HomeMy WebLinkAboutGREENLAND BLK 5 LT 12
Municipality of Anchorage Page I of
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: ,.-~;b5 q¢ o ~;Z~, PID Number: ~1~ Ill - ~1
N~: ~~ ~'r~& Wastewater System: ~ New ~ Upgrade
Address:
~7ffl ~o~ ~ ~c~. ~ fl~s~ ABSORPTION FIELD
Phone~__~l~ ~o. of~rooms: ~OeepTrench ~ShallowTrench ~Bed ~Mound ~Other
Total Depth from original grade:
Lot:~ ~ Bloc~ ~~Subdiv~i°n: Depth to pipe boHom~, ~fr°m~ o~g[nal grade: Ft. G ravel depth beneat~pipe Ft.
Township: Range: Section: Fill added above original grade: Gravel length: ~
WELl.: E~I~T~ New U Upgrade Gravelwidth: ~1 Uumber of lines: Distance~en]ines:
Ft. ~
Classif~vate, A,B,C): ; Total Depth: ~o: Total absorption area: Pipe material:
Driller: ~,~e Drilled: Static Water Level: Inst~ Date instated:
--~Yield: ~IGpM ~Pump Set St: Ft~ -~ Ft. TANK
SEPARATION DISTANCES ~ Septic D Holding D S.T.E.P.
To Septic Absorption LiE Holding >ublic/Private Manufacturer: Capacity in gallons:
From Tank Field Station Tank Sewer Lines ~R ~ ~N~ I
Material: Number of Compa~ments:
Sudace
wat.~ 1oo% I~'+ ~ ~ LIFT STATION
LOt Size in~nuf~cturer:
m~- Electrical Inspections
Drain
Remarks: BENCH MARK
(~ ~O '~l~ ~ Location and Description:
A~umed Elevation: ~¢,
ENGINEER'S SEAL
Depa~ment of Health and Human Se~ices approva~ 't~2'., c ~
72-013 (Rev. 9/91) MOA 25
,E~.~I~SW~8032~,..,.E.,: AS ' BUILT DRAWING
~0' AI_LEY
/ ,"
. .~ q~Fqd 'r~[K ~ .
C7' I I ~ ,'tu
~ I I i~ou' ~'~ .....
~ =: g2.dO r FINAL GRADE
WFLL ~ I I ......... ~ (M~I) POINI) / = g3,52-1
.... ~ / ~
ORIGINAL GRADk ~ FI ~ / /
/ / N =; f]3.OD.~ ~ Il H / / z--ORIGINAL GP~DE
t J U MAR i:~OAD ~ ~ : ' ~ ~ / / (sou~.'~-:~,~
ST1 56.0 47.0
................. MT2
~S~ WA~R AND WAS~WA~ CONS~TA~S, ~C.
_EOAL DESCRIP)ION:
G.E[NLAND SUBmWS~ON, LOT ~2, BLOCK 5 }": ........... ?-'/Fktf'":i
AS-BUILT OF SEPTIC SYSTEM UP(~BADE
~REPAREB FOR', SHERRY MATTHEWS PHONE NUMBER:
a/o RE~AX ~ROPERT~ES (ATTN: CAROL DOUTHIT) 257-0~fi ~ '.. C.E .".~
'
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box '196650, Anchorage, Al( 995'19-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Aug 28, 1998
Expiration Date: Aug 28, 1999
Permit Number: SW980329
Legal Description: GREENLAND BLK 5 LT t2
Design Engineer: 0041 AK Water & Wastewater Consulta
Owner Name: SHERRY MATTHEWS
Owner Address: 4741 JUMAR ROAD
ANCHORAGE , AK 99516-2246
Parcel ID: 015-171-37
Site Address: 004741 JUMAR AVE
Lot Size: 18000 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [~ SepticTank [] Holding Tank [] Privy
[] Private Well ~ 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 engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Alaska Water & Wastewater Consultants, Inc.
7320 East Chester Heights Circle ~ Anchorage - Alaska 99504
(907) 337-6179 N Fax (907) 338~3246
Consulting Engineers
August 18, 1998
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Kef: Septic Upgrade Design for Lot 12, Block 5, Greenland Subdivision.
