HomeMy WebLinkAboutTALUS WEST BLK 4 LT 2Talus West
Lot 2
Block 4
#015-201-40
Municipality of Anchorage Page I of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Dmposal System and/or Well Inspection Report
Permit Number: ~co'0o, 02~9,0' PID Number:
Na'"e~'o&,,) ~ D~,{, I~, ,, Ze Il Wastewater System: [] New [~ Upgrade
Address;
Phone:
~ ~S-' 70~ [No. of~droom.: ~ Deep Trench OShallowTre~ch OBed OMou,d UOther
LEGAL DESCRIPTION so.*,,~.: Total Depth from original grade:
~' ~ GPO/Sq. Ft.
Township: ~ Range: ~ Se"t on: i Fill added above original grade: Gravel length:
Number of lines: ~Distance belween lines:
WELL: ~h O New O Upgrade Sravelwidth: ~'~ Ft. ~I ~ ~t.
Classification (Private, A.B.C): Total Depth: Cased TO; Total absorption area: Pipe materiak
Driller: Date Drilled: Static Water Level: Installer: Date installed:
Yield:GPM I Pump Set at: Ft, I Casing Height Above Ground:Ft. TANK
SEPARATION DISTANCES s Septic B Holding B S,T.E.P.
To septic Absorption Lifl Holding )ubfic/Pfivate Manufacturer: Capacity in gallons:
. FrO~ Ta.~ Freld Stalion Tank Sewer..,, An cA¢¢~ye ~¢n ~ I ~X O
Well I01 ' J ~ I -- _ > ~¢ t Material:~ ~E¢ { Number of Co~artments:
Lot ~, ~ Size in gallons: ~ Manufacturer;
Foundation ~ ~' 7~,
Curtain Pump Make & Model ~ Electrical ~nspections performed by:
I
Remarks: ~ A~ ¢~'( ~ ~ BENCH MARK
~,ve~ ~ 0ooo~7 alla~
ENGINEER'S SEAL
Inspections performed by: ~be¢ %~¢~l~n~ Dates:lst 8/16{0o
Department of Health and Human Services approval
Reviewed and approved by:' ~~ ~, ~ Date:~' / 2- oO
PERMIT NO: SW000295
PID NO:
015-201-40
#1 NEW 1250 GAL.
SEPTIC TANK
o
NEW 86'-LON ,'
SOIL ABS. TR.
ABANDONED
W. 8.0' GRAVEL SEEPAGE PIT
~. ',
~" .~. ~ TBM~
PAGE 2 OF 2
SWING TIES:
FROM: COR. "A" COR. "B"
TO:
DBL. C.O. "C" 22' 53'
S.T.C.O. "D" 50' 77'
S.T.C.O. "E" 59' 84'
DBL. C.O. "F" 61' 86'
TR. C.O./M.T. "G" 72' 103'
TR. M.T. "H" 94' 101.5'
TR. C.O. "1" 102' 100.5'
WEL~
,/
PLAN VIEW
SCALE: 1" = 30'
LOT 2
BLOCK 4
FINAL
GRADE RIGID
::2'
0' GRAVEL
BOT. TR. ELEV. 81.6'
BOT. T.H. #1
, ~ ELEV. 73.6'
WATER @ 74.7'
CROSS SECTION
NOT TO SCALE
LOT 2, BLOCK 4, TALUS WEST
SEPTIC SYSTEM UPGRADE
AS-BUILT INSPECTION REPORT
FLATTOP TECHNICAL SERVICES
14530 ECHO STREET
ANCHORAGE, ALASKA 99516
SCALE: AS NOTED
DRAWN BY TFM
SEPTEMBER, 2000
MUNICIPALITY OF ANCHORA GE
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~ Aug 15, 2000
Expiration Date: Aug 15, 2001
Permit Number: SW000295
Legal Description: TALUS WEST BLK 4 LT 2
Design Engineer: 0019 Flattop Technical Services
Owner Name: John Zell
Owner Address: 11865 Wilderness Dr.
Anchorage, AK 99516-
Parcel ID: 015-201-40
Site Address: 011865 WILDERNESS DR
Lot Size: 18343 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
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.
1.) NEAREST EDGE OF ABSORPTION FIELD SHALL BE A MINIMUM OF 5 FEET TO THE NORTH LOT LINE
BETWEEN LOT 1 AND LOT 2.
CIVIL & ENVIRONMENTAL ENGINEERING * ENERGY CONSERVATION & ANALYSIS
THEODORE F. MOORE, P.E. 14530 ECHO ST.
PH: (907) 345-1355 ANCHORAGE, ALASKA 99516
August 7, 2000
M.O.A. DH/tS
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 2, Block 4, Talus West S/D, located at
11865 Wilderness Drive. St. The present system is no longer able to accept water at an adequate rate to
qualify for issuance ora HAA certificate. Soils logs, perc test results, a site plan, design drawings and
specifications are enclosed for.your review. We are also requesting a waiver allowing the new trench to
be constructed within 2 feet of the north property line common with Lot 1.
The proposed system will be constructed in the vicinity of test hole # 1. As can be seen from the soil
log, the native material between 2' and 13' below ground level is a gravelly silt with a measured perc
rate of 22 minutes per inch. Using a slightly conservative soil application rate of 0.45 gpd/sq, ft., this 4
bedroom residence requires a total absorption area of(4 x 150)/0.45 = 1333 square feet. The proposed
84-foot long trench design with an effective gravel depth of 8 feet has a total absorption area of 1344
square feet.
The lot line waiver is requested to allow maximum length of the proposed trench while avoiding the
necessity of removing a large birch tree located about 10 feet from the lot line. Because there is already
a trench on Lot 1 approximately 20 feet north of the lot line, granting of the waiver will have only a
limited impact on the ability to construct future upgrades to the wastewater disposal system on Lot 1.
The topography of the lot in the area of the proposed construction slopes gently down towards the
northwest at approximately 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.
SEPTIC
AREA
CONSTRUCT
84-FOOT LONG
SOIL ABS. TR.
WITH 8' GRAVEL
BELOW PIPE
,,
,,'
/ i/
SEPTIC
SYSTEM
100,
LOT 1
INSTALL NEW ,,'
1250 GALLON
SEPTIC TANK /
_ FDN. C.C.
LOT 3 , /., ~ /
~.~.~,.~R't00 ' /~. ~. , ),WELL', //
~ / /' i" ' 'ABANdoN EXISTING ~ /
~ // / SEPTIC TANK& -- % ) ', /
~EEPAGE PIT ~ .'~ ', /
,, ~,, ~/ ~ /
__ ~ ~ ,, ~ / % ,, BLOCK1
LOT 2 / . / ,
%' BLOCK4 _
I .-' ., ~ ~ ~ "-. OV / .~' BIOCYCLE
LOT 14
BLOCK3 ,'/
~ ~ ~~ ..'/
~..- / ~OT ~3
WELL AND SEPTIC SYSTEM
SITE PLAN
~'~ATrro? TECHNICAL SERVICES 1 INCH = 50 FEET
14530 ECHO STREET DRAWN BY TFM
ANCHORAGE, ALASKA 99516 AUGUST, 2000
NOTE: THIS IS NOTASURVEYED PLAT.
