MPLE to
~'"
a Un~adff~c~ory
S~mp{~ ova, ~0 hour~ old, resul~ m~y
not be over 48 hours o~d a~ ~xaminat}on
to lad{rata r~liab[~ rmsulu.
now sample via special d~ljv~r/mail.
Analysis Began )
Analytical Mathod; O Membrane Filter
cu lvlMO.~fUO
TJma;
Client notified of unsatisfactory, results:
Phoned Spoke wlth F,~xed
'
ACTLRIOLOGICAL WATER ANALYSIS RECOR.D
~VlhlO-OdUO Result~ Total Coliform
Membrane {~{Iter: Direct Count
,
Verification: LTB BGB
Fecal CoP{form Confirmation
F{nal Membrane Filter ~esu~{,te
~. Co#
Drinking, Water Analysis Report for Total Coliform Bacteria Anchoraf{e, AK 99B~ 8-1605
' V
R. EAD INSTRUCTIONS O/v RE 'ER, yE SIDE .SEFOR~ CO£££CTI/¢G SA~I,iPLE Tel: {907) $~2,2343
GREA,,'R ANCHORAGE AREA BORL
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
NAME
LOCATION
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE ~~/ ''-I/~ N/~
FROM WELL MANUFACTURER
/
INSIDE LENGTH /¢) INSIDE WIDTH
.,.~g_~: NUMBER OF
__ MATERIAL .__~-~)- " COMPARTMENTS
LIQUID DEPTH ____ LIQUID CAPACITY /~'~G~LLONS.
TILE DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES /
ABSORPTION AREA
] Y x'J-~?FOU N DATION __
DISTANCE BETWEEN LINES
DEPTH: TOP OF TILE TO FINISII GRADE
SQ. FT.
__ NEAREST LOT LINE "/ TOTAL [_ENGTN
. __OF LINES
27/
TRENClt WIDTH'E2_ IN. TOTAL EFFECTIVE
LENGTFt OF EACFI LINE
MATERIAL BENEATH 'FILE '2___IN. ABOVE TILE
IN.
WELL:
TYPE CONST RUCTION _ DEPTH
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATIDN LOT LINE SEWER LINE __, TANK ____ SYSTEM
DISTANCE FROM:
CESSPOOL ......... OTHER SOURCES ..
APPROVED_ ____ DISAPPROVED__ _REMAR~<,S
STANCES .... ~ DIAGRAM OF SYSTEM ~ ~'
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form EQ-032
iq :1: N ]: I"ll.ll'"l I::, ]: '_";i; I'l:::lNC:lili: i!iJETt.,IZE:N ~1 NELL I':li'.,ll::)
::l.l?.tl;il J::;'~]~:'j' F'I:::II:':'. J::l J:::'J:;]'.:I?',*JI:::I'J"E I.,.IEL. L. OFi: 2EIEI r::'HIET
NE{I.I.. I..OG~:; l:::ff;~'.E: FR~g%:~I..i:[I:~:IEI:::, F:II",ID i'"ll.J;~'l'
(3I::' I'HE~/ I.,.IEL.L. E:OHF't..t:ET:[
~[ J",J'L};'i't::II_I ..J::l'l' ~1~ ON.
t.,I]:TI'I THE: I~]l!ii:l~:!U]:F;?.~i:["lEP.,J"l'!ii; I::;'[)F,i'. OI",I- .:ii:; ]: TIE 'L.i;E:P.Ilii:F;i;2!; I::JNI::, I,Jli:L.l.'iii; I:::1:.i!: '.;1!;'1
P1Ui"~I:I:C~F'~:IL:[T'r' OF' F'IhI(::;Hk3E'.f=I(3EL
:I:N%'I'F:fl..I. TIlE :~;['/'.B't"E]:Pi :IN F:IE:E:Ed:;~:I:::,I=IJ",JCEfi I.,.I:['I'H 'I'IIJE CJ:3DE:Z.
TI'IF:IT TILE: ON-~;:I:'I"E~ :~;~=:HIEI:;]: ~5"/~;'i'IZI"I J'ql=l"r'
'"1 I:,~ :, TI I ] I"~EI..I[)E: t"ll:;l~:[~: Till=IN ]~
---
~ .......................... : ~. ~
October 14, 1976
R & M No. 656313
Gerald Johnson
8055 Jewel Lake Road, Apt. 5
Anchorage, Alaska 99502
Re: Soil Log Report for Sanitary System
Williamson Subdivision, Block 2, Lot 11, Anchorage, Alaska
Dear Mr. Johnson:
We are submitting herewith the test boring results and our con~ents
regarding soil conditions encountered at 'the subject site. This in-
vestigation was performed in accordance with your request of October 13,
1976, and those procedures outlined in a letter dated July 15, 1975, by
Mr. Rolf Strickland of the Municipality of Anchorage, Department of
Environmental Quality.
