HomeMy WebLinkAboutGREAT LAND ESTATES #1 BLK 2 LT 7
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP231285
Work Type: SepticTank Upgrade
Tax Code Number: 05113111000
Site Legal Address: GREAT LANDESTATES #1 BLK 2 LT 7 G:1260
Site Mailing Address: 23812 GREATLAND DR, Chugiak
Owner: MISNER WILLIAM H & YVONNE V
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
9/15/2023
9/14/2024
80586
Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
ct /?_0 z 'r /+-) D rs T'Lf,L-C e+
Received By:
Issued By:
Date:
Date:
(S 2-0 Z 3
9
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 051-131-11
Property owner(s) Bill & Yvonne Misner Day phone 907-223-2113
Mailing address 23812 Greatland Drive, Chugiak, AK 99567
Site address 23812 Greatland Drive, Chugiak, AK 99567
Legal description (Sub'd., Block & Lot) Great Land Estates #1, Block 2 Lot 7
Legal description (Township, Range & Section)
Lot Size 80,586
Sq. Ft.
Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN: TYPE OF DWELLING:
(M all that apply)
Absorption Field
❑
Initial ❑ Single Family (SF) ❑X
(w/wo ADU)
Septic Tank
MUpgrade
❑X
(D) F-1
Holding Tank
ElRenewal
ElDuplex
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: Z , Waiver Fees:
Date of Payment: Z $ 23 Date of Payment:
Receipt Number: 6 T � 0 Receipt Number:
Permit No. COS P 2- 3 f Z2 Waiver No.
Permit App_.;- :- :' .. c;
May 30, 2023
MOA Development Services, On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Great Land Estates #1, Block 2 Lot 7 - 23812 Greatland Drive
Septic Tank Replacement
Dear On-Site Services Engineer:
The owner of the above lot has a septic tank that has reached its end of useful life, so we are
submitting this permit application for its replacement. The attached site plan identifies the
location of the home as well as the wells and septic location. No conflicts exist between this
proposed system and any other wells or septic system, whether on this lot or adjacent lots. We
are replacing the septic tank with the same size designed for 4 bedrooms.
The new septic tank will be a minimum of 100 from all wells and surface water. Please refer to
the attached plan for the septic design. If this design is followed, there will be no adverse impacts
to adjacent properties.
Sincerely,
Benjamin Schiller, PE
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231285, Curtis Townsend, 09/15/23
GREAT LAND ESTATES #1, BLOCK 2 LOT 7
LOT
GREATLAND DRIVE /
\
10' SLOPE EASEMENT \ \
WATER SERVICE LINE
(LOCATED)
NEW 1,250 GAL SEPTIC TANK
MAINTAIN 10' SEPARATION FROM
WATER LINE
1 00'WELL RADIUS /
LOT 7
10' UTILITY EASEMENT
LOT 8
UNDEVELOPED
�� GE
ENGINEERING
I
DECOMMISSION EXISTING\
/ \TRENCH
I k---Tl-� v //
2x 50' LONG x 5' WIDE x 0.5' /
EFF DEPTH TRENCHES
6' SEPARATION BETWEEN /
MAINTAIN 10' SEPARATION
FROM WATER LINE /
/
/
/
/
/
PLAN AS -BUILT
0 50 100
FEET
111=50'
LOT 4
/
/
/
/
LEGEND
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEAN(
FS - FLOW SPUTTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
GREAT LAND ESTATES #1, BLOCK 2 LOT 7
DESIGN FACTORS:
600 GPD PEAK FLOW
PERK RATE: 1.8 MIN/IN
APPLICATION RATE: 1.2 GPD/SF
SYSTEM REQUIREMENTS-
5-WIDE TRENCH SYSTEM
1,250-GAL SEPTIC TANK
600 GPD / 1.2 GPD/SF / 5' WIDE * 1.0 RED FACTOR (0.5' EFF) = 100 LF TRENCH REQUIRED
(100 LF SPECIFIED)
BOTTOM OF TRENCH: 4' BELOW GRADE
FLOW LINE ELEVATION: 3.5' BELOW GRADE
N.
3'
1 6"
L
5'
PROVIDE ADDITIONAL MIN 6" FILL
TO ACCOUNT FOR SETTLEMENT
GEOTEXTILE FABRIC
4" PERFORATED PVC (HOLES DOWN)
DRAINFIELD ROCK
TYPICAL TRENCH SECTION
(NO SCALE)
NOTES:
1. GRADE AREA OVER TRENCH TO DRAIN AWAY
2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2'
WITH 2" OF INSULATION
3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER
THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY
f,.
