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HomeMy WebLinkAboutT15N R2W SEC 25 LT 52T15N, R2W, Section 25 Lot 52 #051-281-43 Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room 502 RD. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak.us (907) 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D.J'~/- 1. GENERAL INFORMATION Complete legal description -~ ,/'~, Expiration Date: Location (site address or directions) Current Property owner(s~ercit~n ~ Mailing address Lending agency Mailing address Day phone Day phone Real Estate Agent Mailing Address Day phone Unless otherwise requested, HAA will be held by DHFIS for pickup. HAA picked up by: NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Public Water System Well TYPE OF WASTEWATER DISPOSAL: [%t, Individual On-site .~',' [] Individual Holding Tank [] [] Community On-site [] [] Public Sewer [] The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 5, STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation based on procedures outlined in the Health Authority Approval Guidelines for the Health Authority Approval application show that the on-site water supply and /or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Address ?gle River Engineering Services t .O. Box 773294, Eagle River, AK 99577-329'k Phone Engineer's Printed Name DHHS SIGNATURE Approved for L./Z bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations. Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other Expiration Date: /,¢ - /-'- ,/D o Original Certificate Date: Reissue Date: ECEI VE Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES ~JUN ;~0 ~.000~...__~ Environmental Services Division 825 L Street, Room 502. Anchorage Alaska 99501. Legal Description: T ] -~ ~",~ A. WELL DATA Well type Log present (Y/N) Total depth .2 ~' 0 ~'~- Sanitary seal (Y/N) Ye Health Authority Approval Checklist If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to FROM WELL LOG Date of test ~ ~ 1~-~/~" Static water level Well production 5 g.p.m. WATER SAMPLE: RESULTS: Coliform Date of sample: B, SEPTIC/HOLDING TANK DATA Nitrate Casing height (above ground) + I,~ ~n Wires properly protected (Y/N) ,v'e ~- AT INSPECTION ~, 7 g.p.m. 0.~ mill Otherbacteria I colonies/~oom] Collected by: £t,~ineer Date installed ~-2~-'fg 'Tanksize 1~5'0 Foundation cleanout (Y/N) /v' Depression (Y/N) Date of pumping Z ~. )/¢4t'$ o/~/ Pumper /V,/,~ C. ABSORPTION FIELD DATA Date installed ~-,,?/, - ~ ¢ Soil rating (g.p.d./ft2 or fF/bdrm) 0. 7 Number of Compartments .2- Cleanouts (Y/N) ~/ /V' High water alarm (Y/N) lY//) Length 5 7 / Width Effective absorption area ~'¢'7 Date of adequacy test ~ 2 ye Gravel thickness below pipe Monitoring Tube present (Y/N) Results (Pass/Fail) ,Ocr 55 Fluid depth in absorption field before test (in.); /i/,//~ Fluid depth j[/'/,z/ (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) fi/ 72-026 (Rev. 3/96)* System type 8¢~ O, ,,q Total depth ._,C / . Depression over field (Y/N) jl/' For ¢ bedrooms Immediately after/Y/fl gal. water added (in.): ////~ Absorption rate = ~0~ g.p.d. If yes, give date D. LIFT STATIO~// Date installed Manh/ccess (Y/N) Hi,~ater alarm level at* /O~cles tested E. SEPARATION DISTANCES Size in gallons. "Pump on" level at* *Datum "Pump off" level at* SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot + I 0 0 Absorption field on lot + I00 / Public sewer main Sewer/septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation I S / Property ne [ I 0 / Absorption field I.