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HomeMy WebLinkAboutT12N R2W SEC 30 W2SE4NW4NE4SE457"m L I� . MAY 0 8 2023 Municipality of Anchorage On -Site Water and Wastewater Section < (907) 343-7904 Page 1 of 2 ON -SITE WASTEWATER INSPECTION REPORT Permit Number: OSP221184 PID Number: 021-022-13 Dwelling: ❑N Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New © Upgrade Name TIM & TERESA KAVANAGH ABSORPTION FIELD ❑ Deep Trench El Wide Trench ❑ Bed El Mound Ad Ad dress ddress 1te ALPWEG ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 3 GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Subdivision Block Lot Ft. Ft. Fill added above original grade Gravel length Township Range Section T12N R2W SEC30 W2 SE4NW4NE4SE4 Ft. Ft. Gravel width Beds: Number of Lines Distance between lines SEPARATION DISTANCES Ft. Ft. To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line Ft2 Ft. Well 100'+ NA NA NA 25'+ TANK ❑ Septic ❑® S.T.E.P. ❑ Holding ❑ Other Manufacturer ANCHORAGE TANK Capacity 1500 Gal. Surface Water 100'+ NA NA NA Material Number of compartments Lot Line 5'+ NA NA NA NA STEEL 2 Foundation 10'+ NA NA NA LIFT STATION Manufacturer Capacity Remarks Orenco 250 Gal. Alarm location House Electrical installed by Solid Ground Installer PIPE MATERIAL House to tank 3034 Tank to3034 drainfield A+ Home Services, Inc. Drainfield CO/MT3034 Inspector PES BENCH MARK (Assumed elevation) 2206.5 It Inspdection 151 10/19/22 10/20/22 Location and description 2nd 3rd 4th Bottom House Trim @ A ON -SITE WATER AND WASTEWATER SECTION APPROVAL Engineer's Stamp Conditional Approval: Date OF 1�. annowe leven Septic System CE 8149 Approved Date !Z ly 2023 .. ..... c1gL�' gqq•q�3.- Note: this approval does not include well permit requirements. (8:5ICU 03 1 O X m F9 r -9ZocmC, 010 Ln < z ,00�D r 0 (n y c o c m z z -� mm;o m . z O z O c 1 m m D Dr 0 z n cm Cf)� -c -i�0 zz o m FT] 10 W n N cn D F1 N p O m z p -4 D D rn cn o c-) 1 O W m 0 <> C,a W r — OW � -< co o W rn m m rn—I Z cf) l I I �3 o \ \ 1 \ \ m 1 i O v I H \ W a � I o 0 o ti z ti It I I � 1 \ r-- w NOTES: PANNONE ENG SVC LLC (C.I. 1088) REVISIONS DATE RECORD DRAWING PHONE P.O. BOX 180 P L AX, AK 907997645 45-8201 4/26/2023 �cP•' SCALE 1: 50 DRAWN ACP T12N R2W SEC30 W2SE4NW4NE4SE4 •••• •• • ••••• P.I.D. 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I Z CV X W Z Ln X N a e � r m U W � _ W J 0 � `' 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 ������ _ _0 —..�Wastewater Disposal System Permit Permit Number: DSP221184 Effective Date: 6/22/2022 Work Type: SepdnTankUpgrmdo Expiration Date: 8/22/2023 Tax Code Number: 02102213000 Site Legal Address: T12NR2VVSEC 3OVV2GE4NVV4NE4SE4 G:2943 Site Mailing Address: 13321ALPVVEG.Anchorage Owner KAVANAGHTIMOTHY J&TERESAL Lot Size imSqFt: 54450 Design Engineer: PANN[]NEENGINEERING SERVICES Total Bedrooms: 3 This permit is for the construction of: ODisposal Field BlSeptic Tank FJHoldin��� �p�� �Ph��W�| Water ....Storage.. All construction shall beinaccordance with: 1. The attached approved design. 2. All requirements specified inAnchorage Municipal code Chapters 15.55and 15.G5and the State ofAlaska Wastewater Disposal Regulations (1D/AC72)and Drinking Water Regulations (1O/V\COO) 3. The wastewater code requires inspections during the installation. The eng i 8 h ithe Development Services Depa�mentper AK8C15.65.Provide nuU5oa�' on343-7904 4. FromnDdobwr1StoAph(15.auubnu�acesoil absorpUonsystem calling under ' construction`d.rin` �'� freezing weather shall boeither: m. Opened and Closed onthe same day, or Received By: Date: ("I Issued By: Date: 4-2 Community_Development Department _ Development Services Division On -Site Water & Wastewater Program - - - ----Phone* 907-343-7904 - Fax: 907-343-7997 ON-SITE SEWER/WELL PERMIT APPLICATION Parcel I.D. 021-022-13 Property owner(s) Timothy & Teresa Kavanagh Day phone Mailing address 13321 Alpweg Drive, Anchorage AK 99516 Site address 13321 Alpweg Drive, Anchorage AK 99516 Legal description (Sub'd., Block & Lot) Legal description (Township, Range & Section) T12N R2W SEC30, W2SE4NW4NE4SE4 Lot Size 54,450 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE -OF DWELLING: (N all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) X❑ Septic Tank ❑X Upgrade X❑ (w/wo AD U) Holding Tank ElRenewal F]Duplex (D) El Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: X22.5 Waiver Fees: Date of Payment:— 6ZE'-12 c),2 ,2 Date of Payment: Receipt Number: 05^523G Receipt Number: Permit No. 0_5� PZ 2 / / 8 LI Waiver No. Permit App__- : :'-'C Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221184, Rebecca Carroll, 06/22/22 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP221184, Rebecca Carroll, 06/22/22 Municipality of Anchorage Page / 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: 3'L,c,' ?~::;)3c).5- PIDNumber: O?_1 Name: ~ ~ ?~r~ I~ ~ ~ Wastewater System: ~ New ~ Upgrade Address: ~ ~z{, ~z~ ~. H~ R~ ~- ABSORPTION FIELD Phone: Z~6---&'A/~ No. of B rooms: O Deep Trench D Shallow Trench OBed OMound ~Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: /, ~ GPD/Sq. Ft. Lot: Block: Subdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe [ ~ [ S~tion: Z~ Fill added above original grade: Gravel length: Township: J~ Range: ~ ~ ~,~ Ft. ~ Ft. Number of lines: ~ Distance between lines: WELL: ~ New ~ Upgrade Gravelwidth: J ~ Ft. ~I ~.~ Ft. Classification (Private. A,B,C): Totat Depth: Cased TO: Total absorption area: Pipe material: ~l~O ~ J~ Fi, ~ Et, ~ SO, Et, Driller: Date Drilled: Static Water Level: Installer: Date installed: Yield: Casing Height Above Ground: ~'~ GPMIPump Set at; Ft.I 2 Ft. TANK SEPARATION DISTANCES ~ Septic ~ Holding ~S.T.E.P. To Septic Absorption Lift Holding Public/Pr[vat~ Manufacturer: Capacityin gallons: From Ta~k Field Station Tank S~werLines A~ ~Or~( ~n ~ Material: Number of Compa~ments: Sudaoe Water ~1¢¢I >~' >¢~0' - - LIFT STATION Lot Sizein gallons: Manufacturer: ' Pump on' level at: l "Pump off"level at: lHigh water alarm at: Foundation 7 I / 7 ~ -- ~Z hI ~ ¢~I Cudain Pump Make & Model ~ Electrical~nspections pedormed by: Drain ..... ~¢¢~0I ~1,~.~o~¢~¢ Remarks: ~d,$/~ ~ ~F~,'c~A'on~. ~ BENCH MARK ~ ~t~ ~/o~ .