ALL LOCATIONS SHOWN ARE APPROXIMATE.
'~' 50 "A"F
84-FOOT LONG x 10-FOOT DEE ///"A"
~TION TRENCH WITH 8.0 FEET OF~ / L::
~EL BELOW DISTRIBUTION PIPE
4" DIAMETER F 810 PERF PIPE~
4" DIAMETER D-3034 NON-PERE PIP~
DBL. ~' '~-
NEW 1250 GALLON
SEPTIC TANK
PLAN VIEW
SCALE: 1" = 10'
CONSTRU
SOIL ABSORPTI
SEWER GRAVEl
MONITOR TUBE
CLEANOUT
-- 2' SOIL COVER
~IAL GROUND
FILTER FABRIC
3ID INSULATION
' DIA. F-810 PERF. PIPE
/2"- 2 1/2" SEWER GRAVEL
BOTTOM OF EXCAVATION
CROSS-SECTION "A - A"
SCALE: 1" = 5'
LOT 2, BLOCK 4, TALUS WEST S/D
SEPTIC SYSTEM UPGRADE
PLAN AND CROSS-SECTION
FLATTOP TECHNICAL SERVICES
14530 ECHO STREET
ANCHORAGE, AK, 99516
SCALE: AS SHOWN
DRAWN BY: TFM
AUGUST, 2000
q:fattop C[echnica£ Seroices
14550 q~cfio Street, j~nchorage, J~K 99516
c:pliorte (907) 345-1355
Lot 2, Block 4, Talus West S/D
11865 Wilderness Drive
Waste~vater disposal system installation
Specifications
1.0 General:
1.1 The scope of the project consists of abandonment of an existing 1250-gallon septic tank and
seepage pit and installation ora new 1250-gallon septic tank which discharges effluent into a new 84-
foot long soil absorption trench containing 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 all areas disturbed by the
construction.
2.0 Septic Tank:
2.1 The existing septic tank and seepage pit which are not to be retained in service 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.
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 5 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 an 84-foot long trench to a total
depth of 10 feet below ground level in the vicinity of test hole #1.
3.2 The bottom of the excavation shall be level. Any compacted or smeared surfaces shall be raked
to allow proper infiltration. Sand for leveling or serving as filter material shall comply with Municipal
specifications.
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 6 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: July 31, 2000
PERFORMED FOR: John Zell
DEPTH
(feet) Pt.
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
SOILS LOG -- PERCOLATION TEST
Lot 21 Block 41 Talus West S/D
SM Reddish silty sandy loam
ML Gravelly silt
Variable color and texture
Softer digging below 10', but damp
SLOPE
SITE PLAN
13
14
16
SM Gray silty sand
Damp, dense
Depth to Groundwater Date
NO free water 7/31/00
Water ¢. 17' - 6" 8/1/00
Water ¢, 16' - 9" 8/3/00
Water ¢~. 16' - 9" 8/7/00
Clock Net Time Percometer Net Drop
Date Reading Time (minutes) Reading (inches)
7/31 I2" Presoak 28
8/1 Resoak 27 3/8
Start 10:01 23 7/16
#1 10:31 30 22 1/8 1 5/16
Add water 10:31:30 23 1/2
¢Y2 11:01:30 30 22 1/8 1 3/8
Add water 11:02 23 5/8
#3 11:12 30 22 3/16 1 7/16
PERCOLATION RATE 22 (minutes/inch) PERC HOLE DIAMETER 7"
TEST RUN BETWEEN 7.0 FTAND 7.5 FT
COMMENTS: Recommend trench design be based on 0.45 gpd/sq, ff. with gravel between 2.0' and 10.0' below ground level.
PERFORMED BY FLA3q'OP TECHNICAL SERVICES. I .~*..~t/ ~¢~,.~._ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AN D MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
WR#: WR000057 Piti#: 015-20t.40
Date Received: August 9, 2000
Legal Description: Talus West, Lot2, Block 4
Engineer: Flattop Technical Services
'14530 Echo St., Anchorage, AK 99516
Applicant: John Zell~..
Waiver Requested: _/~foot lot-line waiver
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
On-Site Services
Waiver Review Worksheet
HA#:
Permit#:
Criteria: 1.
2. Special Conditions:
3. Other:
Geology
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal SeParation
Points:
Total:
Waiveris Granted:
List Conditions or Reasons for above:
Waiver is not Granted:
Rec#: 06582 Amount: $t15.00
Name of Reviewer
Date Paid: 8-9-00
George P. Wuerch,
Mayor
Mtmicipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
http://www.ci.anchorage.a~,.us
August 16, 2000
Ted Moore
Fla~op Technical Services
14530 Echo St.
Anchorage, AK 99516
Subject:
Waiver Request for Talus West, Lot2, Block 4
Waiver Request#WR000057
Parcel ID#015-201-40
SW000295
Dear Mr. Moore:
Your request for a waiver of the required 10 feet horizontal separation from the
on-site wastewater disposal system to property line has been approved. The approved
separation distance is 5.0 feet.
This waiver approval applies to the existing on-site wastewaterdisposal system to
property line separation only. Any future upfvade 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,
Daniel J. Roth
Civil Engineer
On-Site Water Quality Program
MUNICIPALITY OF ANCHORAGE
, DEx~,~{TMENT OF HEALTH AND HUMAN SER~,.ES
' ~ Environmental Health Division
825'L' ~-street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name
"¢'/. ,~,¢/¢/o ~ DISTANCES
Address · ~ SEPTIC ABSORPTION
// ~S~ ~./~. ,~~ TANK FfELD WELL
~.~sc.~.~o. LOT LINE ~ /~ ~
township. Range, Section : FOUNDATION Z '~ ~ ~
Material ~ , ¢ ! NO o¢ Compa~
~TRENCH ~ BED ~ W. DRAIN ~OTHER -- -~T ~ ~~ T~ ~
ed above o[,glnal grade Gravel ~ ~ I , ~ ~
~ PRIVATE ~ OTHER (1~ -- -- - J I J /
~ ~ F - ~
-" ~ cedily that this inspeclion was pedormed according ia all I ~Z~/
HealthDe.artmentApproval; ~ ~:~ --Date:
72-0t3 (3/85)
() :l ./.~. "1' / ci /
:L:!SA5 W:i:I..DIZFINt~;SS DF:llVi;i:
l..~::b¢.d ......! ,! !. ~
LL]T S ! 211E =
BL.(;]CI< = 4
f'c, rt.h I':¢¥ the.! !'"h..tri:i.c:ii3~:C!.it.y of' [::~r~c:i'-~cn'ag6:~ (f"-'I,'.::i¢.:~) arid Lhe:
of
nchora e
P.O, E~_~ 196650
ANCHORAGE, ALASKA 99519~6650
(907) 343-4200
TONY KNOWLES,
MAYOR
DEPARYMENT OF HEALTH & HUMAN SERVICES
July 21, 1987
Alan Wien
Alaska Environmental Control Services
1200 West 33rd Avenue, Suite B
Anchorage, Alaska 99503
Subject: Lot 2 Block 4 Talus West Subdivision
Waiver Request WR87-007A
Dear Mr. Wien:
Your request for a waiver of the separation required between
the septic tank and well on the subjedt property has been
granted. This distance has been waived to 79 feet. This
waiver supercedes the previous waiver issued for this property
on January 14, 1987.
