Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAboutT15N R2W SEC 25 LT 129CT15N, R2W,
Section 25
Lot 29-C
#051-312-35
Municipality of Anchorage
On -Site Water and Wastewater Section - (907) 343-7904 Page Of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP221450 PID Number: 051-312-35
Dwelling: P1 Single Family (SF) R with ADU R Duplex (D) El Two Single Family Project: El New P1 Upgrade
Name
Robert Hahn ABSORPTION FIELD
Site Address El Deep Trench [:] Wide Trench ®Bed W1 Mound
15443 Husky St. Eagle River 1 0 Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
4 2.0 GPD/SFI 4.7 Ft,
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 2.18 Ft. 0.25 Ft.
129C Fill added above original grade Gravel length
Township Range Section 1.17-1.27 Ft. 32 Ft.
15 2 25 Gravel width Beds: Number of Lines Distance between lines
SEPARATION DISTANCES 13 Ft. 5 2.4 Ft.
To„ Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist- between trenches
From Tank Field on Tank Line 416 Ft2 Ft.
Well 100+ Septic El S.T.E.P. 171 Holding El Other
i Manuf Capacity
Surface Water Gal,
100+ Mat
Material Number of compartments
Lot LineNA
10+
Foundation 10+ E LIFT STATIONManufacturer Ca 'ty
Remarks Gal,
Tank exvosed during bed installation, no holes seen. Alarm location Electrical installed b
Air compressor and pump alarm tested and working.
PIPE MATERIAL House totank Tank to
Installer drainfield D3 ' 0 - 34
Northern Excavation Drainfield D3034 CO/MT D3034
Inspector Areterra Consulting BENCH MARK (Assumed elevation) 100 ft
InspectionLocation and description
dates.- 11/16/22 2"' 11/16/22
Yd 11/16/22 4`11/18/22 Bottom of Shed Roof
ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp
(OF
Conditional Approval: Date
49M
KENNETH[ 0 s a
Septic System CE 7
Approved' Date
ib__0�7
Note: this approval does not include well permit requiremen s.
(Rev 05_/0_2/18)
AS—BUILT SYSTEM DETAILS/SITE PLAN Permit ❑SP221450
T15N R2W SEC
25 LOT 129C
PID# 051-312-35
I
�SH HED
i
I
� s
r
� D
B
/
MT MTF K
rri
ry
D
F n fel
= X
�c
COs
H
O �
G
C
V) H
3
MT
Frl
o�
Z! EXISTING AIR
r�
CUMPRESSUR
a /
¢I
�I
A /
\
SND Sf'p
U.
LV
rel
c I
of
pi
,
N�
�I
�I
SCALEi 1' = 30'
a
a A -C=82.7' A -H=111.8'
.. B -C=78,3' B -H=106.0
9a 91
95,00
q A -D=86.5' A -I=112.7'
B-D=75Ij
.0 B -I=105.7 o PLYWOOD
FINISHED GRADE
r P'O
v A -E=110.2' A -J=113.8 VISBUEEN HARRIER ❑RIGINAL GRADE 93,73 FILTER FABRIC 34
a B -E=106.3 B -J=105.5 A
91,8
A -F=114.0' A -K=114.0` y
EA GRAVEL
91.30
B -F=104.3 B -K=104.8
A -G=110.9'
F B -G-106.7
SAND FILTER
A DISTRIBUTION LINES
91.55
a
13�
BOTTOM OF SAN 89.0
IR LINE $9,5
4 ■
lk
SCALEr NTS
41 Aw OF At ..- � 1
PREPARED FOR:
gCTER
m
ROBERT HAHN
228 PYRRA ROAD
JO'
Nyk 4 TH *
FORD CITY, PA, 16226-0000
a
a
FIELD BOOKS COMPUTED:
a �
A
; x
N _ 1B ••
BOUNDARY: N ZA DRAWN: KSD
Z o
F
STING CHECKED:N A CHECKED: KMD
a �°
I.•.�i�q�,r
Aseui�T. JLS DATE: �2 �3 22
S$YO�y�
■
�a�
DWG. FILE: GRID: NW0653
•�eR'
c
ACAD FILE: FILE JOB No.: 22167
AK. 3I - "6
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP221450
Work Type: Septic Upgrade
Tax Code Number: 05131235000
Site Legal Address: T1 5N R2W SEC 25 LT 129C G:0653
Site Mailing Address: 15443 HUSKY ST, Eagle River
Owner: HAHN ROBERT J & FRANCES
Design Engineer: ARC TERRA CONSULTING INC
This permit is for the construction of:
Effective Date:
Expiration Date
Lot Size in Sq Ft
Total Bedrooms:
11 /14/2022
11/14/2023
Q Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions:
1. MOA requires that an air gauge and alarm be installed on the air compressor.
2. The steel tank is 22 years. Per Policy W.05 Standard of Care Regarding the Inspection of Steel Septic
Tanks, the tank should be exposed and inspected for holes at the time of construction to replace a failed
drainfield.
-. .4
+-(-) X rr_�Y-ro� Cons, Date:
Issued By:
Date: II /y Z-
M
MUNICIPALITY OF ANCHORAGE
Development Services Department %' Phone: 907-343-7904
On -Site Water & Wastewater Section --� Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 051-312-35
Property owner(s) Robert Hahn Day phone
Mailing address 228 Pyrra Rd. Ford City, PA 16226
Site address 15443 Huskv St. EaLle River
Legal description (Sub'd., Block & Lot) Lot 129C
Legal description (Township, Range & Section) T15N R2W Sec 25
Lot Size 30,000 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
X❑
Initial ❑
Single Family (SF) ❑X
(w/wo AD U)
Septic Tank
p
❑
Upgrade ❑X
(D) ❑
Holding Tank
❑
Renewal ElDuplex
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
Dea Duffus
(Signature of property owner or authorized agent)
Permit/Rush Fees: 616 -
Date of Payment: /D/a pl a
Receipt Number: 00L/ / 56
Permit No.
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221450, Deb Wockenfuss, 11/14/22
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221450, Deb Wockenfuss, 11/14/22
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP221450, Deb Wockenfuss, 11/14/22
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this f Day of of 20_ZZ, by and between
A --.
herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described as
Intermittent Sand Filter
located at (legal description)
T15N R2VV Sec 25 Lot 1290, 15433 Husky St, ChAtgtak-
4tk,9
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
hroughout the teen of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
t shall be.the responsibility of the Owner during the teen of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically S400 to 5600).
ner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative wilt inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
A�vner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfieid
replacement.
Page 1 of 3
(rev. 05/18."2018)
_, caner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
inner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14.60.030.
.4�-caner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
/6 � wner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
caner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
�Iner a`rees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
S. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
_jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05118."2018) Page 2 of 3
ONVNER:
By- (sionature) DaIe
(print name)
STATE- OF ., t 'r='A }
� SS
TI IIRD JUDICIAL DISTRICT )
The foregoing 1 •t merit was ac �-- o?wledged before me titin Slav Of tV
?Q)Ji by
1 l Commonwealth of Pennsylvania - Nc�ar� Seel
V. Dawn Zimmerman, Notary Puolic
0"1-A Y PUBLIC FO rC�if: fC 1115 `1IU�"�� Armstrong County
MV C 11111ission expire.. My commission expires November3.2028
Commission number 1185534
member, Pennsylvania Association e1 t4ota^es
,MUNICIPALITY:
Ry: – G ��-
I� r' Ale".�ir�cti----'Z�l�natttrcl
i
(print name}
t � ;
{
Y Y
z
F
(rev. 05'14 101h)
C)nte.�j– =—
title
"" ^"' ^'"^^ '~^ "^""~'"
WA
Pred
ta
4t cent 4hef0p�Lo
ca
-Aii ii
AM
J.
