HomeMy WebLinkAboutGREENLAND BLK 5 LT 3Greenland
Block 5
Lot 3
#015-171-34
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP241140
Work Type: SepticTank Upgrade
Tax Code Number: 01517134000
Site Legal Address: GREENLAND BLK 5 LT 3 G:2636
Site Mailing Address: 4700 E 115TH AVE, Anchorage
Owner: FLYNN DANIEL T & HEIDI S
Design Engineer: FIRST WATER CONSULTING
This permit is for the construction of:
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
6/27/2024
6/27/2025
❑ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy ❑ 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
. eive48y: T SS c"eA -f"v " l--( C.- Date:
Issued By: % Date:
3
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 015-171-34
Property owner(s) DANIEL T & HEIDI S FLYNN Day phone
Mailing address 200 W 34TH AVE #914, ANCHORAGE, AK 99503
Site address 4700 E 115TH AVENUE, ANCHORAGE, AK 99516
Legal description (Sub'd., Block & Lot) GREENLAND BLOCK 5, LOT 3
Legal description (Township, Range & Section)
Lot Size 18,000 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(N all that apply)
Absorption Field
❑
Initial D
Single Family (SF) ED
-XI
(w/wo ADU)
Septic Tank
I
Upgrade RX
Duplex D
(D)
Holding Tank
EJ
Renewal El
Multiple Dwellings D
Privy
D
(SF and/or D)
Private Well
M
Water Storage
El
THIS APPLICATION INCLUDES A 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)
Permit/Rush Fees: ?zS
—
Date of Payment: _ 6/ 17, L-0- z;"
Receipt Number:
Permit No. 0 5? 2- y 1/ &-y V
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GAIDevelopment Services\Building Safety\On Site Water and WastewaterTormsUient Forms\Permit Application.doc
13030 Sues Way, Anchorage, AK 99516
907-350-9566 / firstwaterAK@gmail.com
!
!!
June 14, 2024
Municipalities of Anchorage
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
RE: SEPTIC TANK UPGRADE PERMIT – ADVANTEX FAP 2.0
LEGAL: GREENLAND BLOCK 5, LOT 3
The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic
tank and pump vault on the above referenced lot. We propose to install a 1500-gallon Advantex
FAP 2.0 with pump basin per the attached design to serve the existing 3-bedroom residence. The
Advantex tank will be installed due to the existing characteristics of this small lot with
encroaching wells. With the Advantex tank, the existing absorption fields can now be considered
to serve 4 bedrooms - a larger number of bedrooms than currently.
No groundwater was noted in the MOA on-site file, but if groundwater is encountered during
installation 4 cubic yards of concrete may be required around the FAP flange for buoyancy. The
lot and area are served by private water and any encroaching wells, easements, … must be staked
prior to construction. The design will not impact any of the neighboring properties. Please
contact us if you have any questions.
Sincerely,
Curtis Huffman, P.E.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241140, Deb Wockenfuss, 06/27/24
FIRST WATER CONSULTING
GREENLAND BLOCK 5, LOT 3
DESIGN DETAILS:
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241140, Deb Wockenfuss, 06/27/24
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this Day of �i N) -6- of 20_j,!J,, by and between
_ k>j A Kj i L_ S j , herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as
located at (legal description)
ADVANTEX SYSTEM
GREENLAND BLOCK 5, LOT 3
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
It shall be the responsibility of the Owner during the term of this Agreement topay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
A�2"wner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
Owner acknowledges that regular maintenance of an AWWTS reduces thep otential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Pagel of 3
Owner acknowledges that the Municipality may request records of maintenance and
pairs from the manufacturer's representative or maintenance provider.
Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
/assessed in accordance with AMC 14.60.030.
.Z/I Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
Aeowner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
/� guidelines for the construction, maintenance and repair of the Owner's AWWTS.
j(z:� Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
Municipality of Anchorage Page ! of `:3
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: __%—__— --. _._ _ PID Number: 01 S 1�7_L
Name:
Wastewater System: o New 1W Upgrade
DONAt-0 (3H(7 (3M(3A TccDO
Address:
H70a E rf5 P►ve. /•1Nct+. 14 Pic 995 r6
ABSORPTION FIELD
Phone:
3 Y 6 " 3 §'8 f
No. of Bedrooms:
3
[13 Deep Trench O Shallow Trench O Bed Mound ❑Other
LEGAL DESCRIPTION
Soil Rating
Total Depth from original grade:
�%' 8 GPD/Sq. . Ft.
I ?, rJ
Lot: Block_ Subdivision:
Deplh to pipe bottom from original grade:
Gravel depth beneath pipe
3 i 6-(?EE11 l /4N U
6,3 Ft-
6,2 Ft.
Township:
Range:
:3w
Section.
22
Fill added above original grade:
Gravel length:
6(
!,O FL
Fl.
_f2a
WELL: Ex/gr ❑ New ❑ Upgrade
Gravel width
Number of tines
Distance between lines
2, J l-1.
.9
SG E PMN Ft.
Classification (Private. A,B.CI:
Total Depth:
Cased To
local absorption arca-
Pipe material:
Ft-
FI
% SQ, Ft.
f ISM° OIA ScH EO H0 PVC
Driller:
Date Milled
Slantwater Level_
Inslaller
Date installed:
rt
cgaAis F_xcFlvr+Trnr6
Yield :
Pump Sol at
Casing He�ghl Above Ground.
�{
TANK Exrsr!NG
GPM
FI
Ft
SEPARATION DISTANCES
El septic ❑ Holding ❑ S.T.E.P.
To
Septic
Absorption
Lin
Holding
Public.,Puvate
Manufacturer:
Capacity in gallons:
From
Tank
Field
Station
Tank
Sewer Lines
6('r
Material:
Number of Compartments: v
Well
to C.O.