~ ~/1~ In ¢~1~(~. [ Assumed Elevation: Ao~ h~¢ ~r ~;~ ~~ ~ ~/o~ ~ ~ ENGINEER'S SEAL qspections performed by: F(~F~ ~¢c h. %vt. Dates: 1st 7/~g/9) . ~partment of Health and Human So.ices approval . ~:d:,,, ~ and approved by: Date: ~-/~ -~ PERMIT NO: SW980395 PID NO: 02102213 SWING TIES: FROM: "A .... B ....C" TO: DBL. C.O. "D" 1'1.5' S.T.C.O. "E" 10 S.T.M.H."F" 12 47' ISF M.T. "G" 14' 9.5' SF M.T. "H" 33.5' ISF F.P. 'T' 32' 34' ISF F.P. "J" 30' 23' M.T. G ~, "FLOWER POT" FLUSHING VALVE ENCLOSURE MONITOR TUBE 2' SOIL COVER 2' FILTER PAGE 2 OF 2 FLUSHING VALVE ENCLOSURES 18' × 20' BOTTOMLESS ISF 1250 GALLON STEP TANK )BL. C.O."D" AIR COMPRESSOR W 1/2, SE 1/4, ~ NW 1/4, NE I/4, ¢,~ SE 114, SEC. 30 ._~-,, ' --~,,~ PLAN V~EW , ~ ,' .~- SCALE: 1" = 30' ,' ~ -- 2" RIGID INSULATION 3/4" DIST. LATERAL INV. @ 95,1' ~YER OF 3/8" PEA GRAVEL BOT. @ 94.8' ORIG GND. ELEV. 96.3' NEW /~-WELL NATIVE GRAVELLY SOIL BOT. EXC. @ 92.8' -- FABRIC AIR DIST. LINE INV. INV. @ 93.3' 92.8' NEW 1250 GAL. INV. @ STEP TANK 92.7' CROSS SECTION NOT TO SCALE W1/2, SE114, NWl/4, NEll4, SE114, SEC 30, T12N, R2W, S.M. SEPTIC UPGRADE AS-BUILT INSP. REPORT FLATTOP TECHNICAL SERVICES 14530 ECHO STREET ANCHORAGE, ALASKA 99516 SCALE: AS NOTED DRAWN BY TFM AUGUST, 1999 Municipality of Anchor. age Department of Hea2a t, Lh,, satrnedet Human Services P,O. Box196650 Anchorage, Alaska 99519-6650 Rick Mystrom htt p://www.ci.a nclmrage.ak.us Mayor Permit Number: #SW 980395980395Date of Issue: 10-05-98 Parcel Identification Number: 021-022-13 Date Started: 7-1~-99 Date Completed: 7-19-99 Is well located at approved permit location? [] Yes [] No Legal Descriptiog: T72N R 2W Sec 30 W,2SE4NW4NE~E4 Property Owner Name & Address: -Homer4~ner~Tim Kavanagh - . Borehole Data: Depth (ft) Method of Drilling [] air rotary [] cable tool Soil Type, Thickness & Water Strata From To Casing type: steel Stick-up 0 2 Wall Thickness:. 025 inches Otgancis and silt 2 4 Diameter: _6 inches Depth: 20feet Liner Type: 4 125 Diameter: __ inches Depth: __ feet Bedrock RECEIVED AUG 20 1999 Municipality et Ancl~orage Dept, Health & Human Services Casing stickup above ground: _2feet Static water level (t~om ground level)://feet Pumping level: 125feet after _2 hours pumping 2. 5 gpm Recovery Rate:2.5gpm Method of Testing: air lift Well Intake Opening Type: [] Open End x Open Hole [] Screened Start__ feet Stopped feet [] Perforations Start__ feet Stopped __ feet Grout Type: Bentonite Volume: 1 bag Depth: Start__ feet Stopped feet Pump: Intake Depth __ feet Pump size hp Brand Name Well Disinfected Upon Completion? [] Yes [] No Method of Disiafection: Comments: Well Driller: Alpine Drilling g Enterprises P.O. Box 110496 AnchorageAK 99511 Attelatio/l~:, The WCkto4Mgo~ ~a well log to the property owner within ;t0 days of completion and thc property ~-~09-i999 12:&3PH FROH AF~C'fIC LIGHT5 ELECT 9Ed7 345 7874 ARCTIC LIGHTS ELECTRIC INC. P.O. BOX 110135 Anchorage, AK. 99515-0135 COMMERCIAL INDUSTRIAL Phone: (907) 345-7896 Fax Line; (9071 345-787,t August 9th, 1999 Flattop Technical 14530 Echo Drive Anchorage, Alaska 99516 Attn: Xed Moore' Phone/Fax: ~5-1355 Re: 13321 Alpweg Residence Lift Station Subject: Project Completion Status Dear Ted: On 8-2-99 we installed necessary wiring, components, and control panel for the permanent installation of a sand filter / sewage tank system at the referenced property. We have confirmed the proper operation of ail controls and certify that all work was performed in strict accordance with the National Electric Code. Note that we performed no other code upgrades on this property not related to the above system installation. All labels and identification stickers were attached to the control panel for future reference. Should you need other assistance on this project, please dc~n't hesitate to contact us. Sincerely, Brian D. Miller President CC: A-?lu$ HomoSorvices CLIENT; Flattop Technical Service PROJECT; CLIENT ADDRESS: 14530 Echo Street, Anchorage AIGska, 99516 PROPOSED USE: Quality Filter Sand SOURCE: SAMPLED FROM: LOCATION: Sm'tnm/KavanaDh ISP L~UU3 LABORATORY TEST REPORT R&M PROJECT: 95.1003, GRAIN SIZE DISTRIBUTION CLASSIFICATION 5UBMITCED BY: Ted Moo~u DATE SAMPLED: 7128/99 DEPTH: LAB NO.: 9254 FIELD NO.; DATE REPORTED; ~7/30/99 DATE RECEIVED; _.7/29/99 COMPACTION NATURAL MOISTURE: WEIGHT 4,7% TOTAL ~/T. TESTED: 4~ GMS. ORGANIC CoN'rENT %; LA. ABRASION LOSS: R&M CLASSIFICATION; GRAIN SIZE DISTRIBUTION CHART ORAJN SIZE (mm) MOISTURE DENS1YY RELATIONSHIP 0.9 0.7 0.4 0.3 ~,~:. Tech ~esponaible: JMM IRE - PERCENT D)CJ MUNICIPALITY OF ANCHORAGE Department of Health and Human Servicas 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 / WATER SUPPLY PERMIT Upgrade Date Issued: Oct 05, 1998 Expiration Date: Oct 05, 1999 Permit Number: SW980395 Legal Description: T12N R2W SEC 30 W2SE4NW4NE4SE4 Design Engineer: 0019 Flattop Technical Services Owner Name: Homer Leslie Burtner Owner Address: PO Box 111041 Anchorage, AK 99511-1041 Parcel iD: 021-022-13 Site Address: Lot Size: 54450 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must not[fy DHHS at least 2 houm prior to each inspection. Provide notification by carling (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 (luring freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special previsions. THIS PERMIT ISSUED FOR THE CONSTRUCTION OF AN ALTERNATIVE INTERMITTENT DOSING SAND FILTER WASTEWATER SYSTEM. THE ATTACHED PROPERTY OWNER AGREEMENT SHALL BECOME A PART OF THIS PERMIT PACKAGE. AIR-LINE SHALL BE INSTALLED A MINIMUM OF 18 INCHED FROM THE TOP OF THE SAND SURFACE WITHIN THE INTERMITTENT DOSING SAND FILTER. PROPERTY OWNER AGREEMENT FOR THE MAINTENANCE OF AN ON-SITE WASTEWATER DISPOSAL SYSTEM This agreement, dated :~(-¢ (""3('X 199~_~ is made between the Municipality of Anchorage Department of Health and Human Services (DHI-IS) and the property owner(s) of: This agreement is made for the purpose of maintaining an on-site wastewater disposal system on the subject property. The property owners agree to th, e following: Submit to the Municipality of Anchorage, on an annual basis, an inspection and operation statement from a registered professional engineer. This inspection and operation statement shall verify that the cng/ricer has inspected all effluent and air pumps, timers, and alarms, and that any deficiencies have been repaired and that the system is functioning as designed. (Signature) (Signature) (Printed Name) (Printed Name) .............................. Notarize Here ...................................... State of ~ 0n this ?