HomeMy WebLinkAboutSKY RANCH ESTATES #2 BLK 1 LT 4Sky Ranch Estates
#2
Lot 4
Block I
#015-302-21
Municipality of Anchorage Page / of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVlRDNMENTAL SERVICES DIVISION
P.O. Box 196650., Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater D~sposal System and/or Well Inspection Report
Permit Number: .~I~./O001,ST~ PID Number: Ot,.,c
Name~-'/~.*O ~O Wastewater System: u New ~ Upgrade
~ZO~I ~ ~ Deep Trench D Shallow Trench ~Bed ~Mound ~Other
Total Depth from original grade:
LEGAL DESCRIPTION So,~a~.~: 1,2 ~/sq.~. /~.0
Lot: Block: Subdivision: 3epth to pipe begum [rom odginai grade: Gravel depth beneath pipe
Township: I Range: I Seclion: Fill added above original grade: Gravel length:
I
I
WELL: E~ ~ New ~ Upqrade Gravelwidth: ; Number of lines: ~Distanceb~eenlines:
Classification (Private, A.B.C): Total Depth Cased To: Total absorption area: Pipe material: ~*
I Driller: Date Drilled StaticWater Level: Installer: Date installed'
Yield: I Pump SOt at: [ Ca~,~:g Heighl Above Ground:
SEPARATION DISTANCES ~ Septic ~ Holding ~ S.T.E.P.
To Seplic Absorplioa Lift ~o[ding ~ublic/Private Manufacturer: CapaciW in gallons:
From Tank Field Slalion Tank Sewer Lines ~1 ~ ~ ~/~ ~ ~ ~ ~0
~ Material: / Number of Compartments:
Surface
Water >t~' >t~ .... LIFT STATION
Lot Size in gallons:~ Manufacturer:
r
Foundation ~ ~ ~ ~ ~ -- -- . "Pump off' level at: "Pump off" level at: ] High water alarm at:
Curtain Pump Make & Model ~ Electrical Inspections performed by:
Drain ....
- Location and Description:
Assumed Elevation:
Inspections performed by: ~{~f~ ~c~ %¢c. Dates: lsL ~/l~/oo -.., ~ ;.. [] *.: . ·
Department of Health and Human Services approval .... ~o -
PERMIT NO:
SW000159
PAGE 2 OF 2
PID NO: 015-302-21
SWING TIES:
FROM: COR. "A" COR. "B"
TO:
S.T.C.O. "D" 65' 74'
S.T.C.C. "E" 68' 77'
DBL. C.O."F" 70' 78.5'
TR. C.C. "G" 72' 76'
TR. M.T. "H" 71.5' 70'
TR. C.C. 'T' 74.5' 68'
PLAN VIEW
SCALE: 1" = 30'
NEW 32' LONG SOIL
ABSORPTION TRENCH
W. 8.0' SEWER GRAVEL
NEW 1300 GALLON
SEPTIC TANK
LOT 4
CLASS "A"
WELL
WHISPERING SPRUCE DRIVE
2" RIGID INSULA:
2' SOIL COVER
1300 GAL,
INV.
INV. SEP. TANK
92.9' 93.4'
BOTTOM OF EXCAVATION ELEV. 84.7
BOT. T.H. #2
ELEV. 78.7'
M.T. DRY 6/16/00
PROFILE VIEW
NOT TO SCALE
LOT 4, BLOCK 1, SKY RANCH ESTATES #2
SEPTIC SYSTEM UPGRADE
AS-BUILT INSPECTION REPORT
FLATTOP TECHNICAL SERVICES
14530 ECHO STREET
ANCHORAGE, ALASKA 99516
SCALE: AS NOTED
DRAWN BY TFM
JUNE, 2000
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
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jun 09, 2000
Expiration Date: Jun 09, 2001
Permit Number: SW000159
Legal Description: SKY RANCH ESTATES #2 BLK I LT 4
Design Engineer: 0019 Flattop Technical Services
Owner Name: Glenn Seaman
Owner Address: 5101 Whispering Spruce Dr. Total Bedrooms: 4
Anchorage, AK 99516-2302
ParcellD: 015-302-21
Site Address: 005101 WHISPERING SPRUCE DR
Lot Size: 16083 SQ. FT.
Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] SepticTank [] Holding Tank [] Privy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
OPT LSE
THEODORE F, MOORE, P,E. 14530 ECHO ST.
PH: (907) 345-1355 ANCHORAGE, ALASKA 99516
May 26, 2000
M.O.A. DHHS
P.O. Box 19,6650
Anchorage, AK 99519
Dear Sirs:
The purpose of this letter is to provide the required design narrative in support of our application for
a permit to upgrade the wastewater disposal facilities on Lot 4, Block 1, Sky Ranch Estates, Unit #2.
The present seepage pit is no longer able to accept the design wastewater flow. Soils logs, perc test
results, a site plan, design drawings and specifications are enclosed for your review. Since one of the
Class A community wells serving the subdivision is located on this lot, there is no site available that is
more than 200 feet from the well. Accordingly, we are simultaneously applying for a separation
distance waiver from ADEC and will provide a copy of the waiver to your office prior to picking up the
upgrade permit. Time is of the essence since sale of the property must be finalized prior to June 26.
The proposed system will be constructed in the vicinity of test hole # 2. As can be seen from the soil
log, the native material between 3' and 10' below ground level is a somewhat silty sand with a measured
perc rate of 2 minutes per inch. The overlying GP stratum has a perc rate of less than 1 minute per inch,
which will provide excellent additional absorption capability with the underlying sand serving as filter
material. Using the soil application rate of 1.2 gpd/sq, f. specified in the wastewater ordinance, this 4
bedroom residence requires a total absorption area of(4 x 150)/1.2 = 500 square feet. The proposed 32'
long trench design with 8 feet of effective gravel depth has a total absorption area of 512 square feet.
The topography of the lot in the area of the proposed trench slopes down towards the north at 5%.
The proposed project will have no significant impact on present or future water supply and
wastewater disposal systems serving adjacent properties, nor will it have any significant impact on
reserved space-surface and subsurface, or on drainage.
Please give me a call at 345-1355 if you have any questions on this submittal.
Sincerely,
Ted Moore, P.E.
' KLATT ROAD R.O.W.
CONSTRUCT 32'-LONG
SOIL ABS. TRENCH
W. 8.0' EFF. GRAVEL
T.H.
~2
10' UTILITY EASEMENT
,'~YSTEM
ABANDON
EXISTING
SEEPAGE PiT
LOT 3
ABANDON
-EXISTING
SEPTIC TANJ
WELL HOUSE FOR
COMMUNITY WELL
R 120' '
LOT 4 ,'
JNSTALL NEW 1250 GAL.
SEPTIC TANK
TOE OF SLOPE BELOW
5-FOOT HIGH RISE TO EAST
I EXI$:i-ING _
I SE'PTIC SY~'i~fiM ',
,,
LOT ~
WHISPERING SPRUCE DRIVE
L 4, B1, SKY RANCH EST. #2
SEPTIC SYSTEM UPGRADE
SITE PLAN
FLATTO? TECHNICAL SERVICES 1 INCH = 40 FEET
].4530 ECHO STREET DRAWN BY TFM
ANCHORAGE, ALASKA 99516 MAY, 2000
NOTE: THIS IS NOT A SURVEYED PLAT.
ALL LOCATIONS SHOWN ARE APPROXIMATE.
4" DIA. F-810 ~-~
PERF. PIPE ~ 32
INSTALL DBL.
C.O. ..
~/ CLEANOUT
1250~
4" DIA. D-3034 INSTALL NEW
ON-PERF. PIPE GALLON
SEPTIC TANK
CONSTRUCT 32'~LONG SOIL ABSORPTION TRENCH __
WITH 8' SEWER GRAVEL BELOW DISTRIBUTION PIPE
4"DIA. D-3034
WASTE LINE
FROM NEW
FOUNDATION C.O.