WA
Pred
ta
4t cent 4hef0p�Lo
ca
-Aii ii
AM
Municipality of Anchorage Poge 1 of 3
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 545-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SWO00151 PID Number: 051 --512--55
Name:NiCK AND ROBYN SCALES WastewaterSystem: [] New · Upgrade
Address:
15445 HUSKY ST. EAGLE RIVER, AK 99577 ABSORPTION FIELD
No. of Bedrooms:
eh°ne:(907) 696--5259 4 IDDeep Trench DShallow Trench mBed nMound BOther*
LEGAL DESCRIPTION .2.0 o.o/s.. ~ 1.8 - 2.5**
129-0 - - (+)0.74 - (+)0.04 F~ 0.27
Township: 15N Ronge: 2W Section: 25 Fill added above odginal grade:Gnrvel length:
3 ~ 30
WELL: [] New [] Upgrade/,,.,''/''''''- °~v"' ''dth: 12 F~ Number of lines:6 IDi~en~ baleen lin":2
R. ~1 ~60 sQ. ~ D 3054/ F-810/SCH 40 PVC
~ DENALI SEWER AND D~IN 6/15/00 - 6/19/00
~,. ~,. TANK
SEPA~TION DISTANCES ~ Septic ~ Holding · S.T.E.P.
-rom Tonk Reid St=Uon m=nk S.w.~ u~.. ANCHORAGE TANK 1500
Well 100'+ 100% 100% -- 25% STEEL 2
s~ ~oo'+ ~oo'+ ~oo'+ - - LIFT STATION
Water
Line ~500 ANCHORAGE TANK~ORENCO SYSTEMS
Foundation 5'+ 10'+ 5'+ -- -- 42" 46"
Droin - NONE KNOWN 20 OSl 05 HHF ALCAN ELECTRIC
I I
Remarks: *BO~OMLESS ]NTERMI~ENT SAND FILTER. BENCH MARK
· * 2.27' OF MOA APPROVED SAND FILTER BELOW TOP OF MANHOLE LID
TOTAL DEPTH.
Inspections pe*rmed by:. AWWC, INC. Dates: 1st 6/15/00¢~ .,/ , ,~,~
3rd 6/~5/00 .~,~ ~...~ ~....~
5th 6/~9/00 ~..' (~-7953 ..."~
Depa~ment of Health and Human Se~ices approval ~?~.~ ...~ .......... ·
Reviewed and approved by:~~ ~, ~ Ddte:~- ~' Oe ~ ~ ~ ~
PERMIT NUMBER: AS BUII T DP WING PARCEL ID NUMBER
SWO00151 ' 051-512-55
% % A B
' % k~ ST1 58.8 48.5
~ k ST2 42.4 56.0
~ ~ ~H 43.e 5S.O
~ % ~T~ ~2.5 ~.2
~ % MT~ 5~.3 S~.~
% MT5 87.9 112.2
~ MT4 89.5 109.6
I I~O~ ,~,~ ~ I / AIR LINE
., .........,..,.... ,.../ ¢¢//. /¢-~ ~ ",~,
'-- ~ ~ ~ . I~R~NT ~D
AIR COMPRESSOR~ / ~ S.T.E,P. T~K
/
/
/
I ,ATE:
AI~ASI~ WATER & WASTEW~FER ~.~.w. ~ ..~
PREPPED FOE: PHONE NUMBER: PAGE HUMBER:
NICK ~ ROBYN SCALES (907) 696-5259 2 OF ~ ~ ~
T15N, E2W, SEC 25, LOT 129C, ~4 '"'. .""
~E Of WORK: ~rOfess~O~
AS-BUILT OF SEPTIC SYSTEM UPGRADE (BOTTOMLESS ISF)
PERMIT NUMBER: AS BUILT DRAWING PARCEL ID NUMBER:
SW000151 - 051-312-35
FIg~I. 6RAPE - /--NgNHOte tip -' 9~,'/4
/ 98,~, - 98.? /
- NBW I COO
T~S~P' 97,~7~ ~} --
blN~5 ~ 98 24
, /
/
; ;;;:' OmWN6/26/2000By: ~&~'j'l''~'~¢ CFi f/' }~,
AI,&SB WATER & WASTEWATER K.D.W. ~ 7////~
NICK & ROBY. SCALES (907) 696-3239 3 OF 3 ,~ [¢p¢~A~/ "}~
T15N, R2W, SECTION 25, LOT 1290 ..'"
PROFILE AS-BUILT OF SEPIIC SYSTEM UPGRADE (BOITOMLESS ISF)
06/01/~00 THU 16:25 FAX 907 762 3149 JACK ~¥~II'[~ REAL ESTATE
ent ~ty: /~.l. aaka Water & ~I/as~:ewateP Consu; 907 338 3246; Jun.1 -0o 14:S1;
PROPERTY OWNER MAINTENANCE AGi~EEMENT
ON-SITE WAiT~WATER DISPOSAL SYSTEM
~]002
Page 2/2
This agreement, d~re4 ~/~ 200~ is made between the MunicipaLity of
Anchorage Department of H~alth ami Human ~vcic~s (DH3IS) and the property owner(s) of
~ agreement is made for the purpose of maintaining an on-site wastewater disposal system
on me subject property.
The prol:,er~ owner(a) agree to ~e fo}lowing:
Tho property owner(s) will have an annual inspeedon of the system performed by a registered
professional engineer. This inspection shalt verify that ail effluent and air pgml~, timers, and
alarms are functioning as flesign~. Any ~lefieiencies shall be correete~l and ~e engineer's
statement that the sysmm is i'uncfioning as designed s~ll b~ fried annually with the DHHS.
Property Own~
(Notarize Here)
Sent By: Alaska WateF & WastewateP Consu; 907 338 3246; dun-27-O0 9:43; Page 2/2
Alcan Electrical Engineering, [nc.
6670 A~c~ic Spur Rd.
Anchorage, Alaska 99515
Fax Cover Sheet
DATE: June 27, 2000 TIME: 8:50 AM
TO: AVVVVC HONE: 337-6179
,Jenny FAX; 338-3248
FROM: AIc..a~ Electrlc PHONE: 563-3787
8kipp Brlngmann FAX: 562-6286
T15N, R2W, $ec.25, Lot 129C (15443 Husky St.)
RECEIVED
000
MUnicipality of Anchorage
Dept. Health & Human Services
In regards to the sewage lift station that Alcan connected at th~ above mentioned location.
All electrical work performed by Alcan was done to 1999 National ]Electrical Code,
(NEC) standards.
If you have any questions please contact me.
Thank you!
Number of pages including ~over sheet: 1
[/[ 'd lgLB'ON 0[~10313 NVOI¥ ~¥g~:6 ooog'~'Nnp
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 07, 2000
Expiration Date: Jun 07, 2001
Permit Number: SW000151
Legal Description: T15N R2W SEC 25 LT 129C
Design Engineer: 0041 AK Water & Wastewater Consulta
Owner Name: Rick & Robin Scales
OwnerAddress: 15443 Husky St.