~c~ day of Cbc_~-- , l°]°1% personally appeared before me, __ who is personally known to me -~ whose identity I proved on the basis of __ whose identity I provdd on the 6ath/affirmation of , a credible witness to be the signer of the aboy~ document, and he/she acl~ledged that he/she signed it. Hy commRssSon expires ~ OOO TECHNICAL CIVIL & ENVIRONMENTAL ENGINEERING · ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345-1355 September 29, 1998 ANCHORAGE, ALASKA 99516 M.O.A. DHHS P.O. Box 196650 Anchorage, Al( 99519-6650 RE: W lA, SE ¼, NW ¼, NE %, SE ¼, Section 30, T12N, R2W, S.M. - 13321 Alpweg, Glen Alps Well and septic system upgrades, lot line waiver to 5' for ISF and conditional HAA certificate Dear Sirs: The purpose of this letter is to provide narrative support for the requested upgrade permits, lot line waiver, and issuance of a Conditional HAA certificate for the subject property. Jim Cross and Dan Roth will recall discussing this project with me over the past summer and participating in a joint site inspection conducted on July 22nd. A site plan, design drawings, specifications, soils logs, soil sieve analysis results, water sample test results, HAA application and other supporting information is enclosed for your review. The purpose of the requested waiver allowing the ISF to be 5' from the lot line is to maximize the distance of the system from a seasonal drainage path. Because this drainage path only carries water during the spring, I understand that a formal separation distance waiver to surface water is not required. The present, undocumented, water supply and wastewater disposal facilities serving this residence were constructed prior to 1970, at a time when Glen Alps was an independently incorporated city. This was one of the first residences to be constructed in Glen Alps. While the systems continue to be functionally adequate from the point of view of the users, they do not comply with present regulations. After much analysis and discussion over this past summer, it appears that the only option is to totally replace both the well and the septic system in order to qualify for issuance of a HAA certificate. The present water supply well will have to be relocated further south in order to allow room for construction ofwastewater disposal facilities outside of its 100-foot protective radius. On August 12, 1998 I measured the total depth of the present well to be 124 feet below the top of it's 12-inch casing, and the static water level was at 20-feet below the top of the casing. While the present well yield is somewhat limited, it has proven sufficient for the needs of the occupants of the house over the past 30 years. ][ have enclosed well logs and some yield test reports for 4 wells in the near vicinity which indicates that adequate water supplies are generally available in this area. Water samples collected from this well on September 24, .1998 were satisfactory, showing 0 coliform or other bacteria per 100 ml., and 0.185 mg/l of nitrate-N. Over the course of the past summer 6 test holes were dug on the lot to try to find a feasible site for construction of a new septic system which meets present code requirements. Test holes #1 - #4, located on the southern half of the lot encountered shallow fractured bedrock, with solid bedrock being encountered between 4 and 6 feet. These less-than-desirable soils, coupled with steep slopes overlooking a seasonal spring, led DHHS to request that we conduct additional soil tests in the vicinity of the existing house. While this area is relatively level and well drained, it had not been originally considered because it is close to the existing well and less than 100 feet from a seasonal drainage path which had surface water in it during the early part of the summer. Soil logs for test holes #5 and #6 are enclosed. While quite rocky looking in-situ, the soil in both test holes was relatively easy to dig with a backhoe to a depth of 7.5 feet. The excavated material was visually classified as gravel, and this classification was confirmed by a laboratory sieve analysis. A perc test conducted between 3 and 3.5 feet below ground level showed a constant perc rate of 2 minutes per inch. The proximity of bedrock necessitates care in designing a wastewater disposal system. Based on this soils analysis and the nearness of the system to a seasonal drainage path, I feel that one of the innovative on-site wastewater disposal technologies which incorporates pre-treatment of the septage prior to discharge to a soil absorption system is most appropriate. The enclosed design is for a 20' x 18' bottomless Intermittent Sand Filter (ISF) with the bottom of the sand filter no deeper than 3.5 feet below the original ground level. The discharge from the bottom of the ISF will be 4 feet above the point at which the native silty gravel becomes hard to dig with a backhoe and is therefore classified as fractured bedrock. The design soil application rate for the 3 bedroom bottomless ISF is (3 x 150 gal./day)/(20' x 18') = 1.25 gpd/sq, ft. The actual application rate will undoubtedly be less. I hope this submittal is adequate for your needs, because I will be out of town and unable to be reached untilNovember 13, 1998. Since the present property owner and the prospective purchaser both wish to proceed with the transaction in the near future, please turn over the permit and conditional HAA certificate to either Leslie Burtner or Tim Kavanagh. In the event that there are some minor design details which I have overlooked in my attempt to complete this submittal prior to my departure, I would most appreciate your noting them on the permit, with the understanding that I will make any necessary amendments upon my return. Doing so still offers ample time for necessary modifications prior to the anticipated construction next summer. Thank you for your assistance in this matter. Sincerely, Ted Moore, P.E. '~ '~'.. R100' WELL~_ ~GAR. i WELL ~.