PLAN VIEW
SCALE: 1" = 10'
MONITOR TUBE
3
CLEANOUT
, SOIL COVER 12"
SECTION "A - A"
SCALE: 1" = 5'
~AL GROUND
_TER FABRIC
7 RIGID INSULATION
4" PERF. DISTRIBUTION PIPE
~_" SEWER GRAVEL
BOTTOM OF EXCAVATION
LOT 4, BLOCK 1, SKY RANCH ESTATES #2
SEPTIC SYSTEM UPGRADE
PLAN AND CROSS-SECTION
FLATTOP TECHNICAL SERVICES
14530 ECHO STREET
ANCHORAGE, AK, 99516
SCALE: AS SHOWN
DRAWN BY: TFM
MAY, 2000
q:fattop q'echnica£ Services
14550 ~,c[io Street, ~ncf~oralte, ~K 99516
~one (90?) $45-1355
Lot 4, Block 1, Sky Ranch Estates, Unit #2
5101 Whispering Spruce Drive
Wastewater disposal system installation
Specifications
1.0 General:
1.1 The scope of the project consists of abandonment of an existing steel septic tank and log crib
seepage pit and installation of a new approved 1250-gallon septic tank followed by a 32-foot long soil
absorption trench with a total of 8.5 feet of sewer gravel.
1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor
deviations from these drawings may be allowed or required by the engineer conducting the inspections.
All construction procedures and material specifications shall conform to Municipal and State
requirements. All separation distances shall be in conformance with Municipal requirements, unless
specifically waived.
1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around
any buried utilities.
1.4 The contractor shall provide adequate cover material and rough grading over all system
components to ensure that proper drainage is achieved after settlement and that there are no residual
depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas.
1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading
after the soil is compacted, as well as placement of topsoil and reseeding ail areas disturbed by the
construction.
2.0 Septic Tank:
2.1 The existing septic tank and log crib seepage pit must be properly abandoned by thoroughly
pumping, removing the tops and backfilling with soil.
2.2 The new 1250-gallon, 2-compartment septic tank shall be Municipally approved and shall be set
level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a
4" cleanout. If the tank is buried less than 4 feet, it shall be insulated with 2 inches of approved burial
type, rigid insulation. In conjunction with final grading around the new tank care shall be taken to leave
a swale on the east side of the tank allowing surface runoff`from the south to pass by the system.
2.3 All pipe connections to the tank shall be equipped with waterproof mechanical couplings. The
waste line from the residence to the septic tank shall have a minimum slope of 1/4'" per foot, and the
waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot.
A cleanout shall be installed within 4 feet of the building foundation, and a double cleanout shall be
installed within 5 feet downstream of the septic tank.
3.0 Soil absorption system:
3.1 The soil absorption system shall be constructed by excavating a 32-foot long trench to a depth of
10 feet in the area shown on the site plan.
3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked
to allow proper infiltration.
3.3 A total of 8.5 feet of approved sewer gravel shall be placed in the bottom of the excavation with
the perforated distribution pipes laid level such that the pipe inverts are no less than 8.0 feet above the
bottom of the sewer gravel. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing
the #200 sieve.
3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on
the design drawings. The portion of the monitor tube extending through the sewer gravel shall be
perforated.
3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A
minimum of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less
than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the
gravel, in addition to the filter fabric.
3.6 The top surface of the cover material shall be raised a minimum of 12 inches higher than the
surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill
slopes shall be no steeper than 3:1.
3.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have
the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and
seed to promote rapid revegetation of all areas disturbed by the construction.
4.0 Inspections:
4.1 A minimum of 4 engineering inspections will be required during the course of the project: (1)
initial stakeout with the contractor to establish the location of the system and to discuss the plans,
specifications and construction procedures, (2) after the native material has been excavated to expose the
infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test
information, (3) after the sewer gravel is in place and the distribution pipes have been laid and connected
up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough backfill and
grading is complete. The septic tank requires one inspection after it is set level and the piping
connected, but prior to backfill. This inspection may be incorporated with any of the above inspections.
