HomeMy WebLinkAboutGLEN EAGLE BLK 1 LT 2 REM
Municipality of Anchorage Page 1 of 5
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 Numbe~-Sw980088 PID Number:._ 050-601-09
NamO:BRUCE TASKY Wastewater System: [] New · Upgrade
~dr..: 77_ L ABSORPTION FIELD*
25845 SUN LOFT DR' EAGLE RIIVNEoER'of AsK~K', 9~,~ ,iJ~ De~p Tr..ch . Sh.llow Trench. B B~I D Mound
Ph°~':(e07) 694--5558 ' ~ ~ s~ ~ ~'~" ~'~ ~'" -;';-' --
LEGAL DESCRIPTION (~,puc,~o, RATE) 4.0 ~/~ ~ 2.64 -- 4.78**
L~t: Bio,lc Subdivision: Dq~ t= ~ t~=m from .;~ ~ ~1 ~h ~---~ ~
2 1 GLEN EAGLE 0.22 - 2.56 ~ 0.66
Township: -- Range: _ Set, n: _ 1.28 -- 2.23 ~ 27 F~
WELL: [] New [] Upgrade J 5.0 ~ 1
~ (p¢~ ~¢,c~. I ?~*"~ ~/_~/ c<,.d T~: T~ ,A,..~,A~ ~ ~ ,,-~ D-3034~F-810
~G~ ~ ~ 135 "'~l /SCH 40 PVC/HDPE
~ ~ ~ ~GLE MT. EXC. 6/15/98-10/30/98
SEPA~TION DISTANCES a ~ a,o~.~ng · s.~.~..
To ~pfl~ ~flon ~ ~ldlng ~ ANCHORAGE TANK 2000
Well 1 OO% 100'+ 100'+ - 25'+ STEEL 2
su~.~, ~oo'+ ~oo'+ ~oo'+ - LIFT STATION
Lot 5'+ 10'+ 5'+ - - 2000 ANCHORAGE TANK/ORENCO SYSTEMS
Foundation 5'+ 10'+ 5'+ - TIMER AC~A~D ~ ~MER ACT~A~D~
Cu~ain 80'+/-- 60'+/-- 80'+/-- -- 20 OSI 05 HHF
Drdn
{ema~s: *THIS IS AN INNOVATIVE (R~CTEX) RECIRCU~TING BENCH MARK
SEPTIC SYSTEM WITH TRICKLE FILTER AND UPFLOW FILTER. TOP OF MANHOLE
· * 1.77' OF M.O.A. APPROVED SAND FILTER ADDED.
I~ ~ 97,95
Inspections pe¢ormed by: AWWC. INC. Dates: 1st 6/13/98 ~ ......
2nd 6/15-1o/98 ~: ~ ~k_...j.._~r ~;.:...~
3rd 10/30/98 I, fl.d }fl le~ .~rness:
Depadment of Health and Human Se~ices approval ,q(~,,~ ........
R,viewed and approved by2~~ ~' ~Dote: ¢' ~¢ -~¢
Municipality of Anchorage Page 1 al. 3
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: 34.3-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number:, SW980088 PID Number:, 050--601~09
'Name:BRUCE TASKY Wastewater System: [] New · Upgrade
23845 SUN LOFT DR. EAGLE RIVER, AK 99577 ABSORPTION FIELD*
Ph°ne:(907) 694-5558 4 DDeep Trench MShallow Trench* DBed [3Mound MOther*
LEGAL DESCRIPTION ^..u~,~o. ~AT~) 4.0 ~O/Sq. ~ 2.64 -- 4.78'* F~
2 1 GLEN EAGLE 0.22 - 2.36 ~ 0.66 F~
- - - 1.28 - 2.23 r~ 27 ~
WELL: [] New [] Upgrade 5.0 n 1 -
~ (~l~t~ ~.~c): T..~j~,~~ C~ T~ r¢~l e~Uon ~ ~ rre~I~ASTM D-505Z~/F-810
G. r, r~ 135 ~, Ft /SCH 40 PVC/HDPE
~ ~GLE MT. EXC. 6/13/98-10/30/98
SEPA~TION DISTANCES a ~p~= a.o~n~ · S.T.~..
