HomeMy WebLinkAboutHOMESTEAD HILLS BLK 2 LT 1Homestead Hills
Lot 1
Block 2
#01 5-1 73-1 6
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program, 4700 South Bragaw St. ,,, , , TV
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us (907) 343-7904 Page 1 of 3
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number. SW040071 PID Number. 015-173-16
Name: KELLY HARRIS
Wastewater System: O New ■ Upgrade
Address:
4300 TRAPLINE DRIVE
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 770-0430 4
■Deep Trench O Shallow Trench O Bed O Mound OOther
LEGAL DESCRIPTION
san Raves: 0.8
Total Depth from original grade: Ft.
CPO/Sq
Block: Lot: Subdivision:
Depth to pipe bottom from orlginal grade:
Crawl depth beneath pipe:
2 1 HOMESTEAD HILL
2.34 Ft.
9.66 FL
Township: Range: Section: —
— —
Ful added above original grade:
Grovel length:
40
SEE DWG. rL
FL
Grovel width;
Number of Imes:
Dleianee between Ines:
WELL: 0 New p Upgrade
2.5 FL
1
— FL
Classification Private, A,B.0 : Total De
Cased To:
Total absorption ores:
Pipe material;
FL
FL
773 so. rL
D 3034 F-810 SCH-40
Driller. G Date Drilled:
Static Wotw Level:
Installer.
A+ HOME SERVICES
Date installed:
5/5/2004
FL
Yletd:pump
Set At
Casing Height Above Ground:
TANK
GPS
rL
SEPARATION DISTANCES
■Septic E3 Holding 0S.T.E.P. 0Other
To
Septic
Absorption
Uft
Holding
Public/Private
Manufacturer.
ANCHORAGE TANK
capacity In gallons:
1250
From
Tank
Field
Station
Tank
Sewer Line.
Well
100'+
100'+
—
—
25'+
Material. STEEL
"""'b'r of comportments:
2
Surface Water
100'+
100'+
—
—
—
LIFT STATION
Size In gallons:
Manufacturer.
Lot line
5'+
*2'+
—
—
—
500
ANCHORAGE TANK ORENCO SYSTEMS
mp on level at
mp o level at:
High water alarm at,
Foundation
5'+
10'+
—
—
—
28
1 28
1 34
Pump Make ! Modelo
Electrical Inspections performed by:
Curtain Drain
NONE KNOW
#20 OSI 05 HHF
M.O.A.
BENCH MARK
Remarks: OLD SEPTIC TANK WAS ABANDONED
Location and Description:
PER UPC.
TOP OF GARAGE SLAB ® WEST CORNER
*LOT LINE WAIVER GRANTED WITH SEWER PERMIT
A"med Eievotlon. 100.00
FL
ENGINEER'S SEAL
�0 4
Inspections performed by: GEG, Ltd. Dates: 1st 4/26/2004.
............ .Q
2nd 4/28/2004
3rd 4/29/2004
r G ness.:
Development Servic s Departm nt pproval°�,
f' E-7953 `
�000
Date: '�"
�OOdProfesslo'r%°oma
Reviewed and approved by:
(Rev. 12/01)
DD��ppO�
PERMIT NUMBER: AS -BUILT DRAWING PARCEL NUMBER:
-
SW040071 015-11 73-16
NOTE: THE WATER MAIN THAT SERVES HOMESTEAD TRAPLINE DRIVE
HILL SUBDIVISION RUNS ALONG THE NORTH SIDE OF
TRAPLINE DRIVE (SEE ATTACHED DRAWING.) APPROXIMATE LOCATION
NEW DRAINFlELD OF WATER KEY BOX
\ I
\ _—_ ---- v
\ _ APPROXIMATE LOCATION
OF WATER LINE
NEW 500 GALLON
UFT STATION
I
DBL3 do DBL4 /
NEW 1250 GALLON
SEPTIC TANK—"
DELI do OBL2 --e'
/W
D
Q
n
� I
�I m
f !a /
,i EXISTING DRAINFlELDS
s TO BE USED AS AN
p RESERVE SITE.
2 INCH PRESSURE LINE UNTIL 5 FEET
OF DRAINFlELD SWITHCED TO 4 INCHES
10' UTILITY EASEMENT
DATE:
r� 05/10/2004
4 DRAWN BY:
GARNESS ENGINEERING GROUP, Ltd. SCALE' M.E.w
CONSULTANTS 3 GENERAL CONTRACTORS 1 = 30,
3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE. AK 99507 • PHONE (907)337-6179 • FAX (907)338-32L6
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
KELLY HARRIS (907) 770-0430 2 OF 3
LEGAL DESCRIPTION:
HOMESTEAD HILL S/D; BLOCK 2, LOT 1
TYPE OF WORK:
AS -BUILT DRAWING OF SEPTIC SYSTEM UPGRADE
-*'OF
ffrP',
ar ssr *,
9 9
Iwi, �'r f e s
fin. -
A
B
ST1
20.02
42.03
ST2
24.64
46.57
DBL1
19.31
38.08
DBL2
19.31
39.6
DBL3
27.89
48.46
DBL4
28.99
49.06
C01
110.41
97.81
MT1
111.70
98.42
CO2
116.94
85.31
MT2
117.49
86.02
ST3
29.59
59.56
MH
31.64
50.94
-*'OF
ffrP',
ar ssr *,
9 9
Iwi, �'r f e s
fin. -
TOP OF TANK
AT INLET - 95
TOP OF TANK
IN - 93.10,
TOB OF BUNG
IN - 92.99.
INVERT OF BUNG
AT INLET - 94.57
TOP OF MANHOLE .- 98.5
t
*i ISI r
JAL GRADE
- 99.03
NEW 1250 GALLON
SEPTIC TANK
TOP OF TANK
OUT - 93.10
ST2
ORIGINAL. GRADE
- 97.87 O
HIGHEST POINT -
DATE:
5/11/2004
DRAWN BY-
GARNESS ENGINEERING GROUP, Ltd. SCALE. RAL
CONSULTANTS & GENERAL CONTRACTORS
3701 E. TUDOR ROAD. SUITE 101 ' ANCHORAGE. AK 99507 . PHONE (907)337-6179 • FAX (907)338-3246 N.T.S.
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
KELLY HARRIS (907) 653-7204 4 OF 4
LEGAL DESCRIPTION:
HOMSTEAD HILL SUBDIVISION; LOT 1, BLOCK 2,
TYPE OF WORK:
20 SCALE PROFILE AS -BUILT
TOP OF TANK
AT OUTLET - 94.94
-INVERT OF BUNG
AT OUTLET - 94.35
TH
FINAL GRADE
- 99.53
--�r-FILTER FABRIC
INVERT OF PIPE
- 95.53
,M OF
- 85.87
GARNESS ENGINEERING GROUP, Ltd.
--- CONSULTANTS & GENERAL CONTRACTORS .
May 11, 2004
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907) 343-7904
Ref: Notification of revisions made to design during installation of septic system on Homestead
Hills S/D; Lot 1, Block 2 (4300 Trapline Drive).
To whom it may concern:
The original design permitted on 4/22/04 (Permit #SW040071) consisted of two trenches that were to
be 12 feet deep maximum by two and a half feet wide by 40 feet long. Installation of the proposed
septic system began on 4/26/04. Prior to breaking ground the test hole was checked by A+ Home
Services for groundwater and was found to be dry to a depth of 18 feet. The north trench was installed
with no obstacles. During installation of the south trench water was encountered seeping in at the east
end of the excavation at a depth of approximately 10 feet. The seep did not subside and the trench
began to fill with water. The second trench was backfilled, and Dan Roth verbally approved a revised
design on 5/3/2004.
The revised design proposed a drain field that was to be 12 feet deep maximum by two and a half feet
wide by 35 feet long running north south. Installation of the revised system began on 5/4/04, at which
time water was again encountered at approximately 10 feet. Installation of the revised design halted
while a new design was approved verbally again by Dan Roth.
The third trench was backfilled, and the new and final design installation was begun. The first
drainfield was unburied and additional four and a half feet of rock was added. This revision was the
final design, and the details of the installation are included in the inspection report. If you have any
questions regarding the installation of this septic system please feel free to call our office at (907) 337-
6179.
Thank you for,y assistance.
P.E., M.S.