(00'
FiS r
—
Sd'
Watere
> f00'
> foo
> foo
-
-
LIFT STATION rx(sr'!NG--
Lot
,
y5
t
G
116-
-
-
Size in gallons:
Manufacturer
Line
Foundation
lot
65
D
"Yo r
—
0
"Pump on" level at
_
"Pump off' level;
High water alarm at:
Curtain
_
_
Pump Make 8 Model
Electrical Inspections performed by:
Drain
-
Remarks: Tesf hole #.t war V_e exc6cVcclYCl(
BENCH MARK
Location and Description:
-la IB.S' er ermi� re urremenf• !`lo r0cfA(,(
SOUTHWEST COr? NC-(� of DCC( -C
cuuFer encaun1-ere (. So,( Wal sh hH r,,0
_
Assumed Elevation:
,S'011 C densely Coi„,(2ac1-ed. Tre,,ch wn oration
a
1UCJ•00 I'L
ENGINEER'S SEAL
rrr-
G!/01 YhGGe(Tle� W, adeCrl 19 uj��er remairy O3-� ar) O(a (UlJSr(lerf
trench en kereo( werh eno(o-1`sYjAern.
wtre Cvun @ The exuhng sor/
1 rr l4 ooy pM1°eo, e t.�
;.: ry°- 1 �•;J�
ex c>/ l ol) 9
/� becf u�cry ochunclaned to /ola.r�� avarlay/e /e
{tccre r^Gro4nrcfuin,
fr•t,` °
y •°"
Inspections performed by: met k Zcch. Svc .Dates: 1st !2 /9 /9 /
+` `•'.'ia,'�,',,` ._'
•,
2nd_ 1219 /91
C•`ave c�°n ac ca°>vt noro7°vo�. tnr
t3•:�� too ooc <°aaDava+nc
Department of Health and Human Services approval
i�
Reviewed and approved by:—�•4--1 •<-1 n (�- Date:
72-013 (Rev. 9/91) MOA 25
._ ti_ I
Permit No. 5 W 9/ 0 3 70
Page 2_ _ of _
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 ®Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Legal Description:
6:R0C_
6AS7- 115 I'll AiE
72-013 A )Rev. 9/91) MOA 25
PIDNO.: Or, -17/3Y
n1_Rnl v1Cw
I" = 30'
5w11VC- T1c--S
t�otl : (3LDP cod;°A° CcR kaf
>: M.j, 831 10,5-1
Flattop Technical Services
14530 Echo Street
Anchorage, Alaska 99516
ENGINEER'S SEAL
WSJai"Oei ea YO�il•eeaaf a.-fr oPrj
l:Ii P
r' 3e VOOfO eeo af�z ar,�
t.
tl.r
Permit No.5: 9 f d_3 7�_
Paye —_�3 _ of _ 3
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 ® Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: 1,0T 3 , 3 L. r< �'� GREEN e-Rnr L> S,"D PID No.: _O ! S / 7 ! 3 t_
(oo' rGM (PoacH)
I r00•a'
95 ( e)krsr
y_tr- - r
s r�+rlaN
90'
M
•LNv
93.0' t
72-013 A (Rev. 9/91) MOA 25
c=fNAr- czeAOC 96.7' 1.
0M16G(N41. 6rriApC- 97.7' C/}Ve)
GAcK r -(w/,
r-f1.TER F46RIC
I'/Ifs' PC -13F P1 P1" INVSRr7 91. 35' 6OT'MONPl
^SEW cs13 6-' riAvc-L,."
-r ri E -N C N GO rr01-I &r. Z'
PRor-rc.e
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NO "ri(Z. SC 9LF
Flattop Technical Services
11530 Echo Street
Anchorage, Alaska 99516
T-. 4. #J.
0r?16% 30T. PO.
13 E E x. 00T. 7 9.
(216/9 /
F.NGINEE,q'S SEAL
M A
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MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM
PERMIT NUMBER:SW910370
DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES
OWNER NAME:JUDD DONALD L & BARBARA
OWNER ADDRESS:4700 E 115TH AV
ANCHORAGE, ALASKA 99503
PARCEL ID:01517134
LEGAL DESCRIPTION: GREENLAND SLK 5 LT 3
LOT SIZE: 17000 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
'.CHIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
PAGE 1 OF 1
1I i -A
4 k__
)- / �f
(UPGRADE) PERMIT
DATE ISSUED:12/03/91
EXPIRATION DATE:12/03/92
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 FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
A SOILS TEST SHALL BE PERFORMED TO A MINIMUM DEPTH OF 18.5
FEET AT THE TIME THE ABSO�R/PTION TRENCH IS CONSTRUCTED.
RECEIVED BY: DATE: (2-15 / 9
ISSUED BY L K✓/ �V. ��/1/ _ DATE
Mun►icipality of Anchorage
Department of Health and Human Services dh�15
Tom Fink, 825 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
343--4744
December 4, 1991
Ted Moore, P. E.
Flattop Technical Services
14530 Echo Street
Anchorage, Alaska 99516
Subject: Waiver Request for Lot 3 Block 5 Greenland Subdivision
Waiver Request #WR910054, PID 4015-171-34, #SW910370
Dear Mr. Moore:
Your request for waiver of the required 100 foot horizontal
separation of a septic system to a private well has been approved.
The approved separation distance is 88 feet from the well to
a lift station and 2 feet from the leachfield to the property
line.
This waiver approval applies to the existing septic system to
well separation only. Any future upgrade to either will
require all separation distances be met or another approval
from this department.
Sincerely,
Daniel J. Roth
Civil Engineer
On-site Services
ljm:#6
Concur:
,I
/ohn Smi. /, P.E.
Program Manager
On-site Services
J
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR# 910054 PID# 015-171-34 HA# Permit # SW910370
Date Received: 11/22/91
Legal Description: Lot 3, Blk. 5, Greenland
Engineer: Ted F. Moore, Flattop Tech. Services
Applicant: ponald Tudd
Waiver Requested: 88, Well to Lift station• 2' Trench to Tot Line
Criteria: 1. Geology: Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3. Other:
Waiver is Granted: Waiver is NOT Granted:
List Conditions or Reasons for above: SEE 4rfi1' 1,0cW
Rec #: OS2 244 Amount: $ 410.00 Date Paid: 11/72/91
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Civil, & EN1'MONME IAL ENGINEEIRING • I•:NERGY CONSERVAIION & ANALYSIS
THEODORE F. MOOKE, P.L. 14530 ECHO ST.
PH: (907) 345-1355 November 22, 1991 ANCHORAGE, ALASKA 99516
M.O.A. DHHS
P.O. Box 19-6650
Anchorage, AK 99519
Dear Sirs:
The purpose of this letter is to provide the required design narrative in support of our application for a
permit to construct a new soil absorption trench on Lot 3, Block 5, Greenland S/D, located at 4700 E
115th Avenue. Soils logs, perc test results, a site plan, design drawings and specifications are enclosed
for your review and approval. In conjunction with this permit application, we are also requesting waivers
allowing continued usage of the existing lift station located 88 feet from the well and construction of the
new soil absorption trench within 2 feet of the south property line abutting a dedicated alleyway.