5 otl
*:49TH ;*
..........
. ' . • . ..........
Benja'n Schiller '
CE 12592
t111��/'R0
FESSI9NP� �i
Co 8 1
s ` SOILS LOG AND PERCOLATION TEST
E N G I N E E R I N G
LEGAL DESCRIPTION: GREAT LAND EST #1 B2 L7
PERFORMED FOR: A. C . E . S
DATE: 4/24/24 PARCEL ID#: 051-131-11
DEPTH TEST HOLE 1
(feet)
1 1' OB
2 GM (SILTY GRAVEL)
3 _•
4 GM (SILTY SANDY GRAVEL)
a PERC TEST LOCATION
5
6
7 PERC TEST 2 LOCATION
8
•�
9
,
10
•
GM (SILTY GRAVEL)
12
13
�•
14
15
'
16
•,�
•
17
18
19
NO WAS WATER ENCOUNTERED?
- IF YES @ WHAT DEPTH?
9.0' DEPTH TO WATER AFTER MONITORING
5/22/2'. DATE OF MONITORING
DATE
READING
START TIME
NET TIME
(MINUTES)
DEPTH TOET
WATER
N DROP
(INCHES)
INCHES)
4/24
1
12:42
9:16
1 1-
7 16
6 16
2
12:52
10:00
1 16
6 16
5 1s
3
1:03
10:00
1 16
6 16
516
4
1:13
10:00
1 16
616
516
5
1:23
10:00
116
61-
51-
6
1:33
10:00
1 -0
616
516
PERCOLATION RATE: 1.8 (MIN/INCH)
COMMENTS: USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED
SITE PLAN
TECHNICIAN: M. JAKUBISIN
DEPTH
(feet)
1-
2
3
4
5
6
7
8
9
1
11
12
13
14
15
16
17
1
1
r" SOILS LOG AND PERCOLATION TEST
AGE
E N G I N E E R I N G
LEGAL DESCRIPTION: GREAT LAND EST # 1 B2 L7
PERFORMED FOR: A. C . E. S
DATE: 4/24/24 PARCEL ID#: 051-131-11
PERC TEST 2
11 OB
GM (SILTY GRAVEL)
GM (SILTY SANDY GRAVEL)
PERC TEST 2 LOCATION
' GM (SILTY GRAVEL)
4
WAS WATER ENCOUNTERED?
- IF YES @ WHAT DEPTH?
- DEPTH TO WATER AFTER MONITORING
- DATE OF MONITORING
DATE
READING
START TIME
NET TIME
(MINUTES)
DEPTH TOET
WATER
N DROP
(INCHES)
INCHES)
4/24
1
2:05
30:00
116
616
516
2
2:35
30:00
1 16
6 6
516
3
3:06
30:00
116
616
516
FhKUULA1lUN KA'F : b.0 (MIN/INCH)
COMMENTS: USCS SOIL CLASSIFICATION WAS VISUALLY DETERMINED
SITE PLAN
TECHNICIAN: M. JAKUBISIN
0 10 25 50 100
SCALE: 1"=40'
P
` 10' SLOPE—
EASEMENT
1
1
CHAIN-LINK FENCE
Lot 6
10' UTILITY
EASEMENTS
GREATLAND DRIVE
Z
a
2 W
� D
\ J
Lot 8
PLOT PLAN ___ AS BUILT SCALE 1 40' GRID __NW 1260 Project No. 23_39±LL1_
X
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, inc. (907) 522-6476 Phone
ken@langsurvey.com ��
Professional Land Surveyors jonathan®langsurvey.com — of Agkk
travis Dion gsu rvey. com
���
I hereby certify that I have surveyed the following described property: % co * �
LOT 7, BLOCK 2, GREAT LAND ESTATES — UNIT No. 1 (PLAT No. 71-274) * ' 4.91H
Anchorage Recording District, Alaska, and that the improvements situated thereon are •
within the property lines and do not encroach onto the property adjacent thereto, that
no improvements on the property lying adjacent thereto encroach on the surveyed* I "— *1 1 1
premises and that there are no roadways, transmission lines or other visible 9•• KENNETH G LANG
easements on said property except as indicated hereon. f , • No. 5202 •.'�� AW
Dated this the ��'� l f' jg ��AW�
Day of f__ ______, _____, at Anchorage, Alaska FDp -i • -"p
ll� f>r�l+��If is the responsibility of the owner to determine the existence of any easements, �\wOy
covenants, or restrictions which do not appear on the recorded subdivision plat. State of Alaska AECC963
LOCATION
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
IPHONE
J Well Absorption area
DISTANCE TO:
Manufacturer
IDwelling /~)~ /
NO. OF Bz.E_?OOMS
No. of com~ments
Inside length Width Liquid depth
Liq. < WellIF HOMEMADE: Dwelling PERMIT NO.