To ~pflo ~on U~ Holding ~/~ ~ ~ ~ ~
Tank ~on Tank ~ U~ A~CHO~A~ TANK 2000
Well 100'+ 100'+ 100'+ - 25'+ ST~L 2
su~, lOO'+ ~oo'+ ~oo'+ - LIFT STATION
Woter
Une 2000~ ANCHORAGE TANK/ORENCO SYSTEMS
Cu~oinDroin ~ 80'+/- 60'+/- 80'+/- - - 20 OS 05 HHF
~emorks: *THIS IS AN INNOVATIVE (R~CTEX) RECIRCU~TING BENCH MARK
SEPTIC SYSTEM WITH TRICKLE FILTER AND UPFLOW FILTER. TOP O~ ~ANHOL[
· * 1.77' OF M.O.A. APPROVED SAND FILTER ADDED.
97.95 ~
Inspections performed by: AWWC, INC. Dates: 1st 8/~3/98 ~/'~ ~//~ [ '~
2nd 6/15-10/98 ~;~~:;::::'
1~¢~"~.
Depadment of Health and Human Sewices approval ~,, .... ..... ~::......~
Reviewed and approved by~~ ~, ~D~te: ¢*~-¢~ ~rof..¢o~
PERM~.UM.ER: AS BUILT DRAWING
SW980088 = 050-601-09
/
ALASKA WATER AND WASTEWATER CONSULTANTS, INC. ,=.~'~"~-~'~,r- ~ ~ %,,
~..,~.~...~. ~.
6901 DEBARR ROAD, SUITE 2B, ANCHORAGE, AK 99504
PHONE: (907) 357-6179/FAX: (907) 338-3246
LEGAL DESCRIPTION:
GLEN EAGLE SUBDIVISION, LOT 2, BLOCK 1,
'PCPIE OF WORK:
AS-BUILT OF SEPTIC SYSTEM (R.U.F. SYSTEM)
PREPARED EOR: PHONE NUMBER:
BRUCE M. TASKY 694-5558
DATE:8/4/99 IDP~WN ~y: ISCALE:
J.L,M. 1 = 40' 2 Of
A B
FCO 2.6 -
C01 30.2 48.0
6" CO 32.4 50.6
MH 59.7 59.0
C02 20.8 33.2
SP 20.2 31,5
CO3 50.0 50.2
MT1 43.3 39.5
004 44.5 34.5
PERMmT NUMBER: AS BUILT D~,WING PARCEL ID NUMBER:
SW980088 ' 050-601-09
~,~o,~e~ ~f ~ ~
r
A~s~ ~ ~ ~s~~ co~s~T~s,
6901 DE~RR RO~, SU~ 2B, ~CHO~GE, ~ 99504
~L ~[sc. IP~IGLEN EAGLE°": SUBDIVISIoN,PH°"E: (907)LOT337-s179/F~:2, BLOCK(9°7)1 ~38-324s
~PE OF WORK:
PROFILE AS-BUILT OF SEPTIC SYSTEM ... ......... :,,.;
..ucE ~. TASKY S~-S55S
J.L.M. N.T.S. 5 Of
RECEIVED
AUG 25 1999
Municipality ct Anchorage
Dept. Health & Human Services z~lCal~ EiectH,,ai EnglneeHng,
6670 Arctic Spur Rd.
anchorage. Al~sk~ 99518
Fax Cover Sheet
DATE:
TO:
FROM:
RE:
Jcrmy-
August 23, 1999 TIME-' 1:38 PM
AWWC HONE:
Jenny FAX~ 338-3246
Alcan Elecffic PHONE: 663-3787
8kipp Eidngmann FAX: 662-6286
Bruce Taek'y-Glen Eagle 8ulx~lvie[en, Lot-2, litlo~k.l
In regards to tho sewage lilt station that Alcan connected at the above mentioned location.
All ¢lec~cal work p~rformed by Alcan was done to 1996 National Eleotrical Code,
(NEC) standards.