Additional backup information from DHHS files supporting the waiver request is also enclosed.
The proposed soil absorption system will be constructed between test holes #1 and #2. As can be
seen from the soil log for test hole #1, the native material between 6' and 16.75' in depth is a somewhat
silty sand with a measured perc rate of 8 minutes per inch. Using the soil application rate of 0.8
gpd/square foot specified in the wastewater ordinance for soils with a perc rate between 6 and 15 minutes
per inch, this 3 bedroom residence requires a total absorption area of Q x 150)/0.8 = 562.5 square feet.
The proposed 50 feet of soil absorption trench with 6 feet of sewer gravel has a total absorption area of
600 square feet, which includes an allowance of 37.5 square feet for the effect of the ell in the trench.
We propose to abandon the existing soil absorption bed in place and to utilize the present lift station to
provide pressure distribution of effluent into the new soil absorption trench. Based on an observed lift
station pump output of approximately 15 gpm, we have specified 3/16" diameter holes spaced 3' on
centers in the distribution pipe. Each hole will pass 0.94 gpm with a residual head of 5 feet.
The topography in the vicinity of the proposed constriction site slopes towards the northwest at
approximately 2 - 3%
The proposed project will have no impact on present or future water supply and wastewater disposal
systems serving adjacent properties, nor will it have any impact on reserved space/surface and subsurface,
or on drainage.
Waiver Analysis - see site plan
The septic system was upgraded in 1982 by the installation of a lift station consisting of a 24" diameter
galvanized culvert set in a poured concrete bottom with a sump pump set on the concrete floor of the lift
station. This pumps effluent in doses of approximately 15 gallons each into an 1100 square foot soil
absorption bed. The lift station is equipped with a separate alarm float which sounds an alarm mounted on
the house when the fluid level rises approximately 6" above the normal "on" position. We measured the
lift station to be located 88 feet from the well serving this residence; at the tune the lift station was installed
it was the opinion of the engineer that Municipal and State regulations allowed installation of a lift station
as close as 75 feet from a private well without the necessity of a waiver. There is no recorded discussion
of this issue at the time the as -built drawing was submitted and apparently no question was raised by the
Health Department at that time.
During our 11/11/91 adequacy test of the wastewater disposal system (the soil absorption bed failed)
we ran a total of 623 gallons of water directly into the lift station and and thus had an opportunity to
observe it's performance over approximately 40 pumping cycles. The lift station performed as designed,
and we verified the operation of the high level alarm. The lift station appears to be well constructed,
watertight, and in sound structural condition. Because the bottom of the lift station is encased in poured
concrete, it would not be feasible to relocate it outside the 100 foot radius from the well, and to do so
would also further reduce the available area for future soil absorption system upgrading.
There is no driller's log for the well serving this lot, however other documents on file at DHHS
indicate that the well was drilled in 1968 and has a total depth of 105 feet. The well is located 69 feet from
the cleanout of the concrete septic tank installed in 1970 to serve Lot 2, which was a legal separation
distance at the time of construction, so no waiver is required for this. The well is located 65 feet from the
cleanout of the septic tank serving the subject lot, which was also a legal separation distance at the time of
installation. A 1979 adequacy test report by Tobben Spurkland reports the tank to be steel with a 2000
gallon capacity, however Carl of Carl's Excavating who upgraded the system in 1982 reports that the tank
is actually a 1250 gallon concrete tank which was found to be in good condition at that time.
On November 11 we conducted a yield test of the well. The initial static water level was at 42 feet
below the top of the casing, and steady pumping of 758 gallons of water from the well at the maximum
pump output of 8.3 gpm caused the water level inside the casing to be drawn down to 65 feet, but no
further, and it returned to the original level within a half hour after the water was turned off. Based on this
test we determined that the total yield of the well is in excess of 8.3 gpm. Water samples collected on
November 6 were satisfactory, showing 0 coliform or other bacteria per 100 ml., and non-detectable
nitrate -N.
Since the subdivision is relatively old, well logs were not generally recorded. The only well log which
we could find in this area is a 1982 log for Lot 9, Block 6, Greenland S/D, located diagonally across the
street from the subject lot. This log indicates a total depth of 66 feet with a static water level of 39'. The
owner of the subject lot reports that his well was originally 70' deep and was subsequently deepened to
105' to increase the yield. This being the case, it is logical that the log for 9/6 Greenland is probably
representative of the soils to 66' at the site of the subject well also. The shallow soils indicated on the log
are consistent with those encountered in the two test holes we recently dug on the subject lot.
The following is a breakdown of how waiver assessment points could be assigned utilizing the
procedure outlined by D.E.C.'s SCRO.
Category Points
Distance to water table (41' to static water minus 10' deep lift station = 31') 4.1
Soil Sorption (clay and sand) 4.5
Permeability (silty sand) 2.0
Water table gradient (essentially level in this area) 2.9
Horizontal separation (88') s 2.5
Total 16.0
Based on this analysis it appears that the waiver can be granted without undue concern as to the
potential for contamination of the well from the lift station, should it leak or fail. An additional
consideration supporting the granting of the waiver is the fact that should the lift pump fail to operate and
the alarm not sound, wastewater would back up into the residence before it would daylight onto the
surface of the ground.
The reason we are requesting a waiver to allow construction of the soil absorption trench within 2 feet
of the south property line abutting the 20' wide dedicated alley is to maximize the efficiency of utilization
of the very limited area available on the lot for construction of soil absorption systems. The proposed
configuration of the trench will utilize the best soils encountered in the test holes, and because the
construction site abuts an alley rather than private property, there will be no impact on the ability to
develop future wastewater disposal systems on adjoining properties. This configuration will allow for the
possibility of one more upgrade to the soil absorption system serving this lot at such time as it is required.
Please give me a call at 345-1355 if you have any questions on this submittal.
Sincerely,
Ted Moore, P.E.
cc: Donald Judd
cv nh"=r .sore, Ar3s, rmmvcp
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Flattop Technical Servi,
7.4530 Echo Street
Anchorage, Alaska 99
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Flattop Technical Services
14530 Echo Street
Anchorage, Alaska 9951Q
L 3. 3 S Cr R C- EN G. A fel D S /G
Soll� AO -SORPTION TRENC.