~.-~,~ (100) , ', ~,. W 1/2, NE 114, E 1/2, NE 1/4, NW 1/,4 E1/2, N'W 1/4 ', ',:% ,W 1/4, NE 1/4, NE 1/4, SE 1,4, SEC, 0 NW 1/4, NE 1/4, T.H. T.H. ', ,~ SE 1/4, SEC 30 ,~,t~ ovv ,~ ,~vv ,t. i ~INSTALL 20' x ~8' ' / NE 1/4, SE 1/4, SEC 30 ~BOTTOMLESS ', / ~'- ~ SAND FILTER ', ~ -., .... ¢//~~ .... W 1/2 SE ~14~ 114, / /INSTALL RE 1/4 ~EC 30 S.E ...... '~ / ~ISTINGWELL , './ / ~ & ~ ~ (TO BE ABANDONED) ~ / ,, ~R~E~E ~ , ,,~ ~.~ ¢ ~w ~/4, .~ 1/4, ~ ~ ,, PROPOSED ,.~ /.¢~ ~ ,, / SE 1/4 SEC 30 ~ ,, .~w w~,~ ~ % T..'.,..~ ~ ' ' .'' WeLL~ : ~ " ~ / ~"- ~ , //A / .%.. ', ; .-~-'." SEPTIC '~, ¢,~ ~. ' . ' SYSTEM ' --4 5' ,' Sl/2, SW 1/4, NW 1/4 ,, NE 1/4, SE 1/4, SEC 30 '.. ~ ~. ~ .,~ ~ W 1/2 SE 1/4 NW 1/4 NE 1/4 SE ¢~ ;~ ~¢ ~-- ~*% %¢~ WELL&SEPTC-STEPLAN ~~A / ~& ~.~ CE 3~89 / ¢"~ ]4¢30AC~OSTRgg~ DRAWN BY TFM ~¢ ~ / w~&%P~fass~°%~ NOTE' THIS IS NOT A SURVEYED P~T , WELL , ALL LOCATIONS SHOWN ARE APPROXIMATE "A" ~ __ FLUSHING VALVES AND"FLOWER POT" ENCLOSURES SUPPLIED BY ORENCO 0.75" DIA, SCHED 40 PVC LATERALS W. 1/8" ORIFICES (SUPPLIED BY "ORENCO") 'i.25" SCHED. 40 PVC MONITOR TUBE 4" D-3034 PIPE FROM HOUSE 1250 GALLON STEP TANK W. "ORENCO" COMPONENTS PLAN VIEW SCALE: 1" = 10' MONITOR TUBE "FLOWER POT" FLUSHING VALVE ENCLOSURE FILTER FABRIC 2" RIGID INSULATION -- 5" LAYER OF 3/8" PEA GRAVEL 2' SOIL COVER NATIVE GRAVELLY SOIL -AIR DIST. LINE FILTER SAND X-SECTION "A - A" SCALE: 1" = 5' Wi/2, SE1/4, NWl/4, NE1/4, SE1/4, SEC 30, T12N, R2W ISF PLAN AND CROSS-SECTION FLATTOP TECHNICAL SERVICES 14530 ECHO STREET ANCHORAGE, AK, 99516 SCALE: AS SHOWN DRAWN BY: TFM SEPTEMBER, 1998 r~ 0 F.- X 0 E Flattop Technical Services 14530 Echo Street, Anchorage, Al( 99516 Phone (907) 345-1355 W ½, SE ¼, NW ¼, NE ¼, SE ¼, Sec. 30, T12N, R2W, S.M. 13321 Alpweg Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project consists of installing a 1250 gallon STEP tank with "Orenco" pump and controls, which discharges into an 18' by 20' bottomless intermittent sand filter (ISF). 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may be allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform to Municipal and State requirements. All separation distances shall be in conformance with Municipal requirements, unless specifically waived. A lot line waiver allows the ISF to be located 5 feet from the property line. 1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around any buried utilities. A buried natural gas line is known to pass through the construction site. 1.4 The contractor shall provide adequate cover material and rough grading over all system components to ensure that proper drainage is achieved after settlement and that there are no residual depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas. 1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the construction. 1.6 The contractor shouM be aware that bedrock was encountered at a depth of 8 feet below ground surface in two nearby test holes. It is possible that jack hammering may be necessary in order to obtain the necessary burial depth for the septic tank. 1.6 The property owner shall enter into a maintenance agreement acceptable to the Municipal Health Department prior to final approval of the system. 2.0 Tanks and Mechanical: 2.1 The existing septic system components shall be properly abandoned by digging down to expose their tops, removing their tops, thoroughly pumping each component and backfilling with soil. 2.2 The new 1250-gallon STEP tank, equipped with an "Orenco", timer controlled, ISF lift station package (as supplied by Anchorage Tank) shall be installed in the approximate location shown on the site plan. The tank shall be insulated with 2 inches of rigid foam insulation and buried with a minimum of 2 feet of soil cover. The control panel equipped with an audible alarm shall be mounted inside the residence. 2.3 The contractor shall be responsible to obtain the necessary Municipal electric permit and inspection, and shall provide a copy of the electrical inspector's report to the engineer overseeing the construction of the wastewater disposal system. 2.4 The on, off, and alarm floats shall be set at the elevations specified by the lift station supplier, and their proper operations shall be verified by the contractor. The initial pump time settings shall be as specified by the manufacturer. 2.5 The discharge line from the lift station to the ISF shall be 1 ~¼" PVC. 2.6 The air compressor supplied by Orenco shall be installed inside the residence. The buried portion of the Orenco specified air line leading from the blower to the ISF shall be installed with a continuous upward slope and fitted with a valve to allow any water which may collect in the line to be drained out inside the building. The contractor shall obtain and install a 0-10 psi pressure gage (available from du Alaska) in the line near the compressor. The engineer may also provide an airflow meter that the contractor shall also install in the air line. 3.0 Intermittent Sand Filter (ISF): 3.1 The ISF shall be constructed by creating an 18' h,, 9a t'nm o-~cavation to a depth of approximately 3.5 feet below ground 1,e, vel in the nort?, 'l~lt'~'l~'; the lot. Construction details shall be as shown on the annotated "Orenco drawings. I'~,~ I l_ 3.2 The bottom of the excavation shall be carefully level container shown on the Orenco side view is optional, but if it necessary to achieve the minimum 18' x 20' inside dimensio: 3.3 The sand filter shall be constructed by placing a min~ inside the 18' x 20' excavation. The "Orenco" supplied air in the native rocky gravel. The plywood used, then additional excavation may be No PVC liner is necessary. ~mof 2.0 feet of approved filter sand )il is required and shall be configured as shown on the "Orenco" drawings and installed at a depth of 12 inches below the top surface of the sand. Filter sand shall comply with Municipal specifications and shall have less than 2% passing the #100 sieve and less than 1% passing the #200 sieve. Acceptable filter sand sources include Quality Sand's "MO.A. ISF washed filter sand", AS&G's "airport sand", or any other sand meeting M.O.A. specs. A sieve analysis from any alternative or unwashed source shall be submitted. 