If you have a~y questions plc..ase contact me.
you!
umbsr of pasee Inalu~ling cover sheet:
PAGE 1 OF 2
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALAS[CA 995].9-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW980088
DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES
OWNER NAME:TASKY BRUCE M
OWNER ADDRESS:23845 SUNLOFT DRIVE
EAGLE RIVER, ALASKA 99577
DATE ISSUED: 4/30/98
EXPIRATION DATE: 4/30/99
PARCEL ID:05060109
LEGAL DESCRIPTION:
GLEN EAGLE BLK 1 LT
2 REM
LOT SIZE: 41225 {SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
THE ATTACHED APPROVED DESIGN.
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).
THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT)
FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
THIS PERMIT IS FOR THE CONSTRUCTION OF AN INNOVATIVE
RECIRCULATING TRICKLING UPFLOW FILTER SYSTEM. THE PROPERTY
OWNER AGREEMENTS ARE A PART OF THIS PERMIT PACKAGE. AS PART
OF THE PERMIT THE PROPERTY OWNER AGREES TO MAKE ARRANGEMENTS
TO HAVE THE SYSTEM SAMPLED ONCE A MONTH UNTIL THE END OF
THIS CALANDAR YEAR. THE M.O.A. WILL PAY FOR LABORATORY FEES
ONLY.
RECEIVED BY :~ '/~, ~/~ ~ ~--~
ISSUED BY: ~ /~/ /~ ~
DATE:
DATE:
K~llw H~it~tuman
SS4-8479
Mountain Excavatiofl
H.C. 83 Dox 2426 4~ Eagle River Rd ¢ Eagle River, AK 90'577
Phone ~M-5~'"60 pgr (digital) 267-9620... ~, Fax 6'94~47'9 ~. Home Phone 696~479 ,~ Email C!ayge@a~Lcom
.......... September 23 100~
Anchora~ T~-~ and Welding
2700 Porcupine Dr.
Anchorage, Alaska 99501
Dear Mr. MacNutt,
I uader~tand ~ur concern in reference to the Trickling Filter installed at Brace Tasky'a residence,
When I received the Trickling Filter I removed all of Lhe shrink wrap from filter and inspected the filter and pa~at,
Due to the fact the pallet was emulsioned and insulated to the bottom of the filter, it appeared to be pan of the
filter and past of the bedding. I then bedded the filter on top of the tank on d.minro~k per hlat2'u~t~olls.
Based on your cuncem, I will remove the pallet from the bottom of the filter without delay and replace the Trickle
Filter per yoor instructions,
I will be at Mr. Tasky's residence on 9.2438 at appioxinlately 1200. I welcome you to attend, left Cramess,
Al~k. Wmer and Waste Water, will be there for inspection per Municipal requirements,
Thank you for bringing this matter to my attention. If there are any other concerns in respect to the system please
feel free to ~ me.
Kelly Heitetuman, Specialty Con~lc~or
~ Moonta/a Excavation
cc: Alaska Water and Waste Water Mr, Bruce Tasky
Dan Roth: MOA DepL of Health
Alaska Water & Wastewater
7320 East Chester Heights Circle- Anchorage -Alaska 99504
Phone (907) 337-6179 - Fax (907) 338-3246
Consulting Engineers
March 27, 1998
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref2 Septic System Upgrade for Lot 2, Bk 1, Glenn Eagle S/D.
RECIRCULATING UPFLOW FILTER (RUF) SYSTEM
To whom it may concern:
1. GENERAL: The existing 3 bedroom home is served by a private septic system and well.
The existing septic system is encroaching groundwater and is experiencing periodic surfacing of
effluent. Two test holes were excavated to the north (uphill) of the existing seepage pit. The soils
are summarized as follows:
2. SOIL CONDITIONS: Two test holes were excavated on September 2, 1997 and a
percolation test performed by KND Engineering on September 23, 1997. According to the soil
logs, groundwater was encountered in the south test hole (T.H.#1) at a depth of 9 feet and in the
north test hole (T.H.#2) at a depth of 4 feet. The soils log for T.H.#1 shows a GM/SM type soil
with a percolation rate of approximately 3 minutes/inch between the 2.5 and 3.5 R. depth. The
soils log for test hole #2 indicates a SM./GM soil between the depths of 1.5 to 6 feet and that no
percolation test was performed (see attached soil logs).
