No preview available
HomeMy WebLinkAboutWILLIAMSON #1 BLK 1 LT 9AWi lliemson #1 Lot 9A Block I #015-073-50 Municipality of Anchorage Page ~1 of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: ~'~ ~/D~ ~ LI PID Number: ~)-/~ '- ~7~ "~-- Name:~A~ I ~ ~A~ ~ ~ ~ Wastewater System: D New ~Upgrade Address: ~1~1 ~ ~E~, ~V~ ABSORPTION FIELD Phone: ~ NO, of Bedrooms: ~Deep Trench D Shallow Trench D Bed D Mound D Other Total Depth from original grade: LEGAL DESCRIPTION Soil Rating: ~,~ GPD/Sq. Ft. Block: Subdiv~ion: Lot: ~A I ~ ~ {/~ ~ ~ Depth to pipe bo~om from odgi~al grade: Gravel depth beneath pipe Township: ~ Range: ~ Section:, Fill added above original grade:,. Gravel length: ~ Ft. I I . Number of lines: ~Distance ~eenlin~: WELL: D New ~ Upgrade Gravelwidth: ~ Ft. ~I ~ Ft. Clarification (Private, A,B,C): ~ Total Depth: Cased TO: Total absorption area: Pipe material: Driller: % DateDrilled: StaticWater Level: Installer: Dateinstal[ed: ~ f Yield'. ~-- ¢ IPUmp Set at GPM Ft, I~sing Height Ab°ye Gr°und:Ft, TANK SEPARATION DISTANCES '~Septic D Holding U S.T.E.P. To Septic Abso~t~on Lift Ho~dlng >ublic/Private Manufacturer: Cspacity in gallons: From Tank Field , 'Station Tank Sewer Lines ANkH ~N I~ ' Material: Number of Oompa~ments: SudaCeWater ~[ IO N ~O LIFT STATION Lot Size in gsllons:~ Man~acturor: Remarks: BENCH MARK /~ Fl, ENGINEER'S SEAL Inspections pedormed by: ~,' ~ Dates: 1st o ~, , ~,~, 72-013 (Rev, 9/91 ) MOA 25 AF BF FT / / / / / / / / / / / / BENCH I~ARK L ~ J~ J ~ EFFECTIVE ROCK IDEPTH 7 SCALE. ~ 50 F~ JTOBBEN SPURI(LAND P.E, 203 W 15TH. AVENUE ARCH. AK. 99501 (907) 279-S9~6 PERMIT fi- Sb/000!64 J J ~;ILLIa~ISON BLOCK I LOT 9A DA VID HAGGETT 5141 E 98th. AVE. j j ££,,G s,STE~ AS Bu,LT I DA?E: JULY 25,2000 J SHEET: 2/$ GRID: 2¥$7 J I ~ '1 PID fi` 015 073 50 Sfondord Trench: 2' Wide 55' Long lf' Deep 7' Sewer rock I000 Go/ Septic tonk Cleon OuI FLOW DIVENTE£ BULLRUN ND SC~iLE Cleon Out Cleonoufs 96~ ?£ENCH INSULyA?EB 93,4 85,5 7 pi. o£ Sept:lc Roc~ /Vi] SCALE DIVE£SION VALVE BUL£NUN 93, 4 96, 41 85,5 MA/P/C, TDP DECK A£SUME~ ELE~A TOBBEN SPURKLAND 203 W15th Ave Anchoroge Ak 99501 BLOCK 1 I ILLIAMSON 5141 E 9gill, AVE SEPtiC SYSTEIvi SCHEIffAT/C SEPTIC SYSTEM SCHEMATIC DATE: JULY 28, 2000 SHEET, GRID, 2437 PERMIT # SW000164 PID # ~15-073-50 WILOIgA3, E~/6 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 13, 2000 Expiratien Date: Jun 13, 2001 Permit Number: SW000164 Legal Description: WILLIAMSON #1 BLK 1 LT 9A Design Engineer: 0007 Tobben Spurkland, PE Owner Name: David Baggett Owner Address: 5141 E. 98th Ave. Anchorage, AK 0000 - Parcel ID: 015-073-50 Site Address: 005141 98TH AVE E Lot Size: 18445 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 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, an¢ heated to prevent freezing. Date: ~~ /~ 203 W 15th. Avenue, Suite 203 ANCHORAGE, ALASKA 99501 (907) 279-3916 Fax (907)-276-6013 SEPTIC SYSTEM DESIGN LOT 9A BLOCK 1 