HomeMy WebLinkAboutGLACIER VIEW HEIGHTS BLK D LT 14Glacier View
Heights
Block D
Lot 14
#050-491-14
Municipality of Anchorage %__°:.
GFil;i Development Services Department 4 ](t
J Building Safety Division
' On -Site Water and Wastewater Program, 4700 S. Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page / of 3
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: S Q SO 30q PID Number. 0Y O
Name
S sen a
Wastewater System: [I NewUpgrade-15 jej
"s 23 3 e_ rive
ABSORPTION FIELD
P��9 4/ZS N«nb« a B.apana�
Tram O SWI" lr, n O 894 O MourW rnnr
LEGAL DESCRIPTION
Sod Ra""°
Tota DePMfr=wpmalpax
GPD/Fit
pl
Blxk La SuD1"wn
D /7l..IiIC�VZW/-+
pepm to ppe Donau horn ongmal pada
Z
Gwal depth D am ppe
FI.
FI
7ownLn,p Range Saa,on
FIO stdWd tlw, or,prw paste .r
Gravy LangM
Z FI.
/ Ft.
Wel(: N=w ❑ Upgrade
""" S
w,mo«p lr/sa
Dlwsna Ml man NN,
FI.
/
^ FI
CNaamuum (PMne, A 9, Cr
Taa Daph
Casey N
Taal stbecrppm wast
F" Melanal
XFI.
FI
1//0 FII
FVC 363
Dr,Iw
owe Dnlbd
siauc Wal« avN
waNlNf
sourNFO!Cjc I
Cd#J
Dn,Miaxad
Fl
, 0S
YNa Pump Sal at
C,wgiNgn , Grew
Fy F�
G/kL/-�-Dllb TANK—
1/
GPM FL
FI
SEPARATION DISTANCES
❑ septic ❑ H Ing ❑ S.T.E.P. ❑ Oth ,
To
Septic
Absorption
Lift
Holding
ublluPrivale
M" 0'
apaplr
From
Tank
Field
Station
Tank
Sewer Line
Ga
Mal«w
N of Compnim«ea.
Srraa Wale,
06
/605L
—
—
'' LIFT STATIO
La Lm—
G.I
FaaWw,on
/0 .�•
/O ��
'Pumpon' N , n
'Pump o.Y io w ,I
Nqn ,eat« w . ,L
in
M
n
Purrp aka 6 Mwel
ENanpal ;pg. pen by
Rem,*'
L 66' CRrg E.rro%li�4* + Ct2JS c
BENCH MARK
45K_ ��
i S Y C_
loul,m wa D.srnpuon
F_C'(zt ��ir'11
Aaaumad NvaUaL
/dam Fi
.� a,,.........
r1P: ~S,f.l
r 'a �•...
r
Inspections performed by: /� Ot i 1?w LCrrh . Dates: 1s14711—?10X
44TH ..:/
o
n0 O
Q / S
.e.: .
�� Sle.en W
Development Se ices DepartmentApproval
/�s;:,•. PE 6256 •;�vr
Reviewed and approved by: 0,4 Date: oI 29 -OS
t����AI76FE5S%1)1 ,.0
DESIGN NOTES:
1. Total Depth of Trench is 6' O Test Hole Elevation.
Terrain slopes toward front of lot.
Septic System Construction
2. Sewer Service Line minimum 2% slope.
Does Not Preclude Adjoining
S.T. 1
Lots From Sanitation
24
Improvements.
3. Lots Served by Private Water Wells.
27
'J1.01 0'
32.5
cb0,
66 65 �ry °\
C.O. 1
35.5
31
*L
75
69.5
50
J
13
X
1
Tank
*, W.
;9p -z- 9
`87,88
I
NORTHRIM sh".. GLACIER VIEW HTS
;. BLOCK D, LOT 14
ENGINEERING "'�9 AS -BUILT
77237 Bear Paw Circle LAYOUT
Eagle River, Alosko 99377 adj
6 0 (..
907.694 7018 Dote:
" " VV '
9/23/05 12 of 3
F.C.O.
W
24
S.T. 1
7
7
24
S.T. 2
29
27
\ D.C. 0
32.5
30
C.O. 1
35.5
31
i?: 0-- 2
75
69.5
NORTHRIM sh".. GLACIER VIEW HTS
;. BLOCK D, LOT 14
ENGINEERING "'�9 AS -BUILT
77237 Bear Paw Circle LAYOUT
Eagle River, Alosko 99377 adj
6 0 (..
907.694 7018 Dote:
" " VV '
9/23/05 12 of 3
Foundation Cleanout
Tank
4 h oat l
or Equal
4' PVC
�ipnnnut To End -Point of New Trench
1000 Gallon Septic
Tnnk
'Existing Tank'
Flat
Elevation = 99' +
Existing Tank Elevations FFabric Filter--- .
DESIGN NOTES, Elevation = 9 '
1. Depth of Trench is 6' from test hole elevation. Effective Depth
2. Septic Tank & Solid Pipe to be placed on compacted
stable soil, free from boulders.
3. Sewer Service Line is Minimum 27 Slope.
4. Water -Tight Couplings. 3' cover over trench.
5. See Specification Sheet.
6. All Work To Conform to Municipality of Anchorage (AMC)
i Requirements & Specifications.
7. Existing Septic tank was utilized.
I
NORTHRIM
ENGINEERING
17237 Boor Pow Circle
Eagle Riser. Alaska 99577
907-69<-7078
Test Hole Elevation = 84.5'
Elevation = 91'
Tube
Slope
New Absorption Trench
:
,IER VIEW HTS
-1K D. LOT 14
SE __ _1�-- 5 of 3 - sc
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water B Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SWO50309
Legal Description: GLACIER VIEW HEIGHTS BLK D LT 14
Design Engineer: 0838 North Rim Engineering
Owner Name: LARRY SENSENEY
Owner Address: 23033 MYRTLE DRIVE
EAGLE RIVER. AK 99577-9503
Date Issued: Aug 23, 2005
Expiration Date: Aug 23, 2006
Parcel ID: 050-491-14
Site Address: 023033 MYRTLE DR
Lot Size: 31831 SO. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
Disposal Field E 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 DSD at least 2 hours prior to each Inspection. Provide notification by calling
(907) 343-7904 ( 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:
krl
Date: Q
Date: t4 Z u
Municipality of Anchorage
Development Services Department
_Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.enchorage.ak.us
(907)343-7904
ON-SITE SEWERMELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 1050 -LAI- /9 Permit Number SW
Property
Mailing address (1
phone ,< fk'4 9/25
Mailing address (2) Zip Code 9 SS 7' 7
Legal description (Lot, Block & Sub'd.) r�l "40V_ V(CAJ h'T i%sP Lof ct
Legal description (Section, Township & Range)
Lot Size Acre Sq.Ft.