To whom it may concern:
The existing 4 bedroom house is served by a private septic system and a private well. The existing
seepage pit is surcharged and must be upgraded prior to the sale of the house. Two test holes
were excavated to the north of the existing septic system. Conunents regarding the proposed
upgrade design are summarized as follows:
1. SOILS: Attached are the logs which shows the soil profile, and the percolation tests results.
Groundwater seeps were encountered in both test holes at a depth of 13 feet. One soil percolation
test was performed in test hole #1 at 6.5 to 7.0 feet which perked out at a rate of 3.6 minute/inch.
One soil percolation test was performed in test hole #2 at 5.0 to 5.5 feet which perked out at a
rate of 12 minute/inch. A confirmation percolation test was performed between TH#1 and TH#2.
The bench was excavated just below the organics m~d a percolation test was performed between
2.0 feet to 2.5 feet which perked out at a rate of 8.3 minute/inch.
2. TRENCH DESIGN:
a. Percolation Rate: 3.6, 12, & 8.3 minutes/inch
b. Allowable Application Rate: 0.8 gallons/day/ft2
c. Number of Bedrooms: 4
d. Design Flow: 600 gallons per day
e. Minimum Absorption Area: 750 ft2
f. Effective Depth: 4 feet
g. Reduction Factor = 0.50
h. Width: 5 feet (minimum)
i. Minimum Length: 75 feet
j. Effective absorption area: 750 ft2
k. Maximum depth = 7 feet (on uphill side of trench)
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed
upgrade.
4. TOPOGRAPHY: As can be seen on the attached topography site plan, the lot runs from
approximately southeast to northwest at a grade of 5-10 percent. In short, there are no slope
concerns.
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you
for your assistance. ,
Sincerely, ~/~
L. 1 1 5th AVENUU /
\
4e.\,
,, LOF 2, OLOCK 4,
FAtUS WE,ql' S/D '.T/
/
LOI' 14, []LOCK 1,
IANJS WE.Si S/D
TALIJS WE,qT
ALASKA WATER AND WAS FEWA~IER I
7~'0 E. CHEm'ER HEIOHm CIRCLE:, ANCltORAOE, AK 9!)§0~
PHONE: (907) 537-617g/FAX: (907) ~I;~B-3246
L SITE PLAN
Ii"RE:~^r~:D FOR: SHERRY MATTHEW m~ONF
o/o REMAX P~OPERTI? (ATTN'- ~*.OU ~OUm~) (~0~)~-0~
L~. [~,~,,~ .~: [~-~: I ~"~: ...........
I
2C AN EA
PROPOSED DF¢,INFIEI.D .... -.._
E:XCAV,~3E ~ FEEl' DEEP(MAXIMUM %~
EJY 5 FEEl' WIDE BY 75 FEET LONG.
~EWEk I)RAINROCk. ~ ~CO
10 BE USED AS A RESERVE SIW ~ M'~~
IF' TOTAE DEPTH IS I ESS THEN % ¢~0~~ ~ ,. ,, TH~I~
7 FEET (FIELD VEIRF~). IF OVER % CO~~
7 FEf~F TOTAL DEFq'H, SYSIEM IS ~
TO BE COMP{ E'FEIY A[~NDONEO.
X% / , F XI.~TIN{-, , /
X'~;. ~ , h: IJ IX tVt i /
~ ~ WELL / ~. '
t
FNO'IE: FHE C?N'fRACTOR,Io RECSPONSIBI.E ~OR HAVING
/TI.IE NORftt, EAST, AND ~ES7 PROP~:R'P( LINE ADJACENI'
TO THE PROPOSED UPGRADE, AND AlSO THE WELL RADIUS
[-I.A(;OKI) []Y A REGISTERED IANt) SURVEYOR PRIOR TO ,JL)MAR ROAD
CONSTRUCYION. A
~AS~ WAT~ A~) WASTEWA~R CONS~T~S, ~C.