WILLIAMSON S/D DAVID END BAGGETT Municipality of Anchorage Department of Health and Social Services 825 L Street Anchorage, Alaska 99501 May 26, 2000 We are submitting an application for the upgrade of the septic system for this lot. The submittal consists of three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes are also enclosed. The septic system design is based on the following: No Ground Water or Impervious Layer to I7 ~. Use Standard Trench Soil Rating. From Testhole 05/23/00 20 rain/in - 0.6 gal per sq.ft/day No. of Bedrooms 3 Required Area per Bedroom: I50/.6 = 250 sq.ft. Total area required: 250 x 3 = 750 sqfl Testhole depth 15 feet Bottom Rock At l I feet Top Rock At 4 feet Rock Depth 7 feet Total Trench Length 750 / 14 = 53.55 R. USE 55 LF SYSTEM CONFIGURATION STANDARD TRENCH TOTAL LENGTH 55 FT TOTAL WIDTH 2 FT TOTAL DEPTH 11 FT ROCK DEPTH 7 FT COVER 4 FT SEPTIC TANK 1000 GAL The installation of this septic system will not prevent development of adjacent lots. There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface runoffwilI not result from this installation. / / N ££ALE: 1' = 100 FI,, 250 300 TOBBEN SPU£1(LAND P.E, 205 W 15TH. AVENUE ARCH. AK. 99501 (907) 279-5916 WILLIAMSON BLOCK 1 DAVID BAGGETT 5141 E 98Ih. AVE. LOT 9A I SEPTIC SYSTEM DESIGN DATE: MAY 19,2000 SHEET: I/5 GRID: 2457 PERMIT # SVOOOOYY PID # YY ~/ILNgALDV6 %, / / % / I I / / EXIST. TANK INSTALL: 1000 GAL TANK STANDARD TOTAL LENGTH 65 FT TOTAL DEPTH FT WIDTH 2 FT EFFECTIVE ROCK 7 FT COVER 5 FT BULL RUN VA L VE 25 .50 SCALE; TOBBEN SPURKLAND P.E, 205 W [5TN, AVENUE ANCH. AK. 9950! (907) 279-59!6 WILLIAM.eON BLOCK DA VID BAOOET1- 5141 E 98th. AVE. LOT 9A SEPTIC SYSTEM DES/ON DAT£: /dAY 19,2000 SHEEh 2/5 O£/&' 2457 PEBMIf # Pin # l¥ILDI95£,])146 S/onderd Trench: 2' Wide 55' Long 7' Sewer rock Cleon Ou! Monl/or ?LOW DIVERTER BI/LLRUN SCALE IVonlt;or , © 1000 Cai Septic tonk 1-O 1981 TRENCH DIVERSION VALVE BULLRUN 7 F~ o£ Septic Rock ND SCALE 1£5~ 90I, sep~,t'c lank D£/VCH MA£K, ASSUMED ELEIZ 100,00 ITI]BBEN SPURKLAND P,£, IIOT ~03 WIDth Ave Anchor'age Ak 99501 9A BLOCK I t¢ILLIAMSON 514l f 987H. AVE SEP~C SYSTE~ SCHEMA~C SEPTIC SYST£N I ~ATE: ~AY 2& 2000 SHEET, ~/~ GR[~: £437 PERFORMED FOR; Munl.:)pallty o! Anchorage DEPARTMENT OJ: -~EALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG- PERCOLATION TEST ~ER'S SEAL) ' DATE PERFORMED: '~/'/~'~,~/~ LEGAL DESCRIPTION: LOT ~ A. ~ ~,- I 6- 8 9 10 tl 12 13 14- 0 F- t4 o LL~ 20 DISCLAIHFR: Rrnundwater Past and future presence Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? SITE PLAN S L E PERCOLATION RATE I~O (mrnutes/mchJ PERC HOLE DIAMETER ~ ~ T~ST RUN BETWEEN ~/~ FT ANO ~ FT caoditions indicated arR for the dates shown only, and/or depth of gro~.ndwater can not be predicted 'trom these obse~va~lons. PERFORMED BY: ~ ~ __ I "'~- -~ CERTIFY THAT THIS TEST WAS PERFORMED IN · ACCORDANCE WITH ALL STATE AND MUNICIPAL Gbl[ ELINES IN EFFECT ON THIS DA3'E. DATE: ~ i~} ~.