HomeMy WebLinkAboutSILVER CREST BLK 2 LT 21Silvercrest
Lot 21
Block 2
#015-062-52
Municipality of Anchorage Page--1 of.
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 345-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: SWO00070 PID Number: 015-062-52
~ame:DON McCLINTOCK Wastewater System: [] New · Upgrade
Address:
7240 STAMPS CIRCLE ABSORPTION FIELD
No, of Bedrooms:
Dh°ne;(907) 276--4331 4 E]Dsep Trench IShallow Trench OBed r~Mound [3Other
LEGALDESCRIPTION so, Rut]ng, 1.2 GPD/Sq.
Lot: Block: Subdivision: Depih to pipe bottom from o~glnol grc~de: Gravel depth beneoth pipe:
21 2 SILVER CREST 0.78 - 0.98 ~. 2.02 (AVG.)~
- - - 1.8 - 3,3 rt 38 Ft.
n. rt.271 SQ. R D 3034/ F-810/SCH 40 PVC
Ft.A+ HOME SERVICES 5/9/2000
pt, .. TANK
SEPARATION DISTANCES , Septic [3 Holding E] S.T.E.P.
From 'renk Reid StationTank S.w.r Un.. ANCHORAGE TANK 1250
Well 100'+ 100% - - 25'+ STEEL 2
s.,ooo ~oo'+ ~oo'+ - - - LIFT STATION
Water
Line 5'+ '1' - - - 1500~ BIOCYCLE/WESTERN UTILITIES
Foundation 5'+ 10'+ - - -- ~0.5"I 19.5" 45"
Drain -- NONE KNOW~q MEYERS ~E 40 M.O.A.
I
~emarks: * VERBAL LOT LINE WAIVER GRANTED BY BENCH MARK
DAN ROTH ON 5/8/2000, FORMAL WAIVER PORCH CONCRETE SLAB @ SLIDING DOOR
APPLIED FOR.
100.00 n.
Inspections performed by: AWWC, INC. Dates: 1st 5/8/2000 ?.~.::'~..~.~/~ .F.......':.?.
-
2nd_ 5/9/2oo0 ~ ',
3rd _ 5/25/2000
Department of Health..and Human Services approval
Reviewed and approved b /X/. ~-~'~ Date: ~ -/~-~0
PERMIT NUMBER: AS BUILT D~WII~IIII~G PARCEL ID NUMBER:
SWO00070 " 015--06?-52
II
~002 ~ ~ ~DBL2 ST1 - 9.68 ,1.47
kk / =NEW ,IOCYCLE --ST2 - 17 40 40 10
~/ %NEW DRAINFIELD ])BL1 -' 19.71 42.70
~ ~ ~nnT i --001 51.12 51.97 --
~ ~,FO%,~.OT L,,~ CO* ~,~ ~.~0 -
........... ~ 10' UTILI~ ~SEMENT
)Ate:
ALASKA W~I'EII & WAS 1. EW~l ER
PREParED FOR: PHONE NUMBER: sase NUMBER: ~ ~ ~ ~ ~k.~ ........
DON McCLINTOCK (go7) 276-4551 2 OF
~'.~ ~-795~ .."~
SILVER CREST SUBDIVISION; LOT 21, BLOCK 2
AS-BUILT OF SEPTIC SYSTEM UPGRADE
.ERM,T NUMBER: AS BUILT DRAWING P^ROE' ,0 NUMBER:
SWO00070 " O15-062-52
/
Af I~f- 9P.~2 Af~f
Mf CO ~ ~1~ ~ - 97,1 (AVfi,)
~1~ FIlL ~ ~ i ~
¢~~J--'~H~)NII _ _ , .
~ - ~1,0 (AV&)
D~WN BY:
GOHSULTAHIS, lNG, :
PREPPED FOR: PHONE NUMBER: PA~E NUMBER:
DON McCLINTOCK (907) 276-4551
SILVER CREST SUBDIVISION; LOT 21, BLOCK 2
~PE OF WORK:
AS-BUILT PROFILE OF SEPTIC SYSTEM UPGRADE
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
On.Site Services
Waiver Review Worksheet
WR#: WR000037 PID#: 0'15-062-52 HA#: HA000232
Date Received: June 9. 2000
Legal Description: Silver Crest Subdivision, Lot 2'1, Block 2
Engineer: Alaeka Water & Wastewater Consultants~ Inc.
690'1 Debarr Road, Suite 2-B. Anchorage, AK 9950_4
Applicant: Don McCIIntock
Waiver Requested: '1 foot lot-line waiver
Permit~:
Crileria:
Geology
A. Water Table
B. Soil Sorption
C. Permeability
D, Water Table Gradient
E. Horizontal Separation
2. Special Conditions:
3. Other:
Points:
Total:
Waiver is Granted: .
List Conditions or Reasons for abOve:
Waiver Is not Granted:
Date: _~"l~'O O
Rec#: 06608 Amount: $115,00
¢5/N{((ne o¢~evlewer
Date Paid: 619/00
AK Water & Wastewater Consultants, Inc.