7:~20 E. CHOLER HEIO~S CIRC~, ANCHORAGE, ~ fl9504
6BEENLANB SUBDIVISION; LOT 12, BLOCK 5,
DESIGN SEPTIC SYSTEM UPGRADE
mEPARa, .OR: SHERRY MATTHEWSCAROL
PROPEBTIES (ATTN= DOUTHIT) (907)257-0116
]~rE:8/18/98 DRAWN BY:J.L.M. SCAt. E: 1 = 30' PAlm: 2 OF 2
ALASKA WATER ,tlr. WASTEWATER CONSULTANTS~ 1NC.
7320 E. CHESTER HTS. CIRCLE * ANCHORAGE, AK. 99504- ~].~'~..'i,~?' ...... .~'."~.
PHONE; (907) 337-6179 * FAX (907) 338-3246
IsoIc LOG - PERCOLATION TESTI
DATE PERFORMED: 8/7/98
DEPTH
(feet) ;:;]~;:; TEST HOLE #1
~ ~ = GW ....... ORG
J:i~::=~LOAM (SOFT) ~ , --
GC
OL
~ SM OH
7-- j ~] ,; .... DEPTH TO
,~' ,~. DATE
8 I ? ; I ] (' g ?) SEEPS @ 13' 8/7/98 / WELL\ I
~i~,~- ,~ CLOCK NET TIME WATER LEVEL NET DROP
~'~,'~ ~ ~ TIME (MINUTES) READING (INCHES)
, ;t~,-? 8/14/98 - PRESOAK BEGAN AT 9:45 a.m.
13~ 2 2:55 15 2" 4"
' i = 3 2:56
10 4:03 10 3 1/4" 2 3/4"
19~ PERCOLATION ~TE 3.6 (MIN./INCH) PERC. HOLE DIA. 6" (INCHES)
20--~' TEST RUN BETWEEN 6.5 FT. AND 7.0 FT.
COHHENTS:
PERFOMED BY A~SKA WATER & WASTEWATER I, , CERTI~ THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS
DATE. DATE:
DEPTH TO DATE
GROUNDWATER
SEEPS @ 13' 8/7/98
'~1 '5" 8/12/98
11 '8" 8/14/98
ALASKA WATER & WA.;TEWATER CONSULTANTS, INC.
7,320 E, CHES~fER HTS, CIRCLE * ANCHORAGE, AK, 99504 PHONE (907) ,337-6179 * FAX (907) 33D-,3246
[SOIL LOG - PERCOLATION TEST1
LEGAL DESCRIPTION: GREENLAND SUBDIVISION, LOT 12, BLOCK 5
PERFORMED FOR: SHERRY MAI-rHEWS
DATE PERFORMED: 8/7/98
TEST HOLE #2]
ORGANICS
SM & ML
SP
SOIL CLASSIFICATIONS
GW ::::::x:ORG
GP / ML
GM ~ CL
GC OL
SW MH
SM OH
SC
DEPTH TO
GROUNDWATER DATE
SEEPS @ 13' 8/7/95
14' B/12/98
13'10" 8/14/98
DATE
8/14/98
HL
(B.O.H.)
PERC.#~
READING CLOCK NET TIME
TIME (MINUTES)
- PRESO/ BEGAN A7 9:45 e.m.
1 2:42
2 3:i2 30
3 3:14
4 3:44
6 4:14
12 (MIN./INCH)
PERCOLATION RATE
WATER LEVEL NET DROP
READING (INCHES)
6,
3 1/8"
7/8"
i~2"
1/2"
6~
30 3 1/2"
6"
30 3 1/2"
PERC. HOLE DIA. 6" (INCHES)
TEST RUN BETWEEN 5.0 FT. AND 5.5 FT.
COMMENTS:
PERFOMED BY ALASKA WATER & WASTEWATER I, , CERTIFY THAT
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS
DATE. DATE:
ALASKA WATER WASTEWATEB, CONSULTANTS, INC
LEGAL DESCRIPTION: GREEN~ND SUBDIVISION, LOT 12, BLOCK 5
DEPTH --
(~t) PERC. HOLE #5 '~'r~-" ............ '~.o~
Z
o
r I i J!,'i GM CL T~,J
LLI
0 Lin a ~ I \
7-- I-- DEPTH TO b,~ ~ t
<I: GROUNDWATER DATE t: I
10'-- "'"' \, \".,// \~ .-"~'
11-- r~ DATE READING CLOCK NET TIHE WATER LEVEL NET DROP
0 TIHE (HINUTES) READING (INCHES)
12~ LLiI2::: 8/14-/98 - PRESO,~K BEGAN AT 9:4-5 ,a.m.
