HomeMy WebLinkAboutSOUTH HILLS BLK 1 LT 2South Hills
Lot 2
Block 1
#017-063..08
Municipality of Anchorage Page 1 o~_4
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:_ ~W990178 PIDNumber:~017-063-08
Name: Andy & Janet Copping Wastewater System: O New [~Upgrade
^ddress~301 Hillside Way Anch., AK 9951 ABSORPTION,_ FIELD
I No. of Bedrooms:
Phone: 522--8747 Four ( 4 ) ~Deep Trench [] Shallow Trench E] Bed E] Mound O Other
~ Total Depth from original grade:
LEGAL DESCRIPTION Sol[Rating:1 . 2 GPD/Sq. Ft. 11 . 5
Subdivision: )eplh to pipe bogota from origis~l grade: Gravel depth beneath pipe
Lot:
2 Block: 1 South Hills 4 o 5 FL 7. 0 F~.
Township: I Range: I Section: Fill added above original grade: Gravel length:
· 5 Fb 4 0 Ft.
WELL: ~ [] New [] Upgrade 3 F~. 1I - FL
Classification (Private, A,B,C): Total Depth: Cased To: Total absorplion area: Pipe matefiak
Existing Ft. Ff. 500 SQ. Ft. ASTM D3034 PVC __
Ff. Gold Star Const. 10/2-4/99
Yi'~eld: IPump Set at ICasing Heigld AbOve Gr°ur~d: TANK
SEPARATION DISTANCES ~Septic [] Holding [] S.T.E.P.
From Tank Field Station Tank SewerLirms Anchoraqe Tank 1 r 250
Well- > 100 ' > 100 ' N/A N/A- ~,,~; Material:SteAl Numberof Compartments:2
-- Surtace >100' >~oo' N/A ~/A N/A LIFT STATION - N/A
Water
-- Lot > .5 ~ > 1 0 I N/A N/A N/A Skein gallons: IManutacturer:
Line
I
:oundation >5' >10' N/A N/A N/A "Pump on" level al: "Pump off" level at: High water alarm at:
Curtain
Drain None oted )n Lot.
I
{emarks: Old Septic Tank and Absorpti¢ n BENCH MARK
Crib Were Pumped, Crushed and Back- Concrete Slab
1 flO-0 Ft.
-, - EN~[NEEI~S~EAL
Department ot He~all.h and/)--luman Serwces approval
72-D13 (Rev. 919 I) MOA 25
Permit No.
SW990178 Page 2 of 4
Municipality of Anchorage
DFPARTMENT 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
Legal Description: Lot 2, BLK 1,
40'
Well
South Hills Subd,
PIDNo.: 017-0~
I
Alternate Sitel
4 BR:
Hsd. 1
3-08
1~250 Gal.
septic tank
I
1
!
PLAN AS-BUILTi /
SCALE 1" = 40'
Way
Peri'nil No. SW990178 Page 3 of 4
Municipality of Anchorage .
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
Legal Description: LT 2, BLK 1, South Hills Subd.
PID No.: --01 7-063-08
MT
geotextile
C5
f~b~ic
septic rock
PROFILE AS-BUILT'
SCALE 1" = '10' (HORIZONTAL)
NO VERTICAL SCALE
Permit No. SW990178 Page 4 of 4
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Sire Wastewater Disposal System and/or Well Inspection Report
Legal Description:. LT 2, BLK 1, South Hills Subd. PIDNo.:
017-063-08
40 LF x 7' E.D. x 3' W
- ~ 1,250 Gallon
' septic tank
2o~
"'| 91 9
S~ .l I 9--i 34~
· ' 1, 8
SYSTIEM SWING TIES
NO SCALE
Oi'-Z4-O0 08:25 FROJ&CTE ENVIRON~NTAL
~IK CT &E I~nv,ronn, en,a, Se tv ices Inc.
5615301
T-348 P.OI/02 F-BiT
CT&E Ref.~
Client Name
Project
Client Sample ID
M~trix
Ordered By
PWSID
1000247001
Anderson Engineering
LoT 2, Blk I, Sovth Hills
Lo~2, Blk I, Soa~ Hills
Drh~klng Wat~'
0
Sample
Client PO~t
Prin[{:fl Dale/Time 01 f24/2000 8:22
CollectedDnteO2ime 01/20/2000 8:45
Received Date/Time 01/20/200o 9:15
Technical DirectOr Stephen C, £de
Released BY~~~
~ATER$ ~EPT
0.58~ 0.500 ~O/g EPA 300,D
Allowable Prep AnatyM~
LimiTs Date Dace Ini:
(<10) 01/20/2000 Ol/mo/mooo scl.