4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in
advance to ensure the availability of the engineer.
TEST HOLE
LEGAL DESCRIPTION:
DATE PERFORMED:
PERFORMED FOR:
DEPTH --
(feet)
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
SOILS LOG -- PERCOLATION TEST
Lot 4, Block 1, Sky Ranch Estates, Unit
May 17, 2000
Glenn and Betty Seaman
Pt
GM fill
Pt
SM Reddish sandyloam
GP/GW Clean sandy gravel
See perc data on TH 2a
SLOPE
SP Srightly silty sand
Becomes cleaner w. depth
SITE PLAN
#1
LOT 4
12-
13
14
15
16-
17-
18-
19
20
COMMENTS:
Water seep
ML Gray silt
B.H.
Depth to Groundwater Date
Water at 13' 5/17/00
Water at 13.0' 5/24/00
o,
Crock Net Time Percometer Net Drop
Date Reading Time (minutes) Reading (inches)
5/'[7 12" Presoak
Add water & start '[ 0:37 23 3/8
Cfi 10:42 5 '[8 5 3/8
Add water 10:42:30 23 3/8
~ 10:47:30 5 '[7 3/4 5 5/8
Add water 10:48 23 3/8
#3 10:53 5 17 3/4 5 5/8
PERCOLATION RATE '[ (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN 7.25 FT AND 7.75 FT
PERFORMED BY FLATTOP TECHNICAL SERVICES. I ~"..~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ..3~'/7_~'~/' ~(::2'
TEST HOLE
LEGAL DESCRIPTION:
DATE PERFORMED:
PERFORMED FOR:
S N
DEPTH
(feat)
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
SOILS LOG -- PERCOLATION TEST
Lot 4, Block 1, Sky Ranch Estates, Unit #2
May 17, 2000
Glenn and Betty Seaman
SLOPE
Pt
SM Reddish sandy loam
GP Clean sandy gravel
SP/SM Somewhat silty sand
SITE PLAN
SM Somewhat silty sand
many large cobbies
hard digging
Depth to Groundwater Date
NO grounclwater 5/17/00
Monitor tube dry 5/24/00
0%
"" ;'~ 4'~~' BANK
Clock Net Time Percometer Net Drop
Date Reading Time (minutes) Reading (inches)
5/17 12 inch presoak 27 3/8
Resoak
Start 11:34 23 3/8
#1 11:39 5 20 3/8 3
Add water 11:39:20 23 1/2
#2 11:44:20 5 20 5/8 2 7/8
Add water 11:44:50 23 1/2
#3 11:49:50 5 20 5/8 2 7/8
COMMENTS:
PERCOLATION RATE
TEST RUN BETWEEN
See TH 2a for parc test conducted in GP stratum
2 (minutes/inch) PERC HOLE DIAMETER
5.5 FTAND 6.0 FT
PERFORMED BY FLATTOP TECHNICAL SERVICES. I '~.~ ~--.¢~_ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ._.Z'"/
lTEST HOLE #;Za I
LEGAL DESCRIPTION:
DATE PERFORMED:
PERFORMED FOR:
S N
DEPTH
(feet)
1-
2
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99515
SOILS LOG -- PERCOLATION TEST
Lot 4, Block 1, Sky Ranch Estates, Unit
May 17, 2000
Glenn and Betty Seaman
Pt
SM Reddish sandy loam
GP Clean sandy gravel
SP/SM Somewhat silty sand
SM Somewhat silty sand
many large cobbles
SLOPE
Depth to Groundwater Date
No groundwater 5/17/00
Monitor tube dry 5/24/00
o,
SITE PLAN
hard digging
Clock Net Time Percometer Net Drop
Date Reading Time (minutes) Reading (inches)
5/17 5 ~allon presoak 11:57:20 26 112
11:58:20 1 21 1/2 5
11:59:45 2:25 17 1/2 9
3 gallon resoak 12:09:50 26 1/2
12:01:50 1 22 5/8 3 7/8
12:04 3:10 17 1/2 9
PERCOLATION RATE <<1 (minutes/inch) PERC HOLE DIAMETER 8
TEST RUN BE'fVVEEN 3.0 FTAND 3.5 FT
COMMENTS: Th s o.q shows results of 2nd perc test conducted to verify that GP stratum percs at < 1 minute per inch
The GP stratum was thicker at the south end of the test hole than it was at the north end.