Eagle River, AK 99577-
ParcellD: 051-312-35
Site Address: 015443 HUSKY ST
Lot Size: 30000 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] SepticTank [] Holding Tank [] Privy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 (24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15. a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Date: ~,~-- 700
Date: -~-7- O O
ALASKA i,¥ATER & WASTEWATER
May 31, 1999
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Sewer Upgrade for Lot 129C, Section 25, T15N, R2W
(Bottomless Intermittent Sand Filter-ISF)
To whom it may concern:
The existing 4 bedroom house is served by a private well and septic system. The existing septic
system consists of a 1250 gallon septic tank and deep trench type drainfield. The existing
drainfield is surcharged and must be upgraded prior to sale of the house. We are proposing that a
1250 gallon S.T.E.P. tank and a innovative Bottomless Intermittent Sand Filter (ISF) system be
installed. Comments regarding the proposed upgrade are summarized as follows:
1. GENERAL: A test holes was excavated north of the existing septic system to determine an
area suitable for a septic system upgrade. Groundwater was encountered in the test hole and is
believed to be shallow in the area. Given the limited area around the testhole, the setbacks from
the existing septic system, and the contours of the property; it is our opinion that a Bottomless
Intermittent Sand Filter (ISF) system is the most viable option.
2. SOILS: Attached is a log ~vhich show the soil classifications, groundwater monitoring, and
the pemolation test results. The soils below the organics are a GM/SM material to a depth of 2.0
feet an then transition to a GP/SP material (very compact) to a depth of 8.0 feet (bottom of test
hole). Groundwater was found at 6.0 feet excavation and on 5/30/00, the monitoring tube was
checked and found water to be at 4 feet, 8 inches. A percolation test was performed between the
depth of 2.0 feet to 2.5 feet which had a percolation rate of 7 minute/inch. It is our opinion that
due to the overall appearance of the soils, a application rate of 2.0 gallons/day/sq.ft, should apply
for the proposed bottomless intermittent sand filter system.
3. DRAINFIELD DESIGN: Bottomless Intermittent Sand Filter (IFS)
a. Percolation Rate: 7 minute/inch
b. Allowable Application Rate: 2.0 gallon/day/ft2
c. NumberofBedrooms: 4
6901 Debarr PPad,, Suite 2B ~ AncI~orage, AK ~ 99504 ~ (907) 337-6179 ~ Jrax (907) 338-3246
d. Design Flow: 600 gallons per day
e. Minimum Absorption Area: 300 ft2
f. Effective Depth below pressure pipes: 2.5+
g. Effective Depth: 2.5+ inches
h. Width: 12 ft.
i. Length: 30 ft.
k. 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 Graves: 100% passing 3/8" sieve, less than 20% passing the 1/4" sieve, and less
than 1% passing~ IJge #8 s~eve.'
We are proposing ~ exca~vate down tOd depth of 2 feet (maximum- remove all oreanics), place
a minimum of 3'g'inches of sand, install the air supply linc, and cover it with 18 inches 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.
4. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic
upgrade.
5. TOPOGRAPHY: As can be seen on the attached design, we are proposing to install the
bottomless ISF on a generally flat area near the base of a slope that is less than 25 percent; in
short there are no slope concerns.
6. 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.)
7. 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. Thank ~o~ for your assistance.
Presittdnt I ~
NOTE: Attached is a site plan drawing, a design drawing, a detail drawing, a soils logs, and a 7
page construction specification letter which are all part of the design package for this septic
system.
6901 Debarr Road,, Suite 2B N Anchorage, AK ~ 99504 - (907) 337-6179 ~ Fax (907) 338-3246
J I L I
' ALMDALE AVENUE "..
l- / ~ ....
.......... ~ I r-........ ~ ......... / ......
II ~ II I / .10o' WELL RA~USL I \\
LOT 125A Il] 7,// '1 ' ' X \ l{ JOD'/ WELL RADIUS II
~ I \ \ t / I
I j \ \
Il /', , i ~j\ \'' LOT'~124Bf~7~--'' //
J \ J / // \
I\ [ / ~)1 --- \
LOT125B I ,I I ~-/Z.
~\\ ~'. [~100' WELL RADIUS I LOT 123
I
' j / J ' ,
J 7 LENISTING X~XISTING \, I
MI
I "~'-~1 LO]- 129B ,100' WELL RAOlU$~ II
(/)I I I
I \
,q-, I x. / I
~ I
__ _~,J ~:- .......................
t SEE SAW AVENUE
5/51/2000 ,_¢-.- ,~ OF
~:~ ~.....;' '..~
W I'ER & TEWAIZR ..
EICK & ROBIN SCALES (907) 696-5239 1 OF 3 ~9~ .... ;~r~
T15N, R2W, SEC 25, LOT 129C, iJ,~r"C,,~ ..
SITE P~NFOR SEPTIC SYSTEM UPGRADE (BOTTOMLESS ISF)
NOTES:
THE AIR COMPRESSOR SHALL BE
LOCATEO WITHIN THE BASEMENT OR THE
GARAGE. THE CONTRACTOR SHALL PROVIDE A
0-10 PSI PRESSUR GAUGE AT A LOCATION
WHICH IS READILY ACCESSIBLE FROM WITHIN
THE HOUSE. NOTE: A 50 PSi GAUGE WILL NOT
WORK.
THE AIR COMPRESSOR SHALL BE A
THOMAS INDUSTRIES MODEL 5070, AS
SUPPLIED BY ANCHORAGE TANK. THE AIR UNE
SHALL BE 1/2 INCH D~ HDPE (1 PIECE),
INSIDE A 2 INCH SCH.40 PVC JACKET. THE
LiNE SHALL BE BURIEO TO A MINIMUM DEPTH
OF 3 FEET.
THE GONTROL PANEL FOR THE $.T.E.P.
TANK SHALL BE INSTALLED OUTSIDE
RESIDENCE WITH AN AUDIBLE/'V1SUAL
INDICATOR INSIDE THE HOUSE.
DRIVEWAY
NOTE: THE CONTRACTOR SHALL HAVE ALL THE 100 FOOT
WELL RADII SHOWN FLAGGED BY A REGISTERED LAND
SURVEYOR PRIOR TO CONSTRUCTION,
~ PROPOSED BO1TOMLESS INTERMITFENT
SAND FILER. EXCAVATE A BED THAT IS
~ 2 FEET DEEP MAXIMUM. (REMOVE ALL
ORGANICS) BY 12 FEET WIDE BY 30
~ FEET LONG. SEE ATrACHED DETAIL AND
PROFILE (PAGE ,.3 Of 5) FOR
~ CONSTRUCTION DETAILS AND
\
PROPOSED
1500 GALLON
S.T,E.P,
EXISTING C"7'-r LAT _~,D /
4- BEDROOM
HOUSE
EXISTING SEPTIC TANK
TO BE ABANDONED
AIR
(SEE NOTES) /
/ /
/ ~
/
INSULATED
/ AIR LINE
(SEE NOTES)
/
/
/
ALASKA VATER & WASTEWATER
:~: ~-~ CONSULTANTS, lNG.
DATE:
MT
CO
5/5 /2ooo
DRAWN BY:
J,L.M,
SCALE:
1" = 30'
FOR: PHONE NUMBER: PAGE NUMBER:
RICK &: ROBIN SCALES (907) 696-5259 2 OF
LEGAL DESCRIPTION:
T15N, R2W, SEC 25, LOT 129C,
OF WORK:
DESIGN FOR SEPTIC SYSTEM UPGRADE (BOTTOMLESS ISF)
MT
EXISTING DRAINFIELD TO
BE ABANDONED COMPLETELY
PLAN VIEW
~ Pb~O~ ~P D/4" PV6 LA~5 (~,4)~
~ ~ 5~~ ~Fl~ ~l~
J.L.M. ~ ~/ "..~ ~
~S~ WATER & WASTEWATER s~:
CONSULTANTS, INO, ~ ......
