HomeMy WebLinkAboutDROST LT 47APermit Number:OSP261043
Tax Code Number:05110467000
Work Type:SepticTank Upgrade
Effective Date:
Design Engineer:
Site Legal Address:DROST LT 47A G:1358
Owner:BERGQUIST ERIK D & MICHELLE D
Site Mailing Address:21637 AURORA BOREALIS RD, Chugiak
Lot Size in Sq Ft:55449
Total Bedrooms:3
This permit is for the construction of:
Disposal Field Septic Tank Holding Tank Privy
Non-Public
Water Well Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Coodinate with On-Site staff regarding preferred method.
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
4/17/2026
4/17/2027
PANNONE ENGINEERING SERVICES
Expiration Date:
¨þ ¨¨¨¨
Issued To:
Issued By:
Date:
Date:
4/17/2026
4/17/2026
PANNONE ENGINEERING SERVICES
Isatou B Njie
MUNICIPALITY OF ANCHORAGE
On-Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On-Site Wastewater Disposal System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-790A
On -Site Water & Wastewater Section
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 051-104-67
� ERIK D & MICHELLE D BERGQUIST 907-748-4271
Property owner(s., Day phone
Mailing address 21637 AURORA BOREALIS RD, CHUGIAK, AK 99567
Site address 21637 AURORA BOREALIS RD, CHUGIAK, AK 99567
Legal description DROST LOT 47A
Number of Bedrooms 3
Engineering Firm Pannone Engineering Services, LLC.
Building Permit Number
Not Applicable AN
APPLICATION IS FOR: APPLICATION IS AN:
(Z all that apply)
Disposal Field
D Initial ❑
Septic Tank
Upgrade
Holding Tank
❑ Renewal ❑
Privy
❑
Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Permit/Rush Fees: L _z_ S_
Date of Payment: - V/ /t / Z_ "o
Permit No. ko a's r- Z_' / �i � 7
May 2025
Waiver Fees:
Date of Payment:
Waiver No.
Distance:
Pannone Engineering Services LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steve@panengak.com
10 April, 2026
Mailing: P.O. Box 1807 Palmer, AK 99645
Telephone: (907) 745-8200 FAX: (907) 745-8201
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, Alaska
Subject: Drost Lot 47A
21637 Aurora Borealis Rd, Chugiak
Septic Tank Replacement
This is a design narrative for a permit to install a 1250-gallon poly septic STEP tank to replace an existing 1250-gallon
steel septic STEP tank to be issued for this property. The existing tank is 34 years old and is likely perforated and
leaking, it will be removed and replaced per code. Currently the lot is developed. The proposed replacement will be
connected to the existing drain field. This lot and the surrounding lots are served by private wells. There are currently
no wells within 100 of this upgrade.
1. Upgrade Tank Design.
A foundation clean out installed if needed.
The tank will be located: 5+ from any property line.
5+ from any deck/stair support.
10+ from building foundation.
10+ from any water line.
100+ from any surface water.
100+ from any private wells.
200+ from any public wells.
The proposed installation will not affect the future development of this or the surrounding lots.
If you have any questions, please contact me at (907) 745-8200.
Sincerely,
Steven R. Pannone, PE, F. ASCE
Owner/Civil Engineer
10 April 2026
Sincerely,
Steven R.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP261043, Isatou Njie, 04/17/26
150.0'
WELL RADIUS
100.0'
WELL RADIUS
101.7'
100.0'
WELL RADIUS
100.0'
WELL RADIUS
WELL (E)
3BR
SFD
(E)
DISPOSAL
FIELD (E)
DROST LOT 47A
EXIST. 1250 GAL STEEL STEP
TANK, TO BE REMOVED AND
REPLACED WITH 1250 GAL
POLY STEP TANK.
DRIVEWAY
FCO (E)
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EXISTING SEPTIC
DESIGN PARAMETERS
PRIMARY SEPTIC SYSTEM
NO. BEDROOM: 3(450 gpd)
TANK SIZE: 1250g STEP
USE:
TANK SIZE: 1250g STEP
WATER LINE / WELL
RADIUS
LOT LINE
THE CONTRACTOR, AND OR THE PROPERTY OWNER RESPONSIBLE FOR THE INSTALLATION OF THE PROPOSED WASTEWATER TREATMENT SYSTEM SHALL NOTIFY PES A
MINIMUM OF 24-HOURS IN ADVANCE MONDAY THROUGH FRIDAY OF THE REQUIRED PRE-CONSTRUCTION INSPECTION. AT THIS TIME A REPRESENTATIVE OF PES AND THE
CONTRACTOR OR PROPERTY OWNER WILL
1. DISCUSS CONSTRUCTION PROCEDURES AND DESIGN REQUIREMENTS.
2. VERIFY SITE CONDITIONS CONFORM TO THE DESIGN PLANS AND PERMIT.
3. VERIFY THE PROJECT LAYOUT CONFORMS TO THE DESIGN PLANS AND PERMIT.
(Ref: AMC 15.65)
PLEASE REFER TO THE NOTES AND SPECIAL PROVISIONS PAGE FOR MORE INSPECTION INFORMATION.
PES SHALL NOT BE HELD LIABLE FOR INSTALLATIONS NOT MEETING THE REQUIREMENTS OF 18 AAC 72 AND/OR AMC 15.65 AND THE SPECIAL PROVISIONS OF THIS PERMIT AS
APPLICABLE IF THE CONTRACTOR AND OR PROPERTY OWNER FAIL TO GIVE PES PROPER NOTICE. PES WILL ATTEMPT TO DOCUMENT THE SYSTEM AND OBTAIN ANY NECESSARY
WAIVERS AT THE CONTRACTOR AND OR PROPERTY OWNERS EXPENSE. PES MAKES NO GUARANTEES THAT ANY NEEDED SEPARATION DISTANCES WAIVERS WILL BE APPROVED
BY ADEC OR THE MUNICIPALITY OF ANCHORAGE ONSITE DEPARTMENT STAFF.
ABBREVIATIONS
CO CLEAN OUT NO.
DCO DOUBLE CLEANOUT
DV DIVERTER VALVE
(E) EXISTING
FC FOUNDATION CLEANOUT
FS FLOW SPLITTER
MT MONITOR TUBE NO.
MH MANHOLE NO.