&L,o~;, 72-008 (Rev. 4/85) MtJNICIPALITYOF: ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAl. PROTECTION ENVIRONMENTAl. ENGINEERING DIVISION 825 L. Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAl. SYSTEM AND/OR WEI_L INSPECTION REPORT LEGAL DESCRIPTION ~ ~ DISTANCE TO: Absorpti~,~ ~narea Inside length Dwelling NO. OFSEDROOMS No. of cornt rtments Liquid depth PERMIT NO, Material Liquid capacity in gallons Trench wi~- hlches PERMIT NO. Crib depth Total effective absorption a~ea Building foundation Nearest lot line Driller OTHER PIPE MATER ALS SOIL TEST RATING INSTALLER REMARKS DATE LEGAL /a9GS 4 w w I Certified Well l)isrance to water .................................... :...(v.'...~' ..................... ~ .................................... Distance to water while pumph~g .................. i......'..~:..~.d .............................. at rate ' Description o[ Formatlon'Y' .),." ' from to ~t/L "' '"~ " "'"' '>'"" ~ /' ~. ~ . ; · , ~. .... '..~"'.; .~ .-.' h.. . . I certify thc above true and correct. Driller DOTTEN DRILL. lNG John's Road SPENARD. ALASKA CO. We advise, yott to aLtach this certificate to your deed, F.:.,EPF~R]'HENT or-' HEFILTH RN[;, EW,/IROIqHENTF~L ?'~'OTECTION E:?;5 '"L STREET., RNCHORRGE., RK. 99, ± F'EFff"IIT NO. ( E~.OE:FJ:2 ::, RPPL I C~NT DFI'v'~ E:, E:RGGETT 66]b~ H ] NCHESTER L.OCR'T:[ON DOTH DR L. EGRL L:tO DZ HILL] FIHSON :1'~. I..OT SIZE 'T'¢PE OF SOZL FIE:SORP'FION SYSTEH IS: TRENC:H HR',,-.',IMUH NLIHBER OF DE:£:,ROOHS ::: }i: 'I"HE REL:~LIIREE:, SIZE OF TFIE SOIL RBSOF.:PTION S't'£STEH IS: THE L. ENGTt. I DIMENSION IS 'FFIE LE;IqGTFI ,::IN FEE]') OF: THE TRENCH OR I::)F:FtZNf:'IEL. D. THE DE'.'PTH OF FI TRENCH OR PIT' IF; TFIE DISTFINCE E:ETI.,.IEEN THE S';UF:FFICE OF THE GF?.OUND RN[:, THE DOTTOH OF THE E';.,',CRVRTION ,::IN FEET::,. THEF?.E IS NO SE]' HIDTI'I FOR TRENCHE:S. THE GRFI',,/EL [:,EF'TFI IS THE HINII'qlJM DEPTH OF GF.'.RVEL BETHEEN TFIE OUTFFILL PIF'E F:IN[) THE DOTTON OF' ]'HE: E,'-'-0:.'FI'v'RTION (IN FEET). PERM I'l' FIF'PL I C:FIN'r FIRS 'rile RESPONS I D I L I'T'9 TO ]:NFORH TFII S; DEF'RRTMEN'T [.bi_If;?. I Hi:ii I'HE IIqSTF:ILLRTfON ~NE:PISC:TIONS OF FIN'T' HELLS RD3RCENT TO 3"1-.1IS F:'~'.OF'EF~T'¢ FIND THE NUI'dDEfE: OF' RES~DEi',ICES TFIFIT THE HELL. HILL SE.,q'.VE. E:FICI.:::F'ILLING OF' Fff',19 SVS'I'EH NITROUT FINFIL Ii",ISF'ECTION RI'.,IE:, FIPPRO',,,'RL B'9 THIS D, EF'FIRTMEi'.(T' HILL. BE SUB.J'ECT TO PROSECUTION. MINIfdl..IH DISTRNCE 8ETNE:EN R HELL_ RIqD FINV ON-SI'f'E SEHFIGE DISPOSRI_ S"r'STEf"I IS :1..00 FEE:T FOR g F'RI',,,'RTE HEI_L OR :~58 TO 288 FEET FROM R F'UE:LIC HELL. DEF'ENI)ING UF'ON THE TYF:'E C$' F'UDLZC 1.4ELL. I"IINIMUH DISTRNCE FROI"I FI F'RI',/RTE NIELL TO R F'RI'v'RTE SEHER LIIqE IS 25 FEET RND TO FI COMHUNZT"r' SEI.,.IER LINE: IS 75 FEET. HELL. L.OG'.5 RRE F:Eg!UIRED RND MUST DIE RETLIRNED TO THE DEF'FIRTMENT I.,.IITNIN 13~:9 DFI'gS OF THE 1.4ELL C:I3HPLETICIN. O'I"HER f~:E~Z~UIREt"IENTS MR'T' RFIpt...'T'. SPECIF'ICRTIONS FIND CONSTRUE:TION DIRGf4:I::IHS RRE F:I'v'FIZLFIE~L.E TO Zf',ISUIRE PROPER INSTRLL. FIT:[ON. I C:ERTZFV TFIR"r ::L: I FIH FRHIL. IFIR HITR THE RECPJIREHENT'=S FOR ON-SITE SEP.IERS RND HELL...S RS SET FORTH B'¢ THE HUNIC:IF'RLI'FV OF FINCHORRGE. 