HomeMy WebLinkAboutMOUNTAIN AIR ESTATES #1 BLK 5 LT 4 oun'l'ain Air'
E$'l'a'l' s #!
Lot 4
Block 5
#017-211-09
Municipality of Anchorage page
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Waslewaler Disposal System and/or Well Inspection Reporl
LEGAL DESCRIPTION;' SoilR~dng: &Z ~P~'S~.Ft.
Subdivbion: , ~ Deplh to pipe botlom from originalgrade: G~avel depth benealh
pipe
Township;~l Range:II Secli°n: Fill added above original, - i~gra e Ft. Gravel lengtb:
SEPARATION DISTANCES ~Septic U Holding U S,T.E.P.
17034 Eagle River Loop Road, No. ~ '-,*,,' ....... ,
Department of Heallh and Human Services approval · ,,~ ............
PERMIT NO. SW980427 PACE 2 O? 3
Municip. otit oF Anc½oroQe
DEPARTMENT OF HEA~TH AND HUMAN SERVICES
ENVIRONHENTAL SERVICES DIVISION
PO. Box 196650 OAnchorage, Ataska 99519 6650 ~Te~ephone, 343 4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL LOT 4, BLOCK 5, MOUNTAIN AIR ESTATES #1 P.I.D. NO. 017--211--09
BASIN
/ C01-
CUTBANK
NEW ~300 GALLON
SEPTIC TANK
4 BDRM
HOUSE
DRIVEWAY J
SCALE: 40'
PERMIT NO SW980427 PACE 3 OF 3
Humicigo, tifl; oF anchor'o, ee
DEPARTNENT OF' HEALTH AND HUM'AN SERVICES
ENVIRONMENTAL SERVICES DIVISION
PO. Box 196650 OAnchomage, Alaska 99519 66500Tetephone: 343 4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL LOT 4, BLOCK 5, MOUNTAIN AIR ESTATES #1 P.I.D. NO. 017--211--09
FINAL GRADE ST1 ST2 C01
2" INSULATION
96.6'
TOP 2'
INSULATED
EFFLUENT OUTLET
95.5'
NEW
1300 GALLON
POLYETHYLENE
SEPTIC TANK
MT1 MT2
97.8' MT3
93.2'
A B
33.0'
MT1
INSULAT]
:IBUTION
92.5 MT2 = 92.5'
MT3 = 9].4
PRESSURE DISTRIBUTION SYSTEM:
PUMP - BLASTER 26EB (~a6 GPM)
2 LATERALS ,-, 37' & 50' LONG
30 HOLES (2.9' O.C.) ",1 GPM/HOLE
3/16"¢ HOLES FACED DOWNWARD
1"0 LATERALS A
1-1/2"0 SOLID MANIFOLD
WATER FOUND ® 83.9'
82.9' B.0.H.
44.5'
94.3'
N T.S
0CT-10-2000
08:16 S&S ENGINEERING 90? 694 1211 P.03/03
TOTAL P. 03
MUNIC/PALITY OF ANCHORA GE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(9O7) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Sap 13, 2000
Expiration Date: Sap 13, 2001
Permit Number: SW00037'1
Legal Description: MOUNTAIN AIR ESTATES #1 BLK 5 LT 4
Design Engineer: 0003 S & S Engineering
Owner Name: Kenneth & Ann Bradshaw
Owner Address: 15040 Snowflake Dr
Anchorage, AK 99516-
Parcel ID: 017-211-09
Site Address: 015040 SNOWFLAKE DR
Lot Size: 29457 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[] D sposa 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.
Received By:
Issued By:
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 995f9-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Nov 02, 1998
Expiration Date: Nov 02, 1999
Permit Number: SW980427
Legal Description: MOUNTAIN AIR ESTATES #1 BLK
Design Engineer: 0003 S & S Engineering
Owner Name: Norm Billsborough
OwnerAddress: 15040 Snowflake Dr
Anchorage, AK 99516-4432
5LT 4
Parcel ID: 017-211-09
Site Address: 015040 SNOWFLAKE DR
Lot Size: 29457 SQ. FT.
Total Bedrooms: 4 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:
I. The attached approved design.
2. All mquiraments specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of A~aska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours pdor 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.
Received By:
Issued By:
Date: //- ~ -~'~
Date://-- '~- -F~)
ROBERTC. COWAN, RE.