Sincerely,
Morris
Civil Engineer
On-site Services
cc Gus Andress, P.E.
Manager, On-site and Water Quality Programs
unicip tYof
Anchorage
P.O.~DX 196650
ANCHORAGE, ALASKA 99519-6650
(907) 264-4111
TONY KNOWLES,
MA YOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
January 14,1987
Alan Wien
Engineering Technician
Alaska Environmental Control Services, Inc.
1200 West 33rd Avenue, Suite B
Anchorage, Alaska 99503
Subject: Lot 2 Block 4 Talus West Subdivision
Waiver reql/est WR87-007
Dear Mr. Wien:
Your waiver request dated January 9, 1987 for the above
mentioned parcel has been approved. The standard separation
distance of 100 feet from septic tank to well has been waived
to 87 feet.
This waiver applies only to the septic tank to be installed and
any additional future upgrade to this system will require
another waiver approval from D.H.H.S.
Si~erely,
Daniel J. Rdth
Civil Engineer
On-Site Services
ALASKA ei IFJIROF/mlZI1TAL COFITROL Sel D-r e$, IF1C.
~nqinecrin9 6 ~nuironrncnlol $1udies
January 6, 1987
Municipality of Anchorage
Department of Health and Humaa Services
825 L Street, Suite 502
Anchorage, Alaska 99501
Re: Lot 2, Block 4, Talus West Subdivision
MUNICIPALITY OF ANCHOP. AGE
bi, Pt, 01: HEALTH &
~NVIR~)NMENTAL PROTECTION
JAN 9 1987
R£C,E,I
The above referenced lot consists of a 4 bedroom home served with a private well
and ou-site sewer system. The original sewer system was installed on 0ctoher
11, 1972 for a 3 bedroom home. The absorption area was upgraded on July 24,
1978. Both systems are now being used. On September 15, 1986, an adequacy test
was performed and results show the absorption area to be adequate for 4
bedrooms. However, the existing septic tank is only 1000 gailou capacity. We
are applying for a permit to pp_g~qde the septic tank to ~_bedr~oonI capacj_ty by
adding a 500.~allon tank. The existing tank is 77 feet from the well. When it
was installed, the required sep~s-tance was ~D-l~~est that
you grant a waiver for the additional tank to be 87 feet from the well so it can
~e---~aced~-5-~twe~ existing tank and the absorption area. Placing the
additional tank outside the 100 foot radius of the well would require a lift
station to pump the effluent back up to the point of distribution to the two
separate absorption areas. The general contour of this lot slopes downward to
the west.
Any surface drainage will be away from the well. No well log is available.
Total depth, as per MW Drilling report dated September 19, 1986, is ~40 feet and
static water level is at 56 feet. Attached is a satisfactory ~ater sample taken
September 15, 1986. A curreut water sample will be submitted with the Health
Authority after the tank upgrade is complete. We feel that the additional
septic tank will not pose a threat of contamination to the well.
if you have any questions, please feel free to call.
Approved:
Sincerely, /
Alau Wien
Bagineering Technician
1200 LUesl 33rd ~ucnue. $uile [~, Anchoroqe. Alaska 99503,(907) 561-50z~0
ALASKA ENVIRONMENTAL
CONTROL SERVICES, INC.
1200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
12'
SePTIc
T~NK
7¥'
/
/
ALASKA ENVlRON~NTAL
CONTROL SERVICES, INC.
1200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
SHEETNO OF
',..~._j, MUNICIPALITY OF ANCHORAGE ~., ,,,-~
. !. ~ DEPARTMENTOFHEALTH&ENVlRONMENTALPROTECTION
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
LEGAL DESCRIPTION
LOCATION
IWell I Absorption area DwolHng PERMIT NO.
~.~Z Manufacturer ~ ~.~ ?[~.~ Mat.ri,I ,o. o, com,artm.nts
~ ~ Liq. capacity in gallons IF HOME.DE: nside I~gth Width Liquid depth
-- No, of lines ~ Length of each lin~ O Total length of lines~ ~ ~3 inches
~ Top of tile to finish grade ~l ~ t~ Material beneath tile .~ ~.~, Total effective absorptlon area
' Length Width Depth PERMIT NO.
~ ~ Type of crib Crib diameter . Crib depth Total effective absorption area
~ DISTANCE TO:
~ ~( Depth Driller Distance to Jot line PERMIT NO,
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption a~ea(s)
OTHER
SOl L TEST RATING
INSTAELER
72-013 (Rev. 3/7Bi
PERMIT NO.
RF F L I
LOC:Al' I ON
LEGRL
COI.'-!DERY EXCA'v'Fll' I NG
l±,..,b._ WILDERNESS' DR
L2 B4 THLU:, WEST S,*"D
c ' - ,~"- - - =,*-,TEM
' T't'PE QF -,GIL HB~URBTIuN
,_.J...O LK OTIS PI<WY
LOT ,= ¥ ~r=
I:,. TF~ EN ..Fl
:t,:.~, t..~. SQLIRRE FEET
MRSqlMUM NUMBER OF BEDROOMS = ~tr~ SOIL RATING
THE RET~II'rRED SIZE OF THE SOIL RE:SORPTION c ":"' c' = / '
:- . ~ /,, /t-' I ./
THE LENBTH D[MENSZON ZS THE LENOTH (ZN FEET) OF THE TR~f',ICH OR DR~ZNF'ZELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE
GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRRVEL. DEPTH I~ THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE
RND THE BOTTOM OF THE EXCAVRTION (IN FEET).
PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO I~FG~.M THI~ [:,EFRI~THENT DURING TNE
INSTALLATION INSPECTIONS OF RNY NELLS RDJRCENT TO THIS PROPERTY RND TNE
NUMBER OF' RESIDENCES THRT THE NELL. NILL SERVE.
BRCKFILLINLi OF RNY _,~'_,TEM NITHOUT FINRL IN=.FEC'IIuN RND RFPF. ~,RL E,'r TH_.-.,
DEF'RRTMENT WILL BE _,UE, JEL. T TO FR.O=,ECIJTION.
MINIMUM DISI'RNCE E:ETNEEN R WELL RND RNY ON-SITE SEHRGE DISPOSRL. SYSTEM IS
±00 FEET FOR R PRIVATE WELL; QR
150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL..
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS aND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTfLLRTION.
I CERTIFY THAT
±: I AN FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS RS SET
FORTH BY THE MUNICIPALITY OF RNCHORAGE,
2: I WILL INSTRLL THE SYSTEM IN ACCORDRNCE WITH THE CODES.
S: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE NONE THAN 4 BEDROOMS.
I bNED: ...................................................
~R~t I C:RNT C:O!,]D~ R.Y E;:*::C:RVRT I NG
GREA N£HORAGE AREA
· ~ Department of Environmental (~uality
3500 Tudor Road
~-/:, '~;Z~< ~-~ Anchorage, Alaska 99507
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ~6/~ k/3<~/lk3?TLSfZZ~'j~,q MAILING ADDRESS~-~)~f:} L~ok' /'721.:$ /:)~,.fl./l~ 'PHONE -"
LOCATION
LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE
FROM WELL
INSIDE LENGTH
NUMBER OF
'MANUFACTURERL~'td~:~'~/2~L~O' MATERIAL~/'/'¢~ /'Td°/i~ COMPARTMENTS
INSIDE WIDTH ~ LIQUID DEPTH "~ .LIQUID CAPACITY /~O~) GALLONS.