ATTN: Jeffrey Garness, PE
6901 De Bart Road, Suite 2B
Anchorage, AK 99504-
June 12, 2000
Subject: Waiver Request for SILVER CREST BLK 2 LT 21
Waiver # WR000037 Lot Line Request for Parcel ID 015-062-52
Dear Engineer:
Your request for a waiver of the required 10 feet horizontal separation of the on-site wastewater
disposal system to the lot line has been approved. The approved separation distance is 1 feet.
This waiver approval applies to the current on-site wastewater disposal system and lot line
separation only. Any future upgrade to the on-site wastewater disposal system and lot line will
require all separation distances to be met or another waiver approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office at
343-4744.
Sincerely,
JeffPoeQ~
Engineering Technician III
On-Site Water Quality Program
FROM : CARCEL ELECTRIC FAX NE). : .Tun, [37 2[300 12:41PM P1
.. MUNIOIPAL~ OF ANCHo~E,'~UiL~iNG .gA~
~ffO0 ~T ~R ROAD
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
¢07) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Date IssueS: Apr 20, 2000
Expiration Date: Apr 20, 2001
Permit Number: SW000070
Legal Description: SILVER CRI=ST BLK 2 LT 21
Design Engineer: 0041 AK Water & Wastewater Consultant
Owner Name: Don McClintock
Owner Address: 7240 Stamp Cir,
Anchorage, AK 99516-6551
ParcellD: 015-062-52
Site Address: 007240 STAMPS CIR
Lot Size: 54416 SQ. F-]'.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
,./] Disposal Field I¢~ SepticTank ii~ Holding Tank ~.] Privy
Private Well [] Water Storage
All construction must be in accordance with:
1. ']'he 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 ( 18AACS0 ).
3. ']'he engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required far 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.
Received By: ~~
Issued By: /,
Date: ~-/'- ;~),.I '-OO
Date:
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
May l8,2000
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Septic Upgrade Design Revision for Lot 21, Block 2~ Silver Crest Subdivision.
To whom it may concern:
During the excavation of the previously proposed septic upgrade, ponding water was encountered
at the western end of the southern trench. A confirmation test hole was excavated near the
southwest corner of the lot and standing water was encountered at 5 feet below grade.
Groundwater was 12 feet below the existing fill grade in TH#1 on 5/9/2000 and 8' below the
original organic layer. The southern trench xvas then filled and abandoned. The design originally
included two five-wide drainfields. The northern trench was installed on 5/9/2000. Because of
the conditions encountered it will not be possible to install both trenches; consequently, we are
proposing to utilize a BioCycle and use the northern trench (50% of the proposed drainfield
absorption area) as the drainfield.
LOT LINE WAIVER: We would like to formally request that your department issue a
property line waiver on the subject propm~ty for separation between the drainfield and the west
property line at one (1) foot. A verbal waiver was granted by Dan Roth during construction of
the northern trench. There are no wells, septics, or water lines that have been encroached upon.
We do not anticipate any adverse effects by this waiver.
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact us at 337-6179. Thank you for your
assistance.
6901 Debarr Road, Suite 2B - Anchorage, AK 99504 - Ph: (907)337-6179 - Fax: (907)338-3246
N~ TRENCH- '
PROPOSEO~ / ,/ ~ ~-TH~I: NO WATER TO 12 BELOW FILL GRAOE
L /
EXISTIND D~INFIELD TO BE ABANDONED IN P~CE
~ SCALE: /
PREPPED FOR: PHONE NUMBER: PAGE NUMBER: ~ ....... ~ / ~., ..........
DON McCLINTOCK (907) 276-43~1/346-1878 1 OF 1
DESIGN Of SEPTIC SYS'rEM UPGRADE
~ent By: Alaska Water & Wastewater Consu; 907 338 3246; May-18-O0 15:36; Page 2/2
PROPERTY OWNER AGtLEEMENT
FOR 'I'I:tE MAINTENANCE O17 AN
ON-SITE WASTEWATER DISPOSAL
SYSTEM
This agreement, dated p"[ac~ ]5 .:['~ , is made between the Muaicipality of
Anchorage Department of Hea/~ and Human Services (DHHS) mad ~e property
owner(s) of:
This agreement is made for the purpose of mainra/.ning an on-site wastewater disposal
system on the subject proper~y,
The property owners agree to th, e following:
Submit to the Mnnicipaliry of Anchorage, on an annual basis, an inspection mad
operation statement from a registered professional engineer. This inspection and
operation statement shall verify that the engineer has U~spected all effluent mac[ air
pumps, timers, and alarms, and that any deficiencies have been repaired and that the
system is functioning as designed.
(PzSnted Name)
(Sign~mre)
(lh'imed Name) /
(Notarize Here)
STATE OF ALASICA
THIRD JUDICIAL DISTRICT
The foregoing instrument was ack2~owledged before me this / 8 ~ day of May 2000, by
Donald W. McClintock.
OFFICIAL SEAL
STATE OF ALASKA
NOTARY PUBLIC
DEBORAIt J. ItOTEZA?U
Notary Public in and fo~?/~glaska
My commission expires:
STATE OF ALASICA
THIRD JUDICIAL DISTRICT
The foregoing instrument was acknowledged before me this (~> day of May 2000, by
Barbara J. Cleary.