3701 E. Tudor Road, Suite 101 *Anchorage, AK 99507
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: gamessengineering.com
VY -11-2004 07:33P FROM:A+ HOME SERVICES, IN 907-868-6770 TO:3383246 P:1/1
■� - Z�3L
�tFax 5/11./2004 6:31 PAGE 1/1 RightFax
■
Inspection Report
Municipality of Anchorage, Building Safety Division
4700 South Bragaw
INSPECTION; VOICE 343-6300 INSPECTIONS FAN (907)249-7777 INFO! 343-7962
Name ED'S ELECTRIC Permit 04-7771
Address 4300 TRAPLINE DR Phone 272-4591
Legal 8K 2 LT 1 Inspection Date 5/11/2004 PM
Subdivision HOMESTEAD HILLS
CommAnts or Directions
LATE PM"*'CALL B4 FOR SITE MEETLIFT STATION
Inspection Riatro Electrical Reinspection N
NO NONCOMPLIANCE OBSERVED
[� CORRECTIONS ESSENTIAL AS EXPLAINED BELOW
WILL RE-EXAMINE AT NEXT DO NOT CONCEAL UNTIL REINSPECnDN
INSPECTION -
-0011414=N'L"S: (for inspector use onty)
L�L`T"FZIC.�� UNTx-_-�(2'oUtjb1
`�l�►-rl oto
snspecber
MAY -11-2004 TUE 05:24PM ID:A+ HOME SERVICES, INC. F✓wuE:l
_ I MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & 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: Apr 22, 2004
Expiration Date: Apr 22, 2005
Permit Number: SW040071 Parcel ID: 015-173-16
Legal Description:' HOMESTEAD HILLS BLK' 2 LT. V
Design Engineer: 0041 AK Water & Wastewater Consultani Site Address: 004300 TRAPLINE DR
Owner Name: YQ,\' y JAaY Y\S. Lot Size: 23434 SQ. FT.
Owner Address: t4 360 ( Y(PNT6 t3edrooms: 4 Permit Bedrooms: 4
Anchorage , AK 9951 ID D +(
This permit is for the construction of:
❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3. The engineer must notify 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.
J-16 /Of E A/G-. W 6 N TS 7-0 Ali OV 6?L E &)6/ VEL
T6 FNC l ( 4 jV1712 S'00 G 19aaAl LIFT- 5 Ti�4 T"vav � OFA r- T� T•�r �"
SD t4T/4 7 -Pr -MCH
Received By:
Date: Z&4x
Issued By: �L/►_�-'- Date: x62,Leg
Municipality of Anchorage
Mark Begich, A7ayor
Building Safety DIVIsion
P.O. Box 196650 • 4700 Bragaw Street
Anchorage, Alaska 99519-6650 • (907) 343-8301 • Fax (907) 343-8200
littp://«1«v.mtuil.org
4/22/2004
Jeff Garness
Garness Engineering Group, Ltd.
3701 E. Tudor Road, Ste 101
Anchorage, AK 99507
Subject: Waiver Request for HOMESTEAD HILLS BLK 2 LT 1
Waiver Request #WR040018
Parcel ID #015-173-16
PERMIT # SWO40071
Dear Jeff Garness:
Your request for a waiver of the required 10 feet horizontal separation from the
absorption field to property line has been approved. The approved separation distance is
2.0 feet.
This waiver approval applies to the existing absorption field to property line separation
only. Any future upgrade to the on-site wastewater disposal system will require all
separation distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
oodall
ivil_Engineer
On -Site Water & Wastewater Program
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
Waiver Review Worksheet
WR#: 040018 PID#: 015-173-16 HAM Permit#: SW040071
Date Received: 4122104
Legal Description: Homestead Hills Block 2 Lott
Engineer: Jeff Garness
Garness Engineering Grout), Ltd
Applicant: Kelly Harris
Waiver Requested: 2' Lot Line Waiver for existing and new set)tic system to north lot line
Criteria:
Geology
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
Points:
SA F1 ETY
..............................................................................
Waiver is Granted: Waiver is not Granted:
List Conditions or Reasons for above:
Date: Z-ao q By: TOO 6me14-1/
Name of Reviewer
...............................................................................
Rec#: 50518 Amount: $175 Date Paid: 412212004
Municipality of Anchorage
• "� Development Services Department
Building Safety Division ` S • IF y
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
Parcel I.D.
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
/6 Permit Number.5WOg00 1L
Property owner(s) KELLY HARRIS Day phone 770-0430
Mailing address (1) 4300 TRAPLINE DRIVE * ANCHORAGE AK
Mailing address (2)
Zip Code 99516
Legal description (Lot, Block & Sub'd.) LOT 1 BLOCK 2• HOMESTEAD HILLS SUBDIVISION
Legal description (Section, Township & Range) N/A
Lot Size Z 3 , 46'41 Acres/Sq.Ft.
THIS APPLICATION IS FOR:
Number of Bedrooms 4
Sewer Only ❑ Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade N
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.
GARNESS ENGINEERING GROUP Ltd.
Permit Fees: Q Waiver Fees
Date of Payment: 1-1 115 kq Date of Payment:
Receipt Number: Oc) ) SW Receipt Number:
OARNESS ENGINEERING GROUP, Ltd.
R=-- . CONSULTANTS & GENERAL CONTRACTORS ��
April 12, 2004
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907) 343-7904
Ref: Proposed Septic System for Lot 1, Block 2; Homestead Hills Subdivision
To whom it may concern:
The proposed 4 bedroom house is served by a community well and a private septic system. The
current septic system is in a state of failure and must be upgraded. We are proposing to install a
1250 gallon septic tank and a dual 5 -wide trench type drainfield. One test hole was excavated on
the property. The drainfield will be designed around the 30 foot radius of this test hole.
Comments regarding the design are summarized as follows:
1. SOILS: See the attached log which shows the soil classifications, groundwater monitoring,
and the percolation test results. It is our opinion that an application rate of 0.8 gallons/day/ft2
should be used.
2. TRENCH DESIGN:
a.
Percolation Rate: 5 minutes/inch
b.
Proposed Application Rate: 0.8 gallons/day/ft2
c.
Number of Bedrooms: 4
d.
Design Flow: 600 gallons per day
e.
Minimum Absorption Area: 750 ft2
f.
Total Depth: 12 feet (max.)
g.
Effective Depth: 5.0
h.
Width: 2.5 feet
i.
Reduction Factor: N/A
j.
Minimum Length: (2 @ 40') 80 feet long total
k
Effective absorption area = 800 ft2
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic
system.
3701 E. Tudor Road, Suite 101 * Anchorage, AK 99507
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: garnessengineering.com
4. TOPOGRAPHY: The area around the proposed drainfields is relatively flat. In short, there
are no slope concerns.
5. LOT LINE WAIVER: We request a lot line waiver to from the north and west lot line to the
proposed and existing septic system. There are no wells or septic systems that will be affected
with the granting of this waiver.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. - If you have any questions, please contact us at 337-6179. Thank you for your
nccicMnne
NOTE. A site play: drawing, a design drawing, a soils logs, topography site plan, and a 7 page
construction specification letter which are all part of the design package for this septic system.
3701 E. Tudor Road, Suite 101 *Anchorage, AK 99507
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: gamessengineering.com
� - - - - - - - - - - - - - - - - - - - - - -
- - - - - - - - - - - - - - - - - - -- -
L
-1-----------------------
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/ HOMESTEAD HILLS S/D;
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I i 100' WF1 RADIUS
\
l CpOMMUNITY
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SERVED BY
CO0 MUNITY COMMEULLNITY
SERVED BY
COMMUNITY
I
WELL
I ,
I HOMESTEAD HILLS S/D #1;
LOT 1. BLOCK 3.
I �
PTIC I
I I SSE I
k I ARS
11 1
PROPOSED SEPTIC UPGRADE
I I (SEE DESIGN PAGE 2 OF 2)
II �
I I HOMESTEAD HILLS S/D /1; --_
I I LOT 2. BLOCK 3.
EXISTING
1 I / 4 BEDROOM
I I EPTIC j HOUSE
CS
i I ARS I
I I \\
II
I \�
I _ �
I
I
I
I HOMESTEAD HILLS S/D #1;
LOT 3. BLOCK 3.
1
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TRAPLINE DRIVE
/-4HJ1-IXISSNG SEPTA
SYSTEM,
1
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BIRCHBARK_ AVENUE _________-
GARNESS ENGINEERING GROUP, Ltd.
nsvr.cn.m,�Rsm.xn®a..+� CONSULTANTS & GENERAL CONTRACTORS
3701 E. TUDOR ROAD SUITE 101 1 ANCHORAGE. AK 99507 • PHONE (907)337-6179 • FAX (907ma-3246
PREPARED FOR PHONE NUMBER:
KELLY & KEVIN HARRIS 770-0430
LEGAL DESCRIPTION:
HOMESTEAD HILLS SUBDIVISION; LOT 1, BLOCK 2,
TYPE OF WORK:
SITE PLAN FOR SEPTIC SYSTEM UPGRADE
DATE:
4/12/2004
DRAWN BY:
C.J.G.:.
% Yr -
SCAIF
1" = 100,
.....
.....