SEEPAGE PIT:
NUMBER OF PITS / DIAMETER _-- OR WIDTH~-'~,/. LENGTH -:~0. / DEPTH
LINING ~w/qTERIAL~*~t~S CRIB SIZE: DIAMETER<C' DEPTH'~0~- DISTANCE FROM: WELL /~0 /
BUILDING FOUNDATION //~/~ '/- / TOTAL EFFECTIVE
NEAREST LOT LINE //¢~.$.
ABSORPTION AREA (WALL AREA)~ Cg ~J SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE //l~'~/~/,
BUILDING
FOUNDATION
CESSPOOL /~O~U Z%
APPROVED
CONSTRUCTION /~'¢ O~i ~ 'U~
NEAREST / NEAREST
LOT LINE /L~ .¥' SEWER LINE
OTHER SOURCES ,~/d~
DEPTH{/UOT-?FT ¢',)/~?z2~/~F/)D STANCE FROM:
~ SEPTIC /.~ SEEPAGE
/8 -/' TANK L/~O SYSTEM
DISAPPROVED
· REMARKS
DISTANCES:
INSTALLED BY: '~-5'/"~ cA'O~]&~/'-
PIPE MATERIAL: ~.~T//'2-~0 ~
LOT SLOPE:
REMARKS: ,~Z]//-
Form PWo026
DIAGRAM OF SYSTEM
SEWAGE DISPOSAL SYSTEM m APPLICATION AND PERMIT
FINAL IN~4='~'~.iiON~ 24 HOUR NOTICI~ REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
SEPT C TANR
, -
-, SEEPAGE PIT _/,~' /
ALSO oO-s,DER AREA WELLS,
~ CERTIFY THAT I AM FAMIL,AR WITH THE REOUIR£~ENTS OF C';F~E:ATER ANCHORAGE ASEA BOROUGH ORDINANCE NO. 2e-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE
Municipality ,of Anchorage
Department-' ' of ·Health and ---"Human
services
,, ..,:, ' Division of Environmental Services '
_ "On-Site Services Section '825'""L-Street 'Room 502 - '
· :: .- ~,. '.. -' , .:.~ P.O. Box :196650 'Anchor,.ge, AK~ 99519-6650
,::~, -~ · ''''' rJ ;;r~:. ';:: ~¢'::. : : ' -' ;',:www. ci.anchorage:ak.us-' ' :' '
...... . ..... ' -~:~ (9071 343-4744 · %: .;.'
,.~., - .. C-- ERT F CATE OF HEALTH.AUTHORIT¥~.APRROVAb~
FoR:A SINGLE FAMILY DWELblN
Parcel I.D.
Expiration Date:
Ot~-- ~o! - ¥0
GENER,ALi,N~oRM~TiON : %'_'., ,. .
c~3mPlete,'l~j~j'd~s'cripti0fii~.:~.!'~'F:'~?'-~/ocj~- q / ~o[~ :. ~
'.' -' r. ' '.~ ~.:~ , '~' ~? '
Location (stte.addr. essor,d~rect~ons) ' Il ~ ~t/~e~r D~.,~,.,.,,~-... ......
Current Prope~y,:~wfier(~)" "~&~ ~ Pe ~ ~, e .~'~}:/['~ ::~v _ day.phOne' 7~- 7o~.
MailingaddresS~ll~ ~,l~,~w~ ~ez ~cAo~, ~ g~o /
Lending agency ~n ~o~ Day phone
Mailing address
.Rea!Esta!eAg?~' R,~-...~?!,-%!_r.~ _~.¢/*-z~,~ ?ro/~,,,'-/,'~_,- ..~_ay phone
Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by:
2:--NUMBER OF BEDROOMS: ..... /1/ ................... - -- ':
--TYPE OF WATER-SU~PL~': .......... TYPE OF WASTEWATER DISPOSAL:
Individual Well ............ [] ..... IndiVidual On-site []
..... Individual Water Storage - - [] -- - Individual Holding Tank [] ....
...... Community. Class Well [] _. _ Community On-site []
' P~fi ic water, syStem [] ...... Pu~ii(~ Se~er .
The Munici 9ality of A~chorag~ Department of Health and Human Services (DHHS) issues Certificates of
Health AuthorityApproval (HAA) based only upon the representations given in paragraph 5 by anindependent
professior~l cMl engin~e'~' registered in the' State of Alaska..c.'er~ifica~es ~f Health Autl~0~:i!y ~,ppro~,at are
requ red for the transfer of title (except between spouses) on p?~perties se.rye~ by a.~ingle !amilY on-site
wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners.
Certificates of Health Authority Approval are valid for 90 days from the date of,i~sue for properties served by
a private or Class C well and may be reissued with new water sample re~sui{s'les's ih~n 30 days 0Id. 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.
72-025 (Rev. 01/00)*
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown oe~ow, I verify that my investigation
based on arocedures outlined in tl~e Health Authority, Approval Guidelines for the Health Authority Approva
appli~atibn show that the on-site water supply and /or wastewater, disposa
system is safe, functienal and adeeuate for,the numeer of bedrooms and type of structure indicated herein
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 disposa~ system is in compliance with
all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm
Address ' /~'/.¢
Engineer's Printed Name
.... Phone
Date
~IN'EE"R;S '
6. - DHHS.SIGNATURE .... ,h.-., ,.¢ ,...~. _
r' ~ ' A, pproved for ~ bedroo,,nlS:5,-~, ...~
Disapproved.
Conditionar'approva~ for 'bedrooms, with the f ulafions.
Additi~)nal Comments
Attachments:
HAA Checklist
Sep!ic Syste. m Adx(isory
Well Flow Advisery
Maintenance Agreements
Supplemental Engineer's Report
Other
By: ~.,~,~..~ ,L'"" [.,4./. : ~,~"'~,; Original Certificate Date:
Expi~-atio'n' Date; ] ~ ~.-- - O O Beissue Date:
72-025 (Rev, 01100)*
Municipality of Anchorage R E C E I V E
Department of Health and Human Services
Division of Environmental Services SEP 0 ~' ~000
On-Site Services Section 825 "L" Street Room 502
P.O. Box 196650 Anchorage, AK 99519-6650
www.cLanchorage.ak.us MUNICIPALITY OF ANCHORAGE
(907) 343-4744 ENVIRONMENTAL SERVICES DIVISgON
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
A. WELL DATA
Well type
Date completed
Totaldepth '"~'~ t"/~- ft Casedto
FROM WELL LOG
Date of test
Static water level ft
Well production g.p.m
WATER SAMPLE RESULTS:
Coliform (') colonies/100 mi
~.. C/oc~ q/ '7~lu./ ~"eJ'½ -<-/Z) ParcelI.D.: o~_c-ao/
IfA, B, or C provide PWSID Cf __
Well Log
Wires properly protected Y'
ft Casing height (above ground) ~O in.