NICRO LAB
Total Coltfnrln
Ol/2O/2OOO aPT
Received Time Jan,24, 8:30AM
FROM : DI.~MOND MASONRY INC F~X NO. : 907 522 6562 Jan. 18 2000 08:44~M P2
Cus'rok, m-'a
AMOUNT TOTAL MATE~At.
TOTAL
Thank You ...
61G NA-OJ P,~
Received Time Jan,18, 8:36AM
MUNICIPALITY OF ANCHORAGE
Department of Health end Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
/2
ON-SiTE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jul 07, 1999
Expiration Date: Jul 06, 2000
Permit Number: SW990178
Legal Description: SOUTH HILLS BLK 1 LT 2
Design Engineer: 0014 Anderson Engineering
Owner Name: David Ma[em
Owner Address: PO Box 113243
ANCHORAGE, AK 99511-0000
Parcel ID: 017-063-08
Total Bedrooms: 4
Site Address: 007301 HILLSIDE WAY
Lot Size: 72000 SQ. FT.
Permit Bedrooms: 4
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 notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Date:
Date: 7- 7-??
522 7773 522 6779 (FAX) !
ANCF!ORAGE, AK 99524 i~Vl~,ot~ENT^~ SE~V,C[~S roves,oh,
MEMORANDUM
DATE: .July 2, 1999 RECEIVEI
TO: Dan Roth dUI_ 7 1999
FROM: Mike Anderson, P.E. ~ ~--~'/"' Murdcipality u, ,-, .
Oept. Health & Hun~an
SUBJECT: Lot 2, Block 1, South Hills Subdivision
Septic System Design Revision
We recently completed a cross section of Lot 2, Block 1, South Hills Subdivision to
determine the difference in elevation between the location of LeRoy Reid's test hole
from 1980 and those completed during our field investigation. It is difficult to determine
the exact location of his hole, but it appears to have been in close proximity to the
existing absorption crib. The difference in elevation between Test Hole No. 1 and
Reid's Test Hole is 5.5'. This could explain the difference in groundwater levels
between the holes. In addition, the Reid Test Hole is shown fairly close to the
absorption crib and what is noted as groundwater could actually be effluent from the
crib. Mr. P, eid's test hole shows the water level right at the ML layer. This layer could
be holding the groundwater in place causing a perched water table. Our test holes
revealed clean sands and gravels with no evidence of any silt layers. Soils
encountered were very absorbent allowing water to easily pass. Test Hole No. 1 is now
totally dry with no evidence of groundwater in either hole.
We have added the replacement absorption trench to the site plan and have also noted
the existing septic tank and absorption crib must be pumped, crushed and backfilled
during construction of the new system. Hopefully, this will resolve your issues with the
design and permit application and the permit can now be issued.
Thank you for your assistance with this matter.
OLD RABBIT CREEK ROAD
NOTE: Existing Septic Tank and j
Absorption Crib %o be pumped
crushed and back~illed, v
· 't
Bedroom
LOT 2 ~ome
LOT
NOTE:~
No conflicts with
~xisting wells and
otic systems.
40' Long
X 7' Effe
Absorptio
~H2
250 Gallo
)tic Tank
:ive Depth
Trench
LOT 1
SITE PLAN
SCALE 1" = 40'
HILLSIDE WAY'
'ITl
ANDERSON ENGINEERING
P.O, Box 240773
ANCHORAGE, AK 99524
(907) 563-7155
SHEET NO. OF
CALCULAT~ D 8Y OATE
sc,,,.~4x-d-:/"---.,,,' ~%../'~-~'
June 22, 1999
Municipality of Anchorage
Department of Heath & Human Services
825 "L" Street
Anchorage, AK 99502-0650
Subject:
Lot 2, Block 1, South Hills Subdivision
Septic System Design
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The owner of Lot 2, Block 1, South Hills Subdivision intends to construct a
four bedroom home on the lot. A septic system is currently in place on the
lot that served a house which was destroyed by fire. A new system must
therefore be constructed to serve the new house. The attached site plan
and backup documentation describe the proposed system and the location
of the existing well.
