HomeMy WebLinkAboutRABBIT CREEK VIEW & HEIGHTS BLK 10H LT 30ARabbit Creek
View Heights
Block I OH
Lot 30A
#020-581-54
April 14, 2025
PO BOX 240773
ANCHORAGE, AFC 49524
522-7773
677-7766 (FAX)
FORGECIVIL.COM
MOA Development Services, On -Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Rabbit Creek V&H B10H L30A -17041 Jacqueline Cir
Septic system size reclassification
Dear On -Site Services Engineer:
The septic system design documents for this lot specify a 3 -bedroom septic system. The system
was designed as an AWWTS with an Advantex tank, AX20 pod, and 75SF of absorption field
required. However, 100 SF of absorption field was installed, which is large enough for 4 bedrooms,
and the Advantex tank was also 1500 -gallon capacity.
As this is documented in the record drawings for the system, it could have been designated as
having capacity for 4 bedrooms after installation. We are requesting that it be recognized as a 4 -
bedroom septic system at this time.
In addition, during our recent COSA testing we injected more than 600 gallons of water into the
system, which was absorbed immediately. We also request that the COSA be amended to show a
approval for 4 bedrooms.
Sincerely,
Benjamin Schiller, PE
5Y +CW) 0YY(
w/� s
Municipality of Anchorage
Department of Health and Human Services
Building Safety Division
Orl Water and Wastewater Program, 4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 oflPr67—
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SWSW030216 PID Number: 020-113-55
Name: tan
Wastewater System: ❑ New ® Upgrade
Andreae:
ABSORPTION FIELD
Phone:1;1 Number of Bedrooms:
❑ Deep Trench E3Shallow Trench ® Bed ❑ Mound 13 Other:
Soil Re ing:
Total Depth from original grade:
LEGAL DESCRIPTION
Block: Lot Subdivision:
1111) 30 Rabbet Creek Heights
Depth to pipe bottom from original grade.
4.5 Ft.
Gravel depth beneath pipe:
Ft
Township: Range: Section:
Fill added above original grade:
Gravel Length:
Well: ❑New ❑Upgrade
Gravel width:
Number of lines:
Distanoabetween lines:
Classification (Private, A, B, C):
Total Depth:
Casedto:
Total absorption area:
Pipe Materiel:
Exist'p '
100 Ft'
F810/3034 PVC
Driller.
Data Drilled:
Static Water Level:
Installer:
Date Installed:
Ft.
+ Home Svc
71712003
Yield:
Pump Set al: Casing Height Above Ground:
TANK
GPM
Ft. Ft.
SEPARATION DISTANCES
❑ Septic ❑ Holding ® S.T.E.P. ❑ Other:
To
Septic
Absorption
Lift
Holding
ublic/Private
Manufacturer:
Capacity.
Prom
Tank
Field
Station
Tank
Sewer Line
Anchors eTank
15001111"GaI.
Well
133
141
140
87
Materiel:
Fiber lass
Number of Compartments:
2
Salo.. Water
100+
100+
100+
LIFT STATION
Lot Line
28
10.0
28
Size:
250 Gal.
Manufacturer:
Orenco/Anch Tank
52
67
61
"Pump on' level at:
'Pump Or level at
High alarm at
Ti46
Foundation
44 in.
41 in.
in.
Pump Make & Model
Electrical Inspections performed by:
Curtain Drain
6'Qf�de D 'Eds
Electric
Remarks:
Advantex treatment system
BENCH MARK
Location and Description;
Garage Door Threshold
Assumed Elevation:
100.0 Ft.
Engineer's Stamp
OF
Inspections performed by: Pannone Eng. SVC Dates: 1'7/7/2003'
49TH 00
..........................
2nd07/0712003
Department of Health and Human Services approval
��'Steven R.a
r
Reviewed and approved by: Al,Date: !�- 7 "O
�jG No CE 881149
(Rev. 71!99)
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♦�O�I E55\
PERMIT N0: SW030216 AS -BUILT DRAWING P.I.D. N0: 020-113-55
WASTEWATER DISPOSAL SYSTEM Z�s
' LOT 30, BLOCK 10 RABBIT CREEK TITS S/D
� \ \
1 \
LOTS UNDEVELOPED 1 \
NO WELLS OR SEPTICS \ t
W/IN 100 FEET 1 1
PROPOSED DRAINFIEP,D ti
�. BED W/2° FILTER SA'N t
101 X 101 X 0.5 EFLi. t\
BU IED 1`� T 2 1 tt \\
UBD IN--�---- \ jujt}2 1 \
LI 1 \
EXIST°G SY1S EM .
NEW
FIBERGLASS 1
STEP
TANKg W/ADVA
31
Ax 20
LOTS
UNDEVELOPED -
NO WELLS OR S9PT3
W/IN
100 FEET'
EXIST°
_ i -1
EXIST°G
3 BR rr
I
1 �
I O
LOTS UNDEVELOPED
NO WELLS\OR SEPTICS t
W/IN 100'`EEET
� 10X20
491
0, /Y
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/ / /
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NO S /OR SEPT
10 x 20 W/IN Q' FEET
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i
s•',R••••••••Pa•nnone••••••••••; •.• •■� PREPARED FOR:
ren.
Clark Olsen
No. 17041 Jaqueline Circle
C-23 Anchorage, AK 99516
336-1515
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75.4
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. 0. BOX 102954
NCHORAGE, ALASKA 99510
27-3522 P,272-8218 Fax
LTE: 5-2-03 AS -BUILT
".AT.£ 2 1 ^=SO v
PERMIT NO: SW030216 AS ®BUILT DETAILS P.I.D. NO: 020-113-55
WASTEWATER ABSORPTION SYSTEM 3(.S
NOTE: LOT 30, BLOCK 10 RABBIT CREEK HTS S/D
1) ALLWORK SHALL BE PERFORMED
IN ACCORDANCE WITH, & ALL METERIALS
SHALL CONFORM TO AMC15.65,
2) CONTRACTOR SHALL STAKE PROPERTY LINE
IN VACINITY OF DRAINFIELD. Wo
3) ADD A MINIMUM OF 1° OF FILL OVER
Oa
ENTIRE TRENCH. k
4) B.O.T. STANDS FOR BOTTOM OF TRENCH &
5) CONTRACTOR SHALL NOTIFY ENGINEER OF a
ANY VARIATION BETWEEN DESIGN AND FIELD n
CONDITIONS.
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Clark Olsen
17041 Jaqueline Circle
Anchorage, AK 99516
336-1515
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Pannone Eng. Svc., LLC
P. 0, BOX 102954
ANCHORAGE, ALASKA 99510
272-821$ PHONE & FAX
DATE: 6-1-03 AS_BUILT
NOT TO S
PERMIT NO: SW030216 AS -BUILT DETAILS P.I.D. NO. 020-113-55
WASTEWATER ABSORPTION SYSTEM �IS
LOT 30, BLOCK 10 RABBIT CREEK HTS S/D
AX -20 FILTER
WITH INSULATED LID.
ROTATED 90 FOR-,, (�
INLET
3" PVC PIPE
TO AMBIENT AIR
DESIGN CALCULATIONS
Number of Bedrooms - 3
Total Bedrooms - 3
5008 FIBERGLASS
.T.E.P. TANK
INSTALL 4" RIGID INSULATION
OVER TANK & DRAINFIELD. EXTEND
R.I 21 BEYOND SIDE OF TANK. INSTALL
R.Z. AROUND AX -20 FILTER.
ADVANTEX TANK DETAIL
TANK SIZE:
1500 gallon Advantex tank
SOIL ABSORPTION SIZE:
Design flow - 150 gal/br/day, Advantex Sewer System
Total flow - 450 g/day AX20 Pod - Class III System
Perc Rate= <1 min/inch
Application Rate= 6 GPD/SF
Size Required= 450 GPD/6 GPD/SF = 75 SF
Use 109 X 109 Bed, 0.59 effective
2411 of Filter Sand under Bed
109 X 109 Bed = 100 SF Total
;SPARED FOR: PANNONE ENG. SVC.
Clark Olsen P. 0. BOX 102954
17041 Jaqueline Circle ANCHORAGE, ALASKA 99510'
Anchorage, AK 99516 272-8218 PHONE & FAX
336-1515 .,.... _ I .
AS -BUILT
JUL-14-EW Q7: P FROM:A+ HOME SERVICES, IN 907-868,6720-_.
sly
July 14, 2008
A + Home Services
140"1i Avenue
Anchorage, AK 995
ED'S ELECTRIC INC.
P.O. BOX 210707
ANCHORAGE, AK 99521
ANCHORAGE
(907) 2724681
Fax: (007) 272.4800
Subject: Septic Lift Station 17401 Jacqueline Circle, Anchar,"a AK
Ed's Electric, Inc, installed electrical on subject project meeting all code
requirements of the Natit ,wl Electrical Code and all requirements of the
AA micipality of Anchorage.
Thank you,
Dwaynea SBruns
Ed's Electric, 2nc.
MON 05159PM ID&A+ HOME SERVICES, INC. PAGE:2 X
O
co, �
CO FLot 29 \ Lot 15
nd. to Replat
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Fnd. to Replat \� Lot 30(A)
N21.48'fl, 2.01' , 20,095 of 9;.ryY l�»
.' WI ems"
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e��te.n Aa
eed Held
Lot 31 tye y StotYHouse
'm 6 Ftotoe 2�y n Mon.-
s _
mas Ea .nt Cwted
r 9•p,, // / by InNrvm.nt
R iswy
... �.` / O
Lot 5 Loth
:�...,, ,.... O °gag N LEGEND
.,
M Recovered 5/8" Rebar MOA Replat
(R) Record Information, (P70-381) as
corrected for mathematical errors.
He
Lot 4 (Replat) Per Proposed Replat
Fnd. Mon. O Septic Cleanout
J
NOTES 1. This property is within the Municipality of Anchorage's Special Survey Assessment
District 1V96, which was formed to correct plat and survey errors within Rabbit
Creek View and Rabbit Creek Heights Subdivisions. A Complaint and proposed
IL it Replat were filed with the Superior Court in December 1998 (Civil Action No.
�� F, OF q� �� 3AN-98-11718). A revised Replat was filed November 2001.
••..,.qs 2. "(R)" Significant found
r Q� ..•• ♦ errors were on the orig'l plat (P70-381). These errors were
'•.•�F ♦♦
�07t; ••n A analyzed & dimensions adj'd to obtain the intended representation of the lot
7 j�{'%`• ' y* ; 3. 'Rulon." represents a monument found during the retracement survey performed for the
.... ............1... 0 Replat in 1997-98. The notation "Fnd. to Replat" means the bearing and distance from the
0„ 0 found mon. to the "Replat" cor. set in 2002-3. "Held fad. Mon." means original fad. mon.
♦ ROBERT T. KEAN position was held & the "Replat" corner replaced the orig, fnd. mon.
♦j s� 4. The properly lines shown hereon are the "Replat" and determined
No. 3943-5 ; per proposed were
♦b ., using found mon, locations and the intent of the original record plat, P70-381. Changes
♦♦♦ °Ro Essia+� `ice shown on the "Replat" from the record P70-381 plat lot configuration are primarily based
♦
Ik Ik ",:;� on the found monuments postions.
5. Lot 30(A), Block I I(H): The () represent the "Replat" naming convention.
6. A field survey was conducted for this as -built on July, 15, 2003.
7. This property is subject to a Blanket Electric Easmt. recd 11/5/54 at Bk 111 Pg 56.
8. All bearings and distances are per proposed Replat unless otherwise stated.
SURVEYOR'S CER77FICATE
"As -Built"
I hereby certify that I have surveyed the property and facilities described
Block 10, Lot 30
hereon and that the improvements situated thereon do not encroach on
Rabbit Creek Heights Subdivision
adjacent property, that improvements on adjacent property do not
to be re -designated
encroach on the surveyed premises, and that there are no other visible
pending Final Judgment, Civil Action No. 3AN-98-11718
.SaacMwi rights-of-way, EXCEPT AS SHOWN OR NOTED HEREON.
as
3. \4��
Block 1 O Lot 3 O
IFobert T. Kean, R.L.S. 3943-5 Date os
D
Rabbit Creek View and Rabbit Creek
EXCLUSIONS
Heights Subdivision Replat
No data hereon should be used for positioning additional structures,
ORAYN BY:
CHK'D 9Y:
for building fences, or for locating the boundary lines. It is the
PREPARED BY.