3.4 A five-inch thick layer of 3/8" washed pea gravel shall be placed on top of the filter sand with the 3/4" diameter schedule 40 PVC laterals supplied by Orenco buried midway in the stratum such that the orifice shields are completely covered by the pea gravel. The distribution manifold and flushing valves shall be installed in accordance with "Orenco's' details. Two 4-inch diameter ASTM D-3034 monitor tubes shall be installed in the locations shown on the site plan. The portion of the monitor tube extending through the pea gravel shall be perforated. 3.5 The turn-up portions of the distribution laterals with the flushing valves shall be extended as necessary to terminate inside the "flower pot" enclosures, the tops of which are to be mounted flush with the finish grade. 3.6 Approved filter fabric shall be placed over the entire top surface of the pea gravel. Two inches of approved rigid insulation and 2 feet of soil cover shall be placed over the filter fabric. Fill slopes shall be no steeper than 3:1. 3.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and seed to promote rapid revegetation of all areas disturbed by the construction. 4.0 Inspections: 4.1 A minimum of 6 engineering inspections will be required during the construction of the ISF (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the excavation for the ISF has been dug and prior to placement of any filter sand, (3) afl. er the first 12 inches of filter sand has been placed and the air distribution coil installed, (4) after the remainder of the filter sand has been placed, but prior to placement of the pea gravel, (5) after the pea gravel is in place with the distribution laterals and flushing valves in place. A "squirt" test must be conducted at this time to demonstrate that the system is properly constructed, and (6) after final backfill and grading is complete. 4.2 One inspection of the new STEP tank is required to verify that it is installed level prior to backfill. 4.3 The installer shall coordinate the timing ofthe inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. Flattop Technical Services 14530 Echo Street, Anchorage, AK 99516 Phone (907) 345-1355 W ½, SE ¼, NW ¼, NE ¼, SE ¼, Sec. 30, TI2N, R2W, S.M. 13321 Alpweg Water Well Replacement Specifications 1.0 Water Well: 1,1 The scope of the project consists of abandoning the existing drinking water well and drilling a new one at the approximate location shown on the site plan. The project includes installing an appropriately sized pump in the well and connecting the water system up to the existing residence. 1.2 The existing well shall be properly abandoned in conformance with Municipal requirements. 1.3 The new well shall be located at least 100 feet from the proposed wastewater disposal system components. All well drilling and finishing procedures shall be in conformance with current Municipal requirements. TEST HOLE LEGAL DESCRIPTION: DATE PERFORMED: PERFORMED FOR: DEPTH (feet) 1 3- COMMENTS: FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST August 5, 1998 Tim Kavanagh Pt. Peat and loam GP/GM Black, angular, somewhat silty gravel Sidewalls of excavation look like rock, but relatively easy digging to 7.5' with backhoe. Material pulverizes into sandy gravel when dug. Few fragments larger than 1 1/2 inch. B.H. Hard Bedrock SLOPE SITE PLAN % 10% 0( 5< Depth to Groundwater Date _~roundwater 8/5/98 Monitor tube dry 8/12/98 LU 0% 5%1 5% Clock Net Time Percometer Net Drop Date Reading Time (minutes) Reading (inches) 8/7 12" Pre-soak 27 1/2 Add water & start 4:43:30 23 3/8 #1 4:45:30 2 22 1/4 1 1/8 Add water 4;45:45 23 3/8 #2 4:47:45 2 22 1/4 1 1/8 Add water 4;48 23 9/!6 #3 4:50 2 22 7/16 1 1/8 Add water 4:50:10 23 1/2 ¢;N 4:52:10 2 22 3/8 1 1/8 PERCOLATION RATE 2 (minutes/inch) PERC HOLE DIAMETER TEST RUN BET~NEEN 3.0 FTAND 3.5 FT Perc hole difficult to dig through seemingly rocky material which pulverizes as it is dug. 5,, Sieve ana[vsis results classi~ material as GW. PERFORMED BY FLATTOP TECHNICAL SERVICES. I ..~-.~ ~//¢-J~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 16:35 FA% 907 522 3403 R&.~I CUNSLILTANTS [~UO2,'O02 LABORATORY TEST REPORT CLIENT/PROJECT: Flattop Technical Service / Kavanagh / Glen Alps T.H. f/5 R&M PROJECT: 851003 TEST ON: Field Sample ~ NO.: 8323 SOURCE:.__Test Hole SUBMITTED BY: TED M~ORE FIELD NO.: 1 SAMPLED FROM: Test Hole # 5 DATE SAMPLED; 8/5/98 DATE REPORTED: 6/11/98 LOCATION: Kavanagh, GlenAJps DEPI'H; 5.5' DATE RECEIVED: 8FILE8 GRAIN SIZE DISTRJBUTIOE CLAssIFICATION COMPACTION %+3 OPTIMUM MOISTURE: MIN. DRY DENSITY. MAY._ DRY DENSITY: ;ORR, MAX. DRY DENSI~: % FP,~CTURE: METHOD: NATURAL OENSITY~ NATURAL MOISTURE: 4,2% GRAIN SIZE DISTRIBUTION CHART TOTAL WT. TESTED: 1,319 G~Is, ORGANIC cONTENT L,A, ADRA~ION LO88: REMARKS: MOISTURE DENSITY RELATIONSHIP 1.2 0,4 02 20.0% 40 0% 60.0% 80.0% 100,0% Moisture Content MOISTURE - PERCENT _ TEST HOLE FLATTOP TECHNICAL SERVICES 14530 ECHO ST. ANCHORAGE, ALASKA 99516 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: ~~A/~IJ¢~J~SE~L4~,~.~ DATE PERFORMED: Augqst 5, 1998 PERFORMED FOR: Tim Kavana~h DEPTH Pt. Peat and loam (feet) -- SLOPE 6- 7 9 10 11 GP/GM Black, angular, somewhat silty gravel Sidewalls of excavation look like rock, but relatively easy digging to 7.5' with backhoe. Material pulverizes into sandy gravel when dug. Few fragments larger than 1 1/2 inch. B.H. Hard Bedrock 12- 13 14 15 16 17 18 19- 2o COMMENTS: Depth to Groundwater Date ~o groundwater 8/5/98 Monitor tube dry 8/12/98 SiTE PLAN O% 5% 5% Clock Net Time Percometer Net Drop Date Reading Time (minutes) Reading (inches) PERCOLATION RATE (minutes/inch) PERO HOLE DIAMETER TEST RUN BETWEEN FT AND FT Soil conditions were virtually identical to those encountered in T,H. #5. See perc test and sieve analysis results for T.H. #5 PERFORMED BY FLA'PrOPTECHNICALSERVIOES. i ~7--J ~. CERTIFYTHATTHISTESTWASPERFORMEDIN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Waiver WR# 980068 PID# 021-022-19 Date Received: 9-29-98 Services Section Review Worksheet HA# q~0~26 Permit # Legal Description: T12N, R2W, Sec 30 W2,SE4,NW4,NE4,SE4 Engineer: Theodore F. Moore Applicant: Homer Leslie Burtner Waiver Requested: sand fil~er 5 feet between West property line and intermittand dosing Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: ~ Waiver is NOT Granted: List Conditions or Reasons for above: ~. ~.