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HomeMy WebLinkAboutPENNINGTON PARK BLK 1 LT 1APennington Park
Lot lA
Block
#020-181-37
Municipality of Anchorage
On -Site Water and Wastewater Program • (907) 343-7904 Page of
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP191314 PID Number: 020-181-37
Dwelling: Single Family (SF) Duplex (D) Multiple (SF and/or D) Project: New Upgrade
Name:
ESTHER BUMGARDNER FAMILY TRUST
ABSORPTION FIELD - EXISTING
Deep Trench Shallow Trench Bed Mound
Address ND
5400 E 172 AVE., ANCH., AK 99516
Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
0.8 GPD/SF
9 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
1.5 Ft.
Gravel depth beneath pipe
7.5 Ft.
Subdivision Block Lot
PENNINGTON PARK 1 1A
Fill added above original grade
VARIES 2.1- 2.4 Ft.
Gravel length
60 Ft.
Township Range Section
Gravel width
3 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Lift Station
Tank
900 Ft'
Ft.
Well
--
100'+
NA
NA
qATANK
Septic S.T.E.P. Holding Other
Manufacturer
EXISTING
Capacity
Gal.
Surface water
--
100'+
NA
NA
Material
Number of compartments
2
Lot Line
--
10'+
NA
NA
NA
Foundation
--
10'+
NA
NA
LIFT STATION
Manufacturer
Capacity
Gal.
Curtain Drain
NA
*NA
NA
NA
Remarks *None known. ST exposed, integrity
Pump on level at
in.
Pump off level at
in.
High water alarm at
in.
verified & additional cleaning/pumping.
Pump make and model
Electrical Inspections performed by
PIPE MATERIAL House to tank Tank to 3034
Installer MIKE N. ANDERSON
drainfield
Drainfield 3034 CO/MT 3034
Inspector FWCS / MNA
BENCH MARK (Assumed elevation) 100 ft
Inspdection 1s` 8/3/19 8/5/2019
Location and description
2na
3" 8/5/19 4" 8/7/2019
BOTTOM OF SIDING
COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL
O�®�
® Ai
Conditional Approval: Date
!*.49TH *�
Pixzzo
.MICHAEL N. ANDERSON:
its .•.
No. CE 9469 sv
Approve 1 Dated`' S�
8/9/19.. -`
d." ........ 0 low
®ftsszoly�
inspection Neport_a-i-i2.00c
PENNINGTON PARK BLOCK 1, LOT 1A
CRIB
MT
E
MT TANK INTEGRITY CO
VERIFIED \
DIVERTER
TO CRIVD CO
PID: 020-181-37
PERMIT: OSP191314
• WELL
TH#2
1999
O
Co
b
REBUILT / ?
60' TRENCH a
10' UTILITY ESMT 126.2'
N90'00'00"W— 5.13'
SCALE: 1" = 30
FCOCO DIV
CO MT MT
CO CO CO pp
90.6 FINAL GRADE
FILTER FABRIC
EXISTING 87.0 87_0
1.250 GALLON S
STEEL TANK EWER ROCK
VERIFIED 7
CO
88.5
0.0 °
I'D ORG
GM/sm—ml
SEPTIC SECTION 16.0u TH#2 9/30/1999 — DRY
SCALE: NTS 72.5
PREPARED FOR: SUPPORTSERVICES:
ESTHER BUMGARDNER FAMILY TRUST �� OF AL<Q�,
PENNINGTON PARK BLOCK 1, LOT 1A * 49 TH
5400 E 172ND AVE., ANCHORAGE, AK 99516
Michael N. Anderson, P.E. DATE: 8/10/2019 MICHAEL N. ANDERSON
NO. CE 9469
4661 Natrona Ave. DRAWN: FWCSF �`2Af
Anchorage, Alaska 99516 %A 8/10/19 '
(907)727 8864/FAX: (907)345 1391 SCALE: 1" = 30' PESSIO'0
7/30/19
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section - Fax: 907-343-7997
ON-SITE SEPTICIWELL PERMIT APPLICATION
Parcel I.D. 020-181-37
Property owner(s) ESTHER BUMGARDNER FAM. TRUST Day phone 3104298204
Mailinq address 5400 E 172ND AVENUE, ANCHORAGE, AK 99516
Site address 5400 E 172ND AVENUE, ANCHORAGE, AK 99516
Legal description (Sub'd., Block & Lot) PENNINGTON PARK 131, LOT 1A
Legal description (Township, Range & Section)
Lot Size 73,150 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
©
Initial ❑
Single Family (SF)
(w/wo AD U)
Septic Tank
1:1Upgrade
Duplex (D) ❑
Holding Tank
ElRenewal
❑
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.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 5_7
Date of Payment: Z=117
Receipt Number:
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
Michael N. Anderson, P.E.
Civil/Structural Engineering and Construction
4661 Natrona Ave. Anchorage, Alaska 99516
Phone 345 -3377 / Fax 345 -1391
Support Services
Brent M. Western
907-440-4601
July 30, 2019
Municipalities of Anchorage
Departments of Health and Human Services
P.O. Box 196650
Anchorage, Alaska 99519-6650
Fax 249-7847
RE: SEPTIC SYSTEM UPGRADE PERMIT
LEGAL: PENNINGTON PARK BLOCK 1, LOT 1A
PHYSICAL: 5400 E 172ND AVENUE, ANCHORAGE, AK 99516
The septic field has failed and we request a septic permit to upgrade the system on the above
referenced lot. Due to site constraints, we propose to remove and replace the existing trench to
serve the existing 4-bedroom residence. The location of the existing system to excessive slopes
has not shown any or known to have any daylighting issues since installed 20+ years ago. Based
on this information, the soils present and observations of the field it appears that the field will
become saturated prior to any possibility of horizontal / downslope daylighting. The design is
based on the test hole conducted previously for the exiting system.
The lot and area is served by private water and the design will not impact any of the neighboring
properties. Please contact Brent M. Western or me if you have any questions.
Sincerely,
Michael N. Anderson, P.E.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191314, Rebecca Carroll, 07/30/19
Michael N. Anderson, P.E.
ESTHER BUMGARDNER FAMILY TRUST
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191314, Rebecca Carroll, 07/30/19
Michael N. Anderson, P.E.