THIS APPLICATION IS FOR:
Number of Bedrooms X
Sewer Only ❑ Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit Fees: �o 'd Waiver Fees:
Date of Payment: 19 - /0- 6
Receipt Number: 7.1-675-
(Rev.
.1-7(Rev. 12/00)
Date of Payment:
Receipt Number:
�GENGINGTINF M
EERING
Northitim Engineering
17237 Bear Paw Cifcl.-
Eagle River, AK 97577
907.694-7028
August 17, 2005
MOA On -Site Water & Wastewater Program
4700 Bragaw St
Anchorage, AK 99519
RE: Septic System Design, Glacier View Ilts, Block D, Lot 14
The septic system has failed on the subject property. The owners wish to replace
immediately. The soil test was excellent.
Most of the neighboring lots are developed. This site should not negatively impact any of
the other area lots. The lot slopes from back to front at about 15%.
Please review the wastewater system design for the single family home. I have included
design plans & specs, design guidelines, & soil tests. If there is need for additional
information or clarification please give me a call.
Sincerely,
01
eve Eng, PE, PfI
Design Enclosures
�2TI�ZlM-
ENGINEERwG Glacier View tits, Block D, Lot 14
SPECIFICATIONS & DESIGN GUIDELINES
Wastewater System Sizing: This is an existing single family home with 3 bedrooms. The
system is in a failure mode. The septic tank was replaced last year; only the absorption field will
be now replaced. The lot is about 32,000 square feet, as are neighboring lots. Most of the
neighborhood lots have been developed. The 100 foot separation will be maintained on the new
septic system to all area water wells. No adverse impacts to neighbor lots are expected from
replacing the absorption trench. The lot slopes at about 15% as indicated in the drawing. One
soil test was conducted. A sandy soil with an excellent percolation rate. An application rate of
1.2 GPD/FT= with 0.5 reduction factor for utilizing a 5' wide trench was utilized. The old log
crib will be crushed and filled or excavated out and replaced with clean fill.
Specification Requirements: All components and work must comply with the Municipality of
Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater
Regulations.
• Utilize the Existing Septic Tank. If Tank is Damaged, Replace if Necessary.
• Watertight couplings on inlet & outlet.
• 5 foot minimum between the tank and bed. 10 foot to property lines.
• 3 feet of cover or insulation is required for trench; an equivalent of 1" insulation for each foot soil
cover.
• Tank & solid pipe must be set on well compacted, stable soil.
• 4 inch diameter cleanouts with airtight caps are required 1 to 4 feet from foundation wall, prior to any
90 degree bend in 4 inch line, in each tank compartment, and two adjacent opposing cleanouts
between the tank and the absorption field, not more than 10 feet from the tank positioned to provide
cleanout access towards the tank and towards the absorption field.
• All cleanouts must extend to at least ground level.
• In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron.
• Trench to be placed level, minimum of 4 feet to groundwater, 6 feet to bedrock from drain -rock.
• Drain rock to be %x inch to 2'h inch screened. Drain rock to be distributed uniformly throughout the
trench.
• Perforated pipe to be installed level with perforations down.
• Silt barrier (filter fabric) to be installed above the drain rock.
• Smeared trench sides must be raked or scarified before drain rock placement.
• Backfill over drain rock must not be less than 36".
• The finish grade must be mounded to promote drainage over the trench.
• Insulation must be placed over any pipe installed under driveways or parking areas.
• Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM
D2661,
• Sewer Service Line is minimum 2% slope.
• Septic Tank to be pumped every two years or when required.
• Insulation board to be extruded direct burial polystyrene (Dow Styrofoam III or equal)
• The existing log crib will be abandoned; crushed, and filled with sand/gravel or removed and properly
disposed of.
DESIGN NOTES:
1. Total Depth of Trench Is 6' O Test Hole Elevation.
Terrain slopes toward front of lot. Septic System Construction
2. Sewer Service Line minimum 2% slope. Does Not Preclude Adjoining
Lots rrom Sanitation
Improvements.
3. Lots Served by Private Water Wells.
66
NORTHRIM
j ENGINEERING
17237 Bear Paw Circle
Eagle River, Alaska 99377
907.694.7028
1
GLACIER VIEW HTS
BLOCK D, LOT 14 SYSTEM
-- - i LAY❑UT
0 Date
'
8/16/05 1 of 3
Foundation Cleanout
Tank
4 t 00 LO
or Equal
4' PVC
..+ To End -Point of New Trench
1000 Gallon Septic
Tank
'Anchorage Tank'
Flat Terrain
i �� (F ��y Fitter. ---.Yeas w -b T%itJK. IG Eft- 1 Fabric
;DESIGN NOTES,
1. Depth of Trench is 6' from test hole elevation.
2. Septic Tank & Solid Pipe to be placed on compacted
stable soil, free from boulders.
3. Sewer Service Line is Minimum 2% Slope.
4. Water -Tight Couplings. 3' cover over trench.
i5. See Specification Sheet.
16. All Work To Conform to Municipality of Anchorage (AMC)
Requirements & Specifications.
7. Septic tank to be manufactured by Anchorage Tank
j & welding.
NORTHRIM *q''m
ENGINEERING
17257 Bear Pow Circle • �,,. w"
Foyle River, Alaska 99577 a•.•
907-694-7028 1
SEPTIC TANK
ELEVATION
'RENCH END VIE
Effective Depth
if
for Tube
Slope
New Absorption Trench
Lg6(J/
GLACIER VIEW HTS
BLOCK D, LOT 14
om..m er sE sew.: 1, s , %M`2 of 3
18/16/05
tt
DESIGN NOTESt
1. Total Trench Depth Is 6' @ Test Hole Elevation.
2. 3' Minimum Cover Material or Insulate.
3. Trench to be Level w/ washed/screened Drain Rock 1/2' to 2 1/2'.
4. 5' Minimum Undisturbed Soil Between Septic Tank & Trench.
38'
Tube
anout
NORTHRIM
ENGINEERING
17237 Bear Paw Circig
Eagle Rive, Alaska 99577
907.694.7028
4' Perforated
Plan Solid Pipe to.," A�Cleanout
Septic Tank
,Filter Fabric
Perfo ated Pipe Level, Holes Down
...... . . . . .