PERFORMED BY FLATTOP TECHNICAL SERVICES. I ~'~"~,,~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
JUN-05-~000 I~:~B
DEPT. OF ENVIRONMENTAL CONSERVATION
DIVISION OF ENVIRONMENTAL HEALTH
DRINKING WATER and WASTEWATER PROGRAM
555 CORDOVA STREET
ANCHORAGE, AK 99501
h ttp://www.state.ak.us/dec/home/htm
/
Telephone: (907) 269-7519
Fax: (907) 269-7650
P. 02
TONY KNOWLE$, GOVERNOR
June 2, 2000
Flattop Technical Services
Theodore F. Moore, P. E.
14530 Echo St.
Anchorage, Alaska 99516
Re: Sky Ranch Estates, Lower Well # 2, Waiver Request
ADEC # 5{o ~
Dear Mr. Moore:
A review of the site conditions for Sky Ranch Estates Lot 4, Block 1 has been conducted with an
upgrade to provide 140 feet of separation distance between the existing Class "A" water system
and the replacement on-site wastewater system to be reconstructed per the plan provided.
The existing on-lot wastewater system will be stabilized by removed and filling of the no longer
needed item in the old system.
A waiver of up to 146 feet is authorized for the separation distance between the on-site
wastewater system and the Class "A" drinking water well.
This approval does not imply the granting of additional authorizations nor obligate any state,
federal, or local regulatory body to grant requked authorizations.
Respectfully,
William R, Rieth, P.E.
Environmental Engineer
WRR/Ib
Enclosures: As Stared
TOTAL P.02
06/09/00 13:26 FAX 9072697650 DEC DW&WW
, ~
~002/002
DEPT. OF ENVIRONMENTAL CONSERVATION
DIVISION OF ENVIRONMENTAL HEALTH
DRINKING WATER and WASTEWATER PROGRAM
555 CORDOVA STREET
ANCHORAGE, AK 99501
http:/Iwww.state.ak.us/dee/home/htm
TONY KNOWLE$, GOVERNOR
TeLephone: (907) 269-7519
Fax: (907) 269-7650
June 9, 2000
Fla~op.TechnicalServices
Theodore F. Moore, P. E.
14530 Echo St.
Anchomge, Alaska 99516
Re: Sky Ranch Estates, Lower Well # 2, Waiver Request
ADEC # 565
Dear Mr. Moore:
A review of the site conditions for Sky Ranch Estates Lot 4, Block 1 was conducted to determine
ifa waiver could be granted. This waiver Was granted to provide a minimum of 140 feet of
separation distance between the existing Class "A" water system and the replacement on-site
wastewater system to be reconstructed per the plan provided.
The existing on-lot wastewater system that will be taken out of service must be stabilized by
removal or filling to provide a condition that will not cause a pollution or contamination
potential.
This approval does not imply the granting of additional authorizations nor obligate any state,
federal, or local regulatory body to grant required authorizations.
· WRiUIb
Enclosures: As Stated
Respectfully,
Wi!liam R. Rieth, P.E.
Environmental Engineer
QGRE
'ER ANCHORAGE AREA BO/' UGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAl. SYSTEM
NAME ~P-~ /L/OO~) MAILING ADDRESS ~F~" ~1~1
LOCATION_~j~ '~-,~^fO,/'l' (gPP ~l~CJ4 ,t~/~. LEGAL DESCRIPTION
SI=PTIC TANK:
DISTANCE /~ / ¢~. -
FROM WELL ~ MANUFACTURER.~j~:~?~'
INSIDE LENGTH INSIDE WIDTH__
NUMBER OF
COMPARTMENTS ! __
~__LIQUID DEPTH ~.LIQUID CAPACITY. /~)0 GALLONS.