Manufacturer
I Material
Foundation //7~' Nea rest lot lin e//~ ~'_;/,
Total length~.~f I,~ines I Trench ~.~
'/*-¢ I ,._~(~ inches
Material beneath tile ~,,,~ ,//
inches
Depth
Well
DISTANCE TO:
No, of IJney Length of e~?~e
Length
[] UPGRADE
Liquid capacity in gallons
Dista nce,~/~ Ii,nfs
Total ef fecd~a~.D.ption area
Top of tile to finish grade
Width
PERMIT NO.
Type of crib Crib diameter Crib depth Total effective absorption area
Well Building foundation Nearest lot line
DISTANCE TO:
Class Depth Driller Distance to lot line PERMIT NO.
DISTANCE TO: Building foundation Sewer line Septic tank Absorpt on area(s}
OTHER
PIPE MATERIALS
SOIL TEST RATING '~-~ ~
LEGAL
PERMIT NO.
RF'PL !
L OCFtT I ON
LEGRL
HRRF.:'¢ R MRCKEY
LOT ? BLK 2 r3RERT LRND EST;
t'-llJb~ I C: I F'RL I ]-'-¢ L--IF I-]I'-~L-':HL]RRt3E
DEPBRTMENT ""%IHERLTH RND ENVIRONMENTRL "f"*ITECTION
825 'g STREET, F~NCHORRGE., K4K. -q.D~,¢
264-4720
E~4--S I TE SEbJE~:
~T RT E,U~, &&¢..
LOT SIZE
75~40 SQURRE FEET
TYPE OF SOIL RBSORPTION =,~=,TEM IS: TRENCH
MH,:':,Itl_M NUMBER OF BEDROOMS 4 SOIL RRTING (':,Q FT/BR)=
THE REQUIRE[:, _,I~.E OF THE SOIL RB~CRFTION ~=,TEM
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRCtINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE
GROUND BND THE BOTTOM OF THE E)4CRVRTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
.... I~E_!3REC,.,'BI DEEq]H l_~'] THF .t'!T~'.~.~!)~I QEPTH_~E_lt:' GRRVEL BETI,~EEf~_THE ~PIFZE~____
RND THE BOTTOM OF THE EXCRVRTION (IN FEET).
RED SEPT I ¢: TRNI-':-:' S. I ZE= :1 ;::-'5~-3 GFILLE~t'-IS
PERMIT RPF'LICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DIJRING THE
INSTBLLRTION INSPECTIONS OF RNY WELLS RD.JRCENT TO THIS PROPERTY 8ND THE
NLMBER OF RESIDENCES THRT THE WELL WILL SERVE.
Tb~] ( 2 ) l' ~'4SPE;]T I m]~'-,IS RRF. REg!!J I F-:E[:,
E~RCKFILLIN~.~ OF RNY SYSTEM WITHOUT FINBL IN=,PECTId.~ RND RPPRO'¢RL BY THIS
· ')EPBRTMENT WILL BE SUBJECT TO PRCSEC_TI(N.
~INIMUM DIST8NCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DISPOSBL SYSTEM IS
100 FEET FOR R PRIVRTE WELL OR i50 TO 200 FEET FROM R PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC: WELL
MINIMUM DISTRNCE FROM R PRIMRTE WELL TO R PRIYRTE SEWER LINE IS 25 FEET RND
TO R COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS RRE REQUIRED RND MUST BE RETURNED TO THE DEPRRTMENT WITHIN ~0 DRYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MBY RPPLY. SPECIFICRTIONS RND.CONSTRUCTION DIBGRRMS RRE
RVRILRBLE TO INSURE PROPER INSTRLLRTION.
I CERTIFY THRT
1: I BM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FORTH B9 THE MUNICIPRLITY OF RNCHORRGE.
2: I WILL INSTRLL THE S~STEM IN RCCORDRNCE WITH THE CODES.
~: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THRN 4 BEDROOMS.
-', I ut~E[ ........
