HomeMy WebLinkAboutTRAILS END BLK 1 LT 7Treils End
Block
Lot 7
#015-191-08
S107242"0742
parcel Ideutific a do�, i IN ua'ti-r 5 - ./q t - OF
P.
Attention: TlSc P-c-ide C ii ,7:tslalllation log to i'i, DSD xi,Wn 0xvs rjfp-Liir,.p ii -,Hlxion.
beveFoptnent 55,ervices Department
auilding 50fe-ry Divfsion
L
On -Site Water Wastewater Program
470C Ehore R�ad
R0, Box 196650
Maw Seg;ch
lknchovaae, A,,, 99507
Mayor
(?Wj 34,9-7904
Pump Installation Log
�Ykl Drilling Nrind Number-
SW Date of SS E:
parcel Ideutific a do�, i IN ua'ti-r 5 - ./q t - OF
P.
Attention: TlSc P-c-ide C ii ,7:tslalllation log to i'i, DSD xi,Wn 0xvs rjfp-Liir,.p ii -,Hlxion.
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program, 4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99507 Page of
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: 0sP101048 PID Number: 015-191-08
Name:
Philip and Pamela Okeson Wastewater System: [] New [] Upgrade
Address:
8361 Longhorn Street Anchorage, AK 99516 ABSORPTION FIELD
Phone: Number of Bedrooms:
344-9094 3 [] Deep Trench [] Shallow Trench [] Bed [] Mound [] Other:
Soil Rating: Total Depth from odginal grade:
LEGAL DESCRIPTION GPD,F~ Ft.
Block: Lot: Subdivision: Depth to pipe bottom from odginal grade: Gravel depth beneath pipe:
1 7, Trails End
Ft. Ft.
Township: Range: Section: Fill added above odginal grade: Gravel Length:
Ft. Ft.
Well: [] New [] Upgrade Gravelwidth: Ft. Numberofli .... [ Distance between lines:Ft.
Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material:
Existing Ft. Ft. Ft2
Ddlle~: Date Drilled: Static Water Level: Installer: Date Installed:
Ft. BT" Construction 10/2~/2,30~' "'7 /7 t/~ O
Yield:GPM Pump Set at: Ft. Casing Height Above Ground: Ft. TANK
SEPARATION DISTANCES [] Septic [] Holding [] S.T.E.P. [] Other:
· T~ To Septic Absorption Lift Holding ~ublic/Pdvate Manufacturer: Capacity:
.rom~
Tank Field Station Tank Sewer Line Anchorage Tank 1,000 Gal.
Matedak Number of Compartments:
we, >100' > 100' N/A N/A >25' Steel Two (2)
Surface WaterLot Line >100'>5, >100'>10' N/AN/A N/AN/A ~ Size; Gal.Manufacturer:LIFT STATION
"Pump on" level at: "Pump oH level at: in. High water alarm at:
Foundation >5' > 10' N/A N/A in. in.
Pump Make & Model Electrical Inspections performed by:
Curtain Drain None Noted
Remarks:
Existing Septic Tank Abandoned in Accordance with BENCH MARK
Location and Deschption:
Municipal Code. Patio Slab. Center of Patio Doprs. North End of House.
Assumed Elevation:
Existing Absorption Pit Remains in Service. 100.0 Ft.
Inspections performed by: A. Harala Dates: 1st 7/8/2008
2nd 7/8/2008
Development Services Department Approval
Conditional Approval Date: ~. ~,~,~~
Reviewed and approved by: //']~?/...///~. Date: ¢--2 3"11
90.00 90.00
Page 2 of 3
Permit No.: 0SP101048
PID No. 015-191-08
S2 63,8 85.6'
1 O' Utility
/
/
/
/
./
Easement
Existing Tenk
Pumped, Crushed I
end Abendoned in
Accordance with
Municipel Code.
Three Bedroom
Home
Existing
Well
NOTE;
Septic Tank Only
Replaced Under
This Permit.