ROBERTA. SHAFER, RE.
SEWER&WATER
JV~AIN EXTENSIONS
ENGINEERING STUDIES
AND REFORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ONSITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
October 16, 1998
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694-1211
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
P.O. Box 196650
Anchorage, AK. 99519
REFERENCE: Lot 4, Block 5, Mountain Air Estates Subdivision
Request you issue a permit to install a septic system to serve the four bedroom
dwelling on the referenced property.
A test hole was excavated and percolation test performed. The approximate location of
the test hole is located on the attached site plan.
~ Il '/~ /
At the time of excavation 10/8/98 water,was encountered in the test holeP After seven
days of ground water monitoring the test hole -
We do not anticipate any adverse effects on neighboring wells, septic systems, reserve
areas or drainage patterns by the installation of the proposed septic system. The
construction of this system will not prevent any future development on any of the
adjacent properties.
If you require additional information, please contact us.
Sincerely,
Robert C. Cowan, P.E.
RCC/rdp
Enclosure
17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER. ALASKA 99577
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
LEGAL DESCRIPTION: ~ Z~.~ ~( A ~ Z. ~ / Township, Range, Section:
1
2,
3-
4-
5
6
7
8
9
10
11
12
13
14-
15-
16-
17-
18-
19-
20-
COMMENTS
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT II '/:~ 0
DEPTH? p
E
Depth tn Water Aiterh,4
Monitoring? u,- Y
SLOPE SITE PLAN
Reading Date Gross Net Depth to Net
Time Time Water Drop
~o/,i/,~ ~ o - 6 '/~." _
" ". -' to
~O q
PERCOLATION RATE ~ ~ (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN 'l //~"- FTAND ~l'l[~' FT
PERFORMED BY: ~A~ ~..I. mt,,~. I .~. ~R M. 9~ ~ CERTIFY THAT T~IS TEST WAS PERFORMED
ACCORDANCE W, ,~LL O,~', :~U.~PAL GUIDELINES IN EFFECT ON THIS [:)ATE. DATE:
72-008 (Rev. 4185)
SEWER&WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOWTEST
ROAD DESIGN
SO]LTEST
PERCOLATION
TEST
STRUCTURAL
MECHANICAL
INSPECTIONS
ROBERT C. COWAN, RE.
ROBERTA. SHAFER, RE.
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694-1211
REFERENCE: Lot 4, Block 5, Mountain Air Estates #1 Subdivision
October 16, 1998
GENERAL:
The scope of this project includes installing a leachfield and 1500 gallon S.T.E.P tank to
serve the four bedroom residence.
Construction shall be in accordance with the approved site plan and 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 any necessary underground utility
locates.
Unless specifically agreed otherwise, the property owner shall be responsible for final
grading areas subsequently depressed from soil settling.
Contractors installing wastewater disposal systems must be certified by the Municipal
Health Department for system installations. Owners installing their own systems must
also receive prior approval from the Municipal Health Department.
SEPTIC TANK INSTALLATION:
A septic tank is to be constructed by a certified septic tank manufacturer. Construction
shall include two 4" cleanouts for pumping access.
The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank.
17034 NORTH EAGLE RIVER LOOP SUITE204 EAGLE RIVER, ALASKA99577
Page 2
Lot 4, Block 5, Mountain Air Estates #1
October 16, 1998
All standpipes on the septic tank shall extend a minimum of 12 inches above final
grade.
4. Septic tanks installed with less than 4 ft. of cover shall be insulated.
A foundation cleanout shall be installed one to four feet fi:om the building foundation.
In the line between the tank and the leachfield there shall be two adjacent cleanouts
(unless an effluent pumping system exists within the septic tank). These cleanouts shall
be located on undisturbed soil not more than 10 ft. t~om the tank. The first cleanout, in
line, shall be to clean toward the leachfield. The second cleauout shall be to clean
toward the septic tank. Two flow dividers shall be installed sending 3/4 flow to longer
trench and remaining 1/4 flow to shorter trench.
Final grading over the septic tank shall be such that a positive slope exists away from
the septic tank.
ABSORPTION TRENCIt/DRAINFIELD INSTALLATION:
Excavate the proposed trench to the dimensions shown on the design. The bottom of
the excavation shall be within 2 inches of level. If the sidewalls of the excavation
become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock)
placement.