ASP
RTK
responsibility of the owner to determine the existence of any easement
KEAN & ASSOCIATES
,p8 #
NoA GRID:
or restriction that does not appear on the recorded subdivision plat
6927 Old Seward Hwy.
03119AJO
3241
and to verify that all improvements meet all subdivision covenants
Suite 101
SCALE.
DATE:
and zoning ordinances.
Anchorage AK 99518
F'= 40'
07/25/03
MUNICIPALITY OF ANCHORAGE 74-03
7 _ Cd - b 3
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
12.CJo
Date Issued: Jun 24, 2003
Expiration Date: Jun 23, 2004
Permit Number: SW030216 Parcel ID: 020-113-55
Legal Description:
Design Engineer: 0062 Pannone Engineering Services Site Address: 017041 JACQUELINE CIR
Owner Name: CLARK A. & DEBRA K. OLSEN Lot Size: 20598 SQ. FT.
Owner Address: 17041 JAQUELINE CIRCLE Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE , AK 99516-5551
This permit is for the construction of:
P Disposal Field Z Septic Tank ❑ 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 DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 (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:
Date: `F ZS C• '
/
•� •1F3Y L3�����
Date: a
Municipality of Anchorage
I'1r4E _84
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE-SEWERIWELL_ PERMIT APPLICATION --_
FOR A SINGLE FAMILY DWELLING
Parcel I.D.O OR () (/ 3 5-5 Permit Number SW 0 3 0 2/
Property owner(s) C I Q r l< Ol Se_n Day phone 336 -/ S S
Mailing address (1
Mailing address
Legal description (Lot, Block & Sub'd.)
Ue- IIY)e. L/ r,
Legal description (Section, Township & Range)
Lot Size Acres/Sq.Ft.
THIS APPLICATION IS FOR:
Zip Code _
Number of Bedrooms
Sewer Only ❑ Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
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 Fees:
Date of Payment:
(z��P 2
Receipt Number:377
(Rev. 12/00)
Waiver Fees:
Date of Payment:
Receipt Number:
Pannone Engineering Services, LLC P.O. Box 102954
Consulting Engineers Anchorage, Alaska, 99510
(907) 272-8218 (907) 272-8218 Fax
June 1, 2003
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
4700 S. Bragaw Street
P. O. Box 196650
Anchorage, Alaska 99519
Subject: Lot 30, Block 10 Rabbit Creek Hts S/D,
Septic System Replacement Permit Request
Failed Septic System — PLEASE RUSH
Gentlemen:
My firm was asked to investigate a failed septic system serving this lot. We found the existing
trench was operating perfectly fine, but found in the record that the water table is located
approximately 2.5 feet below the bottom of the existing trench. We excavated an additional water
monitoring well and found this to be consistent. The system does not meet the code requirements
of the MOA and needs to be upgraded to meet those codes. An exsting permit to install a new
system was issued on August 16, 1999 (Permit Number SW990283) for a REACTEC System. I
would like to requests a permit be issued using the existing test hole data for a new Advantex
system. I have attached a design showing the system and location. The installation of the
proposed system will not preclude neighboring lots from being developed.
If you have any questions or concerns, please contact me at 2273522 or 272-8218.
Sincerely,
teven R. P none
Civil Engineer
Attachments:
C:\Work\Letters\30-10 Rabbit Creek Hts.001.doc
PERMIT N0: SW
BU IED
03 DESIGN DRAWING P.I.D. NO: 020-113-55
WASTEWATER DISPOSAL SYSTEM
LOT 30, BLOCK 10 RABBIT CREEK HTS SID
1 t
29 t
1 \
l i
LOTS UNDEVELOPED ti ii
NO WELLS OR SEPTICS t 1
W/IN 100 FEET \ k
PROPOSED DRAINFIELD
�• BED W/2° FILTER SAN i
10' X 10' X 0.5 EFtt,
4e 1 1 \ t
T 1 1 \
\ i
k t
_,_EXIST ° G SYS El
NEW FIBERGLASS 1 0
STEP TANK, W/ADV -
1 AX 20
LOTS UNDEVELOPED
NO WELLS OR S4PTICS
W/IN 100 FEET/
_ L-LYLVLYLL LLV LTL
k \
- ---- - ----
EXIST°G
3 BR
i a
`-.EXIST°G_ _
-WELL
LOTS UNDEVELOPED
NO WELLSIOR SEPTICS t
W/IN 100 `,FEET I
\`�$�jj '10 %2
' 4921
J3 /
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r
i
i
i
K LOTS UNDEVELOPED
I NO��++S ; OR SEPT:
10 x 20 W/IN'Tj Oa FEET
G I Clark Olsen
49 ��Aw 17041 Jaqueline Circle
i Anchorage, AK 99516
,•%fir 336-1515
IID
TO
I
..vsau JJLYV e O VV Li,l,•
0, BOX 102954
RCHORAGE, ALASKA 99510
27-3522 P,272-8218 Fax
LTE. 5-2-03
1 I DESIGN
•nr c. ..� n_en.
PERMIT NO: SW03 DESIGN DETAILS P.I.D. N0; 020-113-55
WASTEWATER ABSORPTION SYSTEM
NOTE: LOT 30, BLOCK 10 RABBIT CREEK HTS SID
1) ALLWORK SHALL BE PERFORMED
IN ACCORDANCE WITH, & ALL METERIALS
SHALL CONFORM TO AMC15.65.
2) CONTRACTOR SHALL STAKE PROPERTY LINE
IN VACINITY OF DRAINFIELD. 4!
3) ADD A MINIMUM OF 1° OF FILL OVER zno mw
ENTIRE TRENCH.
4) B.O.T. STANDS FOR BOTTOM OF TRENCH
5) CONTRACTOR SHALL NOTIFY ENGINEER OF
ANY VARIATION BETWEEN DESIGN AND FIELD
CONDITIONS.
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Clark Olsen
17041 Jaqueline Circle
Anchorage, AK 99516
336-1515
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ANCHORAGE, ALASKA 99510
272-8218 . Drmvp r. wAv
DESIGN
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17041 Jaqueline Circle
Anchorage, AK 99516
336-1515
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ANCHORAGE, ALASKA 99510
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DESIGN
PERMIT NO: SN03 DESIGN DETAILS P.I.D. NO: 020-113-55
WASTEWATER ABSORPTION SYSTEM
LOT 30, BLOCK 10 RABBIT CREEK HTS SID
AX -20 FILTER
WITH INSULATED LID.
ROTATED 90 FOR
CLARITY.
1500g FIBERGLASS
/—S.T.E.P. TANK
E
��.DIBCNaA6E 40
DRI12N H'IBLD6
3" PVC PIPE
TO AMBIENT AIR
INSTALL 4" RIGID INSULATION
OVER TANK & DRAINFIELD. EXTEND
R.I 2' BEYOND $IDE OF TANK. INSTALL
R.I. AROUND AX -20 FILTER.
ADVANTEX TANK DETAIL
DESIGN CALCULATIONS
Number of Bedrooms - 3
Total Bedrooms - 3
Il kly
TANK SIZE -
1500 gallon Advantex tank
Desi n flow - 150 SOIL ABSORPTION SIZE -
Design gal/br/day, Advantex Sewer System
Total flow - 450 g/day AX20 Pod - Class III System
Perc Rate= <1 min/inch
Application Rate= 6 GPD/SF
Size Required= 450 GPD/6 GPD/SF = 75 SF
auk� Use 101 X 10' Bed, 0.59 effective
�E,.,...... q(a!+� 24" of Filter Sand under Bed
"�j� 10' X 101 Bed = 100 SF Total
.....h....
van R. Pannonei
• PREPARED FOR- PANNONE ENG. SVC.
No. CE 8149 Clark Olsen P. 0. BOX 102954
( ,.�.ii 17041 Jaqueline Circle ANCHORAGE, ALASKA 99510
1 1Q �•� 3Anchorage,
AK 99516 272-8218 PHONE & FAX
DATE: 6-1- 3
NOT TO SCALE DESIGN
ALASKA WATER & WASTEWATERANCH CONSULTANTS, INC. o Dov
69PHONEA(907) 33556,79B
*FAX (907) 3s6-32469504
SOIL LOG PERCOLATION TEST
LEGAL DESCRIPTION: RABBIT CREEK HEIGHTS SUBDIVISION; LOT 30, BLOCK 10
PERFORMED FOR: JEFF AND TONI OLIVER .. .............
7/9/99 QQQ o A. Gornese:
E
DATE PERFORMED: —7953
°(feetTEST HOLE #1 44��gd'Orofeesloak
1 bOO000�
SOIL CLASSIFICATIONS 1
2 FILL '::s;a GW ORG SITE 100' tt tt
3 `s itisat>.. GP ML 1 tt
GM CL TH#2 tt t
4 GC OL rH#i t t
0 0�090 SW MH i t
5 '• �•• SP CH
ORGANICS SM : Ok S(df \ --
8 AND LOAM SC--
i
7 DEPTH TO
8
i
i
9 SM/ML
WITH SOME
10 GRAVEL
11 DATE READING CLOCK NET TIME WATER LEVEL NET DROP
TIME (MINUTES) READING (INCHES)
12 7/12/99
oN05.
13 GM k5 SEG
14 B.O.H. Aa0
V��S r•
15\C\
5 \N
17 Rego
18
Pte°
19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
20 t TEST RUN BETWEEN 6.5 FT. AND 7.0 FT.
COMMENTS: WATER O &C BELOW ORIGINAL ORGANIC LAYER. SOILS LOOK TIGHTER THAN PERK RATE INDICATED.
PERFORMED BY ALASKA WATER & WASTEWATER. 1, JEFFREY A. GARNESS, CERTIFY THAT THIS
WAS PERFO ME I ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON
DATE: Z L
GROUNDWATER
DATE
13.0'
7/9/99
SEEPING � 12'
7/9/99
11.75'
7/17/99
ALASKA WATER & WASTEWATER CONSULTANTS, INC.'�F�O
995046901 DEAR ROAD, 31I79 t FAXANH0OjA3GE�-38PHONE (907) 337 d
SOIL LOG — PERCOLATION TEST o* : y*pp4
LEGAL DESCRIPTION: RABBIT CREEK HEIGHTS SUBDIVISION; LOT 30, BLOCK 10 '•"•" ' "' '...... '
PERFORMED FOR: JEFF AND TONI OLIVER a A. e...
DATE PERFORMED:_ 7/9/99 ppAg —7953
gf� TEST HOLE #2 �� ''p........• o' `�
�t4� �o/asslot`�
t �V40000
FILL
SOIL CLASSIFICATIONS 1
2 SITE PLAN
:V& GW ORG I" = 100' ,� 1
3 tdil GP ML 1 1
GM CL TH#2
4 GC OL THp 1
"a as o SW MH
5 — ORGANICS o; .S 4 SP CH , ,1
SM OH —
8 Sc � --
j
7 MY. DEPTH TO
WM MSOME GROUNDWATER DATE
8 GRAVEL 9.5' 7/9/99
NO MONITORING BE INSTALLED ".�
9 1r
Mt GM
10 B.O.H.
It—
DATE READING CLO
12
13
14
15
16
17
18
19
PERCOLATION RATE 4.0 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
20 TEST RUN BETWEEN 6.5 FT. AND 7.0 FT.
COMMENTS: WATER ® R 5' BELOW ORIGINAL ORGANIC I AYER COIL HAN LOOK TIGHTER TPERK RATE INDICATED
PERFORMED BY ALASKA WATER & WASTEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS
WAS PERFO ME IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON
DATE:
CK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
7/12/99
PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING
1
3:54
—
6"
—
2
4:04
f 0
3 3/8"
2 5/8"
3
4:05
—
8"
—
4
4:75
10
3 1/4"
2 3/4"
5
4:i5
8"
—
8
4:25
10
3 3/8"
2 5/8"
7
4:25
—
8"
—
8
4:35
10
3 7/2"
2 1/2"
9
4:38
—
8'
—
10
4:48
10
3 9/18"
2 7/18"
11
4:48
—
B"
—
72
4:58
10
3 1/2"
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On -Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Aug 16, 1999
Expiration Date: Aug 15, 2000
Permit Number: SW990283 Parcel ID: 020-113-55
Legal Description: RA15SIT CREEK HEIGHTS BILK 10 LT 30
Design Engineer:
0041 AK Water & Wastewater Consulta
Site Address:
017041 JACQUELINE CIR
Owner Name:
Jeff & Toni Oliver
Lot Size:
20598 SQ. FT.
Owner Address:
PO Box 110016
Total Bedrooms:
3 Permit Bedrooms: 3
ANCHORAGE, AK 99511-0000
This permit is for the construction of:
❑✓ Disposal Field ❑✓ Septic Tank ❑ 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.