4P 4P AP. WiY4P-4p-4p.
........... .......
........................... . . . .
W, W,
..........
LKWirqum 6' to Bedrock, 4' to Groundwater
GLACIER VIEW HTS
5' WIDE TRENCH I
BLOCK D, LOT 14
O -PLAN & PROFILE,
SE V = 5 %T3 of 3 SE
SOILS LOG - PERCOLATION TEST
� Lo 11 r T kR I M Date Performed: 8/8/05
E��_91NEERING
Performed For:-Greatlancl Realty
Legal Description: Glacier View Hts, Block D, Lot 14
DEPTH
(FEET)
T.H. Location: See Drawing
Groundwater? No
Depth
Water Depth
AF -Ear Minnitoring.None Date: 8/15/05
# I
Date
Gross Time
Organic
Depth
Net Drop
1
8/15
2
--
13'
L --
3
8/15
1
1 min.
4
1.
3
8/15
5
--
13'
SW
6
8/15
4
Sand
14'
1.
......
w/ Gravel,
7
--
13'
--
8
8/15
7
1 min.
9
11
10
11
12
13
14
15
16
17
18
19
20
T.H. Location: See Drawing
Groundwater? No
Depth
Water Depth
AF -Ear Minnitoring.None Date: 8/15/05
# I
Date
Gross Time
Net Time
Depth
Net Drop
1
8/15
0
--
13'
L --
2
8/15
1
1 min.
14'
1.
3
8/15
3
--
13'
--
4
8/15
4
1 min.
14'
1.
5
8/15
6
--
13'
--
6
8/15
7
1 min.
14'
11
21 Percolation Rate 1 min,/Inch Perc Hole Diameter 6'
Test Run Between 2' and 3'
Comments: (-,rPntPr than 907 -;nnci
Performed ByNorthR'm Eng, I CERTIFY THAT THIS TEST WAS
Performed in Accordance with All State/Municipal Guidelines in Effect
ON THIS DATE. DATE: 8/15/05
NOR THRIM
ENGINEERING
77237 Boor Pow Circle'
Eagle Rio r. Alaska 99577
907.694.7028
TESTHOLE LOG
I
GEOTECHNICAL
T. H. 1
Dale:
—8/15/05 -11 -of 1
C"
Municipality of Anchorage
Development Services Department =t7Ee 1 i'
Building Safety Division
On -Site Water and Wastewater Program, 4700 S. Bragaw St.
P.O. Boz 196650 Anchorage, AK 99519-6650 Pagel of 'L
www.U.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: _ .SW Dy$a7 PID Number. 050- 119/ - /of
Name
LAreRY SENSEi✓Y
Wastewater System: ❑ New [3 Upgrade
;'10 k7ZE AC• f:4 &tV X;VEje,AK
ABSORPTION FIELD
F1arr / — 1 NunWar M BWrooma
O Dap Twrrh 0 Stellae Trarrh 0 SW O Mouit ihlr
LEGAL DESCRIPTION
SWRMp
I"DOP ° °°
GPDIFP
FI.
81 o Lot Sea,r1MM
D I`I GtACIM VIEW HEIErTS
Depn W ppa Govan tom wlg M arae
ph G Mh ppe
rLI
Ft
To vv Range SM]wn I
Fa a"ose Mww o.ginM OWa
Gla LMgm
FI.
FI.
Well: ❑ New ❑ Upgrade
c a w°
Nu bwa Mn
UMMtn GMw Jem
Fl.
FI
c4"ftaltan W.". h a, c3- TOM Dapet
Dawn la
TdM Mtnrytgn r
P MMMW
M
rEWT ?/ ✓(, I G FI.
Fl
Ft'
Dtww "e D'aw
swc WMM LM
imtM {
Ft
t/) t l /
(J
Pure setts
I
uM
Ca"H -"Nw ove mIXu
50d TANK
GPM
Ft.
Fl
SEPARATION DISTANCES
El septic ❑ Holding ❑ S.T.E.P. ❑ Other.
To
Septic
Absorption
Lift
Holding
ublicAldvate
Mkda..
+P+alr
From
Tank
Field
Station
Tank
Sewer Line
, A/LHOICACTr= 77WK.
1 000 GM.
w"
13-$'
+100 F
'
M'M
ST£EL
Numtar d convwi ,
,g
swl—w"
+100'
t100'
LIFT STATION
LN LYr
SS F
1}10 '
Gal
Fan"Mpn
Id
+ ro'
'Pulp On' Neal M . M
Npn -MM MMm M
M
in
C~ Dram
, f. sO �
,trot
Para MMe ui ENcmul t^rPaouont pMamW Dy
Rem
BENCH MARK
La:Mpn.na Darmpptt
nl LY
Sc.t
d ,..
10 0.0 FL
Inspections performed by: CMdiSTDPHE� IA_tgOD Dates: 1"115,10 °*
2n° i GIRISTOPFIER R WOOD
Developme t Services Department Approval
Reviewed
and approved by: ate:
Permit No. SW04327
Page 2 of 2
Municipality of Anchorage
DEVELOPMENT SERVICES DEPARTMENT
ON—SITE WATER & WASTEWATER PROGRAM
4700 SOUTH BRAGAW STREET P.O. BOX 196650, ANCHORAGE, AK 99519-6650
On—Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: GLACIER VIEW HTS. LOT 14, BLOCK D 050-491-14
SWING TIES
h�
,`.I C 1 13.9' 23 S'
ti^ �
4 GAL, TANK
EXISTING 1000
SEPTIC AREA) C HOUSE
SCALE 10-30'
2
1 •,a B.M. B
'�.gRjVE
CARPOR ';� �v• i;''.,t�.
T
.y ss3o.
bo.
15 S9 a°o
e �
O - SEPTIC PIPE
-� - WELL
• - MONITOR TUBE
ELEVATIONS
MOT TO SCALE)
SEPTIC TANK
TANK
1,000 GAL
101.1
96.5 / 96.5
szoe,
40.
�Y
�O
'S6
�O
L'% CARPORT SLAB
ASSUMED ELEVATION • 100'
REPLACEMENT ONLY
100.8
TO EXISTING SEEPAGE PIT
06-20-05
ENGINEER'S SEAL
'••&MSTOPHa R. WOW'!