Once the gravel is installed, the distribution pipe is to be installed level with the
perforations faced downward. Gravel is then to be placed over the distribution pipe to
provide a minimum of 2 inches of cover over the pipe.
A silt battier must be installed between the final gravel layer and the native soil backfill.
Ensure the silt barrier covers the entire gravel surface before placing backfill.
Monitor tubes shall be of four (4) inch diameter, installed approximately in the
locations shown on the design, and extend a minimum of 12 inches above final grade.
The portion of the monitoring tube extending through the gravel shall be perforated
fi:om the bottom of the trench to the invert of the distribution pipe. This is equivalent to
the effective depth of the gravel as noted on the design.
Page 3
Lot 4, Block 5, Mountain Air Estates #1
October 16, 1998
Backfill over the final gravel layer must not be less than twenty-four (24) inches.
Insulation must be installed when the backfill depth is less than thirty-six (36) inches.
The finish grade over the trench must be mounded to prevent the formation of a
depression after settling.
MINIMUM MATERIAL SPECIFICATIONS:
Any septic tank proposed for installation must be constructed by a Municipal approved
septic tank manufacturer.
The following pipe materials are approved for use in septic system installations in the
Municipality of Anchorage:
T_vpe of Pipe Perforated Solid
Cast Iron Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM F810 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
Use of a type of pipe other than listed above must be approved by the inspect'rog
engineer.
Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical
Company Styrofoam HI or equal).
Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco,
or equal).
A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed
between the fmal leachfield gravel layer and the native soil backfill.
All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3%
passing the #200 sieve.
When sand is being used as a filter material, its gradation specifications must conform
to current M.O.A. or D.E.C. requirements, which ever requirement applies.
Page 4
Lot 4, Block 5, Mountain Air Estates #1
October 16, 1998
INSPECTIONS:
Typically there will be a minimum of three (3) inspections required during the installation of
the wastewater disposal system. These inspections will occur as follows:
The first inspection must be conducted after the excavation of ditches, pits,
trenches, or beds and before the installation of any gravel. A septic tank may be
set in place, but may not be baekfilled before this inspection.
The second inspection must be conducted after the placement of the silt barrier,
gravel, distribution lines, standpipes, cleanouts, and insulation, but before the
placement of any other backfill.
3. The final inspection is to occur upon final grading of the property.
Often there will be more than these 3 inspections required. Especially with the installation of
multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting
engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a
pre-construction meeting will take place on-site. The inspecting engineer will not coordinate,
direct or control in any way the contractors activities.
The owner shall contract with the contractor to perform the work outlined in these
specifications and plans and in accordance with the attached M.O.A. permit. There will be no
contractual arrangement existing between the contractor and S & S Engineering. S & S
Engineering shall be the owner's representative and will inspect the work as stated above to
document the contractors activities. Final acceptance of the contractors work rests with the
owner and the M.O.A.
S & S Engineering shall have no liability to the owner or to others for acts or omissions of the
contractor or any other persons performing work on this project or the failure of the contractor
to carry out the work in accordance with these construction documents. S & S Engineering's
inspecting engineer will not be responsible for the construction means, methods, techniques,
sequence, procedures or the safety precautions incident to this project.
CONTRACTOR/INSTALLER
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
PHONE
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION
DISTANCE TO: I
Well
Manufacturer
Liq. capacity in gallons
DISTANCE TO:
Absorption area
Manufacturer
Inside length
IF HOMEMADE:
Dwelling
Well
DISTANCE TO: JO~ ~F'
No. of lines Length of each line
/
Top of tile to finish grade
Length
Type of crib
DISTANCE TO:
Class
DISTANCE TO:
Width
:rib diameter
Well
Depth
' Building foundation
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
·
REMARKS
S & S ENGINEERS
5610 Silverado Suite A7
ANCHORAGE, ALASKA 99502
"(907) 274-9397
I Dwelling
W dth
Material
Foundation Nearest lot line
Total length of lines Tren~c~ ~vid~h
/~ ~ .~- ~'<~:> inches
Material beneath tile
Depth
Crib depth
NO. OFBEDROOMS
PERMIT NO.
,,"//~2 7'
No. of compartments
Liquid depth
PERMIT NO.
Liquid capacity in gallons
PERMIT NO.