ESTHER BUMGARDNER FAMILY TRUST
STAKE UTILITY EASEMENT PRIOR TO CONSTRUCTION.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191314, Rebecca Carroll, 07/30/19
Municipality of Anchorage
Department of Health and Human Services
Division of Environmental Services
OmSite Services Section 825"L" Street Room 502
P,O, Box 196650 Anchorage, AK 99519-6650 Page / of '7.~
www.ci,anchorage.ak,us (907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: ~-~t,k3 ~C{ L)'~ ~ ~ RID Number: ~,'TZO --I 8~, -,.~ ~-- _
Name: '~ ('~W~ %~,~ Wastewater System: ~ New ~Upgrade
~.d .....%~o ~ f?~.z ~ g~c~ ~,~ ABSORPTION FIELD
Phone: ~ '~ ~0 ~ ~ Number~edro.s: ~eepTrench g Shal,.Trenc, ~ Bed ~ Mound = Othe.
Soil Ragng: To~ Dop~ from original grade:
LEGAL DESCRIPTION ?~)~ ~) GPDIFI'
S bdMsion: Depth to pipe ~tt~ fr odg~nal grade: Gravel depth beneath pipe:
TownshTp: Range: ~ect~n: Fill added above original grade: Gravel Length:
Gravel ~dth;
Well:
DdYer: ~" ~,"GO ', Date Dfilled:.~ Static Water Levoh.~ ,1 ,ns~llen~(,,~" ~ . Oate ,nstallod>>d~ ~r
Yield:/0 GPM PumpSetat~0 FI. CasingHeightA~veGr°und:/ "~. TANK '
SEPARATION DISTANCES ~septio U Holding D S.T.E.P. U Other:
To Septic Absorption, Lilt Holdin~ ~blio/Prival~
T~nk Field Station Tank Sower Uno ~CY ,~ [ ~ ~ aal.
t.~ ~ 'Pump eh" level at: "P ~t: High water ala~ at:
Engineer'~SJamp
Depa.ment of ~alth?~ Human Services approval
Permit No. SW990380 Page 2 of 2
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 545-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: LOT lA B1 PENNINGTON PARK SUBD. PID No.: 020-181-57
MARK A B CRND PIPE
ELEV. ELEV.
C01 31.8 43.6 104.4 97.2
C02 259 535 995 ,969
TC01 279 54.6 95.4
TC02 54.2 59.2 98.2
CO3 .37.7 625 95 91.9
L C04 37.7 623 95 91.9
DIVIDER 40.1 647 9.3.9 90.7
__ ____ MT___ 63.~ 868 90.;~ 79.54
C05 80.6 108.6 90.8 87.24
C06 651 8.3.0 912 87.54
' I -
EXISflNO CRiB
SCALE[ 1"=180' ,
F~°' ~o,~ ~o~ ~ .... .,..~ ~..,
'~.~%, ,;' -
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box '196650, Anchorage, AK 995'19-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Oct 08, 1999
Expiration Date: Oct 07, 2000
Permit Number: SW990389
Legal Description: PENNINGTON PARK BLK 1 LT lA
Design Engineer: 0088 Anderson Construction & Eng'g
Owner Name: Ester Bumgardner
Owner Address: 5740 E 172ND STREET
ANCHORAGE, AK 99516-5607
Parcel ID: 020-181-37
Site Address: 005400 172ND AVE E
Lot Size: 73150 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.
5. The following special provisions.
ANY PORTION OF THE PROPOSE[) ABSORPTION FIELD SHALL BE CONSTRUCTED A MINIMUM OF 35
FEET FROM THE 25+% SLOPE.
Date:
M 'tchael Anderson P. E.
14250 Golden View Drive
Anchorage, AK 99516
(907) 345-3377 home
(907) 345-1391 fax
October 7, 1999
Department of Health and Human Sca'vices
On-Site Se~'vlces Section
P. O. Box 6650
Anchorage, AK 99519-6650
Re: Lot lA Block 1 Pennington Park Snbd.
To Wlmm It May Concern:
The above residence has a aa-septic system boilt in 1972 which is in failnre. Two test holes were
excavated on thc south west side of the lot. The first bole had a perc rate greater than 60 minates
per inch while the second test hole had a much better pcrc rate of 2.7 minntes per inch both at
apporximately the same elevotiou. The excavation on test bole #1 took twice the time compared to
test hole #2 due to the stiff soils. Water was also found at 17 feet in test hole #1. No water was
discovered in test hole #2 even after the 7 day waiting period. However test hole #2 is 15 feet from a
slope of 25% or greater, bnt no otber area was available to install a new system. Tbe system will be
designed with a perc rate of 0.8 gallons per day per foot squm'ed for a single trench 58 feet long aod
6.5 feet of effective depth. This is a slower perc rate for added safety and life on the new system.
The slope of the lot is to tbe west with a greater slope on tbe far west side of the lot. Tile surrounding
systems appear to be perfoming well. This new system will not impact any of the neighborlog system
to the best of my knowledge.
Please feel free to call me if yon have additional qnestions. You may reach me at 345-3377.
--1t I
17'
OM
-172ND
~.-~MOUND OVER
~I X,,f==~: ~''-FILTER F'ABRIC
2,0' ~DRAIN~ ROCK
AVENUE-
SLOPE GREATER THAN 25%
1250 GALLONG
DOUBLE
0.0.
10' UTILITYEASEMENT
L
SEPTIC DESION PREPARED FOR
JIM &: ESTHER BUMGARDNER
LOT IA, BLOCK 1
PENNINOTON PARK SUBDIVISION
PREPARED BY
MICHAEL N. ANDERSON, P.E.
14250 N. GOLDENVIEW DRIVE
(907) 545-.3377 / FAX (907) 545--1391
100'
EXISTING
FRAME
HOUSE
4 9 ~_U~H ...
Cl-'_ - 9469
SCALE: 1"=50' SEPTEMBER 1, 1999
IDESlGN. _60 B!~R!A_: .................................
4, BDRM = 600 GPD
SOILS = 0.8 GPO/SQ. FT.
~0_o/o.~ ~ ,~o p.jT._ ?'D .............
