HomeMy WebLinkAboutTRAILS END BLK 1 LT 3 P-604Trails End
Lot 3 P-604
#015-191-12
Municipality of Anchorege Page 1 of.
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Aleska 99519-6650 Telephone: 545-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SW000208 PID Number; 01 5-- 191 -- 12
Nome:DAVID BOGARD Wastewater System: [] New · Upgrade
Address:
8281 LONGHORN STREET ABSORPTION FIELD
No. of Bedrooms:
Ph°ne:(907) 346-3689 3 nDaep Trench OShallow Trench BBed OMound BOther*
LEGAL DESCRIPTION 2 GPD/S.. ~ 5' MAX. FL
- - - 0- 1,4
WELL: [] New [] Upgrade~,,/'/ or~,.~ w[6~: 1 2 F~ Number of 6 lines: Oi~t<3nce ~tween linea:FL
~. A+ HOME SERVICES 7/10/00 - 7/11/00
FL FL TANK
SEPARATION DISTANCES D Septic [] Holding · $.T.E.P.
From Tank Reid Station Tank Se~.r U... ANCHORAGE TANK 1250
Well 100'+ 100' 100'+ -- 25'+ STEEL 2
su~oc~ lOO'+ lOO'+ lOO'+ - - LIFT STATION
Water
Line 1250 ANCHORAGE TANK/ORENCO
Foundation 5' 10'+ 5' - 41" 45"
DrDin NONE KNOWN #20 OSI 05 HHF M.O.A.
I I
Remarks: * BOTTOMLESS INTERMITTENT SAND FILTER. BENCH MARK
TOP OF MANHOLE LID.
I Aseumed eev<~Uon: 99.57
Inspections performed by: AWWC, INC. Dates: 1st 7/5/2000
2nd 7/10/2000
4th 7/13/2000
Department of Health and Human Services approval 70i~,.~"~' .0~-7953.. '"~7
~.,~ '.~ .......... '~.o~
Reviewed' and approved by: ~'/.-~'~ ..-, -.' ~J~/. ~"~o~ Dote: 7" I ~"0~ '~,~,~,or,,s,o~=.-~ ~ '~ '='
PERM~ NUMBER: AS ]~UILT I)]~d~WING PARCEL ID NUMBER:
SW000208 " 015-191-12
~l~- ~,l~ r~ ~ ST1 24.8 6.1
Ar~- ¢~,16 ST2 26,9 12,6
MH 27,~ 1
MT1 29.4 20.9
/ ~w~o~o~ X ~ ~'~ ~'~
I~J ~ ~K~~ MT3 50.8 48.5
Aq~- ¢4~¢ Af~f~ ¢4,~ MT4 47.6 49.5
~ ~ ~' ~ ~ ~ ' ~ ~ '~GENERAL WATER LINE
~1 ] = "! ~ ~ ROUTE PROFESSIONALLY
, -.~ ~ ~ ~ NEW
~ I I ~%' - ' ~ ,~MT5 ~ DRAINFIELD
TEST HOLE~- ~1 X~.-.
PERFORMED BY S ~ ~~.~-
S ENGINEERING ON l; I ~%~ IIIlllll ~NEW 1250 GALLON
6/~W93 ~-'- ~ '"'." i~ ~llllll~ / S.T.E.P. TANK
: ~ ~/ ~XI~I~ ~AIR COMPRESSOR
' ~' ~ .' ~; ~DROoM HOUSE ~PANEL WITH REMOTE
A~RM IN GARAGE
/ LONGHORN)ATEt STRE~
~/~Wzooo
........ ' ....... ' ................... CONSULTANTS, INC.~ ....................... ''~ ....... 1"
DAVID BOGARB (907) ~46-3689 2 OF
TRAILS END SUBDIVISON; LOT 5, BLOCK 1
AS-BUILT OF SEPTIC SYSTEM UPGRADE
A B
ST1 24.8 6.1
ST2 26.9 12.6
MH 27.4 15.9
MT1 29.4 20.9
MT2 25.2 22.7
MT5 50.8 48.5
MT4 47.6 49.5
PERMIT NUMBER: AS BUILT D~W~G PARCEL iD NUMBER:
SW000208 ' 015-191 - 12
:7 AIj~ bli'J~ COIb 5PAg~12Af ~14" 121^ 50t 40 ?¥C l.A~PAL5 , ,
PROX, 2F~I~f,O~i',ICO (HOL.~¢ ~l~bJ25 AN12PbUgdIN~ /--12 xgO
H. OW" J'YP~ ?ROVtIZ12 V/'I.V~ F~R ~NCO 12~1~N)~ / NO blN~R
Y AN~OP.~ fANK,-~-, ~ / PIPlNd [Z~IdN~12 BY O~NCO AN12
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DISCH, A,~ UIN~ FROM OF 5AN12 AN12 1215~iBLIlqON PiPE
~'I~P 'rANK AN12 MANIPOb12
PLAN VIEW
F PIU~R ~1¢
O~t~/NM- ~i~b 6~P~ 5/4" PVC ~A~PU¢~ (lYF.4) ~
~ ~ 90.2 - 91 i~ I '~ I
~0.6 - q2.2.