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.. . . • ...
'
PAGE NUMBER:
1 OF 2
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953
I NOTE: THE WATER MAIN THAT SERVES HOMESTEAD TRAP LI N E DRIVE
HILL SUBDIVISION IS RUNS ALONG THE NORTH SIDE
OF TRAPLINE DRIVE (SEE ATTACHED DRAWING.) APPROXIMATE LOCATION
OF WATER KEY BOX
\ \ r 2' LOT LINE WAIVER
\ i REQUESTED
� r-
' � I
� I
I
INSTALL FLOW
SPUTTER
INSTALL FLOW
SPUTTER
INSTALL FLOW
QNERTER
I I
I
INSTALL DOUBLE
CLEANOUTS
PROPOSED 1250 /
GALLON SEPTIC TANK
I 2
INSTALL DOUBLE
CLEANOUTS
EXISTIIG SEPTIC TANK /
TO BE COMPLETELY
ABANDONED/
I /
I �
LLJ
/ IY
0
I
I�
m
ETMi _— • :�i_ e
- - - - p /
/ / / N
— EXISTING DRAINFlELDS
TO BE USED AS AN
RESERVE SITE.
NOTE: THE CONTRACTOR SHALL HAVE
THE 100 FOOT WELL RADIUS ON THE
NEIGHBORING PROPERTIES AND THE
NORTH AND WEST LOT LINES FLAGGED
BY A REGISTERED LAND SURVEYOR
10' UTILITY EASEMENT
GARNESS ENGINEERING GROUP, Ltd. S
N RACTORS
12/2004
BY:
C.J.G.
CONSULTANTS 6 GENERAL CO T 1 9, = 309
3701 E. TUDOR ROAD. SUITE 101 • ANCHORAGE. AK 99507 • PHONE (907)337-6179 • FAX (907)338-3246
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
KELLY & KEVIN HARRIS (907) 770-0430 2 OF 2
LEGAL DESCRIPTION:
HOMESTEAD HILLS SUBDIVISION; LOT 1, BLOCK 2,
TYPE OF WORK:
DESIGN DRAWING OF PROPOSED SEPTIC SYSTEM UPGRADE
APPROXIMATE LOCATION
OF WATER LINE
- PROPOSED DRAINFIELDS.
EXCAVATE TWO TRENCHES
THAT ARE 12 FEET DEEP
MAXIMUM BY 2.5 FEET
WIDE BY 40 FEET LONG
EACH (80 FEET TOTAL).
ADD 5 FEET OF CLEAN.
WASHED SEWER
DRAINROCK.
.... ..
eff y me
f • E 795 J.
`cov
l4Pje�p••. ...••'o\F'co
OQ�._r0fesstov' oma'
GARNESS ENGINEERING GROUP, Ltd.
."m� SULTANTS & GENERAL CONTRACTORS
3701 E 7UDOR ROAD, SUFE 101 • ANCHORAOF. AK. 66307 - PHONE: 60 —6176 • FAX: 607 46 • WEHS m 6arrww kwwvq.00m
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: HOMESTEAD HILLSSUBDMSION; LOT 1, BLOCK 2
PERFORMED FOR: KELLY do KEVIN HARRIS DATE: 4/2/2004
(feet ORGANICS TEST HOLE #11
1
2
3
4
5
6
7
8
9
10
11
12
12
14
1!
1E
1j
1E
SOIL CLASSIFICATIONS
READING
GP -GM GWORG
NET TIME
(MINUTES)
- IIII11111ML
DRIVE _
I1N11WI GM
1
.1 GC N,NN�
OL
' .'• '.
MH
M2 31 1 i//iICH
2
-t
SM
OH
►`� �"SC
3"
GM
DEPTH TO DATE
GROUNDWATER
DRY 4/2/2004
DRY 4/9/2004
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
/
TRAPLINE
DRIVE _
4/5/2004
1
\\ TH#1 �,• /
yN
6"
—
2
I e /
I �
N /
3"
3"
O
4:44
—
6"
—
ERVED BY
4:54
MM
CONTY
ii
WELL
------------------------------
--
r\ ____
SITE PLAN-----
_
________________
� F-7
I i.,
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
4/5/2004
1
4:34
—
6"
—
2
4:44
10
3"
3"
3
4:44
—
6"
—
4
4:54
10
2 3/4-
4"5
3 1/4-
5
4:54
—
6"
—
6
5:04
10
3 1/2"
2 1/2-
2"7
7
5:04
—
6"
—
8
5:14
10
3 3/4-
2 1 4"
9
5:14
—
6"
—
10
5:24
10
4"
2"
11
1 5:24
—
6"
—
12
1 5:34
10
4"
2"
Y ., •. PERCOLATION RATE 5.0 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
19
TEST RUN BETWEEN 6.0 FT. AND 6.5 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO
SOILS LOGGED BY: CALEB GALL PERCOLATION TEST PERFORMED BY: ANDREW GRAY
!`nlvt AACAIT C.
PERFORMED BY GEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WASER I RMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 4=41 I 0,'I-- —
i
HOMESTEAD HILLS S/D i1;
LOT 3, BLOCK 3,
� SERVED � SERVED �Y
M14
OMMU TIY
QWELL WELL
n RIRCHRARK AVENU
E. TUDOR ROAD. SUITE 101 • ANCHORAGE. AK 99507 • PHONE (967)337-6179 • JrAX (907)3:
'ARED FOR PHO E NUMB
kFLLY & KEVIN HARRIS Aj 7 - 431
\L bgCRIPTION:
HOMES-TEQD HILLS SUBDIVj ION; LOT 1. LOCK 2,
F WORK:
SI PLAN
_
0
0
ASEPTIC
cli
HILLS S/D;
o0
ogiHOMESTEAD
kNrrY
TRACT 28. BLOCK 1,
SERVED BY
BY
SE D BY
CO MUNTry
ERVED BYSERCOMVED
MMUNfTYWELL
WELL
WELL
TRAPLINd
DRIV
_
�
\N
-HOMESTEAD HILLS /D #1;
LOT 1, BLOCK 3,
r
Y
EPTIC
Fpm
N
O
\
O
S
SEWED BY
CQI.IMUNI Y
WELL
HOM HIj1S-S 1;
—
LOT 2, LOCK 3,
C
ro
YARL
Om/yl+-O
LLI
\
OJ
-r
HOMESTEAD HILLS S/D i1;
LOT 3, BLOCK 3,
� SERVED � SERVED �Y
M14
OMMU TIY
QWELL WELL
n RIRCHRARK AVENU
E. TUDOR ROAD. SUITE 101 • ANCHORAGE. AK 99507 • PHONE (967)337-6179 • JrAX (907)3:
'ARED FOR PHO E NUMB
kFLLY & KEVIN HARRIS Aj 7 - 431
\L bgCRIPTION:
HOMES-TEQD HILLS SUBDIVj ION; LOT 1. LOCK 2,
F WORK:
SI PLAN
I
t } MUNICIPALITY OF ANCHORAGE i
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING
DIVISION
825 L Street - Anchorage, Alaska
99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
PHONE
NEW
Barry Br.'dr-res
344— 5222
UPGRADE
MAILING ADDRESS
SPA Boy 1505T,
LEGAL DESCRIPTION
Lt. 1, Blk. 2 Homestead Hills srL
LOCATION
NO. OF BEDROOMS
Lake Otis
Four
DISTANCE TO:
Well
Absorption area
Dwelling
PERMIT NO. '
v Y
2�1n
�
6
790106
F- Z
Manufacturer
Material
No. of compartments
to ~Gee
1 •
Liq. capacity in gallllonssr
1.2.50
IF HOMEMADE:
Inside length
Width
Liquid depth
C Y
DISTANCE TO:
Well
Dwelling
PERMIT NO.
JAZ
i'
_
Manufacturer
Material
Li uid capacity
qin gallons
w =
DISTANCE TO:
Well
250
Foundation
1
Nearest lot line
PERMIT NO.
.WJ LLZ
Z W
No. of lines
2
Length of each line
Total length of lines
Trench width
Distance between lines
5 and 6
120
lag inches
5 minimum
C �
Top of tile to finish grade
Material beneath tile
Total effective absorption area
60
inches
2400 4
W
Length
Width
Depth
PERMIT NO.
<
,•
J
H
Lu
Type of crib
Crib diameter
Crib depth
Total effective absorption area
Lu
ti
DISTANCE TO:
Well
Building foundation
Nearest lot line
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
J
W
'
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
I Azp
PIPE MATERIALS
Z"/V
Cast to tank PVC perf.
SOIL TEST RATING
250
INSTALLER
O 4/d
Rr'jar,es
REMARKS
PVC uerf placed over trashed rock
and bedded to ,.rade.