90.00
N89°59'30"W
90.00
LONGHORN STREET
TRAILS END
LOTS 6 &:
PLAN AS
SUBDIVISION
7, BLOCK 1
BUILT
SCALE 1" = 4-0'
Ld
o
o
z
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904
On-Site Wastewater Disposal System or Well Inspection Report
Permit Number: OSP101048
Page 3 of 3
PID No. 015-191-08
Existing &
--Finished Grade
Tank & 2 Post Tank Cleanouts Placed Under This Permit.
Existing Tank Pumped, Crushed and Decommissioned
In Accordance with Municipal Code.
PROFILE AS-BUILT
No Sc<~le
On-Site Wastewater Disposal System Permit
Permit Number: OSP101048
Tax Code Number: 01519108000
Work Type: Septic
Permit Effective Dates: June 08, 2010
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Upgrade
to June 08, 2011
Design Engineer: ANDERSON ENGINEERING
Subdivislon: TRAILS END
Site LegalAddress: TRAILS END BLK 1 LT 7 G:2641
Owner/Address: OKESON PHILIP A & PAMELA E
8361 LONGHORN STREET ANCHORAGE AK 995076349
Site Mailing Address: 8361 LONGHORN ST, Anchorage Lot Size In Sq Ft:
Total Bedrooms:
I l)epartment
26997
3
This permit Is for the construction of:
N Disposal Field Y Septic Tank N Holding Tank N Pdvy N Private Well N Water Storage
All construction must be in accordance with: 1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections dudng the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:.
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Issued By:
Date:
Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
www.muni.orglonsite
(907) 343-7904
ON-SITE SEWEPJVVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
O~P/O/O~
Parcel I,D. 01~'~J'"(~and 015-191-08
Property owner(s) Philip and Pamela Okeson
Mailing address 8361 Longhorn Street Anchorage. AK
Site address 8361 Longhorn Street Anchorage, AK
Day phone 344-9094
.Zip Code 99516
Zip Code 99516
Legal description (Sub'd., Block & Lot) Lots 6 and 7, Block 1, Trails End Subdivision
Legal description (Township, Range & Section)
Lot Size ~ and 26,997 .Sq. Ft. Number of Bedrooms Three (3)
THIS APPLICATION IS FOR ([~ all that apply): THIS APPLICATION IS AN:
Absorption Field [] Initial
Septic Tank [] Upgrade
Holding Tank [] Renewal
P~w []
Pdvate Well []
Water Storage []
[]
[]
[]
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit~Rush Fees:
Date of Payment:
Receipt Number.
(Rev. 11/05)
. ..~..~ 1.~ Waiver Fees:
~ - / - ,/C) Date of Payment:
~) ~ 3 ~ ~:~ ~ Receipt Number:.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 (FAX)
May29,2010
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject:
Lots 6 and 7, Trails End Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The septic tank on Lots 6 and 7, Trails End Subdivision has failed and must be
replaced. We are proposing to replace the tank with a new 1,250-gallon steel septic
tank to serve the three-bedroom home on the lot. We are therefore requesting a
permit be issued for the construction of a new septic tank to serve the home. The
attached Site Plan and backup documentation identify the location and configuration of
the existing septic system and the location of the new tank. Also identified on the plans
is the existing well on the lot. The new tank will be placed more than 100' from the well
on this lot and those in the area. The existing tank on the lot will be properly disposed
on the property and backfilled, it is currently located beneath a concrete slab. The
drainage patterns on the property will be maintained after construction.
The ground surface on the lot stopes to the northwest at a 10% grade in the area of the
new tank and in all other areas. The new septic tank will be constructed near the
location of the existing absorption pit and tied in to the existing service line. The tank
will be constructed parallel with the contours of the land as much as possible in
conformance with Municipal requirements.
If the tank is constructed in accordance with our design the following statements apply:
The tank, if constructed as designed, will have no adverse impact on the wells in
the area or those to be constructed in the future.
The tank, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
Lots 6 and 7, Block 1, Trails End
May 28, 2010
Page 2 of 2
The tank, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
The tank, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
Michael E. Anderson, P.E.