TOP OF SAND IN I PROFILE VIEW
OLD BED WAS93.451 ~IC[A~,
7/18/2000
~ ................. ..... CONSULTANTS, lNG, ,=~,==~?~ ....... ~ .... sc~:
DAVID BOGARD (907) 546-5689 5 OF
TRAILS END SUBDIVISION; LOT 5, BLOCK 1
DETAIL OF BOTTOMLESS INTERMITTENT SAND FILTER (ISF)
19~ P01
MUNICIPALITY OF ,.~..NC, t,~,,,,~ . .
4700 SOl :..~ BKAG.A?..,,,,,L'-'- ,. '. ;.
~0~: V~: (Oa:) ~.¢~.t00 i.~: ~'? ',~',.~ ....
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DIVISION
DA 7'E: * '
t¥;;i?(E #~.
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
Permit Number: SW060208
Legal Description: TRAILS END BLK 1 LT 3 P-604
Design Engineer: 0041 AK Water & Wastewater Consultant
Owner Name: David Bogard
Owner Address: 8281 Longhorn St.
Anchorage, AK 99516-1258
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jul 05, 2000
Expiration Da. te: Jul_0.05, 2001
Parcel ID: 015-191-1~
Site Address: 008281 LONGHOR'R-ST "--"-- v
Lot Size: 26999 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construct[on 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.
Received By:
-i
Date:
Date:
ALASI WATER & WASTEWATER
June 19, 2000
Municipality of Anchorage
Department of Health & Human Services
Division of Environmentai Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Septic System Upgrade for Trails End Subdivision; Lot 3, Block 1
(Bottomless Intermittent Sand Filter - ISF)
To whom it may concern:
The existing 3 bedroom house is currently served by three private wells and a septic system. The
existing septic system consists of a 1000 gallon septic tank and a bed type drainfield. The
existing bed is surcharged and must be upgraded. We are proposing that a 1250 gallon S.T.E.P.
tank and a innovative Bottomless Intermittent Sand Filter (ISF) system be installed over the site
of the existing drainfield. One test hole was excavated by S & S engineering on 6/16/93
immediately to the west of the existing bed. Groundwater was encountered at 8 feet below grade
on 6/25/2000. According to the M.O.A. inspection report dated, 1/24/84, the existing bed is 4'
deep. Comments regarding the proposed upgrade are summarized as follows:
1. SOILS: Attached is the log performed by S & S Engineering which shows the soil
classifications, groundwater monitoring, and the percolation test results. The soils below the
organic layers are a GM/fill material to a depth of 3 feet and then transitions to a GM material to
a depth of 10 feet (bottom of test hole). Groundwater was encomxtered at 9 feet during the
excavation of the test hole. Nine days later (6/25/2000), groundwater was found to have risen to
8 feet. A percolation test for this test hole was performed between the depths of 4 feet to 5 feet
which had a percolation rate of 10 minute/inch. The proposed ISF is capable of handling up to
750 gallons per day with 60 minute per inch soils; therefore, it is conservative.