TRENCH:
8.5', DEEP
6,5 EFFECTIVE - 1 7 2 N D A V
2,0' WIDE
58' LONG 525.0' WEST
................................................
Z
5(
APPROXIMATE EDGE OF
SLOPE
HOLE (T~2).~ < ~
TESI HOLE
30' RAOIL
/\
FRAME
HOUSE
325,0' WEST %.
NEIGHBORS SEPTIC /
AREA ~
SEPTIC DESIGN PREPARED FOR
JIM & ESTHER BUMGARDNER
LOT lA, BLOCK 1
PENNINGTON PARK SUBDIVISION
;TING 100'
WELL RADIUS1
I~:~
PREPARED BY
MICHAEL N. ANDERSON, P.E.
14250 N. GOLDENVIEW DRIVE
(907) 345-3377 / FAX (907) 345-1.391
SCALE: 1"=50' SEPTEMBER 25, 1999
PERFORMED FOR:__J~- ~ J~
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
~ MICItAEL N. ANDERSON
DATE PERFORMED: ~'~ ,/~/ lq
2
3
4
5
6-
7
8
9-
10-
12~
13-
14
15
16
17
19
20
COMMENTS
Township, Range, Section:
SLOPE
WASGROUND WATER
ENCOUNI'ERED?
SITE PLAN
IF YES, AT WHA'r
DEPTH?
Depth to Waler Aller
D ele:_~(__~'~L,/' '~'_ Gross
Readin9
Net
Date Time Time
Depth to Net
Water Drop
PERCOLATION RATE .L_(~-- (Imnutes/mch) PERC HOLE DIAMETER
TEST RUN BE'IWEEN ~' ~"~ FT AND ~. ~,2 FT
ACCORDANCE WITH ALL STATE Ar4D MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ._ ' F~['¢ ¢¢
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Aechorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
.E,~O,MED ~OR: ~'~/'/¢C~¢'
3-
5-
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
COMMENTS
DA'rE PERFORME[
Township, Range, Section:
SLOPE
SITE PLAN
N
WAS GROUND WATER 'i-..I
ENCOUNTERED?
mo, o ,o? Rp~-oat,: [~L__L__L I I I 1/ I J
Net Depth t4~o~ Not
Time Water Drop
Date Gross
Time
IO
~ ,,z.., ¢-, ,-9,././..¢ . / o
i?EFClL:OLA'IION RATE -- *~ umnutoo/mch) PERC I-IOLE DIAMETER
]~,~Sff ,~i .IN BETWEEN /~, O FT AND "~' ~:~ FT
GREI
":R ANCHORAGE AREA BOB
Department of Environmental (]uality
3500 Tudor Road
Anchorage, Alaska 99507
SH
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ,~7~/~ ~/_.5"~z~////~.~'~- MAILING ADDRESS~/~//~/~/~-J~ PHONF
/A~z~ LEGAL DESCRIPTION
SEPTIC TANK:
DISTANCE '/3~/'~//~!5' NUMBER OF
FROM WELL ~'~7~ ' MANUFACTURER-:rJ~'~eC'~'~ MATERIAL -~----~/~ COMPARTMENTS /'
INSIDE LENGTH_ -- .INSIDE WIDTH -- LIQUID DEPTH '--.LIQUID CAPACITY/~<~'5~ GALLONS.
SEEPAGE PIT: -- ~ . . ~/z~/~-~:.-~-
NUMBEROF PITS / DIAMETER __~ OR WIOTPI LENGTH DEPTH /~ ~ ~u,~)~'>>z~
~ DISTANCE FROM:
LINING MATERIAL~[~ . CRIB SIZE: ~IAMETER~ DEPTH. / WELL
///~/'~ .~ ~ TOTAL EFFECTIVE
BUILDING FOUNDATION ~ ~, NEAREST LOT LINE~ ~ ABSORPTION AREA (WALL AREA) ~
ADDITIONAL ABSORPTION
WELL:
TYPE,~'°~'~//~///~ CONSTRUCTION ~//~' DEPTH //~ ~ DISTANCE FROM:
SEPTIC~~- SEEPAGE ~/~::
BUILDING ~ / NEAREST ~_ NEAREST /~ /~.
FOUNDATION~2 / LOT LINE /¢ SEWER LINF¢7 TANK SYSTEM -~/~ '
o o-
CESSP ,
OTHER SODRCES /'(//~'/c/z=~-~ /<""-/g/~'c:z'/'-'f/
A~'PRO~_VED-~_-DISAPPROV~D
REMARKS
D I S T A N C E S
INSTALl_ED
PIPE MATERIAL:~//~/~:~
LOT SLOPE:
REMARKS:
Form PW-026
DIAGRAM OF SYSTEM
G.A.A.B.
GREATER ANCHORAGE AREA E]OROUGH
DEPARTMENT OF ENVIRONMENTAL. QUALITY
SEWAGE DISPOSAL SYSTEM -- APPLICATION ANi) PERMIT
PERMIT NO.-
]NSTALLAT{ON t-OCATION
INSTALLATION Of: SEPTIC TANK ~ ~ . SEEPAGE PIT--~
TYPE AND SIZE OF FACILITY TO BE SERVED ~/ ~
FINANCED THROUGH
~OIL, TEST rESULTS ~
OTHER
NOTE: THIS PEI~MIT IS NOT VALID wI'rHOUT SOIL TEST
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT .~ ~) DRAIN FIELD .
SEPTIC TANK To SEEPAGE PIT WALL
WELL TO SEPTIC TAnK ¢~ .... seepage
WATEr main tO SEPTIC tANK ~ ., SEEPAge
SEPTIC TANK, __/~, seepage Pit /~¢ / ,
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
GRAVEL BACKFILL
CONFORM 'to BOROUGH REGULATIONS REGARDING INSTALLATION.
GREATER ANCHORAGE AREA BOROUGH
DEPARTMENT OF ENVTRONMENTAL QDALITY
3330 "C" Street
ANCHORAGE, ALASKA 99503
Case
Legal Description: Lot v/-# Dl~ck' ~/
This Form Reports Soils Log ~
Soil Test Must Be Logged To 4'
Depth
Feet Soil Characteristics
lO=-
ll--
12--
13--
14--
Dated Pe~rformed ~-]Jj~/~
Subdivision Ny~,,,,~7~-Z'~7
Percolation Test
Below Proposed Seepage System
<
Was Ground Water Encountered? j/o__ d~m.