Notary Public in and for Alaska
My commission expires:
ALASI(A WATER & wASTEWATER
CONSULTANTS, INC.
April 13, 2000
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services. Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Septic Upgrade Design for Lot 21, Block 2, Silver Crest Subdivision.
To whom it may cotlcern:
The existing 4 bedroom house is currently being served by a private well and septic system. The
existing septic system consists of a 1250 gallon septic tank and a deep trench type drainfield.
The existing drainfield is in a state of failure and is in need of an upgrade. A test hole was
excavated in the area of the proposed upgrade. The proposed septic system will be designed
around the 30 foot radius of the test hole. We are proposing that a new 1250 gallon septic tank
and two five foot wide drainfields be installed. Comments regarding the proposed design are
summarized as follows:
1. SOILS: Attached is a log which shows the soil classifications, groundwater monitoring, and
the percolation test results. The soils below the organic and fill layers which end at a depth of 4
feet, are a SW material to a depth of 8 feet. From 8 feet to 8.5 feet there is a lense of GP
material. At 8.5 feet, the soil transitions to a GM material to a depth of 16 feet (bottom of test
hole). No groundwater was encountered during the excavation of the test hole. Water was
encountered 11 days later on 4/10/2000 at 15' below existing grade. Given'the fact that the edge
of the test pit is only 10' away aud downhill from the existing saturated drainfield, it is my
opinion that the test hole is being influenced by laterally nfigrating wastewater. A percolation
test was performed between the depth of 4.5 feet to 5.0 feet which had a percolation rate of 4.7
minute/inch. It is out' opiuion that due to the overall appearance of the soils, an application rate
of 1.2 gallons/day/ft2 should be used.
2. TRENCH DESIGN:
a. Percolation Rate: 4.7 minutes/inch
b. Allowable Applicatiou Rate: 1.2 gallons/day/ft2
c. Number of Bedrooms: 4
d. Design Flow: 600 gallons pet' day
e. Minimum Absorption Area: 500 ft2
6901 Debarr Road, Suite 2B r_ Anchorage, AK 99504 - Ph: (907)337-6179 ~ Fax: (907)338-3246
f. Total Depth: 3' below original grade (not existing fill)
g. Effective Depth: 2 feet
h. Width: 5 feet
i. Reduction Factor: 0.70
J'.k Minilnum Length: 72 feet total lengh (2 ~ 36 feet long each)
Effective absorption area = 514 ft2
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed
upgrade.
4. TOPOGRAPHY: As can be seen on the attached topography site plan, the average
topography of this property is a 8 to 15 percent running from approximately southeast/east to
northwest/west; in short, there are oo slope concerns. The trench is to be installed parallel to
slope contours.
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact us at 337-6179. Thank you for your
assistance.
~~SinclmI'
P.E., M.S.
NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, a soil log, and
a 7page construction specification letter which are allpart of the design package,Jbr this septic
system.
6901 Debarr Road, Suite 2B - Anchorage, AK 99504 - Ph: (907)337-6179 ~ Fax: (907)338-3246
/ SILVER CRE~ S/D
................ '-'-' .......
S~LWR CREST SIP / ~ ~ ~/] ~
~ ~ ~ ~t j~ ~ SEP~C TANK ~ ~ ~ , ~'
~ SYSTEM. SEE DESIeN ~ ~ ~ _ ~
~x PA~E 2 OF 2 k -~STING SEPT(C
DIMOND STRE~_~--'~
kkk /// ~ ~1 ii
LOT ~B
I
O()NDULTANT~, INO. 1
DON ~oOLINTOOK (gO7) ~7~-4~]/~4,~-~878 ~ OF ~ 4~ ..... ;'"¢~
L[GAL DESCRIPTION:
SILVER CREST SUBDIVISION; LOT 21, BLOCK 2
SITE PLAN OF SEPTIC SYSTEM UPGRADE
/ ~ THE CONTRACTOR MUST HAVE THE 100 FOOT WELl_ RADIUS
· ~ AND THE WEST LOT LINE FLAGGED BY A REGISTERED LAND
/ SURVEYOR PRIOR TO ANY CONSTRUCTION.
X ///
~ FE~ DEEP BELOW ORIGINAL (NOT FILL) G~DES, BY 5 FE~ WIDE
CONSULTANTS, INC.
DON McCLINTOCK (907) 276-4331/346-1878 2 OF 2 ~ ' 'e¢ ess..
SILVER CREST SUBDIVISION; LOT 21, BLOCK 2 qhT$i "...k ....' &~
-- DESION OF SEPTIC SYSTEM UPGRADE
ALASKA WA'rER & WASTEWATER CONSUL'rANTS, INC.
6901 DEBARR ROAD, SUITE 211 * ANCHORADE, Al< 99504
PHONE (907) 337-6179 · FAX (907) 338-3~J46
~G_- - PERCOLATION TEST]
DATF PERFORMED' 3/30/2000 .... ~f'r~ '~.~r ~ es s..:
- '
(feet) L-:::::z~':_: I/1:~/ iflULh_ ¢fl I '~.¢2,'%, ' ' ....... , ~,?