Pt -AN � X-EECTroN
D ATC If /9/
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Flattop Technica(Services
14530 Echo Street, Anchorage, AK99516
Phone (90 7) 345-1355
Lot 3, Block 5 Greenland Subdivision
4700 East 115th Avenue
Wastewater disposal system installation
Specifications
1.0 General:
1.1 The scope of the project consists of construction of 50 lineal feet of soil absorption trench
containing 6.5 feet of sewer gravel, and providing pressurized distribution from an existing lift station.
1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor
deviations from these drawings may be allowed or required by the engineer conducting the inspections.
All construction procedures and material specifications shall conform with Municipal and State
requirements.
1.3 All separation distances shall be in conformance with Municipal requirements, unless specifically
waived.
1.4 The contractor shall be responsible to obtain any necessary utility locates, and to work around any
buried utilities.
2.0 Septic Tank:
2.1 The existing 1250 gallon concrete septic tank is to be retained in service.
3.0 Lift station:
3.1 The existing 24" diameter galvanized steel culvert lift station is to be retained in service with the
following modifications.
3.2 The pressure discharge line to the existing soil absorption bed is to be disconnected inside the lift
station, with care taken to ensure that the penetration through the side of the culvert is sealed watertight.
3.3 A new 1.25" diameter Schedule 40 PVC discharge line shall be run from the lift station to the new
soil absorption trench, and connected up to the existing lift station pump with appropriate flex pipe and a
quick disconnect union. The new penetration through the lift station wall shall be fitted with a watertight
seal around the discharge line.
4.0 Soil absorption system:
4.1 The soil absorption system shall be constricted by excavating a trench as shown on the
construction drawings to a total depth of 12.5' below ground level in the vicinity of test hole #2.
4.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked to
allow proper infiltration.
4.3 A total of 6.5 feet of approved sewer gravel shall. be placed in the bottom of the excavation with
the perforated distribution pipes laid level such that the distribution pipe inverts are no less than 6.0 feet
above the bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than
3% passing the #200 sieve.
4.4 The horizontal pressurized distribution pipe shall be 1.25' diameter schedule 40 PVC with 3/16"
diameter holes drilled in the bottom every 3,feet. The end of the distribution pipe shall be capped and all
joints shall be glued.
4.5 A 4" diameter monitor tube shall be installed in the location shown on the design drawings. The
portion of the monitor tube extending through the sewer gravel shall be perforated.
4.6 Approved filter fabric shall be placed over the entire top surface of the sewer gravel before backfill
with unclassified material.
4.7 The top surface of the cover material shall be raised a minimum of 12 inches higher than the
surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill
slopes shall be no steeper than 3:1.
4.8 Topsoil and revegetation of disturbed areas shall be the responsibility of the owner.
5.0 Inspections:
5.1 A total of 4 engineering inspections will be required during the course of the project: (1) initial
stakeout with the contractor to establish the location of the system and to discuss the plans, specifications
and construction procedures, (2) after the native material has been excavated to expose the infiltrative
surface to ensure that it is level and at die right elevation, and conforms with the soil test information, (3)
after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic
tank, but prior to placement of filter fabric, and (4) after final backfill and grading is complete.
5.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in
advance to ensure the availability of the engineer.
Flattop Technical Services
14530 Echo Street
Anchorage, Alaska 99516
u Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
T". H. # 4
s-�
�,"�:'.(ENGINEER'S�ERi�' •'Y,{
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PERFORMED FOR: pyn Tu.o(1: DATE PERFORMED:__11 /ly /9/
LEGAL DESCRIPTION:1-3._(3,j 6reeotcrno( S /D Township, Range, Section: _S e c 2 2, T 12 /yr ri 3
DEPTH �^ SLOPE circ o, Al,
(FEET) M I-. rill
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
1 G, X517
18
19
20
P 4-
5M rvo(o(ul3 sandy /ou/
M11 gray er!>
,Saac(� �rzlvPl
M C dray srlf
SM
M
v.
v
U riaY S r l y sand
occc4slvnal �enJ�J
o MAr SP
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
7
S
L
O
P
F
Depth to Water Alter M' 7' Dr y
Monitoring? Date: 1 22/9f
Reading Date
I fly
Gross
Time
Net
Time (/�r,n
Depth to
Water
Net
Drop X,2,
2" Pres yerk _
12; 17
27 V-4
t 14,-o
1: 08
2 2 VY — 2 7
t 0
1:37.1,5"
Z3 7116-
/r61#
1#
I :N7:1S
10
22 'rh
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2 3 7/1
4# 2
1{ 57; y
! 0
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/ -7/00
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1:56,'rS
23 P/ 161
t 14,-o2
06: yy
10
? z '/y
2 3 5'/g
1 SY/6
22 s/16
/'�/l6
PERCOLATION RATE 9 (minutes/inch) PERC HOLE DIAMETER
r ff. #'I TEST RUN BETWEEN 8• S_ FT AND _` 10._ FT
COMMENTS —P[rc I-ejP Coq duc%a 9' Ss,' of T N m _`
PERFORMED BY: F 1 "it"V %iG,hnlCRl feee c e_r I =1 _e.o� %ita+� CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 11 / 2 2 /9 /
72-008 (Rev. 4/85)
Flattop Technical Services
Date
14530 Echo Street
,w °°�4'"�e� �! �Ea'L; 0
Anchorage, ,Alaska 99516
Net
Drop
• ..� Municipality of Anchorage
DEPARTMENT
OF HEALTH & HUMAN SERVICES�7of...?moi?::;`;
825 "L" Street, Anchorage, Alaska 99502-0650
TFI O F. r•t°°RE
SOILS LOG — PERCOLATION TEST
l'/.` "'o�•. CE - 3532•o,i * ; A
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-1"• (+• �• 2
gym_<'r/v�, ..,�.��`�°� .
PERFORMED FOR: --D old 7"vzri DATE PERFORMED: 11 //y /9/
LEGAL DESCRIPTION: L>3
DEPTH
(FEET) P f
1
2•
3 M G,
4
lctno( S /p Township, Range, Section: S e c. 2 Z
7' 12 /y� (j 3S,
CITC Ill nn�
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maxed lenser of SP, 6P
5 M 1 dense tejF
6-
7 _ SP/Srr Sll�aNy S'd/
8-
9 S r1
10
12
13
14
15
16
i3 -H.