Upon investigation of the trench previously dug for the proposed sanitary
system, it was found that the soils within were well graded sands and
gravels (SW). The required square feet of absorption area per bedroom
in such a soil is 125 ft2/bedroom. Since a percolation test was not
performed, it is unknown if the existing soil conditions will support an
absorption area of less than 125 ft2/bedroom.
Groundwater was not encountered in the test hole.
We appreciate being given this opportunity to be of service to you.
Should you have any questions with regard to the above, please do not
hesitate to contact us.
Very truly yours,
R & M CONSULTANTS, INC.
J~nes W. Rooney
Vice President
JWR/sc
xc: Municipality of Anchorage
Test Hole locations are
approximate and have not
been located by survey
methods.
T.H. 2
10/12/76
ORGANIC MATERIAL
SAND W/TRACE GRAVEL
(SW)
GRAVELLY SAND (SW)
Occasional Cobbles
SAND (SW)
0.0~
0.5'
-10.0' T.D.
This log represents subsurface soil
conditions within Williamson Su~dv.
Block 2, Lot 11, Section 15, T12N,
R3W, S.M., Anchorage, Alaska
ATE: 10/14/76
I~NO 6563].5
SANITARY SEWER TEST HOLE
GERALD JOHNSON
ANCHORAGE, AIJ%SKA
02° 18'
124.96
44.5*
L~OB Of TEST BORING
Date Began R~M Hole No.
Date C'~mpleted CONSULTANTS
(NC. Sheet, of
Rig N,o.
ANCH0~AGE- FAIRGANKS---JU~Y~AU Total Depth
Project No. ALASKA
Project Name__ , r' '
L(~cation Ground Wat,~r Table
Method Used , Depth In Ft
Field Par~y , ~ Geologlst_ : Time
Weather , Date
Samplin~ DESCRIPTION Location Notes ~ D~agram:
o Soil type, c01or, texture,
~~ ~ ~ ~ e estimated particle size, :
~ o c - ~ ~ ~. ~ ~ sampler driving notes.
~ ~ ~ c ° ~ ~ depths circulati°n ~ost, ~roffic. Ditch,
o ~ o ~ notes on drilling ease, j j
- - ~ ~ ~ ~ bits used~etc.
o~ ~ ~ ~ e o o ~ T, Vegetalion:
/
O
3
4
.... Unless otherwise noted ~11 sQmples ~re token w/l~"lD Standerd Penetration Sampler driven w/l~lb, hammer, 30'drop.
MUNICIPALITY OF ANCHORAGE
Department of Health A Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
Parcel I.D. #
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include 10t, block, subdivision, section, township, range)
(b)
Location (address or directions)
Property owner __ .~/?z ~-~, Telephone: (home) Business
Mailing Address
(c) Lending Institution Telephone
Mailing Address
(d)
(e)
Real Estate Company and Agent ¢-~/
_ - ' t .
Address /~ ~ ~' ~) ~ ~ ~~~'
Telephone ~¢ - ~ /
Mail the HAA to the following address: (or check here ~if hold for pick up.)
List contact person and clay phone number below:
S & S EN61NBERIN6
Eagle River, Alaska 99577
2. TYPE OF RESIDENCE
Number of bed~'doms ~.~' ~oO/~
Single-Family/~
3. WATER SUPPLY
Individual Well ~
Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site ~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legailty and status.
72-025 Toy. 7/86) Page 1 of 2
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATIOH
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my inv'estigation of this
Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe,
functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the 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,
Telephone ~ ~ g./~- ~ ,~2 ~/~';'-
S & S ENGINEERING
17034 Eagle RiYer Loop Road No. 204
Eagle River~ Alaska 99577
Name of Firm
Address
Date
6. DHHS APPROVAL
Approved for /'~/' bedrooms by
Approved ,~/~..~ Disapproved
Terms of Conditional Approval
Conditional
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections
or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions
in the professional engineer's work.