If Yes, At What Depth?
Reading Date Gross Time Net Time Depth to H2(1 Net Drol
Percolation Rate Minute
Proposed Installation: Seepage Pit
Depth of Inlet Depth to Bottom
COMMENTS: ~)~,.5-~7~~..~
Drain Field
of Pit or Trenc~
Test Performed
Da te:
MEMORANDUM
E.
MUNICIPALITY OF ANCHORAGE
l
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 020-181-37
1. GENERAL INFORMATION
Expiration Date:
Complete legal description PENNINGTON PARK BLOCK 1, LOT 1A
Location (site address) 5400 E 172ND AVENUE, ANCHORAGE, AK 99516
Current property owner(s) ESTHER BUMGARDNER FAMILY TRUST Day phone
Mailing address
Real estate agent
5400 E 172ND AVENUE, ANCHORAGE, AK 99516
2. TYPE OF DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone
3. NUMBER OF BEDROOMS:
4
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER
DISPOSAL:
Private Well ®
Private Septic
Water Storage ❑
Holding Tank
❑
Community Well ❑
Community
❑
Public Water System ❑
Public Sewer
❑
Waiver request for:
Distance:
Received by:
Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 42 YO
Waiver Fee $
Date of Payment 2/11/9
Date of Payment
Receipt Number 103 9 5D
Receipt Number
COSA # 6=913(46
Waiver #
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the
on-site water supply and/or wastewater disposal system is (are) 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 (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in
effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm ANDERSON CONSTRUCTION & ENGINEERING Phone 345-3377
Address 4661 SHOSHONI DRIVE, ANCHORAGE, AK 99516
Engineer's Printed Name MICHAEL N. ANDERSON, PE Date 8/3/2019
Comments: This investigation was completed in compliance with MOA guidelines, regulations,
and best industry practices / methods. 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 in land use,
local soil characteristics, groundwater levels that may fluctuate during the year, quality of
construction (workmanship & materials), the water usage of the family being served by the
system and maintenance. 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, any estimate of how long a system will function satisfactory
for current or future occupants or guarantee that no unseen encroachments, deficiencies or
discrepancies exist can be given by FW(5 and Anderson Construction & Engineering
6. DSD SIGNATURE 4
System #1 Approved for q
bedrooms
System #2 Approved for
Disapproved
Conditional approval for
bedrooms
SOFA\�
�.. 'S (�
*.49 TH
.MICHAEL N. ANDERSON r
No. CE 9489
Af
i
�F'ESSIO���
bedrooms, with the following stipulations:
.\�� "hPALITYA���i
Original Certificate Date: � ^ « L c
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory K Other
COSA Checklist blue sheet
Legal Description: PENNINGTON PARK BLOCK 1 LOT 1A Parcel ID: 020-181-37
If more than 1 septic system on lot: COSA Checklist # of Structure served by this system _
A. WELL DATA
❑ Well log is filed with Onsite (or attached) Water storage tank volume NA gallons
Date drilled PRE 1975 Well disinfected for coliform test? ❑ Yes ® Nc
Total depth 106 ft ® Coliform bacteria is Negative
Cased to 50+ ft Nitrate 2.28 mg/L EJNitrate less than MRL (ND)
® Sanitary seal is functioning correctly Arsenic ug/L ® Arsenic less than MRL (ND)
® Wires are properly protected
WE
Casing height (above ground) 12 in. Collected by `.`
Date of flow test for COSA 7/24/2019 Date of Sample 7/24/2019
Static water level at beginning of test 48 ft.
Well production at time of test 0.77 gpm
Comments Well data per MOA record docs. Shallow well — may consider storage for peak use.
B. TANK DATA —11/9/1994 - 1250 -gal C. LIFT STATION - NA
Age of tank(s) 20 years ❑ Required maintenance completed
Tank type/material SEPTIC / STEEL Age of lift station years
Measured operating fluid level in septic tank 48" Lift station material
® Standpipes/foundation cleanout per record drawing Comments: Additional cleaning / pumping of tank at
Date of pumping 6/6/2019 tank integrity inspection during field upgrade.
D. ABSORPTION FIELD DATA — 60'L x 3'W x 7.5'ED — 0.8 GPD/SF = 900 SF
Which system tested (date installed) 8/5/19 INSTALLED
® ALL standpipes present per record drawing
Total measured depth from grade 11.1 ft (max)
Measured depth to pipe invert from grade 3_6 ft (min)
❑ N/A — pressurized field
® Monitor tubes go to bottom of effective. If not, state
depth into effective
® Code -required soil cover over field
❑ System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Comments/Deficiencies:
COSA Checklist copy 2.docx
Adequacy test date NA - NEW SYSTEM
Results ❑ Pass For _ bedrooms
Fluid depth prior to test _ in
Water added gal
New depth _ in
Elapsed time min
Final fluid depth _ in
Absorption rate _ gpd
Any rejuvenation treatment (past 12 months) N
If yes, enter date
WE
E. SEPARATION DISTANCES — Per MOA record docs & observations 5117119.
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100'
® Yes
if No
Community Sewer Manhole/Cleanout > 100'
® Yes
if No
ft
® Yes
if No
Neighboring Tank > 100' ® Yes
if No
ft
Private Sewer/Septic Line > 25' ® Yes
if No
Absorption Field on Lot > 100' ® Yes
if No
ft
Holding Tank > 100' ® Yes
if No
Neighboring Absorption Fields > 100'
Surface Water > 100'
® Yes
Animal Containment > 50' ® Yes
if No
® Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ® Yes
if No
ft
® Yes
if No
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' ® Yes if No ft Surface Water > 100'
ft
ft
ft
ft
ft
® Yes if No ft
Property Line > 5' ® Yes if No ft Wells on Adjacent Lots:
Absorption Field > 5' ® Yes if No ft Private Wells > 100' ® Yes if No _
Water Main > 10' ® Yes if No ft Community Wells > 200' ® Yes if No _
Water Service Line > 10' ® Yes if No ft If septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10'
® Yes
if No
ft
If absorption field is under driveway comment below
Property Line > 10'
® Yes
if No
_ ft
Wells on Adjacent Lots:
Water Main > 10'
® Yes
if No
ft
Private Wells > 100' ® Yes if No ft
Water Service Line > 10'
® Yes
if No
ft
Community Wells > 200' ® Yes if No
Surface Water > 100'
® Yes
if No
ft
F. ENGINEER'S COMMENTS
G. ENGINEER'S CERTIFICATION
1 certify that I have determined through field inspections and review
of Municipal records that the above systems are in conformance
with MOA COSA guidelines in effect on this date.