RPPL I CRNT
HBRF.:Y R MRC:~.'.:EY
T':':I iF-r) BY ............. [:,RTE : '¢4. 0
I-,-IE L L
PERMIT NO. <
RF'PLICRNT
~ LOCRTION
DEF'RRTMENT CIF. F.F.F.F.F.F.F.F.~,HEFtL TH RND ENV I RONMENTRL F~_~g~TECT I ON
:325 '''/ '_--.TREET., Rf.,ICHORRGE., RK. -:~gf "~'~
' ']~4-4 7';-"A
RI'-4C, I-Ji'-.I--S ]: TE SEI---IER F'EF-: f'l I T
TYPE OF SOIL RBSORPTION SYSTEM IS:
MRXIP1UM NUMBEF.: 0F BEDROOMS =
SOIL F.:RTING (SQ FT,-/BR)=
THE RE,*UIRED SiZE THE SOl' . .:SORPTIO. S'.'STEM
[)EF'TH= ~ L E~'4'3T H = ~ O '3 F~ R "." E L [:.EPTH=
THE LENGTH C'ZMEN~ZON ~ THE LENGTH (IN FEET.'.' OF THE T~ENCH OR DRRJNF~ELD.
THE DEPTH OF R TRENCH OR P~T Z5 THE C'~TRNCE BETWEEN THE SLIRFRCE OF THE
THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE
~NO THE ~OTTOM OF THE EXCaVaTION <IN FEETt.
PERMIT ~PPLIC~NT H~ THE ~E~POH~IBILIT'¢ TO INFORH THIS OEF~T~ENT DURING THE
IH~T~LL~TION IN~PECTION~ OF ~NY WELL~ ~DJ~CENT TO THI~ PROPERTY ~ND THE
NUMBER OF RE~IDENCE~ THaT THE WELL WILL ~E~VE.
8flCKFILLIN~ OF tiNY ~'Y~TEM HITHOUT FINAL INSPECTION ~NE ~PP~OV~L BY THI~
EEP~THENT WILL BE ~U8.TECT TO PRO~ECLITION.
HINI~IJM OI~T~NCE BETWEEN ~ WELL ~NE ~N~ ON-~ITE ~EW~GE D~PO~L ?~'~TEH I~
ie~ FEET FOR ~ PRIVflTE WELL OR 15~ TO 20~ FEET F~OM ~ PUBLIC WELL DEPEHEINO
UPON THE TVPE OF PUBLIC WELL
MINIMUH OI~T~NCE FROM ~ P~IV~TE WELL TO ~ PRIVATE ~EHER LINE I~ 2~ FEET
TO ~ COMMUNITY SE~E~ LINE I~ 75 FEET.
WELL LOG~ ~RE REQUI~EO ~NE MU~T 8E RETURNEE TO THE DEP~RTMENT WITHIN ~:~
OF THE WELL COMF'LET)ON.
O~HER ~EQUIREMEHT~ M~¥ ~PPL¥. ~F'EC)FlC~TIONS ~HO CONSTRUCTION OI~GR~M~ ~RE
~V~ILfiBLE TO IN'LIRE PROPER IH~T~LL~TION.
PERi'"! I T E;-::P I F-:ES C,E;3EI"IE:ER _?..I..
I CERTIFY THRT
±: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FORTH BY THE MUNICIPRLITY OF RNCHORRGE.
2: I WILL INSTRLL-THE S"¢STEM IN RCCORDRNCE WITH THE CODES.
3: I UNDERSTRND THRT THE ON-SITE 5EHER SYSTEM MR'¢ REQUIRE ENLRRGENENT IF THE
. _ _ MORE
RE~IDEHEE I~ REMODELED T0 INCLUDE THRN 3 BEDROOMS.
~ I OWED: ......
~P~L I C~NT
ISSUED BY_ ' _C,~TE__ ./ 0 ', 4. 0
PERFORMED FOR~
LEGAL DESCRIPTION:
THIS FORM REPORTS:
CONS
TEST
MACKEy
L~ 7
T.K3CTtON
LAB
Block 2-Unit 1
Visual Soils Examination
180C~/. 48TH AVE. STE. 'C'
ANCHORAGE, ALASKA 99503
248-1333
DATE PERFORMED: 8/1/80
Subdivision Great Land
Percolation Test
ACTL-80--1412
DEPTH SOIL
FEET DESCRIPTION NOTES
6" TOPSOIL
~ 1 ' ORANGE/BRN SA-CRV,
GRAVELLY SAND
-SP-
-
13'
BOTTOM OF HOLE
WAS GROUND WATER ENCOUNTERED NO
IF YES, WHAT DEPTH
LEGEND
® -- Perc zone
®S- Sample taken
~1 -- Frozen zone
GENERAL SITE SLOPE
Water table
READING "DATE GROSS TIME NET TIME DEPTH TO H2_O NET DRAINAGE
PERCOLATION RATE:
PROPOSED INSTALLATION
COMMENTS:
DRAINAGE REQUIREMENTS: 150 Sq. Ft./BEDROOM
0 SEEPAGE PIT [9 DRAIN FIELD D OTHER
TEST PERFORMED BY: L.B. DATA CERTIFIED BYI: KINNEY R. BAXTER: ~.~..