AT INSPECTION
7['~-t
7, */ g.p.m
V...'¢(/ 'F<cF i~y
Nitrate ~o.5- mg/I
Date of sample: ,¢{ ~ '/{o o
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material %'/-e e /
Date installed ~ { I~'1oo Tank size
Collected by:
gal Number of Compartments
/'/ . High water alarm ,v.
System type '7-,*e'~ c 4
__ Depression over field__
For /-Y' . bedrooms
Cleanouts Y Foundation cleanout~ Depression over tank
Dateofpumping Iv. A. (N~c.~) Pumper
C, ABSORPTION FIELD DATA
Date installed ,¢/id {oo Soil rating (g.p.d./ft2 or ft2/bdrm) o,
Length ,¢4¢ ft Width 'Z,$' ft Gravel below pipe ~. Oft
Total depth/¢. '7 ft Effective absorption area/-~7¢ ft2 Monitoring tube
Date of adequacy test ~./~. (_? '~-"0 Results (Pass/Fail)
Fluid depth in absorption field before test o in Water added__
Elapsed Time: min Final fluid depth in
Any rejuvenation treatment (past 12 mo.) (Y/N & type)
gal. New depth in.
Absorption rate >= ~'o0 g.p.d.
If yes, give date __
72-026 (Rev. 01/00)*
D. LIFT STATION hi./~.
Date installed
"Pump on" level at __ in
Datum
E, SEPARATION DIS'DANCES
Size in gallons .__
"Pump off" level at __
__ Cycles tested
in
Manhole/Access
High water alarm level at in
Meets alarm & circuit requirements
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lotI o / On adjacent lots '~ /o o '
Absorption field on tot 1 ~ ,' On adjacent lots --~ ~ co,
Public sewer main __ ~. ~ co ' Public sewer manhole/cleanout
Sewer/septic servk,'e line ~ ~5' Holding tank ~. A,
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation ~',¢" Property line I 7 '
Water main _ ~, 'Z~~ ' Water service line
Drainage '> ~'~' ' Wells on adjacent lots.
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line ~5-' (" ~"'~"'~'"'
~'~,'~' ) Building foundation '7~' Water main
Water Service line '~ ~-
Curtain drain .Nc, ~,~ .~r,~ ¢,-,
COMMENTS
Absorption field ~- ~o '
Surface water -> ~oo,
Surface water ~ ~o~, Driveway, parking/vehicle storage
Wells on adjacent lots '~ /oo '
G. ENGINEER'S CERTIFICATION
I 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
Date ~'¢~/-¢.~, ,/,¢¢- ~',
HAA Fee $ :~' O~ --'-
Date of Payment ~./,¢~'
Receipt Number ,¢)~//-¢ ¢ ~/~/~,~.)
Waiver Fee $
Date of Payment
Receipt Number
72-026 (Rev. 01/00)*
08-31'00 TZ:ZI
FROM-CTE [NVIROHt~NTAL 5615301 T-510 P 02/03
CT&E Environmental Services Inc,
LaboraTory Division ~~
Laboratory Analysis Report
CT& £ ReLa
Ordered By
FWd. ID
1004939001
Flanop T¢cha~cal S~,.
L2 B4, Talus West ~
L2 B4, Talus W~st S/D
Drmk~g Water
0
Sample Rem~ks-
N~r~¢-N
0 500 IJ 0.500 mgL EPA 3DO 0 10 mx 0~25/00 SCL
~lcrobiolo~y
To~ Coliform
coFl0OraL SMI8 9222B
08/24/00 JDT
200 W Potter Or,ye, Anohorage. AK 99518-1605 -- Tel: (907) 562-2343 Fax (907) 561.5301
3180 peger Roaa. Fairbanks. AK 99709-5471 -- Te~ [907) 474.8656 Fax: {907) 474-9685
08-3t-00 IZ:ZI FROM-CTE EN¥1ROH~NTAL
LaboratOry Division
Drinking Water Analysis Report for Total Coliform Bacteria
READ ~NSTRUCT~ON$ ON REVERSE SIDE BEFORE COLLECTING 8AMPLE
MuST BE COMPLETE[~ BY WATER SUPPLIER
PUBMC WATER ~iYSTEM ID~ __ -- --
'~. PRIVATE WATER SYSTEM
SAMPLE DATE. ~_,._~._ ~-- "~ {:~ ~? ;
SAMPLE TYPE
~. Routine
Repeat Sample
{refer to lab noc~
_ Special Purpose*
MMO-MUG Result;
Treama Water
~ Un~reated Water
2o0w PoAer D.ve
Anchorage, AK 99518-1605
Tel (907)562.2343
Fax' (907~ 56%5301
TO BE COMPLETED BY LABORATORY
MMO-MuG
~ ~n Ref .No.
sen[ to ADEC' ANC FBI<. JUN
~..~-/5'~ 'T/= ~ Date
BACTERIOLOGICAl- WATER AN~YSI$ RECORD
Colome$1100ml
COLIFORM
Client notified of unsatisfactory results:
~ ,"" 'M-W DRILLIN'd INC.
DATE
ANCHORAGE, ALASKA 99511 QTY. MATER~^LS PRICE AMOUNT
PHONE 349'8535
DESCRIPTION Of WORK
Al~ charges shall be paid in full within ten
days un/ess other arrangements are made
prior to drilling. The customer shall pay in*
retest at the rate of 1 ~ % per month on any
amount not paid within ten days. Failure to
pay may result in a lien against the property.
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'L
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 regulations in effect on
the date of this inspection.
NameofFirm A.E.C.S. r Inc. Telephone 561-5040
Address 1200 West 33 Avenue, Suite B, Anchorage 99503
Date
Engineer's Seal
This department has received written confirmation from the engineer
regarding the Conditional Approval of February 20, 1987.
The corrections have been accomplished and an inspection has been
completed by the engineer. The subject ~roperty meets with Municipal
standards and is now approved. A copy o~ the inspection report is
attached for your convenience.
DHHS APPROVAL
Approved for four ( 4 ) bedrooms by .~"/~ ~..<3~ "~.~..._¢.~ Date
ApprovedXXXXXXXXXX Disapproved Conditional
July 17, 1987
Terms of Conditional Approval
CAUTION
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
certificates based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in
order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data
before a certificate is, issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional
engineer's work.
Page 2 of 2 72-025 IRev 8/86) Back
L~.? MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date ~
1. GENERAL INFORMATION
(a)
(b)
(c)
Legal Description (include lot, block, subdivision, section, township, range)
i~q L2 T~,Ld.S odE. S1' T!2~I R~ ~) .5£c, 22
Location (address or d~recb0ns)
Applicant Na~e~ ~"~'
%elephone: Home Business
Applicant is (check one): I'e~ding Institution []; Owner/builder~*; Buyer []; Other [] (explain);
Address
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family~L Multi-Family
Number of Bedrooms
Other
WATER SUPPLY
Individual Well'~ Community [] Public []
Note: Jf community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsite~,, Public [] Community [] Holding Tank []
Note: If corn munity well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page I of 2 72-025 (11/84}
' ? '
~-NGINEERING FIRM PROVIDI~iNSPECTIONS, TESTS, FILE SEARCH, D~[')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 regulations in effect on
the date of this inspection. !