3. DRAINFIELD: The intent is to install a Recirculating Upflow Filter (RUT) system that will
allow the use of a small drainfield in the area of test hole #1. The size of the drainfield wilt be
based upon the previously established criteria for the RUF systems, which dictates that soils
percolating between 1 & 30 minutes/inch have an allowable application rate of 4 gpd/ft2, and soils
2
percolating between 30 & 60 minutes/inch have an allowable application rate of 2 gpd/ft . Given
the perk rate of 3 minutes/inch the 4 gpd/ft2 application rate would apply. We are proposing to
install a 5 foot wide trench that is 25 feet long and has an effective depth of 6 inches. This
corresponds to an absorption area of 125 ft2, or an application rate of 3.6 gpd/ft2 (assuming 450
gpd total flow).
4. ORENCO PACKAGE SYSTEM: The STEP tank with the trickling and upflow filters will
be manufactured by Anchorage Tank & Welding to meet the latest design criteria established by
Orenco Systems, Inc. The point of contact at Anchorage Tank is Lowell McNutt. Since you are
familiar with the operation of the system I won't elaborate. As with their standard STEP tank, it
is equipped with a high water alarm per M.O.A requirements.
5. SURFACE WATER: Per the owner, there is a foundation drain which runs along the north
side of the house, which intercepts subsurface water that migrates through this area. In short, it
acts as a curtain drain and appears to be diverting subsurface flow away from the proposed
drainfield site. The line discharges through a subsurface 4 inch line (under the driveway) that
daylights 85 feet from the southwest house comer. This drain outlet will be relocated such that it
will daylight at a point greater than 100 ft. away from the proposed septic upgrade. There are no
surface waters within 100 feet of the proposed upgrade.
6. TOPOGRAP}IY: The proposed trench location is on the downhill side of the existing house
on a 10 % slope. There are no slopes greater than 25 % within 50 feet of the proposed trench.
7. CLOSING: I am open to any suggestions from your department that would be an
improvement to the proposed system. I am unaware of any negative impacts that this installation
would impose on adjacent wells, or septic systems. If you have any questions, please call me a
337-6179, or 244~9612.
Sincerely,
V J~a. mes P.Williams, P.E.
Civil Engineer
THE CBNTRACTDR SHALL
L~CATE ~HIS WELL,
WELL
LOT 8, ~K 1, GLEN
EAGLE S/D,
NEW SEPTIC
SYSTEM
WELL
WELL
NDTEj THIS IS NOT A SURVEY. THE LDCATIDN DF ALL WELLS, SEPTIC SYSTEMS,
AND STRUCTURES IS APPRDXINATE, THE CDNTRACTOR SHALL ENSURE THAT THE REQUIRED
SEP^RATIDN ~ISTANCES ARE MAINT^INE~ TO ALL ADJACENT WELLS & SEPTIC SYSTEMS,
SEPTIC SYSTEM UPGRADE, LOT 2, BK 1, GLENN EAGLE
PREPARED FOR: BRUCE TASKY
PREPARED BY, ALASKA WATER & WASTEWATER
lATE, 3127/98 DRAWN~ WILLIAMS SCALE: 1# = 100'
LOT 3A, ~K 1~ GLEN
EAGLE
LDCAT1GN
SEPTIC SYSTEM
", Jomes P.
'.. CE-9608 ..'
N{]TD
CONTRACTOR SHALL INSTALL DRAINFIELD PRIOR TD THE PURCHASE AND I ~
I INSTALLATION OF THE 8000 GALLON STEP TANK AND UPFLDW CHAMBER UNI~I
EXISTING WELL/
STEP TANK WITH RECIRC-
ULATING TRICKLING FILTER.
PER ANCH TANK DESIGN
FOR THREE BEDROOMS,
APPROXIMATE LOCATION SUBSURFACE__
(PER
SLOPED AT
INCH/FT,
EXISTING
!
/
/
!