Attachments
LOT 15
/ TRACT A
/VD~
, .... ¥ ', / ',
/
,,
T~ ,,,,'" 2
~:~ AREA MAP
~,:~...~ _~_, ~ .......~4 sc,~ ~' = ~oo'
9CIO0
10' Utility
go.o0
Easement
I
I
I
I
NOTE~:
Existing Septic Tank Located
Under Concrete Slob. Slab
Removal Will be Required to
Access Tank. Sewer Uno and
Foundation Cleanout. Tank is
Approximately ~2' Below Cround.
Ex;sting Absorption Crlb
To Remain in Sew;ce.
Place Ne* 1,250
Gallon Septic Tank,
and 2 Post Tank
CIeanouts.
/
/
/
/
\
\
\
\
\
90.00
N89'59'30"W
Tennis Court
Pump, Crush and
Abandon Existing Tank
in Place. Backfill to
95~ of Idox. Dens~ty.
ce Cleanout
Existing --
Well
Bedroom
Home
90.00
LONGHORN STREET
TRAILS END SUBDIVISION
LOTS 6 &: 7, BLOCK 1
SITE PLAN
SCALE 1' = 40'
L~J
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOTS 6 AND 7, BLOCK 1, TRAILS END SUBDIVISION
GENERAL:
The scope of this project includes the pumping, crushing and backfilling of
the existing septic tank on the property. The tank is located beneath a 6"
thick concrete slab which will require partial removal prior to demolition of the
tank. The tank is buried approximately 10' below ground. Backfill must be
compacted to 95% of maximum theoretical density after the tank is crushed.
Work also includes the procurement and placement of a new 1,250-cjallon
septic tank at the location shown on the Site Plan. Work also includes the
placement of a foundation cleanout and placement of two new post tank
cleanouts. The new delivery line must then be tied into the existing outfall
line to the absorption pit. The new septic tank must be placed 100' from all
private wells including the well on this property and any surface water in the
area. A minimum of 4' of cover is required over the septic tank.
Construction shall be in accordance with the approved site plan, design
drawings, Municipal Permit with any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal Regulations.
The Contractor shall be responsible for obtaining all underground utility
locates and for the layout of the septic system and verification of the location
of all lot lines. The Contractor must also verify the location of wells in the
area and assure that the separation distances are met.
Unless specifically agreed otherwise, the contractor shall be responsible for
final grading areas subsequently depressed from soil settling. Property
owner shall be responsible for revegetation of affected areas unless
specifically agreed otherwise.
Contractors installing wastewater disposal systems must be certified by the
Municipal Development Services Department Building Safety Division On-Site
Water and Wastewater Program for system installations. Owners installing
their own systems must receive prior approval from the On-Site Water and
Wastewater Program before beginning system installation.
SEPTIC TANK INSTALLATION
1. A new 1,000-cjallon septic tank must be procured from an approved source
and installed at the location shown.
Lots 6 & 7, B;ock 1, Trails End
May 28, 2010
Page 2 of 3
2. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
3. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
4. All standpipes on the septic tank shall extend a minimum of 12 inches above
final grade.
5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial
insulation.
6. A foundation cleanout shall be installed one to four feet from the building
foundation. Two cleanouts are required between the tank and the drainfield.
7. Final grading over the tank shall be such that a positive slope exists away
from the septic tank,
DRAINFIELD CONSTRUCTION: - EXISTING ABSORPTION PIT TO REMAIN IN
SERVICE
1. The drainfield shall be constructed to the dimensions shown on the design.
The bottom of the trench shall be within 2" of level.
Distribution piping must be placed level with perforations down atop a level
bed of drainfield rock. Rock should then be placed over the pipe to provide a
minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the drainfield rock
and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations shown on
the design. The portion below ground must be perforated,
Contractor shall verify the septic tank and drainfield are a minimum 100' away
from any private water wells in the area, 150' from a Class "C" Well or 200'
from any community well.
Direct bury insulation must be placed over the distribution system if less than
3' of backfill depth is available. Finish grade over the trench must be
mounded to prevent settlement or depressions.
7, Grade area surrounding the absorption trench to drain away,
Lots 6 & 7, Block t, Trails End
May 28, 2010
Page 3 of 3
8. A minimum 2' of accepting soil is required below the drainfield rock for a 5'
wide trench. All pockets of unacceptable materials must be removed and
replaced.