Page 2 of 2
A. WELL DATA
Well Classification
Well Log Present (Y/~))
Total Depth 0,¢-* Cased to
Static Water Level
Casing Height Above Ground
Electrical Wiring in ConduitS/N)
,~,_URI~;H~ALI'FY OF ANCHORAGE (MOA)
t;~ ' ' ,j,i;t~alth Authority Approval (HAA)
CHECKLIST - FEBRUARY 1984
,.,¥-, 343-4744
Date Completed L~ ~.,-'~
If A, B, C, D.E.C. Approved (Y/N) t~/'t~/'
Yield ~;k"~ &~C'r~ ~
Uepth of Grouting
P~Jmp Set At
[,%..,,t ~ Sanitary Seal on Casing ~N)
-~ Depression Around Wellhead (Y~)
SI:PARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Fiel,d(o~ Lot
To Nearest Public Sewer Line r~/,~ To Nearest Public
t
To Nearest Sewer Service Line on Lot '~' ~
I CD'C) ; On Adjoining Lots
--- ~ Oo~'N ; On Adjoining Lots
Sewer Cleanout/Manhole
Water Sample Collected by ~__~', '~ '¢~-"~-~,~¢~-~--~ ; Date
Water Sample Test Results ~ ~ ~ --~~.
B. SEPTIC/HOLDING TANK DATA
Date Installed ~o/~(¢ Size
Standpipes 4~/N) "¢
Depression over Tank (Y~
Pumping/Maintenance Contact on File (Y/N) __~
Holding Tank High-Water Alarm (Y/N) /,~¢
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
No. of Corrlpartrnents "2.~--.
Air-tight CapsdC~'N) _ y Foundation Cleanout ¢~/N)
I, e Last Pumped 1'7~ - 'Z-4 -
; for
/
Temporary Holding Tank Permit (Y/N).
To Building Foundation
'f'o Disposal Field
To Water-Supply Well
To Property Line
To Water Main/Service Line
To Stream, Pond, Lake or Major Drainage Course
Comments. ~
72-026 (Rev, 7/88) Front Page 1 of 2
C, ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absortion Area
Depression over Field (Y~
Results of Last Adequacy Test
\'¢~'~~ Type of System Des gn~"~..~
Length of Field ~J"-
Depth of Field 4)
Gravel Bed Thickness ~
Statndpipes Present,~/N)
Date of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIELD:,A.. ~'~'~ ~¢zY~ /¢~ -/,~'¢~/~,-~,~.
To Water-Supply Well ~ ~ ~ To Property Line . . .
To Building Foundation/ /~' ~ To Existing or Abandoned System on
Lot ~/J~¢ ; On Adjoining Lots ~"'~:~ Iar~ \/
To Water Main/Service Line \c:~ I~ To Cutback (if present)
To Stream, Pond, Lake, or Major Drainage Course \ ~:;,.o f .A~
To Driveway, Parking Area, or Vehicle Storage Area ,¢~:::~ I..~
D. UFTSTAT ON & /^
Date Installed
"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
-- ?_g._~p Off" Level at
Vent (Y/N) -----.
Pumping Cycles during Adequacy~'~P~
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this
inspection. .::', ' '
Signed
5 & 5
Company ~gle Ri~er Loop Road No. 204
Ea le River, Alaska. 99577 /
Date g_, /~-I Z~',~/'~?"~
MOA NO. ~'/~ --o-,~-'~ ~2'~ /
Receipt No. _ ,-~
Date of Payment.
Amount: $
72-026 (Rev 7/88) Back
Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
&CHEMI '°'"~~
CAL & GEOLOGICAL LABORATORIES OF ALASKA, INC. ~ ~
ANALYSIS REPORT BY SAMPLE for Work Order # 10984
Date Report Printed: DEC 22 88 @ 14:39
Client Sample ID:LI1, B2 WILLIAMSON
PMSID :UA
Collected DEC 20 88 @ 11:05 hrs.
Received DEC 20 88 0 14:00 hrs.
Preserved with :4 DEG. C
Analysis Completed :DEC 21 88
Client Name : S & S ENGINEERING
Client Acct : SNSENGP
P.O.# NONE REC'D
Req #
Ordered By : RJS
Send Reports to:
Laboratory Supervisor :STEPHEN C, NDE i)S & S ENGINEERING
Special ~/ ......................................
Instruct:
Chemlab Ref #: 3771 Lab Smpl ID: 1 Matrix: WATER
Allowable
Parameter Teeted Result/Units Method Limits
NITRATE-N 0,44 ms/1 EPA 353.2 10
Sample ROUTINE SAMPLE
Renmrk~: SAMPLE COLLECTED BY RJS.