(N) NEW
NIC NOT IN CONTRACT
(P) PROPOSED
R.I. RIGID INSULATION
TH TEST HOLE
TYP TYPICAL
ESMT/SETBACK
BOUNDARY
NOTES:
1. CONTRACTOR TO VERIFY THE PRESENCE
OF A FOUNDATION CLEANOUT. IN THE
CASE THAT NO SUCH CLEANOUT IS
PRESENT; CONTRACTOR SHALL INSTALL A
DOUBLE CLEANOUT ON THE INLET SIDE
OF NEW TANK.
2. WELL RADIUS TO BE STAKED PRIOR TO
COMMENCEMENT OF WORK.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP261043, Isatou Njie, 04/17/26
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SCALE: NTS
*4' MIN.
10' MAX.
*: DEPTH OF BURIAL TO BE FIELD DETERMINED
BASED ON INCOMING LINE ELEVATION.
DISCHARGE TO BE
CONNECTED TO EXISTING
DISTRIBUTION PIPING
INLET PIPING TO BE
CONNECTED TO EXISTING
LINE
1250 GAL GREER DEEP BURY
POLY STEP TANK
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Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP261043, Isatou Njie, 04/17/26
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NOTES & SPECIAL PROVISIONS:
4. CONTRACTOR RESPONSIBILITIES:
4.1. THE CONTRACTOR SHALL FAMILIARIZE THEMSELVES WITH THE SITE CONDITIONS AND LOCATIONS OF
ALL LOT LINES, EASEMENTS, WELLS (E & P), SEPTIC SYSTEMS (E & P) AND SHALL MEET MINIMUM
SEPARATION DISTANCES OR AS NOTED.
4.2. THE CONTRACTOR (BOTH WELL AND SEPTIC SYSTEM CONTRACTORS) SHALL HAVE ANY WELL LOCATION
AND SEPTIC LOCATION STAKED AND ANY LOT LINE AND WELL RADIUS SHOWN ON THE PLAN WITHIN
30 FEET OF THE PROPOSED SYSTEM STAKED BY A REGISTERED LAND SURVEYOR BEFORE STARTING THE
WORK.
4.3. THE CONTRACTOR IS RESPONSIBLE FOR ALL R.O.W. AND OTHER REQUIRED PERMITS, OTHER THAN THE
ATTACHED.
4.4. THE CONTRACTOR SHALL CALL FOR LOCATING OF ALL BURIED UTILITIES.
4.5. THE CONTRACTOR SHALL PROVIDE 24 HOUR NOTICE TO THE ENGINEER PRIOR TO START OF WORK.
ALL SURVEYING AND LOCATES SHALL BE IN PLACE PRIOR TO NOTIFYING THE ENGINEER.
4.6. THE CONTRACTOR SHALL NOTIFY THE ENGINEER OF ANY DISCREPANCY BETWEEN THE APPROVED
DRAWINGS AND SITE CONDITIONS/LIMITATIONS POTENTIALLY CAUSING THE NEED TO MODIFY THE
DESIGN.
4.7. AT THE COMPLETION OF THE WORK, THE CONTRACTOR SHALL SUBMIT RED-LINE AS-BUILT DRAWINGS
TO THE ENGINEER. THE RED-LINES SHALL INCLUDE PIPE LENGTHS, ORIGINAL GROUND ELEVATIONS,
PIPE ELEVATIONS, AND TANK ELEVATIONS.
4.8. THE CONTRACTOR SHALL PROVIDE PHOTOGRAPHS OF THE SYSTEM INSTALLATION TO INCLUDE
BOTTOM OF EXCAVATION, TOP OF PIPE WITH CLEAN-OUTS AND MONITOR TUBES INSTALLED,
INSTALLED TANK AND FINAL GRADING.
5. THE CONTRACTOR SHALL CERTIFY THAT ALL WORK WILL BE PERFORMED IN ACCORDANCE WITH THE
APPROVED PERMIT, AND ANY AND ALL CHANGE ORDERS, AND THAT THE AS-BUILT REDLINES ARE TRUE AND
ACCURATE REPRESENTATION OF THE PROJECT AS CONSTRUCTED.
BY ACCEPTANCE AND CONSTRUCTION OF THE ATTACHED PLANS THE OWNER, CONTRACTOR AND APPLICABLE
REGULATORY AGENCY AGREE TO THE PROVISIONS SET FORTH ON THIS PAGE AS APPLICABLE AND ANY
SUBSEQUENT SPECIFICATIONS (IF ATTACHED).
1. GENERAL NOTES:
1.1. ANY MODIFICATIONS TO THE ATTACHED PLANS NEED TO BE APPROVED BY PES AND THE OWNER OF THE PROPERTY.
1.2. PES SHALL BE NOTIFIED A MINIMUM OF 48 HOURS IN ADVANCE BEFORE CONSTRUCTION OF THE PROPOSED WASTEWATER
TREATMENT SYSTEM.
1.3. PES SHALL BE NOTIFIED A MINIMUM OF 24 HOURS IN ADVANCE TO PERFORM A MINIMUM OF FOLLOWING INSPECTIONS:
1.3.1. A PRE CONSTRUCTION MEETING IS REQUIRED BY STATE AND MUNICIPAL REGULATIONS BEFORE A ONSITE WASTEWATER
TREATMENT SYSTEM MAY BE INSTALLED.
1.3.2. TOP OF SEPTIC AND OR HOLDING TANK (TANK IS SET IN PLACE LEVEL WITH ALL PIPING ATTACHED (CLEANOUTS, MANHOLES,
INLET AND OUTLET PIPING).
1.3.3. BOTTOM OF EXCAVATION OF THE DRAIN FIELD/S.
1.3.4. AFTER PLACEMENT OF FILTER SAND (IF NEEDED).
1.3.5. AFTER INSTALLATION OF THE DRAIN ROCK WITH ALL ASSOCIATED PIPING IN PLACE INCLUDING DISTRIBUTION LINES
CLEANOUTS AND MONITOR TUBES PRIOR TO INSTALLATION OF FILTER FABRIC AND INSULATION (IF NEEDED).