2: I HILL. If.,ISTFILL. THE S'gSTEI'd IN FICCOF~'.DRNCE [,.IITH THE CODES. 3:: I UND, EF,?.STRNE) TFIFYf' "FHE ON.-SITE E;EHER ?gS'I'EH HR'¢ REgfl. J IF?.E ENL. RRI3ErqENT IF: THE F?.ES]DENCE ZS REMODELED TO P4CL. UE:,E HORE: THRN E: E:EDROOMS. S; I GNIED: FIF'F'I_ I CFII'.4T I)FI',,/ I E:' BFIGGETT .['L:;SUI='D ~ .......... ~_ ............. ~ ................................................ : ...................... V4. 0 '¢4. O:i · ~ -- ~' ~o ~r ~-~ ro¢ * · ' ~ t: SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG -- PERCOLATION TEST PERCOLATION TEST LEGAL DESCRIPTION:__ lC;) '~L.o~ K J 3 4 5 6 7 8 9 10 11 DATE PERPOR','ED: ~-I~/-81 t~ILL. IAM &,o/',l s/E:) SLOPE 12 13 WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? SITE PLAN S L O P E 14 15 16 19 - ~ ? ' 20- 2225-E ----IUNE 25~ 1971 PERFORMED BY: Reading Date /,~0 ~ 'oO PERCOLATION RATE_ TEST RUN 8ETWE iN Gross Net Depth to Net Time Time Water Drop CERTIFIED BY: (minutes/inch) 72-008 (6/79) MUNICIPALITY OF ANCHORAGE ..~ DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 995'19-6650 343-4744 CERTIFICATE OF HEAt. TH AUTHORrTY APPROVAL FOR A SINGLE FAMILY DWEI_LING Parcel I.D.# 1. GENERAL INFORMATION Complete legal description l_~'~' /1~i ~'~ [ Location (site address or directions) Property owner Mailing address Lending agency Mailing address Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~ TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: lng to the legality and status of system. TYPE OF WAS'rEWATER DISPOSAL: Individual on-site Flolding tank Community on-site Public sewer If community well system, provide written confirmation from State ADEC attest- NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system, 72-025 (Rev. 1/91) Front MOA 1121 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, Phone ordinances, and regulations in effect on the date of this inspection. Name of Firm Address Enginee¢s signature ~ ~/~~ / bedrooms. DHHS SIGNATURE /~' Approved for 3 Date Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments Date The MUhicil~ality of A~'~orage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates dased only upon the representations given in paragraph 5 above by an independent professional engine, er 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. 724~5 (Rev. 1/91) 8ack MOA#21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SEP, VICES Enviroemental Services Division 825%" Street. Room 502 · Anchorage, Alaska 99501e (907/343-4'744 Health Authority Approval Checklist LcgalDesoriptiol, ~0~2 119; ~t W[~l/~ ParcelI.D.: A. WELL DATA Well type __ ~ ff A. ~. or C, attach ~EC letter. ADEC water system Log prcsoot (Y/N'~ ¥/ Date completed Total depth i .,2~ ,l.?