5. The following special provisions.
THIS PERMIT IS ISSUED FOR THE CONSTRUCTION OF AN INNOVATIVE REACTEC WASTEWATER
DISPOSAL SYSTEM. AS A CONDITION OF THIS PERMIT THE PROPERTY OWNER SHALL MAKE
ARRANGEMENTS FOR THE SYSTEM TO BE SAMPLED ONCE A MONTH BY A PRE -APPROVED PERSON
FOR A MAXIMUM OF 12 CONSECUTIVE MONTHS AFTER BEING PUT IN USE. THE M.O.A. WILL PAY FOR
THE LABORATORY COSTS ONLY. THE ATTACHED PROPERTY OWNER AGREEMENTS SHALL BECOME A
PART OF THIS PERMIT PACKAGE.
Received By:
Issued By:
Date: 0
Date: 0 —&—/ %
Municipality of Anchorage
Department of Health and Human Services
825 1" Street 14
P.O. Box 196650 Anchorage, Alaska 99519-6650
http://www.ci. anchorage. ak. us
August 19, 1999
leff Garness, PE
Alaska Water & Wastewater Consultants, Inc.
;901 De Barr Road, Suite 2B
anchorage, Alaska 99504
Subject: Waiver Request for Lot 30 Block 10 Rabbit Creek Heights
Waiver Request #WR990047
Parcel ID #020-113-55
SW990283
Dear Mr Garness:
Your request for a waiver of the required 10 feet horizontal separation
on-site wastewater disposal system from the
separation distance is 5.0 feet. Also, to property line has been approved. The approved
a 1 foot waiver from the on-site wastewater disposal
system to the northwest property line.
This waiver approval applies to the existing on-site wastewater disposal system to
Property line separation only. Any future upgrade to the on-site wastewater disposal
system will require all separation distances be met or another approval from this
department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-4744.
Sincerely,
) X.
Daniel J. Roth
Civil Engineer
On -Site Water Quality Program
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR#'�1Q �1tY1 u� PID# 020-113-55 HA# Permit # SIA 1
Date Received: July 29, 1999
Legal Description: Lot 30 Block 10 Rabbit Creek Heights
Engineer: Jeff Garness, PE, Alaska Water & Wastewater Consultants Inc
6901 De Barr Road, Suite 2B, Anchorage Alaska 99504
Applicant: Jeff & Toni Oliver
Waiver Requested: Lot line waiver of 5 feet from the system to the northeast
property line & a 1 foot lot line waiver to the northerwest property 1;n
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: i( Waiver is NOT Granted:
List Conditions or Reasons for above: 5-4e pbG/iYE.BrQ/J A;7fiCYk,9 LEiTtr�
OF TuJ7-7Pi6gTtQA/,
Date: R-14 -9 I By: 12XA1
Name of Reviewer
Rec #: 05213/7207 Amount: $ 115.00 Date Paid: July 29. 1999
Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road, Suite 2B — Anchorage — Alaska 99504
Phone (907) 337-6179 — Fax (907) 338-3246
Consulting Engineers
July 21, 1999
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Septic Upgrade and Lot Line Waiver Request for
Lot 30, Block 10, Rabbit Creek Heights Subdivision
RECIRCULATING UPFLOW FILTER (Reactec) SYSTEM
To whom it may concern:
1. GENERAL: The existing 3 bedroom home is served by a private septic system and a private
well. The existing septic system does not meet Municipal requirements and must be upgraded.
There are numerous site constraints which are as follows:
• The location of the house and driveway
• The location of a ditch with flowing water along the southwest property line
• The location of the 100' well radius
• The presence of groundwater
• The location of the curtain drain
• The location of the existing septic system
Given these site constraints, we are proposing to install the Recirculating Upflow Filter
(REACTEX) system. The ditch running along the southwest property line is to be culverted and
buried within 100 feet of the proposed septic system upgrade.
2. LOT LINE WAIVER REQUEST: As can be seen on the attached site plan and design, we
are proposing to install the primary site along the northeast property line and the alternate site
along the northwest property line. We request that a 5 foot lot line waiver from the northeast
property line and a 1 foot lot line waiver from the northwest property line be granted. We are
unaware of any adverse effects this would have on neighboring properties.
3. SOIL CONDITIONS: Two test holes were excavated on July 9, 1999. The soils below the
fill and organics was a SM/ML material to a depth of 13 feet in TH#1 and 9 feet in TH#2. At 13
feet and 9 feet, the soils transitions to a GM material to a depth of 13.5 feet in TH#1 and 9.5 feet
in TH#2 (bottom of test holes). Groundwater was encountered during the excavation at a depth of
12 feet in TH#1 and at 9.5 feet in TH#2. On April 17, 1999, groundwater was found to be at
11.75 feet in TH91. In TH#1, a percolation test was performed between the depths of 6.5 feet to
7.0 feet and the rate was measured at less than 1 minute/inch (see attached soil logs). In TH#2, a
percolation test was performed between the depths of 6.5 feet to 7.0 feet and the rate was
measured at 4 minute/inch (see attached soil logs). The soils appeared to be much tighter than
the perk rates indicated.
4. DRAINFIELD: The intent is to install a Recirculating Upflow Filter (Reactex) System that
will allow the use of a small drainfield in the area around a 30 foot radii of the test holes. The
size of the drainfield will be based upon the previously established criteria for the Reactex
systems, which dictates that soils percolating between 1 & 30 minutes/inch have an allowable
application rate of 4 gpd/ft2, and soils percolating between 30 & 60 minutes/inch have an
allowable application rate of 2 gpd/ft2. Given the percolation rates were less than 1 minute/inch
and 4 minute/inch, we propose that a 4 gpd/ft2 application rate would apply. We are proposing
to install a 14 foot wide drainfield that is 14 feet long that is 6 to 7 feet deep (maximum). We
propose that 2 feet of M.O.A. approved sand filter be added and then 6 inches of clean, washed,
sewer drainrock be added below the distribution line (a total of 1 feet of drainrock). This
corresponds to an absorption area of 196 ft2, or an application rate of 2.3 gpd/ft2 (assuming 450
gpd total flow).
4. ORENCO PACKAGE SYSTEM: The STEP tank with the trickling and upflow filter will
be manufactured by Anchorage Tank & Welding to meet the latest design criteria established by
Orenco Systems, Inc. The point of contact at Anchorage Tank is Lowell McNutt. As with their
standard STEP tank, it is equipped with a high water alarm per M.O.A requirements.
5. SURFACE WATER: There is a ditch with flowing water that runs along the southwest
property line. The ditch will be culverted and buried within 100 feet from the proposed septic
system.
6. TOPOGRAPHY: As can be seen on the attached topography site plan, the lot slopes from
approximately south/southeast to north/northwest at a grade of approximately 5-15 percent. In
short, there are no slope concerns. In the area of the proposed primary site the slope is
approximately 5 percent.
7. CLOSING: I am open to any suggestions from your department that would be an
improvement to the proposed system. I am unaware of any negative impacts that this installation
would impose on adj" Gent wells, or septic systems. If you have any questions, please call us at
337-6179. )
M.S.
ro�
� LOT 27, BLOCK 10 / !
RABBIT CREEK HTS S/D ! !
l ! l LOT 16, BLOCK 10
RABBIT CREEK HTS S/D
oN 9 ! ! 1
o �
M6w
„Mj U
ALTERNATE SITE
S LOT 32, BLOCK 10
RABBIT CREEK HTS S/D
(solo �
1 1 LOT 31, BLOCK 10
RABBIT CREEK HTS S/D
LKISTING
3'BEDROOM
\ \ / HOUSE
LOT 3, BLOCK 10
RABBIT CREEK HTS S/D
JPC�j/
LOT 4, BLOCK 10
CREEK HTS S
~ \ BARNTBLDG./ NO WELLD
\ PER M.O.A. RECORDS
LOT28, BLOCK 10
RABBIT CREEK HTS S/D
LOT RABBIT CREEK HTS BLOCK iS/D
v
LOT 29, BLOCK 10
RABBIT CREEK HTS S/D k
C�S PROPOSED S PTIC UPGRADE
(SEE DESIGN, PAGE 2 OF 2)
r� EXISTING
SEPTIC LOT 14, BLOCK 10
Tuu�
I
i
� I
LOT 5, BLOCK/10
RABBIT CREEK HTS S
SYSTEM RABBIT CREEK HTS S/D
Y
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SEPTIC UPGRADE
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PAINE ROAD
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504
PHONE: (907) 337-6179/FAX: (907) 338-3246
RABBIT CREEK HTS. SUBDIVISION;
LOT 30, BLOCK 10
.. .✓ .....
OF WORK:
SITE PLAN FOR
SEPTIC UPGRADE
•„
e r A. G ess:
OQ P
PARED FOR: PHONE NUMBER:
JEFF AND TON]
OLIVER
(907) 348-0638Q
n9. E-7953 v,
tv
Q�444o�p....,....•tl\�o\
DRAWN BY.
SCALE:
SCALE:1
PAGE:
7/21/99
L. M.
— 1OO
1 OF S
�o f esslon o0
04op000�
PA
-PROPOSED DRAINFIELD BED UPGRADE.
EXCAVATE 6 TO 7 FEET DEEP MAXIMUM
BY 14 FEET WIDE BY 14 FEET LONG.
ADD 2 FEET OF M.O.A. APPROVED SAND
FILTER AND THAN ADD 6 INCHES OF
CLEAN, WASHED SEWER DRAINROCK
BELOW THE PIPE AND 2 INCHES ABOVE
THE PIPE. (SEE DETAIL, PAGE 5 OF 5).
INSTALL
SAMPLE
THj1 PORT
1
�I
St
�
St
1
i
i
'OSED UPFLOW FILTER
DETAIL, PAGE 4 OF 5)
PROPOSED 1500 GALLON
(SEE DETAI�L.,N PAGE 3COF 6)
d
i
IG IXISTING TRENCHES ARE
\TO NNG BE AABANIDONED COMPLETELYE \ i
i
DITCH WITH FLOWING \ \ ya�/ ���� / / eXISTING CURTAIN
WATER (SEE NOTES)
TO BE CULVERTED.
NOTES:
\ / 1. THE CONTRACTOR SHALL HAVE THE NORTHEAST
PROPERTY LINE, THE NORTHWEST PROPERTY LINE,
AND THE 100 FOOT WELL RADIUS FLAGGED BY A
-.e REGISTERED SURVEYOR PRIOR TO CONSTRUCTION.
2. THERE IS A DITCH RUNNING ALONG THE EAST/
SOUTHEAST PROPERTY THAT HAS FLOWING WATER.
/ THE EXISTING CURTAIN DRAIN OUTFALL FLOWS INTO
/ THIS DITCH. THE DITCH IS TO BE CULVERTED AND
BURIED WITHIN 100 FEET OF THE PROPOSED SEPTIC
\ / SYSTEM.