MATERIAL SPECIFICATIONS:
1. Septic tanks must be constructed by a municipally approved septic tank
manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and
solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662
or A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow
Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Fernco, or equal).
5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed
between the final drain rock layer and the native soil layer.
6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the
#200 sieve.
INSPECTIONS:
Municipal Ordinance requires a minimum of two inspections. These inspections
must be conducted under the supervision of a professional engineer registered
in the State of Alaska. The first inspection must be conducted after the
excavation of trenches, beds or pits and before the installation of any gravel. A
septic tank may be set in place, but may not be backfilled.
The second inspection must be conducted after the placement of the geotextile
fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No
backfill should be in place at the time of inspection.
Contractor or owner shall provide a copy of all field survey layout and
construction notes for use in preparing the certified as-built of the completed
system.
Parcel I.D. #
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
GENERAL INFORMATION
Corn plete legal description
Location (site address or directions)
Property owner
Mailing address
Day phone
Lending agency
Mailin. g address
Agent. -~'O P--~o ~ ~_.
Address
Day phone
~-. A,'-~ ~E-~;LA~.Day phone
Unless otherwise requested, HAA will be held
NUMBER OF BEDROOMS: ~ r
'YPE OF WATER SUPPLY:
Individual well
Community well
Public water
=
NOTE:
ing to the legality and status Of system
TYPE OF WAsTEWATER DISPOSAL:
Individual on-site .. .
Holding tank
If community well system, provide written confirmation from State ADEC attest-
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-~25(Rev. 1J91) 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 flies 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 --~o ~,~.¢,~ ¢ r~_[~ Phone ¢%-)q- 7~1 IA
Address , ~0~ ~ I~ /a 7_.o'~
Engineeds signature T~ ~~.,.~
Date
DHHS SIGNATURE'
~ Approved for -/-/-//~'-,~' bedroo~ns.
Disapproved.
__ Conditional approval for
bedrooms, With the following stipulations:
Note: The well for this property meets existing State and Municipal Codes,
There are nitrates present. It is su~e~ted that periodic test~n_~ he
pe. rformed to insure the wells continued suitability. Current nitrate
concentration ~s 5.0! mg/!. EPA ~,o-.-4 .... co~c~rat!e~ is !0_0 mg/!.
More information on nitrates i's available from the On-site Services Program,
Additional Comments
By:
The Municipality of Anchorage Department of'Heaith and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional enginee[ 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.
RECEIVED
Municipality of Anchorage- 8EP 2 1
DEPARTMENT OF HEALTH & HUMAN SERVICESMuN~c~P^ur~ oF ^NCM
Environmental Services Division ENVIRONMENT^LSERVICr;~[~J~'~I~
825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744
Legal Description:
A. WELL DATA
Well type
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Health Authority Approval Checklist
P~ ~/--I, -TPJ~I~<- ~-m~ Parcel I.D.:
IfA, B, or C, attach ADEC letter. ADEC water system number
Date completed
Cased to ~/'Z) +
Casing height (above ground)
Wires properly Protected (Y/N)
Date of test
Static water level
Well production
FROM WELL LOG AT INSPECTION
g.p.m. ~.5
g.p.m.
WATER SAMPLE RESULTS:
Coliform (~
Date of. sample: q/~ ~ ~C/
Nitrate
~. ~ ~ ~ ~//.~ Other bacteria
Collected by: ~ ~.
B. SEPTIC/HOLDING TANK DATA
Date installed. '~ ~ '7 J Tank size
Foundation cleanout (Y/N) ~
Date of Pumping O c~J~- ) E~,~
C. ABSORPTION FIELD DATA
~.o-r_.,"C~ Number of Compartments J Cleanouts (Y/N) y
Depression (Y/N) t,q High water alarm (Y/N) ~"1
Pumper 'J ,~ ~-~- c~-5
Soil rating (g.p.d./fF orfF/bdrm) ~.~
[,)~ ~ Gravel thickness below pipe
Date installed I ~ 7~
Length D,4 J~,v~ Width
Effective absorption area ~)t~ ~,~ ~,x~ Monitoring Tube present (Y~)_~ Depression over field (Y/N) __
Date of adequacy test I/~/7/~ Results (Pass/Fail) For ..'~
Fluid depth in absorption field before test (in.); ~ ~ Immediately after ~ ~gal. water added (in.):
Fluid depth I ~ (ins) Minutes later: '~ ~4v-.5 Absorption rate = '~ ~ ~ ~ g.p.d.