PREPPED FO~: PHONE NUMBER: PAGE NUMBER:~].~.~
DETAIL OV BOTTOMLESS INTERMITTENT $ANV VILTKR (ISV)
ALASKA WATER & WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD, SUITE 2B * ANCHO~GE, AK. 99504
PHONE (907) 357-6179 * FAX (907) 358-3246
[SOIL LOG - PERCOLATION TEST[
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE PERFORMED:
T15N, R2W, SECTION 25, LOT 129C,
RICK &: ROSIN SCALES
5/m/oo
ORGANICS
I TEST HOLE #1 I
GM/SM
GP/SP
HARD DIGGING
SOIL CLASSIFICATIONS
ORG
NL
CL
OL
NH
CH
OH
SC
DEPTH TO DATE
GROUNDWATER
6' 5/19/00
4'-8" 5/30/00
SITE
3 BEDROOM SEPTIC
BOUSE SYSTm
LOT 129B .'100' WELL RADIUS~I
DATE READING CLOCK NET TIME WATER LEVEL NET DROP
TINE (NINUTES) READING (INCHES)
IPERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING
,5/19/00
1 1:52 6"
2 2:22 50
2:22
1 7/8"
4 1/8"
4 2:52 30 1 3/4" 4 1/4"
5 2:52
6 3:22 30 1 3/4" 4 1/4"
PERCOLATION RATE 7.0 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 2.0 FT, AND 2.5 FT.
COMMENTS:
PERFORMED BY ALASKA WATER &: WASTEWATER. I, JEFFREY A. GARNESS, CERTIFY THAT THIS
WAS PERFOJ~k~D IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON
DATE:
'~ ~'~' ~ ~ MUNICIPALITY OF ANCHORAGE
Zi ~. DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
I 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
[] UPGRADE
LEGAL DESCRIPTION
~ ~ Material ~ No. of compartments
~ ~ ~ DISTANCE TO: Well'[r~(/~ Dwelling PERMIT NO.
O Z ~ Manufacturer Material Liquid capacity in gallons
~ ¢ Well Foundation t Nearest lot line ~ ( : PERMIT NO~
Nm~ DISTANCE TO:. ~+0~ ~U~5 Distance~t~e~lines
. Z No, of lin~ Length of each lin~ TotaJ length of~f Trench width ~
--"~ ¢ ~ incheslnChes
~ ~ ~ Top of tile to finish grade Material beneath tile
, iLength ,, /~ Width Depth PERM[TNO.
~ ~ Type of Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
~ DISTANCE TO:
~ DIST~Cfi TO: Buildln~ foundation Se~or lino Septic tank ~ t ~ Absorption
PIPE MATERIALS
APPROVE · ATE LEGAL
72-013
- ' DEPARTMENT '' HEALTH AND EN'./IRONMENTAL' ~Z, TECTION ~,~.~,
TYPE OF SOIL HE.>uRBTIEN _.,=.TEM IS: TRENCH
MR~.~II',ILIM NUMBER ElF BEDROOMS = 4 SGIL RATING .... Q FT,-'BR)=
THE RE~UIRED SIZE OF THE =.OIL MBSORFTILN =,~.¢TEM ~ ~¢~ I~d.
E:.EF'TH= 12 LEFI~3-FH= 49 13 F: Fl'./i L B, EF'TH=
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIEL. D.
THE DEPTH OF 8 TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET),
SEPT I E: TR~-JF; S I ZE= 1250
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PF~OPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILt_ SERVE.
TPJm3 (2) I r4SPEm3TIE~S R~:E~ ~:E[;4~.LIZ ~E[:'
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL. SYSTEM IS
i00 FEET FOR A PRIVATE WELU OR
i50 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELl_.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PERF11 T E,'-~-:F' I I~ES DEE:EF1BER -?:1. 1978
I CERTIFY TI-IRT
t: I 8M FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF RNCHORAGE.
2: I WILL INSTALL. THE SYSTEM IN ACCORDANCE WITH THE CODES.
3:: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RES I[~EN,~MODELE~,~:LUDE MORE THAN 4 BEDROOMS.
RF'PL I CANT HARRY MRCKEY
,.,. O 8. E GE(- ~ECHNICAL
8- DEVELJ'PMENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Russell O~$ter
694-2774 SOIL LOG
Soils [:t Foundations
Perfo~ed for:
Name: ///~/~'
Hatltng Address: ~,~'.
Legal Description: ~'~ /~~
Depth (feet) Sot1 Characteristics
Earl Ellis
Land Developmerit
Tel. No.
5
11
15
Ground Water Encountered: Yes No~ If yes, what depth__
Proposed Installation: Seepage Pit: Drain Field__
Comments:
Performed by:
Date:
Well Log: 'Lot 129 C, ~To.dd Subdivision
'Sa~ $owfel. ~
Eale River, Alaska' 99577
Drilled bM: Harry A. ,Mackey
Owners:
Log:
, Triple M~Cabinet and Floorcove~ing
' ~illiam ~ndI Michele ~riggs
,0-7 feet,-, gravely sand to cl~y
8-~8 feet,-,clay more to a hardpan
i~8~43 feet,-~targe boulder
,43~h9 feet,- Gravel, clay and a~little ~t~r
~9~61 feet,-,Sand, gravel ,clay'
,6~ , feet - ,Water - 5 gal min.'or, more~'
Cased to 70 feet and drilled~to'9~,
?0~95 feet,- Course sand, clay to grave~i,
ROBERT C. JOHNSON
Registered Land Surveyor
P. O, Box 456
EAGLE RIVER, ALASKA 99577
2I April 1972
Mr~Rolf Strickland
DEQ- GAAB
Subject's Soils andWater info f0r~_~_BLM L~t l£9~Sectton~.R~
WATER~
Lot~140 adjacent on the south has 55' well at ½ GPM.
Lot~,128 adjacent~,on the west i's cna 15' hill and has 77' well at 1GPM.~
Lo$i. 142 located 330' west and in.the ne~t: tier of lots south has
123' well at 15 GPM~
Lot 129 located'330' west~ has 109' well at~2 GPM.
Lot'129 has a 125' well w~i~ has never been~used or'developed to d~te~
~ellinE~ onL'ot~i40 adjacent on south h~s septic~tan~ and'100', of
dr~i~ til~..(a~out 1 year old)
~elling'on Lot!~i28 adjacent on west has septic tan~' and seepage
pit: now in 5%H~,year off'use and~is situatedi~s~lty till containingi~
lenses of'sandy gravel~
The other adjoining lots h~ve no d~velop~ent on the~at this time~,
SOILS~:
A 5~' te 25' deep by 600' lone'cut for the Glen~Hyyo is located~ 500'
southeast of~Eot:I29 and is a gravelly till ~*~th sandy lenses and~
pockets quit'e similar toH~ cuts Iocated¼mile south as reported
i'n'i971 for theLake Ridge Terrace Subd. project~
A ~' d~ep ~y 40' long road~cut is located 230' north of Lot~*129
and exposes sand and gravel under 30" oftopsoil~
A 10' deep by'J00' lon~!i~hru'cut located 350' northwest of 'Lot~',129
exposes sandy gravel and was used tb surface sor~e of'the local
st~eetso
Lot~i29 has no excavati'ons on it'o
Lo~;,129and~adjoining~iBLM Lot~ are located on a hill which is
excess/o~50' in height andwhich slpoes off on the north~ eas~, and
west° i.