/
~ ~ ~ I HOLE
BAYLIGHT BRAIN~'~"~I~ PER ANCH TANK
BE
'/'"NEW TRENCH: B5 FT. LONG,
AND 6 INCHES DF
\
SEPTIC UPGRADE' LOT B, BK 1, GLEN EAGLE S/D,
PREPARED FOR' BRUCE TASKY
PREPARE]] BY~ ALASKA WATER & WASTEWATER
DATE: 3/27/98 DRAWN: WILLIAMS SCALE: i' = 30'
s P. Willliam~:
CE-960E] .'
· ., '~ MIN COVER = ~ FEET, SLOTTED PVC PIPE.
' 4 INCHES OF BLUEDDARD
OVER TOP OF FILTER. DRAINRDDK FROM TOP DF DLO£K PEA, TD
2 INCHES OVER TOP DF SLOTTED PVC PIPE,
INFILYRATO '--8,5 FEET MIN OF, ANCHORAG,E, /
SAND ~ND GRAVELS BLOCK PEA, NEW 20(]0 OALLDN STEP TANK, 4 INCH )IA, PVO
WITH RECIRCULATING TRICKLING FROM HOUSE,
FILTER· PER ANCHORAGE TANK DESIGN, (ASTM D3034 SOLID)
R CHAMBER (iR INCHES TALL) SET TANK LEVEL
DN BOTTOM DF TANK IS COVERED WITH /
MIN, OF 2 INCHES DF DRAINRDCK. DOTTOM
/
DF )DX TO DOTTOM DF BLOCK PEA IS
APPROX, 15 INCHES,
1,25 INCH PV¢ PRESSURE LINE
FROM STEP TANK, CHECK VALVE
NOTE, THE DPFLDW CHAMBER SHALL BE INSULATED WITH 2' IN STEP TANK PREVENTS BACK-
OF SPRAYED DRETHANE~ BY ANCHORAGE TANK. FLOW TD TANK, MIN DURIAL DEPTH
DF 4 FEET, AND 4 INCHES OF INSULA-
TION DEAR) (2 FEET WIDE) EVER THE
TOP DF THE PIPE, FDR EFFECTIVE
BURIAL DEPTH DF ~ FEET.
TOPS)IL AND RESEEDING TO DE THE RESPONSIBILITY OF THE HOMEOWNER
/. FOR LOCATION DF N,l~ SEE PLAN DRAWING
4 INCH PVC, 6 INDHES OF DRAINROEK BELOW PIPE,
R INCHES DF DRAINRDCK ADDVE PIPE,
-- FILTER FABRIC OVER DRAINRDCK
'?i
A, TRENCH LENGTH = R5 FEET
I I D, TOTAL ABSORPTION AREA = 1~5 SQ. FT.
PREPARED FDR~ ~RUCE T~SKY .......... I ..................
, ~ ~ ~dames P, William~
PERFORMED FOR:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
2
3
4
5
6
7
8
9
10-
11-
12-
13-
14-
15-
16-
17-
18-
19-
20-
d
COMMENTS
Township, Range, Section:
SLOPE
WAS GROUND WATER .~/_
ENCOUNTERED?
$
L
Depth to Water Alter ,~,
Monitoring? Date:
SITE PLAN
Gross Net Depth to Net
Reading Cate Time Time Water Crop
5 ~ ~l'. oq - ~,'. -
~ II '.1~ Io~ ~" 5~/~''
PERCOLATION RATE __
TEST RUN BETWEEN
2. ~.~ (minutes/inch) PERC HOLE DIAMETER I
·' 6
~ //
ACCORDANCE WITH ALL STA~7~AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE.
724308 (Rev. 4/85)
CERTIFY THAT THIS TEST WAS PERFORMED IN
~. , ,%...'
Municipality of Anchorage ~ ~oo
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650 ~ ~ Kenneth
SOILS LOG -- PERCOLATION TEST ~ ~',,
PERFORMED FOR; ~ ~$ /~ DATE PERFORMED:
LEGAL DESCRIPTION: ~/~ ~/~ Z/Z/~/ZTOW'ship' Ra,ge, Section: ~ff¢ ~
~ SLOPE SITE PLAN
DEPTH
1
6
7
8
9
WAS GROUND WATER
1 0 ENCOUNTERED?
S
11
IF YES, AT WHAT
DEPTH? p
12
Daplh Io Water Alter
'J 3 Monitoring?