Q-- 1 2:4-1 6"
0 i
~---- ,3 ,.3:15 6"
<r
19-- i PERCOLATION RATE B.5 (MIN./INCH) PERC. HOLE DIA. 6" .(INCHES)
I
20----~ TEST RUN BETWEEN 2.0 FT. AND 2.5 FT.
COHHENTS:
PERFOMED BY ALASKA WATFR & WASTEWATER I, , CERTIFY THAT'
THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS
DATE. DATE:
DEPTH TO
GROUNDWATER DATE
GR~ ':R ANCHORAGE AREA BOROU"' '
DL,~RTNIENT OF ENVIRONMENTAL QUALI-
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
MAILING
__ADDRESS
PHONE____
LEGAL DESCRIPTION _-/Z~Z~.~/}:: ~'_.~_ -' /= _
DIS1ANCE FROM WELL
~,. .... NUMBER OF
__MATERIAL ~ ~/6U~-,Z- ' ~ IC'<'~/. ~//.L// I ~'(~(.)(~ "
'-~ COMPARTMENTS
LIQUID C A p A CITY ____/, 0 ~)~')
GALLONS.
INSIDE LENGTH.
INSIDE WIDTH
LIQUID
__DEPTH
SEE!PAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS__ /_ ____OUTSIDE DIAMETER OR WIDTH /~)'~', ~._'_j (i
LINING MATERIAl ,~.- (~'1~/',~'~(~ ~'~::~ ~:/,);. i ~(~ ~J /~ x
.... . .'~Z/ ':~, '~. DISTANCE FROM WELL
NEAREST LOT LINE /~] TOTAL EFFECTIVE ABSORPTION AREA (WALL AREAi
LENGTH~/,, ;Z"i'~)Z, DEPTH 6 ! ~ .
BUILDING FOUNDATION-,/~.~J)' ,
SQ. FT.
TILE! DRAIN FIELD:
DISTANCE FROM WELL
NUMBER OF LINES
ABSORPTION AREA
DEPTH: TOP OF TILE TO'FINISH GRADE
FOUNDATIO.~~'' . NEAREST LO[ LINE
DiSTANC~E,..BE~EEN LINES TRENCH WIDTH
-~-"-'- __SQ. FT. LENGTH OF EACH LINE_
DEPTFI OF FILTER MATERIAL BENEATH TILE
TOTAL LENGTH
OF LINES
IN. TOTAL EFFECTIVE
IN. ABOVE TILE
WELL: TYPE t/,)i')Ri bi:2IL[,C~i) , DEPTH 110 '
NEAREST ~ SEPTIC
LOT LINE L~'' SEWER LINE~() . TANK
DISTANCE FROM ~ ~ WATER
, BUILDING FOUNDATION. ~ ~_/ _____SAMPLE_~/t'g'A,~.
/ SEEPAGE . ~ /
~0 , SYSTEM____/(~.~ , CESSPOOL
, NEAREST
OTHER
, SO U RC ES _/-..~i ¢','~-'.
DIAGRAM OF SYSTEM
DISTANCES:
s ,~./4~r ~.4,~.
2226
GREAiER ANCHORAGE AREA BOR~dGH
DEPARTMENT OF ENVIRONMENTAl. QUALITY
3500 TUDOR ROAD POUCH 6-650
ANCHORAGE, ALASKA 99502
TELEPHONE 2']9-8686
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
LEGAL DESCRIPTION
INSTALLATION Of: SEPTIC TANK SEEPAGE PIT
, DRAIN FIELD OTHER
FINANCED THROUGH
TO Be INSTALLED BY
SOIL TEST RESULTS //¢~¢/~-~//~/¢¢~///4~/f~ NOTEt THIS PERMIT lb NOT VALID WITHOUT BOil TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INBPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
DIAGRAM OF SYSTEM
MINIMUM DISTANCES, REQUIREMFNTS
FOUNDATION TO SEPTIC TANK ~--
FOUNDATION TO SEEPAGE Pit ~) / . DRAIN FIELD~/~-~
SEPTIC TANK TO SEEPAGE PIT WALL /~ /
SEPTIC TANK ~-- / , SEEPAGE Pit ~/~ ~ TO NEAREST LOT LINE.