694-2543 or 694-9210
Certificate of On -Site Systems Approval
Parcel I.D. 051-312-35
Legal description TI 5N R2W SEC 25 LT 129C
Site address 15443 Husky St Eagle River
Current property owner(s) Robert and Frances Hahn
Expiration Date: 7 1 ?O Z 3
The On-site system(s) is/are approved for 4 bedrooms
Conditional approval for bedrooms, with the following stipulations:
Comments or advisories:
c
Original Certificate Date: 1/17/2023
This Certificate of On -Site Systems Approval (COSA) is intended to demonstrate the subject
system(s) is/are in substantial compliance with municipal code. The Municipality of
Anchorage, Development Services Department (DSD) issues COSAs based upon
representations provided by an independent professional engineer. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
ATTACHMENTS:
COSA Checklist X Well Flow Advisory_
Absorption Field Advisory Nitrate Advisory
Tank Age Advisory X Arsenic Advisory
Other
COSA ApprovMjune 2022
HUHMPA UTY OF AHC HO FRA GCE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval Application
1. GENERAL INFORMATION
Parcel I.D. 051-312-35
Complete legal description T15N R2W See 25 Lot 129C
Location (site address) 15443 Husky St. Eagle River, AK
Current property owner(s) Robert Hahn
2. ON-SITE SYSTEMS SIZED FOR 4 BEDROOMS
Day phone
3. TYPE OF WATER SUPPLY: © Private Well ❑ Private Well serving 2 dwelling units
❑ Private Well serving 3+ dwelling units ❑ Community Well or Public
® Water Storage
4. TYPE OF WASTEWATER DISPOSAL: ✓❑ Private Septic ❑ Private Septic serving 2 dwelling units
❑ Holding Tank ❑ Community Septic or Public Sewer
5. SEPTIC TANK: © Steel ❑ Plastic ❑ Concrete ❑ Fiberglass
Age 22 - See advisory if steel older than 20 years
6. ABSORPTION FIELD: © AWWTS © Bed ❑ Deep Trench ❑ Wide Trench ❑ Seepage Pit
Waiver request for:
Expedited review requested: ❑
Distance:
By applying for this entitlement, this property is subject to inspection by municipal On-site staff
to verify the accuracy of the information provided.
COSA Fee $ �-�O 1� Waiver Fee $
Date of Payment I �1 �'�a C,� Date of Payment
COSA # �5c22 5s` Waiver #
COSA Application June 2022
Legal Description:
T15N R2W See 25 Lot 129C
Parcel ID: 051-312-35
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled 1/1986 _Total depth 400 ft
Cased to 40+ ft
✓❑ Sanitary seal is functioning correctly
F/I Wires are properly protected
Casing height (above ground) 20 in.
Date of flow test for COSA 9/28/22
Static water level at beginning of test 40 ft.
Comments
B. TANK DATA
Measured operating fluid level in septic tank 42"
Date of pumping 12/5/22
0 Required maintenance completed, if AWWTS
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed)New 11/16/22
© ALL standpipes present per record drawing
Total measured depth from grade 3.6 ft (max)
Measured depth to pipe invert from grade ft (min)
FX -1 N/A — pressurized field.
❑ Per record drawings, field is insulated.
® Monitor tubes go to bottom of effective.
If not, state depth into effective
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced gallons date
Any rejuvenation treatment (past 12 months) Text
.If yes, enter date
Comments/Deficiencies:
COSA Checklist June 2022
Well production at time of test 0.22 gpm
Water storage tank volume 1000 gallons
Well disinfected for coliform test? ❑ Yes ✓❑ No
0 Coliform bacteria is Negative
Nitrate 1.54 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑./ Arsenic less than MRL (ND)
Collected by Areterra
Date 9/28/22
C. LIFT STATION
0 Required maintenance completed
Age of lift station 22 years
Lift station material Steel
Comments:
Adequacy test date
Results ❑ Pass
Fluid depth prior to test in
Water added gal
New fluid depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) in
Effective depth used in
Effective depth remaining in
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100'
R] Yes if No ft 0 Yes if No ft
Neighboring Tank > 100' Q Yes if No ft Private Sewer/Septic Line > 25' Q Yes if No ft
Absorption Field on Lot > 100' ✓❑ Yes if No ft Holding Tank > 100' Q Yes if No ft
Neighboring Absorption Fields > 100' Animal Containment > 50' ❑.! Yes if No ft
R Yes if No ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' [2]Yes if No ft 0 Yes if No ft
❑ N/A — Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10' 0 Yes if No ft Surface Water > 100' 0 Yes if No ft
Tank to Property Line > 5' © Yes if No ft
Field to Property Line > 10' n Yes if No ft
Water Main > 10' [✓1 Yes if No ft
Water Service Line > 10' R Yes if No ft
F. ENGINEER'S COMMENTS
Wells on Adjacent Lots:
Private Wells > 100'
Community Wells > 200'
Q Yes if No ft
® Yes if No ft
If tank or field is under driveway comment below
G. CERTIFICATION & 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 Certificate of On -Site Systems Approval Guidelines, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm Areterra Consulting Phone (907)-696-6111
Engineer's Printed Name Kenneth Duffus Date
Engineer's Comments: This investigation was completed in compliance with ADEC and MOA regulations.
The assessment of the condition of the well and septic applies only to the conditions as of the day tested. The
flow and absorption rates may change due to subsurface conditions that may not be observed from the
surface, changes inland use, local soil characteristics, groundwater levels that may fluctuate during the year
and the water usage of the family being served by the system. The operational life of all well and septic
systems are subject to these various and dynamic characteristics and are outside the control of the evaluator
of the well and septic system. Therefore, ArcTerra can not give any estimate of how long a system will
function satisfactory for current or future occupants or can Arclerra guarantee that no unseen
encroachments, deficiencies or discrepancies exist
COSA Checklist June 2022
www.muni.org/onsite
Septic Tank Advisory
Certificate of On -Site Systems Approval # OSC221557
Subdivision: Block: , Lot: T15N R2W Sec 25 Lot 129C
The septic tank for this property is 22 years old. The average life for a steel septic
tank is 20 years. Typical replacement costs range from $7,000 to $11,000.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
This is an example of what the metal of a 30 year old steel tank MAY look like.
Madmg Address P O Box 196650 *Anchorage, Alaska 99519 6650 *www mum org
�xn,.. r s,_., r... ._
Well Nater Advisory
Certificate of On -Site Systems Approval # OSC221557
T15N R2W Sec 25 Lot 129C
This well's productivity was determined to be 0.22 gallons per minute. The
minimum well productivity required under (AMC 15.55) for a 4 -bedroom residence
is 0.41 gallons per minute or 150 gallons per day per bedroom. Although the well
production does not meet this requirement, water storage has been provided to
meet minimum code requirements.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
77 777, ,Mailing Address P O box 196650 *xAnchorage, Alaska 99519 6650 *www mum org %
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this *c_� 3 Day of of 20 a e., by and between
Kra �Q� 1 J -0>r -2 ek , herein the "OWNER," and the Municipality of
Anchorage, herein the "MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants permission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
descri-bed as Intermittent Sand Filter
located at (legal description)
T15N R2W Sec 25 Lot 129C, 15433 Husky St, Chugiak
2. Maintenance. Repairs and Alterations.
(Owner is required to read, understand and initial each section)
L Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in the Municipality.