/ t Cased to /og-Lllt Sanitary seal (Y/N) 7 FROM WELL LOG Nitrate Date of tesl Static water level Well production WATER SAIvlPLE RESULTS: Coliform ~ Date o£ samp,e }%/q~¢¢' Casing height (above ground) Wires properly protected (Y/N) AT INSPECT[ON g.p.m Collected by: Other bacteria B, SE PTIC/ItODEHNO' TAN K DATA Dateiostalled ~/?/o~] Tanksize /OOO Foundation cleanout (Y/N) _ ~ Date of Pumping _t~/q ¢ C. ABSOR~ION F~LD DATA Date installed Length ~ / Widfl~ Number of Comparunents ~[. Cleanouts (Y/N) _ Depression (Y/N) _ ~/ _ High water alarm (Y/lq)_ Soil rating {,~.t~ or fi2/bdrln) o~' Systenl type (}ravel thickness below pipe Total depth [/. (:> Effective absorption area 7,,S~ Monitonng Tube present(Y/N) )tr Depress,on over field (Y/N) ~ Date of adeqaac~ test /'Z//~/¢(.~ Results (Pass/Fail) T ~or '~ bedrooms Fluid depth m absorption field before test (ill.); Fluid depth ~ ~ [,,is.) Miuutes later: Peroxide treannem (past 12 months/(Y/N) __ O'~ added (iii.): hnmediately afier ~ ~al. water Absorption rote = '~ 'g/to6- O g.p.d. _lfyes, give date D. LIFT STATION Ix,4/A Date iustalled Mauhole/Access (Y/N) High water alarm level at* Size iu gallons "Puulp on" level at* *Datum "Pump oW' level at* Cycles tested E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/!:e!fiJng-tmfl< on lot Absorptiou field on lot Public sewer main Sewer/septic service line I'l t./ //.,, ; On adjacent lots ; Ou adjacent lots Public sewer manhole/clealmut Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: / Buildiug foundatiou //C~ / Property line /O t Absorption field Water maiu/service liue ,~oq-.~ Surface water/drainage ~o~ Wells on adjacent lets SEPARATION DISTANCE FROM ABSOR~ION FIELD ON LOT TO: Buildiug foundation ' ~ / Water maitffse~ice line ~ ~ ~ Surhce water ~o ~ ~ Driveway, parkin~vehicle storage area Caaaiu drain ~ O ~ ~ Wells oil adjaceut lots ~ I~ Property line F. ENG~EER'SCERTIFICATION O~ ~ I cer/ifv t/mt I have determined t~/'u~eld inspect/om' and rev/ew of Municipal re~ lh~'f,tti~ ~b&~tems are .... _:7: ............................................................ ......... HAA Fee $ ~O~. OO Waiver Fee $ Date of Payment \~t- '~ ~- c'~ko Receipt Number C)D ',4 c~k~v/ Rev. 8/95 OSS: haa.wk.doc Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF IE-'NVlRONMENTAL HEALTH CERTIFICATE OF INSPECT[ON FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Applicant Name ~'b~C~_~TF Telephone: Home g~&- ~!~ Business Applicant Address ~ ~ ~( ~ (c) Applicant is (check one): Lending Institution ~; Owner/builder ~; Buyer ~; Other ~ (explain); (d) Lending Institution Telephone Address L~ ~ ~~ (e) Real Estate Company and Agent ~ O~ Address Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family~ Multi-Family [] Number of BeOrooms _ '~' Other WATER SUPPLY individual Well/~ Community [] Public [] Note: If 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 