3. THE CONTRACTOR SHALL FIELD VERIFY THAT ALL
\ SEPARATION DISTANCES WILL BE MET PRIOR TO ANY
\ _ / CONSTRUCTION.
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD, SUITE 2B. ANCHORAGE• AK. 99504
PHONE: (907) 337-6179/FAX: (907) 338-3246
RABBIT CREEK HEIGHTS SUBDIVISION; LOT 30, BLOCK 10
DESIGN FOR SEPTIC UPGRADE
F•RUTARLD FOR: PHONE NUMBER:
JEFF AND TONI OLIVER (907) 348-0638
7/21/99 I J.L.M. I 1 = 30,
2 OF 5
A. Garness;
E-7953
pro f e 35101`t=
w
n
O
3"
NCO TRICKLING F
CAP
INSULATED FIBERGLASS UD
`j. Pirt ^•�
i 4'x8' $PVC 6" PYC
w BLUE BOARD
" FERNCO COUPLING
_ INSULATION
SLOPE 1/6' PER 12'
11
Em
FLOW FROM
4' PV TRICKLE FILTER BACK
I+ TO SEPTIC TANK INLET
si� RO K
FLOW FROM
RECIRCULATING PUMP
TO TRICKLING FILTER
O
ryl
I II
I
INLET
DRILL 1/4" DIA. HOLE
n AIR LINE
AT BOTTOM OF ELBOW
FOR DRAINAGE.
TANK SIZE PER
ANCHORAGE TANK
NOTE: 150D GALLON TANKS FOR
(SEE NOTE) 7
3 AND 4 BEDROOM DESIGNS. 200D
I II
3" ABS
ALASKA WATER & WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD SUITE 28, ANCHORAGE, AK, 99504
PHONE:
(907) 337-6179/FAX: (907) 338-3246
AIR DUCT
RABBIT CREEK HEIGHTS
SUBDIVISION; LOT 30, BLOCK 10,
ROUTING
PLAN AND PROFILE OF
RECIRCULATING SEPTIC TANK
VARIES AIR FLOW FROM
ITRICKLECRAWLSPACE
PHONE NUMBER:
(907) 348-0638
WTH SITE O
DRAWN BY:
SCALE:
CONFIGURATION FILTERT
7/20/99
TRICKUNG FILTER
3"
NCO TRICKLING F
CAP
INSULATED FIBERGLASS UD
`j. Pirt ^•�
i 4'x8' $PVC 6" PYC
w BLUE BOARD
_ INSULATION
Em
J INLET
si� RO K
Li
O
ryl
DRILL 1/4" DIA. HOLE
n AIR LINE
AT BOTTOM OF ELBOW
FOR DRAINAGE.
TANK SIZE PER
ANCHORAGE TANK
NOTE: 150D GALLON TANKS FOR
(SEE NOTE) 7
3 AND 4 BEDROOM DESIGNS. 200D
GALLON TANKS FOR 5 BEDROOM
DESIGNS.
ALASKA WATER & WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD SUITE 28, ANCHORAGE, AK, 99504
PHONE:
(907) 337-6179/FAX: (907) 338-3246
LEGAL DESCRIPTION:
RABBIT CREEK HEIGHTS
SUBDIVISION; LOT 30, BLOCK 10,
TYPE OF WORK:
PLAN AND PROFILE OF
RECIRCULATING SEPTIC TANK
'PREPARED FOR:
JEFF AND TNI OLIVER
PHONE NUMBER:
(907) 348-0638
DATE:
DRAWN BY:
SCALE:
PAGE:
7/20/99
J.L.M.
N.T.S.
3 OF 5
:ale=FllTT
n
I
OUTLET
I
u 1
RISER WTI
OUTLET " FOAM
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FROM S.T.E.P.
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INFILTRATOR
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II�I�Iili1�1�1�Im�l��r�r
10 GA COATED
INSIDE & OUT
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COAL TAR PITCH
4' OF 4'x8' BOARD
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COUPLING
11
COLLECTION PPES7 UB
4' SLOTTED
OUT TO
► DRAIN
FIELD
OUTLET
uia iaiou uury une. '�(AS&G BLOCK
�t,H 157 CUBIC I
4' ABS
4' OF 4'x8' BOARD z 4`ti « , CLEANOUT
INSULATION (TYP.2)� $*"xr r �.^ d ' EXTEND
DETO
1SURFAC
IN FROM
RECIRCULATING ► -
SEPTIC TANK
INLET
ALASKA WATER & WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD SUITE 2B, ANCHORAGE, AK, 99504
PHONE: (907) 337-5179/FAX: (907) 338-3246
AL DESCRIPTION:
RABBIT CREEK HEIGHTS SUBDIVISION; LOT 30, BLOCK 10,
E OF WORK:
PLAN AND PROFILE OF UPFLOW FILTER
.PARED FOR: PHONE NUMBER:
JEFF AND TONI OLIVER (907) 348-0638
E: DRAWN BY: SCALE: PAGE:
7/20/99 J.L.M. N.T.S. 4 OF 5
Garness:
7953 m`4
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co MT co
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INS(LATION
FI g. FAMIc
PROFILE VIEW
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD SUFrE 2B, ANCHORAGE, AK 99504
PHONE: (907) 337-6179/FAX: (907) 338-3246
RABBIT CREEK HEIGHTS SUBDIVISION; LOT 30, BLOCK 10, Iff/r.•.L12p)^ .:?
PLAN AND PROFILE OF DRAINFIELD
(PREPARED FOR: PHONE
348-0638
JEFF AND TON( OLIVER `/
7/20/99 1 J.L.M. I N.T.S.
5 O 5
A. Garness:
—7953 : • l
e oA�6
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RABBIT CRTS
BLOC 0
RABBIT CR
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BIT CREEK HTS S/D
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ALASKA WATER & WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD, SURE 2B • ANCHORAGE, AK. 99504 O ••
PHONE (907) 337-6179 • FAX (907) 336-3246 OaG S�0
SOIL LOG — PERCOLATION TEST 0 ,0�0
LEGAL DESCRIPTION: RABBIT CREEK HEIGHTS SUBDIVISION; LOT 30, BLOCK 10 ""' ' Q
PERFORMED FOR: JEFF AND TONI OLIVER ..................
Q
DATE PERFORMED: 7/9/99 �Q A. Garness:
9. .• E-7953 mph
(fPTH
eet) ITEST HOLE #1 �4d1�aa''•.......••''�oAoo
uppa pyo f es siot\c\
1 DOOpoo��
2 SOIL CLASSIFICATIONS
FILL ::b" GW ORG SITE PLAN
I" = 100' � }
3 GP ML
GM CL
TH#2
4 GC OL 1H#1
"o o SW MH
5— SP CH
ORGANICS SM OH —
6 AND LOAM SC o� _
s i
i
8 v i
i
9 SM/ML
WITH SOME
10 GRAVEL
11 DATE READING CLOCK NET TIME WATER LEVEL NET DROP
TIME (MINUTES) READING (INCHES)
12 7/12/99
13—GM SEG
14 B.O.H. NQ
15
�N
16 GP��ONS
17SOR�EO 5
16
19 PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
20 r TEST RUN BETWEEN 6.5 FT. AND 7.0 FT.
b:'r5
COMMENTS: WATER O $.6' BELOW ORIGINAL ORGANIC LAYER. SOILS LOOK TIGHTER THAN PERK RATE INDICATED.
PERFORMED BY ALASKA WATER & WASTEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS
WAS PERFO ME I ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON
DATE: 7
DEPTH TO
DATE
GROUNDWATER
13.0'
7/9/99
SEEPING O 12'
7/9/99
11.75'
7/17/99
ALASKA WATER & WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD, SURE 2B • ANCHORAGE, AK. 99504 AV400
PHONE (907) 337-6179 t FAX (907) 338-3246 00
SOIL LOG - PERCOLATION .:'
LEGAL DESCRIPTION: RABBIT CREEK HEIGHTS SUBDIVISION; LOT 30, BLOCK 10 """' ' ' "' """"""' D
PERFORMED FOR: JEFF AND TONI OLIVER . .........
DATE PERFORMED: 7/9/99 Q� @ '•, e r A7953 ess,: 0 �
(Yr
feet TEST HOLE #2 �0�4. .........
•o;��aoQo
sof esslo� \
1 �040000��
FILL
2 SOIL CLASSIFICATIONS
SITE PLAN
GW ORG 1" = 100'
3e :tea?. G P ML
GM CL TH#2
4 GC OL TH#i
SW MH t 1
5 ORGANICS SP CH
SM / OH
6 SC
7 SM/ML
WITH SOME
R DATE
8 GRAVEL
Tt GM
10 B.O.H.
11
12
13
14
15
16
17
18
19
COMMENTS: WATER ® . ' BELOW ORIGINAL ORGANIC LAYER, COI . OOK TI H R T AN PERK AT INDICATED
PERFORMED BY ALASKA WATER & WASTEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS
WAS PERFO ME IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON
DATE: 2z
DEPTH TO
GROUNDWATER)
PERCOLATION RATE 4.0 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
20 TEST RUN BETWEEN 6.5 FT. AND 7.0 FT.
DATE
READING
NET TIME
(MINUTES)
9.5'
7/9/99
NO MONRORING
BE INSTALLED
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
7/12/99
PERC.
HOLE WAS PRESOAKED
4+ HOURS PRIOR TO
TESTING
1
3:54
— 6"
—
2
4:04
10 3 3/8"
2 5/8"
3
4:05
— 6"
—
4
4:15
10 3 1/4"
2 3/4"
5
4:15
— 6"
—
6
4:25
10 3 3/8"
2 5/8"
7
4:25
— 6"
—
8
4:35
10 3 1/2`�
2 1/2"
9
4:36
— 6"
—
10
4:46
10__.._..._3 9/16"
2 7/16"
11
4:46
— 8"
—
12
4:56
10 3 1/?
2 1/2-
1. SOIL CONDITIONS: Two test holes were excavated on July 9, 1999. The soils below the
fill and organics was a SM/ML material to a depth of 13 feet in TH#1 and 9 feet in TH#2. At 13
,feet and 9 feet, the soils transitions to a GM material to a depth of 13.5 feet in TH41 and 9.5 feet
in TH#2 (bottom of test holes). Groundwater was encountered during the excavation at a depth of
12 feet in TH#1 and at 9.5 feet in TH#2. On April 17, 1999, groundwater was found to be at
11.75 feet in TH#1. In TH#1, a percolation test was performed between the depths of 6.5 feet to
7.0 feet and the rate was measured at less than 1 minute/inch (see attached soil logs). In TH#2, a
percolation test was performed between the depths of 6.5 feet to 7.0 feet and the rate was
measured at 4 minute/inch (see attached soil logs). The soils appeared to be much tighter than
the perk rates indicated.
4. DRAINFIELD: The intent is to install a Recirculating Upflow Filter (Reactex) System that
will allow the use of a small drainfield in the area around a 30 foot radii of the test holes. The
size of the drainfield will be based upon the previously established criteria for the Reactex
systems, which dictates that soils percolating between 1 & 30 minutes/inch have an allowable
application rate of 4 gpd/ft2, and soils percolating between 30 & 60 minutes/inch have an
allowable application rate of 2 gpd/ft2. Given the percolation rates were less than 1 minute/inch
and 4 minute/inch, we propose that a 4 gpd/ft2 application rate would apply. We are proposing
to install a 14 foot wide drainfield that is 14 feet long that is 6 to 7 feet deep (maximum). We
propose that 2 feet of M.O.A. approved sand filter be added and then 6 inches of clean, washed,
sewer drainrock be added below the distribution line (a total of 1 feet of drainrock). This
corresponds to an absorption area of 196 ft2, or an application rate of 2.3 gpd/ft2 (assuming 450
gpd total flow).
4. ORENCO PACKAGE SYSTEM: The STEP tank with the trickling and upflow filter will
be manufactured by Anchorage Tank & Welding to meet the latest design criteria established by
Orenco Systems, Inc. The point of contact at Anchorage Tank is Lowell McNutt. As with their
standard STEP tank, it is equipped with a high water alarm per M.O.A requirements.