CE -10387',
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water B Wastewater Program
4700 South Bragaw Street �\
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: Aug 10, 2004
Expiration Date: Aug 10, 2005
Permit Number: SW040327 Parcel ID: 050-491-14
Legal Description: ;GLACIER VIEW HEIGHTS BLK D LT 14
Design Engineer: 0848 Eagle River Engineering Services Site Address: 023033 MYRTLE DR
Owner Name: LARRY SENSENEY Lot Size: 31831 SO. FT.
Owner Address: 23033 MYRTLE DRIVE Total Bedrooms: 3 Permit Bedrooms: 3
EAGLE RIVER. AK 99577-9503
This permit is for the construction of:
❑✓ Disposal Field 0 Septic Tank ❑ Holding Tank ❑ Privy
All construction must be in accordance with:
1. The attached approved design.
❑ Private Well ❑ Water Storage
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 DSD at least 2 hours prior to each Inspection. Provide notification by calling
(907) 343-7904 ( 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, seated, and heated to prevent freezing.
Received By.
Date: Ze it
Issued By: Date: z/e o
MOA LAND,USE ENFORCEMENT
• �l�l�le GEnlc `( _.
-fang r�p(� icipality of Anchorage
-RU SJ*
pment Services Department
Building Safety Division
rite Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650'
www.ci.anchorage:ak.us
(907)343-7904
121 001
ON-SITE SEWERIWELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. Sr - 4/9 / - /y Permit Number SW
Property owner(s)�rr ✓CL-4—�Day phone 947) 763-946-9
Mailing address (1) 3 0 33 ` 21ya --/
Mailing address (2),&4'ec_ K-1 7 Zip Code '7'75'-T7- 9.5'03
V
Legal description (Lot. Block & Sub'd.) ?a n.i , r'� +) �- . B D L_ I q
U
Legal description (Section, Township & Range)
Lot Size 31..93 / _Acresl�
THIS APPLICATION IS FOR:
Number of Bedrooms,
Sewer Only ❑ Well Only, ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑• Water Softening Unit ❑
Therapy Pool ❑
I certify that the above information is correct I further certify that this application is being trade for a
Single Fa3mily DwellingAnd Is inOc:cordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit Fees: Waiver Fees:•
Date of Payment a. 6 . ,20rzf- Date of Payment:
Receipt Number: ���/�� Receipt Number
(rey. i2M) Af
Eagle River Engineering Services
Christopher R. Wood, P.E.
10421 VFW Road Suite 201
Eagle River, AK 99577
August 6, 2004
Dan Roth
Manager, On -Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: Glacier View Heights L14 Block D
Narrative & Permit Application
Dear Mr. Roth:
(907) 694-5195 tel
(907) 694-3297 fax
The proposed septic tank replacement will have very limited impact on adjacent properties for
the following reasons:
1. The surrounding lots are large, allowing sufficient room for septic sites.
2. Immediate neighboring septic systems are all +30' distance, and wells +100'.
3. This permit is for replacement of the septic tank only.
4. Drainage will not be affected and is not a major consideration in our design.
5. Protective well radius will be maintained for all adjacent properties.
The existing septic tank is corroded and needs to be replaced. Drainage will not be affected, and
is not a consideration in our design.
This work will not affect the reserve area on adjacent lots. If you have any questions please call
our office at 694-5195.
Sincerely,
EAGLEENGINEERING SERVI ES
C iristopher R. Wood, P. .
Principal
\2003\04-076S EPncNARRAi1VE
EAGLE RIVER ENGINEERING
10421 VFW Rd., Suite 201
Eagle River, Alaska 99577
(907) 694.5195
Fax (907) 694.3297
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Eagle River Engineering Services
Christopher R. Wood, P.E.
10421 VFW Rd. Suite 201
Eagle River, AK 99577
(907) 694-5195 tel
(907) 694-3297 fax
SPECIFICATIONS FOR ON-SITE SEPTIC TANK
LEGAL: Glacier View Heights Lot 14 Block D
August 6, 2004
A. GENERAL
1. The septic plan is for a 3 bedroom single family residence only.
2. The drawing and or site plan shall be apart of this specification.
3. All materials and workmanship shall meet the Anchorage Department of Health and State Department
of Environmental Conservation requirements.
4. All soil tests arc advisory to the design and are to be verified or modified in the field by the engineer.
5. All excavations and depths are advisory and arc to be verified in the field by the contractor to meet
Municipality of Anchorage, Department of Environmental Conservation requirements.
6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any
adjacent multifamily wells.
7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer
approval.
8. Any remaining open test hole excavations shall be filled and monitor tube removed.
B. SEPTIC TANK
1. The sewer piping from the house shall be 4" PVC 3034 laid at 2% grade maximum — I% minimum
and insulated with 2" of burial foam if shallower than 3 fl., with 2 fl. minimum.
2. Septic Tank shall be a minimum of 1,000 gallon tank of MOA approved construction, insulated, or
place with 4' of soil cover, min.
Twenty-four (24) hours notice required for all inspections.
\\Eres\docs\WPDOCS\2004\04-076tankonly- spec.doc
GREATER ANCHORAGE AREA BOi%JUGH
WillDepartment of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME 004), ` %7� MAILING ADDRESS 6XT %� t4) � !! C ' PHON�Ej
LOCATION /LdllG � ' `' 1 � d�'!2 �I"�ULEGAL DESCRIPTION / U I �y �jd.4 �i� Ct ���C�F/e
SEPTIC TANK:
DISTANCE _ - NUMBER OF
FROM WELL MANUFACTURER 5/(,/,/ S /--MATERIAL ��! /c's _ COMPARTMENTS
INSIDE LENGTH _ INSIDE WIDTH _LIQUID DEPTH LIQUID CAPACITY l��G0 GALLONS.
SEEPAGE PIT:
NUMBER OF PITS�.�/1D" I`AMETER OR WIDTH l -`?,/w LENGTH—L, DEPTH
E" ��-d
LINING MATERIAL A L CRIB SIZE: DIAMETER DISTANCE FROM: WELL
�d TOTAL EFFECTIVE 9
BUILDING FOUNDATION/ NEAREST LOT LINE ? i ABSORPTION AREA (WALL AREA) _SQ. FT.
ADDITIONAL ABSORPTION
WE1_L:..Wc!% Al or XIV52�11e a Of
'TYPE
_CONSTRUCTION
BUILDING
NEAREST
FOUNDATION
LOT LINE
CESSPOOL
OTHER SOURCES_
APPROVED DISAPPROVED
DISTANCES:
INSTALLED BY:
PIPE MATERIAL:
. W l lw
LOT SLOPE:
REMARKS:
NEAREST
SEWER LINE
REMA
DEPTH
SEPTIC
"TANK _
DIAGRAM OF SYSTEM
DISTANCE FROM:
SEEPAGE
SYSTEM _
G.A.A.B.