Name of Firm ,/'~-~'~ Telephone ~-¢~/-.5'~
Address ./~'¢~ '¢~ '~'~:~' -~/~'~' ~ '/~/ '/~/'~ ¢%>"~'~
DHEP APPROVAL
Approved for ,~-'-~-~/¢'~ bedrooms
~ ~pprcv~
Terms of Conditional Approval ~z~/~
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations 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 requirements. 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.
Page 2 of 2
72-025 (1 ~/84)
.,.~O~.~G ,~I~NICIPALITY OF ANCHORAGE (MOA)
¢3Y ; LTH UTHOmTV P .OWL
~O~O~-~Ng5~ CHECKLIST - FEBRUARY 1984
~' "~ ~ 264-4720
Legal Description:
WELL DATA
Well Classification
?/~
Well Log Present (Y~I})
Total Depth /~/0 '~tt~
Static Water Level
~)U/~'/~~ If A, B, C, D.E.C. Approved {Y/N)
Date Completed ~'A'~'"/¢'~o~ Yield
Depth of Grouting
Pump Set At
Sanitary Seal on CasingON)
Depression Around Wellhead (Y~
Casing Height Above Ground
Electrical Wiring in ConduitS'N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
Cased to /¢0 / ~
¢~' 1 _(~--~ ; On Adjoining Lots /d~/¢'-
//crc / ; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
; Date
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line Cleanout/Manhole
Water Sample Collected by '~'~'P-~
Water Sample Test Results
SEPTIC/HOLDING TANK DATA
Date Installed I0/~/7:~ Size fO00 No. of Compartments
Standpipes i~N) Air-tight Caps (~/N) Foundation Cleanout (Y/~
Depression over Tank (Y/I~ Date Last Pumped
Pumping/Maintenance Contract on File (Y/N) fC/A ;for
Holding Tank High-Water Alarm (Y/N) ¢~/'//~ Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well 77'
TO Property Line '1',~1 11'
To Water Main/Service Line
Course I O0 /
Comments (~ /,d/~'/Y~"~
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Page 1 of 2
72-026(11/841
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata ~,..~ ~ Type of System Design
Date Installed 7/~/~ IO//~/~ C~li~ Length of Field .'~n '~'~
Width of Field ~/rR~c~¢ 25/c~6 Depth of Field
Gravel ~ed Thickness
Square Feet of Absorption Area ~0 ~REN~P+660 ~1~ -~tandpipes Present ~N)
Depression over Field (Y~ Date of Last Adequacy Test
Results of Last Adeq,acy Test ~ ¢ 'r/~ ¢ ~C
Separation Distance from Absorption Field:
To Water-Supply Well I ~O /
TO Building Foundation
LOt
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
To Property Line /.~. /
To Existing or Abandoned System on
; On Adjoining Lots /~.~.
To Cutbank (if present)
/00
Comments
D. LIFT STATION
Date Installed
Size ia Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Comments
Dimensions /
Manhole/Access (Y/N)~_ /
· /,/I "Pump Off~--L v'~'~el~t ___
A/ /,~/' .--*""~Ven, (Y/N, _ __ :
/,,~¢.~/ Pumping Cycles during Adequacy Test. Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I hav. e.6hqcked, varified.or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed 0-~/-~ ~L~.~.'~ Date
Company MOA No.
Receipt No. /~ / ¢ 0 ~ ~
Page 2 of 2 ~ ~
72-026 (11/84)
ALASKA E: IROnmeFITAL CONTROL SeRtJ-F eS, Inc.
~ngin~rin~ $ ~nuironmentol $Iudie*
SHEL RENSLEY
i2] WEST FIREWEEB LANE
SUITE 208
AYCHORAGE ALASKA 99503
SELLER-TRAPP
o2/ia/sv
SIIEL HENSLEY
12] WEST FiREWEED LANE
SUITE 208
ANCHORAGE ALASKA 99503
60~92
LEGAL:TALUS WEST SUBDIVISION LOT 2 BLOCK 4
ADEQUACY TEST FOR SEWER SYSmEM
ADEQUACY TEST DATE-9/15/86
THE TYPE OF ABSORPTION SVSTEM IS A CRiB ~ ~ WITH OF
........ REN~,r~ AN AREA ]020 SQET.
THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY,
THE SURGE CAPACITY OF THE SYSTEM IS 938 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
4 BEDROOM HOME.
SEPTIC TANK ADEQUACY
TIIE EXISTING SEPTIC TANK VOLUME 0 IS ADEQUATE 'FOR
THiS 4 BEI)ROOM HOUSE,
THE SEPTIC TANK/PACXAGE PLANT WAS PUXPED ON 9/~6/S6
THIS REPORT DOES NOT VERTFY THE INTEGRITY OF THE PIPING FOR THE WATER
SUPPLY OR WASTEWATER SYSTEX.
FLOW TEST ON WELL
WEEL FLOW DATE 9/15/86
A FLOW TEST WAS PERFORMED ON THE WELI,, 938
PUMPED AT A RATE OF 7,2i5 GPM OVER A DURATTON OF
THE DRAWDOWN WAS 7.7 ' WITH A RECOVERY TIME OE 10
AND THE STATIC WATER LEVEl, WAS 58.i FEET.
THE WELL IS ADEQUATE FOIl THIS 4 BEDROOM HOME.
GALLONS OF WATER WAS
2,35 HOURS,
MINUTES
1200 ~esl 33rd Auenue. $ui1¢ B oAnchore§c, Alasko 99503,(907) 501-50a0
;'?J27 OLD SEWARD HIGHWAY ' ~ - ,
ANCHORAGE, ALASKA 99518
(907)344-8551
~CTERIOL~IC~L ~TER ANALYSIS
TO BE C~LETED BY ~TER SUPPLIER
FOR ~B USE ONLY
~TE COLLECTED TIHE COLLECTED TYPE OF SYSTE~
~NTH ~Y
Y~R
,~- ~ ~ ~"~Au~ ~ PUBLIC.INDIVIDUAL ~ RESUBMIT SAHPLE
I.D. NO. (PUBLIC SYSTEHS) CTRCLE CLASS Sample rejected because:
~~ CHECK ONE OR ~RE
~. I ~ ~ ~ ~, ~ A B C ~ Sample too long in transit,
NAME OF SYSTEM TELEPHONE NUMBER~
SYSTEM ADDRESS ~ Sample received too late in week
~Not In proper container
~ Leaked out
CITY STATE Z~P CODE ~ Insufficient info~ation provided.
Please read instructions on form.