' DATE: 8/1/80
SULLIVAN wATER WELLS
P. O; BOX 272,._OHUGIAK; ALASKA'99567~';' TELEPHONE 688-2759
OWNER OF LAND
ADDRESS ~Tt(
LEGAL DESCRIPTION
PERMIT NUMBER
DEPTH OF WELL qO a
STATIC LEVEL OF WATER FT. / ~! ~'
DRAW DOWN FT.
GALS. PER HR / °1' ~
KIND OF CASING ~ ~ 6 ~
KIND OF FORMATION: :
From ~ Ft. to '3 Ft. Oc"~ ~50~0~'"9 From--
From Ft. to Ft. ~ ~. ,~ ~ Y From
From Ft. to Ft. ~~ From~
From ~[ .Ft. to lJ~,Ft. C~f ~0~< ~ From~
From Ft. to Ft._ /~a '~ ~3' From
From t~-~ Ft. to 1~ Ft. ~ oe-~< ~ From-
From I ~o Ft. to I,~ Ft. /3~,qoc./< d~o~ From
From ] ff~ Ft. to -~°~Ft~ ~eoc ~ From
From--.Ft. to ' Ft. ~'/
From '~/&~- :Ft'to-~.2ac~'Ft~ "'
From Ft~ to--Ft. 0 ~ ~ ~40 From
From ~'~Ft. to ~ctqFt. l,~u~<r~O
From Ft. to Ft~" / O fi~ ~ t°/~' From__
From Z~q Ft. to~ Ft. ~O<l~ ~0</~ From
Ft. to
Ft. to
Ft. to
Ft. to
Ft. to
Ft. to
Ft. to;
Ft. to i
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Ft. to
MUNICIPALITY OF ANCHORAGE
Ft. DFPT. OF HEALTtt &
ENV'IRONMENTAL PROTSCTION
Ft OCT 2 3 1980
Ft DEfEI\/E~
.1\ L M, L i V
Ft.
Ft.
Ft.
Ft.
Ft._
Ft.
Ft.
Ft. to Ft.
"Ft~ to'' ~ "-Ft. 'i
?'
Ft. to .Ft:
.Ft to
FL to
Ft. to
ADDRESS .Y [~ ~X 7l 70
DATE-Started ~t~O Ended
PE~IT NUMBER ~ 6 ~), 7 7~
DEPTH OF WELL ~ ~
STATIC LEVEL OF WATER
DRAW DOWN FT.
GALS. PER HR ~
KINDOF CASING ~ ~
KIND OF FORMATION:
From o~
From'~ ~
From ~t~,~' Ft. to 4 ~ Ft.
From ~ 7 Ft. to / ~ '~ Ft.'
From Ft. to , Ft.
From / ~'~y)~ Ft. to /~ ~ Ft.
From t~ Ft. to ,~ol Ft.
From ~O/Ft. to ~f~lFt.
From :&~Ft. to &~Ft.
From ~ 9~ Ft. to ~0 Ft.
Fromm. Ft. to~Ft
From~Ft. t° Ft.
From Ft. to Ft.
From Ft. to Ft.
From . Ft. to Ft.
From Ft. to Ft.
Ft. to ~'~ 'Ft.
Ft. toc'~G. Ft. ff-~/~.
Ft. to4-~- Ft.
From--
From
From__
From
From
From.__
,/~.~, 0 ,~,ff,~7 From.·
From
~} "~ ~t~/ From
From
From
From
From
From
From
From
Ft. to__
__ Ft. to
Ft. to
Ft. to
· 'Ft. to
Ft. to
Ft. to:
__Ft. to
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Ft.
MUNICIPALITY OF ANCHORAGE
Ft. DEPT. OF HEALTH &
ENVIRO,NMENTAL PROTECTION
Ft
Ft, OCT 9, 3 1980
FtD Et' r I Xl E I~
i\ L ~., I.. I V
Ft
Ft
Fto.
MUNICIPALITY OF A~CHORAGE
.FDEPT, OF HEALTH &
ENVIRONMENTAL PROTECTION
Ft,
r 1 4 t9b
Ft.