[:z:::...r:: BURIED ORGANIC ~ . . .
2~J~ WASTE, DEBRIS ~OIL Q~SSIFICATIONS ~ / N
[5¢~ MIXED W/SAND ~m~,~~~ /
~,~-~ ~¢o~ ~ - DATE
~,o'o~: ~ o ~ROUNDWATER
~ If:(:~S>:465~ OP (DAMP*) ~o ...... ~ .... 5/~0/00 ~ L.E~_LE~'_J
IILIIII
Ill;lilt I ( NUTES>, O CHES)
,,,,,,,, .................................... ,
; i 3 3:10 6"
E-oN 4/lO/2Ooo 4 3:20 10 3 7/8 2 1/8
IllqHr ~ 5:so lO ~ 7/~" 2 ~/8"
~ 6 ~J~l~ _ 7 3:30 ~ 6
~a) ......... ~-~ ....... ~0 ? .............
19~ , 12 4:0o 10 5 7/8" 2 1/8"
20~ PERCOLATION RATE 4.7 (HIN,/INCH) PERC. HOLE DIA. 6 (INCHES)
TEST RUN BETWEEN 4.5 FT. AND 5.0 FT.
CONNENTS: *PRESUMABLY ~TERALLY MIGRATINO WASTEWATER FROM EXlSTINO SATURATED TRENCH,
PERFORMED BY A~SKA WATER · WASTEWATER. I, JEFFR~ A. OARNESS, CERTI~ THAT THIS
WAS PERFO~ME~ IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON
DATE',
DEPTH TO DATE
,3 ROUNDWATER
...... _P~ ~?01___Go
.... D~_)' ...... ~_1_;]/0
____?~ ........ ?Z~lo.___o__
15' 4/10/00
JO0
I[, ~ MUNICIPALITY OF ANCRORAGE
DEPARTMENT OF HEALTH & ENVIRONMEN1-AL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELl_ INSPECTION REPORT
NAME p HON~-~ []NEW
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION NO. OF BEDROOM8
I
Material No, of compartments
]~D IF HOMEMADE:
~ Manufacturer Material Liquld capacity in gallons
TO:
OTHER
PIPE MATERIALS
72-013 (Rev, 3/78)
WATER WELL LOG
FOSS DRILLING
1336 Ingra Street
Anchorage, Alaska 9950!
STATIC WATER LEVEL_~.FT. ~
YIELD~GA~.PER.MIN. WITN
FEET OF DRAWDOWN.
REMARKS.
COMPLETED--_~ ~ PUMP TO BE SET AT
DATE
The le'r'qill;h d:i. Jnens:i. on :i.s
a'nd
~.t ~:~, 'i:he we].l ~.,~d. il.] s~:,r, ve.
Back.~::i. ll:i.'n.g ,:;rF. ~zm>,' !!.>'~;!.'tc~,m w:i."i:hou't -¢:;i. nal ;i. nsl:>ec'l::i, on and ~;:'q:)proval I::,y t:h:i.s
· ,q~,..: i ~ L w:i.l] I.)e !~ul;>jeci: 1'.')
:lOC) ~:ee't For' a pr:i. va1:e ;,'.~(:~;I. I or 150 'Lo iL;~(;)(;) -f:ee'i: .F. rcmi ,:~i I)ubl :i.(:: ~/~:,;I. :L <leperJ<:li'ng
u. po'n 'U"~e '(:ype oF- publ:L c we;I.l,,
S I G J',,II!!i;D ;;
l ,: oUI:::.L) Ei Y
V4. (]
I ~ MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
I ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELl_ INSPECTION REPORT
NAME PHONE I i~'NEW
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION N~ OF BEDROOMS
Well Absorption area DwelJinfl '~ PERMITNO.
DISTANCE TO: '
Manufacturer~ Material No. of compartments
Liq. capacity Jn gallons Inside length Widtl~--~ Liquid depth
l ~ ~O I F HOMEMADE:
~ ~ DISTANCE TO: Well Dwelling
O Z ~ Manufacturer
% - ~ Material Liquid capacity in 9aJlons
~ Well Foundation Nearest lot Uno ' ~ERMITN~.
~ ~ ~ No. of lines Lengt ~ of each line Total length of linos Trench width Distance between, lines
~ ~ ~ Top of tile to finish grade Material beneath tile Total effective absorption area
~ Length Width Depth .... PERMIT NO,
~-~ ~ ~ype of crib Crib diameter Crib depth Total effective absorption area
~ DISTANCE TO: Well Building foundation Nearest lot line
~ Class Depth Driller Distance to lot line PERMIT NO,
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
REMARKS -
APPROVED ' DATE LEGAL ....
.... , ";B' 'iT"]~ .......