J L It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
J L Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
c' Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Page 1 of 3
-Owner acknowledges that the Municipality may request records of maintenance and
repairs from the manufacturer's representative or maintenance provider.
Owner acknowledges that the fine for failing to maintain and repair an AWWTS may be
assessed in accordance with AMC 14,60.030.
WAC Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
�- Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
�L Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
guidelines for the construction, maintenance and repair of the Owner's AWWTS.
J�—Owner agrees to maintain remote monitoring of the AWWTS as required by the
.' AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
OWNER:
By 61--6t`t�hl (signature) Date: 1a )1 a 1�a
(print name)
STATE OF ALASKA )
) ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this day of
20j.?,- by
d�
NO ARY BLIC fOR ALASKA F , . PaNk
My Commission expires: 05--7,�, -&1j,
MUNICIPALITY:--
By: (signature)
t J a -'n $ �O L.i� /',.. f3 (print name)
Date: t 1 Z 3
Title:
(rev. 05/18/2018) Page 3 of 3
WNER:
By: R(signature) Date: 2. 2G2Z
C_in G, , G, (print name)
STATE OF ALASKA )
ss.
THIRD JUDICIAL DISTRICT )
The foregoing instrument was acknowledged before me this day of W
20��4NOTAR
?k �>r le a
PUBLIC FOR ALASKA
uoIt Al-A,
My Commission expires: S fa Doi..I&xIM
MUNICIPALITY.-
By:
UNICIPALITY:By: (signature)
(print name)
Date:
Title: (C---tiril
(rev. 05/18/2018) Page 3 of 3
Parcel I.D. #
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
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILLY DWELLING
051-312-55
1. GENERAL INFORMATION
Complete legaldescription T15N. R2W. SEC 25: LOT 129-C
Location (site address or directions) 154,45 HUSKY ST. EAGLE RIVER. AK 99577
Property owner NICK AND ROBYN SCAI ES
Mailing address 15445 HUSKY ST. EAGLE RIVER. AK 99577
Lending agency Day phone
Mailing address
Agent MANNY ESCABEDO w/PRUDENTIAL JACK WHITE Day phone (907) 227-5259
Address 5~01 "O" STREET. SUITE 200 ANCHORAGE. AK 99505
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 4-
3, TYPE OF WATER SUPPLY:
Individual well xxx
Community well
Public water
NOTE: If community well system, provide wdtten confirmation from State ADEC attest-
ing to the legality and status of system.
Day phone (907) 696-5239
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.
72-025 (Rev. 1/91) Front MOA #21 Computer Version
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $3570.00 at,
or prior to, closing for the engineering services provided.
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 inspe,cfion, the on-site water supply and/or wastewater
disposal system is in compliance with all MunicipaJ ~,hd State codes, ordinances, and regulations in effect
on the date of this inspection. .fi'fi//I
Name of Firm ALASKA W~ V~ ~'F~/'~TE~R CONSULTANTS, INC. Phone (907) 337-617_9 .
/ , /
Address 6901 DEBARR p,0AD. ~[U~ ~B~/,/~NCHbRAGE, ALASKA 99504 , /' _._
Engineer's Signature ~"~/~/t~/JF'__ ~~~/ Date ~/~-~/~ --
system in accordance with ADEC and Md/A fi)HI~ ' Guidelines & Regulations. The reported results described the
pedormanca of the system under the conditions encountered at the time of the test, and separation distances
measured to readily identifiable features. The operational life of all 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 ~'.~ ~v
of the system, nor do they guarantee that there are no hidden defscts or encroachmsnts, .~,.~%~:~" // / J~'/"/.~.~.~.~l~,
AWWC, Inc. can therefore not provide any warran~y for future estimate of how long the ~'~ ~'" /~
system ~11 continue to meet the operational requirements of the ADEC or MOA DHHS. ~. ~. :./...l..~/t////ff.(~.~ ~. '..,. . . . .~,
The content of this report is for the sole benefit of the owner li'sted above. Any ~J~ /
reliance upe, or uss of this report by any other person or pa y is ,ot authorized,
nor will it confer any legal right whatsoever. ~ '~ ; ~. ef~re~//A.
6. DHHS SIGNATURE q~,-~,, ... ...
~ .,'~,. .. .......... ·
I/" Approved for ~ bedrooms
Disapproved
Conditional approval for bedrooms, with the following stipulations:
There are nitrates present. It is su~eested that periodic testin~ be
performed to insure the wells continued suitability. Current nitrate
concentration is 5.34 mt/1. EPA maximum concentration is 10.0 mt/1.
More information on nitrates is available from the On-site Services Program,
DHHS, 343-4744.
By: Date
II
The Municipality of Anchorage Depadment 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 cedain federal and state requirements. Employees of
DHHS do not conduct inspections or analyze data before a cedificate is issued, The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
72~)25 (Rev. 1/91) Back MOA//'21 Computer Version
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICL~N
Environmental Services Division
825 "L" Street, Rm 502 Anchorage, Alaska 99501 (907)
Health Authority Approval Checklist
Legal Description: T15N, R2W, SEC 25; LOT 129-C Parcel I.D.:
051-312-35
A. WELL DATA
Well Type PRIVATE
Log present (Y/N) Date completed
Total depth. 400' Cased to 40'+
Sanitary seal (Y/N) YES
IfA, B, or C, attach ADEC letter. ADEC water system number
YES 1/86
Casing height (above ground) 2'
Wires properly protected (Y/N) YES
Date of test
Static water level 25'
Well production 3.75
WATER SAMPLE RESULTS:
Coliform 0
Date of sample: 5/30/2000
B. SEPTIC/HOLDING TANK DATA
Date installed 6/15/2000
Foundation cleanout (Y/N)
Date of Pumping. NEW
C. ABSORPTION FIELD DATA
Date installed
FROM WELL LOG
~/56
AT INSPECTION
5/~ ~/2ooo
13.5' ~
g.p.m. *0.26 g.p.m. ~
· 1000 GALLON NSF APPROVED PLASTIC STORAGE TANK _~
Nitrate 5.34 mq/L Other bacteria 0 ~
Collected by: A.W.W.C., INC. [
Tank size 1500
YES**
Pumper -
***2.27' OF MOA APPROVED SAND
FILTER BELOW TOTAL DEPTH.
6/15/oo - 6/19/oo Soil rating (g.p.d./ft2 orft2/bdrm)
Number of Compartments 2 Cleanouts (Y/N)
Depression (Y/N) NO High water alarm (Y/N) YES
**INSIDE FOUNDATION
2 System type BOTTOMLESS ISF
Length
30' Width 12' Gravel thickness below pipe 0.27 Total depth ***2.43 - 3.13
Effective abSorption araa 360 SQ. FT. Monitoring Tube present (YIN) YES Depression over field (Y/N) NO
Date of adequacy test NEW Results (Pass/Fail) For ~
Fluid depth in absorpt!0n field before test (in.~dded (in.}: __
· r~atment (past 12 monthS) (Y/N) If yes, give date :
72-028 (Rev. 3/96)* Computer Version
D. LIFT STATION
Date installed
Manhole/Access (Y/N).
High water alarm level at*
Cycles tested
6/15/00 - 6/19/00 Size in gallons
YES ."Pump on" level at* 42"
46"
NEW
*Datum BOTI'OM OF TANK
1500
"Pump off' level at* 42"
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding 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'+
Absorption field
Water main/service line 10'+ Surface watefldrainage 100%
SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO:
Property line 10% Building foundation 10'+
Wells on adjacent lots 100%
Water main/service line
Surface water 100% Driveway, parking/vehicle storage area 1 o'+
Curtain draiI NONE KNOWN Wells on adjacent Iots~ ......
