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HomeMy WebLinkAboutANOTHER LT 20' ire
I rAffrJ I"
Municipality of Anchorage page ( or
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: 5Cj 00o0,Q I PID Number: O aG--0613 __31
Name:/BG?i YVI
V
11Wastewater System: New '19Upgrade
Address: 16q l C woo tame reti AK is
1. _" 30 ABSORPTION FIELD
Phone:
�% ��— `��� ��
No. of Bedrooms .
�
❑Deep Trench ❑Shallow Trench ❑Bed El Mound XOther
LEGAL DESCRIPTION
Soil Rating:
c 0 GPD/Sq. Ft.
Total Depth from original grade.,
c
Lot: Block: Subdivision:
i70�th
Depth to pipe bottom from orig' al grade:
10`3Ft.
Gravel depth beneath pipe ;r
3 Ft.
Township:
Range:
Section:
Fill added above original grade:
Gravel length:
36
o I Ft.
Ft.
WELL: ❑ New ❑ Upgrade
Gravel width:
I aFL
Number of lines:
S
Distant between lines:
Q�3t FL
elassification1(Private, A.B.C):
�X Is7//7 f/A �(�'
epth:
3 FI.
Cased To:
Yl FL
Total absorption area: (
- QSQ. Ft.
Pipe material:(Pv C Sit' rNO
Driller: /
GfP Qr) 6�i`n�3
rilled:
@tA
Static Water Level:
/qV Ft.
Installer:
WpO y' 13�
Dale inslalletl:
� --� 7"-©0
Yield:
I
Pump S al:
S
Height -A-bsove GroundTANK
''f
GPM
Q Ft.
SEPARATION
DISTANCES
DSeptic El Holding KS.T.E.P.
To
From
Septic
Absorption
Lin
Holding
Public/Private
Manufacturer'
Capacity in gallons:
Tank
Field
Station
Tank
Sewer Lines
,,' 41 _7k
I S O
i©Q`
I(904
(00,4
Materia
umber of Compartments;
D
Surface
Water
jO i —
100`-h
00`
LIFT STATION
Lot
Line
,
Y�
l
rjpi
+
Size in gallons:
/)-5—o
Manufacturer:
0,/cµd,1/}c4- Ti4A,C
Foundation
77
D'
i
�6
"Pump on" level al:
'
"Pump off' level at:
High water alarm at:
qd-
Sa'
4y
Curtainv+
Drain
�o /
DL • i
al. /t
slkVMM Pump Make& Model
a
Electrical Inspections performed by:
Remarks: £K,s rimc, foto 7, c 77,4,.,fc
BENCH MARK
P JMr�laO (', /J
Location and Description: (�
Loi/ Com' J'R
r/pu
no 't-7 R�
Assumed'
©O
^Elevation:
� 1
f r
S & S ENGINEERINGd�
1"34 Eagle River Loop Road, N0,
Inspections performed by: la la River, Alaska 995Zj Da%s: 1st ��-1 —(3CY
491
f-•« •• rj
�dw --
2nd ' I /' 00
o,
'd 9 7 ROBERT C. COWAN �C
Fr`naf
CE-E801 r����
Department of Health and Human Services approval
it
Reviewed and approved by: � Date: 4" 19-on
'j
L JA"V_
72-013 (Rev. 9191) MOA 25
PERMIT NO. SW000021 PAGE 2 OF 3
DEPARTMENT pHEALTH ANDhHUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.D. Box 196650 • Anchorage, Alaska 99519-6650 • Tele hone: 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LEGAL LOT 2, ANOTHER S/D P.I.D. NO. 020-093-31
10' UTILITY EASEMENT
LOT I
Oa \ : � � ��D RoL•1 lyCA
/ �e 13 l 9df
/TH#3� 1
�1
DBL1 Sc DBL2 MT1 \ FLU VALVES
I&S'o ST1
supr.c TgrK MT - SA.VO p.�TQ2 (V•%i T�.�. tfcts�
C C. 0. H /
STH#2 �
MT2
lad
w
\,G SCALE: 1" = 40'
LOT
3P� 1`,'�• ROBERT C. COWAN a Q
����,•� CE -8801
aQC fF ... `; r
PERMIT NO. SW000021 PAGE 3 OF 3
Municipa(it of Anchora e
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Tele hone: 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WPELL INSPECTION REPORT
LEGAL LOT 2, ANOTHER S
97.4'
P.I.D. NO. 020-093-31
FINAL GRADE
MH
INSULATION
NEW
92.4'__z1250 GALLON
S.T.E.P. 92.2'
SYSTEM
MT1=98.4' -\ 1 //-FINAL GRADE MT2 f MT2=97.7'
ORI�— � INSULATION_GINAL GRADE
AIR UNE /
MT1=93.8'-/ MT2=95.3
(0.5' ABOVE SAND BOTTOM)
GROUNDWATER AT 90.8
89.3' B.O.H.
N. T. S.
JUN-16-00 FRI 0227 PM Dynamic Properties FAX NO,
Jun, 16. 2000 2:00P6i REMAX PROPERTIES rug. 21X0, 282MR?
sdt 6i'ds:; aJ )AK Nu. Ft,. ":i
rin-3J-�at9 17 01 ses av711i8JR4 W7 IN M11 r•emq
� 1
roK THE OWN1+It ANCS O lBN:
E(lk'i'(iEMAIM'ENANQ6ORAN
ON•9YfR WASTEWATRA D16isOSAr+
SYATEM
1bhat}teemJmmseebetweenthe MunlalpJRV/ of
Antdiwata DJpJtenam alHoslA and )latwn 1 Wbar`0)NIISI"Oth+prvpoly
)-07- /3N a )-[./I& i sl z;
Ods st centime b nJdf Tertlep Cpo1f of mJ1mJIMnp
an w i to Wutaweter d opesel
syetan onttu wt+lsctptepuN.
I be properly ""it agree to Ne 44110p1ett
Allow deo MuolaipallVel Anrhowfa the potpetopl dfht of entry who property M119
normal uparklns hour$, to illaw ierrmovot 19010ing orotwuldng the µmod Stolear
iapalr or (enation rA dw lyJvm
yubuiit'fa the Munklp+lhy of MrJroapa ole fn now Duh, m inspecdnn tend
opaedon sulfinent Cfom f lelbtwd prorotdunll mtl+ser. Thit leepeedon+ed
opuJftioaI'AwmenghrllV0thMdesentinatbus1R)PAWW1ffltu IJndsit
pumpk dmerJ, and fhrtne, rad inti Joy dJnoJmolto Wada an rapdrld and dnt the
Aynern Is fenctlaoins 91 daiarxl,
(Slprntun) (BiaMWlo)
(AInuANem.)
i � pu�uc :•
��.�UP A17, •',��
STATE ON ALASKA
Y' JudiciAl District ss:
(Hinted Nana1
TUTn. PtM
TCiTSi9TOCERTTPYthat CA,gAvk r OAotcJ r—ga,,. xic- did
appear before me and signed the foregoing docu freely and voluntarily
for the uses and purposes
therein mentioned on the
/6""''" day ot•�-�
seal the day and year in this Certificate First above written.
PUBLIC
No i and far Alaska
My commission Expires:
DEC -15-1994 13:21 +OORDOIA,HISNER & ROBINSON
I+ F 1 Y DRILLING
Wa8 Water - III nalpraftV 67 ted
d
9640 AKULA DRIVE TELEPHONE:
ANCHPAAGC. ALASKA 99516 (907) 345 0593
Date Drilled : 7-•29-93
256 851 285E P.02
WBtL loT o2 A✓+07H62 s/O
Cleave MCDanald
Golden view, Rabbit Creek Ad.
Static Water:Level __148 Feet
Draw Pown N th Feet
Type Malucial Drilled;
Gallons Per Minute
7btal Feet of Casing 44�.T„
0 f F.. to 6" ft. Peal --
ft ft, to 10lt.7..C1ay & Reck w R20_
lU fr_. to 14.ft. _Silty Gravel .-..--
1.4 ft. to 44 ft. Clay wjGravel
44
ft..
Lo
150 ft.
Heclrock
(Grey & Ilard)
1500
fL,
to
480 ft:
Nx)rock
(black) _-_-
480 ft. to !iO3 ft. Baclicx:k wl1120 fraci:ur0a
to
to
iil=J:flf QAII.S.IN(i
$540 AKU(A DAIVs
MOODRAGO, AK DUMB
(907) 04&0593
Ie"d
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On -Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Permit Number: SW000021
Legal Description: ANOTHER LT 2
Design Engineer: 0003 S & S Engineering
Owner Name: Greg Dittmer
Owner Address: 16441 CHASEWOOD LANE
ANCHORAGE , AK 99516-4830
Upgrade
�&no
s/i -7/eyn o
Date Issued: Feb 29, 2000
Expiration Date: Feb 28, 2001
Parcel ID: 020-093-31
Site Address: 016441 CHASEWOOD LN
Lot Size: 51441 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
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 DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
P-10 47.�__
Date:
3-3 �d
w
�a Date: ff— 00
October 26, 1999
ROBERT C.
CIVIL ENGINEERS
(907)694-2979
FAX(907)694.1211
HEALTHAUTHORITY
MUNICIPALITY OF ANCHORAGE
APPROVALS
Department of Health and Human Services
P.O. Box 196650
Anchorage, AK. 99519
SEWER&WATER
MAJNIXTENSIONS
REFERENCE: Lot 2, Another Subdivision
SEWER&WATER
It is requested that you issue a permit to install a septics stem (bottomless
9 Y 11y `
INSPECTION
intermittant dosing sand filter) to serve the proposed three bedroom dwelling on
the referenced property.
ENGANDIREPOTSsTUDIEG
Two test holes were excavated and a percolation test was performed. The approximate
location of the test holes are located on the attached site plan. Ground water was
monitored as shown on the attached soils logs.
WELLINSPECTION
&FLOWTEST
We do not anticipate any adverse effects on neighboring wells, septic systems, reserve
areas or drainage patterns by the installation of the proposed septic system. The
construction of this system will not prevent any future development on any of the
adjacent properties.
SITE PLANS
If you require additional information, please contact us.
ROADOESIGN
Sincerely,
SOILTEST
Robert C. Cowan, P.E.