1.3.6. FINAL GRADE INSPECTION. ENTIRE SYSTEM IS INSTALLED AND BACKFILLED.
1.4. THE ENGINEER (PES) HAS NO CONTRACTUAL RELATIONSHIP WITH THE CONTRACTOR (THE INSTALLER OF THE SYSTEM) AND,
THEREFORE, HAS NO AUTHORITY, CONTROL OR RESPONSIBILITY FOR THE CONTRACTOR'S EMPLOYEES, THE QUALITY OF WORK,
THEIR COMPLIANCE WITH THE DESIGN DRAWINGS/SPECIFICATIONS OR THEIR MEANS/METHODS OF CONSTRUCTION. AT
APPROPRIATE INTERVALS, THE ENGINEER WILL VISIT THE WORKSITE TO OBSERVE THE QUALITY OF THE CONSTRUCTION AND TO
DETERMINE IN GENERAL IF THE CONSTRUCTION IS PROCEEDING IN ACCORDANCE WITH THE DESIGN
DRAWINGS/SPECIFICATIONS.THE ENGINEER WILL NOTIFY THE OWNER IF DEFICIENCIES ARE OBSERVED; HOWEVER, THE FAILURE OF
THE ENGINEER TO OBSERVE A DEFICIENCY WILL NOT RELIEVE THE CONTRACTOR OF THE RESPONSIBILITY FOR CORRECTING ANY
SUCH DEFICIENCY. THE ENGINEER WILL PREPARE RECORD DRAWINGS AND SUBMIT THEM TO THE REGULATORY AGENCY HAVING
JURISDICTION OVER THE WASTEWATER TREATMENT SYSTEM (ADEC OR MOA). FINAL APPROVAL OF THE WORK AND CORRECTION
OF ANY DEFICIENCIES IS BETWEEN THE OWNER, THE CONTRACTOR, AND THE REGULATORY AGENCY HAVING JURISDICTION OVER
THE WASTEWATER TREATMENT SYSTEM (ADEC OR MOA).
2. SCOPE AND SPECIFICATIONS:
2.1. ALL CONSTRUCTION SHALL BE AS SPECIFIED IN THE ATTACHED PLANS. CONSTRUCTION ACTIVITIES SHALL ALSO BE IN
ACCORDANCE WITH THE MOST CURRENT EDITION OF THE FOLLOWING CODES AND POLICIES AS APPLICABLE.
2.1.1. 18 AAC 72
2.1.2. AMC 15.65
2.1.3. AMC 15.55
2.1.4. MOA STANDARD SPECIFICATION FOR COMPONENTS PARTS AND MATERIALS.
2.1.5. ADEC ONSITE WASTEWATER SYSTEMS INSTALLATION MANUAL (OWSIM).
2.1.6. MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS).
2.2. SCOPE OF WORK: INSTALL SYSTEM IN ACCORDANCE WITH THE ATTACHED DESIGN AND SPECIFICATIONS.
2.3. GROUNDWATER WAS ENCOUNTERED AT A DEPTH OF 10 FEET BELOW EXISTING GRADE. IF AN APPARENT WATER TABLE IS
OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 8 FEET BELOW EXISTING GRADE NOTIFY THE ENGINEER IMMEDIATELY.
2.4. STRUCTURES DEPICTED ON THE SITE PLAN ARE BASED UPON ONE OF THE FOLLOWING: CONCEPTUAL PLOT PLAN DEVELOPED BY
OWNER; A PLOT PLAN DEVELOPED BY RLS; OR A SURVEY AS-BUILT.
3. CONSTRUCTION SPECIFICATIONS:
3.1. ALL EXCAVATION DEPTHS ARE ADVISORY. THEY ARE TO BE VERIFIED AND MAY BE MODIFIED BY THE ENGINEER IF ACTUAL FIELD
CONDITIONS VARY FROM THOSE USED TO PREPARE THE DESIGN
3.2. EXCAVATE THE DRAIN FIELD. BOTTOM OF EXCAVATION SHALL BE LEVEL AND SCARIFIED. RECORD ELEVATIONS AT BEGINNING,
MIDDLE AND END OF TRENCH BOTTOM. CONSTRUCTION EQUIPMENT SHALL NOT OPERATE ON THE FLOOR OF THE EXCAVATION.
ANY MATERIAL COMPACTED BY THE OPERATION OF THE CONSTRUCTION EQUIPMENT SHALL BE REMOVED AND REPLACED WITH
NON-COMPACTED MATERIAL.
3.3. PLACE THE SEWER ROCK TO THE SPECIFIED DEPTHS. DO NOT CONTAMINATE SEWER ROCK WITH NATIVE MATERIAL OR SPOILS
FROM EXCAVATION. LEVEL ROCK SURFACE TO ±1" PRIOR TO INSTALLING THE PERFORATED PIPE.
3.4. ALL PIPE SHALL BE SCHEDULE 40 ABS AND OR PVC CONFORMING TO ASTM F628 AND ASTM D3034 AS APPLICABLE OR ENGINEER
APPROVED EQUAL.
3.4.1. ALL PRESSURIZED SEWER LINES SHALL BE CONSTRUCTED OF SCHEDULE 40 PVC CONFORMING TO ASTM D1785 OR ENGINEER
APPROVED EQUAL
3.5. FOR MOA PROJECTS THE MINIMUM SOIL COVER SHALL BE 3 FEET OVER SEWER LINES AND DRAIN FIELDS AND 4 FEET OVER THE
SEPTIC TANK. ONE INCH OF INSULATION MAY BE SUBSTITUTED FOR 1 FOOT OF SOIL COVER.
3.6. FOR STATE OF ALASKA (ADEC) PROJECTS THE REQUIRED SOIL COVER IF 4 FEET FOR ALL WASTEWATER SYSTEM COMPONENTS.
3.7. THE MINIMUM ALLOWABLE SOIL COVER SHALL OVER ANY WASTEWATER SYSTEM COMPONENT SHALL BE 2 FEET WITH 2 INCHES OF
APPROVED INSULATION.
3.8. ALL INSULATION SHALL BE 2" THICK DOW HI-40 INSULBOARD OR ENGINEER APPROVED EQUAL. CENTER INSULBOARD WIDTH OVER
SEPTIC TANK, DRAIN FIELD, OR SEWER LINES.
3.9. GEOTECHNICAL FABRIC SHALL BE TYPAR 3401 OR ENGINEER APPROVED EQUAL. LAP ALL JOINTS 2 FEET MINIMUM. GEOTECHNICAL
FABRIC SHALL CONFORM TO AASHTO M288 CLASS 3 AND HAVE THE FOLLOWING CHARACTERISTICS:
3.9.1. MINIMUM PERMITTIVITY (ASTM D4491) -0.5/sec
3.9.2. MAXIMUM APPARENT OPENING SIZE (ASTM D4751) - 0.20 TO 0.21mm (US SIEVE #70)
3.10. COVER THE DISTRIBUTION PIPE WITH A MINIMUM OF 2" OF SEWER ROCK AND COVER WITH GEOTEXTILE BEFORE PLACING
INSULATION AND BACKFILL.