WELL TO SEPTIC TANK ~ SEEPAGE Pit
DRAIN FIELD . /./~"] /
--, ALSO CONSIDER AREA WELLS,
DRAIN FIELD ./ ~ '
SEPTIC TANK, ¢-~'~ SEEPAGE PIT /[~)~'~"2 /. DRAIN FIELD
DRAIN FIELD /~/) "'
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION ~ FEET INTO UNDISTURBED SOIL.
4 iNCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
PITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL IBAC:KFILL
CONFORM TO E3OROUGH REGULATIONS REGARDING INSTALLATION.
H EALT~ A~THOR~T¥
OR
LICENSED GESIGNER
] CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE.
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE, /..~-g: ~'%~.,~-'2 ..~'/..~ ../'~/~¢~2,¢4~e"'-~ ~'/_~,_~././, ..~..~=- ~.~,~._~_
R&M
Civil Engineers
ENGI _ERING & GEOLOGIC, CONSULTANTS
229 EAST 51st. AVE. -- P.O. BOX 6087 - ANCHORAGE, ALASKA 99503
TELEPHONE 907-279-0483 TELEX 090-35419
Geologists Land Surveyors
JAMES W. ROONEY, P. E.
MALCOLM A. MENZIES, P.E., L.S.
JAMES H. WELLMAN, P.E.
July 6, 1972
R & MNo. 25540-4
RALPH R. MIGLIACCIO
Engi~eering Geologist.
R{em Construction
Star Route A, Box 1721-S
Anchorage, Alaska
RE: Test Hole and Soil Log Report J~or Sanitary System
Lot 12, Block S, Greenland S/d
Dear Mr. Riem:
We are submitting herewith the test boring results and our comments regarding
soll conditions encountered a-t the subject site. This invesk{gation was performed
in accordance wikh your request o~ July 5, 1972, and khose procedures outlined in a
letter dated September 13, 1971 by Mr. Roll StricJdand of -khe Greater Anchorage
Area Borough Department of Envirorumenkal Quality.
A single test hole was put down within the Lot 12 area for the purpose of de~ning
general subsurface soil conditions for the proposed sanitary sys-tem. Excavation
was accomplished with a tractor-mounted backhoe and the test hole was extended
~o a total depth o~ 11 feet below ground surface. The ~nal log prepared for the
'test hole has been included in Draw{ng A-01.
Ground water was not encountered in the 8est hole.
We appreciate being given 'hhis oppor-~unSty to be of service to you. Should you
have any ques-tions wi-th regard -to ~he above, please do not hes$~ate to contact
Very truly yours,
I~ & M ENGINEERING & GEOLOGICAL CONSULTANTS
es W. Rooney /
JWR: wb
. ~
E ncl o au r e
cc: Greater Anchorage Area Borough
ANCHORAGE FAIRBANKS JUNEAU
T.H.-I
7-5-72
ORGANICS
ORGANIC SILT W/SOME
GRAVEL
1.51
SILTY SAND W/SOME
GRAVEL (SM)
SAND W/PEBBLES ( SP)
SILTY SAND ( SP -SM)
i_ 4,.5'
5.5'
SAND Medium to Fine Grein (SP) ~.~F/_t~-/~/
SILTY SAND (SP-SM
7.5
8.5'
SAND W/SOME PEBBLES (SP)
No water table
Note: Hole excavated with tractor mounted backhoe.
Engineering ~ Geolog co Consultclnte
PATE 7-6-72 ,.~SCALE I" : 2' JDWN BY GAW
Riem Construction Property
LOG OF TEST BORINGS
Anchorage Al¢sk~
]CHKD "¥ WED JP~oa. NO. 26540-4.~',ve ~,0. A- Oi
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. # 01 5-1 71 -37
1. GENERAL INFORMATION
Complete legal description
Lot 12; Block 5; Greenland Subdivision
Location (site address or directions)
4741Jumar Road
Anchorage, AK
Property owner
Mailing address
Lending agency
Mailing address
Agent Carol
Address
Sherry Matthews
C/O Carol Douthit Remax
Dayph0ne_ 257-0116
Properties 2600 Cordova, Anchorage
Day phone
Douthit/ Remax Properties
Day phone 257-0116
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 4
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.