RCC/jhm
PERCOLATION
TEST
Enclosure
STRUCTURAL&
MECHANICAL
INSPECTIONS
ONSITE
WASTEWATER
DISPOSALSYSTEM
OESIGN
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
1" - 60' 1 SITE I DESIGN
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17034 EAGLE RIVER LOOP ROAD
EAGLE RIVER. ALASKA 99577
J
2,
ANOTHER,
Q
3Y:
J.H.M.
F
CHECKED BY:
R.C.C.
W
MOUND SLOPE NOT
�
TO EXCEED 3:1
FILTER
(&X�TEND TOBOTTMWITH
OF SAND
=MEI MIT
I I �I
FABRIC
I I
W
J
ARCTIC AIR LINE
SLOPE TO DRAIN_
K
VALVE BOX
6"-3/6"
IL
LOT
2,
ANOTHER,
SUBDIVISION
3Y:
J.H.M.
E%TEND TO BOTTOM OF PEA GRAVEL)
CHECKED BY:
R.C.C.
I DATE: 0-1
R" ED. 2-7-
4 OF 5
p�}S ROBERT C. COWAN
c, .�
1 CE -8801 F
�C
wsvt 1/2" AIR LINE
/ 8' ABOVE BOTTOM OF SAND
SAND FILTER PERIMETER)
SUPPORT FRAME: 1/2"
PLYWOOD SHEETS
36'
SIDE VIEW
36' X 10'
BOTTOMLESS SAND FILTER
rvxAP rvl'l'n FLL'i'Ex k'AdxtC)
MOUNDED SOIL COVER TO
E%TEND TO BOTTOM OF PEA GRAVEL)
INCLUDE TOP SOIL AND SEEDING
PERFORATED MONITOR PIPE
(4(W" R
FILTER
(&X�TEND TOBOTTMWITH
OF SAND
5/4" -AI JACKETED INSULATED
FABRIC
ARCTIC AIR LINE
SLOPE TO DRAIN_
VALVE BOX
6"-3/6"
HOLES
PEA GRAVEL ARCTIC FACING g IN, J
UP
FLUSHING VALVE MOUND SLOPE NOT
SHIELD `COVERT
2" INSUL.
6'Et PVC TO EXCEED 3:1
14
BACKFILL BETWEEN
THE PLYWOOD AND
v v o THE EXCAVATED WAI.[S
EFFLUENT FROM
THE S.T.E.Pfm
USE FLEX
1/E' ➢L1. SGH <➢ PVC GTEHALS
2" INSVL. +SS PSI
(INSUWTE
NA 9CH 40 BOOT (THE SCOT FLANGE PEA GRAVEL
BURIAL RATED
R BONDED TO THE 90 MQ. LINER) MDDES
2 LusuL +ss PD1
BIIHILL RATED
_
- ORIGINAL GRADE
wsvt 1/2" AIR LINE
/ 8' ABOVE BOTTOM OF SAND
SAND FILTER PERIMETER)
SUPPORT FRAME: 1/2"
PLYWOOD SHEETS
36'
SIDE VIEW
36' X 10'
BOTTOMLESS SAND FILTER
17034 EAGLE RIVER LOOP ROAD
EAGLE RIVER, ALASKA 99577
PHONE# (907)694-2979
FAX# (907)694-1211
SCALE: N.T.S
EFFLUENT
FROM
HOUSE
LEGAL: LOT 2, ANOTHER SUBDIVISION
DRAWN BY:CHECKED BY: DATE: 10-2'y-99 SHEET: ^' 1r�•.•"
J.H.M. R.C.C. REVISED: 2-8-2000 1 5 OF 5
PREMIER POLYETHYLENE SEPTIC TANK
with PUMP BASIN ASSEMBLY 30" DIAMETER "
y� i ROBERT C. COWAN
CE.8801
�5a� F86fESS10��
I" VENT J—BOX
GASKETEDMANHOLE COVER
4" TO 1" BUSHING (INSULATTES
—� � (INSULD TO 2' BELOW GRADE
FINAL GRADE
2" INSULATION
GEM CAP
SCH 40
tC TEES
v
m
NEW 1000 GAL.
POLYETHYLENE TANK p SCH 40
z PVC
SCH 40
PVC 90'
4" GROMMET
1" CHECK VALVE
1" FLEX DISCH,
1" BALL VALVE
ORIGINAL GRADE
— EFFLUENT OUTLET
1/16" HOLE
FLOAT TREE
(HIGH, ON, OFF)
PUMP BLASTER
GOULDS TURBINE
MODEL 20EB05
OR EQUAL
EFFLUENT FILTERS
1/8", 1/4", 3/8"
FILTER & PUMP
ASSEMBLY
BLY I
e Municipality of Anchorage .
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: G RP- C. D I ) T MC./L DATE PER
LEGAL DESCRIPTION: L 0 / )L 13 -Ju "rli6'lz S/J Township, Range, Section:
,or EP—T-H1I+AR•) PACK S'u,%)vrl" SLOPE SITE PLAN
1 ;V
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5
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7
8-
91011 9-
10-
11
12-
13-
14-
15-
16-
17
21314151617
18
19
20
COMMENTS
WAS GROUND WATER Y 9 S
ENCOUNTERED?
S
L
IF YES, AT WHATSAg fa 0
DEPTH? P
E
Depth to Water After 3 VC
S•%y
Monitoring? Date: 9—V
Reading Date Gross
Time
Net Depth to
Time Water
Net
Drop
yv
la'rz°
3 rte"
p
V
PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER 6
TEST RUN BETWEEN r�r` FT AND 1 16� FT
5 & S ENGINEERING
PERFORMED BY:vul oopo. I CERTIFY THAT THIS TEST WAS PERFORMED IN
17034 ACCORDANCE WA4&L@iY#ATE*bovMZ7pA1- GUIDELINES IN EFFECT ON THIS DATE. DATE: Io /I S` / °I h
72-008 (Rev. 4/85)
Municipality of Anchorage .
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: V- �� �' D (.T T M 4/Z DATE PERF(
LEGAL DESCRIPTION: 071a AN 0 7-00—IL SI0 Township, Range, Section:
—7E—PT--7r--457PeV19 r_ 7— SLOPE SITE PLAN
10 4{ WAS GROUND WATER y� S
ENCOUNTERED?
11 S
L
IF YES, AT WHAT G O
DEPTH? P
12 E
Depth to Water After o✓u /��i2,=ry ry
13 Monitoring? Date:
14-
15-
16-
17-
18-
19
41516171819
Reading Date
FEET)
Net
Time
Depth to
Water
Net
Drop
h S oq K
l
2
� s I
� w 314Nn & (,-AXV'z 4-
:'
eFr�z�
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if
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a
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5-
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6-
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IN
7 7
8
9
10 4{ WAS GROUND WATER y� S
ENCOUNTERED?
11 S
L
IF YES, AT WHAT G O
DEPTH? P
12 E
Depth to Water After o✓u /��i2,=ry ry
13 Monitoring? Date:
14-
15-
16-
17-
18-
19
41516171819
Reading Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
h S oq K
n
-/
t '
IN
20
PERCOLATION RATE ) a' 0 (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN __q___ FT AND FT
COMMENTS 7-9-S i //O LsL
a at a GIVVIIticcrtilYV
PERFORMED BY: 17.034 Eagle River Loop Road No. 4CERTIFY THAT THIS TEST WAS PERFORMED IN
Eagle River, Alaska 99577
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: oZ / /0 O
72-008 (Rev. 4/85)
EhGlneem"G ROBERT C. COWAN, P.E.
a�rvTw. CIVIL ENGINEERS
.swan (907) 694.2979
INTERMITTENT SAND FILTER SPECIFICATIONS (Bottomless) (sol) ssa-1211
Lot 2, Another Subdivision
October 26, 1999
HEALTHAUTHORITY
APPROVALS
GENERAL STATEMENT OF WORK
SEWER & WATER
MAJNEXTENSIONS
The work covered by these specifications and the plans consist of famishing all labor,
materials, tools, transportation, and equipment necessary to complete an intermittent
sand filter system as described herein and on the attached drawings.
SEWER&WATER
INSPECTION
All work under this project shall comply with current Alaska Department of
Environmental Conservation (ADEC) Wastewater Regulations.
ENGINEERINGSTUDIES
ANDREPORTS
3 Bedroom House = 450 GPD
Use 2.0 GPD/SF for polished effluent
225 S.F. required
10' x 36' sand filter and absorption area
WELLINSPECTION
&PLOW TEST
Sand filter to be constructed on accepting soil
SITE INVESTIGATION-
sITEPLANs
The Contractor who proposes to complete this project must carefully examine the
project documents, have full knowledge thereof, have investigated the site, and be
ROADDESIGN
satisfied with the conditions affecting the work. Conditions include, but are not limited
to those bearing upon transportation, disposal, handling and storage of materials,
availability of labor, water, electric power, roads, and uncertainties of weather, physical
SOIL TEST
conditions at the site including all underground utilities, the conformation and condition
of the ground, the character of equipment and facilities needed preliminary to and
during prosecution of the work. The Contractor must be satisfied with the character,
quality and quantity of surface and subsurface materials or obstacles to be encountered
PERCOLATION
TEST
insofar as this information is reasonably ascertainable from an inspection of the site,
including all prior exploratory work, as well as from information presented by the plans
and specifications made a part of this project. Any failure by the Contractor to become
acquainted with the available information will not relieve him/her from responsibility
STRUCTURAL&
MECHANICAL
for performing the work as stated in these specifications and drawings.
INSPECTIONS
_
Location of utilities will be the contractor's responsibility.
ONSITE
WASTEWATER
DISPOSN_SYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
Page 2
Lot 2, Another SID
October 22, 1999
At least twenty-four (24) hours prior to commencing work, the Contractor shall contact all local utility
companies to obtain underground utility locates. The Contractor shall exert due care to prevent damage to
utilities. Should a utility be damaged, the Contractor shall notify the utility company and shall have repaired
at his own expense any damage resulting from failure of the Contractor to request an underground utility
locate or to exert due care. If any utility company determines that a utility has to be temporarily raised,
lowered, moved, guyed, shored, braced or otherwise protected during construction, it shall be done at the
expense of the Contractor to the satisfaction of the utility company.