Ft.
Ft,
Ft.
Ft.
Ft.
MISCL. INFORMATION:
C. ,6' r , ~.) 6
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 10t, block, subdivision, section, township, range)
Lot 7; Block 2; Greatland Estates Subdivision ~ l
Location (address or directions)
(b)
Property owner
Mailing Address
State of Alaska Telephone: (home)
P.O. Box 58, Juneau, Alaska 99811-0400
Business
(c) Lending Institution
Mailing Address
Telephone
(d) RealEs~te Company and Agent ALL STAR REALTY/Darlene Romine
Address 2207 East Tudor Road, Suite 33, Anchorage, Alaska 99508
Telephone 561-7827
(e)
Mail the HAA to the following address: (or check here r~, if hold for pick up.)
List contact person and day phone number below:
S & S ENGINEERING/694-2979
17034 Eagle River Loop Road, Suite 204
Eagle River, Alaska 99577
2. TYPE OF RESIDENCE
Single-Family ~ Number of bedrooms 4
3. WATER SUPPLY
Individual Well 6~
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 I~ 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, Iverifythat 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.
Name of Firm Telephone ~/~ ~'~"'"~ ,~'
$ & $ ENGINEERING
Address !70~A E~I'_e River Loop Road No. 204
E~gle River, Alaska 9,577 ~~
Date
6. DHHS APPROVAL .., , , .
Approved for /~ o~¢~rooms by ~¢~/~-"' ~ ¢ ~ ~" ~ Date
Approved ~ _ Disapproved Conditional
Terms of Conditional Approval
The Municipality of Anchorage Department of H6alth and Human Services(DHHS) issues Health Authority Approval
cerificated based only upon the representations given in paragraph 5above 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 DHHSdo not conduct inspections
or analyze data beforeacertificateisissued. The MunicipalityofAnchorageisnot responsible for errors or omissions
in the professional engineer's work.
72-025 fRev 7/88) Bac~ Page 2 of 2
/,'"~c~ .O~IUNICIPALITY OF ANCHORAGE (MOA) ~
(,.~__ ~X~ Health Authority Approval (HAA) /~[~
~~, 343-4744 ~ -
A. WELL DATA ~
Well Classifibation ~%,~ ~.' IfA: B, C, D.E.C. Approved (Y/N) ~/~
Well Log Present ~N) ~Date Completed ~-~-~b. Yield
Total Depth+0~* Cased toZ~"~Depth of Grouting ~"
Static Water Level ~\\~
Casing Height Above Ground
Electrical Wiring in Conduit
Pump Set At 'O~,,
Sanitary Seal on Casing (~t~l) ',~
Depression Around Wellhead (Y/~3 I~
; On Adjoining Lots
~. co L~ ; On Adjoining Lots
To Nearest Public Sewer Cleanout/Manhole
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot '~-~
To Nearest Edge of Absorption Field on Lot
To Nearest PUblic Sewer Line ~ IA--
To Nearest Sewer Service Line on Lot ~-~'
Water Sample Collected by ~"~', ~'~ ~e'~L~r~"~4~41~C~ ; Date ~(~
Water Sample Test Results ~'~'~'~'~,~",,~'~"'~'~----~ --"-'~'"~,~-'~--~'- ~
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed '~--\7..- c~qSize \'Z~-Z~
Standpipes I~N) ~ ~ Air-tight Caps (t~)
Depression over Tank (Y/~) ~ ~
Pumping/Maintenance Contact on File (Y/N)
Holding Tank High-Water Alarm (Y/N) I~-//k'~ Temporary Holding Tank Permit (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water-Supply Well \ o~ wY-- To Building Foundation ~'~ ~'-
To Property Line \~ To Disposal Field .~-I
To Water Main/Service' Line \ ~ ~'~"
To Stream, Pond, Lake or Major Drainage Course \ ~ TM ~-
Comments i~0~P¢---..~::, ~ "'~'~'~:z~ . C..~--~..-
No. of Compartments ~--
Foundation Cleanoutd~)N)
Date Last Pumped ~L~o
; for
72-026 (Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Type of System Design
Length of Field -~-L~~
Depth of Field o~
Square Feet of Absortion Area _
Depression over Field (Y~'~
Results of Last Adequacy Test
'SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well ~, L~O
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 ,/-"/¢'. ~ e/,4./J
Gravel Bed Thickness ~
/ ~ Statndpipes Present (~/N)
tJ Date of Last Adequacy Test
To Property Line L~
To Existing or Abandoned System on
; On Adjoining Lots
To Cutback (if present)
fOr-
D. LIFT STATION
Date Installed
Size
"Pump On" Level at
Dimensions
Manhole/Access (Y/N)
"Pump Off~
High Water Alarm Level at '"'-"'"-'"---~ ,-----~'"~ent (Y/N)
Tested for -~:x:~-~_.,~ Pumping Cycles during Adequacy Test.