The testholes placed on the lot revealed poorly graded gravel underlain by
silty sand. Both lenses percolated at rates between 1 and 5 minutes per
inch. Groundwater was encountered during excavation in Testhole No. 1 at
a depth of 16.5'. The water stabilized at 15.8' during the ensuing
monitoring period. We have therefore designed a deep absorption trench
with 7' of gravel beneath the distribution pipe. The distribution pipe will
be placed at 3.5' below the surface and the total depth will be 10.5'. The
existing septic tank will be pumped, crushed, backfilled and abandoned in
place. .,,
The ground surface of the lot slopes from the east to the west at shallow
grades and from south to north at much steeper grades. The absorption
trench will be placed in an area with a slope of 3%. The trench will be
constructed perpendicular to the slope in accordance with Municipal
criteria.
Lot 2, Block 1, South Hills Subdivision
June 22, 1999
PageTwo
If the
1.
system is constructed as designed the following statements apply:
The system, if constructed as designed, will have no adverse impact
on the wells in the area or those to be constructed in the future.
The system, if constructed as designed, will have no adverse impact
on existing septic systems in the area or those to be constructed in
the future.
The system, if constructed as designed, will have no adverse
impact on reserved space, either surface or subsurface, on any lots
located in the area.
The system, if constructed as designed, will have no adverse impact
on drainage patterns in the area. The current drainage pattern will
be maintained.
Sincerely,
Michael E. Anderson, P.E.
Attachments
OLD RABBIT CREI:"K ROAD
NOTE: Existing Septic Tank and
Absorption Crib ~o be pumpe~,
crushed and back~illed.
~/~/
· . · ~~ 40' Long
Absorptio
NOTE :k
Four
Bedroom
LOT 2 {ome
~H2
250 Gallo
)tic Tank
No conflicts with
~xisting wells and
3hic systems.
LOT
SITE PLAN
SCALE 1" = 40'
LO'[' 2, BLOCK 1, SOUTH HILLS
DI--SIGN FACTORS:
SYSTFM REQUIREMENTS:
Four Bedroom System Deep Trench System
Perc. Rate: 3 MinJInch 1,250 Gal. Septic Tank
Application Rate: 1.2 GPD/SF 7' Drainfield Rock
4 Bedrooms X 150 GPD / 1.2 GPD/SF = 500 SF of Absorption Area
500 SF/16 SF/ LF of Trench = 35.7 LF Trench Length
Therefore: Construct a Deep Absorption Trench System With One Lateral
40' in Length with 7' of Drainfield Rock Beneath the Lateral.
Distribution Pipe in Trench Placed at 3.5' Below the Original Ground
Surface. Total Depth to be 10.5' from Original Ground.
Natural
~3' Backfill
Geotextile
Fabric
6"
7
4" Perforated
PVC (Slots Down
Drainfield
Rock
NOTE:
TYPICAL DEEP TRENCH SECTION
(NO SCALE)
Grade Area Over Trench to [)rain Away.
Minimum 4' From Groundwater.
Maintain 10' Separation From Lot Line.
Municipality of Anchorage.
DEPARTMENT OF HEALTH & HUMAN SERVICFS
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
The Real Estate Company
DATE PERFORMED
LEGAL DESCRIPTION: Lr~ 2 / BLK 1 ~ Township, Range, Section:
South Hills Subd. SLOPE
SITE PLAN
1
7
8
9-
12
13
14
15
16
17
18
19-
20-
COMMENTS
WAS GROUND WATER
ENCOUNTERED?
S
DEPTH? p
E
Depthlo Water Alter ~ / . / /
Reading Date Time Time Water Drop
Teskho]e presoaked prior to
PERCOLATION RATE ~
TEST RUN BE'rWEEN "*
test
__ (minules/inch) PERC HOLE DIAMETER ~? L~
FT AND ¢ ~ FT
Percolation test on SM material
3.5 minut:aa par inch_
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
Municipality of Anchorage.
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
The Real Estate Company
DATE PERFORMED
LEGAL DESCRIPTION: LT 2, BLK 1 t
South Hills Subd.