3.11. MATERIAL USED AS FILL SHALL BE CLEAN AND FREE OF ORGANICS, TRASH AND CONSTRUCTION DEBRIS.
3.12. SLOPE ALL FILL MATERIAL TO DRAIN AT 2% MINIMUM SLOPE AND 3:1 MAXIMUM SLOPE AND IN SUCH A MANNER THAT PONDING
AT OR NEAR THE DRAIN FIELD DOES NOT OCCUR. THE FILL SHALL BE LEFT AT 6" HIGHER THAN SHOWN TO ALLOW FOR
SETTLEMENT. SEED SURFACE AFTER COMPLETING INSTALLATION AS PER MOA CODE.
3.13. RECORD THE FINISH GROUND ELEVATION OVER THE BEGINNING, MIDDLE AND END OF SYSTEM.
3.14. MAINTAIN 5' SEPARATION BETWEEN PERCOLATION HOLE AND THE DRAIN FIELD TRENCH.
3.15. EXPOSE, PUMP AND FILL LOG DISPOSAL CRIB OR CONCRETE TANK WITH SOIL TO ABANDON IAW WITH MOA CODE IF NEEDED.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP261043, Isatou Njie, 04/17/26
Municipality of Anchorage Page
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 e Anchorage, Alaska 99519-6650 ¢ Telephone: 343-4744
O~=Sitte Wastewater Disposa~ System arid/or We~ ~r~spectior~ Report
Permit Number:- '~ '~~ PIDNumber: ¢~[1¢~
Name:
~. ~. ~~~ Wastewater Syste~: Q New ~Upgrade
Addr~I :~ ~~ ~ ~& ~ ABSORPTION FIELD _
Phone: ~
~J~ j (~ ....... gDoopTronch~__~~Shallowrrench U Bad.Mound ~Other
LEGAL DESCRiPTiON sci, Rating:~~I~ ~otal Depth from original grade:
Lot: ~ Block: ~~Subdivisi°n: ~ 3epth to pipe bottom~.~fromforiginal~ J,~grade~ Ft, Gravel depth beneath pipe ~l Ft.
Township: ~ Range: ~ Section: Fill added above original ~rade: t Gravel length:¢
Grave~:M~ . % Number of lines: [Distance betw~en~nes:
~ssification (Private~B,C): Total Depth: Cased To: Total absorption area:
Driller: Date Drilled: Static Water Level: Installer: Date installed:
Yield: GPM ~mp Set at: Ft~[~ Casing Height Above Ground:Ft. T~
SEPARATION DISTANCES U Septic [] Holding ~.E.P.
To Septic Absorption Lift Holding ~ublic/Private M~nufacturer: Capacit~in aliens:
Materiah¢ - Number~partments:
SurfaCewater[~)l4 [~1+ I~'~ ~_ ~ L~F% STATION
-~ Lot ~¢ Size in gallons: ~ Manufacturer:
Foundation I ~1 ~J I ~ I ~ / "Pump~¢~on" level at: /FPump~'l°ff" level at: ~___ ~li High water alarm ....... at:
Pump Make & Model ~ Electrical Ins~cti~s performed by: ,
Drain
Remarks: ~, ¢ ~ _ BENCH
~ Location and
~~~~O . AssumeOBevation:
ENG~EAL
Inspections performed by: ~~st~~ ¢~9~
Reviewed and approved by: {TW Date',
72-013 (1/91) MOA 25 r':
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUlYtAN SERVICES
ENVIRONMENTAL SERVICES D~V~S~ON
P.O. Box 196650 e Anchorage, Alaska 99519-6650 e Telephone: 343-4744
On-Site Wastewater Disposal System end/or Well Inspecfiorl Report
Legal Description~ ~--~2-~.. ~
N
72-013 A (2/91) MOA 25
Municipafity o~ Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
DATE PERFORMED:
LEGAL DESCRIPTION:
1
2
4
7
8
Township, Range, Section:
SLOPE
SITE PLAN
10
11
12
13
14-
15
16
17
18
19
20
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT pO
DEPTH?
Depth to Water
I~onitoring? ...... Dale:
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RArE '~' [ immures/tach) PERC HOLE DIAMEfER ~ 1¢
TESf RUN BETWEEN __ FTAND FT
COMMENTS __
PERFORMED BY: A &$ ENGINE~!N_G_. , ¢'"'-'~--~'/~ ~
ACCORDANCE WITH~%S4~,~¢¢~U~ID~"IN~E~S IN EFFECT ONITH'S DATE.
CER'TIFY THAT THIS TEST WAS PERFORMED IN
'7'310 Bulen Drive ® Anchorage, AK 99507
(907) 344-5539 (907) 273-3798
TO WHOM THIS MAY CONCERN:
REFERANCE~ SEPTIC LIFT STATION ELECTRICAL INSTALLATION°
LOCATION: PAT DROST RESIDENCE~NORTH BIRCHWOOD ROAD°
IN REFERANCE TO ELECTRICAL INSTALATION PERFORMED AT LOCATION
DESCRIBED~PROJECT WAS PERFORMED BY A COMPETENT JOURNEYMAN
WIREMAN LICENSNED IN THE STATE OF ALASKA~ AND WIRED ACCORDING
TO NATIONAL~STATE AND LOCAL CODES°
IF YOU HAVE ANY QUESTIONS CONCERNING THIS MATTER PLEASE CALL.
PROFESIONALY YOURS
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW920112
DESIGN ENOINEER:S & S ENGINEERING
OWNER NAME:DROST L M
OWNER ADDRESS:SR1 BOX 2679
CHUGIAK, AK 99567
DATE ISSUED: 5/28/92
EXPIRATION DATE: 5/28/93
PARCEL ID:05110467
LEGAL DESCRIPTION: DROST LT 47A
LOT SIZE: 55449 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD SYSTEM
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 (iSAAC80).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
BED MUST BE AT LEAST 25' FROM SHOLDER OF FILL AREA.
AREA OF OLD CRIB MAY BE UTILIZED PROVIDED THE CRIB AND
ROCK ARE REPLACED WITH APPROVED FILL MATERIAL. A 2'
SAND FILTER MUST BE UTILIZED BELOW THE BED. MAINTAIN
A MINIMUM 6' SEPARATION TO CLAY LAYER AND 4' TO GROUND
WATER. PROVIDE SECOND TEST HOLE AT TIME OF INSTALLATION.