5. SURFACE WATER: There is a ditch with flowing water that runs along the southwest
property line. The ditch will be culverted and buried within 100 feet from the proposed septic
system. O
6. TOPOGRAPHY: As can be seen on the attached topography site plan, ths�i
lopes from
approximately south/southeast to north/northwest at a grade of approximately -1 percent. In
short, there slope concerns. In the area of the proposed primary e the slope is
approximate) 5 rcent.
s y4
7. CLOSING: I am open to any*Sggesti s from your department that would be an
improvement to the proposed system. I am unaw e of any negative impacts that this installation
would impose on adalent wells, or septic systems. If you have any questions, please call us at
337-6179. /
JeffrQjr t'IMItmess,T.E., M.S.
RECEIVID
JUL L21996 S
— lily of Anchorage '
manic"
h gckiuman Serylges
/ QeF:t. `\t,r , John Esrl Siniason i tp-
/// CE-8061 \`
100' \\
I \
I \\
I
\ 1
II \ \ 1
1 \
I
1 \ \ 31100,
\ o I
\\ 100' LOCATION OF
\ / SUBSURFACE DRAIN
DATE INSTALLED: 7/19/96
NO SURFACE WATER IS LOCATED WITHIN
100' OF THE SUBSURFACE DISPOSAL FIELD
OR SEPTIC TANK
SUBSURFACE DRAIN ASBUILT
ENVIRONMENTAL
DATE: 7/19/96
DESIGNED: SHS
MANAGEMENT
AINCORPORATED
oRawN SHS
SCALE: 1^=q0'
LOT 30, BLOCK 10
CHECKED: JES
FIGURE 1 OF j JOB NO. 6456
RABBIT CREEK HEIGHTS
ANCHOR
eNCHOSD 3'� WAEZD'99E3OIrE201
93M FA 2724159
0 MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL
PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501
Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME ^ ��\
PHONE-
NEW
❑ UPGRADE
MAILING ADDRESS }}
LEGAL DESCRIPTION
LOCATION
NO. OF BEDROOMS
Well
Absorption arga
Dwellipgt ;yam
PERMIT NO. - Kt�v'P
VY
DISTANCE TO:
N i
f
M
H
Manufacturey
Mate
No. of compartments
Lin. capacity in gallons
IF HOMEMADE:
Inside length
Width
Liquid depth
Y
DISTANCE TO:
Well
Dwelling
PERMIT NO.
J I=Z
= z F
Manufacturer
Material
Liquid capacity in gallons
0
J=
DISTANCE TO:
Well
Foundation
Nearest lotI'ne
i
PERMIT NO.
w
N%S-4
_
LL z
No. of lines
Length of each line
7r
Total len th of li� s
Trench width
Distance bet7en lines
f Q
, '
inches
,
.I.-
Top of the to finishJgrade
Ma erial beneath ti le
Total effective absorption ares
O
inches,
-
Length
Width
Depth
RMIT NO,
PCD
w
a H
wa
TYpe o
Crib diameter
Crib depth
Total effective absorption area
y
DISTANCE TO:
Well
Building foundation
Nearest lot line
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
W
�
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
PIPE MATERIALS
/, plc
Zt.-
SOILTESTRATING
INSTALLER
REMARKS
sr
c
,
L
/
APPROVED DATE LEGAL
,:, t- FfF,
72-013 (Rev. 3/78)
.Permit,#
Applicant
C,a 11 /,a.y
MUNICIPALITY OF ANCHORAGE
Department Health and Environment a rotection
825 L Street, Anchorage, AK. F9501���
264-4720
# # # HANDWRITTEN PERMIT
4ELL AND/OR ON-SITE SEWER PERMIT
q/J Ali FT —/f (Z- Mailing Address: /2 !z! ! ✓�Dmr�(LK �lv
Location: 4Nc46-A&i �95l5 _ Phone Number: 3�S S91a�
Legal Description:4o7-50 �/� /U /�qp(j/7'�J Lot Size: �;23S 3_S
Type of Soil Absorption System Is:
Trench: _ Lf_�'Drainfield: _ _ Seepage Bed: Holding Tank:
Maximum Number of Bedrooms: b= Soil Rating(sq.ft/br)'I
The Required Size of the Soil Absorption System Is:
DEPTH //
t 0 LENGTH /__': GRAVEL DEPTH /<- 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 _ �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
will be subject to prosecution.
by this department
Minimum distance between a well and any on-site sewage disposal system is 100 fe
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 fI 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 understand that the on-site
sewer system may require enlargement if
th residence is remodeled to
include more hat bedrooms.
Signed:
=CCtw vl/
Issued by:
A licant
Date:
SWP/024(1/81)
Ir r�p�� ST g3 — 02y
ALASKA 6T1 1R0W11TAL C011TROL SCRfcES, Inc.
Enginterinq & Enuironmental Studies
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: 1+ IJ 6•C"T E R DATE PERFORMED:
LEGAL DESCRIPTION: _t wr 36 1�m to Xk%%cr CK �TS.aEC. i -r-go .Raw s. P1.
r— SLOPE SITE LAN
1 Pt Wom 0.+9 *wgA.3%c
2
gC4M BR.3 t..c`l 50L,31)1
-4 KL 3•%SWT aiW Swr
a
s
n
7
CIM ,.00,F GkRFll 1,T-1
-� SA.+9.A yQp%lE3-
1
9 ll Iii&*/90R.
10
11
12
$rrTe-1 of
13 ? 3T
WAS GROUND WATER S 1S
ENCOUNTERED? - �b L
P l �/
IF YES, AT WHAT E
DEPTH? •'•'
/4 F�e3E
Reading
Date
Grass
Time
Net
Time
Depth to
Water
Net
Drop
%:az
o
•`t9
--
s
:32
to
.4(m
.O3
• 31, c
3 : aS
0
cs
t
o
SL
•o
0
•ss'
10
sz
o3
i31tio
3:S'�
o
•sQ
:o
o
A
o -A
'Nsa
4:1e
O
516
S6
3
14
`40.14
10
03
PERCOLATION RATE �� K •�L �(•m-inuteAl l
TEST RUN BETWEENr '•� FT AND 1 FT
COMMENTS
PERFORMED BY: RV. CERTIFIED BY: [., 7
1200 West 33rd Auenot, Suite 8 • Anchorage, Alaska 99503 • 7) 276-1361
DATE:
r
. LEc,EUp \
s/eRaba
\ J
F. H. Field Measured
`tel
o \Jo \
C�
>/ t
o .o
9R,
98
GN \
R
n 9 30
/
4
o
a
s
3
ENGINEERS. INC. oN
m
I 5. E. Corner - Sec.
.S %4 Corner Sec.! N
T II JJ., ft.3W., s. M, o T• II AJ., R 1 s. M.
Q Found B.L.. M., bra55
Found 5L.1-1BrassMon, (1950
Gap Moil, C1470�
Basis of 13ea rings
lab IJo.: 83055 p189` 4Z' E
SCALE: ccGO' a0tZiPARY SuRveY ✓ GRID: DRAWN BY: BE'.M CHECKED BY: MG
SQ S ENGINEERS, T 1 N C. ANCHORAGE, ALASKAW99502
I HEREBY CERTIFY THAT I HAVE SURVEYED THE FOLLOWING DESCRIBED PROPERTY,,,¢
LOT5 Z9 + 30, F31k. 10, Rabbi --Creek Heights ANCHORAGE RECORDING DISTRICT, AK., ��� �� 71%AND THAT THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE PROPERTY LINES ,�
AND DO NOT ENCROACH ON THE PROPERTY LYING ADJACENT THERETO. THAT NO A �,`P .�4i�A
IMPROVEMENTS ON PROPERTY LYING ADJACENT THERETO ENCROACH ON THE PREMISES ' -cc
IN QUESTION AND THAT THERE ARE NO ROADWAYS, TRANSMISSION LINES OR OTHER ...fr ka; "t
VISIBLE EASEMENTS ON SAID PROPERTY EXCEPT AS INDICATED HEREON. ••^.•••�
......r.
DATED THIS I?t^ DAY OF PEC. 1953 ANCHORAGE, ALASKA. nVAN50N '-A
2 ` R,
Vr °y,AF
• WELL LOG
Date Drilleds 3-21-84
Static slater Level to feet
Drax Down NIA feet
Type Material Drilleds
Alan Ketter
Rabbit Creek Heights Subd.
Blk. 10 Lot 30
Gallons Per Minute 7
Total Feet of Casing_ 98
0 feet to 55 feet Cemented gravel,hardpan
55 feet to 65 feet C1ay
65 feet to 84 feet Cemented Rock
84 feet t0 98 feet Rock, Gravel w/water
to
to
Hefty Drilling
S.R.A. Box 1553 H
AnchoragagAl.aska
99507
MUNICIPALITY OF ANCHORAGE
Development Services DepartmentPhone: (907)343-7904
On -Site Water & Wastewater Section Fax: (907)343-7997
Parcel ID 020 -581-54
Certificate of On -Site Systems Approval
OSC251100
Expiration Date: 3/12/2026
Legal description RABBIT CREEK VIEW HEIGHTS BLK 1 OH LT 30A
Site address 17041 JACQUELINE CIR
Current property owner(s) YANKAUSKAS WALTER E &
X The On-site system(s) is/are approved for � bedrooms )% p �/�,��Z5'
Conditional approval for bedrooms, with the following stipulations:
Comments or conditions:
No comments
By:
Original Certificate Date: 4/9/2025
This.,C4rtifici to of On -Site Systems Approval (COSA) is intended to demonstrate the subject
Otem(s) is/are in substantial compliance with municipal code. The Municipality of Anchorage,
Development Service Department (DSD) issues COSAs based upon representations provided by an
independent professional engineer. The Municipality of Anchorage is not responsible for errors or
omissions in the professional engineer's submittal.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory Arsenic Advisory
Other
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax. 907-343-7997
Certificate of On-site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 01 -z- 0 s -',l
Complete legal description Rabbit Creek View & Hights Block 1 OH Lot 30 A
Location (site address) 17041 Jaqueline Circle
Current property owner(s) Randle Lucas
-L-) Vw, ", 4/,qA5;
2. ON-SITE SYSTEMS SIZED FOR// IEDROOMS
Day phone 907-350-7820
3. TYPE OF WATER SUPPLY: X Private Well R Private Well serving 2 dwelling units
F71 Private Well serving 3+ dwelling units R Community Well or Public
R Water Storage
4. TYPE OF WASTEWATER DISPOSAL: FNI Private Septic R Private Septic serving 2 dwelling units
R Holding Tank 1771 Community Septic or Public Sewer
5. SEPTIC TANK: El Steel FN� Plastic F Concrete RN Fiberglass
Age 22 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: OR AWWTS R Bed 0 Deep Trench R Wide Trench El Seepage Pit
Waiver request for:
Expedited review requested: n
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ Waiver Fee $
Date of Payment 3 Z y ZO2S Date of Payment
COSA # C_ 5-110 C Waiver #
COSA Application—June 2022
Rabbit Creek View & Heights Block 10H Lot 30A 020-581-54
1
98
3/12/25
3/12/25
2003
3/13/25
N/A
3/12/25
0
1050
240
(907) 522-7773
Benjamin Schiller, P.E.