3
13-
14-
15-
16
17
18
19
20
COMMENTS
Township, Range. Section:
SLOPE
WAS GROUND WATER ' t[
ENCOUNTERED? ·
DEPTH?
E
SITE PLAN
Gross Net Oepth to Net
Reading Date Time Time Water Drop
IJ
PERCOLATION RATE '~ (mioules/inch) PERC HOLE DIAMEI.ER (f~' ~
TEST RUN BETWEEN FT AND -- FT
Testhole presoaked prior to test.
ACCORDANCE WITH ALL SI'ATE AND MUNICIPAL GUIDELINES IN EFFECT ON THiS DATE. DATE:
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 2, BLOCK 1, SOUTH HILLS SUBDIVISION
GENERAL,:
The scope of this project includes the procurement and
placement of a new 1,250 gallen septic tank. It also
includes the construction of a new 40' long x 3' wide x 7'
effective depth absorption trench at the location shown on
the attached Site Plan. The existing septic tank must be
pumped, crushed, backfilled and abandoned in place. Total
depth of the trench is 10.5' with the distribution pipe
placed at 3.5' below the surface.
Construction shall be in accordance with the approved site
plan, design drawings, Municipal Permit with any special
provisions or conditions, and all applicable State and
Municipal Wastewater Disposal Regulations.
'The Contractor shall be responsible for obtaining all
underground utility locates and for the layout of the septic
system and verification of the location of all lot lines.
Unless specifically agreed otherwise, the contractor shall
be responsible for final grading areas subsequently
depressed from soil settling. Property owner shall be
responsible for revegetation of affected areas unless
specifically agreed otherwise.
Contractors installing wastewater disposal systerns must
be certified by the Municipal Department of Health and
Human Services for system installations. Owners installing
their own systems must receive prior approval from D.H.H.S.
before beginning system installation.
SEPTIC TANK INSTALLATION
The 1,250 gallon septic tank must be procured from an
approved source and installed at the location shown on the
plans.
Lot 2, Block 1, South Hills
June 22, 1999
Page 2
2. A septic tank is to be constructed by a certified septic tank
manufacturer. Construction shall include two 4" cleanouts
for pumping access.
3.-I'he septic tank shall be sufficiently bedded to prevent
settling or shifting of the tank.
4. All standpipes on the septic tank shall extend a minimum of
12 inches above final grade.
5. Tanks installed without 4' of cover shall have a minimum of
2" of direct burial insulation.
A foundation cleanout shall be installed one to four feet
from the building foundation. Two cleanouts are required
between the tank and the drainfield.
7. Final grading over the tank shall be such that a positive
slope exists away from the septic tank.
DRAINFIELD CONSTRUCTION:
The drainfield shall be constructed to the dimensions shown
on the design. The bottom of the trench shall be within 2"
of level.
Distribution piping must be placed level with perforations
down atop a level bed of drainfield rock. Rock should then
be placed over the pipe to provide a minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between
the drainfield rock and the natural soil backfill.
Monitor tubes must be 4" in diameter and installed at the
locations shown on the design. The portion below ground
must be perforated.
Contractor shall verify the septic tank and drainfield are a
minimum 100' away from any private water wells in the
area, 150' from a Class "C" Well or 200' from any community
well.
Lot 2, Block 1, South Hills
June 22, 1999
Page 3
6. Direct bury insulation must be placed over the distribution
system if less than 3' of backfill depth is available. Finish
grade over the trench must be mounded to prevent
settlement or depressions.
7. Grade area surrounding the absorption trenches to drain
away.
8. A minimum 2' of accepting soil is required below the
drainfield rock for a 5' wide trench. Contractor shall verify
this condition prior to placement of the rock. All pockets of
unacceptable materials must be removed and replaced.
MATFRIAL SPFCIFICATIONS:
1. Septic tanks must be constructed by a Municipally approved
septic tank manufacturer.
2. The following pipe materials are approved for use in septic
system installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C.
(perforated and solid), ASTM F810 or H.D.P.E. (perforated,
but not solid) and ASTM D2662 or A.B.S. (perforated and
solid).
3. Insulation shall be at least 2" thick extruded direct burial
polystyrene (Dow Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with
watertight couplings (Caulder, Fernco, or equal).
A permeable geotextile
be installed between
native soil layer.
fabric (Typar, Mirafi or equal) must
the final drain rock layer and the
6. All drain rock shall be .5" to 2.5" in diameter with less than
3% passing the #200 sieve.