LOCATION WHERE SAMPLE WAS COLLECTED
Other
(Specify)
~ RECEIVED FROM ~
~YPE OF SAMPLE RECFIVEU BY ]<~ (
(CHECK ONLY ONE THIS COLUMN) DATE ~/~/~2 TIME ~'~
~DRINKING WATER ~CHLORINATED ANALYTICAL METHOD:
~CHECK TREATMENT ~FILTERED~ME~MBRANE
~UNTREATED OR OTHER
FILTER
~ ~W SOURCE WATER ~FERMENTATIO~; TUBE
.Ew CO.S ROCTXO. On R ,A RS
~ OTHER(Specify) Date & Time Started ~/~/~
IS THIS SAMPLE A CHECK SAMPLE TO A PREVIOUS NON-CONFORMINC SAMPLE? Date & Time Completed
~YES ~NO PREVIOUS COLLECTION DATE
ANALYSIS REQUESTED (IF OTHER THAN TOTAL COLIFORM) ~BO~OR~,,RESULTS
SEND REPORT TO:{PRINT FU~L ~AME,AODRESS AND ZIP CODE ~ Other Bacteria
NAME ~ ~ ~ Test unsuitable because:
- ~ Confluent Growth
CITY ~ STATE ~ ZIP ~Y ~TISFACTORY ~/' ~SATISFACTORY
~CTERIOL~ICAL ~TER ANALYSIS RECORD
FOR LAB USE ONLY
TOTAL COLIFO~S Membrane Filter: Direct Count .... ~ '"~ Coliform/lOOml
Verification: LTB BGB
~CAL COLIFO~ Fina) ~mbrane Filter Results Colifo~/lOOml
~ O~R Repo~ted By Date
Tlm~ A.M.
'
MUNICIPALITY OF ANCHORAGE .
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 L Street - Anchorage, Alaska 99501
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720 I _. ~ -
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND sEwER ~,AC.,~L-IFT~~-
DIRECTIONS: Complete all parts on page 1. Incomplete requests wild/not be processed, Please allow ten (10] ~s for processing.
PROPERTY OWNER
John W. Miller
MAI LING ADDRESS
11865 Wilderness Drive
PROPERTY RESIDENT (If different from above)
2. BUYER
John L./Sharon
MAILING ADDRESS
Post Offic,
Ala
3. LENDING INSTITUT
MAILING ADDRESS
640 West 99503
4. REALTOR/AGENT
Bob Baer,
MAILING ADDRESS
724 East 15th renue 995
5. LEGAL DESCRIPTION
Lot 2 Block 4 Talus West Sub
TREET LOCATION
11865 Wilderness Drive
PHONE
PHONE
PHONE
486-4541
PHONE
272-4581
PHONE
272-0571
S. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One ~ Four [] Other
~ SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY P~i Three [] Six '~
7. WATER SUPPLY
INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY
* ATTACH WELL LOG. A well log is required for all wells ~'riiled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
:~ INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
**If individual/on-site, give installation date Approx, 1.973
If system is over two (2) years old an adequacy test is required
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED,
72 010(3/78)
THIS SIDE FOR OFFICIAL USE ONL
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE
DATE
DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
NUMBER OF BEDROOMS
1, TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
2. WATER SUPPLY
INDIVIDUAL
[] COMMUNITY
[] PUBLIC UTILITY
Connection Verified
3. SEWAGE DISPOSAL SYSTEM
E~} IN DIVIDUAL/ON -SITE
[]PUBLIC UTILITY
Connection Verifi0d
[] Septic Tank et L~] Holding Tank
Size: If Tank is homemade
give dimensions:
[] ONE ~/ THREE E~] FIVE
[] TWO [] FOUR [] SIX
PERMIT NUMBER
DEPTH OF WELl_
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
DATEINSTALLEO
INSTALLER
SOILS RATING
TYPEOFTANK MANUFACTURER
TOTAL ABSORPTION AREA
4. DISTANCES
: WELL TO:
Absomtion Area to nearest Lot Line
MATERIAL
Septic/Holding Tank
Absorption Area
[] OTHER
5. COMMENTS
[~}'/APPR OV ED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI~r- --- ~
825 L Street - Anchorage, Alaska 99501
ENV,RO.MENTAL ENG'NE R'NG D'V'S'ON
Telephone 264-4720 ~-~
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
PHONE
~. PROPERTY OWNER
MAILING ADDRESS
PROPERTY RESIDENT (If different from above)
4.~TO R/AG ENT
MAILING ADDRESS~
[] Other
5.-~ LEGAL DESCRIPTION
'REFT LOCATION ~
TYPE OF RESIDENCE [] One [] Four
,.~'"'"' SI N G L E FAMILY [] Two [] Five
[] MULTIPLE FAMILY ~ Three [] Six ~
7. WATER SUPPLY
~"~INDIVIDUAL* * ATTACH WELL LOG. A well Icg is required for all wells drilled
[~ COMMUNITY since june 1975, For wells drilled prior to that date, give well
[] PUBLIC UTI LITY depth (attach icg if available,) ~
8.-~EWAGE DISPOSAL SYSTEM **lfindividual/on-site, give installation dat~-'~ /~':~-'
~INDIVIDUAL/ON-SiTE** if system is over two (2) years old an adequacy test is required
[] PUBLIC UTI LITY by this Department. ~
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
~2-010(3/78)
_ Tills SIDE FOR OFFICIAL USE ONL.
INSPECTION APPOINTMENTS
TIME iTiME TIME
DATE -- DATE ------ DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE t NUMBER OF BEDROOMB
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
2, WATER SUPPLY PERMIT NUMBER
[] INDIVIDUAl_ DEPTH OF WELL
[] COMMUNITY
DAT~DRILLED
[] PUBLIC UTI LITY
Connection Verified LOG RECEIVED
3, SEWAGE DISPOSAL SYSTEM PER~IT NUMBER
~INDIVIDUAL/ON -S~TE
~PUBLIC UTILITY
Connection Verified ~
INSTALLER
~Septic Tank or ~Hord ng Tank
Size:~ ~ If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTA~ ABSORPTION AREA MATERIAL
4, D~STAN'CES Sept[~)FIo~ing Tank AbsorptiOn Area Sewer Linc Nearest Lot Line
5, COMMENTS
~ APPROVED FOR ~ BEDROOMS
~ CONDITIONAL APPROVAL (~etter must accompanv certificate)
~ DISAPPROVED
DATE ~Y (Title)
LEGAL DESCRIPTION
72-010 (Rev, 3/78)
Florence ~ .~' 0 LL-_.~.,I J.
FFifth ~!ooz~ M Sewer ~nd Water
MESSAGE
Another refund: This one was, also, done during the strike by an
encjineer. Pleaee make the arrangements for a refUn~o
Thank you muchly:
Receipt $47751 Totem Realty
724 East 15th Avenue 99501
% Linda
REPLY
P~eclif~orm® 4S 471
SEND PARTS 1 AND $ WITH CARBON INTACT -
PART 3 WILL BE RETURNED WITH REPLY.
' L~'~mqUNICIPALITY OF ANCHORAG-~
· ~ i Department of Health and Environmental Protection
((~,~_~11i 825 L Street, Anchorage, Alaska 99501
"-, ~ 264-4720
-~.equest ~.or Approval of Individual Sewer and Water Facilities
1. Property Owner: John W. ~[iller
Mailing Address: 11865 Wilderness Drive'
Phone: n/a
Name of Buyer: John L. ~ Sharon V. Trapp
Mailing Address: P- O. Box 825 Kodiak, AK. 9961S Phone: 486-4541
Lending Institution: ABM Escrow
Mailing Address: 640 W. 36th Ave.
Phone: 272-4581
Realtor/Agent: Bob Baer (agent of Seller) Totem Realty, .Inc.