I Teats Performed See Special Imtruction8 Above UA-Unavailable
ND= None Detected "See Nample Remarks Above
NA- Not Analyzed LT-Lo~ Than, GT-Groater Than
7
' ' -- "~. E RECEIVED
INSPECTION APPOIN'rMENTS
ATE
INSPECTOR
TIME
()ATE
INSPECTOR
NSPECTOR ~
DEPT. OF HEAI.'[I &
MUNICIPALITY OF ANCHORAGE I:NVIRONMENI'A[ P[.C.'I'ECTION
DEPARTMI-'NT OF HEAl-TH & ENVIRONMENTAL PROTECTI6N '
E2.R L Street - Anchorage, Alaska 99E01
SEP ~_ 0 1981
ENVIRONMENTAL SANITATION DIVISION
Ta,e.ho.e 2 .-.72o R E C E 1 V 1! D
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIDNS: £',omr~lete all Parts o1~ page 1. Incomplete requests will not be processed. Please allow ten {10) days for processing.
1~- PROPERTY OWNER PHONE
MAILING ADDRESS
PHONE
PHONE
PROPERTY RESIDENT f different from above)
MAILING ADDRESS
3, LENDING INSTITUTION
V1AI LING ADDRESS
~ REAL'rOB/AGENT
MAI LING ADDR ESS
PH 0 N E
PHONE
~', I'E(~AL DESCRIP~'ION. '
~TREET I.OCATION --
6, 'TYPE OF RESIDENCE ' NUMBER OF BL:DROOMS
[] One [] Four
.~. SINGLE FAMILY [] Two ~1 Five
~ MULTIPLE FAMILY ~ Three [] Six
Other
7, WATER SUPPLY
~ NDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTI LITY
8, SEWAGE DISPOSAL SYSTEM
~-~ NDIVIDUAL/ON-SITE** __l~/f) YEAR ON-SITE SYSTEM WAS INSTALL.ED.
[] PUBLIC UTILITY
NOTE: THE NSPECTION FFE MUSTACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
ATTACH WELL t. OG, A well log s required for all wells drilled
since June 1975. [:or wells drilled prior to that date, give well ,
aepth (attach log if available.)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[~ISING LE FAMI LY ~3 ONE ~THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
J~ INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTI LITY
Connection Verified LOG RECEIVED
3. ~NDiAGE DISPOSAL SYSTEM PERMIT NUMBER
VI DUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
[]Septic'rank or E~]Holding Tank
Size: / ~ ~'r) If Tank is homemade SOILS RATING / .,~
give dimensions:
TYPE OF TANK ~ MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
~;~//~PPROV ED FOR ~BEDROOMS
[] CONDITIONAL APPROVAL (letter mnst accompany certificate)
[] DISAPPROVED
DATE
ALASKA
eI'IUIROIqmeI1TAL corl'rROL
~n§inee~'Jn9 $ ~nuironmental StudJe~
S[!RUICI $, IFIC.
RECEIVi:i)
9/14/81
JERALD JOHNSON
SRA BOX 77 J
ANCHORAGE AK
99507
SELLER - JERALD JOHNSON
SUBDIVISION-WILLIAMSON
BLOCK-2 LOT-il
ADEQUACY TEST FOR S}~WER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 528 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 538 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
4 BEDROOM HOME.
THE SEPTIC TANK WAS PUMPED ON 9/15/81
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF
THIS 4 BEDROOM HOUSE.
1250 IS ADEQUATE FOR
1220 UJest 25t1~ Auenue * Anchorage, ^l~ko 995o3 * (coz) 276-1301
September 15, 1981
Gerald D. Johnson
Star Route A Box 775
Anchorage, Alaska 99507
Subject: Lot 11 Block 2 Williamson Subdivision
Approval for the individual
cannot be granted until the
completed:
sewer and water aczlltles
following items have been
· (1) ~ The water analysis report needs to be submitted to
~/~J~ -this office fr~m 'the Chem Lab, 5633 B Street for
'~/'r~ °ur review'
(2) A well log submitted to this office for our files
/ /, and review.
~.~i~{~) The well seal needs to be tightened so that it is
~'~ ~water tight.
,:;~ /(4) Exposed electrzcal to the
wires
head
are
in
~' / .' violation of the Municipality of Anchorage codes and
~ ~,/~ must be encased in conduit.
/(5)
~..../,~( 6 )
The standpipe to the septic tank needs to be raised
above ground level.
The septic tank pumped with a receipt submitted to
this office.
An adequacy test needs to be performed on the existing
leaching area. This test will determine if the system
is adequate according to National Standards. A listing
of private firms performing the test is enclosed. This
report needs to be submitted to this office for our
reivew.
Gerald D. Johnson
September 15, 1981
Page Two
Please notify this office for a reinspection when the noted
descrepancies have been corrected. If there are any further
questions, please call this office at 264-4720.
Sincerely,
James S. Roberts
Associate Environmental Specialist
JSR/ljw
cc: Alaska USA Federal Credit Union
Pouch 6613 99502