..... . I ., ~.. f I O r' '~:; l"l ~ (:} :1, '2!. 'j: 4:'1 i'l (:: G~, t~) e "i:~z'g e e ~"l t: i"i e ~ L.t f' {" ~:,,I C (.?~ O '['" '~: l"t e
"}"}'t ~:' P ~":' :[ S ~'~ r' ~:~ ~" 'i': W :[ <;1 "~: ~'t '[:' o ~" 'z'
}e gr?::B/c:,l .:::l~:~,i::,'~:h :Ls the m:i.y'~.mu.m depth o.1:: .gr.,::lvel J:>e"Lt,,~ee~ -~:'~:: ou.'~::.l':a'~ll p:Lpe
.:':,."~t.~ '~:hO:, [~-O'~:"~:O'(¥~ O'[: the C'~XC,~iV~:i'~::J, OTi (:i.T~ '~:[~'e'~:),,
J'~,,llfl ~i] [)U.J:~ ,]. :i. (:: I.,.,je]. ],
(:)-/2 '{:J'l({:. u..J().l :[ :J. (::o'i'fiJ:~, ]. :.:,"
~{' v? i '[,:..:J:: i.. :;,} '!:(3 :J.T~SL.!f'(}? j:) f' .::) j:}' ,i:.) J'"
V.4.~ 0
WATER WELL LOG
FOSS DRILLING
1336 Ingra Street
Anchorage, Alaska 99501
WELL OWNER USE OF WEL
LOCATION_~ '
~IZ~. oF CA~I~_Lf. OE~ OF
STATIC WATER LEVEL.~FT. "'
REMARKS
PUMP TO BE SET AT~_.
PT.
~tO~
~t O~
Parcel I.D. #
MUNiCIPALiTY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
(9O7) 343-4744
CERTIFICATF OF HEALTH AU'FHORITY
APPROVAL FOR A SINGLE FAMILLY DWELLING
015-062-52
1. GENERAL INFORMATION
Complete legal description ~SILVER CREST SUBDIVISION: LOT 21. BLOCK 2
Location (site address or directions) 7240 STAMPS CIRCt. E. ANCHORAGE. AK 99516
Property owner
Mailing address
Lending agency
Mailing address
DON M¢CLINTOCK
724-0 STAMPS CIRCLE. ANCHORAGE. AK
Day phone_(907) g76-4~51
99516
Dayphone
Agent Day phone
Address_
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual well xxx
Community well
Public water
NOTE-_-: If community weft system, provide wdtten confirmation from State ADEC attest-
lng to the legality and status of system.
4, TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding 'Fank
Community on-site
Public sewer
NOTF_:
XXX
If community wastewater system, provide written confirmation from State ADEC
lng to the legafity and status of system.
72q;)25 (Rev. 1t91) Front MOA #21 Computer Version
Note: Alaska Water and Wastewater Consultants, Inc. shaft be paid $1185.00 at,
or prior to, closing for the engineering services prov/deo.
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply and/or
wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of
structure indicated herein. I further verify that based on the information obtained from the Municipality of
Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater
disposal system is in compliance with all Municipal an¢ State cedes, ordinances, and regulations in effect
on the date of this inspection. ~/
Name of Firm ALASKA WA'TM W~S/TE~E~ CONSULTANTS, INC. Phone (907)337-6179
/ / //· /
// \
Address 6901 DEBARR ROAD, SUhTE2B ,ANCHORAGE, ALASKA 99504 / /
Engineer's Signature ./'~,.J~ t--....~. Date ¢¢ ,/~./c~
In conductb~, this evaluation, AWWC, In.~Ja, ~m.,~.!ed_, ,o. pro%oCd/aathorough, conscientious engine/erin/g analysis of the
system in accordance with ADEC and MGA DHR$ Guidelines & Regulations. The reported results described the
performance of the system under the conditions encountered at the time of the test, and separation distances
measured to readily identifiable features. The operational life of all wells and septic systems depend
on the local soils condition, ground water levels that may fluctuate during the year, and the water
usage of the family being served by the system. These conditions are outside the control of
the evaluator of the system. Satisfactory lest results do not guarantee future performance
of the system, nor do they guarantee that there are no hidden defects or encroachments.
A WWC, Inc. can therefore not provide any warranty for future estimate of how long the
system will continue to meet the operational requirements of the ADEC or MOA DHHS.
The content of this report is for the sole benefit of the owner listed above. Any
reliance upon or use of this report by any other person or party is not authorized,
nor will it confer any legal right whatsoever.
6, DHHS SIGNATURE
/.-"' Approved for Ur' bedrooms
Disapproved
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of
homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of
DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of
Anchorage is not responsible for errors or omissions in the professional engineer's work.
72°025 (Rev. 1/91) Sack MOA #21 Computer Version
Legal Description:
A, WELL DATA
Well Type PRIVATE
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
ECEIVED
Municipality of Anchorage ., .....
Health Authority Approval Checklist
SILVER CREST; LOT 21, BLOCK 2 Parcel I.D.:
112'
YES
015--062-52
IfA, B, er C, attach ADEC letter. ADEC water system number
YES Date completed 6/4/80 _
Cased to 112' Casing height (above ground)
FROM WELL LGG
6/4/8o
Date of test
Static water level 83'
Well production 15
WATER SAMPLE RESULTS:
Coliform 0
Date of sample: 5/30/2000
B. SEPTIC/HOLDING TANK DATA
Date installed 5/8/2000
Feundation cleanout (Y/N)
Date of Pumping NEW
C, ABSORPTION FIELD DATA
Date installed 5/9/2o0o
Length 58' Width _
Effective absorption area. '271
Date of adequacy test NEW
g.p.m.