NAME OF APPLICANT
INSTALLATION LOCATION
GRED ER ANCHORAGE AREA BOF JGH
DEPARTMENT OF ENVIRONMENTAL QUALITY
3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHON CT
2r7�4�-44�561F
(,0,r E l- Fes'
4
SEWAGE DISPOSAL SYSTEM s APPLICATION AND PERMIT
f
MAILING (A�D.pl,RESS
0
LEGAL DESCRIPTION F6i'' LIF or l
INSTALLATION OF: SEPTIC TANK SEEPAGE PIT— DRAIN FIELD
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOIL TEST RESULTS
COMPLETION DATE ANTICIPATES
TO BE INSTALLED BY
r" . om"
c ,' l
PERMIT NO.
PHONE
OTHER
NOTICI THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
FINAL INSPECTION: 44 HOUR ,, NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONME`It"ALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE "'J TYPE
LA ,
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT—� DRAIN FIELD _
— SEEPAGE AREA SIZE
]� f + TYPE
t C3
DIAGRAM OF SYSTEM
SEPTIC TANK TO SEEPAGE PIT WALL
'.
SEPTIC TANK SEEPAGE PIT
DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
SEEPAGE PIT
q
DRAIN FIELD—[^ —.
ALSO CONSIDER AREA WELLS
WATER MAIN TO SEPTIC TANK
SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK, SEEPAGE PIT , DRAIN FIELD
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP 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 BOROUGH REGULATIONS REGARDING INSTALLATION.
G.A.A.B.
OR
LICENSED DESIGNER
I CER'iIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. --�
�AX' { JF �j
DATE � AA SIGNATURE ldf
� --'-
IS'
FORM NO. EQ -014 «„ /-(,!! I ti� r'i ( e ,j� Ffi� /
GREs :R ANCHORAGE AREA E30F J
L7g�J
O _� -
rl � •6, EPARTMENT OF ENVIRONMENTAL QUALITY PERMITNO.
:!�
t ILJI ° 3330 'C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
EY C E D1_S_PQSA �M - APPLICATION AND PERMIT
NAME OF APPLICANT - )Li 17� ���� I. i- �ILING ADDRESS{r!l--J /i& PHONE
INSTALLATION LOCATION
LEGAL DESCRIPTION f �
INSTALLATION OF: SEPTIC TANK
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH
SOIL TEST RESULTS
COMPLETION DATE ANTICIPATED
DRAIN FIELD
TO BE INSTALLLD BY
OTHER
NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL 'PEST
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE
MINIMUM DISTANC
FOUNDATION TO SEPTIC
TYPE
REQUIREMENTS
FOUNDATION TO SEEPAGE PIT
SEPTIC TANK TO SEEPAGE PIT WALL_
DRAIN FIELD
SEEPAGE AREA SIZE
SEPTIC TANK SEEPAGE PIT . DRAIN FIELD
TO NEAREST LOT LINE. /
WELL TO SF PTIC TANK `J SEEPAGE PIT /L-/ L/ ,
DRAIN FIELD ALSO CONSIDER AREA WELLS,
WATER MAIN TO SEPTIC TANK
DRAIN FIELD
SEPTIC TANK, SEEPAGE PIT
TO RIVER, LAKE, S EAM.
SEEPAGE PIT
DRAIN FIELD
CAST IRON INTO AND 0, T OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UU DISTURBED SOIL.
4 INCH DIAMETER CAST IRON
FITTED WITH AIRTIGHT REMOV.
GRAVEL BACKFILL
ON PIPES ON SEPTIC TANK AND SEEPAGE PIT
CAPS.
CONFORM TO BOROUGH REG LATIONS REGARDING INSTALLATION.
L /
G.A.A.B.
OR
LICENSED DESIGNER
TYPE.
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREA ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
DESCRIBE}] SYSTEM IS IN ACCORDANCE WITH SAID CODE. / v -
DATE/ ,T APPLICANT'S SIGNATURE
i
FORM NO., - -01 6."
.A'VCHORAGI,
P�A11{13ANKS'
Il'V16.1A�
249 EAST51ST AVENUE P•O. BOX 6007 ANCHORAGE, ALASKA 99503 TELEPHONE 907-279-0463 TELEX 090.35419
September 22, 1975
Don Zimmerman, Jr.
Box 596
Eagle River
Alaska 99577
RE: Test Hole and Soil Log Report for Sanitary System
Lot 14, Block D, Glacier View Heights
Dear Mr. Zimmerman:
R & M No. 562119
We are submitting herewith the test boring results and our comments regard-
ing soil conditions encountered at the subject site. This investigation
was performed in accordance with your request of September 19, 1975, and
those procedures outlined in a letter dated July 15, 1975, by Mr. Rolf
Strickland of the Greater Anchorage Area Borough Department of Environmental
Quality.
A single test hole was put down within the Lot 14 area for the purpose of
defining general subsurface soil conditions for the proposed sanitary
system. Excavation was accomplished with a tractor -mounted backhoe and
the test hole was extended to a total depth of 13.0 feet below ground sur-
face. The final log prepared for the test hole has been included in
Drawing A-01.
Ground water was not encountered in the test hole.
We appreciate being given this opportunity to be of service to you. Should
you have any questions with regard to the above, please do not hesitate
to contact us.
Very truly yours,
R & M CONSULTANTS, INC.
James W. Roone}�,/iu/
Vice President`()
JWR/WED/ja
xc: GAAB
TH-1
9-18-75
NO 14ATER TABLE
0.0'
0.5'
2.0'
6.0' 61
9.0
(Sit)
13.0' T.D.
Log represents Location of
test hole, Lot 14, Block D,
Glacier View Heights Subdivision
Consultants Inc. Dog ZIP1Te
ANCHORAGE FAIRBANKS ALASKA JUNEAU LOg Of Testst Hole
Anchorage, Alaska
DATE 9-22-75 SCALE 1"=3' OWN BY 14ED GHHD BY l.�D FA'OJ. No. 562119 A-Ol
ORGANICS
SILTY SAND (SM)
SANDY GRAVEL TRACE SILT
�•:::
(GW)
.2-9
{
GRAVELLY SAND TRACE SILT
a
(SP)
; co
SILTY SANDS TRACE GRAVEL
NO 14ATER TABLE
0.0'
0.5'
2.0'
6.0' 61
9.0
(Sit)
13.0' T.D.