Icertifythatl h~ve
of Municipal ~co~¢e ~ove[systems are in confo~ance
Signature
Engineefs ~~~ A, GARNESS
Date.
HAA Fee $ ,-~© ,OO
Date of Payment ~?~ -7/c-~)
Receipt Number b [~/o ~_~-r._~)
72-026 (Rev. 3/96)* Cornputer Vemion
Waiver Fee $
Date of Payment
Receipt Number.
MUNICIPALITY OF ANCHORAGE
MEMORANDUM
WATER WELL ADVISORY
HEALTH AUTHORITY APPROVAL NO. 0~)0 ~2,,"~/
During a recent Health Authority Approval on-site inspection
and test of the potable water supply well on Lot ~~~_~
Block ~ of 7~/~-A/j~ Z~/; ~C,~'Subdivision, the well's
productivity was determined to be ~,~ L gallons per minute.
The minimum well productivity required by this Department
(AMC 15.55) for a ~ bedroom residence is O.~__/ gallons
per minute. Although the subject well currently~cacas ~
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 ~f the subject
Health Authority Approval.
' .~ MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Service~ Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEAl]TH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # 0',.~] ~/~-- ~'-q NAA#
1. GENERAL INFORMATION
Lot 129C; Sec 25i T15N; R2W
Complete legal description
Location (site address or directions)
15443 Husky Street
Eagle River, AK 99577
Pro '~d~:b~er'i "'~±ck ~ Robin Scales
, p y, · : ; , Day phone 696-3239
i~1~iling.address' ':l~Z~3 Husky Drive Eagle River, AK 99577
Lending ag'ency· ' ' Day phone
· "~il~lalli~g a~dress-.
Agent. " Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 4
TYPE OF WATER SUPPLY:
Individual well xxx
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
,;
TYPE OF WASTEWATER DISPOSAL:
Individual on-site xxx
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA
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,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm $ & $ ENGINEERING Phone
17034 Eagle River Leop Road No. 204
Address Eagle River, AJaska 99577
Engineer'ssgnature ~//'~¢'¢~? ~.-~,.,,_- Date 7/~'/~/?
DHHS SIGNATURE
· ~ Approved for
Disapproved.
__ Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The D H HS does this as a courtesy to purchasers of homes
and their lending institutions in orderto 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.
72~25(Rev, 1/91) Back MOA~I
MUNICIPALITY OF ANCHORAGE
~i~ONMmTA~ S~VlC~S OIVlSION
Municipality of Anchorage JUL 2 9
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division 3~4[~4~ E I V
825 L Street, Room 502 · Anchorage, Alaska 99501 ° (907) 34
Health Authority Approval Checklist
Legal Description: ~.-~' t'z-~ C5 $cc.~.~}~t~l,.J) [~_~ Parcel I.D.: O.~ / .- 31 3- -'5 5-
A. WELL DATA
Well type ~,\V,~'~- If A, B, or C, attach ADEC letter. ADEC water system number
Date completed ¢" I, ct q ~'
Log present~_Y.)N) ~ 'To 4o~' , ,V,~,~ "r~ 7~'a "
Total depth c~ ~ , ~O.J~,,~ Cased to 7~ ~ Casing height (above ground)
Sanitary seal
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform 0
Y
FROM WELL LOG
Wires properly protected~/N)
AT INSPECTION
~7- I-~7
Date of sample: "~/-~.'~/~ ~'
B. SEPTIC/HOLDING TANK DATA
Date installed ~ ~'~ ~ Tank size
Nitrate
/o,?
7
.g.p.m;
,Z, ,'Z-~z '"~//... Other bacteria
Collected by: 5 '~ ~ ~{-~_~'.
Number of Compartments ~ Cleanouts (~AI) ~zS5
Foundation cleanout (?O ~'~0 Depression (Y~I,~ ~ High water alarm (Y/N)
DateofPu, rnp.}'~;::' ~[~t'~ Pumper ~"'.-l~, eO~',~ ~
C. ABSORPTI'~N:FIELD DATA'~ . ~,~. 5.
Datei~stailed--:~' ~ ......... .. [~Soilrating (g.p.d./ff~or~. /~ System~pe
Length . ~ ~ ' Width ' '~ Gravel thickness below pipe Total depth
Effective absorption area '"~ ~ Monitoring Tube present~N)~ Depression over field (Y~
Date of adequacy test "~" I ~ ~ 7 ResultS/Fail) /~ ~ For
Fluid depth in absorption field before test (in.); ~ '~ ~ Immediately afte~ gal. water added (in.):
Fluid dept~ ~ ~/~ ~ (ins) Minutes later: ~ ~ Absorption rate = ~ 0 o & _g.p.d.
Peroxide treatment (past 12 months) (Y~ ~P~ /~ If yes, give date
bedrooms
72-026 (Rev. 3/96)*
~ 3 'j'1 ~OI2 /~a,,J
D. LIFT STATION
Date installed
Size in gallons
Manhole/Access (Y/N) "Pump on" level at* ~p off" level at*
High water alarm level at* _,....-~ *Datum
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT 'TO:
Septic/holding tank on lot ~ o c> On adjacent lots
Absorption field on lot \o ~ On adjacent lots
Public sewer main ¢ [ A' Public sewer manhole/cleanout
Sewer/septic service line .~.~- k ,~ Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation ~' ~' '~ Property line __ \ o \ ~ Absorption field~
Water main/service line ~,F) t, ¥ Surface water/drainage Icc, ~ ~
_ Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Property line
Surface water
Curtain drain
~
Building foundation Io Water main/service line
~' ~" Driveway, parking/vehicle storage area
Wells on adjacent lots
ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and review of Municipal recorc ~"~,~ ~l~F. stems are
in conformance with MOA HAA auidelines in effect on this date.
Date _ _
HAA Fee $ ~'~ D~ '/~(~
Date of Payment
Waiver Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
July 18, 1997
Municipality of Anchorage
Department of Heath & Human Services
825 "L" Street
Anchorage, AK 99502-0650
Subject: Lot 129C, P.c. ll~n: ~ubd?A:'~cn
Water Storage System Inspection
Dear Onsite SerVices Engineer:
On July 17, 1997, we visited the house located on Lot 129C l~llin3 Subdiaiai~a to inspect the type and
capacity of the potable water storage system. The inspection was prompted by the homeowner who
requested the inspection be completed to assure the system is in compliance with Ordinance No. 96-
98(S), Section C concerning water storage facility specifications.
The storage system consists of two 250 gallon custom made aluminum storage tanks with varying
dimensions. The exterior of the tanks is covered with 2" of white foam insulation. One tank is free
standing on the furnace room floor. The other is above resting on the floor joists and built entirely
inside the wall.
Tank No. 1 is approximately 81" high by 42" wide and 16" deep. A sight glass is installed to allow
inspection of the water level. Tank No. 2 is approximately 115" long by 24" high and 26" wide with a
riser on top to accommodate the float switch and inlet and outlet piping. Tank No. 2 is above Tank No.
1. It is separated by a 2" X 10" floor joist and connected by copper pipe. The storage system is filled
from the top tank. A 3/4" copper air vent extends from the storage system through an outside wall and
also serves as an overflow.