~ Water main/service line ~¢ 10O / Surface water/drainage 4- I 0O ~'¢Wells on adjacent lots -{- I00 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 7 .3 / Building foundation 1 9 / Water main/service line Surface water '~ l0 0 / Driveway, parking/vehicle storage area + '/Io/ Curtain drain /V/,~ Wells on adjacent lots 4- 100 R ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections in conformance with MOA HAA guidelines in effect on this date. Engineer's Name LoU~5 Date ~'- ~ ~ HAA Fee $ '~, Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number Municipality of AnchoragePage / 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: .¢'/4/¢~,~/~'~ PID Number: ~"-/'~-'~"/ Name: ~,¢,¢~,/~, ~/~ Wastewater System: ~New O Upgrade ~,~,,: ABSORPTION FIELD Pnone~?_ 7 ~ ¢-- ~Z-~ ~ Deep Trench ~ Shallow Trench ~Bed O Mound a Other Total Depth from original grade: LEGAL DESCRIPTION s~,,~.,,.~:¢, ~ GPDISq. Ft ~9~-~ /~1 To..~,p: Rang 2~ ~cc ~ ~ F~ J~ z F~. ~1'--~ ~' wid'~ / Number OI lines: J 0,si,ncc baween I,ges: WELL: ~New g Upgrade Ft 3 /~ ~¢~ ¢-[ Ft. v,.,u: .~.~ ~.~ JP.m.S~,~,: J Casing He,grit Above Ground: TANK SEPARATION DISTANCES ~epJic C Holding e S.T.E,P. su,~o~ ,/~, LIFT STATION LOt / S~ze m gallons: J Manufamurer: Line ]/¢ ~ / 7~/ Curtain ~ Drain ~ /~ Remarks: ~/ ~'/¢~ ~/ ~y-~ /¢/~ BENCH MARK Location and Oesceiption: ~ ,~'/~ / ~,~ ENGINEER'S SEAL Inspections performed by: ~E¢ Dates: 1st ~-z~*¢~~, ~.~¢~..~ Department of HeaVy,man Services approval ',~,. Reviewed and approved by' [ ' Date: [- 7-~ 72-013 [Rev 9~911 MOA 25 Permit No, 8W980174 Page 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchoro§e, Alosko 99519-6650 Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LOT 1 ROSANNA LOT 2 ROBANNA Lot 82 T15N R2W SEC 28 PID No.: 05128143 SEPTIC BED I WELLS N 89'58'00' ~ A HOUSE SWING TIES A-D = 55' B-O = 76' A-C = 54' B-C = 48' 8-E = 21' A-E = 76' SEPTIC +zO' I--- Ld L,d F-- T Z ELEVATIDNS (NDT TO SCALE) SCALE 0 + 89'57'55' E 1 "=60' TEST HOLE MONITOR TUBE SEWER CLEANOUT WELL EASEMENT 298,02 PIONEER ]]RIVE 3/17/99 EN~NEE~e SEAL 05/18/1999 16:16 907?4530?2 AROHIBALD DRILLING PAGE 01 Rick Mystrom, Mayor Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 198650 Anchorage, Areska 995tg-$650 Permit Number~Date Of Issue -__ __ Tax Identification Number.9.?.__.01.61-~ Date Stlrte~l ~_fl_5__~jR Date Completed .6__'l.~_9.JL_ Is well Io~ated et approved permit location? []: Yes O No Legal Oa~rt~iien, Bleak Lot Pmpe~y Owner Name & A~drm~a: T15 NR 2W SEC.25 52 Gordon Lumpkln Lot 52 5~1 Serrano Dr. Pioneer Dr. Chugla. k, AK Waeilla, AE 996~4 ~mhol~ Oa~: Oe~h "' ' ~thod ~O~lllng: ~ air ~ta~ O ~bie~l ~il T~e & Thiekne~ & Water Strata F~ To Liner ~:~Diammer~hes, ~h 1 8~ _~a & ~rav~] ~ 20 ~atng~l~up~oveGmund: ~ .... feet S~d 20 40 ~mplng Level: f~ alter h~, pumping~pm R~RMe~ ~ ~m Well intake O~lng ~: ~d e$one 60 80 ~ Soreen~: ~a~ .feet S~_ fee ~ Pe~o~ns ~ f~ S~pp~ fern S~datoae ,80 100 ~o:t ~Aa[e 100 240 D~h; P~ Pu~Size _bp Brand Name Post-it~ Fax Note 7671 ,,,Mumc?~lmty ol Anonor~ C~ ~ ,~ A~ ZIp gq~5 Post-it~ Fax Note 7671 Oate..~ ./~;. ~r~lk / To _"~"~.]y,~ ~,~.