18
19
20
yray,, SarnewAeAf r-t(l4/
WAS GROUND WATER
l•Qhsp,,,( os S•(' ENCOUNTERED? IBJ
S
Nl a{ erra 1 tY IF YES, AT WHAT L
DEPTH? 0
mary+nally e
C (eianer flan Depth to Water Alter M' T. Dry
5rT in T.Fi• # jMoniterInD? Date: It / 22/9/
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
L ----j PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER
r K -#a TEST RUN BETWEEN
FT AND . FT
COMMENTS les 6 %1o(e wqr d"% {b COn47rm pn ilnui�x p,F Sr -1 rgaAeria•I
P -_hs Cfe? Te'escC in T N #1.
Re risen{�hv� erc race _
P m tart rt+GC r n '7� 1
PERFORMED BY: _F(al'}»n
CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
c-vio %nev. 0! 10i
MUNICIPALITY OF ANCHORAGE Pt � S I 43= O?
J
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
NAMEONE
WPHsONE
�- �IIpGRADE
MAILING ADDRESS
`(`T50�-
5P,� 13o,(
LEGAL DESCRIPTION
re_e,`I v)
LOCATION
11 5tt\ S�-ree t.
N0. OF BEDROOMS
DISTANCE TO:
Well
Absorption area
Dwelling
PERMIT NO.
c) Y
-- Q Manufacturer
Material
No. of compartments
WF
V)
Liq. capacity in gallons
IF HOMEMADE:
Inside length
Width
Liquid depth
9 O Y
DISTANCE T0:
Well
Dwelling
PERMIT NO.
Z
2 z
Manufacturer
Material
Liquid capacity in gallons
❑
j
DISTANCE TO:
Well
'1 a rl
Foundation
y
Nearest lot line )
PERMIT NO. 1
!tu'14-Wr
/'
1
J u. z
No. of line
Length of,�e?��ach line
Total length of lines
Trench wid. h
J
Distance betweep lines
F, z 2
?.r Tl Z
J 2
2S 2 - 4iches
�j ' /"''1 v1
l.-
Top of tile to finish grade
(
Material beneath tile
Total effective abergtion area
_ ❑
�1'. rn.Sj
[� inches
�� I I [7 _)
Length
Width
Depth
PERMIT NO.
W
(9
ai-
Ma:u
Type of crib
Crib diameter
Crib depth
Total effective absorption area
N
DISTANCE TO:
Well
Building foundation
Nearest lot line
.a
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
W
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
PIPE MATERIALS
p Jet
p V C_
SOIL TEST RATING
INSTALLER
REMARKS
cc 2
�1
i
SA
a-
J
APPROVED
LEGAL33
CzDATE c7
li5
c-vio %nev. 0! 10i
%mow' MUNICIPALITY OF ANCHORAGE Mt) A S1
r: \ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL. ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 284.4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
$3o z/
rvr+mC .
(V. or t ld I- �. ?_
ONENEW
--�
RADE
fdAILING ADDRESS
p
� BCF
gg50
LEGAL DESCRIPTION
ts
C
LOCATION ' 5",
Strc c t
N0, OF BEDROOMS
Well
DISTANCE T0:
orvUon arca
Dwelling
g
ER
PMIT NO.
_ _
���LLL...
Manufacturer
Material
No. of c omwnm•nte
w
-
Lint. capacity in gallons
II'HOMEMADE:
Imide length
^------•.
h
WidtI
LGul ddepth
b1=
.pt
DISTANCE TO: Welles
_
Dwelling
PERMIT NO.
X moi•
Mnnulecturer
^_
Material
Iquld capacity In iallans
w I
DISTANCE T0; Well I U G
Foundation y
_
Nearest lot line
I, NO
hM�W/i
� 2 W
_
N3. of liney s -,q Langth2l rich link /�
Yj�� �-�"'_
Total Ixnyth o� lines
/
Trench wi 7'
X5,2•-ntchap
Distance bet {t Imes
',:
Top o till to finish rade
g
- __.
Material beneath Zile
Ota • aCtIM C
Of
(� Inches
A/ II
q,,
w�
angth Width
Dep,n
L
Q� i.
Crib depth
Total effective •-borptlon area
Type of crib
Crib diametei
y
Building foundation!
Nearest lot line
DISTANCE TO:
Wall
.j
Class
Depth
Driller
Dissents to lot Iln•
PERMITtorpNO
W
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Abtlon area(s) by
OTHER
f
Ct
�•f'�IP A ERIALS
V c .
p t1 -
'SOIL TEST RATING
I��
INSTALLER
IS C� 8 3
f o
N se
IIEMARKS
t
ee
*04
Iu XIS e
A PROVED
por
�s
f
I�
�u t;
vI:
I
1t ti
I.
r
DAT
--
8Gterilwnd Bc,
72.013 (Rev, 9178)
ft n'
l333-I_i.L.
Data Drilled:.
Static Water Level- 32� feet
Drax Down feet
Total Feet of Caeir���
Tym M�kte�rlalDrilled t
9 feetto
to C /Q X SO rl
----�e�e to
to
to
Hefty Drilling LEGAL DESCRIPTION:
S.R.A. Box 1553 H Lot 9, Block 6, Greenland Subdiv.
Anchorage,Alaaka
Um
i
Data Drilled:.
Static Water Level- 32� feet
Drax Down feet
Total Feet of Caeir���
Tym M�kte�rlalDrilled t
9 feetto
to C /Q X SO rl
----�e�e to
to
to
Hefty Drilling LEGAL DESCRIPTION:
S.R.A. Box 1553 H Lot 9, Block 6, Greenland Subdiv.
Anchorage,Alaaka
Um
MUNICIPALITY OF ANCHORAGE
Department : Health and Environmental ?rotection
825 L Street, Anchorage, AK. ..9501
264-4720
P_ermit # # HANDWRITTEN PERMIT #
—'� 773 WI=- ON-SITE SEWER PERMIT
Applicant: )10�1 1._. IL&88. Mailing Address:
Location: a_) . Phone Number:
Legal Description: 4-,f 3 r3(0C_k s Ca2,�En/a S/D Lot Size: _
Type of Soil Absorption System Is:
Trench: Drainfield: V✓ Seepage Bed: _ Holding Tank:
Maximum Number of Bedrooms: Soil Rating(sq.ft/br) / 7i
The Required Size of the Soil Absorption System Is:
r r r
DEPTH LENGTH �91 . GRAVEL DEPTHS WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE _ /Z 0 _ GALLONS # #
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
# TWO(2) INSPECTIONS ARE REQUIRED #
Backfilling of any system without final inspection and approval by this departmen-
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 fee -
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I u derstand that the on-site sewer system may require enlargement if
the,res ence is remodeled to include more that 3 bedrooms.