2. DRAINFIELD DESIGN: Bottomless Intermittent Sand Filter (ISF)
a. Percolation Rate: 10 minutes/inch
b. Allowable Application Rate for ISF: 2 gallons/day/ft2
c. Number of Bedrooms: 3
6901 Debarr Road, Suite 2B N Anchorage, AK 99504 - Ph: (907)337-6179 - Fax: (907)338-3246 N akwwc.com
d. Design Flow: 450 gallons per day
e. Minimum Absorption Area: 225 ft2
f. Effective Depth below pressure pipes: 2.5+ inches
g. Width: 12 feet
h. Length: 30 feet.
i. Effective absorption area = 360 ft2
j. Air Supply: Thomas Industries, Model 5070, "Anchorage Tank".
k. Air Supply Line: "Wasteflow' emitterline, 1/2 inch I.D, "Anchorage Tank".
1. Sand Material: In accordance with M.O.A. latest standards
m. Pea Gravel: 100% passing 3/8" sieve, less than 20% passing the 1/4" sieve, and
less than 1% passing the #8 sieve.
We are proposing to excavate to a depth of 1 foot below the top of sand in the existing bed.
Place a minimum of 6 inches of sand, install the air supply line, and cover it with 1.5 feet of
sand. On top of the sand, we will place 6 inches of 3/8 inch pea gravel, with the pressure laterals
midway in the layer. We will use a conventional lift station (Anchorage Tank), equipped with a
programmable timer so that flow can be intermittently dosed to the ISF.
3. SURFACE WATERS: There is no surface water within a 100 foot of the proposed septic
system upgrade.
4. TOPOGRAPHY: Attached is a topography site plan which shows the original topography in
the area. The existing bed sits on a natural bench (approximately 15% slope). Also attached are
digital photos of the lot showing the existing grades.
5. MATERIALS AND CONSTRUCTION PRACTICES: The materials used, and the
construction practices will comply with DHHS' "Intermittent Sand Filter Design, Installation &
Maintenance Manual". The contractor should read this document prior to construction. Copies
are available at the Municipal Onsite Services office (5th floor, 9th & L St.).
President
6. CLOSING: I am open to any suggestions from your department, which would be an
improvement to the proposed design. I am unaware of any adverse impacts this installation
would have on adjacent wells or septic systems. If you have any questions, please contact us at
337-6179. T~ur assistance.
ames's~F.E., M.S.
,SUN ZOO0
~dWP4l(.Ip,~1, ,.
'~c~VIc~,~ D/V!.,"
6901 Debarr Road, Suite 2B - Anchorage, AK 99504 N Ph: (907)337-6179 N Fax: (907)338-3246 ~ akwwc.com
LOT $
i ]]MBERUNE S/D
......... LOT 14
' LOT 7 / LOT 15
] ]]MBERUNE S/D ..... -. ~ TIMBERUNE S/D I
// PEOPOSEO ~
I --/ SY~EM'S ~,~, ~ ~ PROPOSED --
d ~ x / LONGHORN STRE~
I T~ILS END S/D
, / / /j
6/19/2000 ~=.-
Al ~ WATER & W~TEWATER K.D.W. $~A~' 'II
,, ..
CONSULTANTS, INC.~ 1" ~ ........ ~ ~']
DAVID BOGARD (907) 346-3669 1 OF ~ & dla
NOTE: THE CONTRACTOR MUST HAVE
THE 100' WELL RADII FOR THE
REFERENCEO LOT AND FROM LOT 2,
BLOCK 1, TRAILS END S/D FL~GGED
BY A REGISTERED LAND SURVEYOR
PRIOR TO ANY CONSTRUCT[ON.
I x
NOTES:
THE AIR COMPRESSOR SHALL
BE LOCATED WITHIN THE B~SEMENT
OR THE GARAGE. THE CONTRACTOR
SHALL PROVIDE A 0-10 PSI
PRESSURE GAUGE AT A LOCAT[ON
WHICH IS READILY ACCESSIBLE FROM
WITHIN THE HOUSE. NOTE: A 30 PSI
GAUGE WILL NOT WORK.