N/A
Nitrate
Wires properly protected (Y/N)
AT iNSPECTION
4/3/2000
91'
5+
YES
g.p.m.
4.8 mg/L .Other bacteria 0
_Collected by: A.W.W.C., INC.
Tank size_ 1250
YES Depression (Y/N)_
Pumper -
Number of Compartments 2 Cleanouts (Y/N)
NO _ High water alarm (Y/N) N/A
YES
[~BIOCYCLE INSTALLED ON 5/25/20001
Soil rating ~g.p.d./ft2 or ft2/bdrm) 2.4- System type *TRENCH
5' Gravel thickness below pipe_ 2,02' Total depth 6'
Monitoring Tube present (y/N)__YES Depression over field (Y/N) NO
. Results (Pass/Fail)
Fluid depth in absorption field before test (in.); Imme. Cjiately~rrt~
Fluid depth. _(ins) Min~.'F-'~'-'-'- Absorption rate =-'
P..~erJ3xk4et~a--J~t (past 12 months) (Y/N) If yes, give date
72-028 (Rev. 3/98) ComputerVemlon
For , ..---'-- _'~ed'~oo~s
gal. water added (in.):
D. LIFT STATION
I BIOCYCLE I
Date installed
Manhole/Access (Y/N) YES
High water alarm level at*
Cycles tested NEW
5/25/2000
Size in gallons 1500
"Pump on" level at* 30.5 "Pump off" level at*
*Datum BOTTOM OF TANK
19.5"
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
100'+
100'+
N/A
25'+
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Lift station N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation 5'+ Property line 5'+
Water main/service line 10'+ Surface water/drainage 100'+
SEPARATION DISTANCES FROM ABSORPTION FIELD ON LOT TO:
Property line '5'+ Building foundation
Surface water 1 oo'+
Curtain drain NONE KNOWN
F. E.G,.EER'S /
I certify that I h~fe d~te/~e~/f71r~ field inspections and review
of Municipal r~ords/ti~'~,~he~bov~ systems are in conformance
with MOA HA~ gui~e~this date.
Signature
Engineer's Nan~ v JEFFREY A. GARNESS
Date (~
Absorption field 5'+
Wells on adjacent lots 100'+
10% Water main/service line
Driveway, parking/vehicle storage area 10%
Wells on adjacent lots 100'+
ess,
HAAFee$ ~ ~' ~
Date of Payment
Receipt Number
72-026 (Rev. 3/9~)* Computar
Waiver Fee $
Date of Payment
Receipt Number
05"01-00 23:$$ FROM-CTE £NVIRONBENTAL
zt~_ ' CT&E Environmenta, Services Inc.
CT&E Ref.~
Client Name
Client Sample
Matrix
Ordered By
PWSID
Sample Remarks:
1002584001
AK Water & Wa~tewat~r Cansullanr~ Inc.
SiNer Crest Lot 21 Blk 2
Sliver Crea~ Lot 21 Blk 2
Drinking Water
Client
Printed Date/Time 06/01/20011 16 13
Collected Date/Time 05/30/2000 16:00
Received Date/Time 05/30/2000 16:30
Technical Director Stephen C. Ede
Prep AnaLysis
~ATERS DEPT
Nitrate-N
0,500 ~/L EPA )O0.O
10 m~ 05/30/08 SCL
05/50/00 lc.Ap
MUNICIPALITY OF ANCHORAGE
DEPARTIVIENT 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 loll ],~
GENERAL INFORMATION
(a)
(b)
Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
Applicant Name '*P,,,~')
Applicarlt Address _
Telephone: Home ~L/.~., ,~,~c~ Business
(c) Applicant is (check one): Lending Institution rq; Owner/trc~fld~r.~; Buyer [_-1; Other I-] (explain); __
(d) Lending Institution
Address
(e) Real Fstate Company and Agent
Address _ c~_O'? ~E
(f)
Telephone
Telephone
Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family/'~ Multi-Family []
Number of Bedrooms ,~
Other
WATER SUPPLY
Well~[~( Community [] Public []
Individual
Note: If community well system, must have written confirmation from the State Department of Environ mental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsite.~ 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 72.025(11/84)
ENGINF'ERING 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 verity that 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 and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with ell Municipal and State codes, ordinances, and regulations in effect on
the date of this inspect, ion.
N a m e o f Fi r m --*'~r~"~¢-~1'~¢4"1 -9I, ' ¢")/'- ~'/''~4'~'~?~*~ Telephone _-~7~) ' ~/Jo
Address ~0~ ~ ~¢~ 1~ ~ ~.('0/
Engineer's Seal
Apl) roved
r~'/ Disapproved Conditional
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 e 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
WI=LL DATA
MUNICIF)ALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKI,,IST- FEBRUARY 1984
MUNiCIPALI'JY OF ANCHORAGE
DEPT. OF HEALTH &
I~NVJliONMENTAL PROTECTION
t 1985'
Well Classification ~'~
Well Log Present (Y/N) Y'
Total Depth_ J~ ~¢~" Cased tO
Static Water Level
Casing Height Above Ground ~_.