Distance between lines
Total effective absorption area
m PERMIT NO. ' i?~" ,
Total e~fective absorption area
Nearest lot line /],~/~[~¢
Distance to Iol line PERMIT NO.
I Septic tank Absorption area(s)
Building foundation
Driller
Sewer line
LEGAL
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"[ H !!:{ L E t'.,i G T I-.4 [:, :[ P'I E t'.,!:5; Z O Bt :[ S 'T t'4 IE L. E i'.,I C:i 'T H ,:: ]: ."-'.,! F' E E T ;, O !:::' 'l-' FI E T Fi'. f:E I",1 C: H O
!"~...!E E:,E:F'"r'H OF R "F~:.:ENCH Of~: F'IT I~i; 'THE.': !:>Z:i~;"f'RF,!C:E: Ei~ETH[EEF,! THE
(ii:;:L%JN[:, Rt*.,I[:, THE E',OTTEd'"I Of::' THE: E':.'"::E:~::f?h:::F!"]:C!N ,:: IN FEE:T>
T' !f-It IE T' tf:~:: Ei:.::Z ~t"..,,~ C::: i1'"'4J ~ ~..tl Z E;:', "T'" i1'...-~ ::E ::~'~.5:; US; .. ~!!:.t, Ir;;E~ ~:.-'D E::::'
THE GFi:R',,,'E:L. [:,EF:'TH ISi; TF.I[.:.': h!]:NZI"!LIt'"I [.':,E:F'TH OF' GR.F:f'¢E:L. ErE;"F'I,.!E.~:f.,t '!".-.iE
F:IN[:, THE: ['3OTTOP! OF' 'l"f..!ii{ E;:.:;C:F:IVF:!T Z O1'.,I ,:: ]: i",l I::'E:ET
I:::'!iELF-:.rt"! :[ 'T' F:!F:'I:::'L ~[ Jl~: [::~['l,) ............................................ '!" Ml::Uiii; THE: F..'I::":::;F' '" I",1':: '[ I:: l'l [ """r' 'l"l]l "~[ J F' [ ~ Jl~l 1'I '11[ jill[ ~t~ :~; [I' I::l [:: : [: .~ll, '" -- '::U''J T: [:d...l[';'[ ]i ['''J(~ .... . I''' :::
I .q:5;T!:::IL t]::~' T i !')1''I ;.: 1'''! !'7' F: E ''] --F '[ 'Z¢''I':::; OF:' FI!",!"r' 14[i;L..L.S~; .:::.F, :l'l::!!'i':[::j'.t ..... T'O ","H :i: '~:.:, F'~' ] F'E!:~:T'¢ I:;:ll'.,l[> THE
· '-I, ........... r" :::'.1:::'!:;' '"~t::' F;:E:!5I[>EI'.,IIZ:E:i~; THFIT 'I"HE: HELL. I:'f':.. ~...,,i ..... ,='::'r.~,' 'F,
E!',F::U]::I<]:::]:L.L. ZN(:~i !:3!::' I::lJ",l"r' ?'¢:=;'T'[~]'"! !,.!.[TH()UT F'ZNI:::!I.... ]: I'q!E;F'E):.'.: I" ]: Cd"! F:!f',l[:' F:d:::'l:::':;~:)","::! E; .....
[>E]:::'F:IF;:Tf"!Ei:NT I,JTL. L [fi:E: l.~i;I.]!iiiL.]'~:~:)']:T' "['1] F'F[:O'.:~;EC:IJT]: qf',l
I"! :[ I",! 2[ I"ltUf'I [-" i[ ?:;TI::II",I[::E E;E:T'NEEN FI HEL.L. FIt",ID RI",t'¢ r..)N.....l~:'i; :!: TE ::J.:;EJH!:::tGE C' :[: :i~.;F'O:BRL. 5i"r%'!"Eh! ]: ::il;
::1..OO F:'E~:Ei:T F'O[;i: 1::! F'F;:'[VF:ITE!: !-4EL..L (::IF.'. :LS'qO "I"E~ ;2r:f'JO I:::EE'T' ~::!:~:Ot',! FI F::'UE&..IC HEL2..