THE AIR COMPRESSOR SHALL
BE A THOMAS INDUSTRIES MODEL
5070, AS SUPPUED BY ANCHORAGE
TANK. THE AIR UNE SHALL BE 1/2
INCH DIA. HDPE (1 PIECE), INSIDE A
2 INCH SCH.40 PVC JACKET. THE
UNE SHALL BE BURIED TO A MINIMUM
DEPTH OF 3 FEET.
THE CONTROL PANEL FOR THE
STEP TANK SHALL BE INSTALLED
OUTSIDE THE RESIDENCE WITH AN
AUDIBLE~ViSUAL INDICATOR INSIDE
THE HOUSE.
/
/
EXISTING
PERIMETER
TEST HOLE
PERFORMED BY S
& S ENGINEERING
ON B/~B/93
!
I
I
I
AIR COMPRESSOR
(SEE NOTES)
EXISTING THREE
BEDRooM HOUSE
./-
BOTTOMLESS INTERMffrENT
SAND FILTER. EXCAVATE I FOOT
BELOW SAND LEVEL IN THE EXISTING
BRO, BY 12 FEET WIDE, BY 3{;) FEET
LONG. SEE ATTACHED DETAIL AND
PROFILE (PAGE 3 OF 5) FOR
CO STRUCTION DETAILS AND
~N REQUIREMENTS.
EXISTING
SEPTIC TANK WITH
A 1250 GALLON
S.T.E.P. TANK.
/
/
LONGHORN STREET
)ATE:
6/19/2000
DRAWN BY:
K.D.W.
ALASIr WATER & ;VASTEWATER
~"~ CONSULTANTS, INC~
1"=20'
PHONE NUMBER: PAGE NUMBER:
DAVID BOGARD (907) 546-5689 2 OF 5
LEGAL DESCRIPTION:
TRAILS END SUBDIVISION; LOT 5, BLOCK 1
OF WORK:
DESIGN OF SEPTIC SYSTEM UPGRADE (ISF)
~l~ I~IN~ COIL ~ACI~P A1~ ~? ,p p/A. ~CH. ~iO pVC i~^1~i~;~.~
/"W~L~'~IP~P V~ P~ ~NCO ~N)~ /.~ bIN~ ON P~fOM. P~
/ ~I~NUFI~P I~Nk,~ ~ / PIPIN~ P~SI~N~P ~Y~NCO~P
/............. 5 ..... 5 ....... ~ __
"PlA,
PLAN VIEW
/
2 ~f MIN, ~ FIL¢~ 5~P 2'
~~ PROFILE VIEW
' 6/19/2000
........... ~-~ ........ ~ ............ , CONSULTANTS, tNC. ~~ ........... ................ ~OA~:
PREPPED FOR: PRONE NUMBER: 'PAGE NUMBER: .~.,
DAVID BOGARD (907) ~46-3689 3 OF
~OAL O.SCR~ON:
TRAILS END SUBDIVISION; LOT 3, BLOCK 1
DETAIL OF BOTTOMLESS INTERMITTENT SANF FILTER (ISF)
COI~4ENT$
Reading Dat . Tim~ ' Time
pErCOLATION ~TE ~ Im~
TEST RU AND ~ , FT
$ & $ I~-':'ERING
17034 Eagle Rive' leap Rd No. 204 't'"
WITH ALL STA'~£ ANq ...... ., ,.
CERTIFY THAT THIS TEST WAS PERFORMED IN
T ON THIS DATE· DATE;
PROPERTY OWNER MAINTENANCE AGREEMENT
ON-SITE WASTEWATER DISPOSAL SYSTEM
This agreement, dated ~ ~ ,200_0, is made between the Municipality of
Anchorage Department of Health and Human Services (DHHS) and the property owner(s) of
This agreement is made for the purpose of maintaining an on-site wastewater disposal system
on the subject property.
The property owner(s) agree to the following:
The property owner(s) will have an annual inspection of the system performed by a registered
professional engineer. This inspection shall verify that all effluent and air pumps, timers, and
alarms are functioning as designed. Any deficiencies shall be corrected and the engineer's
statement that the system is functioning as designed shall be filed annually with the DHHS.
Property Owner Name
Property Owner Name
(Notarize Here)
State of /~/~ t~6:k--
Judicial District SS.