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.
xxx
72-O25 (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 inspection.
:ne aa~e Qf/t~nis
Alaska Water & Wastewa~gr
Name of Firm C~,~+~ ~ ~// ~
Address 7820 ~~ ~ ~~
, ~chorag~,/~ ~ a b~6
Phone
Date
ALASKA WATER & WASTEWATER CONSULTANTS INC
IS TO BE PAI~2~qg,Tg AT CLOSING FOR
ENGINEERING SERVICES PERFORMED.
6. DHHS SIGNATURE
/ Approved for FO U~ bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The 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) Back MOA#21
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division
ef, i,~ll~QNMl~bl'f^L $i~Rv~ci~$ DLVI8
825 L Street, Room 502 · Anchorage, Alaska 99501 (,~u7) 343-4744
Health Authority Approval Checklist
Legal Description: __~'r !'Z.~, 6L-~, ~, ~--:~I~,qL4aCD ~/J~ Parcel I.D.:
A. WELL DATA
VV~ell type ~0~qf~'r~
Log present (Y~)
Total depth I'l o
Sanitary seal (~N)
Date of test
Static water level
Well production'
If A, B, or C, attach ADEC letter. ADEC water system number
/~ Date completed ~m~- T',~ "7/q 77-
Cased to ~0 ;'f'-- casing height (above ground)
VE$ Wires properiy protbcted (~N)
FROM WELL LOG AT INSPECTION*
g.pJm. 8. q ¢ '
g.p.m.
Nitrate
' //';/,-~'/;?'/~/~ Other bacteria
Collected by: ~I. Af~KA t,~'¢~, ~'
I'Z.~JO Number of Compartments 7- dlean'outs~)
DepressionTjf(]~) /"',.JO High water alarm ~
WATER SAMPLE RESLJLTS:
Coliform ~
Date of ~am'ple: ~/'Z. ', / ~ ~
B, SEPTIC/HOI~DING TANK DATA
Date installed <~/"Z4/q~ Tank size
Foundation cleanout~ "('~ ~'
Date of Pumping 4 ~¢ Pumper
Soil rating ~ oc~¢;~ O,
,~. ~ Gravel thickness below pipe
System type '~=~-~-,~
/,+ I _ Total depth '7 ~-~ I
Monitoring Tube present ~ "]E% Depression over field (~//~1 /~
Results (Pass/Fail) --'- For /"} bedrooms
C. ABSORPTION FIELD DATA
Date installed '~/2.,/fl/'5
Length '-/--'~' Width
Effective absorption area "/..~¢)¢
Date of adequacy test t',~ F,U~
Fluid depth in absorption field before test (in.); ~ Immediately after. ~ gal. water added (in.):
Absorption rate =
If yes, give date
g.p.d.
. Fluid depth ~ . (ins) Minutes later: --
Peroxide treatment (past 12 months) (Y/N)
72-026 (Rev. 3/96)*
D. LIFT STATION
Date installed Size in gallons
Manhol~ "Pump on" level at*. "Pum~gJ~
High water alarr0 ev, e.I at* - ~___~ ~ ..
SEPARATION DISTANCES
SEPARATION DISTANCES FROM.WELL ON LOT: TO:
Septic/holding tank on lot
Absorption field on lot · Jlf~l.--~
Public sewer main
Sewer/septic service line
On adjacent lots
On adjacent lots ]OO 11~
Public sewer manhole/cleanout I~/~
Lift station ~.J/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation ~'Ol ~---. Property line /-"/o ~ Absorption field I
Water main/service line IoI'P Surface water/drainage Jool¢- Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
Date
Surface water
Curtain drain ~O~
ENgINEER's.CERTIFICATION
Engineer,'s Name
Building foundation ../9
Driveway, parking/vehicle storage area
HAA Fee $ N=~/~¢-~
Date of Payment
Receipt Number
Water main/service line JC~ I-t'
loot+
Wells on adjacent lots IOo I.[_
inspections and review of Municipal recor~...,~lq~t ~,,~¢o~..~)4~ ns are
in effect on this date.