Lot 2, Block 1, South Hills
June 22, 1999
Page 4
INSPECTIONS:
A minimum of two inspections are required by Municipal
Ordinance. These inspections must be conducted under the
supervision of aprofessional engineer registered in the State
of Alaska. The first inspection must be conducted after the
excavation of trenches, beds or pits and before the installation
of any gravel. A septic tank may be set in place, but may not
be backfilled.
The second inspection must be conducted after the placement
of the geotextile fabric, gravel, distribution piping,
standpipes, cleanouts and insulation. No backfill should be in
place at the time of inspection.
Contractor shall provide a copy of all field
construction notes for use in preparing the
of the completed system.
survey layout and
certified as-built
MUNICIPALITY OF ANCHORAGE ,/~
Department ~ Health and Environmenta? ~rotection
825 ,~ Street, Anchorage, AK. .,9501
264-4720
* * * HANDWRITTEN PERMIT * * *
Permit ~ ~D~I ~ W~_-L-L--~ftDTLOR ON-SITE SI--WER PERMIT
Phone Number:
App:Lic ant:
Location:
Legal Description: ~'Q, ~CC~ /~L ~ /
Type of Soil Absorption System Is:
Trench: Drainfield: Seepage Bed:
Maximum Number
Lot Size:
of Bedrooms:
Holding Tank:
Soil Rating(sq.ft/br)
The Required Size of the Soil Absorption System Is:
DEPTH <~ LENGTH ¢¢"- GRAVEL DEPTH __ ~ WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HQC-ErTNG) TANK SIZE =--~_3/~ .~ GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 1 9 8 3 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the residence is remodeled to include more that 3 bedrooms.
Signe~: A~DU(~~ ~ ~'A~,/~(~ .... Issued by:
pplicant
Date:
SOILS LOG
MUNICIPAI. ITY OF ANCHORAGE
DEPARTMFNT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6-650, Anchorage, Alaska 99502 ~.76-222~
SOILS LOG - PERCOLATION TEST
[] PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
1
SLOPE
SITE PLAN
10
11
15-
16
17
18
19
2O
WAS GROUND WATER
ENCOUNTERED?
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN
(minutes/inch)
FT AND. FT
CERT,P,EO B~: ~~-~':,' DATE: ~0'-'~--~
72-008 (7/76)
OAAB-HD.I
Gl,, I'I-'R ANCHORAGE AREA BOROL
DEPAFITMEI~T OF ENVlROBIME~ITAL QUALITY
3500 TUDOr( r(OAD ANCHOr(AGE, ALASKA ggB07 27g-8§86
iNSPECTiON REPORT ON-SITE SEWAGE DISPOSAl. SYSTEM
SEPTIC TANK:
DISTANCE FROM WELL__
LIQUID CAPACITY
ADDRESS .....
PHONE
,6;/1 Z
.COMPARTMENTS.
GALLONS. INSIDE LENGTH_ INSIDE WIDTH.
LIQUID
DEPTH__
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS_ ___/ OUTSIDE DIAMETER_
L, ,NO
NEAREST LOT LINE_ Z~')'/~ A:
D,STANCE PROM WELL
, LENGTH_ ~ ., DEPTH
, BUILDING FOUNDATION
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
SO, FT.
TILl-- DRAIN FIELD:
TOTAL LENGTH
DISTANCE FROM WELl /-~---~-FOUNDATION---- . NEAREST LOT LINB__ , OF LI~E'~/ ,
NUMBER OF LINES / DISTAN~LINES TRENCH WIDTH__ / IN. TOTAl. EFFECTIVE
ABSORPTION A~R~ SQ. FT. LENGTH OF
DEPTH: TOP OF TILE TO FINISH GRADE___ .DEPTH OF FILTER MATERiAl BENEATH TILE~ .iN. ABOVE TILE
, BUILDING FOUNDATION.__ ~i~/ WATER
WELL: TypE~_l,/ji.rTi) DEPTH_ '//0 ' DISTANCE FROM . I --SAMPLE~J¢-~O~--, NEAREST
NEAREST ~ SEPTIC (//~ SEEPAGE /',/.2,~,/ __- OTHER
LOT LINE '~)/7/~ ~/~ , SEWER LiNE . TANK_ , SYSTEM_____~ '~'~.~ , CESSPOOL , SOURCES
DIAGRAM OF SYSTEM
GREATER ANCHORAGE AREA L
ItEALTH DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501. 279-2511
RESIDENCE ADDRESS~-~r/~/~ /~T&- / ~X LOCATION OF INSTALLATION
LEGAL DESCRIPTION [/~'~' ~- Z~O~' ~ ,:)o/__~/'/L~- ~-~',/~
APPLICATION TO INSTALL: SEPTIC TANK_ .~ __-, SEEPAGE PIT ~'__.,DRAIN FIELO_ ,OTHER.