COSA Checklist copy 2.docx
OF, ALS
4 9 TH
$OFAU,60, Ap .0
MICHAEL N. ANDERSON -
No. CE 9469
8/10/19.. o
ft
ft
ft
Septic 'Tank Advisory
Certificate of On -Site Systems Approval #OSC191365
Subdivision: Pennington Park BLK 1 Lot1A
Starting at 20 years of age the MOA issues Advisory's for steel septic tanks. The septic tank for
this property is 20 years old. Typical replacement costs range from $6,000 to $9,000.
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 20 year old steel tank MAY look like.
Well Water Advisory
Certificate of On -Site Systems Approval # OSC191365
Subdivision: Pennington Park, Block: 1, Lot: 1A
This well's productivity was determined to be .77 gallons per minute. The minimum
well productivity required under (AMC 15.55) for a 4 -bedroom residence is .42
gallons per minute or 150 gallons per day per bedroom. Although the subject well
currently exceeds this minimum requirement, the production capacity can
fluctuate.
This advisory must be attached to all copies of the subject Certificate of On -Site
Systems Approval.
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MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
r)IVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OI-- ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision section., township, range)
/ i -- /
Location (address or directions)
_. /~/~elephone: Home _ _ . ~-"
Applicant Address ~4~ -¢~0 /~"~ / ?,? "~ '''~ A~¢i~/,.~¢c.~,,- _~?~ ?'¥?~'¢~./-~
(c) Applicant is (check one): Lending Institution []; Owner/builder.~ Buyer []; Other [] (explain); __~_~
(d) Lending Institution _
Address
Telephone
(e) Real Estate Company and Agent ..... /v/ I? ,
Address
(f)
Telephone
Mail the HAA to tbe following address:
TYPE OF FtESIDENCE
Single-Family [~2~"~M ulti-Fa mily
Number of Bedrooms
Other
WATER SUPPLY
Individual Well ~/Community [] Public []
Note: Jf corn munity well system, must have written confirmation from the State Department of Environ mental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsiter~I/ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status,
Page 1 of 2 72-025n1~84)
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS; FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and es of the validation date shown below, I verify tbat my investigation of this Health
Authority Approval shows that the omsite 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 aed 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 __ ~,:.'~7.'(~; "~ .....
,.~ .x,. (' _ Telephone
Address ~_(~P~ ~V,-':~':~ '/ ~,:' ~/""-~':/-( ~(" ~'?>"~)
Engineer's Seal
Approved for _J~/-//¢~-~ /-- bedrooms by~-/Y""~¢"/~¢_~'-'~ '~f~-- Date
;;;rm~V;~onc/itiYnal Ap[~v.( v a~isapprove'd Conditional
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The [:)HEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-025 ($1;84)
ENVIRONMENTAL PROTECTION
MUNICIPALITY OF ANCHORAGE (MOA)
H£^ .TH AUTHORrrY ^PPROVAL (HAA) ' 0 g8B
CHECKLIST - FEBRUARY lg84
264-4720 ~ ~ ~ ~ ~ ~ ~,~
WELL DATA
Well Classification ~¢' I~ ~~Z If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (y/~_~ ('-E- /¢? 5' Date Completed ,/~ '~'~ Yield
Total Depth /f.O¢.~ Cased t~) ~'~) - (~ Depth of Grouting
Static Water Level "~'~:~- ('?~ Pump Set At
~ "~'~ Sanitary Seal on Casing (~1)
Depression Around Wellhead (Y~__~?
Casing Height Above Ground
Electrical Wiring in ConduitS)N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
( ¢.
/~) ¥' ¢ ; On Adjoining Lots
/¢)¢ '(' ; On Adjoining Lots
To Nearest Public Sewer '~ r
To Nearest Sewer Service Line on Lot ~-'~)
To Nearest Edge of Absorption Field on Lpt
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by ~(~ , ; Date
Water Sample Test Results '7-~*~r* (Q~c/~F?/
Comments ~ ~-& ~ /~C? ~-~Z-~;~- ~z~,~ '~ ' - /
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes (~N) ,~ Air-tight Cap (~)
Depression over Tank (YIN)/
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Size (~-~5-~) No. of Compartments
ounda. on
Date Last Pumped ~ -~'~/'"~'
~'¢'- '/(~,~ :for
Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Hold?g Tank:
To Water-Supply Well
To Property Line
To Water Main/Service Line ~. ~"'~
/
Course ~,~'T'
Comments
To Stream, Pond, Lake, or Major Drainage
Page 1 of 2 .
72 026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata -~'~'~ %-- -~ ~'
~..~./~¢.. Type of System Design
Date Installed ~- ® - ~ :~ Length of Field
Width of Field . r.?~'
Depth of Field
Gravel Bed Thickness
Square Feet of Absorption Area '~?~,~/' .~¢-~,,'/'¢. Standpipes Present~_.N)
Depression over Field (Y/¢ /
f
Results of Last Adequacy Test ¢~¢.
Separation Distance from Absorption Field:
To Water-Supply Well /fCC) ('6
To Building Foundation
Lot ~.~--~0
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area _
Date of Last Adequacy Test ¢r~'~.-~'~~ ~'"~'
To Prope~y Line ~ ~
To Existing or Abandoned System on
; On Adjoining Lots ~¢ (~
To Cutbank (if present) ~
Comments
LIFT STA'rlON
Date Installed Dimensi~_
Size in Gallons [~: (Y/,N), __
"Pump On" Level at ,,~~mp Off" Level at
Tii!ti~lifli~;~i;rsl;~iTM /'~' puVmep~::Y/c;:les during A quacy Test, Meets MOA
Comments ~
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checkc, d, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed ~ L~E'~f' [)ate ~"~ ~"~ '¢~¢; j~
Company _~, '~'~'~-~ . Z'"~ ¢- MOA No. ~"~'~ ~;~,='""'~/
Receipt No.