••
V_
C�
•QQ� t•Ai
_
to
114
S.•••••• • • •• •••�• •�•
QQ �+ �.•� NO. 1198-E
•; ��a,
v lIJ
� �pROFESS��N�"3'
a
APPROVED DATE LEGAL
l
I IF 2-0 171 6= F-1 IN i_ H : e=e r --
DEPARTMENT
DEPARTMENT C HEALTH AND ENVIRONMENTAL I )TEC:T I ON
825 'L' STREET: ANCHORAGE, AK. 99501
264-4720
• Cl t-.1—;.ITE =• E 1.•.11= rZ Fes' E 1=--'_ r•-1 I T /
PERMIT NO. 790106 )
APPLICANT LEE BAKER C/O AREA P.O. BX. 249 E. R. 694-9555
LOCATION TRAPL I NE OFF OMALLEY
LEGAL LT. 1 ELK. 2 HOMESTEAD HILLS S/D LOT SIZE 25000 SQUARE FEET
TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = A fy>2 SOIL RATING (SO FT/BR)= 250
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
G' E � T 1-1= •� L E t�1 U T i-1= •� �... _ .= i-„ Imo' 1=e' :� E 1.- G• E F' T 1--� =
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR CERAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAV AT I ON +: I N FEET) .
F-: E r: e._.e I rR E G■ _'Si. 1= F=" -IF I 17: T t l t-•1 K =• I E = ::L ID t= -t e_-1 13 F4 L. L e --I P-4:-7-
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
--- — IF L4 CD a: ^ > I t .9 :_• F="E-: r= T I 1---1 H r --",E: F• C ID 1.J I I:;-,- 1= C)
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM Is
100 FEET FOR A PRIMATE WELL OR
150 TO 200 FEET FROM A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
P E 1*� r -i I T E :=�:1-' I f=.' 1= = Gti E �G E r•� E. E �: _:L •- 7 •�
I CERTIFY THAT
1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM Ito ACCORDANCE WITH THE CODES.
: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS.
S I GNED : -- -------------------
APPLICANT LEE BAE,EP gi
ISSUED BY_ 1 -- -- �- ---,--__GATE_y r
(�.S D
IQ GREYER ANCHORAGE AREA BOP` UGH
GfI�QDepartment of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION- REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME 7oMA 5 STF-&44 7_ MAILING ADDRESS 7/0 :1 E• 7 PHONE 333- k6 P/
LOCATION ��0G6 0"At -LEY LEGAL DESCRIPTION 0T / &VC,� -S79PD
SEPTIC TANK:
DISTANCE eOMM. N=A
FROM WELL /0' MANUFACTURER C 2�,C- MATERIAL
INSIDE LENGTH
SEEPAGE PIT:
STEEL
NUMBER OF
COMPARTMENTS
INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /dOD GALLONS.
NUMBER OF PITS DIAMETER OR WIDTH-2-1,'
IDTH 21,' LENGTH —2- 1 / DEPTH 131
2_06 SK /� Cvf}7z n • n��
LINING MATERIAL C2t/EL- CRIB SIZE: DIAMETER $ DEPTH DISTANCE FROM: WELL /0 ** 7e-
TOTAL EFFECTIVE
BUILDING FOUNDATION aU NEAREST LOT LINE �O ABSORPTION AREA (WALL AREA) �S� SQ. FT.
ADDITIONAL ABSORPTION
"4"44 �}
-WELL: Cioa/�/i
TYPE
CONSTRUCTION
DEPTH
DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION—,LOT LINESEWER LINE TANK l0 SYSTEM /D /�
CESSPOOL—,OTHER SOURCES
APPROVED t__� DISAPPROVED REMARKS
DISTANCES:
INSTALLED BY:
S7'�"cy'Aye_T �CLA'y �� /rivFn�
PIPE MATERIAL: RSTQv,t/
LOT SLOPE:
DIAGRAM OF SYSTEM
E— 21
Pr
T,JK
71
2
N� 3-F3oayl
REMARKS:
SO /c .:z .
407- 1 Ale
/7;;.0 EEC- A6,5-, .ev o y
DATE 4.74 1'73 APPROVED �-
G.A.A.B.
Form No. EQ -031
GREATER ANCHORAGE AREA BOROUGH
i
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO. r_
3500 TUDOR ROAD POUCH 6.650
ANCHORAGC. ALASKA 99502
TEI.tPHOr4t 279.0606
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
NAME OF APPLICANT -� ■T�' '„ �— MAILING ADDRESS _LlSL / PHONE — k6 V
INSTALLATION LOCATION
LEGAL DESCRIPTION ICI�` f 4C /x�j
INSTALLATION OF: SEPTIC TANK SEEPAGE PIT�3X49x + . DRAIN FIELD OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED
�- TO BE INSTALLED BY
SOIL TEST RESULTS ^=/� ^a�"NOTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
PF MIT YAM h QNF YEAR
FINAL INSPECTION, 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE lC / TYPEri - -P-1 Or CQnrYPtPSEEPAGE AREA.SIZE TYPE
MINIMUM DISTANCES. REQUIREMENTS
FOUNDATION TO SEPTIC TANK 5 ft.
FOUNDATION TO SEEPAGE PIT 20 ft. DRAIN FIELD 10 ft.
SEPTIC TANK TO SEEPAGE PIT WALL 15 ft.
SEPTIC TANK 5 ft* , SEEPAGE PIT 20 ft. DRAIN FIELD 10 ft. .
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK • SEEPAGE PIT
DRAIN FIELD ALSO CONSIDER AREA WELLS,
WATER MAIN TO SEPTIC TANK 10 ft, , SEEPAGE PIT 10 ft,
DRAIN FIELD 10 ft.
SEPTIC TANK, 25 ft. SEEPAGE PIT 100 ft. DRAIN FIELD ' 50 ft.
TO RIVER, LAKE, STREAM.
DIAGRAM OF SYSTEM
Ln;asE 1 1 '
SEPTIC
I AA(:*
CAST^IP.f.
Level—t
4• CAST IRON SIPHON
PIP[ N AIRTIGHT CR`B
CAPS
CAST IRON
IRON
INTO
UNDISTURBED SOIL
'1IN11:U:1 I HIRIMUH
C I required whenever line crosses
under driveway,
rRAYEL RA KILL^ .
AROL':ID CR�B,
(CRIB 1' MIRIKU4 ABOVE, NATER
TABLE)
4 INC$ SEVER ,Inc.
CORSICIR ARCA HELLS.
SEEPACE PI1 F.ICALY,TION BASED ON `�SIL'�1•
SOIL IE.T.
O Grade, V -per 1C0'
or 1/4• P r foo:
except 10' precrtding
HOUSE Lank 3 tha. should 1
not exceed 2:.
0 V per 100 on flat
CAST IPnN, A SEPTIC temins.
1'19E 'ThNK % a
It:iO t!S:t: ���-1 4 INCH
nIS7UP.r.ED ----> CAST IRON SIPHON PIPE
SOIL '
�\ �S[[PAGE PIT
J
CRIB
.,LJ•���� GRAVEL OACKFILI
20' MINIMUM
IGE$PrST LAT LINE.
1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 25.68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. I/ (1\ l \
DATE ���^� APPLICANT'S SIGNATURE
MILI!:UH NFLL
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
uaa Tlnual
EXCAVATION S FEET INTO UNDISTURBED SOIL.
10 PIT- 100'
LP SEKL'R LIRE- 1
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
l.rl�l-ruauc
FITTED WITH AIRTIGHT REMOVABLE CAPS.
10 TA!:K- CO"
'
TO rIT- 120'
GRAVEL BACKFILL
1,0 Sr1:ER 1.1:1(.- 4
4n -r:r OULY
•
CAS. ?Poll SCUfR
L IRC
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
I. It
To TA.•IK. 200-
00'1D !.IT - 200'
1 D
ID:'-2�O' O:Lr
/
CA,T
Ch}T IRr,H SENER
\L
�
IOR'.hq Sq!1PCC OF
HEALTH AUTHORITY
6:l'.'A9!ttATloll
OR
LICENSED DESIGNER
rRAYEL RA KILL^ .
AROL':ID CR�B,
(CRIB 1' MIRIKU4 ABOVE, NATER
TABLE)
4 INC$ SEVER ,Inc.
CORSICIR ARCA HELLS.
SEEPACE PI1 F.ICALY,TION BASED ON `�SIL'�1•
SOIL IE.T.
O Grade, V -per 1C0'
or 1/4• P r foo:
except 10' precrtding
HOUSE Lank 3 tha. should 1
not exceed 2:.
0 V per 100 on flat
CAST IPnN, A SEPTIC temins.