Gross Net Depth to Net
Reading Date
Time Time Water Drop
14
15-
16-
17-
18-
19-
20- I
PERCOLATION RATE ~ ~ (minutes/inch) PERC HOLE DIAMETER __
TEST RUN BETWEEN __ FT AND FT
^OOORO^.OE WIT,~..LLSTA~A.D MD.,C~G.,DEL,.EB IN EE~EO'~ ON T.,S DATE. DATE:
72-008 (Rev. 4185)
PROPERTY OWNER AGREEMENT
FOR ~ MAINTENANCE OF AN
ON-SITE WASTEWATER DISPOSAL
SYSTEM
This agreement, dated. .~/~ ?/ 199¢ ,~is made between the Municipality of
Anchorage Department of Health and Human S-~rvices (DHHS) and the property
owner(s) of:
This agreement is made for the purpose of maintaining an on~site wastewater disposal
system on the subject property.
The property owners agree to th, e following:
Submit to the Municipality of Anchorage, on an annual basis, an inspection and
operation statement from a reg/stered professional engineer. This inspection and
operation statement shall verify that the engineer has inspected all effluent and air
pumps, timers, and alarms, and that any deficiencies have been repaired and that the
system is ftmction/mg as designed.
~/-'~X~_
(Signature)
(Signature)
(Printed Name) (Printed Name)
................................ Notarize Here ZT_ZTY .................................
State of ~~ On this t I~j~ day of ~/~l/"t'J , {~Q~
~FUt~ ~ ,"~"~,~,k'~,~ personally appeared before me,
who is personally known to me
~ whose identity I proved on the basis of ~ ~O~I
___ whose idefitity I provdd on the. ~athfaffirmation of
, a credible witness
to be the signer of the above document, and he/she acknowledged that he/she si it.
IVFyy commission h_xp~re
My commission expires .~.~.~_eCh 92 1999
Rick Mystrom,
Mayor
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage. Araska 99519-6650
http://www.cLanchorage.ak.us
Dear Homeowner/Prospective Buyer:
The on-site wastewater disposal system you are purchasing/installing is an "alternative" wastewater
disposal system. This system, known as a "RecirculatingfUpflow Filter Septic System", is undergoing
testing within the Municipality of Anchorage under the Alternative System section of the Wastewater
Disposal Regulations (AMC 15.65). There are certain risks involved with the ownership of one of these
systems:
1. The technology used in this system has been shown to be effective in other areas. The system is
currently undergoing a two year testing period in Anchorage under the guidance of the Department of
Health and Human Services (DF/I-IS) and the State of Alaska Department of Environmental Conservation
(ADEC) to determine its effectiveness in a subarctic environment.
2. The system for this property received a vertical separation distance waiver from both State of
Alaska and Anchorage Municipal Codes to ground water. This waiver was granted due to the system's
expected performance within the site conditions on this property.
I (we) certify that I (we) have read the above statements and am (are) a~vare of the risks outlined. I (we)
also certify that I (we) am (are) in the process of purchasing (property legal description):
(Purchaser Name)
(Purchaser Signature)
(Purchaser Name)
(Purchaser Signature)
.............. Notarize Here .............................................................
State of
On this { [q"~ day of ~){"l' { ,
~Z~ M-T~Si~personally appeared before me,
__ who is personally kno~ to me
~ whose identity I proved on the basis of
__ whose identity I proved on the oath/affirmation of , a credible witness
to be the signer of the above document, and he/she acknowledged that he/she signed it.
My 0omm~ss~on
My co~ission expires ~rOh23, 19~
WATER WELLS
BOX e70'272, CI'KI~IAK. ALASKA ~7 * TELEPHONE ~-TWo~
LEGAL DESCRI~ION
PERMIT NUMBER '
From
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_Et
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From _
DRILLER'S NAME .... ,-:~'-'~'_.:. ~'~-'"~"'~'"-
DEF:'ART'MI~:]xl] O '~IEi;AL.'I"I-,I AND ENVIR(]NMENI"AI_ I i'I"ECT ION
8~5 L. STREET, ANCHORAGE, Al-::. 995~.~ J.