community well system, must have written confirmation from tire State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (11/84) ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As cedified by my seal affixed hereto and as of the validation date sbown below, I verify that my investigation of this Health Authority Approval shows tbat 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 wasteweter 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 . "~gb~,,~/ ~ F.-'~ Telephone Address Date Engineer's Seal 6' DHEPAPPROVAL ~'~') ~ Approved for '~--z_~,_~r~.., bedrooms by Approved _~%.., Disapproved Terms of Conditiohal Approval Conditional. CAUTION The Muncipality of Anchorage Department of Healtb and Environmental Protection (DHEP) issues Flealtb Authority Approval certificates based solely upon the representations given in paragraph 5 above by an iedependent professional engineer registered in the State of Alaska. The DI-IEP does tbis 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 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHE"CKLI ST- FEBRUARY 1984 264-4720 MuNICIpALITY OF ANCHORAOE~ DEPT. OF HEALTH & ENviRONMENTAL PROTECHON RECEIVED Legal Descriouon: __L...OT I~t '~..~: ~[~.1~ ~O~ WELL DATA Well Classification Well Log Present (Y/N) Total Depth _ I~¥ Static Water Level "~ ]'~ ..~ If A. B. C, D,E.C. Approved (Y/N) Y" _ Date Comoleted ~_~O ~ ~; J ~'/ Yield Cased to Casing Fteight Above Ground Electrical Wiring in Conduit IY/N) _~,~'/ Separation Distances from Well: To Septic/Holding Tank on Lot J To Nearest Edge of Absorpuon Field on Lot _i,~,~ '~' To Nearest Public Sewer Line ~ O Cleanout/Manhole Water Sample Collectea Dy Water Sample Test Results Depth of Grouting __ N O ~ J~ Pump Set At "~"~O ~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) : On Adjoining Lots : On Adjoining Lots _ To Nearest Peblic Sewer Comments ~0 L'~J~_ To Nearest Sewer Service Line on Lol ~ ~/I~ : _ B. SEPTIC/~ TANK DATA Datelnstalled ~Ob,~,, ~_l_Size J¢-)-O'~ No. ofComoartments _ Standpipes (Y/N) _'T'¢~O Air-right Caps (Y/N) ~v' Depression over Tank (Y/N) N Pumping/Maintenance Contract on File (Y/N) Holding 'rank High-Water Alarm (Y/N) ["~/~ Separation Distances from Seotic/Holding Tank: To Water-Supply Well I ~¢' ~ To Property Line ~ ,~O To Water Main/Service Line _ ~ ~0 Course J~ [~, Foundation Cleanou! (Y/N). "~ Data Last Pumoed ._ ¢/"~0 :for Temporary Holding Tank Perm~ (Y/N) TO Building Foundation _ ~,'~ To Disoosa Field ~.~ To Stream. Pond. Lake or Major Drainage Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field Type of System Design Length of Field Depth of Field Gravel Bed Thickness Square Feet of Absorption Area Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well I To Building Foundation Lot t'~'~ O To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Standpipes Present (Y/N) Date of Last Adequacy Test ~'/~' To Property Line To Existing or Abandoned