Signed: Issued by: �vL_4�.� -
Applicant
Date:
3���
SWP/024 (1/81) `5- V
), y -otic tti= L'(ti
Io,
V SOILS LOG
___ MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION TERcoLAnoN
�
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
\� SOILS LOG — PERCOLATION TEST
PERFORMED FOR: Doll DATE PERFORMED:_�1I
LEGAL DESCRIPTION: _Lo 13If�c.K GreeniunJ Ju_4riivI,s,1,-�1'.�.4c>c'fiun ,�Z� 5/>f
SLOPE
r SCTA
IE P�LIN-T--� T �1
uyor (U�'� I �I7F-� I�
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
C-�,r
(/'rallStan cl y'� 5r � �•
Gro r77J JCA rrl p, JI+ to !';C; sr I J"
.S rn, 11 cz;A Vv,n.T a'�S n1 un y)
�;10veI, (/✓I
S_ n d
i
WAS GROUND WATER S
ENCOUNTERED? el�� O
P a
IF YES, AT WHAT E
DEPTH? _
WO
Reading
Date
Gross
Net
Depth to
Net
Time
Time
Water
Drop
10 I a a
----0,4
q
-
j0
0
tII�+J
is -43
a
SfioftJ3
1!,� : -
to
C`
-
/
y/io/6.j
itorJ/l
C%
11,.5,
l4-
'vj/o%13
I it 1.6-
;.
013 7
I d
13
PERCOLATI N RATE ,� c�. fJ (minutesrnch)
J-
TEST RUN BETWEEN �-L FT AND FT,
PERFORMED BY: a r I SrJh CERTIFIED BY:
72-008 (6/79)
DATE: YV;0/>33
'r'obben Spurkiand P.E.
0 V1 P- �-. L
Parcel I.D. #
MUNICIPALITY OF ANCHORAGE
0*
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
015-171-34 �11.
HAA# ,`j-�c ., r,i
1. GENERAL INFORMATION
Complete legal description Lot 3; Block 5; Greenland Subdivision
Location (site address or directions) 4700 E. 11
Anchorage, AK
Property owner Gary & Linda Carpenter Day phone
Mailing address _4700 E. 11 5th Ave. An horacre AK 9951 6
Lending agency Day phone
Mailing address
Agent Cyndie Partch/ Prudential Jack White Day phone 762-5827
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual well XX
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 XX
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.1M) Front MOAt21
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 furtherverify 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 incompli nce with all Municipal and State codes,
ordinances, and regulations in effect on the date of th' nspection.
Name of Firm
Address
Engineer's signature
Alaska Water
Alaska Water &
Wastewater Consultan 4%
Do
Shall be PAID $ 1 1 DU
or prior to, closing for the
Engineering Services Provide&
6. DHHS SIGNATURE
Approved for
Disapproved.
j bedrooms.
Conditional approval for
Additional Comments
By:
Phone 33-7_6/79
kr4
Date
AV o A
'• A
%
a.
x
�..
.::....� ..e
n CC
` arfr A.
:795] , S� Ao
VAP
R 1�1FES
'iosra�e
bedrooms, with the following stipulations:
Date
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificatesbased 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 orderto 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.
72-025 (Rev. 1/91) Back MOA W - -
*-D
Municipality of Anchorage 14
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division
825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744
Health Authority Approval Checklist
Legal Description: Gv'e,13LAtNo 'AP1 ( 7 ��5 _ Parcel I.D.:_
A. WELL DATA
Well type I KIVPrT = If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N) �0 Date completed
Total depth �� + Cased to '/0 Casing height (above groun) %�2
Sanitary seal (Y/N)
Wires properly protected (Y/
FROM WELL LOG AT INSPECTI N
Date of test �/1 N �l U (� I t� g� L / W7 7
Static water level
Well production _ g. p.rn, T,S -9-P.M.
WATER SAMPLE RESULTS:
m
Coliform _ Nitrate Other bacteria _
Date of sample: /3I� 9 Collected by:
B. SEPTIC/HOLDING TANK DATA IaSo G(+c ?e[L- M"A F1rrz Vv4wafl WR�IIovS�t
),W. 4-
Date installed �S _ Tank size -� Number of Compartments 1 _ Cleanojutts ) _
Foundation cleanout(Y 1(� �o Depression (Y/@ Pc) rp High water alarm (�I 1)
Date of Pumping `%- �%i Pumper 4ME 2ul4&S 96Y A-1-'"� S�vLrEs
C. ABSORPTION FIELD DATA -�-
Date installed �� _ Soil rating (g.p.d./ft or ft2/bdrm) 0- -System type I IzEl
i
Length 6 i Width r"��� Gravel thickness below i e `4L FIELDM-1fAW 13,11
pipe _ Total depth nrtEas. �
r� _.XEffective absorption area TSb 5F Monitoring Tube presentQY N)�_ Depression over field (Y/& 1%" O&sVn
Date of adequacy test 'ik h`k Results &s/Fail) (�c �For _ Fcwl - bedrooms
Fluid depth in absorption field before test (in.); 5 ki Immediately afterla� gal. water added (in.): �q
11
11
Fluid depth ZO (ins) Minutes later: Absorption rate = _ ��� _g,p.d.