UF'CtN THE: "['"r~F'Ei: OF:' I::'lJ.t:'!i:L. IC: b.![.:.']...[ ....
r'l ]: I'.,t ]2 f"1.1...!?! [} :[ :iCFf:~N(:::E: i:::'F;:OP1 fa PFi: l '?'RTl.:.: I,.IEL..L. TO Ff j::'!:;i: ;r. ',,,'FITE S:-';E;t4EF;: L. :[ NE 1' :5; ;]:~!:; F'EE:'T
TO ::::' C:O!"IFtUf',!IT? :iSE].,.!EI:;i'. L..]:NE I'.F]; ;::'.~!; F:'IEE'T'
!:::!",,'F'4II...I:::IE!L.E 'l"CI :[F,l:i~;tJl:;:E Ptq:OF::'E:f;;:
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 9~)501 264-4720
SOILS LOG - PERCOLATION TEST
PERCOLATION
TEST
LEGAL DESCRIPTION:
5
6
7
8
9
10
11
12
13
f'e~T
2
3
4
SLOPE
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
SITE PLAN
14
15
16
17,
18-
19-
20-
COMMENTS
Reading Date Gross Net Depth to Net
Time Time Water Drop
~ ,, d'~ ~o o.'7~¢ ,07
PERCOLATION RATE ~'~"~ (minutes/inch)
TEST RUN BETWEEN ~" '~' FT AND ~' 4~7 FT
DATE:
72-008 (6/79)
GAAB-HD- I
Gr ~'ER ANCHORAGE AREA BORO' "1
I),..,rARTMENT OF ENVIRONMENTAL QUALI,.
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING
_ADDRESS ,'~"/~//'~-~-~-~-~-~-~-~-~-~='~-'~ --~"~'.,, '-'J~
PHONE
SEPTIC TANK:
LEGAL DESCRIPTION
DISTANCE FROM WELL /'--~= ~ /
LIQUID CAPACITY /.,...,~,..S'~ GALLONS.
NUMBER OF
MATERIAl. '---~ ,/T--~=- COMPARTMENTS
INSIDE LENGTH /~ INSIDE WIDTH
LIQUID
DEPTH z/$.- ~.-
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / __OUTSIDE DIAMETER ~'~'"~- OR WIDTH
LINING MATERIAL ~J~'~'~"-/"~-'~-~ ~---.~,~.-/~*r*J~',~"'-_(DISTANCE FROM WELL / '~:~'
NEAREST LOT LINE /'~-~ /
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
J
LENGTH ~ , DEPTH
BUILDING F O U N D A T I O N/'~,,,,~'~?.~,.
SQ. FT.
TILE DRAIN FIELD: ,,.4_,///,,~
DISTANCE FROM WELL
NUMBER O~
ABSO~r~ N AREA
FOUNDATION
DISTANCE BETWEEN LH'q~S~
SQ, FT. LENGTH OF EACH LINE
· NEAREST LOT LINE
TOTAL LENGTH
OF LINES
__TRENCIt ~ ~
EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
IN. ABOVE TILE
WELL:
TYPE,,~:~--~x_.~,,4---,~~ , DEPTH /-.
NEAREST SEPTIC
LOT LINE ,*'~,,'~'~' /',,~ '" __, SEWER LINF,..'~,,~,/~¢, _, TANK
DISTANCE FROM
, BUILDING FOUNDATION..,~.~~
/.~'/(~,r' / SEEPAGE . .__ -
, SYSTEM _/"~'~g/
WATER
_ SAMPLE ,//t/'Z2.-4/<~'~' , NEAREST
OTHER
, CESSPOOL/~,"f/'~-'--', SOURCE,~;"~///~,
DIAGRAM OF SYSTEM
DISTANCES:
GRE/-,,ER ANCHORAGE AREA BON,.JUGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3500 TUDOR ROAD POUCH 6-65'O
ANCHORAGE, ALASKA 99502
Telephone 279-8686
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
PeRmit NO. ~017
INSTALLATION Of' SEPTIC TANK ~ SEEPAGE Pit ~ -- DR '* Field ' OTHER
TYPe AND SIZE OF'F~ILITY TO BE ~e~ ~D~ ~ ~ ~~ ~ ~ ~~
COMPLETION DATE ANTICIPATED ~/
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL SE SUBJECT TO PROSECUTION.