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
If A, B, C, D.E.C. Apl}roved (Y/N)
Date Completed ~ "'///" ,~"O Yield
Depth of Grouting ~O/-f e '/
Pump Set At '~o//o ,~'~'
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
Cleanout/Manhole N 014
Water Sample Collected by _
Water Sample Test Results
Comments
; On Adjoining Lots
~' I tD ; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on
~, -¢-~ ;Date
/
SEPTIC/HOLDING TANK DATA
Date Installed ~/g'o Size /~2.,~O No. of Compartments
Standpipes (Y/N). ~ Air-tight Caps (Y/N) ~ Foundation Cleanout (Y/N)
Depression over Tank (Y/N) ~- Date Last Pumped
Pumping/Maintenance Contract on File (Y/N) ~/~ ; for
Holding Tank High-Water Alarm (WN) ~/~ Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank:
To WatePSupply Well _ J~ To Building Foundation
To Property Line ~ ~O To Disposal Field
To Water Main/Service Line
Course
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72 026!11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata ~'~
Date installed ~/,~'~
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well J' i O
To Building Foundation ,~- ~'/
Lot /~O ~ ~
Type of System Design 7"*,~ ~'-N~.
Length of Field
Depth of Field '~'
Gravel Bed Thickness
Standpipes Present (Y/N)
Date of Last Adequacy Test q/~, ~/~'-'~
To Property Line ~ / O
To Existing or Abandoned System on
; On Adjoining Lots ~ ~ O
To Water Main/Service Line ~/O
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
To Cutbank (if present)
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
~ certify that I have checked, verified,er conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed~../~ ~ ~/.~~ / Date
Company
Receipt NO. ~5~(~ I ~ ~.~ -~
Date of Payment ~ ~*]'~
Amount:$ Z]~ ~t,'~c~H I ~. ., /~ Engineer's Seal
Page 2 of 2
CONSULTING ENGINEER TELEPHONE: (907) 279-3916
RESIDENTIAL
WELL
INSPECTION
LEGAL:
LOCATION:
OWNER:
TYPE OF WELL:
WELL LOG AVAILABLE:
LOT 21, BLOCK 2, SILVERCREST
7240 STAMPS CIRCLE
PABLO VERA
SINGLE FAMILY
YES
IWUNICIPALh'y OF
D£p;: 0 ANCHo ,-
ENViRo~,~~ F HEALTH RAQc
RECEIVED
INSTALLATION REQUIREMENTS MET: YES
WELL YIELD ]?ROM WELL LOG:
15 GPM WITH 10 FT. DRAWDOWN
PUMP YIELD:
4 GPM
DATE OF INSPECTION:
SEPTEMBER 30, 1985
TEST PROCEDURE:
WELL WAS PUMPED AT A CONSTANT RATE OF 4
GALLONS PER MINUTE WHILE THE DRAWDOWN WAS
MONITORED WITH AN ACOUSTIC PROBE. THE WELL
WAS PUMPED TILL THE DRAWDOWN STABILIZED. AT
THE BEGINNING OF THE TEST WATER LEVEL WAS 87
FEET BELOW TOP OF CASING. AFTER TWO HOURS OF
PUMPING AT 4 GPM THE WATER LEVEL WAS 89 FEET
BELOW THE TOP OF THE CASING.
TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON
SEPTEMBER 24, 1985. TEST WAS NEGATIVE.
TEST RESULT:
THIS WELL MEETS THE REQUIREMENTS OF THE
MUNICIPALITY OF ANCHORAGE.
The Municipal requirement for well flow is
150 gallons of water per bedroom per 24
hours.This well surpasses this requirement.
The assessment of the condition of this well
applies only to the conditions as of this
date. The flow rate of the well may change
due to subsurface conditions that may not be
observed from the surface, and changes in
].and use and other factors that may impact
the conditions of the aquifer feeding the
well.
i.r i...~. [~1~;~ ~';i 203w. 15th AVI~ "C' SUITE 203
ANCHORAGE, ALASKA 99501
CONSUL'FING ENGINEER
TELEPHONE: (907) 279-3916
SEPTIC
SYSTEM
'PEST
LEGAL:
LOCATION:
OWNER:
RESIDENCE:
WATER SYSTEM:
LOT 21, BLOCK 2, SILVERCREST
7240 STAMPS CIRCLE
PABLO VERA
SINGLE FAMILY, THREE BEDROOMS
ON SITE WELL
SEPTIC SYST~,M.
FROM MUNICIPAL RECORDS:
TANK: GREER STEEL, STEEL,
1000 GAL.
ABSORPTION SYSTEM: TRENCH
ABSORPTION AREA: 450 SQ. FT.
SOIL RATING: 85
INSTALLATION DATE: JUNE 1980
TWO COMP.