1'19E 'ThNK % a
It:iO t!S:t: ���-1 4 INCH
nIS7UP.r.ED ----> CAST IRON SIPHON PIPE
SOIL '
�\ �S[[PAGE PIT
J
CRIB
.,LJ•���� GRAVEL OACKFILI
20' MINIMUM
IGE$PrST LAT LINE.
1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 25.68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. I/ (1\ l \
DATE ���^� APPLICANT'S SIGNATURE
RUSH! .
• Municipality of Anchorage
On -Site Water and Wastewater Program
(907)343-7904
Certificate of On -Site Systems Approval
Parcel I.D. 015-173-16 Expiration Date:
1. GENERAL INFORMATION
Complete legal description HOMESTEAD HILLS BLOCK 2 LOT 1
Location (site address) 4300 TRAPLINE DR., ANCHORAGE, AK 99516
Current Property owner(s) EVAN THOMS Day phone
Mailing address
Real Estate Agent RONA FLORIO Day phone 748-4500
2. TYPE OF DWELLING-
Fx] Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
❑
Individual
(]
Individual Water Storage
❑
Holding Tank
❑
Community Class A Well
FX I
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver/Varianoe request for NONE Distance: ---
Received by: (In �O� k id/'l:L Date: PP
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 9% II ot'fq AdSh Waiver Fee $
Date of Payment f ^ Date of Payment
Receipt Number otq y3ck Receipt Number
COSA# C6kbt'J$ct Waiver#
6. 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.
Name of Firm SPURKLAND ENGINEERING
Address 203 W. 25TH AVE.,STE.202A, ANCHORAGE, AK 99501
Engineers Printed Name LARS SPURKLAND
6. DSD SI NATURE
System #1 Approved for bedrooms
System #2 Approved for _ bedrooms
Disapproved
Phone 279-3916
Date 8/1/13
�E.�F Atg AFI
9TH
LAR SPURKLAND,� /
11 00
13
1t. PRn2�ckn \_ ...
Conditional approval for bedrooms, with the following
By: GL/. /6-t 'J Original Certificate Date: Si 3
Th un' ali of crage 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 blue sheet £ - '., .
If more than 1 septic system is on the lot:
COSA Checklist # 1 of 1
Structure served by this system 1
Certificate of On -Site Systems Approval Checklist
Legal Description: HOMESTEAD HILLS BLOCK 2 LOT 1
A. WELL DATA
Well type PUBLIC If A, B, or C provide PWSID # 211669
Date completed Sanitary seal (Y/N) ---
Total
Total depth ft. Cased to ft.
FROM WELL LOG
Date of test
Static water level
ft.
Well production 9.p -m.
WATER SAMPLE RESULTS:
Coliform W colonies/100 mL Nitrate mg/L
Arsenic _ ug/L Date of sample:
B. SEPTIC/HOLDING TANK DATA
Parcel ID: 015-173-16
Well Log (Y/N)
Wires properly protected (Y/N)
Casing height (above ground) in.
AT INSPECTION
Collected by: _
ft.
g.p.m.
Tank Type/Material ANCHORAGE TANKISTEEL Date installed 4/26/04
Tank size 1250 gal. Number of Compartments Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (YIN) N
Date of pumping 8/1/13 Pumper A+ HOME SERVICES
C. ABSORPTION FIELD DATA
Date installed 4/29/04 Soil rating (g.p.d./ftz or ftz/bdrm) 0.8 System type TRENCH
Length 40 ft. Width 2'5 ft. Gravel below pipe 9'66 ft.
Total depth 12'5 ft. Eff. absorption area 773 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 7/23/13 Results (Pass/Fail) PASS For 4 bedrooms
Fluid depth in absorption field before test 28/21 in. Water added 600 38/32
P P gal. New depth in.
Elapsed Time: 140 min. Final fluid depth 32126 in. Absorption rate >= 600 9 P d
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date
D. LIFT STATION
Date installed 4/26/04
"Pump on. level at 28
Datum BOTTOM TANK
Size in gallons 500
in. "Pump ofr level at 28
Cycles tested 3+
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot
Absorption Feld on lot
Public sewer main
Sewer /septic service line _
Animal containment areas
Manhole/Access (Y/N) Y
in. High water alarm level at 34
Meets alarm & circuit requirements? Y
On adjacent lots
On adjacent lots _
Public sewer manhole/cleanout
Holding tank
Manure/animal excrete storage areas _
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5'+
Water main 10'+ Water service line 10'+
Wells on adjacent lots 100'+/200'+
ABSORPTION FIELD ON LOT TO:
z
Property line Building foundation 10+
Water Service line 10+ Surface water 100'+(N.O.)
Curtain drain 50'+(N.O.) Wells on adjacent lots 100+/200+
F. COMMENTS
'WAIVER ON FILE
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name LARS SPURKLAND
Date 8/1/13
COSA brown sheet 10-10-12.doc
Absorption field 51+
Surface water 100'+ (N.O.)
Water main 10+
Driveway, parking/vehide storage 10'+
a�gS��t
s
10� , SPURKLANO.'
rr clj . 115 0 %
1l` 'ORO SNA=
in.
Municipality of Anchorage C�,o�
Development Services Department '-
Building Safety Division S. �,
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
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FORA SINGLE FAMILY DWELLING
Parcel I.D. 015-173-16 HAA# LA 0 V 0
1. GENERAL INFORMATION
Expiration Date:
Complete legal description HOMESTEAD HILLS SUBDIVISION: LOT 1. BLOCK 2,
Location (site address or directions). 1 4300 TRAPLINE DRIVE * ANCHORAGE, AK. 99516
Current Property owner(s) KELLY & KEVIN HARRIS Day phone 770-0430
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
2600 CORDOVA * ANCHORAGE, AK. 99503
Day phone
MARY DEE FOX w/ REMAX PROPERTIES Day phone 257-0168
2600 CORDOVA * ANCHORAGE, AK. 99503
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
❑
Individual On-site .
Individual Water Storage
❑
Individual Holding tank
❑
Community Class A 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 samples. (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 riles and from my investigation and inspection, the
on-site wafer 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 GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507
Engineer's Printed Name
Engineer's Comments:
JEFFREY A. GARNESS, P.E.
In conducting this evaluation, GEG, Ltd. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, Ltd. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for _ bedrooms.
Date
Disapproved.
Conditional approval for bedrooms, with the fllowing stipulations: ````t`�Yt(((((A
_• ,,. � � QTc
`cam.
WATER AND : rn
PROGRAM
Attachments: JO IENT �CN,11�
HAA Checklist ✓ Manitenance Agreements�
Septic System Advisory Supplemental Engineer's Reort
Well Flow Advisory Other
By: ` v • Original Certificate Date:''
(Rev.12101)
p i
unici a i y o nc orage
yc „e
Development Services :Departlment a Y
l Building Safety Division ?
On -Site Water & Wastewiaterprogram
G 4700 South Bragaw'St.
'i P.O. Box 196650 Anchorage,`AK 99519-6650
{ r i www ci.anchorage.6k.us '
I (907) 343-7904
I I
I AUTHORITY APPR�OVALI.CHECKL�IST HEALTH. ,
Legal Description: HOMESTEAD HILLS ; iS/D; LOT '1; BLOCK 2 Parcel ID: 015-173-16
p i �i!' Ek I I` I Illlli COMMUNITY. WELLS;.
4 A. WELL DATA
Well ,type; n ;, If A,E B,'orl,C provide PWSID#. 211669 Well °Log (Y/N) NO
Date completed e I Sanitary�sea�I �Y/N) { ,Wires properly Prot �/N)_'
I
;�,
Total'depth ft. {II Cased to c ft Ca eight (above ground) in. '
I I u ! FROM WELL LOG ( AT.INSPECTIO{{ N
l Date bf test
Static water level Ift, f I ft.
' + l Weil ction r I i; �I. (� m. I I m.
{' 9 P 1 1 9-p•
�',.''I
w WATER SAMPLE RESULTS:
i!; l II i'I III •'EI I J
i Col{form { — colonieS/100 ml ,' itra e — mg./L. t,,' . Other bacteria - colonies/100 ml.