Log represents Location of
test hole, Lot 14, Block D,
Glacier View Heights Subdivision
Consultants Inc. Dog ZIP1Te
ANCHORAGE FAIRBANKS ALASKA JUNEAU LOg Of Testst Hole
Anchorage, Alaska
DATE 9-22-75 SCALE 1"=3' OWN BY 14ED GHHD BY l.�D FA'OJ. No. 562119 A-Ol
MUNICIPALITY OF ANCHORAGE 0``
Development Services Department ��- Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On-Site Systems Approval
Parcel I.D. 050-491-14 Expiration Date: 7- I _17
1. GENERAL INFORMATION
Complete legal description GLACIER VIEW HEIGHTS BLK D LT 14
Location (site address) 23033 Myrtle Dr
Current property owner(s) CONTRERAS Day phone 351-7299
Mailing address
Real estate agent Buyer Day phone 351-7299
Felc
2. TYPE OF DWELLING: ��
`� o
n Single Family (w/wo ADU)
Duplex a Ar'r� r ii �C19 ,.
i I Multiple Dwellings (Single Family and/or Duplex)
1 ti
3. NUMBER OF BEDROOMS: 3 �� CI 5 9�"
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Private Well E Private Septic ❑
Water Storage ❑ Holding Tank ❑
Community Well 1-1 Community ❑
Public Water System ❑ Public Sewer I 1
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 556 Waiver Fee $
Date of Payment Jf iz/`9 Date of Payment
Receipt Number (0&OW Receipt Number
COSA# 4sCt91!00 Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based
on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the
on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater
disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in
effect at the time of installation. I acknowledge that On-Site staff may visit the site to verify the information submitted.
Name of Firm NorthRim Eng. Phone 694-7028
Address PO Box 770724, Eagle River
Engineer's Printed Name Steve Eng Date 4/8/19
0. Ito
6. DSD SIGNATURE eo•fp
System #1 Approved for
y pp bedrooms : d
tevc- '.••••• O
System #2 Approved for bedrooms
Disapproved '4 ESSNP S
r£SS�4��
Conditional approval for bedrooms, with the following stipulations:
By: Original Certificate Date: — ,/
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only upon the
representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is
not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA ue sheet
COSA Checklist
Legal Description: Glacier View Hts Block D Lot 14 Parcel ID: 050-491-14
If more than 1 septic system on lot: COSA Checklist# of Structure served by this system
A. WELL DATA
❑ Well log is filed with Onsite (or attached) Well production at time of test 5+gpm
Date drilled 1975 Water storage tank volume 0 gallons
Total depth 72 ft Well disinfected for coliform test? ❑ Yes ❑� No
Cased to 40+ft ❑■ Coliform bacteria is Negative
El Sanitary seal is functioning correctly Nitrate mg/L ❑� Nitrate less than MRL (ND)
❑■ Wires are properly protected Arsenic ug/L • Arsenic less than MRL (ND)
Casing height (above ground) 24 in. Collected by NRimEng
Date of flow test for COSA 11218 Date of Sample 3/12/19
Static water level at beginning of test 30 ft.
Comments
B. TANK DATA C. LIFT STATION
Age of tank(s) 8/04 years ❑ Required maintenance completed
Tank type/material Steel Age of lift station years
Measured operating fluid level in septic tank 45" Lift station material
❑■ Standpipes/foundation cleanout per record drawing Comments:
Date of pumping 5/8/18
D. ABSORPTION FIELD DATA 9/14/05
Which system tested (date installed) 9/14/05 Adequacy test date 11/2/18
I] ALL standpipes present per record drawing Results E Pass For 3 bedrooms
Total measured depth from grade 7.5 ft (max) Fluid depth prior to test 0 in
Measured depth to pipe invert from grade 3.5 ft(min) Water added 450 gal
❑ N/A— pressurized field New depth 2 in
❑■ Monitor tubes go to bottom of effective. If not, state Elapsed time 30 min
depth into effective
❑■ Code-required soil cover over field Final fluid depth 0 in
System presoaked Absorption rate 450 gpd
(Required if vacant for greater than 30 days prior to Any rejuvenation treatment (past 12 months) unk
date of test)
Gallons introduced gallons If yes, enter date
Comments/Deficiencies:
COSA Checklist yellow sheet
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100'
—0 Yes if No ft 7 Yes if No ft
Neighboring Tank > 100' 0 Yes if No ft Private Sewer/Septic Line > 25' 0 Yes if No ft
Absorption Field on Lot > 100' ✓0 Yes if No ft Holding Tank > 100' ❑✓ Yes if No ft
Neighboring Absorption Fields > 100' Animal Containment > 50' ❑✓ Yes if No ft
Yes if No ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ❑✓ Yes if No ft Z✓ Yes if No ft
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' ❑✓ Yes if No ft Surface Water > 100' ❑✓ Yes if No ft
Property Line > 5' ✓❑ Yes if No ft Wells on Adjacent Lots:
Absorption Field > 5' ❑✓ Yes if No ft Private Wells > 100' ✓0 Yes if No ft
Water Main > 10' ✓❑ Yes if No ft Community Wells > 200' ✓0 Yes if No ft
Water Service Line > 10' ['Yes if No ft If septic tank is under driveway comment below
From Absorption Field on Lot to: (Please enter distances if less than required)
Building Foundation > 10' p Yes if No ft If absorption field is under driveway comment below
Property Line > 10' ❑✓ Yes if No ft Wells on Adjacent Lots:
Water Main > 10' ✓7] Yes if No ft Private Wells > 100' ❑✓ Yes if No ft
Water Service Line > 10' 0✓ Yes if No ft Community Wells > 200' 11 Yes if No ft
Surface Water > 100' ✓0 Yes if No ft
F. ENGINEER'S COMMENTS
-v`%�?1�,1j;d n
G. ENGINEER'S CERTIFICATION ,®"�F� '-i;.�'�c.4 s I8
I certify that I have determined through field inspections and review "4; -- .14.4:,.V`�Q,1
of Municipal records that the above systems are in conformance with / . c'
�k ;
MOA COSA guidelines in effect on this date. i�'E �c - :, .-. �
rQ4S • /�' �\FO ` V -'
COSA Checklist yellow sheet k��\\\ra► �
9a/oX
Municipality of Anchorage
6� .8
Development Services Department ="
Building Safety Division
On -Site Water and Wastewater Program : „ e.