Peroxide treatment (past 12 months) (Y/Ot-�o7 L(�c6v>> If yes, give date
72-026 (Rev. 3/96)*
WA
N yQ0 SNow cove^
D. LIFT STATION f a y 11CMP
Date installed �15��33 Size in gallons 0 ON
" tr
Manhole/Access 61 /N) ?iyw000 eovER- "Pump on" level at' /0 "Pump off' level at`
High water alarm level at' 101' 'Datum IJOTToM O I- �r LVE27
Cycles tested
E. SEPARATION DISTANCES
D_
SEPARATION DISTANCES FROM WELL ON LOT TO: W
Septic/holding tank on lot So U a) On adjacent lots '15� r �19ca)
Absorption field on lot /00 On adjacent lots /Uo
Public sewer main
Sewer /septic service line
tV/A Public sewer manhole/cleanout l-JIA-
Lift station 56
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation S � � Property line S '4— Absorption field S ��
Water main/service line o2 S Surface water/drainage /W /- Wells on adjacent lotsy (7o)
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line o< (WRc t0oS4Building foundation
Water main/service line
7 6 `-J-
Surface water py1�J_ Driveway, parking/vehicle storage area
(�\ /
Curtain drain I vor s 1—Nowti Wells on adjacent lots 10�
F. ENGINEER'S CERTIFICATION
i certify that have de t fined thr field inspections and review of Municipal records
in conforma ce with A g1@Ines in effect on this date. �� ��� . • ° ° ° ° ° ° ° � a' o
Signature
Engineer'$/Name
Date
HAA Fee $_ !!Com) (` x } Waiver Fee $
Date of Payment
Receipt Number �-t`f
72-026 (Rev. 3/96)'
Date of Payment
Receipt Number
IV%;
are
ASSUILT SEWARD & A6!iKiA'.l'_L5 LAND 5URVEY-ING 694.2829
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
SCALE;
FOLLOWING DESCRIBED PROPERTY
O
DATE,L
AND THAT NO IrNCNOACHMLNTs
EXIST EXCEPT A5
INDICATED, IT IS THE RESPONSIBILITY OF THE
OWNER TO DETERMINE THE EXISTENCE OF ANY
�
GRIDr
EASEMENTS, COVENANTS, OR RESTRICTIONS
'rd°pd`
WHICH DO NOT APPEAR ON THE RECMED SUBDI-
$ •, puen. MnrY. owerA s
`4°'�
VISION PLAY. UNDER NO CIaRGUMST•ANCES SHOULD
ANY
FB'
r�^`�
•, �s.hvia
DATA HEREON BE USED FOR CONSTRUCTION
R��xtid�
OF FENCE LINES, OR FDR ESTABLISHING SOUND-
�"�
DRAWN
ARY LINES.
.���.
'��,°`,�'"�-�
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
0*:_
qr
Division of Environmental Services
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # o ts17 13 1
HAA #�J'� �C{C� b
1. GENERAL INFORMATION
Complete legal description leo f 3 B/oC� S (r reps (an of S /D
Location (site address or directions) ti -70o C- f f5"'&A /$&,e
Property owner 00na(et
at Bar-l7cv ct 7ude�
Day phone
3 ye6- 3.6-62
Mailing address
H iGt7 t= fl Y " five fin Morcw
Ak 995" r 6
Y
Lending agency
Day phone
O'3 -0700
Mailing address
k/as w• 3 eve•; A" Gh�'
lik 995^03
Agent Dan WvlSe - Rc NO-)< pro/Ier Nef
Day phone
2 76 - Z -7e -
Address 2600
ec�ro�avcc Sf• /tnL�arcrgp,
r4 (2
��5'03
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water —
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Fran( MOA 021
5. STATEMENT OF INSPECTION BY ENGINEER
J
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm F (a Flre T-echrniccc( _S ervi'rol Phone 3 "1677 13 S6Y
Address l'1530 0:1cam Sf,. I±hchorayc /4l -c 99Si6
Engineer's signature 5� Date l2-/ !G/ 9 1
C. - T-, a ±�
jy 4.
0ea a�eel. •e.elaa°°.11°• ou,
' e CL - 3589
DHHS SIGNATURE
Approved forT� bedrooms.
Disapproved.
Conditional approval for
Additional Comments
WTIC
bedrooms, with the following stipulations:
Date / -? /i 3
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 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.
72-025 (Rev. 1/91) Beck MOA 021
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST.
Legal Description: Ltd 3�4 6!k S green let"( Parcel I.D. O 1.7l'7/ 3'Y _
A. WELL DATA
Well type Prt vol fie. If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N) _
Total depth
Sanitary seal (Y/N)
Date of test
Static water level
Well flow
Pump level
Date completed 1986 Driller
Cased to , I US ' Casing height
FROM WELL LOG
SEPARATION DISTANCES FROM WELL TO:
Wires properly protected (Y/N)
an k
2"
Y
AT INSPECTION
MUNICIF'AI-11Y OF ANCHORAGE
9 1 ENVOQNMENTAL SERVICES DIVISION
`'r- DEC 10 1991
g.p.m. g m
> 6�' C
Septic/holding tank on lot 0/16' Mal 0(1,1t-470' ; On adjacent lots C. 0.
�eA� alleac r9Ta, reglvf Adf =.TO
Absorption field on lot 1010 — ; On adjacent lots y rGQ r -
Public sewer main _ > l G0 t Public sewer manhole/cleanout
Sewer service line 50Petroleum tank No c
WATER SAMPLE RESULTS:
Coliform O col /rov M -f- Nitrate < 0• rhI /-C Other bacteria 0 cot /rao
Date of sample: 11 10"/9 / Collected by: 1= Iae 6F e tech Svc -
B. SEPTIC/HOLDING TANK DATA
Date installed 1966 Tank size 12 rO Compartments _—
Cleanouts (Y/N) Foundation cleanout (Y/N) -Depression (Y/N) N
aloe
High water alarm (Y/N) N, A. Alarm tested (Y/N) _ N. �•
Date of pumping
Pumper fV oo-M tew C>/
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot 66 n?,n co. On adjacent lots '> (C'O' Foundation
16'
To property line H5 ' Absorption field 5 5 Water main/service line Y�'
Surface water/drainage > !00' _
72-026 (Rev. 7/91) Front CONTINUED ON ®ACK PAGE
C. LIFT STATION
Date installed 8 15 63 Manufacturer SfP% 'aN" 006 601v Caulyeyf
W•..Surhp pmrnp
Size in gallons sso + Manhole/Access (Y/N) Y
N`n- attrfght 1 �"
cC "Pump on" level at
Vent (Y/N "Pump off' level at %
High water alarm level 15 it Cycles tested `IO -r
Meets MOA electrical codes (Y/N) A(v non - coln p Pian re 0 6 sere eot
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot 861 On adjacent lots > loo Surface water > lUG'
Watver rsSuBoe 12/N/9l
D. ABSORPTION FIELD DATA
Date installed 1 2 19 19 1 Soil rating 0-6 IYpO(I'ff Z System type ?ren ch
Length 61 Width 2 s` Gravel thickness 6. 2 Total depth f �• S `
Total absorption area 756 a' Cleanouts present (Y/N) Y ( M,T,
Depression over field (Y/N) N Date of adequacy test IV A. new)
Results (pass/fail) !U. /!. for 3 bedrooms
Peroxide treatment (Past 12 months) (Y/N) N If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot 100, On adjacent lots Property line 12' i wa(vev issued
To building foundation 65 To existing or abandoned system on lot �J
On adjacent lots> 30' Cutbank Not, e Water main/service line
Surface water -,� l G0' Driveway, parking/vehicle storage area �> l00 1
Curtain drain A104 e
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Date of Payment
0 ` ( 0-
Date of Payment
Receipt Number
nl �' r3 tj ti
��
Receipt Number
ooe,yw,
Signature
Engineer's
Name %h GocxorE°aye
cooaocacoaaoa�aaJaca
j ,,,'',.