~F~ L~Z~ Date: /~ ' 3- - ~ By: Name of Reviewer Rec #: 04086/5707 Amount: $ 115.00 Date Paid: 9-29-98 THEODORE F. MOORE, P.E. PH: (90?) 345-1355 14530 ECHO ST. September 10, 1997 ~CHORAGE, ~KA 99516 Bob and Maureen Pintner 13310 Glen Alps Road Anchorage, AK 99516 Dear Mr. and Mrs. Pintner: Per your request on August'28 and 29, 1997 1 conducted adequacy tests of the water supply and wastewater disposal systems serving your residence on Lot 1 of Glen Alps S/D. The test results indicate that both systems are functio~fing adequately at this time. I am now in the process of submitting an application with the Municipal Health Department for a Health Authority Approval (HAA) certificate. Unless requested otherwise, I will mail the HAA directly to you after the Municipality has signed it. If you wish to expedite the process you can call the Health Department at 343-4744 to find out if the HAA is ready, and then pick it up from their office at 825 "L' Street. The following is a report of our test procedure and findings. According to an unidentified driller's log, which is filed among the Health Department records for your loi, the well was completed in June of 1976 and has a total depth of 150 feet and a yield of 2.5 gpm. Since other records indicate that another well had been previously drilled on the lot, and somq of my measurements do not readily conform ~vith information contained on the well log, I am not positive tha}: this log applies to the well presently in use. Thewe~headis~catedunderthe~c/~r~faheatedshedattachedt~then~rtheastc~rner~ftheh~use. Dueto the fact that the pump is suspended from the well seal I was unable to remove the well seal and measure either the static water level or the actual drawdown. Water from the well is pumped into a pair of 250-gallon non- pressurized storage tanks located in the crawl space under the main structure of the house. A booster pump draws water from these storage tanks to fill two small "Extrol" pressure tanks. Floats suspended in the storage tanks control the operatioa of a submersible pump installed in the well, subject to a low water level shut-off switch to protect the submersible pump with a timex set to allow 37 minutes of recovc, ry time before reactivating the pump. To measure the yield of the well I isol ~ted the well by shutting off the water line to the storage tanks, and thus was able to use a flow meter to measure otly the water coming directly from the well. When the submersible pump was turned on the first time, the well deliv,;red 400 gallons of water before the low-level control shut offthe pump. The pump re-activated itself after 37 minn ;es and then pumped another 41 gallons over the next 8 minutes before shutting offagain. Based on thc test data ~' determined that the actual yield of thc well is approximately 0.9 gpm, which exceeds the Mtinicipal criteria for a ~proval of a single-family residence. Since a normal 6 inch diameter bore hole holds 1.47 gallons per foot, the lact that 400 gallons of water were available when the pump was first turned on indicates either that the well is n ach deeper than reported on the log (allowing there to be approximately 239 feet of static water above the pump in~q. ke), or that there is a large an?cunt of extra water storage capacity · available in bedrock fissures surrounding the bore hole. Water samples c611ected on August 28, 1997 contained 0 colonies of coliform and 37 colonies of ct?er bacteria per 100 mi., and less than 0.1 mg/l ofnitrate-N. Because the HAA guidelines call for there to be fewer ~.han 10 colonies of other bacteria per 100 mi., you disinfected the well on September 4, 1997 per the procedure I explained to you. I then collected a second bacterial smnple on September 9, 1997 for which the lab results were satisfactory, showing there to be 0 coliform or other bacteria per 100 ml. test holes on either side of the system. As shown on the enclosed soil log, fractured bedrock prevented effective digging below four feet, which corresponds to the approximatD depth of the bottom of the seepage pit. At this depth the rock still had many fissures, and it was possible to separate it with a pick and shovel. The material removed from the hole was visually classified as GP. According to the well log, the driller was able to drive the six inch casing 20 feet into the ground before the rock became too hard to drive it further. This would tend to indicate that the fractured zone extends to approximately 20 feet. Despite the fact that this residence is one of the highest in Glen Alps and on a ridge crest, the total depth of the well is only 75 feet, and has a yield well in excess of 6.5 gallons per minute. This indicates that there is a strong confining strata surrounding the aquifer. Water samples taken from the well showed no bacteria] contamination, and only 0.33 mg/1 of nitrate. A perforated monitor tube installed to a depth of 45 inches in the hole dug adjacent to the seepage pit was dry on 5/15/87. This fact, plus the observed fractures in the rock and the demonstrated absorption of the system, all support a conclusion that there is neither a high water table, nor an impermeable bedrock strata immediately below the seepage pit, Since there is no evidence of groundwater contamination, and the system continues to perform adequately, I would tend to give the benefit of the doubt to the people who installed the system over 15 years ago° While the Municipality has the responsibility to rule on the adequacy of this single family system, Steve Morris at the Health Department requested that I get a clarification from D.E.C. regarding whether the underlying fractured rock strata should be classified as bedrock for vertical separation distance require- ments. At our meeting you indicated that you felt that the separation requirement was not applicable in this case, since the strata does not appear to be impermeable. If, after reviewing this letter, you still hold this opinion, would you please confirm it in writing to Mr. Morris, with a copy to me. Thank you for your review and assistance in this matter. cc: Steve Morris, M,O.A. DHHS Helen Beirne Sincerely, Ted Moore, P,E. FLATTOP TECHNICAL CW[L & ENVIRONMENTAL ENGINEERING * ENERGY CONSERVATION & ANALYSIS TItEOI)OI{I'; F. M()ORI';, ILl';. 