Meets MOA Electrical Codes ~ ~.
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 bhe~.ciate of this
inspection.' ~?~ L)1~-,,3¢, ~,,,
Date EagleRiver, Ala,ka,PSZ7 /~/,i/ ~ o~ /// /0
MOANo. ¢~ ~~ __
Receipt No. ~~ ¢ . % ~ Receipt No.
Date of Payment /0 ¢// ~b Waiver Fee: $
Amount:$ / ~O~ Date of Payment
72-026 (Rev. 7/88) Back Page 2 of 2
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
5633 B STREET · ANCHORAGE, ALASKA 99518 · TELEPHONE (907) 562-2343
FEDERAL TAX I.D. #92-0040440
ANALYSIS REPORT BT SAMPLE for Work Order $ 27816
Date Report P~inted: OCT 8 90 @ 16:44
Client Sample ID:L7 52 GREATLAND EST.
PWSID :UA
Collected OCT 3 90 @ 20:15 ks.
Received OCT 4 90 @
Preserved with :AS REQUIRED
Client Name : S & S ENGINEERING
Client Acct: SNSENGP
P.O.$ NONE RECEIVED
Req $
Ordered By : R. SHAFER
Analysis Completed :OCT 5 90 Send Reports to:
Laboratory Super~sgr ~STEPHEN C. EDE 1)S & S ENGINEERING
Special
Instruct:
Che~mlab Ref #: 904064 Lab Smpl ID: 3 Matrix: WATER
Allowable
Parameter Tested Result Units Method Lir~ts
NITRATE-N 0.14 mR/1 EPA 353.2 10
Sample ROUTINE SAMPLE.
Remarks: COLLECTED BY RAY.
i Tests Performed ' See Special Instructions Above UA:Unavailable
ND= None Detected "See Sample Remarks Above
NA= Not Analyzed LT=Less Than, GT=Greatez Than
:;:.:,:~ ~ ~ · ,~::MUNICIPALITY OF ANCH ~
/ l: I :'l > ::::::::::::::::::::::: DEPA.TMEND~F HEALTHAND ENvlRO.~i~ENTAL p. OTEcTi'ON : I l
' :'~: :~::( ::::' ':" ~": ':": : ::; iSION OF E"VIRONME.TAL HEALTH
': CERTIFICATE OF INSPECT ON FOR HEALTH AUTHORITY ~PPROVAL
, .': : . . .: OF ON-S TE SEWER AND WATER FACiLiTv .
~ (a)' Legal DeScription (include ?t, block, SUbdivision, seCtiOn, township, range) : ~ . .
, :: ' LOcatiOn (addreSs OrdireCtiOn~) : ::' : ~ .::: ( = , ::
~ .::, , ::.~:-. ~.:.:,' ~:'::'~ :. .... :: Y : elephone Home ~RR-35
?i? :! ::?: ~". ii. TYPE OF RESIDEN
3: WATER SUPPLy ' ' :: ;'
· Individual W~II
No · ' '
: Note: If cOmmunity well System, must have written:confirmation from the State Department of Environmental Conservation
atteSting to the legality and status.
Page I of 2
72-025 (11/84)
:AUtb0ritYA°Pr°Va Sh0wSthat~ °n-s {e~ater~u~Pp yand/~rwastewate~:d sl~ .~ system ssafe, funct ona and adequate .
f0.r {he number °f bedr°°ms ~d t~Pe'of St~uct~ure ind Ca{ed herein~ fUdhe~ verify that based on the information obtained
f~om the Municipality of AnChOrage files ;a~d: from my investigation and i~spection, 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
Address S~ 196X Eagle River ~ 99577
Approved '~ : ~i~pprOved COnditional.