RECEIVED BY:
April 21, 1992
ROBERT SHAFER, P.E.
ROGER SHAFER, P,E,
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
HEALTH AUTHORITY
APPROVALS
SEWER &WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
ANDREPORTS
WELLINSRECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
PoO. Box 196650
Anchorage, Alaska 99519-6650
REFERENCE: Lot 47A; Drost Subdivision;
Request you issue a permit to upgrade the septic system serving the
referenced property° Due to area constraints we also request you grant
a waiver for the horizontal separation distance between the proposed
septic system and the north and east lot lines°
In January of this year we applied for a Health Certificate on the
property° During this approval review, Dan Boll~s found file data
which suggested the existing system encroaches an impermeable layer.
To verify this suspicion we excavated a test hole and performed a
percolation test near the existing leachfield. The existing system was
found to be encroaching an impermeable layer as suspected°
Attached please find a site plan depicting the proposed septic upgrade°
The upgrade consists of a septic tank effluent pumping system and an
~levated mound type leachfi~ldo
The system is outside neighboring w~ll radii, and we do not anticipate
any adverse effects on the neighboring properties by the installation
of the proposed system.
Sincerely,
RJS/gm
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
50'
SCALE
UPGRADE
N~
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Anchorage, Alaska 99502-0650
SO~LS LOG -- PERCOLATION TEST
LEGAL DESCRIPTIO~"~'~'~~,; J~T~°wnship' Range, Section:
SLOPE SITE PLAN
1
2
3
4
5
6
7
8
9
10
11
t2
13
14
15
16
17
18
19
WAS GROUND WATER
ENCOUNTERED?
S
IF YES, ATWHAT ~)
DEPTH?
Monitoring? [.~ ' Date:
Reading Date
Gross Net Depth to Net
Time Time Water Drop
-4. ~_ " t '~ ele" ~/~"
20
PERCOLATION RATE
TEST RUN BETWEEN
(m~nutes/inch) PERC HOLE DIAMETER
AND ~ FT
PERFORMED BY' 170~4
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE·
CERTIFY THAT THIS TEST WAS PERFORMED IN
DATE: ..... _'~"~ \ -- g~'~'~-
72-008 (Rev. 4/851
Tom Fink,
Mayor
unicipality ot Ancl orage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
May 28, 1992
Roger Jo Shafer, P.Eo
SaS Engineering
17034 Eagle River Loop
Suite 204
Eagle river, AK 99577
Subject: Waiver Request for Lot 47A, Drost Subd.~ PID 051-104-67
Waiver Request #WR920020
Dear Roger;
Your request for waiver of the required 10 foot separation
between a septic system and a lot line has been denied.
Do to the nature of the fill material and the presence of a
slope greater than 25% the waiver cannot be granted. However~
the required 50' separation to.the top of the slope has been
waived to 25'
Should any future upgrade be necessary all separation
requirements will be met or necessary waiver(s) obtained.
Sincerely,
Daniel N. Bolles
On-Site Services
db/180
DEPARTMENT OF HEALTH & ENV]RONMENTAL PROTECTION ~,/~&¢'~
ENVIRONMENTAL ENGINEERING DIWS~ON
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ¢~4L~
ON-S~TE SEWAGE D~SPOSAL SYSTEM AND/OR WELL ~NSPECT~ON REPORT
NAME
MAILING A [~,1~ E S S
LEGAL DESCRIPTION
DISTANCE TO:
Liq. capacity in gallons
IF HOMEMADE:
IPHONE~ ~EDNE~
Dwelling
Material
Inside length Width
NO. OF BEDROOMS
No. of compartments
Liquid depth
DISTANCE TO:
[)welling
Manufacturer 1 Material
Well Foundation ~.~ ~arest Jot~i~ j
DISTANCE TO: / j~ / / ii~e~s ~r~h width .......
No. of lines
' / ~& inches
Top of tileto fini~ 9fade beneath tile
'~ r'~~¢ inches
Length Width Depth
Type of crib Crib diameter
Well
DISTANCE TO:
Class Depth
DISTANCE TO: Building foundation
PERMIT NO.
L-i q ~i d~-c a p~ci t~y i_n~g~a, ,~ n~s
Distance between lines
Total effectiv~e~absorptign area
PERMIT NO.
Crib depth Total effective absorption area
Building foundation Nearest lot fine
Driller
Sewer line
Distance to lot line
Septic tank
PERMIT NO.
Absorption area(s)
OTHER
SOIL TEST RATING
INSTALLER
REMARKS
DATE
PERMIT NO.
% C:%P'~I_ I T~' OF F~P-~CHC~RRGE
DEPARTMENT ~ HEALTH AND ENVIRONMENTAL OTECTION
825 'L" STREET, ANCHORAGE, AK. DD50i
264-4?20
OP4--SITE SE~4ER PER~ IT
800t87 )
APPLICRNT
LOCATION
LEGAL
BILLY KOLBRIK
BIRCHWOOD
POST OFFICE BOX 5-Si6 FT. RICH 688-S6i5
LOT SIZE S47D6 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: DRAINFIELD
MAXIMUM NUMBER OF BEDROOMS
SOIL RATING (SQ FT/BR)= 200
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
DEPTH= 4. 5 I_EN~TH= 42 GRAVEL. DEPTH= 2
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRGINFIELD.
THE DEPTH OF 8 TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION <IN FEET).
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
I~:E~U I RED, SEPT I r; TRt4K S I ZE= 10~-_~O 8R~_LOP4S
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLRTION INSPECTIONS OF 8NY WELLS RDJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
TWO ( 2 ) I P4SPECT I O~-~S ~tRE REQU I RED
BACKFILLING OF ANY S~¢STEM WITHOUT FINAL INSPECTION AND ~tPPROVRL B9 THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
t00 FEET FOR R PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PER~ I T E)(P I RES DECEMBER ~i.. iDG~]'~
I CERTIFY THRT
i: I AM F8MILtAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORRGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS.
SIGNED:
APPLICANT
BILLY KOLARIK
ISSL ED BY ..............
94.0
O&
E ENG,,4EERING & DEVELO~ .JENT CO.
Box 90, Davis St., Eagle River, Alaska 995'77
694-2774 or 688-2280
~u~se~ O~,ster
694-2774
Performed for:
Legal Description: ~-~'~
IGep~h (fee~}
0
2__
4__
5
7__
Mailing Address: -~ ~,',
Se~ Characterlsflc~
688~2280
!