Peroxide treatment (past 12 months) (y/N) b,I o If yes, give date
System type ~, ~'-~
Total depth
bedrooms
72-026 (Rev. 3/96)*
D. LIFT STATION
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Cycles tested
SEPARATION DISTANCES
~Size in gallons
at*
"Pump off" level at*
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
On adjacent lots
Absorption field on lot '~ I ~
Public sewer main t',,4/,,.~
Sewer/septic service line ~ ~2..~
On adjacent lots
Public sewer manhole/cleanout ~/,'/,'~
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK oN LOTTO:
Foundation --~ Property line '7 I r~ Absorption field
Water main/service line '7 ,~, ~
Surface water/drainage
Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
Surface water
Curtain drain
Building foundation ~'o ~ Water main/service line
Driveway, parking/vehicle storage area
Wells on adjacent lots
~o 'b
F. ENGINEER'S CERTIFICATION
~ certify that ~ have determined thru fie~d inspecti~ns and review ~f Municipa~ rec~.ds that the:~b~V~'sy~ms are
in conformance with MOA HAA guidelines in effect on this date. , ? '. i oi.. .. ;: .' ~ : '.' .,/~
Signature ~'
Engineer's Name
Date ~ ~ , ,~ c,, ..... .,.~,,. ,.,
HAA Fee $ ;~ ('~} ~ /J-?~
Dete of Payment :~ ~' ~//":/
Waiver Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
Parcel I.D. #
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
HAA #
GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailin. g address
Day phone
Day phone
Agent
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
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.
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. 1191) Front MOA #21
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, t verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or was!ewa, ter 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
suppry and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
~1~°~-~',,L°'-''~¢-~ '~-~' Phone ~q_~c~ [L~
Name of Firm
Address ~..o'~ ~ l ~ L~ ¢¢ ¢,o'%
EngineeFs signature ~ ~-I~ Date_ ~1 t,-1/~ P~
/
D~H7 SIGNATURE
Disapproved.
bedrooms.
Conditional approval for
bedrooms, with the following stipulations:
Additional Comments
By: '*'-'
,- Date
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health AtJthority
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.
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division
825 L Street, Room 502- Anchorage, Alaska 99501 · ,(90~4~,~~
Health Authority Approval Checklist r~~~w~
Legal Description:
A, WELL DATA
Well type
If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N) J"-[ Date completed
Total depth. [~ ~,~Jr~.~,~ Cased to
Sanitary seal (Y/N) '""""~,-~¢-~',--'~' ~ -
FROM WELL LOG
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform
Date of sample: ti [ ~1[q¢*
g.p.m.
Casing height (above ground)
Wires properly protected ~/N)
AT INSPECTION
Nitrate ~,~ ~ ~'~/L.
Other bacteria
Collected by: - \ '~ ~.
B. SEPTIC/HOLDING TANK DATA
Date installed 1 ~'7 ! Tank size
Foundation cleanout (Y/N) ~!~
[ ~ Number of Compartments __ Cleanouts (Y/N) ~/
Depression (Y/N) ~ High water alarm (Y/N) ~( ~
Date of Pumping O~' bq~ Pumper
C. ABSORPTION FIELD DATA
Date installed l q ~"
Length ~)~[wt~,.,~ Width ~ Gravel thickness below pipe
Effective absorption area D~ Monitoring Tube present (y/N) "//
Date of adequacy test I I / I~/l ~ Results (Pass/Fail) '~
Soil rating (g.p.d./ft~ or ff~/bdrm) {~ ~-~,- System type ~--~ Total depth
Fluid depth in absorption field before test (in.); /~
Fluid depth /& (ins) Minutes later: 35 ~.~
Peroxide treatment (past 12 months) (Y/N) /~
· Depression over field (Y/N) ~
For ~ .bedrooms
Immediately afterg-~ gal. water added (in.): ,~ ~/"
Absorption rate = ~ ~/,~C, q.p.d.