Waiver Fee
Date of Payment
, ReceiPt Number
72-026 (Rev. 3/96)*
CT&E Environmental Services/nc,
Laboratory IDivlslon
200 W, Potter Drive
Anchorage, AK 99518
Tel: (907) 582.2343
Fax: (907) $8t-,~301
ChernLab Ref, #:
Client N~rne:
Project Name:
Client Sample ID:
Matrix:
98
Ales;ge Water&Westewater
Greenlan¢ 8/D L12 B5
Greenland $/D L12 B5
Drinking Water
PWSID
Sample Remarks:
Client PO#: n/a
Printed Dale/Time: 9/24/g8 09:00
Collected Dale/Time: 9t21/98
Received Dale/'rime: 9/22/98 12:00
Technicat Director: Slephen Erie
Parameter
I':~,esult$ PQL t,lnits
Total Coliform (MF)
Nitrate
0 col/lDO mi
0,14,5 0,1 m~j/L
Allowable Prep Analysis
M~elhod Limlt~ Date Date Init
SMg222B 9t22198 KAP
EPA 300 10,0 9/22/98 GCP
DE PARI'Mi
8 2 b
Dake
J~_~_e_22, 1977 Wed.
MUNiCIPAI..I'FY OF ANCHORAGF
OF HEALTH AND ENVIRONME~ L. PROTECTION
L Stzeet., Anchorage, A~LasKa 9950]
279-2511, ex'i:, 224 o~ 225
#2:
REQUEST FOR APPROVi'..L_ OF INDIVIDUAL ,%EWER AND WAI''ER .... FAC'[ZiTIES.
]_rL~Lltul:.ion Requesk:
Mai].ing Address:
Phone
Pz-opez ty Owner: Loren E. Graham Phone: 344-3885
,:~ai].ing Address: Star Route A Box 1724A 99507
~. I',cgal Dcscriptioa: Lot 12 Block 5 Greenland Subdivision
R¢ ..... dencc:
o]_n~j].e Family .... i '-, ~ (X)
Multiple Family ResiJcnce: ( )
Number of Bedrooms: Five
Numl;~ez of Bedrooms:
b. Wel] System: Individual Well (X) Commun.Lty/Pub].ic System ( )
Peumi.'t. tl ................ Depth of Well
128' Well LO9 on ~]_e ( )
Ba c tzeria.1. Ana].ysis
Sewage Disposal 'q ,-'-~, ·
,_y.,t .m. O.n-:s ~ ; System (x) Public U~i].it.y ( )
J"Cl.-mJ_k t~ :[nsL:at.Led 9/1972 ln,~ta,..Ler
omb,-~.,; Tank Size -_ /~0 ManuJ:act:urer
Absorp't:Jon zlrea SoLls Rahe Material
t:o N(:aresh Lot Line
Lo AbsorjfLion Ar(?a
Absorpt:i. on Area
,-I_.a.,.I.~a ano E]~v.Lronmental Proi~.ection
Request :fo:c App~ov'al of f.ndividual Sower ay~d Water I~aci].i-Lies
_~ MUNICIPA[_!TY OF ANCHORAGE "',u:.!ic?>!.n
~-Q ~x Department of Health and Environmental Proteotio,~,'?~,m 'nON
~~~q 825 h Street, Anchorage, Alaska 99501
~ 279-2511, ext 224, 225
uest for Approval of Individual Sewer and Wa'her
Property Owner: .... ~,~ Cm/Z~__~L~/~
Mailing Address: . ,~i~'~// ~/i).~.__/22.~ --z~,,~./~,, Phone:
Name of Buyer:
Mailing Address:
Phone:
Lending Institution:
Mailing Address:
Phone:
4. Realtor/Agent: __/?__j~!z~ ~,~ z ~ ~ ~_L"_'~
Mailing Address:
Phone:
Legal Description:
Street Location:
Single Family Residence: (~)-- Number of Bedrooms:
Multiple Family Residence: ( ) Number of Bedrooms:
Water Supply: *Individual Well (~/ Public/Conm~unity System
If Individual Well, well depth
If Community System, name of system
( )
Sewage Disposal System: On-site System (zd/ Public System ( )
If On-site System, date of installation:
*NOTE: A well log is required on ALL wells drilled si~]ce 6/75.