L_~"r '/7
PLOT PLAN
12__
13__
14___
15__
16 ....
Ground Water Encountered: Yes No__ If yes, what depth
Proposed Installation: Seepage Pit Drain Field
Comments:
Performed by: _(~'~ ~- ~z~ ~r~,¢~_
!
r HERLTH RND EN'¢IRCNMENTBL r'"OTEC:TION
[EPRRTMENT) '
825 *L STREET, RNC. HORFIGE, BK.
264-4729
~=~--- -- . ' 0~4--5
F'ERMIT NO. ( )'
RPPL. IC:RNT ~zl(~ ~a(~(~ ¢0 ~d~ 5---~/~ ~'% ~c~
L. OC:RT I ON ~(¢
LEGAL ~ ] S. ~ ~ ~ h~ ~ t ~ LOT SIZE 3 ~, ]?~ SeLIflRE FEET
TYPE OF SOIL flBSORBTION SN"STEF1 [5' ~ror~m
MFIXIhlUM NIJMBER OF BEDRJOM~ _.
SOIL. RRTING (SQ FT,"'BR)= lO0
THE REQJIRED SIZE OF THE SOIL RB_~ORPTION SYSTEM IS:
[)EPT'H== ~-,~ LE~'4OTH= LcL ORRVE~- [)EPTH= ~
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF R TRENCH OR PIT IS THE DISTBNCE BETWEEN THE SURF8CE OF THE
GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OLITFFILL PIPE
RND THE BOTTOM OF THE EXCRVRTION (IN FEET).
PERMIT ~PPLIC~NT H~S THE RESPONSIDILIT9 TO INFORM THIS DEP~RTMENT DURING THE
INST~LL~TION INSPECTIONS OF ~N? WELLS NDJBCENT TO THIS PROPERTV BND THE
NUMDER OF RESIDENCES TH~T THE WELL NILL SERVE.
TL4C, < 2 ) I ~'4SF)ECT Z Oi'4S RREi ~:EQL~ I:
88CKFILLING OF RN¥ SYSTEM WITHOLIT FINRL INSPECTION RND RF'PROVRL BY THIS
DEPRRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTBNCE BETHEEN ~ WELL RND HNY ON-SITE SEWBGE DISPOSRL. SYSTEM IS
100 FEET FOR 8 PRIVBTE WELb OR
150 TO 200 FEET FROM R PUBLIC HELL DEPENDING UPON THE TYPE OF PUBLIC WELL.
WELL LOGS 8RE REQUIRED 8ND MUST BE RETURNED TO THE DEPBRTMENT WITHIN DO DRYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS M89 RPPLY. SPECIFICBTIONS RND CONSTRUCTION DIBGRBMS RRE
8VRIL~BLE TO INSURE PROPER INSTRLLRTION.
PERP1 I T EXF' I RES [)ECEMBER _~..~L.. ~L ~'~---~ 80
I CERTIFY THRT
~.: I 8M FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FOR~TH BY TH~ MLmNIC. IPRLI FY OF RNCHORRGE.
2: I WILL I~'4STRLL TH~E~%S¥STEM IN RC:CORDRNCE NITH THE CODES.
2:,_I I_INDER~RND THRT/ TI'~E ON-S.,I"~E SENER S'¢STEM blRY REQUIRE ENLRRGEMENT IF THE
RE--,IDENCE J,'S REMODELJED ~O Il'ICl tiDE IAORE THRN 2: BEDROOMS.
V2. 2
GAAB HD- I
GR~ 'JER ANCHORAGE A~EA BO~Og ~
~E~RT~ENT OF ENVIflON~ENTAL QUALI1 ~
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 279-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE FROM WELL ~~ .. MATERiAL~-~T~ ~;/x, .COMPARTMENTS
LIQUID CAPACITY~.~~5~'~ GALLONS. INSIDE LENGTH ~-- INSIDE WIDTH
LIQUID
DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS. / _OUTSIDE DIAMETER ___ __OR WIDTH
LINING MATERIAL.f~'~.(t/'~-~"~'~h-Z~ '~"/'i¢'¢~-~'~--':z~. DISTANCE FROM WELL_~
NEAREST LOT LINE__
LENGTH ~'~'~' '"
, , DEPTH_
BUILDING FOUNDATION
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) ~--~ ~:~=~ SQ. FT.
TILE DRAIN FIELD:.-¢/,/~
DISTANCE F ROM WELL _ ..~>.~-~, "F~'~DATION.
NUMBER~ ~~'~__.DISTANCE BETWEEN LINES
TOTAL LENGTH
NEARES~T LINE OF LINES
TRENC'LWIDTH IN. TOTAL EFFECTIVE
\
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE
__IN. ABOVE TILE__
WELL: TYPE ~'z~'~'zz~':~ ., DEPTH ~'~ .....
,~-- NEAREST ,.~ SEPTIC
LOT LINE , SEWER LINE ...... , TANK
DISTANCE FROM WATER
,BUILDING FOUNDATION ...... ~'~ SAMPLE
SEEPAGE
~ , SYSTEM .......... ~" , CESSPOOL
NEAREST
OTHER
SOURCES
DISTANCES:
DIAGRAM OF SYSTEM
APPROVED ~-~ ' r .~~ ''~ ~.
DATE
2192
....................... TYPE ..................
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.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE Of HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051-104-67
1. GENERAL INFORMATION
Expiration Date:
Completelegal description DROST SUBDMSION; LOT 47A
Location (site address or directions) 21637 AURORA 80REALIS * CHUGIAK, AK 99567
Current Property owner(s)
Mailing address
Lending agency
PATRICIA DROST Dayphone 688-3717
21637 AURORA BOREALIS * CHUGIAK, AK 99567
Day phone
Mailing address
Real Estate Agent
Mailing address
MARCIA WHITCOMB w,/ PRUDENTIAL V1STA Day phone 727-6499
16635 CENTERF1ELD DRNE * EAGLE RIVER, AK 99577
Unless othe~vise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OFWATER SUPPLY:
Individual Well E~
Individual Water Storage
Community Class Well E]
Public Water System
U
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 (HA.A) 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.
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ at, or p#or
to closing for the engineering services provided.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I vedfy 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 vedfy 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 ALASKA WATE.R &: WASTEWATER CONSULTANTS, INC.