System on ; On Adjoining Lots "~ To Cutbank (if present) Comments D. LIFT STATION N 0 ~'~ ~-, Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA Comments ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA crud HAA guidelines in effect on the date of this inspection. Signed ~ Date_ ~¢'//~/~'~,~ MOA No. Company Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) Engineer's Seal ~ ANCHORAGE, ALASKA 99501 CONSULTING ENGINEER TELEPHONE: (907) 279-3916 SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOCATION: OWNER: RESIDENCE: WATER SYSTEM: SEPTIC SYSTEM: LOT 10, BLOCK 1, WILLIAMSON 5141 E 98TH. AVENUE DAVID BAGGETT SINGLE FAMILY, THREE BEDROOMS ON SITE WELL FROM MUNICIPAL RECORDS: TANK: GREER STEEL, ].000 GAL. ABSORPTION SYSTEM: ABSORPTION AREA: SOIL RATING: 225 INSTALLATION DATE: ,~,. HO. '222,-[5 .... TWO COMP. TRENCH 720 SQ. FT. APRIL 29, 1986 DATE OF PUMPING: APRIL 30, 1986 DATE OF 7'EST: APRIL 29, 1986. TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK IS BURIED 3.5 FEET. LIQUID LEVEL IN TANK IS 51 INC[.IES. WATER Fi, OWING INTO TANK COULD BE HEARD. TRENCN SUMP IS 11.5 FEET DEEP. 43 INCHES OF LIQUID IN SUMP. PERFORATIONS IN SUMP COULD BE SEEN TO WITHIN 3.5 FEET OF GROUND LEVEL. WATER WAS ADDED TO THE SUMP AT A CONSTANT RATE OP 6.75 GALLONS PER MINUTE. THE WATER LEVELS IN TANK AND SUMP WERE MONITORED. A TOLTAL OF 300 GALLONS WERE ADDED. THE WATER LEVEL IN THE TANK DID NOT CNANGE. THE WATER LEVEL IN THE SUMP ROSE AT A RATE OF ONE INCH PER 40 GALLONS. THE INFILTRATION RATE WAS THEN MONITORED FOR 40 MINUTES. THE WATER LEVEL DROPPED AT A CONSTANT RATE OF 1/8 INCH PER 10 MINUTES. THIS SHOWS AN INFILTRATION ]{ATE OR 30 GAL- LONS PER HOUR OR 720 GALLONS PER 24 HOURS. TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The operational life of ali septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family beii~g served by the system. These conditions are outside the control[ of the evaluator of this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi- rements of the Municipality and State. CONSULTING ENGINEER TELEPHONE ]907) 279-3916 RESIDENTIAL WELL INSPECTION LEGAL: LOT 10, ]BLOCK 1., WILLIAMSON ~1 LOCATION: 5141 E 98TH. AVENUE OWNER: DAVID BAGGETT TYPE OF WELL: SINGLE FAMILY WELL LOG AVAILABLE: YES INSTALLATION REQUIREMENTS MET: YES WELL YIELD FROM WELL LOG: 6 GALLONS PER MINUTE PUMP YIELD: 6.75 GALLONS ~ PER MINUTE DATE OF INSPECTION: APRIL 29, 1986 TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 6.75 GALLONS PER MINUTE WHILE THE DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE. THE WELL WAS PUMPED TILL THE DRAWDOWN STABILIZED. STAT!C WATER LEVEL WAS FOUND AT 68 FEET~BELOW TOP OF CASING. AFTER 30 MINUTES OR PUMPING THE WATER LEVEL STABILIZED AT 82 FEET. A TOTAL OF 300 GALLON8 WAS PUMPED. TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON APRIL 30, 1986. TEST WAS NEGATIVE. TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The Municipal requirement