INSPECTIONS
Typically, there will be a minimum of eight (8) inspections required during the installation of the waste
water disposal system. These inspections will occur as follow:
Inspection of work in progress may be made by the Engineer and ADEC at any time. The following
schedule of required inspections is to be adhered to. Twenty-four (24) hours notice is required prior to each
inspection. Inspections can only be arranged during weekdays and during normal working hours. The
following inspection schedule is to be strictly adhered to:
1. Septic tank/lift station is in place, but not backfilled. Sewer piping from building to tank is
complete, properly bedded and backfilled.
2. Sand filter pit is excavated and prepared for filter construction. Prior to placement of filter
liner material.
3. Engineer to be notified with Contractor's schedule during actual construction of the sand filter
to allow spot inspection during construction. Any deviation from reported schedule is to be
reported to the Engineer.
4. Final inspection of the sand filter with all pressure piping in place, but prior to placement of
cover material. Flow testing of pressure piping at this time will require completion of lift
station wiring prior to this inspection.
5. Inspection of final grading.
The Owner shall contract with the Contractor to perform the work outlined in these specifications, plans and
in accordance with the attached ADEC Authority to Construct. There will be no contractual arrangement
existing between the Contractor and S&S Engineering. S&S Engineering shall be the Owner's representative
and will inspect the work as stated above to document the Contractor's activities. Final acceptance of the
Contractor's work rests with the Owner.
Page 3
Lot 2, Another SID
October 22, 1999
S&S Engineering shall have no liability to the Owner or to others for acts or omissions of the Contractor or
any other persons performing work on this project or the failure of the Contractor to cavy out the work in
accordance with these construction documents. S&S Engineering's inspecting Engineer will not be
responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions
incident to this project.
All landscaping, fences, sidewalks, paving, driveways, utility markers and other improvements, removed to
facilitate the Contractor's operations shall be fully restored to their original condition and location by the
Contractor unless otherwise directed by the Engineer.
Items damaged by the Contractor during removal, storage, or restoration, shall be repaired or replaced in
kind by the Contractor. This work shall be considered incidental to the project.
MINIMUM MATERIAL SPECIFICATIONS
1. Any septic tank proposed for installation must be constructed by a ADEC approved septic tank
manufacturer.
2. The following pipe materials are approved for use in septic system installations in the
Municipality of Anchorage:
Type of Pip
Perforated
Solid
Cast Iron
Yes
Yes
ASTM D3034 (PVC)
Yes
Yes
ASTM F810 (HDPE)
Yes
No
ASTM D2662 (ABS)
Yes
Yes
ASTM D2241
Yes
Yes
ASTM D2239-74
Yes
Yes
Use of a type of pipe other than listed here must be approved by the inspecting Engineer.
1. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company
Styrofoam HI or equal).
2. Septic tank inlets and outlets shall be fitted with water tight couplings (Caulder, Femco, or
equal).
3. When sand is being used as a filter material, its gradation specifications must conform to current
MOA or DEC requirements.
Page 4
Lot 2, Another SID
October 22, 1999
SEPTIC TANK/LIFT STATION
A. General
The work under this section consists of the performance of all operations pertaining to
firmishing and installing the septic tank/lift station and piping to the sand filter.
B. Materials
1. Tank for Lift Systems
a. Septic tank shall be a two compartment steel tank specifically for the use
of Orenco Systems, Inc. patented lift station assembly Orenco No. 4200,
or approved equal.
b. The tanks shall be designed for soil loading conditions as required by
ADEC and State regulations. The design or analysis shall be in accor-
dance with accepted engineering practice and local regulatory agencies.
c. All welding shall be in accordance with applicable codes and standards.
2. Risers
a. First compartment shall have a separate 4" pump out riser. The second compartment
shall have a separate 4" pump out riser.
b. An additional second compartment manhole riser shall be 12 gauge sheet steel and shall
extend 12" (minimum), above surface grade, shall have a minimum nominal diameter of
24" and shall be capable of being equipped with the following:
1. A junction (Nema 4x) box or equal, bonded or attached to the
riser.
c. UL listed electrical cord grips, installed in the J -box.
d. A lid - shall be furnished with the riser. It shall be constructed of
fiberglass or equivalent aggregate finish, meet H-10 loading
requirements and have a latching mechanism.
Page 5
Lot 2, Another S/D
October 22, 1999
e. Riser installation - each riser shall be sealed or welded to the top
of the tank in such a manner as to prevent infiltration of ground
water.
f. Lid insulation - 4" rigid extruded polystyrene shall be placed in
the riser directly below and attached to the lid.
g. Riser insulation - 2" sprayed shop applied urethane on
circumference of riser with 46465 Tnemec coating.
3. Effluent Pumping Assembly
a. Effluent pumping assembly shall be Orenco systems (TM) Model 20-OSI-05-HHF series,
or approved equal, consisting of the following:
1. 1/2 H.P. 110 volt or equal U.L. Listed effluent pump.
2. Screened pump vault (U.S. patent No. 4439323) 59" deep,
3/16" thick high-density PVC cylinder houses the pump,
level controls and screen and serves as a baffle to prevent
the screen from clogging.
Fifteen 1 1/2" diameter holes are drilled in the vault at a level that
places them at about the midway point in the depth of the septic.
Flap check: Allows the vault to drain when removing the tank.
Screen: 15" diameter cylinder of high-density polyethylene 1/8"
mesh.
3. All piping shall be PVC or other non -corroding material.
b. Pump controls and alarm system shall be Orenco systems SICTETMRO 110 volt with
the following options consisting of:
1. Event counter
2. Elapsed time meter
3. Program timer
Page 6
Lot 2, Another S/D
October 22, 1999
4. 10 watt heater
5. Remote alarm panel option with a minimum of 80 DB
sound pressure at 24", operating temperature 30AC to
65AC, continuous sound to be located in the home.
6. Oil -tight visual alarm with push -to -silence feature.
Automatic audio -alarm reset.
7. 15 amp motor rated toggle switch, double pole, double
throw with three positions; manual (man), automatic (auto)
and center (off) (H.O.A.).
8. Nema 4x -rated, fiberglass, or equal, enclosure with hinged
cover.
9. All controls to be installed as per manufacturer's
recommendations.
10. Control panel to be installed on outside wall of home within
sight of septic tank/lift station.
c. Piping from the septic tank to the sand filter is to be 1 1/4" PVC schedule 40 solvent weld
piping properly bedded as described in Materials Specifications and sloped to drain back
to the septic tank. Insulation board 2" thick and T wide centered over pipe is to be placed
where soil cover is less than 4' depth over pipe.
CONSTRUCTION SEQUENCE
In order to insure proper inspection procedure, the system is to be installed in the following order:
I. Sewer line from house to tank
H. Septic tank/lift station
III. Sand filter
IV. Final grading
Page 7
Lot 2, Another S/D
October 22, 1999
CONSTRUCTION
1. Pipe Grade and Alignment
Variance of individual pipe sections from established line and grade shall not be greater
than 0.02 feet, providing that such variance does not result in a level or reverse sloping invert.
During the progress of the work, the Contractor shall provide instruments such as transits,
or levels, for transferring grades from offset hubs or other construction guides from the
control points and bench marks provided to the Contractor by the Engineer. The Contractor
shall provide qualified personnel to use such instruments and who shall have the duty and
responsibility for placing and maintaining such construction guides.
2. Pipe Laying
All pipe shall be laid with Class C bedding, free of large stones and organic matter.
Each section of pipe shall be handled carefully and placed accurately, the spigot end shall
be fully inserted pointing in the direction of flow and glued in place to make a water tight
seal.
Each section of pipe shall be properly supported to insure true alignment and an invert
which is smooth and free from roughness or irregularity.
At all times, when work is not in progress, open ends of pipe and fittings shall be securely
and satisfactorily closed so that no undesirable substance will enter the end of the pipe or
fittings.
3. Bedding of Pipe for Sewer Lines
The pipe should be bedded with Class C bedding materials, compacted to 95%. Native
materials may be used as back fill material above the pipe, provided it is free of large stones
and organic matter to a point one (1) foot above the top of the pipe.
All pumping services shall be installed in accordance with the manufacturer's
recommendations and standards. Electrical installation is to be to code by a licensed
electrical contractor, with Municipality inspection where required. If MOA inspection is not
required, a licensed electrician is to provide a letter to the Engineer stating that the system
meets or exceeds all applicable codes.
r
Page 8
Lot 2, Another S/D
October 22, 1999
4. Excavation
Excavate to proper depth to allow gravity flow, install tank level, tolerance 0.05 foot, on
undisturbed or compacted to 95% classified sand fill material. Line excavated tank pit walls
with 2" +35 PSI burial foam full depth of tank. Back fill between tank and foam with sand
material and compact in a manner to prevent damage to tank surface coating.
Create a level sand surface over the tank and add 2" burial foam +35 PSI directly over
tank. Mound unclassified soil over tank location to a depth of 2' above finished grade to
allow positive drainage away from tank and counteract buoyancy.
5. Connections
All connections to be as per ADEC requirements, PVC 3034 piping with Caulder or
equivalent couplings for inlet riser pipes.
All tank connections are to be completely water tight.
SAND FILTER
The work under this section consists of the performance of all operations pertaining to furnishing and
installing the sand filter.
A. Materials
1. Sand Filter
a. The Contractor shall provide a washed sand to meet ASTM C-33 Concrete Sand
Specifications with the additional requirement that all but 1% of the materials
passing the #100 sieve be removed. A sample of the proposed filter sand must be
submitted to the Engineer for testing one (1) week prior to construction. A sample
will be taken from the sand bed during construction for purposes of quality control.
If the sample does not meet specifications, all sand will be removed and replaced.
b. The Contractor shall be responsible for providing pea gravel that shall be a
washed material containing no fines (0% passing the 9100 sieve) and a maximum
size of 1/4" diameter.
c. The Contractor shall provide the manifold assembly. The manifold assembly
shall be the Orenco Model SFM 1036 or equivalent with orifice shields and flushing
f
Page 9
Lot 2, Another S/D
October 22, 1999
assembly. All drilled holes to be cleaned of burrs and pipes flushed, prior to
assembly. Flushing valve to include riser to finish grade.
d. Side walls and top of the filter box to be insulated with 2" direct burial polystyrene
insulation and be inside the plywood box.
e. The Contractor shall be responsible for providing filter fabric.
f The linear air difuser line and compressor is available from Orenco, no model
number available. The feed line from the house to the filter is HDPE arctic
insulated pipe 3/4"-2" SDR -11 Maskell-Robbins or equivalent. The compressor
will have a gauge (0-10 psi) and be installed in a heated area, crawl space, or garage.