The Muncipality of AnChorage Department of Health and Environmental Pr°teCti0n;('DHEp) issues Health Authority
Approval certificates based soleiy upon the representat °ns g yen in Paragraph 5 abOve by an independent profess ona
:engineer:r~g Stered in t:he s¢ie of A aska The DHEP d~e~ ihis a's'a courtesy td PUrchasers of'h0rneS and their end ng
;:; ~;ii~StitUti0n~.in °rder'~ ~at ~f~ ~e'r:t~ n fed~f~i and State requirements:' Emp oy~es: 6f DREP don0t conduct inSpections or
analyze data befOre a certificate is isSued. The MuniCipality of AnchOrage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-025 (11/84)
MUNICIPALITY OF ANCHORAGE (MOAJ
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description:
MUNICiPALiTY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
i: 3 1 41986
WELL DATA
Well Classification --~1L/,~.--~-- If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (~¢~" Date Completed ~-~..~--~:~c~ Yield
Total Depth LtOO'~ Cased to J2-'''4~ I ~ Depth of Grouting LA.'~.
Static Water Level ~, r~ O~
Casing Height Above Ground
Electrical Wiring in Conduit ~.N~
Separation Distances from Well:
To Septic/Holding Tank on Lot
Pump Set At
Sanitary Seal on Casing
Depression Around Wellhead,¢¢~
J COO, ~ ''~ ; On Adjoining Lots
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
To Nearest Edge of Absorption Field on LOt ~, f~ ~ ~4- ; On Adjoining Lots
t-.J ~ To Nearest Public Sewer
t,J ~_ To Nearest Sewer Service Line on Lot
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed ~;~-~'7-'-¢C~O Size J 7---~-¢ No. of Compartments
Standpipes~_Y,~PF. Air-tight Capsj~CV, N~ Foundation Cleanout,(.~
Depression over Tank.,ef~ Date Last Pumped
Pumping/Maintenance Contract on File (Y/N) ~¢r · for
Holding Tank High-Water Alarm (Y/N) /"1)/~ Temporary Holding Tank Permit (Y/N) t.--/
Separation Distances from Septic/Holding Tank:
To Water-Supply Well I°6) ~ ~' To Building Foundation '
To Property Line Z'°~ "~ To Disposal Field
To Water-MaN~/Service Line JO ~ ~ To Stream, Pond, Lake, or Major Drainage
Course
Comments
Page I of 2
ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field/¢~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well [ 0 ~ ~ 4..--
To Building Foundation ~ ~
Lot NI ~
To Water,Mei. WService Line Z-C:~ ~
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments"~t",~ ~,,/~.~¢_~_ TH.~-r ~
Length of Field r~-c~
Depth of Field
Gravel Bed Thickness
Standpipes Present ~
Date of Last Adequacy Test
Type of System Design
To Property Line \ O
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if present)
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
Signed $ & S
.~RB
Receipt No.
Date of Payment
Amount: $ ~
** 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.
Date 2,
MOA .o.
Page 2 of 2
72-026 (11/84)
14 DATE~ /~ RECEIVED
INSPECTION APPOINTMENTS
TIME TIME '..~ %.~. TIME
DATE DATE
INSPECTOR INSPECTOR I N S P E C-T~ R
MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGF~
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF HEALTH &
825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL PROTECTION
ENVIRONMENTAL SANITATION DIVISION [}C~' ~_ 0 1980
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER E/~t~E D
DIRECTIONS: Complete ail parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1 PROPERTY 0~,~ER __ //~J /y2 // ~U~,~/'
MAILING '" S . -' /~'.~ '
pR Dp ERTY RJ~SI DENT (I.f/differeC)~t from above) ,Cd
PRDNE
MAILING ADDRESS
3. LENDING/f~TITUTIO~I_ [ ./.-~ ~ .'~ ("-'o P 0
MAILING ADDRESS
5. LEGg~L DESCRIPTION ~ ~ .~ / /~ ¢..,~ ./ /,/'~ - ~' -' ~
S~R~T EOCA~ION ~ ' ~ ~ . ~ '
6. TYPEOF RESIDENCE ~ /- NUMBER OF~BEDROOMS
~ Four ~ Other
One
~ SINGLE FAMILY ~ Two ~ Five
~ MULTIPLE FAMILY ~ Three ~ Six
7. WATER SUPPLY
~l~ INDIVIDUAL*
COMMUNITY
[] PUBLIC UTILITY
*ATTACH WELL LOG. Awell log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON-SITE** YEAR ON-SITE SYSTEM WAS INSTALLED.
[] PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 (Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[] INDIVI DUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified
INSTALLER
[]Septic Tank or [] Holding Tank
Size: /~-2~-0 If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER /~. _ ,,.~__
TOTAL ABSORPTION AREA MATERIAL
4, DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line
I
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS
[] CONDITIONAL APPROVAL {letter m~ccompan¥ certificate)
I~ DISAPPROV ED ~