~ Fmm~/~ Attention: The well driller shall provide a Well log to the property owner within 30 days of completion,. ~g3NICIPALITY OF ANCHORAGE DEP~,RT~ENT OF HEALTH ~ HU~ SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF 1 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PER/4IT PERMIT NUMBER:SW980174 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAI~E:LRMPKIN GORDON O & NANCY C OWNER ADDRESS:531 SERRANO DRIVE WASILLA, ALASRA 99564 DATE ISSUED: 6/15/98 EXPIRATION DATE: 6/15/99 PARCEL ID:05128143 LEG/%L DESCRIPTION: T15N R2W SEC 25 LT 52 LOT SIZE: 108900 (SQ. FT.) NL~4BER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: THE ATTACHED APPROVED DESIGN. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AIqD THE STATE OF /YLASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED /LND CLOSED ON THE SAME DAY B. COVERED, SEALED ~ HEATED TO PREVENT FREEZING THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THE SAND USED IN THE FILTER LAYER MUST BE A CLEAN C0/LqSE SAND WITH 4% OR LESS PASSING A ~100 SIEVE AND 2% OR LESS PASSING A ~200 SIEVE. SAND USED MUST BE FROM AN APPROVED SOURCE OR A SIEVE ANALYSIS PROVIDED. Rick Mystrom, Mayor Mnnic pal ty of Anchorage Department of Health and Human Services 625 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 August 27, 1997 Gordon 0 & Nancy C LumpkiD 531Serrano Drive Wasilla, Alaska 99645 7755 Subject: T15N R2W Section 25 Lot 62 Permit #SW960266, PID #051-281-43 The subject permit, issued August 26, i996 by this office for a single family well and/or on-site wastewater system, has expired as of August 26, I997. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. krhen applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. j~C,erely' ~ O a/~l,, e s ross, P.E. P~gram Manager On-site Services enc: Copy of Permit cc: Eagle River Engineering Services MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW960266 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:LUMPKIN GORDON 0 & NANCY C OWNER ADDRESS:531 SERRAND DR. WASILLA, AK. 99654 DATE ISSUED: 8/26/96 EXPIRATION DATE: PARCEL ID:05128143 LEGAL DESCRIPTION: T15N R2W SEC 25 LT 52 LOT SIZE: 108900 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM 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 (iSAACS0) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. 1 OF 8/26/97 SPECIAL PROVISIONS: THE SAND USED IN THE FILTER LAYER MUST BE A CLEAN COARSE SAND WITH 4% OR LESS PASSING A #100 SIEVE AND 2% OR LESS PASSING A #200 SIEVE. A SIEVE ANALYSIS MUST BE PROVIDED ON THE SAND USED. RECEIVED BY: ISSUED BY: Eagle River Engineering Services Louis Butera, P.E. P.O. Box 773294 (907) 694-5195 tel Eagle River, AK 99577-3294 (907) 694-3297 fax August 7, 1996 Jim Cross, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Lot 52, T15N R2W Section 25 Narrative & Permit Application Dear Mr. Cross: The proposed well and septic system will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are large, allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance. 3. Reserve space is adequate, due to absorption capacity. 4. Drainage will not be affected and is not a major consideration in our design. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. \ 1996\96-072A-N^R.DOC SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: Lot 52, T15N R2W Section 25 08/26/96 GENERAL. 1. The well & septic plan is for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. 9. Any remaining open test hole excavations shall be filled. SEPTIC TANK 1. The septic tank shall be an MOA approved 1,250 gallon septic tank BED 1. 4. 