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH
PERCOLATION TEST RESULTS
TO BE INSTALLED BY._
ANTICIPATED DATE OF GOMPLETION.
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS ~S 'r0 SERVE AS-~. L~:~/20 y , PERMIT T0 INSTAkk A
AS DESCRIBED BELOW, SIZE OF UNIT TO BESERVEI]
. SEPTIC TANK 81ZE Z(--0~) ~ _TYPE __ SEEPAGE
//0 / L/''Z)7- /4 DIAGRI
Z... -
DISTANCES:
,O/f.
Hoalth Authoritg
I certify that I am familiar with the requkements of Greater Anchorage Area~h Ordinance No. 28-68 and that the
above described s~tem is in accordance with said code. ~/~~~
dREATER ANCHORAGE AREA BOROUGH
tiEALTN DEPARTMENT CASE
327 EAGLE STREET
ANCHORAGE, ALASKA 99501
Papfomraed Fora
L~'al Description: Lot 2 Block/ 5uDQ~vxsxon ,)~f///9 ~///
This Fomm Repomts
Depth
Feet Soll Characteristics
Location Sketch
if Yes At ~,,at Depth
Re adin,9., { Date G~oss Time
r~rop ~sed ' ~'~
[~stallal'~on: Seepage
Net Time
Depth To H20
Drain Field
Net Drop
Depth Of inlet
COMMEN £~.
Test Performed Bs,:.~.f
', ......
August 16, 1971
8ed~or, d
Avenue
Alask8
Sub~ect: Lot 2, Block 1. Sou:hht11 Subdivision
In revtet~Hng our 1970 files, we have discovered that yo~ received
a ftf)al 'Inspe(:8lert Em said sy:item prior to Lacbfill. If this
cesspool shall be backftlled without the permission of ~he health
authority. All persons shall contact the Health Department gtvtn~
]'e an effort to e~llevtate this sttuatioe, this offic~ requests
that you send or bring to our office, ~.lithtn 15 (lays from
receipt of ti)is letter, data convetni~g the sewer system. This
data should be tn the fo~m of receipts for backfill, septic tank,
c~tb, percolation test, excavation work, etc., nlonu with
detailed d~a~Hng of the system. If such eecetpt~ have bee~)midlatd.
a), tnspocto)' ObS~)PVe what he can of your systef~ a.d discuss
wi th you.
),'1~, however, th(s situation remains unchanged and you ~,~okt', ))o
effort to comply with Borougit regulations, this office will be
forced to t~eat your sewage system ~ ae illegal ~yst~m and
~)tar. t cot~rt p~oceedtngs.
If you have any qeestions concerning the above, please feel free
to call this office for assistance.
Sincerely,
Tim Rumfolt
.Sanitarian
825 "L" STREET
ANCHORAGE, ALASKA 99501
(90?) 264-4111
GEORGE M. SLILLIVAN,
MAYOR
DI_:PARTMEN] OF IIEALTH AND ENVIRONMEN I'AL PROTECTION
October 10, 1980
Wally/Edith Bedford
% Judie Rowland
Century 2]. - Sleeper, Inc.
8050 Old Seward Highway
Anchorage, Alaska 99502
Subject: Lot 2 Block I South Hills Subdivision
The adequacy test performed on the subject property's
sewer system has failed. Therefore, an upgrade will be
necessary.
Prior to the upgrade, a soils test must be obtained so
that a permit can be issued by this department. A listing
of private soils engineers J_s enclosed.
If there are any further questions, please call this
department at 264-4720.
Sincerely,
Robert C. Pratt, R,S.