If yes, give date
72-026 (Rev. 3/96)*
D. LIFT STATION ~'"'l/I /
Dateinst~lied ': '"
Manhole/Access (Y/N)
High water alarm level at*
Cycles tested
E. sEPARATION DISTANCES
Size in gallons
"Pump on" level at*
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot _
Public sewer main iN/A
Sewer/septic service line I'"'/'/",,~.
*Datum
"Pump off" level at* __
On adjacent lots '7 Icao
On adjacent lots ~, I ~
Public sewer manhole/cleanout
Lift station t'"./,~
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation .-~ Property line ~ t ~ Absorption field
Water main/service line ~.~ Sudace water/drainage ~'J,
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line ~ / O Building foundation ~.:.~,~
Surface water h.\ l 0
Curtain drain t",//o
Wells on adjacent lots
Water main/service line
Driveway, parking/vehicle storage area )
Wells on adjacent tots '> ~o-0
ENGINEER'S CERTIFICATION
I certi that ~ have determined thru f~e~d ~nspecti~ns and re~iew ~f Municipa~ rec~rd~.~``the~ab~ve~/ste~ are
fY ....
in confo~ance w~th' MOA H~ gu/defines ~n effect on this date.
Engineer's Name t~u~ ~po~ ~,~
Date ~%~ J ~ ~ ~ ~ ~
HAA Fee $ L~ ~ ~-
Date of Payment
Receipt Number
72'026 (Rev. 3/96)*
Waiver Fee $
Date of Payment.
Receipt Number
T.SPURKLAND P.E.
203 W. 15th. AVE. SUITE 203
ANCHORAGE, ALASKA 99501
(907) 279-3916
Fax (907)-276-6013
Municipality of Anchorage
Department of Health and Social Services
825 L Street
Anchorage, Alaska 99501
Subject: HAA Lot 7 Block 1 Trails End
October 26, 1998
Gentlemen;
Per your request I witnessed the installation of a groundwater monitor pipe on this property on
December 15, 1998. Discovery Drilling installed a 2-inch observation pipe to a total depth of 16
feet. The observed material consisted mainly of gravel. No water was observed during installation
and the monitor was dry on December 23, 1998.
A survey As Built done in 1993 is enclosed. I have shown the location of the well and the septic
tank.
Yours
LOT 15
N 89°59'40'' E
LOT 6
90' S 89'¢9'40" W 90'
10' UTILIT'r' EASEM~,~T
I I ......
LOT 7
LOT 16
TRACT A
LOT 6
24,2'
LOT 8
L
W
~)
6'4
Z
,o
POLE
N 89 ,39'30" E 90'
LTREET
Dec-28-9@ 08:17A Anchorage RQfu~e
907 273 2797
A N CI-i 0 I{A (~: IC
Fax Cover Sheet
I-H-IONIE:
FAX'
FROM: t9o ~g Daniels
RE: - ~
CC:
PI'lONE:
FAX:
(90l) 2/3-278)0 (9(Jf) 2,10-27'18
(907) 2~3-.2~97
Message:
J)
~ /4o ~-~
~" "I,~EPARTME~,OF HEALTH AND ENVIRONMENi~I PROTECTION
' 825 L Street, Anchorage~ A!~ska 9950]_
I 279-2511, ext~ 224 or 225
Date Received: August 10, 1977
D}lte' ~, ~onday
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FA~].I.,~TIEo
Lending Ihstitution Request:
Mailing Address:
Pro~f~y..~wner:
Mailing Address:
Legal
Phone:
Mary /Lnn Holstien ~ Phone: 376-5863
% Patsy Timperly, United Realty 276-5353/~77^5-~D~
Description: Lot 7 and~I~ails End Subdivision
Single Family Residence: (x) Number 'of Bedrooms: _T_hree .~
Multiple Family Residence: ( ) Number of Bedrooms:
5~
Well System:
Permit #
Construc~ion~
Individual Well (x) Con~aunity/Public System ( )
Depth of Well ~- Well Log on File
Bacterial Analysis
( )
'7.
Sewage Disposal. System: On-site System (x) Public Utility ( )
Permit ~ Installed Installer .