Address 6901 DEBARR ROAD, SUER. 2B * ANCHORAGE. AK 99504
Engineer's Printed Name JE.I-I-~EY A. CAENESS. P.E.
Phone 337-6179
Date
Engineer's Comments:
In conducting this evaluation, AWWC, In~ attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results desctfbed 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 co/?s condition, groundwater levels that may
fluctuate durtng the year, and the water usage of the family being served by the system.
These conditions ara 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. AWWC, 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 of this report by any
other person or party is not authorized, nor will it confer any legal tfght whatsoever.
5. DSD SIGNATURE
J//" Approved for ,-~ bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the ~owing stipulations:
Attachments: HAA Checklist
Septic System Advisory
Well Flow Advisory
Manitenance Agreements
Supplemental Engineer's Reort
Other
Original Certificate Date:
Municipality of Anchorage
Development Services Department
Building Sofet~ Division
On-Site Water & Wastewater Program
4700 South Bmgaw SL
P.O. Box 196650 Anchorage, AK 99519-6650
www.c~.anchorage,ak.us
(~07) 343-7g04
HEALTH AUTHORITY .APPROVAL CHECKLIST
Legal Des(~lptlon:
A. WELL DATA
Well type PRIVA'IT
Date completed ~ 1972
Total depth UNK fi`
DROST SUBDNISION; LOT 47A
Parcel ID:
*PER PREVIOUS HAA'S
If A, B, or C provide PWSID# N/A Well Log (Y/N)
Sanitary seal (Y/N) YES Wires pmparly protected (Y/N)
Cased to *40+ fi` Casing height (above ground)
Date of test
Static water level
Well predu~on
WATER SAMPLE RESULTS:
Coliform 0 calonies/100 mi.
Arsenic: N/A mgJL.
051-104-67
NO
FROM WELL LOG AT INSPECTION
~ 5/16/2002
fi` 2`3 .fi`
g.p.m. 5.11 g.p.m.
Nl~ate 2.41 rngJL. Other becteda __
Date of sample: 5/21/2002 Collected by:
12+ in.
0 .colonies/100 mi.
AKWWC~ INC.
B. SEPTIC/HOLDING TANK DATA
Tank Typa~laterlal S.T.E.P./STEEL
Tank size 1250, gal. Number of Compartments
Foundation deanout (Y/N) YES
Date of pumping 5/16/2002
C. ABSORPTION FIELD DATA
Date installed
2
Depmssidn over lank (Y/N) NO
Pumper
6/18/92 Soil rating (~]or ff~odrm) 0.7
Date installed 6/18/92
Claanoute (Y/N). YES
High water alarm (Y/N) YES
SANITARY PUMPERS
#MTt/MT2 - THE ,.U(~.ID ~ &T 'IHE $TARTI
IOF 11.1£ tr..~l W~S I BEU:)W 'n, iE NV~'T INI
lU~ ~o 7' Bo-ow ~ INW-"(~'l~. I
System type *BED
in. Absorption rate >= 450+ g.p,d,
NONE KNOWN If yes, give date -
Length *,36 * lt, Width · *`30 fi. Gravel below pipe 0.5 fi`
Totaldepth 4.0-4.,3. ft. Eff. edsorptlonama 660 fl= Monltoringtube YES Depression over fleid NO
' Date of adequacy test 5/16/2002 Results(Pass/Fail) PASS For 3 bedrooms
· '11.5/ New depth 113( in.
Fluid depth in absoq~tlon field before test 2.5 in. Water added 1031 gal.
Elapsed Time: 965 min. Final fluid depth 11t/
Any rejuvenation treatment (past 12 mo.) (Y/N & type)
UFT STATION
Date installed 6/18,/1992 Size in gallons 1250
"Pump on" level at 42 in. "Pump off' level at 42 In.
Datum BOTFOM OF TANK Cycles tested ,3
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tanldlift station on lot100'+
Absorption field on lot 100'+
Public sewer main N,/A
Sewer/septic service line 25'+
Manhola/Accese (Y/N) YES
High water alarm level at 46 in.
Meets alarm & circuit requirements?, YES
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhola/cieanout
Holding tank N,/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+
Water main N,/A Water service line 10"+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Pmpen'y line '10'+
Water service line 10'+
Curtain drain NONE KNOWN
COMMENTS
Building foundation 10'+
Surface water 100'+
Wells on adjacent lots 100'+
Absorption field. 5'+
Surface water, 100'+
Water main N`/A
Driveway, parking/vehicle storage 2'+
*PER AS-BUILT SURVEY AND 1992 INSPECTION REPORT
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal reoorcl$ that the above systems are in
conformance ~ MOA HAA guidelines in effect on this date.
Engineer's Printed Name ,Jc~'~EY .4. OARNESS
Date
Waiver Fee $
Date of Payment
Receipt Number,
I hereby:certify that ~ he~e surveyed the' following'
Anchorage Re~g Precinct, ~ ~ that ~
improvcm~ts situa~ ~ereon ~ ~t~n ~e property
l~cs ar~ do ~ot ovzrl~p or encroa~ on ~ prope~y
lying a~acent ~hareto, th~ no lmp~vemen~ on 9~p-
~ty l~g adjnmn~ t~creto en~oz~ on ~e D=em~ m
qu~ti~ sad ~at there ~ no roadway,-~an~ission
1Lre~ ~ other v~ble eas~en~ on eatd pr~ except .
ns ~dica~ed hereon. - . ' . ' · ~
Dat~ at Eagle ~x'~, ~aska " " : ' ·
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D.# ~.~-)~ -
GENERAL ~NFORMATION
Complete legal description
Lot 47A; Drost Subdivision;
Location (site address or directions) 21637 Aurora Borealis Road
Property owner
Mailing address
Pat Drost Day phone h.m 688-3717
wk 561-1633
HC 78 Box 2679 Chugiak, Alaska 99567
Lending agency
Mailing address
CITY MORTGAGE ATTN: Steve Aldrid~¢ Day phone 277-0700
121 W~st Firewood Lan~ Anchorage, Alaska 99503
Agent
Ad d tess
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUNIBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well XX
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
XX
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev, 1/91) Front MOA #21
5, STATEk~ENT OF INSPECTION BY ENGINEER
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 application 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
5 & 5 ENGINEERING
Add ress 17034 Eagle River Loop Read
Eagle River, Alaska 99577
Engineer's signature
Phone
Date
.6,
DHHS S~GNATURE
Approved for -~
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
Date
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025 (Rev 1/91) Back MOA 421
A. WELL DATA
Well typ~-~t ~/-~ If A, B, or C, attach ADEC letter.