Associate Specialist
RCP/ljw
ALASKA ENVIRONMENTAL
THINKING OF THE FUI'URE
SBA BOX 1584R · ANCHORAGE, ALASKA 99507
CONTROL SERVICerS
MUNICIPALIq'Y OF ANCI,O~ACq'
RECEIVED
INSPECTION APPOINTMENTS
TIME ~ \A',~Y ' [ ~ TIME
T~SPECTOR INSPECTOFi
INSPECTOR A~i.i~.~ ~p~
-- MUNICIP . A~MUNAUg''
MUNICIPALITY OF ANCHORAG~ DEPT. O~ 1] ,lti l &
DEPARTMENT OF HEALTH & ENVIRONMEN'rAL PROTECTI~/IRONMSqlAL ~, < i'~CTION
825 L Street - Anchorage, Alaska 99501
'r.l.phon. 264-4720 R E C E 1 V [ D
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1, Incomplete req~ests will ~ot be processed, Please allow ten (10) days for processing,
1, PROPERTY OWNER , PHONE
MA~I N~ ADDRESS
~ROPERTY RESIDENT (If different from above) PHON~
2. a~YER ' - PHONE
~A~ L~G A~DRESS
~ LENDING INSTITUTION PHONE
~AILING ADDRESS
~ RE~LTOR~AGENT: / PHONE
MAILING ADDRESS
'~.' LEGAL DESCRIPTION
STREET LOCATION
fY, lb'
_ . /,~
6. TYPE OF RESIDI.=NCE
~ SINGLE FAMILY
[] MULTIPLE FAMILY
NUMBER OF~BEDROOMS
[] One [] Four
[] Two [] Five
E~_ Three [] Six
[] Other
7. WATER SUPPLY
I~ INDIVIDUAL* *ATTACH WELL LOG. A well log is required for all wells drilled
[] COMMUNITY since June 1975. For wells drilled prior to that date, give well
[] PUBLIC UTI LITY depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM "~ INDIVIDUAL/ON-SITE" /?~ ? YEAR ON-SITE SYSTEM WAS INSTAl. LED,
[] PUBLIC UTI LITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATE[).
72-010 ,R er. 6'79)~"~ ~/
, THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
2, WATER SUPPLY
[] INDIVIDUAL
[] COMMUNITY
[] PUBLIC UTILITY
Connection Verified
3, SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON -SITE
[]PUBLIC UTILITY
Connection Verified
[]Septic Tank or []Holding Tank
Size: icao~-'~ If Tank is homemade
give dimensions:
NUMBER OF BEDROOMS
[] ONE [] THREE [] FIVE
[] TWO [] FOUR [] SIX
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
[] OTHER
DATE INSTALLED
INSTALLER
SOILS RATING
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA
4, DISTANCES
WELL TO:
Absorption Area to nearest Lot Line
MATERIAL
Septic/Holding Tank Absorption Area \
Nearest Lot Line
5. COMMENTS
72 010 (Rev. 6/79)
1, PROPERTY OWNER
Wally/Edith Bedford
MUNICIPALITY OF
DEPARI'MENT OF HEALTH & ENVI~ONMENTAL'PI;~TI-_'CTION
Environraentai Sanitation Division
825 L Streel., Anchorage, Alaska 99~1 Telephone 21~-4720
MAILING ADDRESS
2. LEGAL DESCRIPTION
Lot 2 Block 1
.lls
Subdivision
3. TYPI: DWELLING
SINGLE FAMILY
MULTIPLE FAMILY RE
E
E] FHER (Describe)
4, WATER SUPPLY
INDIVIDUAL
COMMUNITY/PUBI_.IC
5, SEWAGE
DIVI DUAL/ON-SITE
LIC UTI LITY
NG TANK (Maintenance Requi
E3 APPROVED }R BED[
~ CONDITIOI' {OVAL (See
for a three
DISAPPROVED
DATE 27 , BY (TITLE)
19,,0
72-014 (3/78)
' ' 1~1 ' ' ~ e
Co~dztlona~ if monies are escrow/edeCo have th
existing l~ching ~rea upgraded. The/~grade would
include ~ feet o~ leaching line w~Lt~ 6.feet of gravel
backfill/. Prior ~o the upgarde~ permit will need to
be obtained from t~is depar~m~fnt.