3/77
GREATER ANCHORAGE AREA gOROIJGH
Department of Environmental Quality
3500 Todor Road, Anchorage, Alaska 99507 279-8686
Date Received
Time of Inspection
Date of Insovction
REQUEST FOR. ,APPROVAI'~ OF
INDIVIDUAL SEWER & WATEr,, FACILITIES
Address= Phone
5. Type of Fa cili%y to be I~spected:._._~.~.~¢~¢=¢~~
Number of' Bedrooms:
Well Data:
^.
ova
Sewage Disposal ~. '
C. Septic Tank: 1.
D. Seepage Pit: lo Size 2.
Disposal Field: Total Length of Lines
Distances:
A. Well To:
Sept:lc Tank
, Nearest Lot l,~ne__~'~ , Other Contamination
Foundatio~ to Septic, Tank_. ::~__~; Absorption. Area ~/'P~
Absorption Area to Nearest Lot Line ..... ~.~ /
¢~/ Absorption Area /~
/
, Sewer Lines
Requect fo: A~c~,roval
Pa~e Two
9, Comments:
o~ .Lndividuol Sewer & Water Facflit~;
Approval Valld for One Year F'com Date Siqned
Greater Anchorage Area Borough, Department of Enviro{~a~enta] Quality
DIAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a true
and accurate representation of the subject sewer and water facilities located at:
Signed Date
July 5~ 1977
R&M No. 751517
Loren Graham
SRA Box 1724-A
Anchorage, Alaska 99507
Re: Sanitary Sewer System Flow Test Lot 12, Blk 5, Greenland Subdivision
Dear Mr. Graham:
On June 29, 1977, at your request, our office conducted a percolation
test of the septic system on the above described lot.
The following table represents the level of the liquid in the seepage
pit. All measurements were taken from the top of the standpipe.
SUMMARY OF MEASUREMENTS
Level of Liquid
Meter Reading
Time in Seepage Pit in Gallons
Test #1
3:42 7.1' 5408.3 (initial)
3:50 6.9' 5433.3
4:00 7.O' 5433.3
4:10 7.1' 5433.3
Test #2
4:13 6.85' 5459.0
4:19 6.65' 5483.3
4:45 6.85I 5483.3
Test ,f3
4:55 6.2' 5558.8
5:00 6.1' 5583.5
5:15 6.25' 5583.5
5:25 6.35' 5583.5
The meter used during the test was a Rockwell 5/8:' Standard Water Meter,
which had previously been calibrated by R & M Consultants, Inc.
It is our understanding that the septic system on the lot consists of a
tank and seepage pit, with an overflow pipe leading out of the pit into
July 5, 1977
Loren Graham
Page -2-
a leach field. Since the house on the lot was occupied at the time of
the test, it can be assumed that the seepage pit and leach field were at
their normal level and degree of saturation.
It is assumed that the existing five bedroom residence will house ten
people, the average load on the disposal system can be expected to be
750 gallons per day or 0.52 gallons per minute. Since the outlet level
of the seepage pit was not known, tests were run at three varying depths
in the pit. In Test #1, the system accepted 25 gallons in 28 minutes,
or 0.89 gallons per minute. Test #2 shows an acceptance of 25 gallons
in 32 minutes or 0.78 gallons per minute. Tkes~__e_measurements i~_Lgate
tile seepage pit is accepting more than the
In Test #3, conclusive measurements were not obtained, but percolation
rates were significantly higher than in the previous two tests. It
appears that this test was done at a level at or above the outlet pipe,
and that the combined exfiltration rate for the seepage pit and leach
field is approximately 1,5 gallons per minute.
(.~e conclude that the septic system is performing in an acceptable mai~ner .~.
o~.~i, ve2bedro, om residence.
If you should have any questions concerning this test or this letter,
please do not hesitate to contact us.
Very truly yours,
R & M/. COI~SULTANTS, INC.
Staff Geologist
SH/JMB/gld
Jim McCaslin Brown, Ph.D.
Head, Earth Sciences Dept.