To: null
Page: 68 of 98
2024-08-02 19:28:16 GMT
19073086608
79
Noun ■ ■ommengoo man 0 ■ on ■o■ ■ e
no ■ ■ ■E■ on ■ ■ ■■ ■E■ ■■ 11
so an MEN so so 0 a onsmom III Miss
Advar ex® Field Maintenance Report
Annual InGnection
From: Wes Anderson
AnchorageTank
907-272-3543
Retrieve O&M Info
Daily flow,__
Recirc ratio_
Timer settings:
Perform Field Sampling/Observations
NTU (15 x NTUs)
p> 9)
D
Properly OwnerRrooking rtr
1
Operutor
A+ Home Services Tech
Walter Yankauskas
Dial tone (telemetry only)
❑ Yes ❑ No
Inspect/Clean Pump System
Inspect/Clean Discharge Pump System
Contact Phone
Site Addross
17041 Jacqueline Circle, Anchorage AK 99516
Riser/Lid LJ
(907) 345-7206
AX Sfte Ink
County ID #
Pod #
RTU #/UL #
Date of Last Inspeoflon
AX -101878
SW030216
201556
RTIJ101849
05107!2024
Retrieve O&M Info
Daily flow,__
Recirc ratio_
Timer settings:
Perform Field Sampling/Observations
NTU (15 x NTUs)
p> 9)
D
l3 7
1
(26)
Odor of Sample
Typical Musty El Earthy Moldy
Non -typical ❑ Sulfide ❑ Cabba e ❑ Decay
Oily film in PVU ❑ Yes No
Foam In tank El Yes No
Check Control Panel
Recirc Amp
Discharge Amps
11.7
I 4 I
1 6
Audible and visual alarms
❑ OK
Dial tone (telemetry only)
❑ Yes ❑ No
Inspect/Clean Pump System
Inspect/Clean Discharge Pump System
Inspect
Inspect Clean
Riser/Lid .................. ...
Splice Box ....................
Float Cords ...................
Floats ........................
Pump........................
Blotubea Filter .................
Biotube Pump Vault ............
Recirculating Splitter Valve.......
Comments
Signature
Ef
Measure Sludge/Scum
Sl.,dne
Scum
atart
Clepn
Previous
Current.
Previous
E2ndComparEtment
[GUrymnt
nent
6
Previous
Curr tont
Provious
InspecVClean Adv,-a�5n/Tex Filter
Clepn
Laterals/Orifices
IrFJ,
Odor: Normal
lel
❑ Pungent
Biomat: Normal
❑ Excessive
Bridging/Ponding: F4None/Minor
❑ Excessive
Inspect/Clean Discharge Pump System
Inspect
Riser/Lid LJ
Splice Box
Float cords
Inspect Clrrrepppa,,,n
Floats /R.._..%
Pump
Inspect/Service Other System Components
Inspect Clean Inspect Clean
Disinfection Equipment ❑ ❑ Dispersal Latemis/Orifices
Obsefvations._�g�. - ----- -
Additional Services Rendered
❑ Cleaned textile sheets? ❑ Replaced UV items?
❑ Replaced/Used other items?
Parts Used: W - Warranty, B = Billable (✓ appropriate selection)
W B item Number Description
Finall/Safety Inspection/
f J SV reinstalled IE s bolted on
anifold reconnected; flush valves closed Control panel reactivated
Summary/Recommendationsii6'System pertarming: no further action needed Ll Tank needs pumping
I -I Gall for service # i. - El Other?
8
Date
Fax completed form to 1-866-384-7404
Clepn
Laterals/Orifices
IrFJ,
IInst
Pod Bottom
Intake Vent
iz/
Inspect Clrrrepppa,,,n
Floats /R.._..%
Pump
Inspect/Service Other System Components
Inspect Clean Inspect Clean
Disinfection Equipment ❑ ❑ Dispersal Latemis/Orifices
Obsefvations._�g�. - ----- -
Additional Services Rendered
❑ Cleaned textile sheets? ❑ Replaced UV items?
❑ Replaced/Used other items?
Parts Used: W - Warranty, B = Billable (✓ appropriate selection)
W B item Number Description
Finall/Safety Inspection/
f J SV reinstalled IE s bolted on
anifold reconnected; flush valves closed Control panel reactivated
Summary/Recommendationsii6'System pertarming: no further action needed Ll Tank needs pumping
I -I Gall for service # i. - El Other?
8
Date
Fax completed form to 1-866-384-7404
ft
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
TICS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this �j Day of /a
of 20 25 , by and between
,herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY",
(AMC) 15.65.365. In con
in accordance with Anchorage Municipal Code
sideration of the mutual covenants contained herein', the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systerns. The Municipality grants permission to the
ze and operate an Advanced Wastewater Treatment System (AWWTS)I,
owner to utili
ac
descn'bed
Advantax System
located at (legal description)
Rabbit Greek Views & Heights L30A B10H
2. MaintenancLjjepairs and Alterations,,
(Owner is required to read, undersand and initial each section)
LLZM-w Throughout the term of this Agreement, the owner shall enter into a service agreement
with ars AWWTS service and, maintenance provider approved by the Municipality or the
manufacture's representative. The
AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated
accordance with the equipment's approval for operation in the Mun
It shall be the responsibility of the Owner during the term of this
r
septic effluent in
icipality.
Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $60U).
owner agrees that only mair�tenance and repair personnel approved by the Munki"pality
is representative will inspect
or the manufacture
repairs or permitted alterations to the system.
and make any necessary maintenance,
Owner acknowledges that regular maintenance of an AWWTS reduces the potential
ould include. sewage backup and costly repairs or drea*nfield
failure of the system, which c
replacement,
(rev. OS/1 S/2018) Page 1 of 3
4
D
(honer acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
Owner acknowledges that the fine for failing to maintain and repair an AWWTS ma be
PY
assessed in accordance witli AMC 14*6090304.
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS, The Municipality will give at least 24-hour notice.
owner a�r�es that an, sale or transfer of title of thepropertywill no# occur without a new
Certificate of an -Site Systems approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipafity are the govemm`g
guidelines for the construction, maintenance and repair of the owner's AWWTS.
DL-.-�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 o
Agreement shall in no way constitute a waiver of the provisions, nor in any way
the validity of the Agreement -or any pact hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
f this
affect
�. Amendment.
ihls Agreement shall only be
amended by
authorized representatives of
the Owner and
Municipality. Any attempt to
amend this
agreement bv either an
unauthorized representative or unauthorized means shall be void.
b. Jurisdiction: (:hairs 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 Alask
parties under this Agreement.
7. Severabill8tv._Any proUisions of this
WEEMM�jurisdiction sha11 not ir��a�idate the remaini�tag provisions of the Agreement.
a shall governthe rights and obl�gatians of the
Agreement decreed invalid by a court of competent
(rev. 05/18/2018)
Page 2 of 3
I
0
4b
m
■
L
I
do
OWNER:
&I
By: 0LLt^%-.Q 0
D m +rNy L Nn jer
(signature)
(print name)
STATE OF AIMMM �"�¢SN1MrZ�'✓
T
ss.
'00,0 U n�
of
Date: � I
IC i A/U-
The
foregoing instrument was acknowledged before me th
20' by 1)/NLA 1+ dF
NOTARY PUBLIC FOR--rt�49� moo* �"'
My Commission expires:
MUNICIPALITY:
BY -b
4
1
(rev. 05/18/2018)
ignature)
Date:
day of
DENNIS DING
Notary Public
State of Washington
Commission # 23007311
My Comm. Expires Mar 23, 2027
(print named Title: ' , � 4"� 1 �--
Page 3 of 3
Municipality of Anchorage
Development Services Department e`
Building Safety Division ° #
On -Site Water and Wastewater Program • __
4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 020-113-55 HAA #_ 030-37
3
1. GENERAL INFORMATION Expiration Date: I I — 0-5-- 03
Complete legal description Lot 30 Block 10 Rabbit Creek Hills
Location (site address or directions) 17041 Jacaueline Cir. Anchorage AK
Current Property owner(s) Clark & Debra Olsen Day phone 336-1515
Mailing address 17041 Jacqueline Circle Anchorage AK 99516
Lending agency Day phone
Mailing address
Real Estate Agent Kathy Fernandez/Prud Vista R E Day phone 441-9000
Mailing Address 4241 B Street. Anchorage AK 99503
Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by:
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage ❑
Community Class Well ❑
Public Water System ❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank ❑
Community On-site ❑
Public Sewer ❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to home owners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A
or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
(Rev. 11199)
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation
based on procedures outlined in the Health Authority Approval Guidelines for 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 applicable Municipal and State
codes, ordinances, and regulations in effect at the time of installation.
Name of Firm Pannone Ena. Svc. Phone 272.8218
Address P.O. Box 102954. Anch, AK 99510 /
Engineer's Printed Name Steven R. Pannone, P.E. Date ?40/0_3
Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious
-
engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The
♦♦��
reported results describe the performance of the system under the conditions encountered at the time of
4V♦�1r�
the test, and separation distances measured to readily identifiable features. The operational life of all
Ar L�,.•'
wells and septic systems depend on the local soil condition, ground water levels that may fluctuate
Al -V
during the year, and the water usage of the family being served by the system. These conditions are
outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results
..
�'
do not guarantee future performance of the system, nor do they guarantee that there are no hidden defe
or encroachments. PES can therefore not provide any warranty for future perfomtame nor give any
j Ste
estimate of how long the system will continue to meet the operational requirements of the ADEC or
♦♦♦.,
MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon
or use of this report by any other person or party is not authorized nor will it confer any legal right
whatsoever.
♦ ?�'>;
♦♦.'%
6. DSD SIGNATURE
Approved for 3 bedrooms.
Disapproved.
Conditional approval for
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
X
bedrooms, with the following stipulations:
V ®�
ON-SITE 6y;
iii�cTcrc ""
rsrvv—• rtt:
WASTEWATER
��,; ' • ...:. ° ,.ate;•.
Maintenance Agreements
Supplemental Engineer's Report
Other
By:/ Gl% !tel Original Certificate Date:
Expiration Date: Reissue Date:
(Rev. 11199)
Municipality of Anchorage
• Development Services Department =
Building Safety Division
On -Site Water and Wastewater Program -
4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 020-113-55 HAA##
Expiration Date: 03
1. GENERAL INFORMATION
30 /o
Complete legal description Lot 31ock Rabbit Creek Hts
Location (site address or directions) 17041 Jacqueline Cir., Anchorage, AK
Current Property owner(s) Clark & Debra Olsen Day phone 336-1515
Mailing address ' 1}7041y Jacqueline Circle, Anchorage, AK 99516
W26
Lending agency IS EajQn Day phone _toyy-O 7�d
Mailing address
Real Estate Agent Kathy Fernande7JPrud. Vista R. E. Day phone 441-9000
Mailing Address 4241 B Street, Anchorage, AK 99503
Unless otherwise requested, HAA will be held by DHHS for pickup. NAA picked up by:
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage ❑
Community Class Well ❑
Public Water System ❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank ❑
Community On-site ❑
Public Sewer ❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to home owners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A
or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
(Rev. 11/99)
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation
based on procedures outlined in the Health Authority Approval Guidelines for 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 applicable Municipal and State
codes, ordinances, and regulations in effect at the time of installation.
Name of Firm Pannone Eng. Svc. Phone 272-8218
Address P.O. Box 102954, Anch. AK 99510
Engineer's Printed Name Steven R. Pannone, P.E. Date
Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious
engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The
reported results describe the performance of the system under the conditions encountered at the time of i
the test, and separation distances measured to readily identifiable features. The operational life of all i
wells and septic systems depend on the local soil condition, ground water levels that may fluctuate i {V
during the year, and the water usage of the family being served by the system. These conditions are AV
AV
outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results 0
do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects
or encroachments. PES can therefore not provide any warranty for future performance nor give any
estimate of how long the system will continue to meet the operational requirements of the ADEC or
MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon 1'0d
or use of this report by any other person or party is not authorized nor will it confer any legal right It
whatsoever.
6. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
X Conditional approval for bedrooms, with the following stipulations:
At the time of title transfer, the new prnpPrry mmar shall
"gn rha ntrnrbpd
maintenance agreement which shall be returned to this office before an uncond-
itional approval is issued.