2. Construction of Sand Filter
The sand filter construction is to follow procedures as outlined in the Orenco Installation
Manual as applicable to this design.
Pea gravel and filter sand are to be hand leveled to proper depth (tolerance within 0.02
feet) in filter, taking care not to allow mud or fine soil material into the filter or gravel layer.
This would include any soil material picked up by excavation machinery buckets while
loading specified material. The Contractor should estimate filter material volumes such that
allowance is made for wastage of material in contact with the ground at site. Work on the
sand filter may be suspended at the Engineer's discretion due to inclement weather
conditions, such as rainfall. The sand filter and material stockpiles will be completely
covered by a tarp over night during construction until finished.
The area over the sand filter to be finish graded with a minimum of 2 feet of cover and to
prevent ponding of surface water run off. Side slopes shall not exceed 3:1. Six inches of top
soil and seed are required over the entire sand filter when the side slopes approach 3:1, or at
the discretion of ADEC.
The Engineer will reject any sand or pea gravel that does not meet specifications or is
contaminated in transit or while handling. If such material is placed in the filter, all soil
material may be required to be removed and replaced with new material.
CONTRACTOR/INSTALLER
MUNICIPALITY OF ANCHORAGE <`>
DE. 4TMENT OF HEALTH AND HUMAN SERI S
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
014 -SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Namndleve McDonald DISTANCES
Address FROM TO SEPTIC ABSORPTION WELL
P.O. Box 110384, Anchorage, AK 99511 TANK FIELD
Phone(s) Permit No.---
o.No. of Bedrooms WELL 115' 140'
345-0064 850439 3
LEGAL DESCRIPTION LOT LINE 20' 3 5 ' 10,
Lot 2 Block -- Subdivision Another
FOUNDATION 40' 75' 60'
Township, Range, Section
AS -BUILT DIAGRAM (Show location of well, septic system, property lines, foundation,
driveway, water bodies, etc.)
TANKS
® SEPTIC ❑ HOLDING
Manufacturer Capacity in gallons
Greer 1000
Material No. of Compartments
Steel 2
TYPE OF SYSTEM
[]TRENCH EX BED ❑ W. DRAIN ❑ OTHER
Depth to pipe bottom from Total depth from original grade
original grade
3 FT 5 FT
Fill added above original grade Gravel depth beneath pipe
2 FT .5 FT
GravellengthGravel width
55 FT _ _ 27 FT
Total absorption area Distance between lines
148�O FT 6 FT
Number of lines Soil rating Pipe material
41 3 3 0 Sp FT PVC
Installer Date Installed
ATC Enterprises 7/85
WELLS
[:X PRIVATE ❑ OTHER (Identifv)
Classification (A,B,C) Total Depth Cased to
665 FT 60 FT
Installer Date Installed:
Rampart Drilling 8/7/85
REMARKS:
Two feet of sand fill were placed
below the drainfield rock in accor-
dance with engineered design for
this field.
I /�%/ l%LaALZ �' SIN' 0 �7ZS oA1
Municipal and State guidelines in effect on this date: -�
Health Department Approval:
72-013 (3/85)
Miami
it
ONE
811011
MIM
MISIM'
OF
SUMEMEEZEMEEMENE
ME©SEEMEMENE®®EN
MMMMMMMM
Scale: NO SCALE
Inspections Performed by:
461-4
Date: Q �
0%-+
certify that this inspection was performed according to all
Date: ZrZO'"afv
OF
dqp Alk
.491" 9 t
f®i- I¢e 0, see d aapaaeaaeas�aaro�aac
.a ep a aaioe6i�Y5d�Ko`5ns as vY�{6!
'.Michael E. Anderson
iP •e 4381 - E'
851U�®
1-1 IJ !%J 1: (= 1: f:�de:N L_ 1 **1"- *V (.-.3 r-:-- ����������F:�'::
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L STREET, ANCHORAGEr AK 99501
264-4720
(3 1%J_$3 X 0- EE E3 E" &0 EE FR ak ���L_ F=< M I -r"
PERMIT NO:
DATE -ISSUED:
APPLICANT:
ADDRESS:
CONTACT PHONE:
LEGAL DESCRIP:
LOT SIZE:
850439 ENGINEERED DESIGN
07/24/85
CLEVE E MCDONALD
P O BOX 110384
ANCHORAGE, AK 99511
561-2985 '
SUBDIVISION: ANOTHER LOT: 2 BLO[Ko NA
SECTION: 3 TOWNSHIP: 11N RANGE: 3W
1.18A (SQ.FT. OR ACRES) `
certify that:
1. 1 am familiar with the requirements for on-site sewers and wells as set
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of Chis permit.
3. I will adhere to all MOA and State of Alaska requirements for the set back
distances from any existing well, wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot.
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
THEN (1) AN ELECTRICAL PERMIT AND INSPECTIONMUST BE OBTAINED; (2) AS-BUILTS
WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE
ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN.
SIGNED
��-________-_--_--��-----------------
DATE:
v -�---���--�-��-
APPLICANT:
CLEVE E MCDONALD
ISSUED BY DATE:
(akolyn ---------------- __-��__��______
PERFORMED FOR
Z SOI LS LOG
PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG —PERCOLATION TEST
CLEVE MCDONALD
LEGAL DESCRIPTION: Lot 2, Another Subdivision
EF Peat (PT)
1 II
2� Organic Silt
y� (OL)
4
5
�`.. Sandy Silt with
6 '.;o some Gravel (SM)
ra. _
8
Date
Gross
Time
9 -
Depth to
Water
Nab
aw OF At,, it,
1
7/13
P• •• + ,.
0:00
4"
•
11
a • '•os •u.N«• oMwi..
12
4 3/8"
as •••• •
Michael E, Anderson �'
3
®� %oDE
e
13
4 5/8"
�pNOFESS��
14
0:45
15
4 7/8"
1/4"
16
0:60
17
5 1/8"
1/4"
18
19
tit
=, 4
�'• 4381•E o ��
•0 s
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION KI
SLOPE
c
t
DATE PERFORMED: July 13, 1985
SITE PLAN
4S GROUND WATER S
.COUNTERED? YES L
O
P
YES, AT WHAT 8 FT E
PTH?
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
7/13
0:00
0:00
4"
0
2
0:15
0:15
4 3/8"
3/8"
3
0:30
0:15
4 5/8"
1/4"
4
0:45
0:15
4 7/8"
1/4"
5
0:60
0:15
5 1/8"
1/4"
I 1 PERCOLATION RATE 60 (minutes/inch)
ll__JJ TEST RUN BETWEEN 5 FT AND 8 FT
COMMENTS See Attached Letter
330 FT2/Bedroom
PERFORMED BY: M. Anderson CERTIFIED BY: 4'Lt.gti DATE: 7/19/85
72-008 (6/79)
401 E. FIREWEED LANE
ANCHORAGE, ALASKA 99503-2197
(907) 276-3770
ANCHORAGE • JUNEAU • BETHEL
July 19, 1985
�F ©� q,
40P
Municipality of Anchorage
Dept. of Health and Environmental Protection
825 L Street
Anchorage, Alaska 99501 F�
Attention: Susan Oswalt
Subject: Lot 2, Another Subdivison
On -Site Sewer System
Dear. Ms. Oswalt:
In early June, I inspected the property described as Lot
2, Another Subdivision. At that time the owner had recently
completed excavation of a curtain drain system along the
perimeter of the lot. He had also dug several test holes
in search of an adequate percolation zone for his septic
system. The area shown on the percolation test form was
excavated and a lens discovered which appeared to have the
acceptable characteristics. The water table was located
at 7 feet below the surface so a percolation test was not
run.
The water table was monitored until July 13, when the attached
percolation test was run. At this time the water table
had dropped an additional foot to 8 feet. This does not,
however, provide the necessary 4 feet separation from the
bottom of the recommended drainage bed.
The prescribed design for this lot is to remove the
approximately 5 feet of organic laden material to the gravelly
silt layer and installing two feet of sand. The standard
bed system would then be placed atop this sand layer. The
system should then be backfilled to the surface using the
sandy soil to encourage evapotranspiration and prevent
freezing. To prevent surface runoff from contaminating
the field the soil should either be mounded one to two feet
above original ground or a dike, constructed of impervious
material, placed around the perimeter of the field. A detail
is attached which describes the recommended design.
Sincerely yours,
Michael E. Anderson, P.E.
xc: Cleve McDonald
ENGINEERING, INC.
401 E. FIREWEED LANE
ANCHORAGE, ALASKA 99503-2197
(907) 276-3770
JOB
SHEET NO.
CALCULATED BY.____- _-_-DATE
CHECKED BY
SCALE
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Plot Plan Certificate:
I hereby certify that I have surveyed the following des-
cribed property:Lo
and that the proposed mprovements and drainage patterns
are as shown hereon.
It is the responsibility of the owner or builder,
prior to construction, to verify proposed build-
ing grade relative to finished grade and utilities
connections, and to determine the existence of
any easements, covenants, or restrictions which
do not appear on the recorded subdivision plat.
.: OF A
s ° ¢c
i —
®q °e°a /e •+eats u� na/ra•a •bi.° e
a 11
John A. Sraufa �° ar"S': `Af
���j'°e LS 6270 aI
Ul,r '+.iUjjj"'A.iV'T JUM1111n(D W��L �ZOAGE
ENVIRONMENTAL PROTECTION
1.207 Ramona St. 99515 ArCHORAC.E, ALAsJKA
344-7714 F t. 2
SIX INCH WATER WELL DRILLED ------------OUT TO THE DEPTH OF 665 AEC E I V E D
DRILLED AT THE RATE OF X20.00 PER FOOT. Cha44e P& 500 /.t. on.iy
PROPERTY OWNER
At. Uwe lRcDona ld 561-2985
LOCATION OF WELL SITE Lt.
Bik-..-- Sub.