SEPTIC SIZE /~'~ TYPE (~/~;~t~) '/'')~- SeePAge Area SIZE ~;4~'~/~' TYPE ~ ;~J'~'
TANK ;
DIAGRAM OF SYSTEM
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
(
FOUNDATION TO SEEPAGE Pit ~)
SEPTIC TANK , SEEPAGE PIT
TO NEARESt LOT L~N~.
WELL TO SEPTIC TANK ',
DRAIN FIELD
WATER MA]N TO SEPTIC TANK
DRAIN FIELD
SEEPAGE
DRAIN FIELD
DRAIN FIELD
PIT ~__,
ALSO CONSIDER AREA WELLS.
SEEPAGE PIT
SEPTIC TANK, ~') ~) SEEPAGE Pit ., DRAIN FIELD
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSINGGaP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 inCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUG/~:~LATIONS REGARDING INSTALLATION.
,/ HEALTH AUTHORITY
OR
/ //// LICENSED DESIGNER
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATEr ANCHORAGE AREA BOROUGH ORDINANCe NO. 28-68 AND THAT THe ABOVE
gREATER ANCHORAGE AREA BOROUGF
HEALTH DEPARTMENT
32? EAGLE STREET
ANCHORAGE, ALASKA 99501
Performed For ~/~-;,e~ /~z_/~ ~/-~'~-' Date Performed
This Fcrm Reports a. ~o~ls ~og ~.--, ,~ _.~ercolation Te§t
Depth
Feet
O, ~-- --
Soll Characteristics
Was Ground Water Encountered?
If Yes, At What Depth -~
Location Sketch
Reading Date Gross Time Net Time Depth To HpO Net Drop
Proposed Instali~'~on: Seepage Pit F~,, Drain Field
pth T " :"'"
Depth' Of Inlet De o Bottom Of PiT Or Trench
COMMENTS:,, ,,,, ...... ........ /?~,> . _ , , , r ~ -~- ~ =-
...... ,,. , zT~--e, ooy~.', ii- , .......",i .............
~'~',.D" . ,0 ...... , ,,,, ....
Test Performed B3,:
Da, e: -;-7.. ~-~/z '
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
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # n17-2t1-09~
1. GENERAL INFORMATION
Complete legal description
Lot 4, Block 5, Mountain Air Estates #1
Location (site address or directions) 15040 Snowflake Drive
Property owner
Mailing address
Norm Billsborouqh Day phone 688-4928
2825 Rose Street, ~202, Anchorage, AK 99508
Lending agency
Mailin. g address
Premier Mortgage/Bob Vogt Day phone .563-~C~ ~7~
3000 A Street, Suite 102, Anchorage, AK 99503
Agent
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
NOTE:
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
Public water
If community well system, provide written confirmation from St~tb AD[:C attbst~ '
lng to the legality and status of system.
XXX
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025(Rev. 1/91) Front MOAft21
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 and State codes,
ordinances, and regulations in effect on the date of this inspection.
$ & S ENelNEERING
Name of Firm ............... , _.. ,:...., ,~,, ~n,~ Phone ~~ - D''O 7 ~j
Eagle River, Alaska 99577
Address ~ ~
E ngineeds signature .~-/'~'~-~.. /¢'~.--.~---~ Date II 1D.I /~ ~
Conditional Health Authority Approval is requested.
to cover the cost of septic system upgrade.
by June 15~ 1999.
6. DHHS SIGNATURE
Approved for
Disapproved.
bedrooms.
Monies to be escrowed
Upgrade to be completed
. ~%~ OF A
·
~ % ROBERT C, COWAN Y ~
Conditional approval for bedrooms, with th-e following stipulations:
Money shall be put in escrow for theamount of 1.5 times the high bid from
wastewater disposal system pursuant to permit # SW980427 attached. This
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The D H HS does this as a courtesy to purchasers of homes
and their lending institutions in 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.