264-4720
[] N ...... S ][ -1'" F] W EZ L.. 1_. F' Eli t:~ F~I I T
F'ERM I ]' NO:
DATE ISSUED:
850329
06 / 19/85
AF:'F'L. I CANT:
ADDRESS:
RONALD I_ENN
P.O. BC)X 77~007
EAGI....E RIVER, A~::.
995'77
LEGAL DESCR I F:':
L O T S I Z E:
SUBDIVISION: GLEN EAGLE
SECTION: 15 TOWNSHIP: 14N
43560 (SQ.Ft'. OR ACRES)
LOT: 2 BLOCK: 1
RANGE: 1W
certify that:
]., I am familiar with the requirements for on-site sewers and wells as set.
~ort. h by the Municipality o~ Anchorage (MOA) and the State of Alaska.,
~'~i. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria o~ this permit.
.~;. I will adhere to all MOA and State of Alaska requirements for the set back
distances From any existing well, wastewater disposal system or public
sewer~st.e~this or any adjacent or nearby lot.
GNED DATE:
APF'L. ICANI": RONAL. D LENN
6RE''r ANCHORA6E AREA BOr
Q Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
I,-H
NAME
LOCATION
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING ADDRESS ~) / ~
SEPTIC TANK:
FROM WELL
INSIDE LENGTH
INSIDE WIDTH
.UMBER OF /
MATERIAL __COMPARTMENTS __
LIQUID DEPTH LIQUID CAPACITY /~'?~'~) GALLONS.
SEEPAGE PIT:
LINING MATERIAL g~'~'//-~/~ GRIB SIZE:
OR WIDTH ~0 LENGTH .~3 DEPTH ~
DIAMETER ~/ DEPTH ~ DISTANCE FROM:
BUILDING FOUNDATION /~/~' NEAREST LOT LINE /'~" TOTAL EFFECTIVE
WELL 2~')¢'''
ABSORPTION AREA (WALL AREA) (~-/~' SQ. FT.
ADDITIONAL ABSORPTION
WELL:
BUILDING SEPTIC
FOUNDATION TANK
CESSPOOL
APPROVED
NEAREST
LOT LINE
OTHER SOURCES
DISAPPROVED
NEAREST
SEWER LINE
REMARKS
DISTANCE FROM:
SEEPAGE
SYSTEM
DISTANCES:
INSTALLED BY:
PIPE MATERIAl -
Form No. EO-O31
DIAGRAM OF SYSTEM
~erformed For
Leoal Qescrintion:
This Form Re~orts Soils Lo~
nenth
~eet Soil Characteristics
"()ne test is worth a thousand opinions"
/'~,~' ,.~ [ ,- /~. ,, Date Performed
Lot~_B1 ock
Water Encountered? /~,-~
Was
Ground
Ie Yes, At what De~th?
Subdivision_
Percolation Telt
1
Readinq Date Grass Time Net Time De~th to H20 Net Dron
Percolation Rate ~li nute
Prnnosed Installation: SeeDaoe Pit Drain Field
Den. th of I,.n, let Depth To Bottom Of Pit Or Trench
cn~!'~ENTS: '~,'" "' :i '7zA' i'-'~',l, , ,: ~.. 1', ~ ~,',-/ ~{' ,,"
Test Performed By ,~f~'~ "~'~ ~' ~ .
. ~ /~ . ; Data Certified
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CER1 IFICA1 E C)F IN,':3PECIION FOR H[_ALTH AUTHORllY APPt4OVAL
OF ON-SINE SEWER AND WATER FACILITY
264-4720
Application Date
GENERAL INFORMATION
(a)
Legal Description 0nclude lot, block, subdiwsion, section, township, range)
Locabon (address or directions)
(b) Appli(;ant Name. _.~c~-'~ L.,-~---.t~-~ Telephone Home . _ Business .
Apphcant Address ...............
(c) Apphcant~s (check one) Lending Institution[] Owner/builder/~', Buyer[] Other[] lexpta;n): ~ _
(d) Lencmg Institution ..................... Telephone _ _
Address .............
(e) P, eal Estate Company and Agent . ~.~7~._ /'~'~-"'L/--~'~U/ - ~-~x;?;'~- L-~: t4 .