Septic Tank Size ~ ~ Manufacturer
Absorption:Are Soils Rate M~ter~a.
Distances: Well to Sepnic Tank
Absorption Area
to Sewer Line
Nearest Let line
Absorption Area
to Nea-rest Lot Line
~MUNICIPALITY OF ANCHORAGE~' ~\' ~5~'~.~
Department of Health and Environmental Protection'
825 L Street', Anchorage, Alaska 99501
279-2511, ext. 224, 225
uest for Approval of Individual Sewer ahd Water Facilities
Mai~ng Address: ~_L~/~ ~_=-- Phone:
Name Of Buyer:
Mailing Address:
Phone:
Lending Institution:
Mailing Address: Phone:
Rea ltor/Agent: ~~_~~
Maili~ Addr~ss'~~~ ~2-~-~-~-~.-v~--- Ph°ne:~"~--~ ~--~
Street Location: ~_~ ~
/
Single Family Residence: (~ Number of Bedrooms: ~
Multiple Family Residence: ( ) Number 6f Bedrooms:
Water Supply: *IRdividual Well (~
If Individual Well, well depth
If Community System, name of system
Public,Community System (
Sewage Disposal System: On-site System (~ Public System
If On-site System, date of installation:
*NOTE: A well log is required on ALL wells drilled since 6/75.
3/77
Department of Health and Environmental Protec'tlon. .
r{eqdl~t: f~r Approval of Individual Sewer and Water Faci].ltles
}e$orl~t~on: Lot 7 and 8 Trails End SubdivIsion
)roved
( ) Letter Attached:
( )
Date:
Hovember 12, 1974
MrS. Mary^. HOlstein
Box 54
Wesllla, Alaska
99687
SUBJECT: Overflo~)ng sewage at Lot 7, 6lock 1, Tratls End Subdivision
flHfl Longhorn Drive = Case ~1637
Dear Hrs. Holstein:
£nclosed, please find a duplicate cop¥oFour letter regarding the subject
property that was dated October 15, 1974-and returned to us unclaimed.
you have any questions, please feel free to contact me at 274-4561,
extension 155.
Sincerely,
Charles F. Sellers,
Environmental Control Offtcer ]!
CFS/ko
Certified No. 740404
$~NOER: Be suve fo fallow Instructions on other s~de
PLEASE FURNISH SE?VICE(S) INDICATED BY ~HECKED BLOCK(S)~
~-~ ~.h~owto. ~.ho~,.date and address ~ Deliver ONLY
REC~T
e numbered article described belew.
CERTIFFEO NO.
DATE DELIVERED
~ERY lextra fee reauire~ ............................
PS For~
Art, 1~7! 3800 NO INSURANCE COVERAGE PROVIDED-- (See other side)
NOT FOR INTERNATIONAL MAIL
October 15, 1974
SUBJECT:' Overflying se~age at Lot 7, Block 1, ?ratls End Subdtvtson
~HH Longho~ Drive - Case ~1637
Dear ~s'. Uolstetn:
~nother complaint has been ~cetvad by thts Oepart~ent regarding overflowing
sewage at the'subject property. ~e would like to bring the following items
to your attention:
a) The system on ~e subject property ~as observ&d overflowing
on ~y 7, 1974 and agat~ on October 14, 1974.
b)
The life expectancy for se~er sysbems tn ~chorsgets 7 to
g years. The subject se~er system ~as constructed In
August, 19~5.
c) Public sewe~ wtll not be available in the near future.
Due to the reoccurring p~lem of OVerflYing se~age and considering ~e
above mentioned items, it is recommended that · new absorption system be in-
stalled,
Any further occureaces of overflowing sewage wtll result in legal action
against both the propert~v caner and the tenant.
The potential health hezar~-~(r~.overflewlng sewage must have your taF~diate
a~tentton. -.
If I can be of any further assistance to you, please feel free to contact me
at 274-4561, extension 155.
Sincerely,
C. R. Sellers, ~
EnvtronmentaT Contrul Officer II ~- '~
CFS/ko
cc: ~lvln Kivtaho [tenant)
Certified Ho. 740388