5~ 6. The bed is to follow the natural land contour to maintain uniform total depth of the bed bottom. The bottom of the bed shall be level, plus or minus 1.5". A 2' filter sand layer shall be required at a total depth of 7'. Material shall be an MOA approved filter sand. The total depth of the gravel layer is not to exceed 5' at any point. The effluent line shall be laid level within 0.03'. The bed gravel is to be covered with typar fabric material. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the bed. Mounded side slopes not to exceed 3:1. The area over the bed is to be finish graded to prevent ponding of surface water runoff. The septic tank and Ieachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: BOTTOM OF 2' FILTER SAND LAYER = 7' below grade BOTTOM OF GRAVEL LAYER = 5' b~,l,.o,3~v~jgrade t,,/' SAND FILTER THICKNESS = 2' of'~-BtEC'approved material GRAVEL THICKNESS = 6" under pipe, 2" over pipe BED LENGTH = 57' BED WIDTH = 15' SOIL RATING = 0.7 GPD/ft2 BEDROOM CAPACITY = 4 SEPTIC TANK = 1,250 gallons minimum Twenty-four (24) hours notice required for all inspections. \1996\96-072a-spc.doc ~ SEPTIC BED I WELLS +100' ~97,94 N 89°58'00, W LOT 1 ROi]ANNA I BED DETAIL NOTE'. PRESSURE TANK TO BE ~ - TEST HOLE PLACED IN SHOP, WATER LINE · - MONITOR TUBE ~o 2's' ./~ FROM SHOP TO PROVIDE o - SEWER CL~NOUT 5'~/ HOUSE WITH WATER, ~ - WELL ~SEMENT jo 5, NOTE: POSSIBLE 20' UTILITY OR L~CHFIELD ~ 2.5, / SECTION EASEMENT ON SOUTH BOUNDARY. ~- - EXISTING L~CHFIELD IT IS THE RESPONSIBILITY OF THE OWNER TO VERIFY LACK OF EASEMENT NO SURFACE WATER PRIOR TO WELL CONSTRUCTION, NO KNOWN CURTAIN DRAINS WELL/SEPTiC SITE PLAN LEGAL: LOT 52~ T15N R2W SEC.25 OWNER: LUMPKIN ...... 77 s4 EAGLE RJVER, A~. ~577 ~l?Or~ss~o~~ LOT 2 ROBANNA N£1~"O~ ALTE""*' S ~x~57'55' E EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 694-5195 ERES Project No,: 96-072 Calculated By: LB Date: 8/12/96 Legal: LOT 52 T15N R2W SEC 25 Single Family 4 Bedroom Dwelling TEST HOLE Bed Subsu~ace Wastewater Disposal Field Water use at 150 gallons per bedroom = 600 gallons Percolation rate = 0.3 minutes perinch Wastewater application rate = 0.7 gallons per day per square foot Required absorption area = 857 square feet Bed width(W)= 15 feet Gravel depth (D) = 1 feet Required length = Required absorption area / Bed width Required length = 857 / 15 Required length = 57 f, , Total Excavation Depth = 7.0 f~ , Z 2' Sand Layer of ADE~ O~ filter sand required r~l Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 10- 11 13- 14- 15 16 17 18 19 20 ~_.LA'7' >,.//7'H COMMENTS DATE PER ORMED: Township, Range, Section: SITE PLAN SLOPE WAS GROUND WATER ENCOUNTERED? , ~{~ S IF YES, AT WHAT ~ ~ DEPTH? p E Oepth to Water Alter ~ ~/.~. ~ Monilorino? ~r~ Da~e: Reading Date Gross Net Depth to Net Time Time Water Drop / ,.- 7. ,- Z/~5 ~.' ~2.', ~,~, (~ . ~ ;/~ ~, ~o,, ~,, PERCOLATION RATE ~' / (mlnules/inch) PERC HOLE DIAMETER ~'~ II TEST RUN aETWEEN '~ FTANO 5 FT PERFORMED SY: /'"/,TN , z~Pg$ ~ERTIFY THAT THIS TEST WAS PERFORMEO IN ACCORDANCE WITH ALL STATE ANO MUNICIPAL GUiDELiNES iN EFFECT ON THIS DATE, OATE: 72-00S (Rev. 4~85~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: DATE PERFORMED: Township, Range, Section: "r')5~J ,,P~2 3 4- 5 6 7 8 9 10 11 12 13 14- 15- 16- 17- 18 19 20 COMMENTS SANoY G,eAv~/ SLOPE SITE P [.~N WAS GROUND WATER ENCOUNTERED? S IF YES, ATWHAT ..--.