II II i ,e — , � � I —
I Arsenic mg./L I I I Date of sample. (� Collected by:
I •.I II � J' ., ', . I � I I I 1 i, �. ' ' j I � i r I 5
{ r i I
{ B. SEPTIC/HOLDING TANK DATAI I i' c II
is
�,1,
Tank Type/Material f r STEEL l I , ,I; Date installed 4/29/2004
'g J
-1250 I
Tank size gal i Number of Compartments t 12 { Cleanouts (Y/N) YES
II {l ', I.• ill, �. ... �, II�II'''i I -III III ��,.. Ifilkl� I ".• ',( �'.. -
!I I Foundation cleanout (YIN) +YES , i Depression over tank (Y/N),` NO Ec , [High waters alarm (Y/N) YES
Date of pumping Pumper
4 C. ABSORPTION FIELD DATA I ,s
BELOW FlNAL'GRADE� {E (
C I I 4/2x%2 oa' K: 0.8 TRENCH
Date,installed Soil'ratmg p.d./ r ft /bdlIrm) y � { jj'' System type
i{� ;f
Length i'' I 40 ft I sl �; i Width' I I j 2 b . (I i ft j i. Graved below pipe 9.66 ft,
{1
{ t`: Totlal del th •12 ft.i Eff. absorption area 773 ft� `Monitonn tlube YES i De ression over field NO
P
P I 1. 9( p
1 j
1 Date of adequacy test I I c `NEW I Results (Pass/Fail) i' I For 4 rrts-
—
Fluid {depth in absorption field before test I— in. Water a ' a ( New depth — in.
i
J; Elapsed Time: min I . I epth ins I+Absorption rate > — g.p.d.
I I -
[ ? enation treatment (past ,12 mo.) (Y/N &type) I — '' If yes, give date —
I
yf i k I� t I� I I 1 I' I I i•r, ,�i� I
1
r 1
D. LIFT STATION
'Date installed 4/29/2004 Size in gallons' 500 Manhole/Access (Y/N) YES
"Pump on" level at 28 in. "Pump off' level at 28 in. High water alarm level at 34 ' . in.
Datum BOTTOM OF TANK Cycles tested 3 Meets alarm & circuit requirements? YES
E. SEPARATION DISTANCES COMMUNITY WELL
SEPARATION DISTANCES FROM WELL ON LOT TO:
k/I'ft t f I t On ad'acent lots
Septic tan i s a ion on o 1
Absorption field on lot On ots
Public sewer main Public sewer manhole/cleanout
Sewer erviceline Holding tank
Ji
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ _Absorption field
5'+
Water main 10'+ Water service line 10'+ - Surface water
100'+ '
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line *2'+ Building foundation 10'+ Water main
10'+
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage,, 5'+
I
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
,
*LOT LINE WAIVER GRANTED WITH SEWER PERMIT
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and :
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
ff
Qom E
rhe s.
7953o`p-
Engineer's Printed Name JEFFREY A. GARNESS
4� s
; o i
hi 104,0
Date 6
p0ro f es*sl
44000 �
Ve-
HAA Fee $ J Waiver Fee $
y
i
3
}
,J/ a i1 UH _ . Date of Payment
Date of Payment y
`
Receipt Number DS��U c� Receipt Number
(Rev. 12/01)
lis
Sent By: MARY DEE FOX;
9072799059; May -21-04 1:25PM; Page 2/2
c.
HEREBY CERTIFY -THAT I HAVE SURVEYED THE
'OLLOWING DESCRIBED PROPERTY:
.00
ND THAT NO ENCROACHMENTS EXIST EXCEPT AS
VDICATED. IT IS THE RESPONSIBILITY OF THE
WNER TO DETERMINE THE EXISTENCE OF ANY
ASEMENTS, COVENANTS, OR RESTRICTIONS
HICH DO NOT APPEAR ON THE RECORDED SUBDI-
ISION PLAT. UNDER NO CIRCUMSTANCES SHO"
YY DATA HEREON BE USED FOR CONSTRUCTION
F FENCE LINES, OR FOR ESTABLISHING BOUND-
RY LINES.
SCALE;
DATE:
'-'�
GRID:
F&
DRAWN:
.pl'.r'
& ASSOCIATES
��`OFA%",
rCID• 4
Oven. Awk Siwird f
��, •. LS - .6918 `t'av
r Muinicipality ofArichora er, ,
Department.of Health and Wiman Services ,
Y, r F =.�IVISIO(1'Of EnVIr011t1lenta� ;Services
1 t t .fl i. :+ ► r.+ .i : : r ■ 1 /���;
On=Site,Service's` Section $25 L ,;Street ?Room' 502 '
'r ,� rsti:y41 r 1";.; F I P O `:Box�196650 �J'Anchorage,�AK.99519-6650 't;Mt
1 cl i � i n. r .. Y.L = f) ✓ I, .. � 't A/�tF t, 1£ i f {
)ar',',wwwj.ci:anchorage:ak.us j`
t i
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' `r1YCERTIFICATE OF, HEALTH ALITHORI�TY'APPROVAL,�,,
i, '�' Z i 1 -
FORA` SINGLE FAMILY DWELLING ' `
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Parcel I.D., '015 1 73
t^ -- r. i{,.. I f'>f ♦, a F. t7E'tir ..t lrl �-r h,•.!' r .,, Y,t rVIY } r
Expiration Date t
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'A GENERALINFEORMATION^',,, t`k,`i ', f "I��� r';_ <,k+'r;l
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Complete'�legal 'description
Y !. f „ _ Y ,1 `(,0 .�t 1Q br4. rr' r IR iy b 11 + '�tti} };I1, j'1'FFII.�J 6 °{JS I ' 1 e 11• 1t� 1{L it*1 t ,..�', it ..r,i UrI
4AN�'�t :a ��Fii it �. ° •. �.
Location (site, addre`ssror�directions)!.- 4300iTr'anline' Drive;" A' chorag Alaska.
I , .—.•i ,/.'1 lv .,lit {'.:.1 , �'..r t'I,t.•.!, ' 1,5'.1 1.
, ;� 1' , -a d >,f ,t IF F it JS 1 .i, {+{. r r 1 i ( ,•. r' tj:r,l r f"� }'. i
' tE' ir5i+ ri r! it i.• i!'S X.F I"1! `- �S.,i, =1.1 ±;11)} ,.,. rth lT % �l. r )ry'
Current Property`oi itner(s)1' t. �rric�la McKibben Day phone
�: i 1 'Ft 1 i:i t' ..,1 I t. E- !{ , 6 J, �• I r t t r. f S .
s. '!�_( '.{tT �" ar+) rF //�/��� { .:�` •t � {}�'. r �, +' tc , r'h 1..11 sw'1 n1i r ':f� r',
' Mailing address
1 '' 1 �! .iylY t,f 1: ,}.° ayI p`x'�. �t 't•'4}I° r- S. i lr j: rhe 1'r.;�41 r"i.` {.yi�' Sy, l,l..i -�f �y4 i.i{ Ii � 1 1�,
}'�SI{.1�"Sk,i.td i •M� i"'� .1r+ � 1.'1'2 .T. 'Y r i ' 7
yy.+,'{ ¢1:I trJ:r2 '+ �t�111J•i �4i'�1{S.i1"l t: lcDay.phone�b:?�;�d`slt-fr'L^i
Lending agency,(
i. 3^ Pi, ii •>
t,t
1 ,h
Mailing address
Real Estate Agent' Day
phone a '
Mailing Address }
• t
Unless. otherwise'requested, HAA'will be held byOHHS for pickup :'HAA picked up by
2. NUMBER OF. BEDROOMS: _4_
3. TYPE OF WATER SUPPLY TYPE OF WASTEWATER DISPOSAL
----- Individual Well ❑ , - ; Individual On-site
Individual Water Storage ❑ ; ; _ Individual Holding tank ❑
Community Class A Well ® Community On-site ❑ ,
Public Water System ' ' ❑ Public Sewer ;;= : ❑ ;
The Municipality. of Anchorage. Department of Health and Human Services (DHHS) Issues Certificates of .
Health Authority Approval "(HAA) based only 'upon the representations given in 'paragraph 5 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) on properties served by a single family
on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon'request to home
owners. 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 less than 30 days old.
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.
-STATEMENT,OFINSPECTIO-N..'13Y'ENdINEtR-';,.",,';t3'v-,.I'
V
;T, t AAs certified eyu 0 %46rdtq� nd
ased:ton',proce ures],k elkeall
inVestig6tion*,tJb
aAuthoritygApptoybl: -80p ic
a ion,�,,.s owsj,;,iV.
h--.th6,,66,_, J.'W-
"ade quaie , ��i , on't.the -nu-mbe,r,,-off66dFC
diff -,t atibased'on'-t e-4infotniaticin�"obtain6dFti6'n*'
,investigation ;t;and lnspection,,�� ionsite�,wk6xi,,
my j.
�the.
616ib�l.6nd State';' code
'i compliance with all japp116
ime..o fi6A6lQ1oK..'
Name of Firmi1iKin Engrneering
I—, V.
Addtb Mpta ICA
ih 4A i 6�`< R hi6i A K<
'il�Engifieerd' Kenneth Print6d'Namp�;K
1',-.,r
J
fflddtibn�fote]
,�s ownj belowlll, It'ven
Uth&ity Approval; Guidelines kfoFithis e'
arisupply�andvorlfiwastewater�dis'o,bsaI s'y'ife"
)rnslandLi'" 'd .......