Date of Payment
Amount: $
Page 2 of 2
72-026 (11/84)
Seal
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot lA Block I Pennington Park Subdivision
Location (address or directions)
5740 East 172
(b) Applicant Name Jim Bumgardner Telephone: Home 345-1089 Business 345-1089
Applicant Address SPA Box 1718 Anchorage~ Alaska 99516
(c) Applicant is (check one): Lending Institution I-1; Owner/builder []; Buyer []; Other [] (explain);
(d) Lending Institution Alaska Mutual Bank
Address Pouch 4-9003 Anchorage
(e) Real Estate Company and Agent
Address
% Mar~_.Sch,~hone
Ak 99509
338-7890
Telephone
(f) Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family~]~ Multi-Family []
Number of Bedrooms four(4)
Other
WATER SUPPLY
Individual Well ~ Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status,
SEWAGE DISPOSAL
Onsite [[~x Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
0
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Hea~th
Authority Approval 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 Telephone
Address
Date
Engineer's Seal
This Department has received written confirmation that the conditional approval
has been taken care of thru (A.E.C.S., Inc.), therefore, this property is now
fully approved.
DHEP APPROVAL
Approved for ~ bedrooms by /~, ,
Approved xxx~ Disapproved Conditional
June 27, 1985
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
ALASKA PCI1UII O[/m [1TAL COIqTROL I[1C.
~n§ineerin§ $ ~nuironmenlol Stu~lics
JIM BUMGARDNER
SRA BOX 1718
ANCHORAGE ALASKA
99516
SELLER-SAME
JUNE 20 1985
JIM BUMGARDNER
ANCHORAGE ALASKA
99516
50289
LEGAL:PENNINGTON PARK BLOCK 1LOT IA
ADEQUACY TEST FOR SEWER SYSTEM
ADEQUACY TEST DATE-6/20/85
THE TYPE OF ABSORPTION SYSTEM IS A SEEPAGE PIT WITH AN UNKNOWN AREA.
THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER P~R DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 1000 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
4 BEDROOM HOME.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR
THIS 4 BEDROOM HOUSE.
THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON 6/13/85 .
ADDITIONAL COMMENTS :
WELL WIRES IN CONDUIT JUNE 13 1985.
REPAIRED LINE AND REPEATED ADEQUACY TEST.
1200 IJJesl 33:1 Auenue, Suite [3, Anchor~qe, Al~sk~ 99.503.[907) 561-50L40
ALASKA 'IIROFIm FITAL COFITF OL IFIC.
JIM BUMGARDNER
SRA BOX 1718
ANCHORAGE A!.~SK~
99516
SELLER-SAME
JIM BUMGARDNER
SRA BOX 1718
ANCHORAGE ALASKA
99516
JUNE 20 1985
50289
LEGAL:PENNINGTON PARK BLOCK 1LOT iA
ADEQUACY TEST FOR SEWER SYSTEM
ADEQUACY TEST DATE-6/20/85
THE TYPE OF ABSORPTION SYSTEM IS A SEEPAGE PIT WITH AN UNKNOWN AREA.
THE SYSTEM IS CAPABLE OF ACCEPTING 600 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 1000 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
4 BEDROOM HOME.
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR
THIS 4 BEDROOM HOUSE.
THE SEPTIC TANK/PACKAGE PLANT WAS PUMPED ON 6/13/85 .
ADDITIONAL COMMENTS :
WELL WIRES IN CONDUIT JUNE 13 1985.
SYSTEM PLUGGED BETWEEN TANK AND FIELD.'
REPAIRED LINE AND REPEATED ADEQUACY TEST.
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information
Application Date 3-7-85
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 1A~ Bk. l, Pennington Park Subd. Sec. ll, TllN, R3W S.M.
Location (address or directions)
5740 E 172
(b) Applicants Name Jim Bumgardner
Telephone - Home34,SylOS~usiness 345-1089
Applicauts Address SRA Box 1718, Anchorage, AK 99516
(c) Applicant is (check oue) Lending !nstt~u~ion I ]; OWner/builder
Buyer ~ ; Other ~-~ (explain);
(d) Lending Institution Alaska Nutual J~ank, Att_n: Mary. ~5ghpbe~e. lephone 338~78.90
Address Pouch 4-9003~ Anchorage, Ali 99509
(e) Real Estate Co. & Agent __~__~__
Address
(f)
Telephone
Mail the HAA to the following address:
ttold for pickup
2. T~pe of Residence
Single-Family ~ Multi-Family ~--~ Other (describe) ........
Note: If community well system, must have written confirmation from the Sta~e
Department of Environmental Conservation attesting to the legality and s~atue.
4. Sewase Dispose.i.
0nsite ~ Public ~_~ Community ~ Holding Tank ~
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 2]
As certified by my seal affixed hereto and as of the validation date shown below:
verify that my investigation of this Health Authority Approval shows that the on-si
water supply and/or wastewater disposal system is safe, functional and adequate for
the number of bedrooms and ~Ype of structure indicated herein.. I further verify th~<
based on the information obtained from the M~nicipality of Anchorage files and from
investigation and inspection, the on-site water supply and/or wastewater disposal
system is in compliance ~th all Municipal and State codes, ordinances, and regula-
tio~ in effect on the date of this inspection.
Name of Firm Alaska Soil Testing and Engineering ST85-260 Telephone~.~61-7453
Address 6100 A Street, Anchorage, AK' 9c. 502
Date
(Note upgrade recommendations.)
(ENGINEER SEAL)
DEEP Approval
Approved for
Approved
Terms of Conditional
bedrooms
Disapproved
CA~fION
THE MONICIPALITY OF ANCHORAGE DEPA/{TMEN"f OF NEALTH AND ENVIRON!~ENTAiL PROTECTTON
(DHEP) ISSUES NEALTH AUTHORI?f APPROVAL CERTIFICATES BA~ED SOLELY UPON THE RF~PP~ESEN~i'-
ATIONS GIVEN IN PARAGI~ 5 ABOVE BY AN INDEPEN-DENT PROFESSIOM&L ENGINEER REGISTERED
IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
MENTS. EMPLOYEES OF DHEP DO NOT CONDUCT INSPECTIONS OR A~NALYZE DATA BEFORE A
CERTIFICATE IS ISSUED. T~ MIrNICiPALITY OF ANCHORAGE IS NOT RESPONSIBLE FOR ERRORS
OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK.