14530 I';CIIO ST. PIt: (907) 345-1355 June 21, 1993 ANCHORAGE, ALASKA 99516 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 1 I 1 1 1 RE: Waiver - field to surface water - w~, SE~, SW~, NE~, SE~, Sec 30, T12N, R2W, S.M. Dear Sirs: By means of this letter we are requesting a HAA certificate and a waiver of the normally required 100 foot separation distance between a soil absorption system and surface water down to 53 feet for the subject lot. A site plan arid other relevant backup documents along with a description of our adequacy test procedure and results are included to assist you in your review. According to the driller's log, the well serving the residence on this lot was completed in June of 1974 and has a total depth of 75 feet and a yield of i0 gpm. On June 1, 1993 we conducted a yield test of the well. At the start of our test the static water level stood at 14 feet below the top of the casing. Steady pumping of 782 gallons of water from the well at the maximum pump output of 7.8 gpm caused the water level inside the casing to be drawn down to 28 feet, but no further. Based on our test data we determined that the total yield of the well is in excess of 7.8 gpm, which exceeds Municipal requirements for a single family residence and also exceeds the FHA lending criteria that a well be able to supply 720 gallons of water within a 4 hour period. Water samples collected on June 1 were satisfactory, showing no coliform or other bacteria and 1.5 mg/l of nitrate-N. According to inspection documents on file at DHHS, the original wastewater disposal system serving tiffs residence was installed in 1974 and consisted of a 1000 gallon septic tank followed by a single 48 foot long soil absorption trench. In 1973 the original soil absorption ~'ench was abandoned and replaced by two parallel 3 foot wide drainfields with a total length of 155 feet having 6 inches of gravel beneath the horizontal distribution pipes. The installation was inspected by a municipal inspector. In February of 1986 the system was tested by AECS and found to be adequate for a three bedroom residence, however the well was fouhd to be 90 feet from the drainfield. On 3/11/86 DHHS issued a waiver allowing the existing dralnfield to be 90 feet from the well. The records do not give any indication that surface water was observed within 100 feet of the system. On June 1, we conducted an adequacy test of the wastewater disposal system. Measured quantities of water were added, first into the septic tank and later into the standpipe at the east end of the upper drainfield, while fluid levels were monitored in the septic tank and soil absorption system standpipes before, during and after the flow of water was stopped. The line between the septic tank and the upper drainfield was found to be obstructed, but the line has since been repaired by Carl's Excavating and a double cleanout installed. The standpipes in the upper &'alnfield initially had 6 and 7 inches of fluid in them, and these levels rose only 1 inch during the course of the test before the fluid overflowed into the lower drainfield. The standpipes in the lower drainfield initially had 0 and 3 inches of fluid in them, mid these increased to 11 and 8 inches, respectively as water was being added. A total of 782 gallons of water were added to the system, and within 1 hour after the flow of water was stopped all the fluid levels were back within 1/2 inch of their original position. Based on this observed behavior, we concluded that the system continues to be able to accept water at an adequate rate for a 3 bech'oom residence. ~)7) 274-461. Static wster )eye ~7~--~=- ~t. ' Scree~ ( ); perforated,( Depth in feet from _tOJ~ Parcel I.D. # MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services :On-Site Services Section P,O.'Box 196S50 Anchorage, Alaska 99519-665C ..... 343-4744 :, A~PROVAL FORA SINGLE FAMILY DWELLIN GENERAL'INFORMATION.i, ',' ;, .... , .... Locaho¢'(s~te ad{ress or d~rec~bons Agent N, ~, ' Day phone Address Unless otherwise req~este~, HAA will be held for pickup, 2. NUMBER OF. BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well ' ' Community well Public water NOTE: If community Weil system, provide written confirmation from State ADEC attest- lng to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: ndividual on-site Holding tank C~)mmu,nity 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[Re¥,1/91) Front ~OA#21 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 bn-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 wastew, ater disl~osal syste~ is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection..5'~ cc,~,~-io,~ o~ I')A ~9~'2.~' . · _ ., '. Address I/~0 ~-~/., '~.4~ - ~ ~/~'r .... ... Eng,neeFss,gnature" ~~ .~ .~te . : . · . .. .... . .., . ..... .~ .~ , -~ .... ~ ~ . C 358 6,; DHHS SIGNATURE X Approved '~oF ~ bedrodms. :" '[~ DiSapproved. Conditional approval for bedrooms, ~Vith: it~ fol'iowing Stipui~ti0ns: Additional comments Date · \.The Mdn~ci~lity of Ar{~h0rage Department of'Health and Human Services (DHHS) issues Health Authority · Approval Ce'rtificateS"based only upon the representations given in paragraph5 above by an independent professionai enginee~'~'egistered in the State of Alaska. The DH HS dOes this as a courtesy to purchasers of homes and their lending inst~tuhons ~r~ orderto satisfy certain federal and s,tate req u~rements, Employees of DHHS do not conduct inspections or analyze data before a certificate .is. issued. The Municipal ty of Anchorage is not responsible for errors or omissions in the professional engineer's work, .... ~ :. 72-025 (R~.1/91) Back MOA~21 Municipality of Anchorage D DEPARTMENT OF HEALTH & HUMAN SERVICE9 [ C [ l V [ D Environmental Services Division 825 L Street, Room 502. Anchorage, Alaska 99501 · (907) ~4,~4 Municipality of Anchorage Health Authority Approval Checklist°ept' Health & Human Services Legal Description: ~ I/~.