DRILLER B¢nn.i a GCa" o� Rainpa t t t &iti.in.g Woff.
WELL LOG:
0----17' S44i W 4an4 c i.a.A. 15% /Aae. ga,awet. Seve2at 4mctLt bouLdeu. Wet ma tehicLC.
17---32' Wet 4ttt4 gAgyet. 45% 5-L Niut".
32--665'
Bed.,wck. R -dedv' wn taoW t4pe
Mock.
Illed U m. Ha�td. no 44gAtjtwnt
wa test V.i.eid
4hoiata . untit
aAe�t 525 A. Thin, a&e"
o.
ggLu!� .type Mack.,
and po&ot 4 at,P."p
tA,&L ,tvwe4 o�, po&ou a dock y i eidiAq m in,tanat amounts v. wate>t. Uel good cleam wale -t
bea&tnq atea-d .atom. 525 to 665 4. The4e water pnoduc -Eve a4Aa4 wtU &&eak in with
q4 a te,i V,ie wi th u4e o.- Wed,(.. ZlUt inQ continued Pwa 500 .to 665 A .in, o�tdet .to
break ,in ams much wadi a4 pa4,d4bd e. TtU d Welt ddd t ptave the dart
40 A. anon 645 to 665 4, Aecovet o�, p&oductLan die wed. Total. watx.,t V.itU 4houtd
4how 800 .to 900 qad l ono o.� watrut xecave44 dn. a 24 hou�t .t une ?flame. Thies Welt 4houtd
a 4o 4nzAza4e aster 4evetat weeks o.� u4e .to overt a thou4and gPD. Wa eA ,vs pumped
cCea& (hAet 48 howw ,t ime ed ap4e). One. hoh4e 4ubme4dbd a pump jhouLd be 4n4t aUed
on down to 550-600 A. Oven 500 A o� wateA 4tan4ing .in Welt og bo,tton. 1.6 qnt4
pe,t A .&L tedetue. Oven 800 gaUo" o.- wateA .in. &e4ewat t a4xa..
�i�23r98
Coat o� Dn.i.11i 4: $20.00 pest X 500 4: $10,OOQ.00
We ante q -tad ,to 9,We a pod di4coun t an .thi4 We -U,, beta e- o4 .the exce44.i.ve. depth.
COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING.
WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF $10tOOo.00
THANK YOU VERY MUCH.
\ Municipality of Anchorage .,
!� Development Services Department
Building Safety Division
On -Site Water 8 Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsiteonsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 612D -6q3 - -3.1 COSA# 0 D ID0i O
1. GENERAL INFORMATION Expiration Date: :% - oZ b pp - 0 O
Complete legal description _ANOTHER S/D. LOT 2
Location (site address)
16441
CHASEWOOD _LANE.
ANCHORAGE. AK 99516
0
Individual On-site
Current Property owner(s)
RICK
KING
Day phone 317-2511
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
16441 CHASEWOOD LANE, ANCHORAGE, AK 99516
Day phone
CHRIS SWIRES W/REMAX Day phone 338-8292
110 W. 38TH, SUITE 100. ANCHORAGE AK, 99503
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
0
Individual On-site
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Weil
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given In paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of On -Site Systems
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 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 GARNESS ENGINEERING GROUP, Ltd.
Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, GEG, LID. 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 idontiflable 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 confor any legal right whatsoever.
5. DSD SIGNATURE
_Z Approved for '_3 bedrooms.
Disapproved.
Phone 337-6179
Date _0��
ooP�F,. �F.....-95; 40
.
Conditional approval for bedrooms, with the fllowing stipulations:
Attachments: /
COSA Checklist V
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Reort
Other
ooq�� i (rrrrfri,,�
``QP��tY OF,tUy�,yO'�
ONSITE =�c
WATER AND
WASTEWATER
PROGRAM
By. Original Certificate Date: — —
(R" 11N5)
\ Municipality of Anchorage
C• -- Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907)343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: ANOTHER S/D, LOT 2 Parcel ID: 0.2,C) –093,31
*DID NOT DO EXTENDED TEST ON OLD WELL. HOWEVER, TO PERFORM INDIVIDUAL
A. WELL DATA WATER SAMPLES, SWITCHED TO OLD WELL AND FLUSHED SYSTEM. CONFIRMED
OLD PUMP STILL PRODUCES.
Well type PRNATE/PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES/YES
Date completed 1986/7-29-1993 Sanitary seal (Y/N)YES ES Wires property protected (Y/N) YES ES
Total depth 665/503 ft. Cased to BEDROCK/44 ft. Casing height (above ground) 18+ 18+in.
FROM WELL LOG
Date of test 1986 / 7-29-1993
Static water level UNKNOWN\148 ft.
Well production UNKNOWN/1.0 g,p,m,
WATER SAMPLE RESULTS:
AT INSPECTION
•4/15/2008
180 ft.
0.4 —
9 -p.m -
Coliform 0/0 colonies/100 ml. Nitrate 0/0 mg./L. Other bacteria 0/0 colonies/100 ml.
Arsenic:2.67 0.730 ug./L. Date of sample: 4/15/2008 Collected by:
GEG Ltd
B. SEPTIC/HOLDING TANK DATA k Qaubi c- 6/o -s pt; vc 4 v Sc f'4 i G Tan k
Tank Type/Material S.T.E.P./STEEL Date Installed 5/2000
Tank size 1250 gal. Number of Compartments 2
Foundation cleanout (Y/N&JO Depression over tank (YIN) NO
Cleanouts (YIN) YES
High water alarm (YIN) YES
Date of pumping 1/3/2008 Pumper NORTHLAND PUMPING
C. ABSORPTION FIELD DATA
Date installed 5/2000 Soil rating .p.d./f or ft'/bdrm) 2_0 System type ••ISF
Length 30 ft. - Width 12 ft. Gravel below pipe 0.25 ft.
Total depth 0.5 ft. Eff, absorption area 360 ftMonitoring tube YES Depression over field NO
Date of adequacy test 4/15/2008 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before lest DRY in. Water added 565 gal. New depth ••'8 in.
Elapsed Time: 50 min. Final fluid depth DRY in. Absorption rate >= 450+ g,p,d_
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date –
••CHECKED AIR COMPRESSOR 4/15/2008. 4.5 PSI.
•••INADVERTETLY SURCHARGED THE ISF WITH DELIVERED LOAD OF. WATER
D. LIFT STATION *INSPECTED BY A+ HOME SERVICES.
Date installed 5/17/2000 Size in gallons 1250 Manhole/Access (Y/N) YES
'Pump on" level at TIMER In. "Pump off' level atTIMER in. High water alarm level at 44
Datum BOTTOM OF TANK Cycles tested ' Meets alarm & circuit requirements? YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+
Public sewer main N/A
Sewer /septic service line 25'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Holding tank N/A
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+
Property line
59+
Absorption field
5'+
Water main N/A
Water service line
• 10'+
Surface water
100'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main N/A
Water service line *10,+ Surface water 100'+ Driveway, parking/vehicle storage 5'
Curtain drain '20'+ Wells on adjacent lots 100'+
F. COMMENTS 'PER YEAR 2000 INSPECTION REPORT
G. ENGINEER'S CERTIFICATION
1 certify that I have determined through field inspections and Q e
review of Municipal records that the above systems are in 0 •""
conformance with MOA COSA guidelines in effect on this
date.
Engineer's Printed Name JEFFREY A. GARNESS Qlp
OM
Date
COSA Fee-' -/,;0 y U
Date of Payment r'/ 12q to 2
'i
Receipt Number. 10 ✓ to
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
Gar ess:
CE—
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
Nater Well Advisory
Health Authority Approval # 080108
During a recent Health Authority Approval on-site inspection and test of the
potable water supply well on Block , Lot 2 of Another subdivision, the
well's productivity was determined to be 0.4 gallons per minute. The
minimum well productivity required by this Department (AMC 15.55) for a
3 -bedroom residence is 0.3 gallons per minute. Although the subject well
currently exceeds this minimum requirement, all parties concerned are
advised that the production capacity of the well may fluctuate. Restriction
of non-critical water uses such as washing cars and watering lawns and
gardens may be required.
This advisory must be attached to all copies of the subject Health Authority
Approval.
_: _+: Sep. OS_02:33PMP2
ANALYTICA
GROLT
Gamess Engineering Group, Ltd.
Attn: Jody GEG, Ltd.
3701 E Tudor Road, Suite 101
Anchorage, AK 99507
907-337-6179
Fax: 907-338-3246
Client Sample ID:
Sampling Location:
Client Project:
Sample Matrix:
COC #:
PWS#:
Residual Chlorine:
Comments:
1993 Well 1
Private Well Testing
Aqueous
63544
Lab#: A0804124-OIA
Analytica International, Inc.
4307 Arctic Blvd.
Anchorage, AK 99503
Phone: 907-258-2155
Fax: 907-258-6634
Report Date:
4/232008
Receipt Date:
4/152008
Sample Date:
4/152008
Sample Time:
11:45:OOAM
Collected By:
KM
Flae Definitions:
MRL - Method Reporting Limit
MCL = Maximum Contaminant Limit
B - Present also in Method Blank
11= Exceeds Regulatory Limit
M - Matrix Interference
J = Estimated Value
D = Lost to Dilution
•• = RL higher than MCL; target not detected
INC = Too Numerous to Count - result rejected
CF = Confluent Growth - result rejected
TCNG = Turbid Culture No Growth - rejected
Analysis Method Prep
s MRL MCL Method Prep Analysis
Parameter Result Units Flags _ Date Date Analyst
200.8200.8 (Aqueous) - Family Well Water 1 Test was conducied by. Analyrica - Thornton
Arsenic 2.67 ug/L 0.15 JO 200.8 4212008 4222008 GY
Lab#: A0804124 -01B
Analysis Method Prep
s 11IRL MCL Method Prep Analysis
Parameter Result Units Flags Date Dale Analyst
4500-NO3E (Aqueous) - Nitrate Test was conducted by: AnalJ9ica - Anchorage
Nitrate as N <MRL mg/L 0.10 JO 4/182008 4/182008 JK
Lab#: A0804124 -OIC
Analysis Method Prep
s MRL MCL Method Prep Analysis
Parameter Result Units Flags Date Date Analyst
9222B (Aqueous) - Membrane Filtration h1F Test was conducted by: Analyrica -Anchorage
Bacteria, Other <MRL CFU/100mL 1.0 4/152008 4/152008 DC
Total Coliform <MRL CFU/IOOmL 1.0 / 4/152008 4/152008 DC
Reported by: Steve Gaither, Page 1 of 2
Laboratory Project Manager
ANALYTICA
GROUP
Gamess Engineering Group, Ltd.