Additional Comments
M41 tK AND m
Attachments: _ PROGRAM
HAA Checklist X Maintenance AgreementiJ
Septic System AdvisorySupplemental Engineer's
rNT —
Well Flow Advisory Other"Jim, )
By: ��_�,� A 1,
Expiration Date:
(Rev. 11/99)
Original Certificate Date: :3 – – Q 3
Reissue Date:
Municipality of Anchorage
Development Services Department
Building Safety Division a
On -Site Water and Wastewater Program s, =T•
4700 South Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
3c> /o
Legal Description: Lotclock ; Rabbit Creek Heights Parcel I.D.: 020-11355
A. WELL DATA
Well type P If A, B, or C provide PWSID # _ Well Log Y
Date completed 3/21/1984 Sanitary seal Y Wires properly protected Y
Total depth 98' ft Cased to 98' ft Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test 3/21/1984 7/23/2003
Static water level 10' ft 9 ft
Well production 7.0 9 -p.m 7.0+ Artesian g.p.m
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml Nitrate 1.11 mg/I Other bacteria 2 colonies/100 ml
Date of sample: 7/23/2003 Collected by: Laura Pannone
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Anch. Tank Fiberglass
Date installed 7/7/2003 Tank size 1500 gal Number of Compartments 2
Cleanouts Y Foundation cleanout Y Depression over tank N High water alarm Y
Date of pumping n)'e_lJ Pumper
C. ABSORPTION FIELD DATA
Date installed 7/7/2003 Soil rating (g.p.d./ft2 or ft2/bdrm) 6 System type Bed
Length 10 ft Width 10 ft Gravel below pipe .5 ft
Total depth 7' ft Effective absorption area 100 fe Monitoring tube Y Depression over field N
Date of adequacy test ty� Results (Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test &kW in Water added= gal. New depth= in.
Elapsed Time: 0 min Final fluid depth = in Absorption rate >= `rjfg.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date
(Rev. 11/99)
D. LIFT STATION
Date installed 7/7/2003 Size in gallons 250 Manhole/Access Y
"Pump on" level at 44 in"Pump off' level at p 41 in High water alarm level at 46 in
Datum Bottom of Barrell Cycles tested % V ALO Meets alarm & circuit requirements? Y
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 133 On adjacent lots 100'+
Absorption field on lot 141'
Public sewer main N/A
Sewer /septic service line 50'+
On adjacent lots 100'+
Public sewer manhole/cleanout NIA
Holding tank NIA
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 52' Property line 25' Absorption field 10'
Water main N/A Water service line 251+ Surface water 100'+
Drainage 1001+ Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10' Building foundation 67' Water main N/A
Water Service line 251+ Surface water. 1001+ Driveway, parking/vehicle storage 5'
Curtain drain None Observed Wells on adjacent lots 1001+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
l certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name Steven R. Pannone, P.E.
Date
HAA Fee $ l Waiver Fee $ _
Date of Payment
C� d !1 Date of Payment
Receipt Number 13 7 O r J p Receipt Number
(Rev. 11199)
i'4r 49TH s,
9Ste Ven R. Pannone
�n'•._ No.
ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND
REPAIR AGREEMENT
MEMORANDUM OF UNDERSTANDING
BETWEEN MUNICIPALITY OF ANCHORAGE
AND����1�
THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this
day of 20t 3 , by and between r eS herein the
"OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In
consideration of the mutual covenants contained herein, the parties to this Memorandum of
Understanding agree as follows:
1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants
permission to Owner to utilize and operate an Advanced Wastewater Treatment System
(AWWTS), described as��f; = SyS�rlocated at
Anchorage, Alaska.
2. Definitions.
A. Alteration. Any change to the design or function of an AWWTS that
includes the installation or removal of any parts, components or pieces
not included in the original construction permit and design. Prior to
performing any alterations to an AWWTS the owner must obtain a
Wastewater Disposal System Construction Permit from the Municipality
pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65
B. Certificate of On -Site Systems Approval. An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with AMC
Page 1 of 5
15.65. These approvals certify that the systems are adequate for the
homes that they support and meet the codes that were in place at the time
of system construction.
C. Damage. Any man-made or natural change in a system that would
inhibit the system from performing as designed.
D. Maintenance and Repair. The scheduled and as needed replacement of
existing parts, components and pieces of an AWWTS that were included
in the original design which would allow the AWWTS to continue to
perform as designed.
E. Permit (Construction). An On -Site Wastewater Disposal System
Construction Permit as defined by AMC 15.65.
F. Permit (Operating). An Advanced Wastewater Treatment System
Operating Permit. An annual permit, issued by the Municipality, that
allows the Owner to operate an AWWTS, upon meeting all requirements
of this agreement, the conditions of the "Operating Permit, the
requirements of the On -Site Wastewater System Construction Permit
and all relevant provisions of AMC 15.65.
3. Fee. Owner shall pay to Municipality an annual fee of ZUM - 0
($.00), payable on or before the issuance of the operating permit and annually
thereafter. The annual fee is due on or before the anniversary date of the approval by the
Municipality of installed system.
Page 2 of 5
4. Term. The term of this Memorandum of Understanding shall be for the life of the
AWWTS. The term begins on the date of approval by the Municipality of the installed system
and shall continue while the AWWTS system is in use or operational or until the property is
sold or title is transferred by owner and a new certificate of on site approval is issued to the
new owner or transferee of the property.
5. Alterations, Installation and Removal of Additional Equipment. Owner agrees not
to make any alterations, removal of parts or additions to the AWWTS without a Construction
Permit from the Municipality.
6. Maintenance and Repairs.
A. Throughout the term of this Memorandum of Understanding, the Owner shall
maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner
during the term of this Memorandum of Understanding, and any extensions or renewals
thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3)
adjustment(s), (4) replacement costs, and (5) inspection costs. Further, owner agrees to
comply with all applicable ordinances, laws, regulations, rules and orders for the AWWTS.
B. Owner agrees to provide the Municipality a written schedule of routine
maintenance and repairs which have been performed on the system pursuant to the terms and
conditions contained in the Owner's AWWTS Operating Permit. This schedule shall be
submitted to the Municipality annually upon the renewal of the permit. The schedule of
maintenance and repair contained in the Owner's AWWTS Operating Permit is:
Page 3 of 5
C. Owner acknowledges that the fine schedule for failing to maintain and repair an
AWWTS are codified in AMC 14.60.
D. Owner agrees that only maintenance, repair personnel certified by the
Municipality will inspect and make any necessary maintenance, repairs or permitted
alterations to the systems.
E. Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS upon 24 hours written notice.
F. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On -Site Systems Approval.
G. Owner agrees that the relevant provisions of the standard specification
guidebook for AWWTS is the governing professional guidelines for the construction,
maintenance and repair of the Owner's AWWTS.
7. Nonwaiver. The failure of either parry at any time to enforce a provision of this
Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in
any way affect the validity of this Memorandum of Understanding or any part hereof, or the
right of such parry thereafter to enforce each and every provision hereof.
8. Amendment.
A. This Memorandum of Understanding shall only be amended, modified or
changed by a writing, executed by authorized representatives of the parties, with the same
formality as this Memorandum of Understanding was executed and such writing shall be
attached to this Memorandum of Understanding as an amendment.
Page 4 of 5
B. For the purposes of any amendment modification or change to the terms and
conditions of this contract, the only authorized representatives of the parties are:
Owner:
Anchorage: Purchasing Officer
C. Any attempt to amend, modify, or change this contract by either an
unauthorized representative or unauthorized means shall be void.
9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of
Understanding 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 Memorandum of Understanding.
10. Severability. Any provisions of this Memorandum of Understanding decreed invalid
by a court of competent jurisdiction shall not invalidate the remaining provisions of the
Memorandum of Understanding.
OWNER:
By.
Date:
STATE OF ALASKA
THIRD JUDICIAL DISTRICT
MUNICIPALITY:
By: i
Title
Date:
ss.
foregoing innsstru ent was ackr��o(w�ledged befo/W me this ay of r .1' ,, 26O-1, by
v�YheaG� t / i. Y ii-latfl ti \I \ On �. ) _ l��[il�l 11`1 on-beh4f-
OFFICIAL SEAL
STATE OF ALASKA
DEBRA L. STOUT NOTARY PUBLIC FOR ALASKA
NOTARY PUBLIC
My Comm. Expires: March 24, 2006
Page 5 of 5
MUNICIPALITY OF ANCHORAGE
• DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services o
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650 y
343-4744 t^ 6�) �p�0
9
CERTIFICATE OF HEALTH AUTHORITY u0
APPROVAL FOR A SINGLE FAMILY DWELLING �g
Parcel I.D. # AL -
1. GENERAL INFORMATION
HAA # � 0 ' :4��
Complete legal description Int 30 r orl, r Rat h; t c-,-PPK hPi ghts
Location (site address or directions) 17041 Jacqueline Circle off Clarks Road in
Bear Vallev
Property owner R_M_ Lemon & L. r,. St.Aubin
Day phone 345-487
Mailing address 17041 Jacoueline Circle, Anchorage, AK 99516
Lending agency
Mailing address.
Agent
Address
Kathi. Johnson, Jadr lhite Co.
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual well X
Community well
Public water
Day phone
Day phone 563-5500
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 X
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) F,.w MOA 021
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm Environmental
Address
206 E. Fireweq6/ Ln
Engineer's signature
6. DHHS SIGNATURE
Approved for
Disapproved.
Inc. Phone 272-9336
Anchorage, AK 99503
Date G _12-U_6
' 1 1
�......t.-...�/L%-.....
C/ 9 John- Simpson r 4�
it CE-f3C51
/ �)edrooms.
Conditional approval for
Additional Comments
bedrooms, with the following stipulations:
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 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 (lieu. 1/911 Back MOA u21
Municipality of Anchorage -1
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division
825"L" Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-474
T
Health Authority Approval Checklist <<,
s
Legal Description: Loot 30, BK 10, Rabbit Creek Heightl;Ircell.D.: <� I
A. WELL DATA
Well type Private If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N)
VA
Date completed 3/21/84
Total depth 98' Cased to
Sanitary seal (Y/N) Y
Date of test
Static water level
Well production
FROM WELL LOG
3/21/84
10' below ground
WATER SAMPLE RESULTS:
7
Casing height (above ground) 18"
Wires properly protected (Y/N) Y
AT INSPECTION
Artesian Well— see attached
document dated 5/4/95
7
9—
p.m-
Coliform 0 Col/100m1 Nitrate 0.993 mg/1 Otherbacteria 0 C01/100m1
Date of sample: 6/18/96
B. SEPTIC/HOLDING TANK DATA
Collected by: John Simpson
Date installed -j/-j,)/g4 Tank size 1000 gal Number of Compartments 2 Cleanouts (YIN) Y
Foundation cleanout (Y/N) y Depression (YIN) N High water alarm (Y/N) N
Date of Pumping 6/5/96 Pumper A+ Herne Service, Inc.
C. ABSORPTION FIELD DATA
Date installed 3/12/84 Soil ratingp.d./ Z or ft2/bdrm) 0.48 System type Trench
Length 147.5' Width 24" Gravel thickness below pipe 54„ Total depth 102"
Effective absorption area 132 7.5 Monitoring Tube present(Y/N) Y Depression over field (Y/I� N
Date of adequacy test 4/21/95 Results (Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test (in.); 12.5 Immediately after700 gal, water added (in.): 19
Fluid depth 45 Minutes later: 16.75 (in.) Absorption rate = 26479-p.d.