~ V~, Ni,u'/,O /llE'/,,/_/ 5~ '/~/ A. WELL DATA Well type Log present (Y/N) ~"'~J Total depth ) Sanitary seal (Y/N) Parcel I.D.: If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to FROM WELL LOG 71 /? Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION '~. ,5- g.p.m. Date of test Static water level Well production WATER SAMPLE RESULTS: Coliform Nitrate Date of sample: ,,~/ /ff B, SEPTIC/HOLDING TANK DATA Date installed 7/z-,~/?~ Tanksize Foundation cleanout (Y/N) ¥' Date of Pumping t,l,,4. ~N~.) C. ABSORPTION FIELD DATA Date installed '7 / 2.E / ~ ~ Length ~' .Width g.p.m. O. ~'2./ ,~?/~ Other bacteria No,,~_ Collected by: Fl~f.~.~ T~'c%~'~'4/ Z'~-~_r Number of Compartments ~ Cleanouts (Y/N) High water alarm (Y/N) Depression (Y/N) Pumper ~. ,'~. Soil rating (g.p.d./ff~ or ff~/bdrm) I g" Gravel thickness below pipe Effective absorption area .~'43 ~' Monitoring Tube present (y/N). 7' Date of adequacy test /~/.,4. ('/~-~ o.~) Results (Pass/Fail) ?,~.rj- Immediately after Absorption rate = If yes, give date Fluid depth in absorption field before test (in.); Fluid depth (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* System type --~Y'£ ~::~, .? ' Total depth .~,.5" Depression over field (Y/N) For ~ gal. water added (in.): ~ ~/.5"'~ g.p.d. bedrooms D. LIFT STATION Date installed 7/2 8/ Manhole/Access (Y/N) High water alarm level at* Cycles tested N. ,,~. E. SEPARATION DISTANCES Size in gallons ._~.~ ,z¢~j~,,-~/ "Pump on" level at* '7 2'" "Pump off" level at* '7 *Datum hr~^ Ao (,~ On adjacent lots On adjacent lots SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot / ~0j Absorption field on lot / ,¢_.C ' Public sewer main h/..4. Public sewer manhole/cleanout Sewer/septic service line ~. 2_~z- ' Lift station I d'~ ' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation '7' Property line q~" Absorption field Water main/service line ~ ~' Surface water/drainage ~ t~o ' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Wells on adjacent lots Property line 6 ' Surface water Curtain drain N .,A. Building foundation. //' Water main/service line ~, /~, ' Driveway, parking/vehicle storage area. ~ 3'~ ' Wells on adjacent lots / ~S' ' ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections in conformance with MOA HAA guidelines in effect on this date. Signature ,'~..~'.-~'"¢'~"~ Engineer's Name 7-'-~o.~='~'*"~ /='. Date ~ //~ / HAA Fee $ /,J.,4, Date of Payment Receipt Number 72-026 (Rev. 3/96)* MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services Qn-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description t,v Vz/ S.E' '/~'., N~.,J '/','., N.E '/'/~ ~ v,/.., ~ ~z c ~0 Location (site address or directions) I'~ .~ ~. f .4-If ~, Property owner H~,r~¢¢- /-.¢~'/~ ~,'"/~,~*- Dayphone Mailing address ?.o.r~o,,< ///o¢//,, ,4-~_~,o¢-,~?.e,, /~ Lending agency ~¢-~N¢' (x£,4 Day phone Mailing address Agent /k/o,~ ~ Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ;~ TYPE OF WATER SUPPLY: Individual well ~'~ 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 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. 72-4325 (Rev. 1/91) Front MOA #21 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, m-o,~c-~,/-,o,~, / Engineer's signature ~~ ¢ ~ Date 9/g9/~ 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for ~ bedrooms, with the following stipulations: Money shall be put in escrow in the sum of 1.5 times the amount of the wastewater disposal system pursuant to permit SW980395 attached. 1999. 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 DH HS does this as a Courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 ° (907) 343-4744 Health Authority Approval Checklist Legal Description: ~' '/~ 5'~ '/~, J~x~/v~ A. WELL DATA Parcel I.D.: Well type ~'~'~/'¢ If A. B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) Total depth ~'~ Sanitary seal (Y/N) Date completed Cased to 13¢~n>c ~- Date of test Static water level Well production WATER SAMPLE RESULTS: FROM WELL LOG Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION ~,/ /~../ g,p.m, g.p.m, Coliform (~ Cc,/ / lc.o' ,,~,.,~ Date of sample: ._~ B, SEPTIC/HOLDING TANK DATA Date installed Foundation cleanout (Y/N) Date of Pumping ~'/~0/~ C. ABSORPTION FIELD DATA Date installed Tank size Pumper. _~-_c c~ ~ ~/ Soil rating (g.p,d./ff~ or ff=/bd~) ~ ~ ~ ~Xn ~ Number of Compartments 4dn~ Cleanouts (Y/N)__ Depression (Y/N) ,~ High water alarm (Y/N) ~', ,~, System type Length ~n .~ Width Effective absorption area Date of adequacy test /~. Gravel thickness below pipe Monitoring Tube present (y/N) W Results (Pass/Fail) ~J. ,~, Fluid depth in absorption field before test (in.); Fluid depth (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) 72-026 (Rev. 3/96)* Immediately after M~ ~ Total depth L,Y,~ Depression over field (Y/N) For gal. water added (in.):, Absorption rate = g.p.d. If yes, give date bedrooms D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) "Pump on" level at* "Pump off" level at* High water alarm level at* *Datum Cycles tested E. SEPARATION DISTANCES A/oF~- c~,o<~.~,~j.~/ ~,y.~,~L~ ,~ /~ SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ~-, [oo ' On adjacent 10ts '~> ioo ' Absorption field on lot ~ Io~, Public sewer main /'J. ~'. On adjacent lots Public sewer manhole/cleanout Sewer/septic service line Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ~ .5- ' Property line z. ~o ' Absorption fie d. ~X,-~ ~- Water main/service line '~' ~o ' Surface water/drainage < too ' Wells on adjacent lots ~ ,~4,o, SEPARATION DISTANCE FROM ABSORPTION FI ELD ON LOT TO: Property line _~> to' Building foundation ;> ~o ~ Water main/service line '> /~ ' Sudace water ~ t~.-'o ' Driveway, parking/vehicle storage area ~> ~o ' Curtain drain No,~ $ ¢ e~ Wells on adjacent lots ~ ENGINEER'S CERTIFICATION ~n l~ r~ ~n ~ ~/ I cedi~ that I have determined thru field inspections and review of Municipal records that in conformance with MOA H~ guidelines in effect on this date. Signature Engineer's Name Date ~ / Waiver Fee $ HAA Fee $ Date of Payment ~)/~ Receipt Number ~ ~'/~ ~'~-~ Date of Payment Receipt Number 72-026 (Rev. 3/96)*