Atm: Jody GEG, Ltd.
3701 E Tudor Road, Suite 101
Anchorage, AK 99507
907-337-6179
Fax: 907-338-3246
Client Sample ID:
Sampling Location: 1986 'Well 2
Client Project: Private Well Testing
Sample Matrix: Aqueous
COC #: 63544
PWS#:
Residual Chlorine:
Comments:
Lab#: A0804124 -02A
Analytica International, Inc.
4307 Arctic Blvd.
Anchorage, AK 99503
Phone: 907-258-2155
Fax: 907-258-6634
Report Date:
4/23/2008
Receipt Date:
4/15/2008
Sample Date:
4/15/2008
Sample Time:
12:15:OOPM
Collected By:
Kh1
Flae Definitions:
MRL = Method Reporting Limit
MCL = Maximum Contaminant Limit
B - Present also in Method Blank
11- Exceeds Regulatory Limit
M - Matrix Interference
J = Estimated Value
D = Lost to Dilution
• • = RL higher than MCL; target not detected
TNC - Too Numerous to Count - result rejected
CF = Conflucnt Growth - result rejected
TCNG = Turbid Culture No Growth - rejected
Analysis Method Prep
s MRL MCL Method Prep Analysis
Parameter Result Units Flags Date Date Analyst
200.8/200.8 (Aqueous) - Family Well Water 1 Test was condncled by: Ana/ytica - Thornton
Arsenic 0.730 ug/L 0.15 10 200.8 4/21/2008 4/22/2008 GY
Lab#: A0804124 -02B
Analysis Method
Prep
Prep Analysis
Parameter Result Units Flags MRL MCL Method
Date Date Analyst
-k 4'1c un/ -,' 0 -IV I est was conaucrea Oy: Anatyttca-Anchorage
Nitrate as N <MRL mg/L 0.10 10 4/18/2008 4/18/2008 JK
Lab#: A0804124 -02C
Analysis Method Prep
s MRL MCL Method Prep Analysis
Parameter Result Units Flags Date Date Analyst
92228 (Aqueous) - Membrane Filtration MF Test was conducted by. Analyrica -Anchorage
Bacteria, Other <MRL CFU/100mL 1.0 4/15/2008 4/15/2008 DC
Total Coliform <MRL CFU/IOOmL 1.0 1 4/15/2008 4/15/2008 DC
Reported by: Steve Gaither,
Laboratory Project Manager
Page 2 of 2
DI�R-21-2008 11:19A FROM:
70:3383246 P:1/1
A+ I-Icme %13,ervdces, Inc.
Inspections
Tank -Type: _�� �_ ---- -- —• —
Name:
--
Address:—/ (o y_cf1Phone Number:
Inc ection ti
'timer Setting. 4 Qom-
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Air Flow
Elapsed Time
Event Counter
Date k
'PR 11:43P FROM:
ME AAROW PUMP & WER SERVICE, LLC
P.O. Box 110496
Anchorage, AK 99511
Office: (907) 346-9355 • Fax (907) 333-8978
Eagle River: (907) 622.9335
CUSTOMER
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70:3383246 P.1
JOB SITE
MOO TO
N° 08002
J
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L4179110.9
WELL DEPTH
—
8wl
CHLOPoNATED
PUMP DEPTH
6 (PERSON
OU NTITY
DESCRIPTION
PRICE
AMOUNT
Cody,00
LABOR
HOURS
RATE
AMOUNT
TOTAL MATERIAL
TOTALLABOR
WORK ORDERED BY
DATE COMP. I
TOTAL
LABOR
PAY THIS AMOUNT
Thank You
SIGNATURE
it Hereby Acknowledge the Satisfactory Completion of the Above Descrlbed Work and agree that It above work Is not paid for In 90 days I agree to allow Aarow
Pump 8 Well SeMoe, LLC. the right to remove unpaid for equipment and charge for labor already performed a tabor to remove unpaid for equipment.)
TERMS: ACCOUNTS PAYABLE AT 10TH OF MONTH FOLLOWING PURCHASE.
SERVICE CHARGE AT RATE OF 1.6% PER MONTH WILL BE CHARGED ON OVERDUE ACCOUNTS.
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ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND
REPAIR AGREEMENT
MEMORANDUM OF UNDERSTANDING
BETWEEN j/�J UNICIPALITY O ANCHORAGE
AND C �I %LYI /�l • %) msl fa6(
THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this
Day of
of 20_, by and between &-/" /,/
herein the "OWNER," and the Municipality of Anchorage, herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein, the
parties to this Memorandum of Understanding agree as follows:
1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality
grants permission to Owner to utilize and operate an Advanced Wastewater
Treatment System (AWWTS), described as located
at /1*441 GkR5ewood Lan e- , Anchorage, Alaska.
2. Definitions.
A. Alteration. Any change to the design or function of an AW WTS that
Includes the installation or removal of any parts, components or pieces not
included in the original construction permit and design. Prior to
performing any alterations to an A W WTS the owner must obtain a
Wastewater Disposal System Construction Permit from the Municipality
pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65.
B. Certificate or On -Site Systems Approval. An approval by the
Municipality of existing water and wastewater disposal systems given at
the time of property sale and title transfer in accordance with AMC 15.65.
These approvals certify that the systems are adequate for the homes that
they support and meet the codes that were in place at the time of system
construction.
C. Damage. Any man-made or natural change in a system that would inhibit
the system from performing as designed.
D. Maintenance and Repair. The scheduled and as needed replacement of
existing parts, components and pieces of an AWWTS that were included in
the original design which would allow the A W WTS to continue to
perform as designed.
B. Permit (Construction) An On -Site Wastewater Disposal System
Construction Permit as defined by AMC 15.65.
F. Permit (Operating) An Advanced Wastewater Treatment System
Operating Permit. An annual permit, issued by the Municipality, that
allows the Owner to operate an A W WTS, upon meeting all the
requirements of this agreement, the conditions of Operating Permit, the
requirements of the On -Site Wastewater System Construction Permit and
all relevant provisions of AMC 15.65
3. F//e%%e.. Owner shall pay to Municipality an annual fee of l�
($4
$ y'.00), payable on or before the issuance of the operating permit and annually
thereafter. The annual fee is due on or before the anniversary date of the approval by the
Municipality of installed system.
4. Term. The term of this Memorandum of Understanding shall be for the life of the
AW WTS.
The term begins on the date of approval by the Municipality of the installed system and
shall continue while the AW WTS system is in use or operational or until the property is
sold or title is transferred by owner and a new certificate of On -Site approval is issued to
the new owner or transferee of the property.
5. Alterations, Installation and Removal of Additional P.guipment. Owner agrees
not to make any alterations, removal of parts or additions to the AW WTS without a
Construction Permit from the Municipality.
6. Maintenance and Repairs.
A. Throughout the term of this Memorandum of Understanding, the Owner shall
maintain AW WTS in good repair. In addition, it shall be the responsibility of the
Owner during the term of this Memorandum of Understanding, and any extensions or
renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2)
maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs.
Further, Owner agrees to comply will all applicable ordinance, laws, regulations,
rules and orders for the A W WTS.
B. Owner agrees to provide the Municipality a written schedule of routine
maintenance and repairs which have been performed on the system pursuant to the
terms and conditions contained in the Owner's AW WTS Operating Permit. This
schedule shall be submitted to the Municipality annually upon the renewal of the
permit. The schedule of maintenance and repair contained in the Owner's AWWTS
Operating Permit is:
C. Owner acknowledges that the fine s edule for failing to maintain and repair an
AW WTS are codified in AMC 14.60.
D. Owner agrees that only maintenance, repair personnel certified by the
Municipality will inspect and make any necessary maintenance, repairs or permitted
alterations to the system.
E. Owner agrees to grant the Municipality reasonable access to test and inspect the
AW WTS upon 24 hours written notice.
F. Owner agrees that any sale or transfer of title of the property will not occur
without a new Certificate of On -Site Systems Approval.
G. Owner agrees that the relevant provisions of the standard specification guidebook
for AW WTS is the governing professional guidelines for the construction,
maintenance and repair of the Owner's AW WTS.
7. Nonwaiver. The failure of either party at any time to enforce a provision of this
Memorandum of Understanding shall in no way constitute a waiver of the provisions,
nor in any way effect the validity of the Memorandum of Understanding or any part
hereof, or the right of such party thereafter to enforce each and every provision
hereof.
8. Amendment.
A. This Memorandum of Understanding shall only be amended, modified or changed
by a writing, executed by authorized representatives of the parties, with the same
formality of this Memorandum of Understanding was executed and such writing shall
be attached to this Memorandum of Understanding as an amendment.
B. For the purposes of any amendment modification or change to the terms and
conditions of this contract, the only authorized representatives of the parties are:
Owner. 4C J i f+o., jAo i Pet.7Y� G; a ? . O�wr $ •t�
Anchorage: Purchasing Officer
C. Any attempt to amend, modify, or change this contract by either an
unauthorized representative or unauthorized means shall be void.
9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of
Understanding shall be brought in the Superior Court for the Third Judicial District of the
State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and
obligations of the parties under this Memorandum of Understanding.
10. Severability. Any provisions of this Memorandum of Understanding decreed
invalid by a court of competent jurisdiction shall not invalidate the remaining provisions
of the Memorandum of Understanding.
OWIYF,R:
By: M G( m , PIV
Date: 41Z - IG S
STATE OF ALASKA
THIRD JUDICIAL DISTRICT
MUNICIPALITY:
By:
Title:
Date:
) ss.
The foregoing instrument was acknowledged before me
2006, by cif Fl6n QIMS-14end
INWARYLOUBLIC FOR ALASK
My Commission expires: W%{plao/
STATE Olt ALASKA
OFFICIAL SEAL
JENNIFER R. HUNTLEY
NOTARY PUBLIC mY�cvllo
My Commission Expires
April 22, 2008
Jody Maus
Senior Engineer
Gamess Engineering Group, Ltd.