--. O DEPTH? p E (]eplh lo Water Aller M~nitoring? ~J"'-'~ Dale: Reading Date Gross Net Depth to Net 'r~me Time Water Drop ~~ 2:~ ~/ ~ ?0~ ~" PERCOLATION RATE ~' / TEST RUN BETWEEN ..~ . (m~nules~lnch) PERC HOLE DIAMETER . _ FT ANO ~ FT I" Municipality of Anchorage Page ' 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: ..4'/.~'¢~:'~'/~ '-{ PID Number: O~--/'~--~"/~ Name: ~ ~ Wastewater System: ~New D Upgrade Address: ~/ ~,,~Z ~., ~7/~ ~k ~? ABSORPTION FIELD Phone: ~ NO o~edrooms: ~-7~'~ ~ Deep Trench Q Shallow Trench ~Bed QMound QO~her Total Depth from original grade: LEGAL DESCRIPTION so,~,n~:~. ~ ~,s~.~ ~%-~ /~' Township: Rang 2~ ~C~ ~ ~ J~ ~ / FL WELL: ~New Q Upgrade ~lwidt~ / F[ ~ /~ ~, ¢-~ Ft. ~.,~: ~,~ ~ ..~s~,~: I TANK ~ GPM ~ ~/r~( Ft I SEPARATION DISTANCES ~,c ~ ,o~n~ ~ m From Ta.X Field Slat,o~ Tank Sewer Lmnes ~. ~ . /C f ~ Surface ~ / w~ ,/.~. ~/~. */~' LIFT STATION Lot ' Size 'n gamm°ns: I Manu'acmrer: ~ Line //¢ ~ / Remarks: ~/ ~'/~r ~,~/ ~r~ J~ BENCH MARK ;ocation and Description: I Assumed Elevation: ENGINEER'S SEAL Inspections performed by: $~ Dates: 1st ~-z~-¢~. ~.,~~~ ~ ff~?~m] ~ 2nd~-~d-~ ~,,.~,.~ Department of¢~ ~e ~', Heal~n~ ~man Services approval[_ 7-7~ ~*'~"~;'~o..~,~%~CE4m Reviewed and approved by: ~~ /~' Date: 72-OI3 (Rev 9~91 ) MOA 25 Permit No. SW980174 Page_ 2 of 2 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 Telephone: 345-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: Lot 52 T15N R2W SEC 25 PID No.: 05128143 LOT 1 ROSAflNA LOT 2 EOSANNA SEPTIC 8ED I WELLS 297.94 N 89°58'00' ~/ A HOUSE SWING TIES A-D = 35' B-O = 76' A-C = 54-' B-C = 48' 8-E = 21' A-E = 76' SEPTIC +30' L~ Ld F-- -n ELEVATIONS (NOT TO SCALE) SCALE 1"=60' ~'57'55' E 298.02 PIONEER DRIVE TEST HOLE MONITOR TUBE SEWER CLEANOUT WELL EASEMENT ./I I%..o% U X 90.7 3/17/99 ~8 SEAL ~.?...." ...~'...~ % 05/18/1999 1G:lG 90?74530?2 ... ARCHIBALD DRILLING PAGE Rick Mystrom, Meyer Municipality of Anchorage Department of Health and Human Services 826 "L" Street P.O. Box 196650 Anchorage, Araska 995t9-6650 Permit Number.~w~q_~ol ?,[ Date Of Issue -... Tax Identification Number~2 ~0_.t:~.- 5'~2 Date ~terted .~_'i 5 ~8 D~te Completed F; 'L~_9.~_ ls well to~ated at approved permi~ Io~etion? ~ Yes O No Legal De,l~rtptlon Block Lot Property Owner Hame & AC~dm~a: . T15 RR 2W S~C.25 52 Gordon Lum~kin Lot 52 521 Serraao Dr. Pioneer Dr. Chugiak, AK Waellla, AK 996~4 ~mhele Oa~: OeWh ~thad ~ Odlllng: ~ air ~taw ~ ~ble ~1 ~il T~e a Thickne~ a Water Strata F~ Liner T~:~Diam~er~es, ~h ~ ~ ~raval . S 20 ~atng ~l~up ~ove ~mund: ~ ,fe~ ~ Weir bvol (~m ground I~el): BO fe~ S~d 20 40 ~mplng Level: f~ after hm. pumping gpm C~ar~ I~d ~ Gr~ve1 4~ 60 ~h~TlMIng: Well Intake O~lag ~: ~ Open End D O~en Ho~ Sand e.~one .. 60 80 O Screen~; ~a~ feet 9~ fe~ D Pedo~ne ~ , , f~ S~pp~ fe~ ~d at one ~0 1 00 Soft ~hale 100 240 D~h; ffo~ : O ~,to 6~ Pu~ Size _bp Brand Name ...... Well D~f.f~ U~ C~tJon? ~ '~ , Mun~c~pahty ol Anc~or~qe C~ ~=~ ~. ~ ~ ~ Zip Attention: The well driller shall provide a Well log to the property owner within 30 days of complelion,. MUNICIPALITY OF ANCHORAGE DEP~RTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ~J~AS KA 99519-6650 PAGE 1 OF 1 ON-SITE WELL AND WASTENATER DISPOSAL SYSTEM PERMIT PERMIT ~ER:SW980174 DESIGN ENGINEER:EAGLE RI~-ER ENGINEERING SERVICES OWNER NAME:LUMPKIN GORDON 0 & NANCY C OWNER ADDRESS:531 SERRANO DRIVE WASILLA, ALASKA 99564 DATE ISSUED: 6/15/98 EXPIRATION DATE: 6/15/99 P~RCEL ID:05128143 LEGAL DESCRIPTION: T15N