Log present (Y~
Total depth
Sanitary seal'N)
Municipality of Anchorage
Department of Health & Human Services
HEALTH AgTHOBTY APPROVAL CHECKLBT
ADEC water system number
Date completed _ ~x~"l~'~ ~ Driller~
Cased to '¢¢EO Ur~ Casing height
Wires properly protected(~N) ~//
Date of test
Static water level
Well flow
Pump level
FROM WELL~
AT ~NSPECT~ON
g.p.m. ':~. ~ 4,"' g.p.m.
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot j (~ :~/
/
Absorption field on lot J
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
Public sewer main
Sewer service line
WATER SAMPLE RESULTS:
Coliform ~
Nitrate
~¢q~,/~-"¢--~ Other bacteria
Collected by: ,. ~ ~ '~-~[~!
SEPT"C/HOLD"NG TANK DATA
Date installed ~¢/Z4::)/q'~ Tank size J'~Y.~--~ '~.l.~Compartmonts
Cleanout~N) ~ Foundation cleanout~)_ ¢ Depression (Y~
High water alar~N) ~ Alarm teste~N)~
Dateo .u .i
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot 1~)'~/ On adjacent lots , l~~
TO propertyline '~'~/ II /
Surface water/drainage
Absorption field
Foundation
Water main/service line__
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
C. L~FT STATION
Size in gallons ["'~---------~:~
Ven~4) ~ "Pump on" level at
High water alarm level
Meets MOAelectricalcode (~N)
SEPARATION DISTANCE FROM LIFT 'STATION TO:
Well on lot l
On adjacent lots
Manufacturer .~ t-J ~ ~---.1 .~> '~.. I.~.~ ~-~-.
Man hole/Acces~N)~/
"Pump off" level at ~ /r
Cycles tested
Surface water
D, ABSORPTION FIELD DATA
~_~Date installed ~ /
Length~¢' ___ Widt~
Total absorption area ~,(~'0
Depression over field (Y(~
Results (pass/fail)
(past 12 months)
Peroxide
treatment
!
Gravel thickness ~), ~
Cleanouts presen (~N)
Date of adequacy test
for '¢-.P
If yes, give date
Soil rating ~).'~ .~4r ,~,¢_.r¢ System type ~
Total depth
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot I ~
To building foundation
On adjacent lots -'~2~'
Surface water I ~:::~E~
Curtain drain
, On adjacent lots /¢~ ¢~f~ Property line_
To existing or abandoned system on lot _
Cutbank ~/Jr- _Water main/service line
Driveway, parking/vehicle storage area
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
$
Signature ~17034
Engineer's Name
~ate
HAA Fee $ __
Date of Payment
Receipt Number
Waiver Fee: $
Date of Payment
Receipt Number
~HAFER
NO, 8
,, DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME ~,F / TIME
DATE DATE
,NSPEOTOR ,NSPEC
MUNICIPALITY OF ANCHORAGE MUNIClPALI~ OF ANCHORAGE
) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIO~EPT. O~
825 L Street - Anchorage, Alaska 99501 ENViRONmENTAL
ENVIRONMENTAL SANITATION DIVISION BEC ~
Telephone 264-4720
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROpeRTY OWNER
PROPERTY RESIDENT (If different from above) PHONE
2. BUYER PHONE
MAI LIN G ADDR ESS
3. LENDING IgTITU~,O¢
MAILING ADDRESS
4, REALTOR/AGENT PHONE
MAILIN6 ADDRESS
5. LEGAL DESCRIPTION
STREET LOC,~I ON
6. TYPE OF RESIDENCE
~, SINGLE FAMILY
[] MULTIPLE FAMILY
7, WATER SUPPLY
INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTI LITY
Loo F,BEDROOMS
NUMBER
[] One [] Four
~ Two [] Five
[] Three [] Six
[] Other
ATTACH WELL LOG. A well log is reouired for all wells drilled
since June 1975. For wells drilled orior to that date, give well
depth (attach log if availableJ
5. SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
YEAR ON-SITE SYSTEM WAS INSTALLED,
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
~ THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SlX
PERMIT NUMBER
2, WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DR I LLE D
[] PUBLIC UTI LITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[]INDIVIDUAL/ON -SITE DATE INSTALLED
[]PUBLIC UTILITY
Connection Verified INSTALLER
[]Septic Tan~.,,~r []Holding Tank
Size: (~_O~'-/~L) If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5, COMMENTS
[~-APPROV ED FOR ,"~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accof134~ certificate)
[] OISAPPROVED ?
'.
72-010 (Rev. 6/79)
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental quality
3500 Tudor Road, Anchorage, Alaska 99507 279~8686
Date Received
Time of Inspection
Date of Inspection
RHQUEST FOR APPROVAL OF
INDIVIDUAL SE~ER & WA//{.R FACILITIES
FOR
1, Aopro,~al Requested By:__ !~3--
Address:__ ,~ ~ ~
2. Prooertv O~ner:__~]21_~_/~~
3. Legal Description:_~S_ '~W ~ ~~
4. Location: ~ . ~n~
5. Type of Facility to be Inspected:_ 'i -~ ?~ ~'.
Number of gedrooms:~__~
6, Well Data:
A, T~e~d B. Dept~ .......
7. $ewsge Disoosal Svstem:
A, Installed_ 3~ B. Installer_ ._~]].~.~.
C, Septic Tank: 1, Size~2. Manufacturer_~.~gct
D, Seepage Pit: 1~ Size !}~ 2, Matertal~?~.~3~2
Disposal Field: Total Length of Lines
Distances:
A, Well To: Septic Tank ~j~, Absorption Area__..~.~ , Sewer Lines
~ Nearest Lot I, ine._~ , Other Contamination
Bo Foundation to Septic Tank__ ~L~~ AbSorption Area ~,__
Co Absorption Area to Nearest Lot Line ~
Reques. t for Approval of., _vidual Sewer & Water Factliti~
Page TwO
Comments:
nm .Disapproved. .Date_ Oun~ 25, 1973
/J , Ap,.~rova? Valid for One Year From Date Si~ned
~reater Anchorage Area Borough, Department of Enviro~menta] Quality
DIAGRAM OF SYSTE~
I certify that the information contained in this request for approval to be a true
and accurate representat~.on of the subject sewer and water facilities located at:
Signed Date