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcell.D. HAA# 05Dyg5
Expiration Date:
1. Gk ERALtiINFORMATION
� p'mplet&.fe it desctipxi0n t; LAe/Ei2 Ni/Ew tifl4hc7-9 1 BL002"k- D, Go T- i
,;Location (site address oiF�Iirections) Z3a33 i%'t YL� /�,PiV�
'Current Property owner(S) Luiz?Y xcgsFiJ6y Day phone _469U- ?/ZS
Nlailing'address',ar X3033 /LfY,eTtF_ Q2JE
Lending agency Day phone
Mailing address
Real Estate Agent P, d22-4 0�A�-' 1 Day phone G94! V25
Mailing Address 6_e,609T 44AJ,6 Re5g4zy CSF Fi44rGE i?iJER-
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY: Y� TYPE OF WASTEWATER DISPOSAL:
Individual Well Individual On-site
Individual Water Storage Individual Holding tank ❑
Community Class Well ❑ Community On-site ❑
Public Water System ❑ Public Sewer ❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered In the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.)
Certificates are valid for one year for properties served by Class A or B wells or a public water system. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-
site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm Phone
Address /U37 /� eGr P4ca (? rr,c i2
Engineer's Printed Name —37TEVE �6 Date 3 OS
p`E ..... 40 1
i C2.� '
so * . t91i! , ,�
i isAj
5. DSD SIGNATURE
_LeL Approved for _ bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Additional Comments �J`; ON-SITE r"
Attachments:
HAA Checklist X
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By; /%,,g5, Original Certificate Date: —.2 �c�S
(Rev 01102)
Municipality of Anchorage
• Development Services Department ;
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: l+' G I L ✓ V -eery G 1 Q S Parcel ID: 6 -6�0 - 4 9
A. WELL DATA 131 `t` k 0 4. -t/
Well type /0 If A. B, or C provide PWSID # _ Well Log (Y/N)
Date completed =a%S Sanitary seal (Y/N) Wires properly protected (YIN)
Total depth -72Z -ft. Cased to Qft. Casing height (above ground) in.
FROM WELL LOG AT INSPECTION
Date of test ?It 05'
Static water level ft. ft.
Well production g.p.m. S g.p.m.
WATER SAMPLE RESULTS:
Coliform ci colonies/100 mi. Nitrate �� mg./I.'*"DL Other bacteria 41 colonies/100 ml.
Arsenic: mg./I. Date of sample:*/OSi Collected by: or w
B. SEPTIC/HOLDING TANK DATA — EXIMWC r"# -
Tank Type/Material 4,VrMOOe" J r �.irFEG Date installed d'
Tank size poo gal. Number of Compartments Z Cleanouts (Y/N)
Foundation cleanout (Y/N) Depression over tank (Y/N) High water alarm (YIN)
Date of pumping Mi/ S Pumper •�. �, S
C. ABSORPTION FIELD DATA —NEoJ
Date installed2as Soil rating (g.p.d./ft2 ort140bdrm � System type 7-R4VC-ff
Length q/ , ft. Width S ft. Gravel below pipe ft.
Total depth 7 ft. Eff/..aabsorption area �ft' Monitoring tube -y—Depression over field _�
Date of adequacy test A Results (Pass/Fail) For -? bedrooms
Fluid depth in absorption field before test _ in. Water added_ gal. New depth_ in.
Elapsed Time: _ min. Final fluid depth _ in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes, give date
D. LIFT STATION
Date installed
'Pump on" level at in.
Datum
E. SEPARATION DISTANCES
Size in gallons ManhoWAccess (Y/N)
"Pump off" level at in. High water alarm level
Cycles tested Meets alarm & circu' equirementsl
SEPARATION DISTANCES FROM WELL ON LOT TO:
r
Septic tanknift station on lot , //i 6 1 -
Absorption
Absorption field on lot
Public sewer main
r
Sewer /septic service line Z.5
On adjacent lots / 6 a � *
On adjacent lots a G 'f
Public sewer manhole/cleanout
Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation /cl Property lined Absorption field 5
r �
Water main X/ Water Water service line .5 * Surface water
Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line /0 r f Building foundation /0 �t Water main
Water Service line Z S t Surfacewater 100 er" Driveway, parking/vehicte storage
Curtain drain Wells on adjacent lots OQ .-
F. COMMENTS
G. ENGINEER'S CERTIFICATION
1 certify that I have determined through field inspections and IRS � � q,g;,.. •a ,
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date. l ,. C
Engineer's Printed NameSTr'�/E fes! �� s'•,�
PE a2s6 vow
�19F•......•
Date o� 3/os ��� PNOfE55V0��'�
HAA Fee $ 4W - fD
Date of Payment q�11
�t' /IBJ
Receipt Number h 1 1q
(Rev. 12/01)
Waiver Fee $
Date of Payment
Receipt Number
W.c -1! _y.
N
,
S t ,.•r r �- �• '�
e •.•
r p-
1` 4 f
ft
S
5"9,SS a't.sb
Z.3o33
r
tl '"'
rllt al
w/ �F
f V�
�.r 7Jr
AS -BUILT
1 hereby certify that 1 have surveyed the following described
ff.,:..fT-.��
Anchorage Recording Precinct, Alaska, and that the improve-
ments situated thereon are within the Property lines and do not
overlap or encroach on the property lying adjacent thereto, that
no improvements on property lyin adjacent thereto encroach
on the premises in question and that there are no roadways,
transmission lines or other visible easements on said property
except as indicated hereon.
Dated at Eapile River, Alaska
this -lay of a .5 't,2(K)
ROBERT C. JOHNSON
SCALE: Registered Land Surveyor No. Bg0-LS
Box 77-0456, Eagle River, Alaska 99577
Phone (907) 6942543
MUNICIPALITY OF ANCHORAGE
• Department of Health & Human Services M
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D. # L�`�l - 1 I HAA # SO, cg__�4 .
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
(b) Property owners Telephone: (home) Business
Business
Mailing Address ��'� �IBJ �'V__�, `�`✓�� _
(c) Lending Institution Telephone
Mailing Address
(d) Real Estate Company and Agent l-3 d tJe,
Address
Telephone
(e)'Mail the HAA to the following address: (or check heif hold for pick up.)
List contact person and day phone number below:
S & S ENGINEERING
17034 Eagle Rwer Loon Road No 204 _
Eagle River, Alaska 99577
2. TYPE OF RESIDENCE
Single -Family- Number of bedrooms
3. WATER SUPPLY
Individual Wele 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 Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legailty and status.
72-02e(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 this
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.