R2W SEC 25 LT 52 LOT SIZE: 108900 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: THIS PER-MIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ~NCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ~J~ASKA WASTEWATER DISPOSAL REGULATIONS (18~21C72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SD/gE DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THE SAND USED IN THE FILTER LAYER MUST BE A CLEAN COARSE SD~N-D WITH 4% OR LESS PASSING A $100 SIEVE AND 2% OR LESS PASSING A $200 SIEVE. SAND USED MUST BE FROM AN APPROVED SOURCE OR A SIEVE ANALYSIS PROVIDED. Rick Mystrom, Mayor Mun cipal ty of Anchorage Department of Health and Human Services 825 %" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 August 27, 1997 Gordon 0 & Nancy C Lumpki~ 531 Serrano Drive Wasilla, Alaska 99645 7755 Subject: T15N R2W Section 25 Lot ~3 Permit #SW960266, PID #051-281-43 The subject permit, issued August 26, 1996 by this office for a ~single family well and/or on-site wastewater system, has expired as of August 26, 1997. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. Ail inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. j~e~erely' ~ oa~,.es ross, P.E. P¢ogram Manager On-site Services enc: Copy of Permit cc: Eagle River Engineering Services MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AMD HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW960266 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:LUMPKIN GORDON O & NANCY C OWNER ADDRESS:531 SERRAND DR. WASILLA, AK. 99654 DATE ISSUED: 8/26/96 EXPIRATION DATE: PARCEL ID:05128143 LEGAL DESCRIPTION: T15N R2W SEC 25 LT 52 LOT SIZE: 108900 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM 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 (iSAACS0) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. 1 OF 8/26/97 SPECIAL PROVISIONS: THE SAND USED IN THE FILTER LAYER MUST BE A CLEAN COARSE SAND WITH 4% OR LESS PASSING A #100 SIEVE AND 2% OR LESS PASSING A #200 SIEVE. A SIEVE ANALYSIS MUST BE PROVIDED ON THE SAND USED. ISSUED BY: ': Ea le River En ineerin Service Loui~ Bu~era, P.E. .P.O. Box 773294 (907) 694-5195 tel Eagle Pdver, AK 99577-3294 (907) 694-3297 fax August 7, 1996 Jim Cross, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Lot 52, T15N R2W Section 25 Narrative & Permit Application Dear Mr. Cross: The proposed well and septic system will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are large, allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance. 3. Reserve space is adequate, due to absorption capacity. 4. Drainage will not be affected and is not a major consideration in our design. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. \ 1996~96-072A-NAR.DOC SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: Lot 52, T15N R2W Section 25 08/26/96 GENERAL 1. The well & septic plan is for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. 7. The excavation is to b.e exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. 9. Any remaining open test hole excavations shall be filled. SEPTIC TANK 1. The septic tank shall be an MOA approved 1,250 gallon septic tank BED 1. 4. 5. 6. The bed is to follow the natural land contour to maintain uniform total depth of the bed bottom. The bottom of the bed shall be level, plus or minus 1.5". A 2' filter sand layer shall be required at a total depth of 7'. Material shall be an MOA approved filter sand. The total depth of the gravel layer is not to exceed 5' at any point. The effluent line shall be laid level within 0.03'. The bed gravel is to be covered with typar fabric material. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the bed. Mounded side slopes not to exceed 3:1. The area over the bed is to be finish graded to prevent ponding of surface water runoff. The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: BOTTOM OF 2' FILTER SAND LAYER = 7' below grade BOTTOM OF GRAVEL LAYER = 5' bt~otl~v,~grade 6~g' SAND FILTER THICKNESS = 2' of:&q~ffapproved material GRAVEL THICKNESS = 6" under pipe, 2" over pipe BED LENGTH = 57' BED WIDTH = 15' SOIL RATING = 0.7 GPD/ft2 BEDROOM CAPACITY SEPTIC TANK = 1,250 gallons minimum Twenty-four (24) hours notice required for all inspections. \1996\96-072a-spc.doc ~ SEPTIC BED I WELLS +100~ 897,94 N 89'58'00' W LO* , I N EOBANNA NEIGHBOR ALTERNITI S 57'55' E PIONEER D~! ./E BED DETAIL NOTE: PRESSURE TANK TO BE ~ - TEST HOLE PLACED IN SHOP, WATER LINE MONITOR ~o 2.5' .// FROM SHOP TO PROVIDE o - SEWER CL~NOUT 5'~ HOUSE WITH WATER. + - WELL ~, NOTE: POSSIBLE 20' UTILITY OR PROPOSED L~CHFIELD ~ 2.5' SECTION EASEMENT ON SOUTH BOUNDARY. I- EXISTING L~CHFIELD IT IS THE RESPONSIBILITY OF THE OWNER TO VERIFY LACK OF EASEMENT NO SURFACE WATER PRIOR TO WELL CONSTRUCTION. NO KNOWN CURTAIN DRAINS WELL/SEPTiC SITE PLAN LEGAL: LOT 52, T15N R2W SEC.~5 ~2~.. .... JOBff 96-072AIDATE: 08/26/961 SCALE 1" = 60' ~ P.O. Box 77~4 Ax. · x (907) 694-5195 FAX: (907) 694-3297 N 89°58'00, ~/ LOT 1 ROBANNA / ~ PROP ~ X~..X 12SD GAL EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 Eagle River, Alaska 99577 (907) 694-5195 ERES Project No.: 96-072 Calculated By: LB Date: 8/12/96 Legal: LOT 52 T15N R2W SEC 25 Single Family 4 Bedroom Dwelling TESTHOLE Bed Subsur[ace Wastewater Disposal Field Water use at 150 gallons per bedroom = 600 gallons Percolation rate = 0.3 minutes perinch Wastewater application rate = 0.7 gallons per day per square foot Required absorption area = 857 square feet Bedwidth0N)= 15 feet Gravel depth (D) = 1 feet Required length = Required absorption area / Bed width Required length = 857 / 15 Required length = 57 Total Excavation Depth = 7.0 2' Sand Layer of ADE~ O~ filter sand required Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage. Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR:. LEGAL DESCRIPTION: DATE PERFORMED: Township. Range. :Section: "'~}SfiJ ~2 3 4- 5- 6 7 8 9 tO 11 12 13 14 15 16 17 18 19 20 COMMENTS ~LAY~Y EAt. iD /qo l~/A76~ SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? I- N L IF YES, AT WHAT __.... DEPTH? Oeplh to Water' After MoAitoring? /'~ r'.>, Dale: PERCOLATION RATE '~ / (mmutes/,nch) PERC HOLE DIAMETER ~// PERFORMED BY: /~/'-/~ , ~ ~ ~ CERTIFy THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDeLiNES IN EFFECT ON THIS DATE. DATE: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: /... OATE PERFORMED: Township, Range, Section: "~}5~/ ~. 5 6 7 8 9 10- 11 13- 14 S~DY G,R,'~v~/-- SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, ATWHA~' DEPTH? OeplJ1 lo Water A~er ~;-- -,,:~ - v~ Manilming ? ~2,-~ Oat~ SITE PLAN 15 16 17 18 19 20- PERCOLATION RATE ~' / (mmules~nch) PERC HOLE DIAMETER .. TEST RUN BETWEEN 5 FT AND ~ FT PERFORMED BY: ~/~ ~'~" I ~,~:'-' '~ ~'~ ~" - CERTIFY THAT THIS TEST WAS PERFORMED IN ACCOROANCEWITHALLSTATEANOMUNiCiPALGUIDELiNESiNEFFECTONTHISOATE. DATE,