(DHEP SEAL)
RR4/eJ/D18
[Page 2 of 2]
7-19-84
A. WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH ALPfHORITY APPROVAL (HAAi
CHECKLIST - FEBRUARY 1984
mUNICIPALITY OF ANCHORAG~
DEPL OF HEALTH &
I-=NVIRONMENTAL PROTECTION
APR ?
Legal Description:
Pennington Park Subd.; Sec. 11~ TllN, R3W~ S.M.
Well Classification
Well Log P~esent (y/N)N (Pre 6/75) Date Completed
Total Dapth106 ft(1978 Rpt)Cased to 50+ ft.
Static Water Level 45 ft. Pump Set At
Casing ~ight Above Grcund 12 inches
Individual If A, B, c~ C, D.E.C. Approved(Y/N)
1973 Yield 600+ gp~
Depth of Grouting
90 ft.
Sanitary Seal on Casing (Y/N)
Electrical Wiring in Conduit (Y/N) N (See comments)Dap=ession A~ound Wellhead (Y/N) N
Separation Distances f~.omWell:
To Septic/Holding Tank on Lot 128 ft.
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewe~ Line 100+ ft.
; On Adjoining Lots 100+ ft.
134 ft. _; On Adjoining Lotslo0+ ft.
To Nearest Public Sewer
Cleanout/Manhole 100+ ft. To Nearest Sewe~ Service Li~e on LOt 50 ft.
Wate~ Sample Collected By Mark Ho].~, P.E. ; Date 2-27-85 ~
Wate~ Sample Test Results Satisfactory
C~t~nts Casing depth is unknown, but casing was observed at 50 ft. Well yield per
24 hour drawdown test. Well electrical wiring to be placed in conduit.
fonwell conduit insta].lation~) Installation after ground thaw
Funds
to
SEPTIC/HOLDING TANK DATA
Date Installed 1973 Size 1250 gal. No. of Ccmpartments 1
Standpipes (Y/N) Y Ai~-tight Caps~ (Y/N)Y Foundation C].eanout (Y/N) Y
Depression ove~ Tank~ (_Y/N) N Date Last Pumped~ 3-2-85 (Receipt attached)
Pumping/Maintenance Contract on File (Y/N) N/A~ ; for
Holding Tank High-Water Alarm (Y/N) N/~ Temporary Holding Tank Permit JY/N) N/A'~
Separation Distances f~omSeptic~ol~ing Tank:
To Water-Supply Well 128 ft.
To P~operty Line 50 ft.
To Water Main/Service Line 47+ ft.
Coup, se 100+ ft.
Corfl~nts
To Building Foundation 47 ,ft.
To Disposal Field 6 ft.
To Stream, Pond, Lake, ~ Major D~ainage
Funds to be escrowed for two compartment tank replacement. Installation
to occur after 6round thaw.
Receipt $
Date Paid:
Amc un t:
[Page 1 of 2] 2-15-84
Ds
C. ABSO~I~ FIELD DATA
Soils Rating in Absorption Strata
Date .Installed 1973
Width of Field }2 ft.
Septic~ Tank &
225 ft2/bdrm(Ins,f~)Of System DesiGn Seepage Pit
Length of Field 28f$inst. Rpt. )
· Depth of Field l0 ft.
Gravel Bed Thick~ess 6 ~t..
Standpipes P=esent (Y/N) y
~ate of Last Adequacy Test 3-6-85
Squace Feet of Absc~ption A~ea 720 ft.
Depression over Field (Y/N) N
Results of Last Adequacy Test Unsatisfactory (See Comments)
Separation Distance f~cm A~sc~ption Field:
To Water-Supply Well 154 ft. To P~operty Line 50+ ft.
To Building Foundation 53 ft. To Existing or Abandoned System cn
Lot __ N/A ; On Adjoining Lots 100+ ft.
To Water Main/Service Line 50+ ft. To Cutbank(if p=esent) N/A
TO Stream/Pond/Lake/or Majo~ D~ainage Course 100+ ft.
-~To D~iveway, Packing A~ea, or Vehicle Storage A~ea 22 ft.
C(~lTr~nts The seepase ~it is unsatisfacto.r~r as ~er the attached adequacy test report
of 3-6-85. The absorption system should be u~0$raded by incre~sin~.,~the
capacity of the existing system or by installing a new system. Funds to
LIFT STATION be escrowed for replacement of absorption field. Installation to
occur after ground thaw.~__~
~-,
Date Installed N/A~ Dimsnsions
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested fo~
Manhole/Access ,! Y/N)
"Pump Off" Level at
Vent _(Y/N )
Electrical Codes(Y/N)
Pumping Cycles du~ing Adequacy Test. Msets ~DA
Cc~ments
** Check Permitted Bedrocm Rating Against HAA Request **
I certify that I have checked, verified, or eonfczn~sd to all MOA, H~ Gu
on the date of this inspection.
SiGned, _~~,~--/~ Date 3-6-85
Co~lpany Alaska Soil Testin~ and Ensr. MOA NO. ,ST8~-260
(Note upgrade recommendations.)
KB1/d5/s
[Page 2 of 2]
2-15-84
ALASKA SOIL TESTING AND ENGINEERING
6100 A Street, Anchorage, Alaska 99502
(907) 561-7453
April 22, 1985
Municipality of Anchorage
Health and Environmental Protect~ion
Environmental Health Division
825 L Street
Anchorage, AK 99501
Attn: 14r. John [~ennedy
Subject: Lot iA, Bk. l~ Pennington Park Subd. Adequacy Test
Gentlemen:
in response to our conversation of April ].8, 1985, I have reviewed
the adequacy test which was submitted for your review on April 17, 1985.
The adequacy test indicated that the existing s~epage pit was
unsatisfactory for the four bedroom single family dwelling. The data
indicate that the seepage pit rings allow very little flow into the
surrounding gravel until, the l~quid level approaches the top of the
rings which are four feet below grade. However, the absorption rste,
at a ].iquid level of 5.~ feet below grade, is approximately ~00 gal/day.