3701 E. Tudor Road
Anchorage, Alaska 99507
RE: 16411 Chasewood Lane
Dear Jody:
I've enclosed the application for the Muni maintenance agreement for the Chasewood
Lane property that my wife and I are buying. Thank you for the information that you've
shared with me about the septic system. Would you review this maintenance and repair
agreement (I'm not sure of the name of this septic system to enter in Item No. 1), and tum
it in to the Muni?
Also, I understand that your firm is testing the septic and the well for the owners. They
have agreed to allow us to review your reports prior to closing. Would you contact me
when you have your inspection reports completed, so I can review them.
Thank you for your assistance.
Sincerely,
Clifton M. Olmstead
P.O. Box 774462
Eagle River, Alaska 99577
Cell: 229-0648
Municipality of Anchorabe
De artment of Health and Human Services li
P Division of Environmental Services} I
On -Site Services Section 825 "L" Street Room 502
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-4744
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FORA SINGLE FAMILY DWELLING
Parcel I.D. 020-093-31
HAA# fllCCC
Expiration Date:
1. GENERAL INFORMATION
Complete legal description Lot 2,
Another
Subdivision
Location (site address or directions)
16441 Chasewood Lane
Current Properlyowner(s) Greg Dittmer
Day phone
345-2622
Mailing address 16441 Chasewood Lane,
Anchorage, AK 99516
Lending agency
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, HAA will be held by DHHS
for pickup. HAA picked up by:
/,o
2. NUMBER OF BEDROOMS:
3
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Cyj
Individual On-site
50
Individual Water Storage
❑
Individual Holding Tank
❑
Community Class 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 prcperties 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 Municioality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
-2 015 P,v p1 CCS'
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation
based on procedures outlined in the Health Authority Approval Guidelines for the Health Authority Approval
application show 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 applicable Municipal and State
codes, ordinances, and regulations in effect at the time of installation.
5 8 5 ENGINEERING Phone l f7 - �- cl 7 41
Loop Name of Firm�7e,¢� ,ver
Address Eanle Rfv P Road No. 20q
er.-A1aslca 99577
Engineer's Printed
6. DHHS SIGNATURE
V- Approved for i bedrooms.
Disapproved.
Conditional approval for
Additional Comments
N Date r
tt,
bedrooms, with the following stipulations.
Attachments:
HAA Checklist Maintenance Agreements
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
By: ��{ � _ / �. �c-�� Original Certificate Date: 6 - / 9 C c
Expiration Date: 67/ - / e7 - O o Reissue Date:
75-025 iRw 01 001'
IF i4iaN1,�
"
•f
••��
fit^
�t+i
.Y ;'FJJGHJFeR 4'i�. �<L
tt,
bedrooms, with the following stipulations.
Attachments:
HAA Checklist Maintenance Agreements
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
By: ��{ � _ / �. �c-�� Original Certificate Date: 6 - / 9 C c
Expiration Date: 67/ - / e7 - O o Reissue Date:
75-025 iRw 01 001'
Municipality of Anchorage
Department of Health and Human Services
Division of Environmental Services
On -Site Services Section 825 V Street Room 502
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-4744
RECEIVED
JUN 0120
MUNICIPALITY OF ANCHORAGE
vIRONMENIAL SERVICES DMV
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: ),OT- M o rHz- R 'S/0 Parcel I.D.:
A. WELL DATA 08.0-093-3/
Well type PAlv4 rf. If A, B, or C provide PWSID # — Well Log A rT.ic-t/tiJ
Date completed 7/a9 93 Sanitary seal Yl� J Wires properly protected YE S
Total depth so 3 ft Cased to it Casing height (above ground) ay{ in.
FROM WELL LOG AT INSPECTION
Date of test -2 q q 3
Static water level t M g ft °� S~ I ft
Well production ) 9 -p.m y S 9 -p.m
WATER SAMPLE RESULTS:
Coliform O colonies/100 ml Nitrate 0-S7 mg/I Other bacteria' colonies/100 ml
Date of sample: 0 o Collected by: S a 5 ENGINEERING., .
17034 Eagle River Loop Road No. 204
B. SEPTIC/HOLDING TANK DATA Eagle River, Alaska 99577
Tank Type /Material
Date installed S_// -7 /00 Tank size SV gal , Number of Compartments
pug cos
Cleanouts Yi S Foundation cleanout TAN< Depression over tank N 0 i High water alarm yE S
Date of pumping 141A N4 w Pumper
C. ABSORPTION FIELD DATA
Date installed 17 /o o Soil rating (g.p.d.M2 or ft2/)drm) a System type 1 • D • S . F.
Length 3 0 ft Width I a• ft Gravel below pipe 3 +_
Total depth �ft Effective absorption area3 6 0 1? Monitoring tube y±J Depression over field M v
Date of adequacy test N�g '^�i�^- Results (Pass/Fail) For 3 bedrooms
Fluid depth in absorption field before test in Water added p_ in.
Elapsed Time: min Final fluff in Absorption rate >= g.p.d.
Any rejuvenatio past 12 mo.) (Y/N 8, type) If yes, give date
72-026 (Rev. 01/00)*
D. LIFT STATION
Date installed-rh7/40 Size in gallons P-S'O Manhole/Access Y -f _f
"Pump on" level at � *1 in "Pump off" level at 32- in High water alarm levet at 114 in
Datum Q a r r a rt Cycles tested oL Meets alarm & circuit requirements y �1
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 10 0 F On adjacent lots )OC 'I -
Absorption
fAbsorption field on lot /00 t On adjacent lots / 0
Public sewer main N /A Public sewer manhole/cleanout V14
i
Sewer /septic service line A S Holding tank N 1A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation '77 Property line LY'Y Absorption field 7
Water main 10 �4- Water service line iy Surface water 1 a 0 4 -
Drainage
Drainage N 1A Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line S a , Building foundation Sa I Water main 14
Water Service line 10 Surface water /00 f Driveway, parking/vehicle storage S f
Curtain drain a o 4 Wells on adjacent lots 100 t
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and a !�
review of Municipal records that the above systems are in i r
conformance with MOA HAAuidelines in effect on this date. r A /
g n ROBERT . COWAN ,?•/
CE -8201
Engineer's Printed Name 80,6647- C . Co w4 v /i l.• . ;.;.;
Date C13/loo 4 •`
HAA Fee $ � `I D
Date of Payment
Receipt Number 4777 (F.1117)
72026 (Rev. 01/00)•
Waiver Fee $
Date of Payment
Receipt Number
MUNICIPALITY OF ANCHORAGE
M E M O R A N D U M
WATER WELL ADVISORY
HEALTH AUTHORITY APPROVAL NO. Doo a a3
During a recent Health Authority Approval on-site inspection
and test of the potable water supply well on Lot
Bloc{ -- of ,g N o % i� �%Z Subdivision, the well's
productivity was determined to be O. ys' gallons per minute.
The minimum well productivity required by this Department
(ADiC 15.55) for a 3 bedroom residence is 0.3 / gallons
per minute. Although the subject well currently exceeds this
minimum requirement, all parties concerned are advised that the
production capacity of the well may fluctuate. Restriction
of ncn-crit'-cal water uses such as washing cars and watering
lawns and gardens may be required.
This advisory must be attached to all copies of the subject
Health :.uthority Approval.
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw SL
P.O. Box 196650 Anchorage, AK 99519-6650
www.el.anchorage.ak.us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 020-093-31 HAA# 4M b/0 S y
1. GENERAL INFORMATION Expiration Date: 1 O
Complete legal description "ANOTHER SUBDIVISION: LOT 2
Location (site address or directions) 16441 CHASEWOOD LN
Current Property owners)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
SARAH CHAMBERS Day phone 345-2221
16441 CHASEWOOD LN. ANCHORAGE, AK 99516
Day phone
KATHI CHAMBERS (REMAX PROPERTIES) Day phone 257-0147
2600 CORDOVA ST. ANCHORAGE, AK 99503
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
❑
Community On-site
❑
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 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) for properties served by a single family on-site wastewater disposal and/or
water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water sample results less than 30 days old. (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 AuthorityApproval 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 Munfclpality 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 Finn ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone
Address 6901 DEBARR ROAD, SUITE 2B • ANCHORAGE. AK 99504
Engineer's Printed Name
Engineer's Comments:
JEFFREY A. GARNESS, P.E.
In conducting this eveluatlon, AINWC, Inc attempted to provide a thorough,
conscientious engineering analysts of the system In accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described Me performance of the
system under the condNons encountered at the time of the test and separation
distances measured to readily Identilable features. The operational Via 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. AK=, Inc. 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 o/ this report by any
other person or party Is not authorized, nor will it confer any legal tight whatsoever.
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
337-6179
Date o
Conditional approval for bedrooms, with the fllowing stipulations:
The attached septic system maintenance agreement shall be sign
owner at transfer of title and returned to this office
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
y�{g7..,� ya;s:...P
9G533
00000��t (OFA
�G ON-SITE G
WATER AND
WASTEWATER :
PROGRAM
v new
Manitenance Agreements
Supplemental Engineer's Reort
11-< . Other
By: Lf% • Original Certificate Date: -7- 31—OL
(iw. 11%)
\ Municipality of Anchorage
(• "l Development Services Department'°:
\ Building Safety Division
OnSke Water S Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.d.anchorage.akus
(907)343.7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: ANOTHER SUBDIVISION; LOT 2 Parcel ID: 020-093-31
A. WELL DATA
Well typo PRNATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 7/29/93 Sanitary seal (YIN) YES Wires properly protected (Y/N) YES
1-503 1-32
Total depth 2-665fL Cased to 2-44 ft. Casing height (above ground) 18+ in.
FROM WELL LOG AT INSPECTION
Data of test 7/29/93 4/29/00
Static water level 148 iL 251 ft,
Well production 1 g.p.m. •0.45 g.p.m.
WATER SAMPLE RESULTS: *S&S ENGINEERING
Coliform 0 colonies/100 ml. Nitrate 0.5 mgA. Other bacteria 0 colonies/100 ml.
Data of sample: 7/9/01 Collected by: AWWC. INC.