On this ~.d day of ['~'~P'/~_... in the
year ,~ODO , before me, the undersigned notary
pubI~, personally.appeared:/
(.Oaot i c.,aar'
lmowntometobe
the person(s) whose n~fle(s) is/are subscribed to the
within instrument and acknowledged that he/she/they
executed the same for the purposes therein
contained.
In witness whereof, I hereunto set my hand and
o~/~ttal s~al.. . .~ r'k '
Nofta/y Pitblic (signature)
(No~'~r~ted nme)
My co~ssion expires:.,
MUNICIPALITY Of ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
(907) 343-4744
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILLY DWELLING
015-191-12
GENERAL INFORMATION t'~- LEO ~/
Complete legaldescription TRAILS END SUBDIVISION: LOT ;5. BLOCK 1
Location (site address or directions) 8281 LONGHORN STREET. ANCHORAGE. AK 99516
Property owner
Mailing address
Lending agency
Mailing address
DAVID BOGARD
8281 LONGHORN STREET ANCHORAGE. AK
Day phone (907) 546--5689
99516
Day phone
Agent CAROL BATFS w/FORTUNE PROPERTIES Day phone ('907) 265-9126
Address 2525 "C" STREET SUITE 100. ANCHORAGE. AK 99505
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE:
XXX
If community well system, provide written confirmation from State ADEC attest-
ing to the legafity and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding Tank
Community on-site
Public sewer
NOTE:
XXX
If community wastewater system, provide written confirmation from State ADEC
lng to the legality and status of system.
72~)25 (Rev. 1/91 ) Front MOA ¢Y21 Computer Version
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $1300. O0 at,
or prior to, closing for the engineering services provided. J
5. STATEI~IENT OF INSPECTION BY ENGINEER
As cedified 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 vedfy that based qn the information obtained from the Municipality of
Anchorage files and from my investigation and insl~9~,tion, the on-site water supply and/or wastewater
disposal system is in compliance with all Municip¢'Cnd State codes, ordinances, and regulations in effect
on the date of this inspection. V
Name of Firm ALASKA WA'I~ ~ YASq-~WATER CONSULTANTS, INC. Phone (907) 337-617.~L
Address 6901DEBARR~OAD/~ :I'E/2J~ANC~ORAGE, ALASKA 99504
Engineer's Signature (,,J'~ '(-//~,-"~'" Date 7?/9 /c:c' _
In conducting this evaluation, AWWC, I¢c.~att! lpted to provide a thorough, conscientious engineering analysis of the
system in accordance with ADEC and MOA [J HS Guidelines & Regulations. The reported results described the
performance of the system under the conditions encountered at the time of fha test, and separation distances
measured to readily identifiable features. The operational life of afl wells and septic systems depend
on the local soils condition, ground water levels that may fluctuate 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 the system. Satisfactory test results do not guarantee future performance
of the system, nor do they guarantee that there are no hidden defects or encroachments.
AWWC, Inc. can therefore not provide any warranty for future estimate of how long the
system will continue to meet the operational requirements of the ADEC or MOA DHHS.
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. DHHS SIGNATURE
P'"" Approved for ~
Disapproved
Conditional approval for
bedrooms
bedrooms, with the following stipulations:
Additional Comments
By: /)~,/~'.~. .... ~- LC''/, /<:~,~'~- Date 7- / ~'-' ~ o
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.
72q325 (Rev. 1/91) Back MOA ¢Y2-1 Computer Version
CEIVED
Municipality of Anchorage JUL 18
DEPARTMENT OF HEALTH & HUMAN SEI~uV~ ot, ^NC.O~
Environmental Services Division ,,.,P~NMEHTAL SERVICES DIV.