A Smith Aqua Air V-200 Goulds Pressure Tank with a capacity of 40 gallons feeds the house. Water is
transferred to the pressure tank from the storage tanks with a transfer pump. The water storage system
was installed by Todds Plumbing of Eagle River. The overall condition of the water storage system is
good with no detectable leaks.
Water was delivered to the site by Pure Glacier Bottled water and injected in to the storage system. The
system had been previously drained. 487 gallons of water was pumped at a rate of 10 gallons per
minute. The site glass in the upper tank indicated 4" of caPacity remaining. This would indicate the
system will hold a volume in excess of 500 gallons, is therefore in
compliance with the Municipal Ordinance, ~.'.'
Sincerely,
Michael E. Anderson, P.E.
SEWER&WATER
INSPECTION
ENGINEERING STUDIES
~uNO REPORTS
WELL INSPECTION
& FLOWTEST
ROADDESIGN
801LTEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ROBERTC. COWAN, P,E.
ROBERTA. SHAFER, P.E.
WELL RECOVERY TEST DATA
CiViL ENGINEERS
(907) 694-2979
FAX (907) 694-1211
CLIENT:
WELL LOCATION (legal): L-%~..~
TEST DATE:
WELL DEPTH: ~ ~. W~LL DRILLER:
CASING DEPTH:
TEST PROCEDURE:
1) Draw water down to pump.
2) Shut pump off 15-60 min.
-record time
-record meter reading
3) Turn pump on. Drawdown.
4) Shut pump off. -record time
-record meter reading
6) Calculate gaL/min, recovery.
TEST DATA: START TIME:
MISC DATA: I (
Casing Height:
Sanitary Seal?
Wires in Conduit?
Grading O.K.?
Pump Depth:
Samples Taken? ~"~.~
Date:
t,"/,. '. ~,~ STATIC WATER LEVEL: ,~... I
TR,AL II PUMP II TIME II METER II
I ON
---- -"- ~o.L~
2
ON
%
OFF
3 o~ ~ ~ ~
OFF %~ ~ ~
OFF
4 ON
OFF
OFF
5 ON
OFF
RESULTS: WELL CURRENTLY PRODUCES: ~ I D, (~ ~PH
FLOW RATE NOT GUARANTEED--SUBSEQUENT VARIATIONS CAN OCCUR.
17034 NORTH EAGLE RIVER LOOP . SUITE 204 . EAGLE RIVER, ALASKA 99577
,7 DATE RECEIVED
~ ' INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
MUNICIPALITY OF ANCHORAGE DEPT. OF I!~,:',LTH &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTioi~NVIRONMENT/\L
825 LStreet-Anchorage, Alaska 99,01 FEB 6 1981
ENVIRONMENTAL SANITATION DIVISION
T ,..hoo. 2B.-.,20 .RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete ~equests will not be proce~ed. Please allow ten (10) days for processing.
1. ROPERTY WNER . ~ . P ONE
~ROPERTY RESIDENT (if different from above) ~
2. ~ - ' PHONE
ILING ADDRESS ~ .
LEGAL DESCRIPTION
6. TYPE OF RESIDENCE NUMBER OF~BEDROOMS
[] One ~ Four
~' SINGLE FAMILY [] Two ~-~ Five
[] MULTIPLE FAMILY [] Three [] Six
[] Other
7. WATER SUPPLY
~ * ATTACH WELL LOG. A well log is required for all wells drilled
INDIVIDUAL*
[] COMMUNITY since June 1975. For wells drilled prior to that date, give well
[] PUBLIC UTI LITY depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON-SITE** ~Oi,'~00 YEAR ON-SITE SYS'IJEM WAS INSTALLED.
[] PUBLIC UTILITY ~ .~.~6.c~T V 'LzP'~" j~c~ ~
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTI LITY
Conl]ectioo Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTENI PERMIT NUMBER
[] I NDIVI DUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY i~)
Connection Verified INSTALLER
[]Septic Tank or [] Holding Tank
Size: If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCESwELL TO: Septic/Holding Tan~; Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
^PPROVEDFOR BEDROOMS
/
[] CONDITIONAL APPROVAL {letter must accompany cert[ficatel
[~ DISAPPROVED
72-010 (Rev. 6/79)
,¢,/; MUNICIPALITY OF ANCHORAGE DEPT. OF I EALTH &
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIo~NVIRONMENTAL p;:dLT{£CTION/~
825 L Street - Anchorage, Alaska 99501
FEB 5 197
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720 RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
PROPERTY RESIDENT (If different from above~- PHONE
, PHONE
2. BUYER ~ ~ ~' .
5. LEGAL DESCRIPTION
STREET'O.E'
NUMBER OF BEDROOM
B. TYPE OF RESIDENCE [] One ~OOM~Four
[~INGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY [] Three [] Six
[] Other
WATER S PPLY
7. ~ INDIVIDUAL~
[] COMMUNITY
[] PUBLIC UTI LITY
8. SEWAGE DISPOSAL SYSTEM
[~ INDiVIDUAL/ON-SiTE**
* ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.) I J ~t~J~ ~'ln · L~/~ Z .L~. ~
**If individual/on-site, give installation date /~'?~
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.
72-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR I NSP ECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
'~ SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO '~ FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
~ INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
'~INDIVIDUAL/ON -SITE DATE INSTALLED
[~PUBLIC UTILITY
Connection Verified C~ _ ~-~3-
INSTALLER
~]Septic Tank or []Holding Tanki ~ ~ ,~
Size: I ~,(,~(~"~ If Tank is homemade SOILS RATING
give dimensions: I
TYPE OF TANK MANUFACTURER
4. DISTANCESwELL TO: Septic/Holdingl ~ ~).1 Tank Absorption\ I ~kIArea~' Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
[~ APPROVED FOR. ,z~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must a/c~mpany certificate)
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
DTI002496
ALAS
KA
LOT
124E
LOT
124A
N00*07'50')E
(N00°16'15"E
NOO"17'19"E 100.78'
(N00°17'30" 101.00) R)
._
80MM
HUSKY STREET
(SAN BOWFEL AVE)
ANCHORAGE RECORDING DISTRICT, ALASKA
AS -BUILT OF:
BLM LOT 129C
T12N R2W Sec25 S.M. AK PLAT 72-131
SURVEY CERTIFICATE: 1, John L. Schuller, Have conducted a
physical survey of this property as shown on this drawing and that the
improvements situated hereon are within the property lines and no
enchroachments exist other than noted. Under no circumstance shouh
any information on this drawing be used for construction of fences,
structures, improvements, or for establishing boundary lines.
EXCLUSION NOTES: It is the owners responsibility to determine
the existence of any easements, covenants, or restrictions which
do not appear on the recorded subdivision plat.
WORK ORDER NUMBER: DATE; SCALE; E-MAIL;
NOV 22, 2022 1 »=40' schullerOak.net
2 2 -1 1 1 DRAIN BY: ICHECKED BY, GRID NUMBER: BOOK/PA7;E
JLS NW0653 220365
LOT
129B
FND ALUMINUM MONUMENT
FND 5/8" REBAR
S"v
OF 4N, L A 1v
Z_d 0 1 V
49TH
?A
?A
?A ?A
.. ......................
i.
..J, HN L. SCHULLER.: 0
T 1Q_1 r)A r).q
q
ew O.W.04p,
0 1831 Talkeetna Street
k�' -.jk. Z1, Z2,..
• Anchorage, Alaska 99508
�® lfessiono\ (907) 227-1455 office
(907) 274-4992 fax