The surge capacity of the seepage pit is also approximate].y ~OO gal at
a liquid level of ~.5 feet below grade. Therefore, the capacity of the
existing septic system is approximately ~00 gal/day.
No overflow or surface seepage was noted during the site inspection.
The existing system is to be upgraded after the ground thaws as
discussed in the previously submitted Health Authority certificate application.
I trust that the additional analysis is sufficient for your review,
but please call if 1 may provide additional assistance.
Very truly yours,
Mark Holum, P.E.
Manager
ALASKA SOIL TESTING AND ENGINEERING
6100 A Street, Anchorage, Alaska 99502
(907) 561-7453
Location:
Type:
Address:
Client:
Adeqaacy Test
Lot ]A~ Bk. 1, Pennington Park Subd.
Septic TanM and Seepage Pit, (See Installation Rpt., Attached)
5740 E. 172 st.
Jial gumgardner~ SRA Box 1718, Anchorage, AK 99516
Date
2-26-85
2-27-85
3-2-85
3-4-85
3-5-85
3-6-85
Time
~uantity of Depth Below Depth Below
Water Added to Grade of Water Grade of Water
Seepage Pit Level in Level in
Seepage Pit Septic Tank
(Gal.) (Ft.) (Ft.)
2:41 pm 0 4.5
3:01 32 2.8
3:19 124 2.0
3:27 124 2.9
3:42 134 2.5
3:45 140 2.4
4:08 193 1.9
4:19 202 1.8
4:32 216 2.0
4:55 235 2.1
5:03 235 2.5
10:03 am " 4.2
10:09 255 2.8
10:34 347 2.3
11:14 442 2.1
12:57 pm 583 1.5
1:15 611 1.8
1:21 " 2.3
1:52 " 2.8
3:00 " 3.7
Septic Tank and Seepage Pit Pumped
4:00 pm 0 8.5
5:44
9:39
9:54
10:O0
10:06
10:.10
11:50
l:O1
2:32
4:52
9:17
11:50
am
pm
i38 8.0
452 7.0
0 7.2
~oo 5.0
75o
4.4
5.3
5 · 4
5.7
5.8
6.46
6.52
6.2
6.2
6.2
6.2
6.2
6. ~L
6.2
7.1
7.1
6.8
6.8
1/2
Location:
Comment;
Conclusion:
Performed by:
Adequacy Test
Lot lA, Bk. 1, Pennington Park Subd.
Testing of the seepage pit during 2/26-27/85 resulted in
system failure due to lack of surge capacity as evidenced
by the rise in the seepage pit water level. Excess solids
in the seepage pit were removed by pumping on 3/2/85, and
the system was retested on 3/4-6/85. Seepage pit failure
reoccurred as indicated by the feature of the ~ater level
to return to the initial level over a 24 hour period.
Depth of the seepage pit is 12 feet below ground surface.
The ground level in the seepage pit are is approximately
five feet below the ground level[ near the septic tank.
The seepage pit absorption rate is unsatisfactory for
U fo~ro.~!~single family dwelling.
Mark tlolum, P.E. ST85-260 ~ .... -x
DEPARTMEN
825
MUNICIPALITY OF ANCHORAGE
OF ltEALTlt AND ENVIRONMENT,
L Street, Anchorage. A].aska
264-4720
rROTECTION
99501
Date Received: April 6~ 1978
#2: Time #3: Time
~1: Time 9~.30 a.m.
Date 4-10-78 Monday Date Date
Insp Prat-c insp Insp
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
Lending Institution Request: First National Bank of Anchorage
Mailing Address: Post Office Box 4-2090 99509 Phone: 274-152].
Proper%y Owner:
Mailing Address:
James/Esther Bumgardner
Star Route A Box 474E 99507
Phone: 272-0571
3. Legal Description: Lot iA Block 1 Pennington Park Subdivisiom
Single Family Residence: (x)
Multiple Family Residence: ( )
Number of Bedrooms: Four
Number of Bedrooms:
Well System:
Permit ~
(]on struction
Individual We].]. (x) Con. unity/Public System ( )
Depth of Well%pprox. 106' Well Log on File
Bacterial Analysis
( )
Sewage Disposal
Permit =
Septic Tank Size
Absorption Area
We].].
System: On-site System ~) Public Utility
Installed 1973 Installer
~D Manufacturer
Distances:
to Sewer Line
~o Nearest Lot
( )
Soils Rate
to Sept .o T nk
Nearest Lot line
L~ne
Material
to Absorption Area
Absorption Area
Department of Ilealth and Environmental Protection
Request for Approval of Individual Sewer and Water FaciliLi. es
Legal Description: Lot iA block 1 Pennington Park Subdivision
COlRme~t s:
Af fadavit Attached ~__
Approved:
Disapproved:
Letter Attached: ( )
Date:
Date:
Department Worksheet:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
2510 East Tudor Road, Anchorage, A~aska 99504 276-2221
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection:
2. Property Owner:
Mailing Address:
3. Name of Buyer'
Mailing Address:_ Same
4. Name of Lending Institution:_
201
Mailing Address:__ 36th
5. Name of Realtor or Agent'
Mailing Address: .......
6. Legal Description: T,ot lA
Location' 172nd o£f
CMRO_ VA
James and Esther Bumgardner
Box 474 :E. Star Route A
James and Esther Bumgardnel
_FHA CONV_ × ._
Beeper 265-7617
Day Phone:__.__2~-52!
__Day Phone:__~.¢~-!933
First Nati~naJ~_B~ Sn,~h _Center Br~nch
W. 36th
and C Street __Phone:~3,TZp-_l_~
Es~her_Bumgardnmr
Phone: ..
Block l_~_,~on ~rk
Golden Vie,w~,Jz~e_ off R~bbiL_C=:Rd.
7. Type of Facility to be Inspected:
8. Water Supply
Type of Supply:
Residential - No. Bdrms .... 4
Public Utility_
Individual
If Individual, number of dwellings presently served __
If Individual,.depth of well
Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation 19.13
Individual (on-site)_
72-003(3/76)