DATE OF PUMPING: OCTOBER 1, 1985
DATE OF TEST:
SEPTEMBER 30, 1985
TEST PROCEDURE: TOILET WAS FLUSHED AND WATER WAS HEARD
ENTERING THE TANK. 100 GALLONS OF WATER WAS
ADDED TO THE TANK WHILE THE WATER DEPTH IN THE TANK WAS MONI-
TORED. WATER DEPTH DID NOT INCREASE.
WATER WAS ADDED TO THE CLEANOUT TO THE TRENCH AT A CONSTANT RATE
OF 4 GALLONS PER MINUTE WHILE THE WATER DEPTH IN THE TANK AND THE
SUMP WERE MONITORED. A TOTAL OF 450 GALLONS WERE ADDED. THE
WATER DEPTH IN THE TANK REMAINED CONSTANT AT 49 INCHED, WHILE THE
WATER DEPTH IN THE TRENCH INCREASED FROM 58.5 INCHES TO 68.5
INCHES. AFTER 19 HOURS THE WATER DEPTH IN THE TRENCH WAS BACK TO
50.5 INCHES.
TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF
THE MUNICIPALITY OF ANCHORAGE.
The operational life of all septic systems depends on the local
soil conditions, groundwater levels that may fluctuate during the
year, and the water usage of the family being served by the
system. These conditions are outside the control of the evaluator
of this septic system. We can therefore not give any estimate of
how long the system will continue to meet the operational requi-
rements of the Municipality and State.
APPLI( NT FILLS OUT UPPER HAI ONLY
Properly Owner
Mailing Addre~
.. ._
Lending Institution //~_
Address
Address
ZIp Code
Phone
Zip Code
Phone
7
Phone
Legal Description
Type of sidence
W.ter
I-~]/'rndlvldual ATTACN WELL LOG. A well Icg is required for all wells drilled since June 1975.
[] Community For wells drilled prior to that date, give well depth (attach Icg if available).
BI Public Utility
{~ndividual Year Individual Installed:
~ Public Utility When Connected to Public Utility:
~ Holding Tank
NOTE: THE INSPECTION PEE MUST ACCOMPANY EACFI REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time
Time
Date Date
Inspector Inspector
Time
Date
Inspector
Inspector
.RECE! ED
(',~) APPROVED BEDROOMS
) DISAPPROVED
) CONDITIONAL APPROVAL*
DATE I ' ;:~-- ~' ~ ~
'CONDITIONS OF APPROVAL
Soils Bating
Date Sower Installed
Well To Absorption Area
Well to Tank / ~;,
tWell Log Received
Septic T~mk Size
ALASKA i dlROFlm[ FITAL COI1TROL SeRul'CeS, IiqC.
~nqineerin§ $ ~nuironmenlal $ludie$
DECEMBER 30 1983
HYDE HOPKINS
7240 S'rAMPS
ANCHORAGE AK 99501
SELLER - HYDE HOPKINS BUYER - 7240 STAMPS
SUBDIVISION - SILVER CREST BLOCK - 2 LOT - 21
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 900 SQFT.
THE SYSTEM IS CAPABLE OF ACCEPTING 675 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 675 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
4 BEDROOM HOME.
THE SEPTIC TANK WAS PUMPED ON 1/2/84 ,
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1250 IS ADEQUATE FOR
THIS 4 BEDROOM HOUSE.
1200 LUesl 33rd Avenue, Suite B · Anchoro§e, Aloskn 99503 · (907) 276-1361
------ DA:~ RECEIVED
TIME TIME TIME
'. MUNICIPALITY OF ANCHORA~,
MUNICIPALI'FY OF ANCHORAGE ENVIRONMENTAL
e ~ 825 LStreot-Anchora,e. Alaska 99,01 AU6 I ~ 1980
ENVIRONMENTAL SANITATION DIVISION R [ C E I V
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on pa~0 1. Incomplete requests will not be precassed, Please allow ten (10) days for processing.
~AILING A~DR~S~
PR~PERT~ RESIDENT (If diff~rent'fmm above) PHONE
2. ~UYE~ PHONE
~AI LING ADDRESS
3. LENDING INSTITUTION PHONE
MAILING A~DRESS '
4. REALTOR/AGENT [ PHONE
MAI~G ADDRESS
5. LEG_,A~L DESCRIPTION
:. =~,,,~STREET LOCATIONT/~2t
[6. TYP[: {~ RESIDENCE
NUMBER OF~BEDROOMS
[] One [] [:our [] Other
,~ SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY [] Three E~] Six
7. WATER j~JPPLY
~] INDIVl DUAL* * ATTACH WELL LOG. A well Icg is required for all wells drilled
[] COMMUNITY since June 1975. For wells drilled prior to that date, give well
[] PUBLIC UTILITY depth (attach Icg if available.)
S. SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON-SITE** /.~,~ff/'~,) YEAR ON-SITE SYSTEM WAS INSTALLED,
[] PUBLIC IJTI LITY
NOTF: THE INSPECTION FEE MUST ACCDMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED,
72.0. 6,7a,
THIS SIDE FOR OFFICIAL USE ONLY
1, TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER~
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[]INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
E~]Septic Tank or [] Holding Tank
Size: If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
' 5, COMMENTS
I~'~APPROV ED FOR Z/- BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE BY
72-010 (Rev. 6/79)