SEEPAGE Pit:
NUMBER OF PITS / DIAMETER '-- OR WIDTH ~Jl LENGTH~'~-~/. DEPTH 1¢ I
LINING MATERIAL ~¢'1~¢~./~(~CRIB SIZE: DIAMETER~(~LDEPT" ~¢ DISTANCE FROM:
BUILDING FOUNDATION ~0f NEAREST LOT LINE ~ ~ TOTAL EFFECTIVE
, ~ ABSORPTION AREA (WALL AREA)
WELL ~'/i~/~O '¥-
SQ. FT.
ADDITIONAL ABSORPTION
WELL: ~~
TYPE C')0444/~1'~ ~ CONSTRUCTION
BUILDING NEAREST
FOUNDATION LOT LINE
CESSPOOL
APPROVED
OTHER SOURCES
DISAPPROVED
DEPTH DISTANCE FROM:
NEAREST SEPTIC SEEPAGE
SEWER LINE TANK SYSTEM
REMARKS
INSTAt. LED BY: ~//(2~
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
DIAGRAM OF SYSTEM
Form NO. EQ-031
DATE
APPROVED ~' C~, /'~'4'&/~--
G.A.A.B.
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PERMITNO,
INSTALLATION OF: SEPTIC TANK
SEEPAGE PIT DRAIN FIELD . THER
SOil TEST RESULTS -- _ ~ ¢ NOTE~ THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED· BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
FOUNDATION TO SEEPAGE PIT
SEPTIC TANI( TO SEEPAGE Pit WALL
Well TO SEPTIC TANK.
DRAIN FIELD ~ j
WATER MAIN TO SePTiC TA~K
SEEPAGE AREA SIZE
TYPE
DRAIN FIELD
SEEPAGE PIT ~/~) /~
· DRAIN FIEL~ ~
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION S FEET INTO UND]STURBeD SOIL.
4 INCH DIAMETER CAST IRON SIPHON P]PES ON SEPTIC TANK AND SEEPAGE PIT
PITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO, 28-6S AND THAT THE ABOVE
'E$CRI'EDSYST'MISINACCORDANCEW[THSAI, CODE.~ ~ ~ . /~_¢.~1~
Per f~ormed for
3330 "C" Street
Anchorage, Alaska 99503
SOILS LO(; PEROLATION ........
Glacier Exeavabin&.
Legal Description:
7his form reports:
Lot lt~Bl~o_cjz ~, .Skz-Ranch
Soils log
~IIEATER ANCHORAGE AREA BOROUGH
Da te Pe rfo rJilO d L')/2 0/'[~=_
Percolation ~est
E, epti~
Feo, C
4-
6-
7 -
'i J - W?o~°
,2 -
16~ BOTTOM OF TEST HOLE
(,)round water encountered? No
If yes, at whaL depth? ................
,~eadi ['J9 J Date
Gross 'fi rna
Net Time I De)th to Water j I.,et Drop
..................... .'_ZTT_-__i .......................................
Percolation rate tillnute.
P',,'opose(: installa~i-$-n-:-''~-c~-~ge Pit Yes Drain Field ......................
:)ti,tn of inlet __.. Depth to bottom oJ i)lt or tr(-~ll~l, --'""-,~ .....................
· :--, --. oF/%--~'XV,-~,',-X'-T'%ot dz, ainao'e area ;,eg~m. Jred p~;C_~o.¢q~'5).o~: ...............
,,U, ,, .~,,] S. ~,~ o,~ ...... . --. ==.:_.~ ....../ ...................
............... ...............................