Peroxide treatment (past 12 months) (Y/N) N If yes, give date N/A
D. LIFT STATION N/A
Date installed
Size in gallons
Manhole/Access (Y/N) "Pump on" level at*
High water alarm level at* *Datum
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
"Pump off' level at*
Septic/holding tank on lot 104 Ft On adjacent lots 100 Ft+
Absorption field on lot III It On adjacent lots 150 Ft+
Public sewer main N/A Public sewer manhole/cleanout N/A
Sewer /septic service line N/A Lift station N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation 12 Ft Property line 38 Ft Absorption field 8 Ft
Water maintservice line N/A Surface water/drainage 100 Ft+ Wells on adjacent lots 100 Ft+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation 10 Ft Water main/service line N/A
Surface water 100 Ft+ Driveway, parking/vehicle storage area 10 Ft+
Curtain drain 50 Ft+ Wells on adjacent lots 1 1 1 Ft
Property Line 10 Ft
F. ENGINEER'S CERTIFICATION
_ off@
1 certify that! hav�etermined thru fi t5tt1e,inspections and review of Municipal re�ev'1ems are
in conformanceryrrr i OA guid lines in effect on this date. ®Gj
Signature �i . -P ,49th % Fa
John Earl Simpson
Date CE-8Cu1
HAA Fee $ (o Waiver Fee $
Date of Payment 4e11,P40%1/ ,(0 Date of Payment
Receipt Number Receipt Number
Rev. 8/95 OSS: haa.wk.doc
Location.(site addressor directions) 17041 Jacqueline Circle
off Clarks`Road in -Bear Vallev
3. TYPE OF WATER SUPPLY:
Individual well X
Community well
Public water,
NOTE: If community wellsystem,'provide v
ing to the legality and status of syst
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site,
If community wastewater system; provide written confirmation .from State ADEQ
attesting to the legality and status of system.
72-025 (Fe, 1/91) F10M MOA p l
5. : STATEMENT OF INSPECTION BY. ENGINEER _
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm Environments Mang ement Tn . % Phone 272-9336
Address 206 E. Firewe
Engineer's signature Date
Ad
,., x,r
Additional Comments
8Y << Date
cy.
4
')rhe Munii
;appioval
profesb
and`fCiei►fE
- oonduct
responsibl
only upon the representatic
red in the State of Alaska. The
for errors or omissions in the professional engineer's work.
72-025(RW..1/91) Back MOAN
Municipality of Anchorage o z
Department of Health and Human Services ✓�
HEALTH AUTHORITY APPROVAL CHECKLIST n {
ITI ® m t9
Legal Description: Lot 30 Block 10 Rabbit creek Parcel I.D. C n
Heights v,
A. Well Data C7 < $
Well type Private If A, B, or C, attach ADEC letter. ADEC water system number z
Log present (Y/N) Y Date completed 3/21/84 Driller Hefty Drilling
Total depth 98' Cased to 98' Casing height 18"
Sanitary seal (Y/N) Y Wires properly protected (YIN) Y
FROM WELL LOG AT INSP CTION
Date of test 3/21/84 *Artesj �iinelll -see attached document
Static water level 10 ft below ground 5 e P_ o boy P_
Well flow 7.0 g,p,rn•
Pump levelt Unknown
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot 104 ft.
Unknown
On adjacent lots 100 ft +
Absorption field on lot 111 ft. ; On adjacent lots 150 ft. +
Public sewer main not applicable Public sewer manhole/cleanout not aWl; abt
Sewer service line not applicable Petroleum tank none observed
WATER SAMPLE RESULTS: nr�nr�
Coliform V co t r -torts I I OOM I Nitrate O• % 7 `91L Other bacteria 0 0 0 (CS W
Date of sample: 4/21/95 Collected by: Simon Schroeder
B. SEPTIC/HOLDING TANK DATA
Date installed 3/30/84
Cleanouts (Y/N)
High water alarm (Y/N)
0
Tank size 1000 gal Compartments 2
Foundation cleanout (Y/N) Y Depression (Y/N) N
N Alarm tested (Y/N) N/A
Date of pumping 8/17/94 Pumper A+ Home Services, Inc.
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot 104 ft. On adjacent lots
100 ft +
Foundation 12 ft.
To property line 38 ft. Absorption field 8 ft. Water main/service line N/A
Surface water/drainage 100 ft. +
72-026 (3/93)' Front CONTINUED ON BACK PAGE
C. LIFT STATION N/A
Date installed
Manufacturer
Size in gallons Manhole/Access (Y/N)
Vent (Y/N) 'Pump on" level at "Pump off" Level at
High water alarm level
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot On adjacent lots
D. ABSORPTION FIELD DATA
Cycles tested
Surface water
Date installed 3/12/84 Soil rating (GPD/Ff) 0.48 System type trench
Length 147.5 ft Width 24 inches Gravel thickness 54 inches Total depth 107 inches
Total absorption area 1327.5 sf Cleanout present (Y/N) Y Depression over field (Y/N) N
Date of adequacy test 4/21/94 Results (pass/fail) Pass for 3 Bedrooms
Water level in absorption field before test 12.50 inches After test 16.75 inches
Parnririp treatment (nest 12 months) (Y/N1 N If ves. Give date N/A
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot 111 ft. On adjacent lots 100 ft. +
To building foundation
10 ft.
line 10 ft.
To existing or abandoned system on lot N/A
On adjacent lots 100 ft. + Cutbank N/A Water main/service line None observed
Surface water none observed Driveway, parking/vehicle storage area none observed
Curtain drain none observed
E. ENGINEER'S CERTIFICATION
t certify that I have checked, verified, or conformed to all MOA and HAA guidelines in
HAA Fee $
Date of Payment E �— S
Receipt Number
72-026 (3/93)• Back
Waiver Fee $
Date of Payment _
Receipt Number
John
CE-8u6l
of this inspection.
lYVlNCIVIilYI1:1Y l
TO: On-site services
RE: Residential Well located at Lot 30, Block 10, Rabbit Creek Heights
This is to certify that the residential well at the above referenced property has been
inspected and found to be artesian.
This conclusion is based upon results of an inspection on April 21, 1995. A total of
700 gallons were pumped out of the well over a period of 100 minutes with an
average flow rate of 7 g.p.m. Upon completion, the electrical power to the pump was
shut off and the pressure tank in the garage was allowed to drain. After the water was
drained out of the tank, the flow out of the water outlet was measured to be
approximately 0.5 g.p.m. This is consistent with the owners statement that the well
was artesian when they acquired it and there was a trickle out of the bleeder hose. In
1987 a packer was installed approximately 5 ft. below ground level in the well casing
to prevent water outflow from the top of the casing, this was confirmed by visual
inspection on April 21, 1995. Also a check valve was installed in the water line to
prevent unwanted flow into the water tank.
These findings represent the conditions found and observed at the site at the
particular time of the site inspection and are the result of services rendered within the
scope authorized by the client. Changes due to natural processes and human activity
will affect the conditions described herein.
ENVIRONMENTAL MANAGEMENT, INC.
LMS � v 1
E. Simps6n, P.E. Date
President
MUNICIPALITY OF ANCHORAGE 0
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information Application Date Ag &vf 20
(a) Legal Description (include lot, block, subdivision, section, township, range)
Ra6b,'f C�aeK He,�l,ts Block !O Lot 30
Location (address or directions)
VC/"nc Circ/C iinc.(ioro�P ijiar,� �!-7L/E
s9cy
(b) Applicants Name Le#e, Telephone — Home,3V 59iieness
Applicants Address Cade AnCAO .ye /} 1acKo qq )'/ 6
i
(c) Applicant is (check one) Lending Institution ; Owner/builder r
Buyer E�:j ; Other E_:J (explain);
(d) Lending Institution Telephone
Address
(e) Real Estate Co. 5 Agent
Address
Telephone
(f) Mail the HAA to the following address:
2. Type of Residence
Single—Family FLIZ Multi—Family Other (describe)
Number of Bedrooms 3
3. Water Supply
Individu<.1 Well EEj— Community E:::] Public Q
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
4. Sewage Disposal
Onsite [�Eq Public [_. ! Community =1 Holding Tank =
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
(Page 1 of 2]
Joh• jC., �(k.l<:
Cr112it f i 4 S.
5. Engineering Firm Providing Inspections, Tests, File Search, Data and Information
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 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 regula-
tions in effect on the date of this inspection.
Name of
Firm Xla5I<a Env �on�nenfa/
L-ai1r Sem r, r A,. Telephone S6/ SU yp
Address
12oo W
33 Ave.
A 4 fqe
Date
(�',OF
/98y
o
°ap
(ENGINEER
SEA'4,
..... ...r...
® �? L6roy C. Reid, Jr,
6. DHEP Approval
�� ••. No. 22 1.9
Approved
for
bedrooms By
-'Y��Cq 9�y!?%Rq " aie �
Approved
Disapproved
Conditional
Terms of
Conditional
Approval
CAUTION
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED
IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
MENTS. EMPLOYEES OF DHEP 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.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 2] 7-19-84
0 0
MUNICIPALITY OF ANCHORAGE (MOA)
MUNICIPALITY Cr �'NrHORAGE
HEALTH AUTHORITY APPROVAL (HAA) DEPT.0 &
ENYIRCPIV. 1} 16,i +dG77ECTION
CHECKLIST -FEBRUARY 1984
AUG 2 11984
A. WELL DATA
RECEIVE®
Well Classification prrvo,4t If A, B, or C, D.E.C. Approved(Y/N) A//}
Well Log Present (Y/N) i Date Ccmpleted 3 -2 1- 8 y Yield 7 GPr7
Total Depth 98 Cased to q 8 Depth of Grouting not 5-1-kd
Static Water Level 10 Pump Set At dnernt s-7
Casing Dight Above Ground I Sanitary Seal on Casing /N) Y
Electrical Wiring in Conduit f/N) Y Depression Around Wellhead (A)
Separation Distances from Well: ✓
To Septic/Holdirg Tank on Lot /o/ On Adjoining Lots A//I
To Nearest Edge of Absorption Field on Lot / 2 q' ; On Adjoining Lots NR
To Nearest Public Sewer Line NA To Nearest Public Sewer
Cleancut/Manhole NFA // To Nearest Seder Service Line on Lot NA
Water Sample Collected By Poi./ (R��d P` o ; Date
Water Sample Test Results Saf 's4�.Ctotu
Commants iijgQ,riv,�,.-..� of u£ f!f! /o�
B. SEPTIC LDING TANK DATA
Date Installed 3- Iz-sy ° Size /oo o No, of Ccapartments Z
Standpipes &N) y Air -tight Caps ) Y Foundation Cleanout
Depression over Tank (Y N Date Last Pumped M A
Pumping/Maintenance Contract on File (Y/N) NR ; for Nh
Holding Tank High -Water Alarm (Y/N) IVA Temporary Holding Tank Permit (Y/N) NA_
Separation Distances from Septic/Holding Tank:
To Water -Supply TAbll /01 To Building Foundation /3, 5
To Property Lire
Y_ 6 -'A
To Water Main/Service Line /V4
To Disposal Field /3 11 6g.E.)
To Stream, Pond, Lake, or Major Drainage
Course Nom(
Commnts i;� }o�2wu4Yc.v le✓� '-k 'i 3 it ac rc c, res l b/L7%S J
8 L{J � C) d /PC4
%�abblf C�eeK l{e.9h�'S �
[Page 1 of 21 - Go> g o Block /0
2-15-84
0
C. ABSORPTION FIELD DATA
lsea,6 , et,�'t AI kA,
Lc,( 3 o eit lu
Soils Rating in Absorption Strata 313 o'/6 Type of System Design Tamen cA-
Date Installed 3- iz -A-- Length of Field / 117-- s -
Width of Field 2y Depth of Field -Lw81,5- /Z: /kc &-
Gravel Bed Thickness S-1/1,
Square Feet of Absorption Area /3 2 7-5' Standpipes Present OL14)
Depression over Field (Y N Date of Last Adequacy Test o ivA
Results of Last Adequacy Tbst n/A
Separation Distance from Absorption Field:
To Water -Supply Wall / z 4 To Property Line
U
To Building Foundation 26'l To Existing or Abandoned System cn
Lot NA ; On Adjoining Lots /✓A
To Water Main/Service Line v,+ To Cutbank(if present) /VA
To Stream/Pond/,take/or Major Drainage Course NA
To Driveway, Parking Area, or Vehicle Storage Area /9 l
Comments �eF as -bw
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical
Comments
Manhole/Access (YA)
"Pump Off" Level at
Vent (Y/N)
Cycles during Adequacy Test. Meets MOA
*" Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, cr conformed to all MOA HAA Guidelines in effect
on the date of this inspection.
Signed Date A -f 18 /96y
CoMany 14 e C3 MOA No, :LT- oz q
KB1/d5/s
[Page 2 of 21
1 -ib -84