825 "L" Street, Rm 502 Anchorage, Alaska 9950'1 (907) 343-4744
Health Authority Approval Checklist
Legal Description: TRAILS END S/D; LOT 5, BLOCK 1 Parcel I.D.: 015~191-12
A. WELLDATA I* NO LOG FOR 1969 WELL. INFORMATION PER 1984 WELLS ONLY.I
Well Type. PRIVATE If A, B, or C, attach ADEC letter. ADEC water system number N/A
Log present (Y/N) 1984 WELLS ONLY* Date comp eted
Total depth 466'/125'/175'(+/-) Cased to BEDROCK
Sanitary seal (Y/N) YES
DEC. 1984
Casing height (above ground). 12'+
Wires properly protected (Y/N) YES
Date of test
Static water level
Well production
FROM WELL LOG
J g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 Nitrate
Date of sample: 6/19/2000
AT iNsPECTION
6/14/2000
64'/55'/47'
**0.25
g.p.m.
495 GALLONS OF STORAGEI
PRESSURE TANK.
3.72 mq/L Other bactada 0
Collected by: A.W.W.C., INC.
SEPTIC/HOLDING TANK DATA
Date installed 7/5/2000 Tank size
Foundation cleanout (Y/NI YES
1250 Number of Compartments 2 Cleanouts (Y/N) YES
Depression (Y/N) NO High water alarm [Y/N) YES
Date of Pumping NEW Pumper -
C. ABSORPTION FIELD DATA
Date installed 7/! 0/00-7/11/00 Soil rating (g.p.d./fl2 or ft2/bdrm)
Length_ 30' .Width 12'
2
Gravel thickness below pipe
~'** BELOW ORGANIC LAYER]
System type BED (ISF)
0.25 Total depth ***5' MAX.
Effective absorption area 360 SQ FT Monitoring Tube present (Y/N) YES Depression over field (Y/N) NO
Date of adequacy test NEW Results (Pass/Fail) For ~
Fluid depth in absorption field before test (i~added (in.): __
Fluid depth (ins ' er: Absorption rate =
.-Pemxl-d~'~atment (past 12 months) (Y/N) If yes, give date
72-026 (Rev. 3/g6)* Computer Version
D. LIFT STATION
Date installed 7/5/2000
Manhole/Access (Y/N) YES
High water alarm level at* 4-5"
Cycles tested NEW
Size in gallons 1250
"Pump on" level at* 41" "Pump off" level at*
,*Datum BOTFOM OF TANK
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septir2holding tank on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
100'+
100'
N/A
25'+
On adjacent lots 100'+ .....
On adjacent lots 100'+ .......
Public sewer manhole/cleanout N/_A______,
Lift station 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation 5' Property line 5'+
Water main/service line 10% Surface water/drainage 100'+
SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO:
10'+ Building foundation
100'+
NONE 7OWN
F,C¢
fhCC ,'C'e _e, terns ere/n conformance
r~ ~__/ff~ ~is date.
F ~jJEFFR~ A. GARNESS
Property line
Surface water
Curtain drain
F. ENGINEER'S CEI~
I certify that I h~e
of Municipal re/corc
with MOA HA~ gui
L
Signature ~
Engineer's NTe
Date_ ?//8/
Absorption field __
Wells on adjacent lots __
100'4-
10'+ Water main/service line__ 10'+
Driveway, parking/vehicle storage area 'l 0'+
Wells on adjacent lots__ 100'+
HAA Fee $ ~,~,-), o ~
Date of Payment ~,~/~ '¢ (~L¢"-)
Receipt Number O ~ ~-~'-'~-~
72-026 (Rev. 3/96)" Computer Version
Waiver Fee $
Date of Payment
Receipt Number
MUNICIPALITY OF ANCHORAGE
MEMORANDUM
WATER WELL ADVISORY
HEALTH AUTHORITY APPROVAL NO.~)~ 9~
During a recent Health Authority Approval on-site inspection
and test of tl!e potable water supply well on Lot ~
Block } of -~A /A ~ E~//~ Subdivision, the well's
productivity was determined to be O.~gallons per minute.
The minimum well productivity required by this Department
(AMC 15 55) for a ~ bedroom residence is O ~]3'ga!lons
· ~ ~o~$ ~o~.,~c~'
' per minute. ~ the subject we±l currently ~zm=ee~-mnzs
minimum requirement, all parties concerned are advised that the
production capacity of the well may fluctuate. Restriction
of non-critical water uses such as washing cars and watering
lawns and gardens may be required.
This advisory must be attached to all copies Of the subject
Health Authority Approval.