PerformedDy: jaraes Mask
.,~: 040 ~G/7.l)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address
r,/3'/' ,~/4/'/ fSo,-,~ o/ ,¢.-,(40¢~,¢ Dayphone
p. 0. r~o~ /00 '7~0., /Y,o,4. /4~
Day phone
Agent 1-<~¢,% 7-o)//o~ Pr=~'~'/-~'/ ~/~/~ ¢. ~ Day phone
Address ~// "~" ~/. ~L4~ ~ ~ ~
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system,
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
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 code,';,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm f~/~/-/~,f~ 7~,z~;~-~/ _~ ~c~- Phone :~ ¢~-~ /~-~-
Address /'~/f~ ~-~o ~/¥, /¢,/,4.~/~.~_.~:~.~, ,.zC&
Engineer's signature ~;~¢-~-~ '*? ¢¢'~
~-. __ Date
DHHS SIGNATURE
__ Approved for /7/.
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DH HS does th is as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
Municipality of Anchorage JUN 2~ ~000 //~
DEPARTMENT Of HEALTH & HUMAN SERVIC~.~I¢*P^LI]'¥ o~: ^NCHO
Environmental Services Division "m~'~MENTALSEJ~¥ICES D'
825 L Street, Room 502 · Anchorage, Alaska 99501 ° (907) 343-4744
Health Authority Approval Checklist
Legal Description:
A. WELL DATA
Well type ~"[~.c_C '~/~
Log present (Y/N)
Total depth
Sanitary seal (Y/N).
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform
Date of sample:
B. SEPTIC/HOLDING TANK DATA
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed
Cased to
FROM WELL LOG
g.p.m.
Casing height (above ground)
Wires properly protected (Y/N)
AT INSPECTION
Nitrate Other bacteria
Collected by:
Date installed ~"/~0/O0 Tank size I~O~ Number of Compartments
g.p.m.
N
bedrooms
__ Cleanouts (Y/N)
High water alarm (Y/N) ~/. ,~.
Foundation cleanout (Y/N) ~' Depression (Y/N)
Date of Pumping .N.,~. (/~) Pumper --
C. ABSORPTION FIELD DATA
Date installed ~'/~o
Length ~ ~- ' Width ~-~"
Effective absorption area ~- ] 2
Date of adequacy test --
Fluid depth in absorption field before test (in.); ·
Fluid depth (ins) Minutes later:
Peroxide treatment (past 12 months) (Y/N)
Immediately after
Absorption rate = ~> ~¢,,?
If yes, give date /'-'. ~.
Soil rating (g.p.d./fF or fF/bdrm) ~ System type -/-~,~
Gravel thickness below pipe ~, o' Total depth
Monitoring Tube present (Y/N). 'r' Depression over field (Y/N)
Results (Pass/Fail) ?'~.c.r For
gal. water added (in.):
g.p.d.
72-026 (Rev. 3/96)*
D. LIFT STATION )k/. /~.
Date installed
Manhole/Access (WN)
High water alarm level at*
Cycles tested
E. SEPARATION DISTANCES
Size in gallons
"Pump on" level at*
*Datum
"Pump off" level at*
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer/septic senzice line
C/,~..~.r '~"
On adjacent lots ",> /o O '
On adjacent lots '1> I¢o'
Public sewer manhole/cleanout
Lift station /V, ,~.
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation g' ~ ' Property line 20'
Water main/service line '~.5-~ ' Sudace water/drainage "~ ./oO '
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line I1' Building foundation
Absorption field
Wells en adjacent lots
Weter main/service line "~ ~4-o,
Surface water _ ~ too,
Driveway, parking/vehicle storage area
Curtain drain /k/o,~ ~ 5' e ~','~
Wells on adjacent lots "~ /~o '
ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and review of Municipal records tl~t,~th~bo~s~,,$({~[ns are
in conformance with MOA HAA gu~dehnes /n effect on this date
Engineer's Name -7~ ~o~,~o ~ ~.. ,"'-fo 0~'-4
Date ~'~ '~1.,
HAAFee $. ~00 ~
Date of Payment__l~ /'Z--/f/_z~
Receipt Number ~ ~' ~'~ '7 (~'~JT~
72-026 (Rev. 3/96)*
Waiver Fee $ __.
Date of Payment
Receipt Number
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTj~yr'~J~r.~ALiTY OF ANCHORAGE
825 L Street. Anchorage, Alask, 99501 DEPT. OF HZALTil &
ENVIRONMENTAL P;;O [ECTION
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720 OCT 2 J 1980
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND ~E~_~.TI.~$
DIREGTIONg: Complete ~11 parts on page 1. Incomploto requests wJ[I not bo processed, Please ailow ten ~ays for processing.