./ ~ % ~-.b .,~ '-~,~'"--- >-v ,~-.'~.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-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
01.,_0 3 08 HA^#
GENERAL INFORMATION
Complete'legal description .
T,n~ 2;
1; ,qn.t-h Hilln
Location (site address or directions) 7301 ~]].~d~ way
Property owner
Mailing address
Lending agency
Mailin. g address
Agent
Address
Andy and ,Tnn~_h C. oppl nq Day phone
730% Hillside Way Anchorage, AK 99516
R22-R747
Day phone
'Day phone
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDFIOOMS: Four
3, TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE:
4. TYPE OF wASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE-":
XXX
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system. -.: .
XXX
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA~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.
Name of Firm And~r~n ~Ingl nme~'ing Phone 522-7773
Address P.O. Box 240773 Anchoraqe,
Engineer's signature ~ ~* ~
AK 99524
Date 1/24/00
DHHS SIGNATURE
~/ Approved for 4
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
Date
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.
Legal Description:
A, WELL DATA
Well type
Log present (WN)
Total depth 1 1 3 '
Sanitary seal (Y/N)
RECEIVED
Municipality of Anchorage dAN P-- 4 f)00 ~0/~l. ~
DE-'PARTMENT OF HEALTH & HUMAN SERVICESMuNiclP^Uf¥ or. ^NcI{ilI
Environmental Services Division ~ViRO~ENTALSERVIC~
825 L Street, Room 502 · Anchorage, Alaska !)9501 · (907) 343-4744
Health Authority Approval Checklist
Lot 2, Block 1, South Hills ParcelI.D.: 017-063-08
N
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed 8 / ? 1 __
Cased to > 4 0 ' Casing height (above ground) 2 '
Y Wires properly protected (Y/N) Y
AT INSPECTION
6/2.1 /99
70'
68
FROM WELL LOG
g.p.m.
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:.
Coliform 0 . Nitrate
Date of sample: 1 / 2 0 / 0 0
B. SEPTIC/HOLDING TANK DA'IA
Date installed 10/2/99 _Tanksizel~250
Foundation cleanout (Y/N) Y
Date of Pumping_ NRW
C. AB.~;ORPTION FIELD DATA
Date installed 1 0 / 4 / 9 9
5R'~ mg/r. _ Other bacteria_ 0
Collected by: MEA
Number of Compartments 2 _ Cleanouts (Y/N)_ .
Depression (y/N) N High water alarm (Y/N) N
Pumper C~,qn F~ f:¥'llr, t~ i r~n -
_g,p,m,
Y
Soilrating (g,p,d./ft~orft~/bdrm)_ 1 .2 .Systemtype.Da~.p 'PrRnqh
Length _ 4 0 ' Width 3 ' Gravel thickness balow pipe
Effective absorption are,'~ 56 0 Monitoring Tube present (y/N) ~'
Dateof adequacytest.._Ne~ Co~st. _Results(Pass/Fail)
Fluid depth in absorption field before test (in,);
Fluid depth (ins) Minutes later:__
Peroxide treatment (past 12 months) (Y/N)
72-026 (Flev. 3/96)*
N
Immediately after_
Absorption rate =
If yes, give date
7 ' Total depth _ 1 2 '
. Depression over field (Y/N) _ N
For .bedrooms
gal. water added (in.): __
.g.p.d.
N/A
D. LIFT STATION - None on Lot
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
F,
Septic/holding tank on lot > 1 0 0 '
Absorption field on lot > 1 0 0 '
Public sewer main N /A
Sewer/septic service line > 25 ~
Size in gallons
"Pump on" level at*
*Datum
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
biff station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation > ,5 ' Property line ~ 5 ' Absorption field
Water main/service line > 1 0 ' Surface water/drainage > 1 0 0 '
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line > 10 ' Building foundation ~ 10 '
Surface water > 100 '
Curtain drain None Noted on Lot
ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and r
in conformance with MOA HAA guidalin., es in effect on this date.
Signature ~ ~--~,~~
Engineer's Name Michael E, Anderson, P.E.
Date 1 /24/00
>5'
Wells on adjacent lots
"Pump off" level at*
N/A
>100'
Water main/service line
Driveway, parking/vehicle storage area > 1
Wells on adjacent lots > 100 '
HAA Fee $ -~ ~
Date of Payment
Receipt Number
Waiver Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*