Name of Firm S & S ENGINEERING Telephone
17034 Eagle River Loop Road No. 204
Address Eagle River, Alaska 99577
Date , /��, V
m gro�9'GiFar,.
6. DHHS APPROVAL _�,
Approved for bedrooms by G�� '�'! /�" Date
Approved Disapproved —Conditional
Terms of Conditional Approval
The Municipality of Anchorage Department of Health 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
MUNICIPALITY OF ANCHORAGE (MOA)
• M Health Authority Approval (HAA)
fij
CHECKLIST - FEBRUARY 1984
343-4744
Legal Description:
A. WELL DATA
Well Classification t GJI Glut_ If A, B, C, D.E.C. Approved (Y/N) P�
Well Log Present (YIQ Date Completed ^- 1q -1S Yield 6)FH 4 --
Total Depth Cased to 4,=j+' Depth of Grouting
(
Static Water Level �'�1 Pump Set At _ J
N
Casing Height Above Ground 12 Sanitary Seal on Casing PN)
Electrical Wiring in Conduit((YYN) y Depression Around Wellhead (Yflq) r_ -
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot
; On Adjoining Lots \ C::'� '4 -
To Nearest Edge of Absorption Field o Lot On Adjoining Lots
To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole
To Nearest Sewer Service Line on Lot
Water Sample Collected byDate
Water Sample Test Results (:::) 77��A O
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed'l'Z'1-'fs _Size No. of Compartments
Standpipes &N)I _Air-tig {ht Caps 0)/N) _ Foundation Cleanout
Depression over Tank (Yo _ r-' Date Last Pumped
Pumping/Maintenance Contact on File (Y/N) r-' A ; for
S
Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
7 /
To Water -Supply Well42_
To Building Foundation
To Property Line — 1 'Z� Inc To Disposal Field
)
To Water Main/Service Line �
1
To Stream, Pond, Lake or Major Drainage Course
CommentsP�oV
72-026 (Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata \ k1 t/f'� Type of System Design
Date Installed ` Z�I - S Length of Field 2 +
Width of Field Depth of Field
i
hGravel Bed Thickness
Square Feet of Absortion Area .^r Statndpipes Present(/N) y
Depression over Field (YQ +S Date of Last Adequacy Test Z _5 _'31
Results of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water -Supply Well 14b To Property Line d (�
To Building Foundation To Existing or Abandoned System on
Lot ; On Adjoining Lots 30/ 4
To Water Main/Service Line
To Cutback (if present)
To Stream, Pond, Lake, or Major Drainage Course _ C) CD ("E
To Driveway, Parking Area, or Vehicle Storage Area
Comments
D. LIFT STATION t-/I/`�
Date Installed
Size in
"Pump On" Level at ---
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
`*Check Permitted Bedroom Rating Against HAA Request"
"Pump Off" Level at
Vent(Y/N)
Cycles during Adequacy Test.
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in
inspection. ; & S ENGINEERING
Signed 17034 Eagle River Loop Road No. 204
XV
Eagle River,
Alaska 9957-7
Company
Date 7
MOA No. C
00-Y
Receipt No.'D
/vI
im
Date of Payment ���� �/ 9
Amount: $ 1 )a i»
Receipt No
Waiver Fee: $
Date of Payment
72-026 (Rev. 7/88) Back Page 2 of 2
of tfiis
P• 'Mo
�
Kn�8-- zaaI
GREATER ANCHORAGE AREA BOROUGH
Eagle River Area
V\ �/Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
nFPFO )AiJA44
O00, f
I !0'JJ(; Date Received _January 12, 1977
�' ti� i vppti n Time of Inspection __9,3(I -am
40 �l��+a'� a�� `�0�� Date of Inspection-�31- 7�"I n%
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
FOR
1. Approval requested by: Spokane Mortgage
Mailing Address: 320 C Street, Suite 250 Phone: 277-0543
2. Property Owner: Don Zimmerman, Jr. Phone: 694-2947
Mailing Address:
3. Legal Description; Lot 14 Block D Glacier View Heights
4. Location: ,Mile 5 Emile River Road, see attached map
5. Type of facility to be inspected Singel Family No. of bedrooms 3
6. Well Data:
A. Type Individual B. Depth e 158' _
C. Construction _® D. Bacterial Analysis _
7. Sewage Disposal System: on-site system
A. Installed B. Installer
C. Septic Tank: 1. Size 2. Manufacturer
D. Seepage Pit: 1. Absorption Area 2. Material
E. Disposal Field: Total length of lines
8. Distances:
A. Well to: Septic tank , Absorption area Sewer Lines
Nearest lot line Other contamination
B. Foundation to septic tank , Absorption area
C. Absorption area to nearest lot line
EQ -034 (1/74) Page 1 of two pages
MUNICIPALITY OF ANCHORAGE MUNIGPALM OF ANCHORAGE
DEPT, OF HEALTH &
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTEC 411% ENTAL pROTEC 10H
2510 East Tudor Road, Anchorage, Alaska 99504 276.2221
REQUEST FOR APPROVAL. OF JAN 12 W7
INDIVIDUAL SEWER and WATER FACILITIES RECEIVED
1. Type of Inspection: CMRO _VA_V FHA CONY
2. Property Owner:_ jz
Mailing Address:_ Day Phone:
3. Name of Buyer: ))
y�
Mailing Address: Day Phone: f`; E S� %
e� e.
4. Name of Lending Institution:
Mailing Address: U / C' -Q lli11l1� Phone:_ _C->� 7 % c) `i..
5. Name of Realtor or Agent: c %9�^ — �/l ._i 1
Mailing Address: r� Phone: -._c -:;Z
6. Legal Description:_ i�i�0�,
Location: L ��� LVA re>��
7. Type of Facility to be Inspected:_,'�As C3-6(?�No. Bdrms.
8. Water Supply
Type of Supply: Public Utility Individual_
If Individual, number of dwellings presently served _
If Individual, depth of well
9. Sewage Disposal System
Type of System: Public Utility_ Individual (on-site) 1,�
If Individual, date of installation 7 — 74�2
L�l� / � �.��.s ./t�l1Z--i �-C-i.-V L� `� (�,-�"s'�= ` Ir-��/,���J� `•d.2J'd ��i-"-y~-�
L04-
72-003(3/76)
72-003(3/76)
Page 2 of two pages - RE st for Approval of Individual er & Water Facilities
Legal Description Lot 14 Block D Glacier View Heicahts
Comments
Approved
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quali
DIAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED _ _ Date
EQ -034 (1/74)