RECEIVED
Municipality of Anchorage NOV 2
DEPARTMENT OF HEALTH & HUMAN SERVICES ·
t~UNICIPALII'Y OF ANCHC1~
Env ronmenta Serv ces D v s on I?NvlRO;;)Nt~N~AL' E~VlCES Off~l~"L., ,..-~,
825 L Street, Room 502. Anchorage, Alaska 99501. (907) 343-47448
Health Authority Approval Checklist
LegalDescription:~.oT .~ ~LK .5' h~M ~/?" '~'~#/ Parcell:D.: 6) 17 -- ;), II -- ~2~
A. WELL DATA
Well type
Log present (Y/~) r,/0 Date completed
Totaldepth )3 ~' ( ,~.,~.~"/
~, ,--¢ ,/Cased to ~/O
Sanitary seal~/N) ¥¢c ~
¢,4. I v/y ~' ~ If A, B, or C, attach ADEC letter. ADEC water system number
Casing height (above ground)
Wires properly protected (~/N)
Date of test
Static water level
Well production
FROM WELL LOG
AT INSPECTION
B=
WATER SAMPLE RESULTS:
Coliform
Date of sample: ) 0 / 3. -~ /
SEPTIC/HOLDING TANK DATA
Nitrate ~ ~ } Other bacteria ~
$ & $ ENGINEERING
Collected by: 17034 Eagle River Loop Road No. 204
Eagle River, Alaska ~577
Date installed
Tank size ~ e~ ¢ Number of Compartments ~- Cleanouts (2~/N). ~-
Foundation cleanout (Y/li~
Date of Pumping ~-¢ ~'~'
Pumper
ABSOflPTION FIELD DATA
Date installed J..
Length j ,3 S'" Width
Effective absorption area ~ '~ ~'-5' Monitoring Tube present CN) ¥~J Depression over field (Y/(~-)
Date of adequacy test c'I]3-H/~1<~ Results(Pas~ ~4-, ~ For ~ .~----bedrooms
Fluid depth in absorption field before test (in.); Immediately after ~aT~. water added (in.):
Fluid depth (ins) Minutes later:~ate = g.p.d.
Peroxide tr~hs) (Y/N) If yes, give date
72-026 (Rev. 3/96)*
D. LIFT STATION
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Size in gallons
evel at*
*Datum
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot ! O O /-¢--
Absorption field on lot
Public sewer main
Sewer/septic service line
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Lift station
)oo -/-
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation IO -/- Property line ! ~ '+ Absorption field
Water main/service line / 0 d-- Surface water/drainage / oo Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Property line_ I0 + Building foundat on. / O '-~ Water main/service line
Surface water ~ 0 ~ -~ Driveway, parking/vehicle storage area
Curtain drain H o ,-~_ ~-. ,-' 0~ ;J Wells on adjacent lots ) O o
ENGINEER'S CERTIFICATION
Engineer's Name ~&~A~
HAA Fee $
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment_
Receipt Number
· 0CT-~8-1998 14:38 CT~E ESI ANCHOF~:qu::
tal Services In c,
90?5615301 P,0~×07
CT&E Ref.# 986195001
Client Name It & $ Engineering
Project Nme/~
Matgx D~ng Wator
Oede~d By
PWSm
Remarks:
10/28/98 09;21
10/23/98 12:15
10/23/98 16:15
Stephen CEde
I oB/lOO ~L, NO toll
0,100 U 0,100
.?' 10/Z3/98 mAP
, , 'i!i r~x 10/23/98 10/26/98 GCP
RECEIVED
~lOV 2 3 1998
M..U-inalitv of A~;chorage
Dept, Health & H~iman Serv,~es
0 o /
C,o c.,o
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
Parcel I.D. #
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
I GO¢l.O
(b) Property owner ~.~¢1~,~ ~¥'~J Telephone:(home)~'~""l?fTBusiness.
(c) Lending Institution Telephone
Mailing Address
(d)
Real Estate Company and Agent
Address
Telephone
(e)
Mail the HAA to the following address: (or check here~', if hold for pick up.)
List contact person and day phone number below:
2. TYPE OF RESIDENCE
Single-Family ~ Number of bedrooms
3, WATER SUPPLY
Individual WelltriS' Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legalitY and status.
4. SEWAGE DISPOSAL
On-site~l~ 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.
72-025 (Rev. 7/88) Page 1 of 2
5. 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 th is
Health 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.