Date
i
l
HAA Fee $
Waiver Fee: $
Date of Payment
0 ` ( 0-
Date of Payment
Receipt Number
3�� L�
��
Receipt Number
MW)L... I `/S1-76?
INSPECTION APPOINTMENTS
DAVE RECEIVED ®!�
TIME
TIME
TIME
DATE
DATE
DATE
INSPECTOR
s
INSPECTOR
INSPECTOR
— MUNICIPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIOr%NVIRONMENTAL PROTECTION
825 L Street • Anchorage, Alaska 99501
ENVIRONMENTAL SANITATION DIVISION Nov 1 1979
Telephone 264.4720 R � � p )/ E DREQUEST FOR APPROVAL OF INDIVIDUAL
WATER AND ;)EWER FACIL I S
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for 95 ssin .
since June 1975. For wells drilled prior to that d give we11
1. PROPERTY OWN J
ti Y►Ale� • �{/L�LA�
L
V►4 �'�1� 17
MAILING : '
1-7 26+ tlwi "! mn la"d asly64Ake 4��1a
PROPER' Y RESIDENT (If different from above)
PHONE
OL2.
❑ PUBLIC UTILITY
BUYER —�
-PHONE
MAI LI NGADDRESS OF fr
3. LENDING INSTITUT ON Q�/s® ��q`� /L PHONE
's � t.T d4-- #' �� ® 9alr
MAILIN�jA�DDR SS tl � A s
/y*/f f71�'�I�� Ii/�� /�etr�P _ 7C
4. REALTOR/AGEN' —HONE
MAILING ADDRESS
5. LEGALQASCRIPTION �� �
STREET LOCATION
--
6. TYPE OF RESIDENCE
NUMBER OF,BEDROOMS
[� SINGLE FAMILY
❑ One ❑ Four ❑ Other
❑ Two ❑ Five
❑ MULTIPLE FAMILY
L@O' Three ❑ Six
7. WATER SUPPLY
--"
E!f' INDIVI DUAL*
* ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that d give we11
❑ PUBLIC UTILITY
——s—
depth (attach log if available.) �/�i �' % �o 09
8. SEWAGE DISPOSAL SYSTEM
of��,e!
INDIVIDUAL/ON-SITE**
_YEAR ON-SITE SYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-otofri si7��V-�-t
3i CrS
('A.
401,
3
O-
THIS SIDE FOR OFFICIAL USE ONLY
.
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ 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
DATE INSTALLED
INSTALLER
,
❑Septic Tank or ❑Holding Tank
Size: If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL T0:
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
Ghti�_
c
EJ APPROVED FOR BEDROOMS
LAY CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE (
BY
G, 3,979
Tionald Judd
L-34COW Routo A Mo, Y122 -b
71jiohorar Mas)".1
"Ubjoct. Lot 3"Iock, Green? -ind 1,W)clivitiion
Approva'! for You- irl'Jiv.j�
I % dual swwar anA waten- Pacilitic"q
can not be grantod, until the fal.-Lowing jtopj�,, hjV(! I)Gc�vj
�.'Tater "ximlysir,- rnvort bo aolivorcxl to thit3 Of- ice
for ou- roviow.
Tno skeptic 'L;aak' p-l-rapad with a subr-aft-ted to
this offiUce. u;f;,ure jjjv�� 1:114..pwapax. put the
1; 41 -
nuraber of' (pati j.)UjApO%-j fro,.,, .1-11,o Unk, thir
I
to Vorijir Ito sA� c4.
%.n
Ll of tftu drainfield t-dll acaej to
he expose'd so that. 'ula oall 'meanwra tho, cUstanml to tho
we. 1. 1 . If. it is -"lot, 7.00 ract or 111orcr thra drain2iclld
will nae '? t(.,) be replac-ecl.
/(4) jv, adeqt1acy t�t2jj- jje. per -fox -ac -Ad on tho leaching
1.01d"s teszt will D'.' the 3!Y sto;na is, adec'nua-to
c
OLOOO-rding to National stanilardls. N 1.j3tjjlq O -E prj.vatc
flmms pw f tho 'd
L
:rr_, thore 4rp- any -4f -U3 IlActr Please conLact IL-JIL; 0 J.' f i c
at 2G,1-4720. pjc�cj*jo jjo,trjfy this, Office f-O.T.' a xe-irn3pectioll
06`1:1011 1:110 liotod do"ca-4:11pancie"3 havo boon
Sincerely,
Robort C.
RCP1j.jw
Tobben Squrkl and P.E.
8155 Cranberry St.
Anchorage, Alasl<a 99502
Phone (907) 243-5302
ADS:^o ACY TEST
Mr. Donald Judd
SRA Box V2213
Anchorage, Alaska 99505
STJT 3, -BLOCK 5, GRM"NLAND SID
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
NOV 7 1979
RECEIVED
Nov. 6, 1979
Gentlemen:
Per your request I performed an adequacy test on ypur sewer system on Nov. 5th and 6th.
1979• Yoklowing are my findings and conclusions.
Residence: Spl itt level, three bedrooms, built in 1968. On site water and sewer.
Sewer System: 2000 gal. steel tank. Dia. 75y2 inches, length 9 feet, burried 3 feet belo
ground.
Drainfi.eld along back lot line, dimenbions unknown. Drainpipe 6'/2 feet
below ground.
Test Procedure. Tank was pumped on Nov. 5th. Prior to pumping the wnterlevel in the
drainfield was observed to be 10 inches above invert of drain.
Approximately 2200 gal. was pumped from the system. At the termination
of ptunping fluid was flowing back into the tank from the drainfield.
This flow ceased after 5 minuita. At that time the depth in the tank
was 38 inches. The level in the drain ryas 1 inch above invert.
Or. Nov. 6th the drainfield was recharged. On inspection it was found tha'
the tank had filled up during the preceeding 24 hours. The level in the
drain had not changed.
500 gal introduced into the system. The drinfield accepted this charged
without any increase in wnterlevel.
Conclusion: The existing system is adequate for a three bedroom house.
®F A ZM
......
P,a'. No. 222.5-E
r&�O. )UNE 25, 1971
y