for well flow is 150 gallons of water per bedroom per 24 hours.This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flow rate of the well may change due to subsurface conditions that may not be observed from the surface, and changes in land use and other factors that may impact the conditions of the aquifer feeding the well. DATE T~SPECTOR TIME TIME DATE gATE INSPECTOR INSPECTOR MUNICIPALITY OF ANCHORAGE MUNIOPALITY OF ANCHORAGE ~-~ DEPARTMENT (:iF HEALTH & ENVIRONMENTAL PROTECTION DEPT, OF I IEAI.'[t & 825 L Street - Ai~chorage, Alaska 99501 ENVIRONMENTAL F't:OTECTI()N Ii - ' (~:~1,)) ENVIRONMENTAL SANITATION DIVISION Telephone 264-4720 DIRECTIONS: COral)leto all parts oll page 1, Incomplete requests will not be processed. Please allow ten 10) days for processing, PROPERTY OWNE~.~Rp! . . -'- S' PROPERTY RESI DENT (If differeat from above) ]~PHONE 2, BUYER , ]EpNoN ' MAILING ADDRESS ~P~ONE Al LINO ADDRESS 14. REALTOR/AGF~'i' __ ~, ,, ' ~' / PHONE PHONE LEGAL DESCRIPTION 6, TYPE OF RESIDENCE SI NG L E FAMILY MULTIPLE FAMILY 7, WATER SUPPLY ,., INDIVl DUAL- COMMUNITY PUBLIC UTILITY -'~. 'SEWAGE ISPOSAL SYSTEM NDIVI DUAL/C ~I-SITE*~ [] PUBLIC UTI LITY NUMBER OF BEDROOMS [] One ~3 Four [] Other [] Two ~] Five ~ Three E] Six ATTACH WELL LOG. A well log is required for all wells drille¢ since June 1975, For wells drilled odor ~o [nat pate, ~we well ae[~th (attach log if available.) /(~/ YEAR ON-SITE SYSTEM WAS INSTALl_ED. NOTE: THE INSPECTIOE FEE MUST ACCOIVlPANY EACH REQUI-'ST BEFORE PROCESSING CAN BE INITIATED. THIS SIDE FOR OFFICIAL USE ONLY 1, TYPE OF RESIDENCE NUMBER OF BEDROOMS ~J.--'~l N G L E FAMILY [] ONE ~,,,,"'~R E E [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY ~IN DIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER _[~IVIDUAL/ON -SITE DATE iNSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or [] Holding Tank Size: / '~ ~' z~ If Tank is homemade SOILS RATING TYPE OF TANK ~' MANU FACTUR ER ~r~.~'~_~__~ TOTAL ABSORPTION AREA MATERIAL 4, DISTANCESwELLTO: Septic/HoldingTank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5, COMMENTS [J~-~-APPROV ED FOR ~.~ BEDROOMS [] CONDITIONAL APPROVAL (latter must accompany certificate) [] DISAPPROVED 72 010 (Rev. 6/79) ./ 825 "1." STR El_-. F ANCHORAGE, ALASI<A ,~)9501 (90/) 264 4111 September 21, 1981 David P. Baggett Star Route A Box 80-C Anchorage, Alaska 99507 Subject: Lot 10 Block i Williamson Subdivision Approval for the individual sewer and water facilities cannot be granted until the following items have been completed: (2) The water analysis report needs to be submitted to this office from the Chem Lab, 5633 B Street, for our review. A well log needs to be submitted to this office for our files and review. If there are any further questions, please call this office at 264-.4720. Sincerely, James S. Roberts Associate Environmental Specialist JSR/ljw cc: Alaska Mutual Savings Bank Post Office Box 1120 99510