,of I structure', in icated�jherei
�tfie,tMuhldi&it ,lofjAfichorage�>,filesl�andlf
Municipality
ply .�andtfore.-'was ewater��dysposalj,system:;,. s, -41!n
.,.or inances,,�iand,regulatio'6s',.,in','effi sat ,,t el'.F::'
`Phone
4t A
0 ".;1
iv
inn
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j
-, _a r,[ 1} ol
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14
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I
DHHS SIGNATURE �4 L• C E 7 116 2�
@$eggs AW
roved foredr`o'om'is`,t,
Disapproved E sl
S
isapprove
"
n itional
l. d 6" a approval for bb'droonis'with the f6lio"' t
Wing is ipu ations,
j ZA
.,,Attachments:
HAA h cklist Miainte'nance Agreements
-Septic System Advisory*
Supplemental Engl,neees. Report
'Well 'Flow AdvisoryOther.
By: Original Certificate Date:
Expiration Date- Reissue Date -
m—.
'Munici ali of Anchorage R E C E I V E D
P: t3' g
Department of `Health and Human Services
Division of Environmental Services NOV 2 7 2000
On -Site Services Section 825 "L" Street' Room 502
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us MUNICIPALITY OF ANCHORAGE
(907) 343-4744 ENVIRONMENTAL SERVICES DIVISION
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Homestead Hills SID—Block 2 Lot 1 Parcel I.D.: 016-173-16
A. WELL DATA
Well type community If A, B, or C provide PWSID # A Well Log
Date completed Sanitary seal Wires properly protected
Total depth ft Cased to ft Casing height (above ground) in.
FROM WELL LOG AT INSPECTION
Date of test
Static water level
ft
Well production g,p.m
ft
g.p.m
WATER SAMPLE RESULTS:
Coliform colonies/100ml Nitrate mg/I Other bacteria colonies/100 ml
Date of sample: Collected by:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material _ Steel
Date :installed 9/28/79. Tank size 1250 gal Number of Compartments.Z
Cleanouts X Foundation cleanout p Depression over tank r High water alarm n_
Date of pumping 67h2-7/0-2 Pumper Old McDonald Pumping
C. ABSORPTION FIELD DATA
Date installed 9/28/79 Soil rating (g.p.d./ft2 or ftZ/bdrm) 250 System type Trench
Length 120 (55 &_65) ft Width 4 ft Gravel below pipe 5 ft
Total depth_9 ft Effective absorption are 200 ft2 Monitoring tube I Depression over field n
Date of adequacy test 7/12/00 Results (Pass/Fail) pass* For A bedrooms
Fluid depth in absorption field before test_10 in Water adde 600 gal. New deptlz30 in.
Elapsed Time 440 min Final fluid depth -19 in Absorption rate >= 600 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) no If yes, give date
(Rev. 11/99)
D. LIFT STATION
Date installed Size in gallons Manhole/Access
"Pump on" level at in "Pump off" level at in High water alarm level at in
Datum Cycles tested Meets alarm & circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot On adjacent lots
Absorption field on lot On adjacent lots
Public sewer main Public sewer manhole/cleanout
Sewer /septic service line Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 6' Property line 1 0' + Absorption field 5 '
Water main 25'+ Water service line 26'+ Surface water 10 0' +
Drainage 100'+ Wells on adjacent lots 2 0 0'+-
SEPARATION
'+SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10' Water main 2 5' +
Water Service line 25'+ Surface water 10 0' + Driveway, parking/vehicle storage *2 ' +
Curtain drain 100'+ Wells on adjacent lots 2 0 0'+
F. COMMENTS
*Field oaerational_in top 3,5' of trench only & last 15' of trench encroaches driveway between 2'
and 0'
G. ENGINEER'S CERTIFICATION
.v •( ,........
Gj•• ••�'sVr �@
! certify that 1 have determined through field inspections and
• .„
so49TH
"�•�•
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
$.1• N••• •/.•
O
•••.
...*...4e"h
�s . r
. ate/
¢� �C �• '::.
Engineer's Printed Name Kenneth M. Duffus
�.. 7116
dQ ��F••••�
Date 1111'7��
•:••.•����
��d1i low
tea. ���
HAA Fee $ It '
Date of Payment �% 7
Receipt Number
(Rev. 11/99)
Waiver Fee $
Date of Payment
Receipt Number
(�) MUNICIPALITY OF ANCHORAGE (-_N'
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
1. GENERAL INFORMATION
,�W/ _/z /_y
Application Date
(a) Legal Description (include lot, block, subdivision, section, township, range)
I�omE�•� ��rul ��� ter! �� �
Location (address or directions) -
(b) '.Applicant Name ��n� ��—Telephone: Home :!�(05 Business ✓ ds
Applicant Address -tMri% cr
(c) +Applicant is (check one): Lending Institution ❑ ; Owner/builder,; Buyer ❑ ; Other ❑ (explain);
(d) Lending Institution Telephone
-- - Address
(e) Real Estate Company and Agent
(f)
Address
Telephone
Mail the HAA to the following ad.
'—pat;
• ,� �.s.-�
uta t1�.,_c�r�—
2. TYPE OF RESIDENCE
Single -Family Multi -Family ❑ Other + -
Number of Bedrooms
3. WATER SUPPLY
Individual Well ❑ Community I Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite 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.
Page 1 of 2
72.025 (11/84)
5. ENGINEERING FIRM PROVIDINL.A SPECTIONS, TESTS, FILE SEARCH, DA�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 ins ection.'��
Name of Firm n ' 1 Telephone
Address _74114Z el V 0 8-7tt A?d e.. /'�JCl.?jv^� e, . M
Date 162 &6'
._ '��Cec'�'r �e=(�E c,,.fA� sEPP.�f�r�N A�so�-PT�r� �r�•
so Co
roe :4
q'�'/ ...... ••••.•••�
0� Ca y S. Ma
1 QQ�`r� ,•• 6353 •� : V��
ht, PROFE�
6.. DHEP APPROVAL
Approved for "w' �4' bedrooms by "• '� I^"-'� Date�z--J---$(o
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 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
�cDEPT. OF HEALTH &
NVIRONMENTAL PROTECTION
MUNICIPALITY OF ANCHORAGE (MOA) NOV 26 1M
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST FEBRUARY 1984
RECEIVED
264-4744
Legal Description: pDnlr�" Mb eule.' :5U60.
LOT l I , DLOM 2 -
A. WELL DATA
Well Classification.' • If A, B, C, D.E.C. Approved (Y/N)�
Well Log Present (Y/N) Date Completed Yield
Total Depth Cased to
Static Water Level
Casing Height Above Ground _
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
To Nearest Edge'of Absorption Field on Lot
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Depth of Grouting _
Pump Set At
Sanitary Seal on Casing (Y/N) —
Depression Around Wellhead (Y/N)
- ; On Adjoining Lots
—;On Adjoining Lots
_ To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
; Date
Water Sample Test Results
Comments - :F An7EI C CON19TZMAT 00
B. SEPTIC/HOLDING TANK DATA
Date Installed '� 73 Size No. of Compartments 2
Standpipes (Y/N) ES I UAir-tight Cap (Y/N) y�� Foundation Cleanout (Y/N. Ko
Depression over Tank (Y/N) o Date Last Pumped ( (! g g G
Pumping/Maintenance Contract on File (Y/N) ; for
Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N)
Separation Distances from. Septic/Holding Tank:
To Water -Supply Well -f- -:50 f!(,r7(71mVN(T-�11 To Building Foundation
To Property Line 4101 To Disposal Field S
I
To Water Main/Service Line +0 To Stream," -Pond, Lake, or Major Drainage
Course 30 'TO 0*610E �aaf -+100 -TO MAJOE tjk're tolj .S9
Comments Ste/-�``ti�1Y,�1 (�(T5 113�P�fJ �01� NJO�'.
..
Pagel of t
72-026 (Rev 8186) Front
/
Jo�
r0��i�r:�
C. ABSORPTION:FIELD DATA
19
Soils Rating'i, 't -!:5rJ&DP-M Type of System Design -rP-=,fJQ4
Date Installe Length of Field 170LE
Width of Field. Depth of Field
Gravel Bed Thickness
Square Feet mfAbsorption Area °�°`° �` Standpipes Present (Y/N
Depression over Field (Y/N
Results ofLast Adequacy Test
6,6AM—Eq 13 Q Z 1)
Separation Distance from Absorption Field:
To Wat I er-Supply Well 415d (WVWJIT�� To Property Line
To Building Foundation. 4ZO, To Existing or Abandoned System on
Lot. On Adjoining Lots + Z5 I
To Water Main/Service Line 410 To Cutbank (if present)
To Stream/Pond/Lake/or Major Drainage Course 4- IW'
To Driveway, Parking Area, or Vehicle Storage Area �Z
KI ON
Date Installed _
--
Size in Gallons
"Pump On" Level at__High Water Alarm Level at
-
Tested for
Electrical.��doo (Y/.N)
Comments
CUmamsiono __---
Manhole/Access (Y/N)
"Pump Off" Level at
-_'Vent (YYN) `
` .