NameofFirm l~-~)%~,~,=· (..~,J~l.t*g~-l"~l~,J~.Telephone ~'~7--1 t~ ~
Addre
Date I ~ -- ~ -- ~O
6. DHHS APPROVAL
Approved for ¢ bedrooms by
Approved ~ Disapproved
Terms of Conditional Approval
Conditional
The Municipality of Anchorage Department of H'ealth and Human Services (DHHS) issues Health Authority Approval
cerificated 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. 7/88) Back Page 2 of 2
'~L'-O~ /~e-',~.~% MUNICIPALITY OF ANCHORAGE (MOA)
,,,,,. ~; ,,~,~/g,.~/ Health Authority. Approval (HAA)
4-~ . ~ CHECKLIST FEBRUARY 1984
~/~,~ /~., ~ Legal Description:
WELL DATA ~
Well Classification P~,~UA~ IfA, B, C, D.E.C. Approved (Y/N)~ %
Well Log Present (Y/N) ~ Date Completed Yield ~ ~k~" I i~1~'%_ (I,~''~ ''~)
TotalDepthl'~' Casedto'~'~Ot Depth of Grouting
Static Water Level S~I t
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
SEPARATION DISTANCES FROM WELL:
TO Septic/Holding Tank on Lot ~ O~,~.. I
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
To Nearest Sewer Service Line on Lot
Water Sample Collected by
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
· On Adjoining Lots
I '
[ ~ ~ ;On Adjoining Lots
To Ne~.rest Public Sewer Cleanout/Manhole
ttS'
Water Sample Test Results
Comments
Date Installed ~,8~ Size
Standpipes (Y/N) _ Y~
Depression over Tank (Y/N)
Pumping/Maintenance Contact on File (Y/N)
Holding Tank High-Water Alarm (Y/N) ~ IA,
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water-Supply Well ~ --~'~,- ~ To Building Foundation
To Property Line ~' ~,-0 ~
To Disposal Field
To Water Main/Service Line ~,~ .~1~O t
TO Stream, Pond, Lake or Major Drainage Course ~/A
Comments {~ [ (~~e~ ~ ~e~T ~A~ ~
72-026 (Rev. 7/88) Front
% No. of Compartments
Air-tight Caps (Y/N) Y~'~' Foundation Cleanout (Y/N)
I~ Date Last Pumped [ ~"/~/~ 0
Temporary Holding Tank Permit (Y/N)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed ?Z'/-~'~8 ~
Width of Field ,,~-- ~
Square Feet of Absortion Area
Depression over Field (Y/N)
Results of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well ~ \ ~,'
Depth of Field ~ t
Grav.~,l Bed Thickness ~ ~
~-~"" /~ ~('J ~ Statndpipes Present (Y/N)
~) Date of Last Adequacy Test
Type of System Design ·
Length of Field J~[~ /C~(;-"
To Property Line
To Building Foundation
Lot
To Water Main/Service Line
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
~'~"'~ To Existin. g or Abandoned System on
,~q 1. ; On Adjoining Lots '~ LO0 ~
To Cutback (if present)
D. LIFT STATION ~
Date Installed Dimensions
Size in Gallons Man,~ole/Access (Y/N~-~"-
"Pump On" Level at Pum~
High Water Alarm Level at ~ Vent (Y/N)
Tested for ~/~ Pumping Cycles during Adequacy Test.
Meets MOA Electrical C~
Comments ~
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or :onformed to all MOA and HAA guidelines in effect on the date of this
Date ~.-~ '"~O
MOA NO. ~'"J'~ CII, O '" ~ 3 ~
Receipt No.
Date of Payment
Amount: $
72-026 (Rev. 7/88) Back
Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
NORTHERN TESTING LABORATORIES, INC.
2505 FAIRBANKS STREET
:~$0 INOU~TRIAL WAY
A107325
L4, B5, Mt. Ai=e
KaieZel Engineering
8441 Miles Cou:t
Anchorage AK 99504
AttnJ Robert Kniefel
Our Lab ~:
Your Sample ID:
sample Ma:rix~
Commen~s~
ANCHORAGE, ALASKA ~5~ I 907-277.83~
FAIRBANKS, ALASKA 9~701 ~7~${,3~16 · FAX 455,3125
Repel: Da~e~ 12/05/90
Date Arrived~ 12/03/90
Date Sampled~ 12/03/90
Time Sampled~ 1605
colle¢%ed By? Kniefel
Flag Defini~ions
U = Below De~ection Limi=
DL Sta~d in
H Above Regulatory Max.
~ = Below De~e¢:ion Limit
Zs~imated Value
Da%e
Method ~arameter Un£~s Result! ~lag Analyzed
Anchorage ope=atione 'Manager