Address _ ~Z~¢:_ _~t ~ __
(f)¢~'~"~AA tO tho following address:
SRB 196X
TYPE OF RESIDENCE
Single-Family,j~' Multi-Family [] Other
Number ol Bedrooms .... .~_~___.
WATER SUPPLY
Individual Wetl~i~ Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsite ~ Public [] Community [] Holding Tank []
Note: If commumty well system, must have written confirmation from the State Department of Enwronmental Conservation
attesting to the legality and status.
Page 1 of 2 -,., ;5,;~ 84~
E GINFERING FIRM PROVIDING INSPEC"IIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
A~; (;(u tlhed by my s<~al alhxed Ilereto and a~; of th~: w~hdahot~ date shown below, I verify that my U~vestigat~on of th~s Health
Authority Approval shows that th~:or~ sde wah:r supply and/or wastow;der disposal system is safe. functional [,nd adequate
for the numberer bedroonu;;u~dtypeofshu~:ttu(~nd~c~todbe~e~n I~ulthervo~[fythat based on tho mformahon obta~r~ed
from the Municipality o~ Anchorage files al~d from my investigation and inspection, the on-site water supply and/el
wastewater disposal system ~; u~ compliance with all Mumcipal and State codes, ordinances, and regulatior~s in effect on
the date of this ~nspechon
Name of Firm ~ & ~ [~~ _ _ Iclephone .............
Address _. ~~ .... ~.~.. ,. / ~ ......
Date ........... "' / ~' '"',~ ~
DHEP APPROVAL
Approved ~ 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 a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements, Employees of DHEP do not conduct inspections or
analyze data before a certificate ~s issued The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal DesCrjption: ~ ~
WELL DATA
Cased to ~r~ ' ~ h
If A, B, C, D.E.C. Approved (Y/N)
Date Completed ('4:) - ~' Yield
Depth of Grouting
Pump Set At ~' ~-.-~::'
Sanitary Seal on Casing ~N)
Depression Around Wetlhead (Y~
Well Classification
Well Log Present
Total Depth ~(~:) '
Static Water Level
Casing Height Above Ground '~'~'¢::> ~
Electrical Wiring in Conduit
Separation Distances from Well:
To Septic/~$',di::~} Tank on Lot ~ ~
To Nearest Edge of Absorption Field on Lot ~.~
To Nearest Public Sewer Line ~'J
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer
Cleanout/Manhole ~1/(~ To Nearest Sewer Service Line on Lot \ ~ ~,~
Water Sample Collected by ~ ~ ~:3~.~ ~/,..3 ~;~:~'Z~-.-~ ; Date r~ _ ~ ~ ~
Water Sample Test Results ~ ~ ~ ~~
SEPTIC/~TANK DATA . .,~ ~~ ~ . ~0~
Datelnstalled ~'Z~-~ Size 't~ No. of Compa~ments ~ Lz~ ~O~
Standpipes~) Air-tight Caps') Foundation Cleanout (Y~ ~ '
Depression over Tank (~ Date Last Pumped ~-~~
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/.i;t~j, Tank:
To Water-Supply Well I
To Property Line
To Water Mare/Service Lin~
Course i~ /A
Comments
; for --
Temporary Holding Tank Permit (Y/N) ~'-'/,A
To Building Foundation '"~,~
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed r7 ~-~' ~
Width of Field
Square Feet of Absorption Area
Depression over Field (Y~D
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation
Lot f,..5 ]
To Water M~t"'~Service Line
Type of System Design
Length of Field '~'~'~'
Depth of Field
Gravel Bed Thickness L~
~ ~ ~" "1f2 Standpipes Present.N)
Date of Last Adequacy Test
1, ~ To Property Line (-~:~'
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
To Existing or Abandoned System on
; On Adjoining Lots ~ ~'y
T utbank (if present)
Comments
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 **
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed ~ ~' ~'~_ _E~JG_IN£ER;N~ Date -~/~""/'~
Com~ ~IVER, A~S~ ~ MOA No.
~H. 6~2~iu
Receipt No. ~ X
Date of Payment ~ - ~- ~
Amount: $ C~
Page 2 of 2
72-026 {11,84)