Pumping Cycles during Adequacy Test. Meets MOA
`
°^Check Permitted Bedroom Rating Against HAA Request
| certify that 11 ve checked, verified, or conformed to all MOA and HAA guidelines `
signed Date
Company - 1i 1P
Receipt No.
gels foods* JAIG861
Date of Payment ( - ®r 9 see*@* 0;4
Amount: *690; see
S. Mei
72-026 (Rev 8/861 Back
MUNICIPALITY OF ANCHORAGE
MEMORANDUM
O*D Dat
To: L K 0,,a`7-
From:
Re:
Signed
91-015 (5/76)
ISAACS PUMPING SERVICE
(Norm Tibbetts Owner)
1 6218 Quinhagak Street
ANCHORAGE, ALASKA 99507
Phone 563-3300
(ThankcYou
• 6 O SN& BILL SHEFFIELD, GOVERNOR
DEPT. OF ENVIRONMENTAL CONSERVATION Telephone: (907)
Address:
ANCHORAGE/WESTERN DISTRICT OFFICE
437 "E" STREET, SUITE 303 274-2533
ANCHORAGE, ALASKA 99501
DATE: November 17, 1986
PWS I.D.# 211669
To Whom it May Concern:
According to records on file in this office the HOMESTEAD HILLS
Water System is in compliance with the State Drinking
Water Regulations
Sincerely,
Michael P. Lewis
Environmental Engineer
".1
e-., t"\ .-
,S'�S.ery ,�-t91�,/oN 9rCE� .TNS �;�aes � . Q 6' _�� P ���� � ;Qk
5. LEGAL DESCRIPTION
it MUNICIPALITY XGE
ANCHORAGE F-47
MUNICIPALITY OF ANCHORAGE ;DEPT. OtA1ALTH &
NT' L PROT MMI919NMENTAL P"3TECTION
DEPARTMENT OF HEALTH& ENVIRONME A
0*
825 L Street - Anchorage, Alaska 94501
MAR 1 6 1976
ENVIRONMENTAL ENGINEERING DIVISION
STREET LOCATION
Telephone 264-4720
RE CE'VI'Qs'
REQUEST FOR
APPROVAL OF INDIVIDUAL WATER AND SEWER FACILI IE
DIRECTIONS: Complete all parts on page,11. Incomplete requests will not be processed. �lease allow 'ten (10) days for processing.
1. PROPERTYOWNER
SINGLE FAMILY
.0 Two ED i Five
PHONE
MAILING ADDRESS
Three 0 Six
7. WATER SUPPLY
PROPERTY RESIDENT (If different from above)
A7
El INDIVIDUAL*
PHONE
2. BUYER
ZMle)� �Ivlfi
PHONE
MAILINGADDRESS
depth (attach log if available.)
3. LENDING INSTITUTION
17NIV
47
PHONE
trx-f5r
give I II
M L NG ADDRESS
If system is over two (2) years old an:adequacy test, is required
4. REALTOR/AGENT
E3 PUBLIC UTILITY
by this Department.
9civ 71 _S11
MAILI ESS
_NG ADDFC
c?,9,51 177,
,S'�S.ery ,�-t91�,/oN 9rCE� .TNS �;�aes � . Q 6' _�� P ���� � ;Qk
5. LEGAL DESCRIPTION
STREET LOCATION
6. TYPE OF RESIDENCE
NUMBER OF BEDROOMS
0 One Fo3r
-Other
SINGLE FAMILY
.0 Two ED i Five
ED ''MULTIPLE FAMILY",
Three 0 Six
7. WATER SUPPLY
El INDIVIDUAL*
ATTACH WELL LOG.1A well lc�g is required for al� w�ells drilled
COMMUNITY
since June 1975. For wells drilled prior to that date, give well
13 PUBLIC UTILITY
depth (attach log if available.)
B. SEWAGE DISPOSAL SYSTEM
**If individual/on-site, installation :'date
>K INDIVIDUAL/ON-SITE""
give I II
If system is over two (2) years old an:adequacy test, is required
E3 PUBLIC UTILITY
by this Department.
NOTE: THE INSPECTION FEE MUSTACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010QLU)
M
Oq P/i
7\
. ........................................................................ ........................
_ THIS SIDE FOR OFFICIAL USE ONL .
DATE RECEIVED
INSPECTION APPOINTMENTS 1+
~
TIME
TIMETIME
41t .t ,'i lo, l
i
DATE
iiJ
DATE
DATE
INSPECTOR
INSPECTOR
INSPECTOR
DIRECTIONS:
P
1. TYPE OF RESIDENCE ''
NUMBER OF BEDROOMS
❑ ONE j ❑ THREE .; 0 . FIVE ❑ OTHER:
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
❑ ..TWO. ; FOUR ❑ SIX
2. WATER SUPPLY
PERMIT NUMBER
•i
❑ INDIVIDUAL
DEPTH OF WELL` = "
❑ COMMUNITY
DATE DRILLED I
❑ PUBLIC UTILITY
Connection Verified
LOG , 1 -
3.
3. SEWAGE DISPOSAL SYSTEM
PERMIT NUMBER 1
❑INDIVIDUAL/ON -SITE
DATE INSTALLED
❑PUBLIC UTILITY
Connection Verified
INSTALLER
,
Septic Tan r ❑Holding Tank
X0� UNL ' ;
Size: If Tank is hom
SOILS RATING
emade
,give dimensions:
TYPE OF TANK
H
MANUFACTURER I'
TOTAL ABSORPTION AREA
MATERIAL
;
G
4. DISTANCES i
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
WELL TO:
Absorption Area to nearest Lot Line!',
I I.:t
5. COMMENTS
APPROVED FOR BE 0 S
❑ CONDITIONAL APPROVAL (le ter ccompany certificate) _
C9_�ISAPPROVE Db
_
DATE .�
i,
BY (Title)
LEGAL DESCRIPTION .; .
iruiu trsev.siiu)
R&M CONSULTANTS. INC. 3024 COROOVA ■ 'BOX 6087 ■ ANCHORAGE. ALASKA 99502 ■ PH. 907.279.0483 ■ TLX. 090.25360
ENGINEERS
GEOLOGISTS
PLANNERS
SURVEYORS
April 20, 1979 R&M No. 951103
Area Inc., Realtors
Parkgate Professional Building
Eagle River, Alaska 99577
Attention: Susan Gallion
Re: Adequacy Test on Existing Sanitary, Sewer System; Lee Baker Property,
Lot 1, Block 2, Homestead Hills Subdivision, Anchorage, Alaska
Per your request of April 5, 1979, we conducted a test of the sanitary sewer
system on the above described property.
The septic tank was pumped prior to the performance of the test on the seep-
age pit. During the test the liquid level in the seepage pit was monitored
as 900 gallons were removed and 700 gallons were pumped back into the seepage
pit. All liquid levels were measured below the top of the standpipe and are
shown in the following table:
Initial Liquid
Water Second 24 -Hour Total
Reading Removed
Added Reading Reading Rise
(gallons)
(gallons)
3.8' 900
700 4.85' 4.2' .65'
The capacity of the seepage pit is 15 gallons per inch. After twenty four
hours the liquid level was measured again at.4.2 feet. It had risen .65 feet
or 7.8 inches. This indicates the surrounding soils are saturated at
present, due to excess surface runoff, and liquid is not currently perco-
lating into the surrounding soils from the seepage pit. If the 3 bedroom
residence on the property is to house 6 people, the average load on the
system can be expected to be 450 gallons per day. We can therefore conclude
that the system is not disposing of effluent at an adequate rate for a 3
bedroom residence.
ANCHORAGE FAIRBANKS JUNEAU VALOEZ WASILLA
!April 20, 1979
Area Inc., Realtors
Page -2-
We appreciate this opportunity to be of service to you. Please contact us if
you have any questions regarding this letter or if we can be of additional
service to you.
Very truly yours,
R&M CONSULTANTS, INC.
Ernest R. Rahaim
Staff Geologist
GS/RM/12-A
Vr ;" X 1, c ' s �n �itee7 j
ary A. Smith
Project Manager
"r tJ +r`.y� ?.�.,;t`+� O 1\/1�•* ,��- �,.�� 5.�..� fti"- 1•.. ;,y.����fyr `� ! > .sy' i r �-�f' }_R.� t at.-;+.�: F. � •�. •�'.F