Mailing Address: 724 E. 1Sth Avenue
Phone: 272-0571
5o
Legal Description: Lot 2, Block 4, Talus West Subdivision
Street Location: 1186S Wilderness Drive
Single Family Residence: (~ Number of Bedrooms:
Multiple Family Residence: ( ) Number of Bedrooms:
Water Supply: *Individual Well (~
if individual Well, well depth
If Community System, name of system
Public/Community System ( )
Sewage Disposal System: **On-site System (x) Public System (
If On-site System, date of installation: approx. 1973
*NOTE: A well log is required on ALL wells drilled since 6/75.
** If on-site sewer system is over two(2) years old, an adequacy
test is required by this department.
A fee of $25.00 must accompany each request before processing
can be initiated.
3/77
"ONE TEST I$ WORTH A THOUSAND OPINIONS"
2204 CLEVELAND AVENUE · ANCHORAGE, ALASKA 99503 · Z77-O231
June 2, 1978
Department of Health & Environmental
825 L Street
Anchorage, Alaska 99501
Protection
Attention: Rolf Strickland
RE : Inspection of On-site Water and Sewer System for
Lot 2 Block 4 Talus West Subdivision
Dear Rolf,
On May 31, 1978 I inspected the water system at the referenced
location by verifying that the well casing extended a minimum
of 1' above grade and sloped away from this location. On that
date a water sample was taken and submitted to the Alaska
Department of Health and Social Services for bacteriological
analysis.
On June 1 and June 2, 1978 a percolation test was conducted on
the existing seepage pit. At the time water was introduced
on June 1 the crib would accept only 500 gallons of water. The
results of the test are shown below. The septic tank was pumped.
Date Time Water Level (from bottom)Comment
6-1-78 10:15A.M. 28" Before filling
6-1-78 10:20A.M. 70" After filling
6-2-78 10:20A.M. 46" After 24 hours
The results of the test indicate:
1. Capacity of crib 11.9 gallons per inch
2. Drop over 24 hours is 24 inches
3. Volume drop over 24 hours is 285 gallons
4. The crib is "storing" more than the volume of the
4' diameter rings indicated as installed, but something
is probably obstructing free flow to the seepage area.
-2-
The results of the bacteriological analysis are to be
completed. If you have any questions please call.
Very truly yours,
CONSTRUCTION TEST LAB
Neal Hausam, P.E., L.S.
NH/ja
cc: Linda Hoeger, Totem Realty
Enc: Copy of GAAB Inspection Report
GREATER ANCHORAGE AREA BOROUGH
Department of Environment
~U~/C~/~treet, Anchorage, Alaska 99503 274-4561
3330 "C" al Quality
~ '~ Received June 29, 1976
0/~' ~ ' Time of Inspection 2:30 p.m.
~ ~ Date of Inspection
REQUEST FOR APPROVAL OF Thurs.
INDIVIDUAL SEWER & NATER FACILITIES
FOR
V.A.
4.
5.
6.
Approval requested by: Security Pacific Mortgage Corporation
Mailing Address: 319 West 5th Avenue Phone: 272 9501
Property Owner: Robert J. Dickson Phone:
Mailing Address: .Contact: new owners John W. Miller 349-5226
Legal Description: Lot 2 Block 4 Talus West
Location:
NHN Wilderness Lane
Type of facility to be inspected ..Single Family No. of bedrooms -~'"~'~
Well Data: Individual
A. Type p~/~. B. Depth
C. Construction D. Bacterial Analysis
Sewage Disposal e system
A. Installed 1974
C. Septic Tank: 1. Size
D. Seepage Pit: 1. Absorption Area
E. Disposal Field: Tota~l length of lines
Distances:
B. Installer
2. Manufacturer
2. Material
A. Well to: Septic tank
Nearest lot line
B. Foundation to septic tank
· Absorption area
Other contamination
Sewer Lines
, Absorption area
C. Absorption area to nearest lot line
~"=~EQ - 034 (l/74)
Page 1 of two Daom~
Page 2 of two pages - Re~
~egal Description Lot
~t for ADDroval of Individual S ,r & Water Facilities
2 Block 4 Talus West
pproved ~-~/~ Disapproved Date
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
Date
EQ-034 (1/74)
OF ANCHORAGEGR~ZATE;~ ANCHORAGE ARL; BOROUGP
B(partment of Environmental Quality
St.~ Anchorage, Alaska 99503 274-4561
JUN 2 9 1976
DATE: June 25,
FACILITIES
L~, I,.. ~ '- ~ -- '"' -
1976
.lype or inspection: bMJ,O
Property Owner: Robert J. Dickson
VA xx FHA CONV
Mailing Address: NHN Wilderness Drive
Nam.~.,~of Buyer: John W. Miller
Da..¥ Phone contact realtor
Mailing Address: 1835 So. B~agraw Anchoysge _zD._~y Phone e65 8383
Name of Lending Inst'itut~on: Security Pacific Mortgage Corp
Mailing Address: 319 West 5th Ave Anchorage Phone 272 9501
Name of Realtor or Agent: Admiral Realty (Sammye Seawell)
Mailing Address: 939 W 5th Anchorage ~hone 279 8586
Legal Description:
Location:
Lot 2 Block 4 Talus West s/d
NHN Wilderness Lane Anchora~ge Alaska 99507
o
Type of Facility to be 'inspected:
Water S'upply
Type of Supply: Public Utility
If Individual, number of dwellings
If Individual, depth of well unk
Sewage Disposal-System
Type ~o'f System: Public Utility
If Individual, date of installation
sf residence NO. Bdrms. 4
Individual xx
~resentiy served i
Individual (on-site)
1974
***PLEASE SEND REPORTS TO:
SecurifV Pacific Morfgage CorporMJon
319 WEST 5TH AVENUE
ANCI{ORAGE, ALASKA
Sincerely yours,
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3500 Tudor Road, Anchorage· Alaska 99507 279-8686
Date Received , q
Time of Inspection
Date of Inspection
RHQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
1. Approval Requested By:,/ z }
Address: ~ ~ ;~-/ Cc.~.. -::~'t.: ~.'/ ,: ~L~/~ Phone~ ~-'7 ~-' ? ::' :::~ .:;:'
5. Type of F~c]lity to be Inspectgd:__~, ~, . ~~__,
6. Well Data:
C. C, onstruction ~
7..Sewage Dts.6osal System:
B. Depth ,,/~0
D, 'Bacterial Analysis
-B. Installer
C. -Septic Tank: 1. Size ,/o-~ 2. Manufacturer- ~,~_~z~ ,-~Y
D. oeepage. ~A-Pit: '1., . ,Size 2. Material~
E. Disposal Fiel'd: Total. ~ength of Lines
Distances:
A. Well To: Septic Tan~ b'7~ , Absorption Area /~-z~ , Sewer Lines
· Nearest Lot Line
B. Foundation to Septic Tank
· Other Contamination
Ab'§orption Area
C. Absorption Area to Nearest Lot Line
Reque.~t for Approval of I~ idual Sewer & Water Facflitie
I~age Two ~
9. Comments:
.~:~D~sapproved Date _S~/m
Approval Valid for One Year From Date Signed
Greater Anchorage Area Borough, DeDartment of ~nvironmental Quality
DIAGRA~ OF SYSTEM
I certify that the information contained in this request far approval to be a true
and accurate representation of the subject sawer and water facilities located at:
Signed, Date