B. SEPTIC/HOLDING TANK DATA
TankType/Materlal STEEL Date Installed 5/17/00
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (YIN) YES Depression over tank (YIN) NO High water alar (YIN) YES
Date of pumping 7/20/01 Pumper NORTHLAND PUMPING
C. ABSORPTION FIELD DATA MONITORING TUBES WERE DRY ON 79 2001
Date Installed 5/17/00 Soil rating 0.p.d r ft'/bdrm) 2_0 System type ISF
Length 30 ft. Width 12 JL Gravel below pipe 0.25 fL
Total depth ---!—IL Eft. absorption area 360 ft' Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass/Fall) PASS For 3 bedrooms
Fluid depth In absorption field before test_ in. Water added _ gal. New depth _In.
Elapsed Mme: — min. Final fiuld depth _ in. Absorption rate >_ -- g.p.d.
Any rejuvenation treatment (past 12 mo.) (YIN & type) NONE KNOWN If yes, give date –
D. LIFT STATION
Date installed 5/17/00 Size in gallons 1250 Manhole/Access (YIN) YES
'Pump on' level atTIMERin. 'Pump ofr level atTIMERIn. High water alarm level at 45 in.
Datum BOTTOM OF TANK Cycles tested N/A Meets alarm & circuit requirements? YES
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAlft station on lot
100'+
Absorption field on lot
100'+
Public sewer main
N/A
Sewer /sepfic service line
25'+
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Holding tank N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line *10,+ Surface water 100'+
Wells on adjacent lots 100'+ '
PER YEAR 2000 INSPECTION REPORI
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main N/A
Water service line `10' Surface water 100'+ Driveway, parking/vehicle storage 5'+
Curtain drain '20'+ Wells on adjacent lots 100'+
F. COMMENTS 'PER INSPECTION REPORT
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.
Englneefs Printed ame JEFFREY A. CARNESS
Date _7 2. g' La f
HAA Fee $ 300 • civ
Date of Payment7 /a q0r
Receipt Number '7&9'6
(Rev. 12=)
Waiver Fee $ 0 i rp
Date of Payment
Receipt Number
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
Water Well Advisory
Health Authority Approval # 010384
During a recent Health Authority Approval on-site inspection and test of the
potable water supply well on Block — , Lot 2 of Another subdivision, the
well's productivity was determined to be 0.45 gallons per minute. The
minimum well productivity required by this Department (AMC 15.55) for a
3 -bedroom residence is 0.31 gallons per minute. Although the subject well
currently exceeds this minimum requirement, all parties concerned are
advised that the production capacity of the well may fluctuate. Restriction
of non-critical water uses such as washing cars and watering lawns and
gardens may be required.
This advisory must be attached to all copies of the subject Health Authority
Approval.
('`
t^
PROPERTY OWNER MAINTENANCE AGREEMENT
ON-SITE WASTEWATER DISPOSAL SYSTEM
This agreement, dated August 2 , 2001, is made between the Municipality of
Anchorage Department of Health and Human Services (DIiHS) and the property owner(s) of
Rick L. and Judy C. King
This agreement is made for the purpose of maintaining an on-site wastewater disposal system
on the subject property.
The property owner(s) agree to the following:
The property owner(s) will have an annual inspection of the system performed by a registered
professional engineer. This inspection shall verify that all effluent and air pumps, timers, and
alarms are functioning as designed. Any deficiencies shall be corrected and the engineer's
statement that the system is functioning as designed shall be filed annually with the DHHS.
Property Owner Name
Rick L. King
(Notarize Here)
p-1millawt �� ,L !
1- I
State of Alaska
Judicial District 3rd ss.
On thisQday of August in the
year 2001 , before me, the undersigned notary
public, personally appeared: Rick L. King &
Judy C. King known to me to be
the person(s) whose name(s) is/are subscribed to the
within instrument and acknowledged that he/she/they
executed the same for the purposes therein
contained. f\
In wimesi whereof. I hereunto setim hand and
nz ef> L �
OFFICIAL SEAL (Notary's printed name)
Stato Of Alaska My commission expires: 1 `
DEBRA L. STOUT �ON iarn�
NOTARY PUBLIC
Municipality of Anchorage °
Development Services Department
Building Safety Division °
On -Site Water and Wastewater Progrun
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
Water Well Advisory
Health Authority Approval # 010384
During a recent Health Authority Approval on-site inspection and test of the
potable water supply well on Block — , Lot 2 of Another subdivision, the
well's productivity was determined to be 0.45 gallons per minute. The
minimum well productivity required by this Department (AMC 15.55) for a
3 -bedroom residence is 0.31 gallons per minute. Although the subject well
currently exceeds this minimum requirement, all parties concerned are
advised that the production capacity of the well may fluctuate. Restriction
of non-critical water uses such as washing cars and watering lawns and
gardens may be required.
This advisory must be attached to all copies of the subject Health Authority
Approval.
n
MUNICIPALITY OF ANCHORAGE
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
Application Date
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Lot 2, Another Subdivision
Location (address or directions)
February 10, 1986
(b) Applicant Name Cleve McDonald Telephone: Home 345-0064 Business 276-1451 x 213
Applicant Address —P.O. Boa: 110384 Anchorage Ak. 99511
(c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ❑ ; Buyer ❑ ; Other ❑ (explain);
(d)
(e)
M
Lending Institution
Address
Real Estate Company and Agent
Address
Telephone
Mail the HAA to the following address:
2. TYPE OF RESIDENCE
Single -Family i7 Multi -Family ❑ Other
Number o1 Bedrooms 3
Telephone
3. WATER SUPPLY
Individual Well © Community ❑ 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 0 Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department o1 Environmental Conservation
attesting to the legality and status.
Page 1 of 2
72-025 111,641
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION - I
As certified by my seal affixed hereto and as of the validation dale shown below. I verify that my Investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the Information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm Quadra Engineering Telephone 276-3770
Address 901 East Firm,,eed Lane, Anchorage, Alaska 99503
Date February 10, 1986
at E. And -nun
A381 -E
Engineer's Seal
6. DHEP APPROVAL
Approved for '��`'C3),
edrooms by 'Q" 2IC-2.0' Date 2 Zo —S6c
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
FAWI'1A3I17di_1
Well Classification
Private
^ MUNICIPAUTY OF ANCHORAGc
DEPT. OF HEALTH &
MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION
HEALTH AUTHORITY APPROVAL (HAA) FEB 131986
CHECKLIST - FEBRUARY 1984
2644720
Legal Description: Lot 2, 1�hFS��Lf7�
If A, B. C, D.E.C. Approved (YIN)
Weft Log Present (YIN) Y Date Completed 8/7/85 Yield .5 GPM
Total Depth 665' Cased to 60' Depth of Grouting
Static Water Level 20 Pump Set At 550'
Casing Height Above Ground 21 Sanitary Seal on Casing (YIN) y
Electrical Wiring in Conduit (YIN) Y Depression Around Wellhead (YIN) N
Separation Distances from Well:
To Septic/Holding Tank on Lot 115' ; On Adjoining Lots 300'+
To Nearest Edge of Absorption Field on Lot 140' ; On Adjoining Lots 3001+
To Nearest Public Sewer Line N/A To Nearest Public Sewer
Cleanout/Manhole N/A To Nearest Sewer Service Line on Lot N/A
Water Sample Collected by C. McDonald ;Date 2/12/86
Water Sample Test Results Acceptable
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed 7/85 Size 1000 Gal - No. of Compartments 2
Standpipes (YIN) y Air -tight Caps (YIN) Y Foundation Cleanout (YIN) _
Depression over Tank (YIN) N Date Last Pumped New Tank
Pumping/Maintenance Contract on File (YIN) _
Holding Tank High -Water Alarm (YIN) N
Separation Distances from Septic/Holding Tank
To Water -Supply Well 115'
To Property Line 20'
To Water Main/Service Line N/A
Course N/A
N/A
for
Temporary Holding Tank Permit (YIN)
To Building Foundation
To Disposal Field —
40'
35'
To Stream. Pond, Lake, or Major Drainage
Comments Tank was recently installed and has yet to be put into
service.
Page 1 of 2
72-02601,64)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata 330 Ft2/Bedroom Type of System Design Bed
Date Installed 7/85 Length of Field 561
Width of Field ' r , Depth of Field
Gravel Bed Thickness 21 under drain rock
Square Feet of Absorption Area 1512 Ft2 Standpipes Present (Y/N) Y
Depression over Field (Y/N) 27 Date of Last Adequacy Test New System
Results of Last Adequacy Test New System
Separation Distance from Absorption Field:
To Water -Supply Well 1401 To Property Line 121
To Building Foundation 751 To Existing or Abandoned System on
Lot N/A ; On Adjoining Lots 3001+
To Water Main/Service Line N/A To Cutbank (if present) 3001+
To Stream/Pond/Lake/or Major Drainage Course N/A
To Driveway, Parking Area, or Vehicle Storage Area 5' to Drivewa
Comments
D. LIFT STATION N/A
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at _
Tested for
Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Check Permitted Bedroom Rating Against HAA Request •'
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Icertify thatl avechecked,v Wied,orconformedtoall MOA and
HAA guidelines ineffect onthe date ofthis inspection.
Signed �%G;( 2/11/86
Company QUADRA EngineerinMOA No. ST 85-199
Receipt No. 3-7
Date of Payment R ' i'3--5lSo r ~ •� CE OF .44 %10
tp.,,.. q l
Amount: $ �e �� ��:�,�7-r, �s'r ��, Engineer's Seal
Page 2 of 2
72-026 (11,84)
401 EAST FIREWEED LANE
ANCHORAGE, ALASKA 99503-2197 Q
(907) 276-3770
DATAFAX NO. (907) 279-5092
ANCHORAGE JUNEAU BETHEL FAIRBANKS
February 20, 1986
Municipality of Anchorage
Department of Health and
Environmental Protection
825 L Street
Anchorage, Alaska 99501
Attention: Steve Morris
Subject: Lot 2, Another Subdivision - Water Sample
Gentlemen:
I hereby certify the water sample collected from the system
located on the subject property was collected in accordance with
specifications required by the Municipality of Anchorage and the
Chemical and Geological Laboratories of Alaska, Inc.
Sincerely yours,
7� Cr a ^'
Michael E. Anderson, P.E.
MEA/jb
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