~AILIN~ AP6~'[88 · · -- ~ ~ .... --
MAILING ADDRESS
5. LEGAl. DEaN
~rYPE OF RE~CE I
/[~/ [] One [] Pour [';] Other
SINGLE FAMILY [] Two [] Five
'E'9 MULTIPLE FAMILY [~ -hreo [] Six
WATER SUPPLY
¢, INDIVIDUAL" ' ATTACFI WELL LOG. A well log is required for all wells drilled
COMMUNITY since June 1975. For wells drilled prior to that date, give well
PUBLIC UTI LITY depth (attach log if available.)
S. SEWAGE DISPOSAL SYSTEM ''if individua /on-site, installation date \ ~,~&
I~] INDIVI DUAL ~ON-SITE** give . _.
If svstem is over two (2) years old an adequacy test is required
[] PUBLIC UTILITY
Dy this Department,
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
'~-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
TIMB
DATE
INSPECTOR
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME
DATE DATE
INSPECTOR INSPECTOR
DIRECTIONS:
NUMBER OF BEDBOOMS
TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
2, WATER SUPPLY
L-_3 INDIVIDUAL
[]' 'COMM~JNiTY
Lq PUBLIC UTILITY, ,.
Connection Verified
3. SEWAGE DISPOSAL SYSTEM
[]INDIVIDUAL/ON -SITE
[]PUBLIC UTILITY
Connection Verified _
[-~lSeptic Tank or [] 4old ng Tank
Size: __/~2C) if Tank is homel~a~ie
'give dimensions: _'~
rFYPE OF TANK
TOTAL ABSORPTION AREA
4, DISTANCES
WELL TO:
Absorption Area to nearest Lot Line
[] ONE [] THREE [] FIVE
[] TWO [] FOUR [~ SiX
[] OTHER
P~RMIT NUMBER
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
DATE INSTALLED
INSTAL[:E~ '
SOILS RATING ,.
MANUFACTURER
Septic/Holding Tal~k [Absorptio ]Sewer Lille
'[Nearest Lot Lin~
COMMENTS
DATE
LEGAL DESCRIPTION
¢; *PPROVED PeR BEDROOMS
Lq CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
72-010 (Rev. 3/78)
825 "L" STREET
ANCHORAGE, ALASKA 99501
(907) 264-4111
GEORGE M. SULLIVAN,
MAYOR
DEPARTMENT OF HEAL'rFI AND ENVIRONMENTAL PROTECTION
October 27, 1980
Dennis Balascio
Star Route A Box 1631-C
Anchorage, Alaska 99507
Subject: Lot 4 Block 1 Sky Ranch Estates Subdivision
Approval for your individual sewer and water facilities
cannot be granted until the following items have been
completed:
(1) The septic tank pumped with a receipt submitted
to this department.
(2)
An adequacy test be performed on the existing leaching
area. This test will determine if the system is
adequate according to National Standards. A listing
of private firms performing the test is enclosed. This
report needs to be submitted to this department for
our review.
If there are any further questions, please call this
department at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Assoclate Specialist
RCP/ljw
CC:
Alaska USA Federal Credit Union
% Kathy Hanson
Pouch 6-613 99502
Konni Snyder
% Totem Realty
724 East 15th Avenue 99501
ALASKA I FIUIROFImeFITAL COF1TROL SeRUICeS, IrlC.
~nqineePinq 6 ~nWronmental Studies
MUNICIPALITY OF ANCHORAQE
DE?T. OF I.!~All ! &
ENVIRONMEN1,A,L
NOV '1 2 1980
RECEIVED
NOtJI...HE, I..I,, :L:L
724 Iii, 15TH
AN CI-IO~:~ A[.;IE AK 995 0 ;I.
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t220 UJcst 25t1~ J~u¢~u¢ · J~nchere§¢, Alaska 99503 · (907) 276-1361