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Home My WebLink AboutNORTH WOODS UNIT 4 BLK 18 LT 11North Wood Block 18 Lot 11 #051-064-34 Municipality of Anchorage On -Site Water and Wastewater Program - (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP151171 a an* - ling: W Single Family (SF) E] Duplex (D) El Multiple (SF and/or D) Project: El New 11011 Upgrade Name: William & Donna Arnold ABSORPTION FIELD 7 Deep Trench 7 Shallow Trench 7 Bed E] Mound Address 23316 Blue Skies Drive Chugiak, AK 9567 El Other Phone Number of Bedrooms Soil Rating Total depth from original grade GPD/SF 1 Ft, LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe Ft. Subdivision Block Lot North Woods #4 18 11 Fill added above original grade Ft., Gravel length Ft. Township Range Section Gravel width Ft. Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic 1! Absorption j Holding 1 Sewer IStationTank Total absorption area Number of trenches Dist. between trenches From Tank IField Lift Line Ft' Ft. Well N/A N/A N/A WAX N/A ❑TANK 9Septic ❑OS.T.E.P. ❑ElHolding Mother Manufacturer Anchorage Tank Capacity 11,500 Gal. Surface Water>100'N/A N/A N/A ' Material Number of compartments Lot Line >5' N/A N/A 1 N/A Steel 2 NA LIFT STATION Foundation >5 N/A N/A N/A 1 Manufacturer Capacity I Curtain Drain None Noted I Gal. Remarks Septic Tank Only Replaced Under Pump on level at in. Pump off level at in. High water alarm at in. This Permit. Existing Septic Tanks Decom= missioned per MOA Code. Pump make and model Electrical Inspections performed by Installer PIPE MATERIAL House to tank D3034 Tank to drainfield D3034 G & S Excavating Drainfield CO/MT D303 BENCH MARK (Assumed elevation) 100 ft Inspector Wade Roberts Inspectes:tion 1" 6/24/15 6/24/15 Location and description 2nd da 3`d4th Bottom of Siding. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL 441l't, Conditional Approval: Date go i 49th ..... 5-1 ............. I .............................. 0 -;Q, . VICHAEL E. ANDERSON Bio. CIE — 4131181 Approved /06,/13 12-2-18 .. ........ Date I F q S I f Inspection Report-9-1-12.doc NORTH WOODS f4 BLOCK 18 OT 11 PERM|T#OGP151171 PID #O51 -O84-34 EXISTING SEPTIC TANKS DECOMMISSIONED PER MOA CODE NEW SEPTIC TANK ONLY PLACED UNDER THIS PERMIT. �WAIMMTA it MICHAEL E. ANDERSON No. CE -4381 11-29-18 44. fROFESS EXISTING ABSORPTION SYSTEM NOTE \` NOSLOPES >25%WITHIN 8YORSURFACE WATER WITHIN 1OO'OFTHE LEGEND PROPOSED SEPTIC SYSTEM C0 -CLEANOUT 2CD-DOUBLE CLEANOUT ALL WELLS ONSURROUNDING LOTS WITH IMPACTS TOTHIS FCO-FOUNDAT|ONCLEANOUT PROPERTY ARE SHOWN. NOCONFLICTS WITH WELLS DRSEPTIC MH - MANHOLE SYSTEMS. MT-MON|TOR|NGTUBE O 40 80 FDV-FLOW D|VERTERVALVE FEET GV-SEPT|CVENT TH-TESTHOLE | D.5 Septic Tank only replaced under this permit. Existing Septic Tan Decommissioned per MoA Code. I . ............ �z 4 t . ..... ..... Z� MICHAEL E. ;7;;;;, PROFILE AS -BUILT Na. (NO SCALE) CE -4381 -2-18. 104114�1. fR7 E- S- S,1\1�10 EIR O Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program, 4700 Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 4 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT c~P Permit Number: 'b-W~01019 PID Number: 051-064-34 Name: William Arnold Wastewater System: [] New [] Upgrade Address: ABSORPTION FIELD 23316 Blue Skies Dr, Chugiak, AK 99567 Phone: Number of Bedrooms: 688-0884 5 ~ Deep T .... h ~ ShallowT .... h ~ Bed ~ Mound ~ Other: Soil Rating: Total Depth from original grade: LEGAL DESCRIPTION 1.2 Block: Lot: Subdivision: Depth to pi~ bo~om from original grade: Gravel depth beneath pipe: 18 11 No~h Woods Phase 4 2 it. 4 Ft. Township: Range: Se~ion: =ill added above original grade: Gravel Length: 1.5 ~,. 63 ~. ~ ~ G .... I width: Number of Ii .... I Distance between lines'. Well: New U pgrade Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pipe Material: Exist'g Community ~t. ~t. 630 ~,~ 3034 PVC Driller: Date Drilled: Static Water Level: installer: Date installed: ,t. Flintstone Excavation 6/15/2010 Yield: GPM Pump Set at:Ft. Casing Height Above G .... d:Ft. TAN K SEPARATION DISTANCES ~ Septic ~ Holding ~ S.T.E.P. ~ Other: T~ To Septic Absorption Lift Holding ~ublic/Private Manufacturer: Capacity: Tank Field Station Tank Sewer Line Anchorage Tank 1000 Material: Number of Compa~ments: We~, 200+ 200+ 200+ Steel 2 ~w~ 100+ 100+ ~ / LIFT STATION Size: Manufacturer: Lot Line 26 22.8 ~. Foundation 5+ 10+ "Pump off' level at: "Pump off" level at: in. High water al .... t: in. in. / ~ Pump Make & Mode, Ele~rica, Inspections peff .... d by: 50+ 50+ CuKain Drain Remarks: New garage not constructed at this time. 2 inches of rigid BENCH MARK Location and Description: insulation over new tank and field. Garage Finish Floor Assumed Elevation: 100.0 Ft. Engineer's Stamp Inspections pedormed by: PANNONE ENG. SVC, LLC Dates: 1st 6/14/2010 2nd 6/15/2010 ~;~....... Development Services Department Approval Qon~tional Approva~ Date: Reviewed and approved b~;/~W~{',9 .~('}[~W[ Date: / '~ CO A B \TI~ M1 \ \ \ ~ _\ ,, ~C- 79.2 //~ ~ __~ % -~-- 78.7 78.3_z/' % ~ ~ ~ ]T~-~-- -- 79.0 /74.9 ~-~-- SE~TIC~AREA (E)~ ~ .......... Ul ~5 73.8 ~ ~ ~ ~AWWU.~E~ SERVIO~ ~ LOT SERVED BY x ~ ¢~ ---¢- .... - ~ / // / / / /~ /AWWU WA~ER S~WCE ~~5~~%¢ % 150Qg CO~ECT TO~iST~ ~I~TEORITY ~ ~ k ~ ~ I~U S~ViCETO x k~ / / %~ ~ ~ ~65LFxS'Wx4'ED INS~L ED'~ ~N ' ~ ~ 7% - AETH/(E) ~ ~CONNECT TO EXIST'G _ %R~X~N) X~X,j-~ q~ ~lO00g SEPTIC TAN~ DCO~DV 28 GARAGE (P) CONSTRUCT~ CONNECT GARAGE FLOOR AETH (E) DRAIN TO NEW SEPTIC TANK UOT NO WELLS W/IN 200 p BED S~5 kL) BLIC WATER . YSTEM PER CODE WELLS W/IN 200' ~~. D a t e P.O. BOX 100217 ANCHORAOE, AK 99510 ~"' PHONE (907) 272-8218 FAX (907) 272-8211 ~" ~"~ _. NORTH WOODS S/D BLOCK 18 Lot 11 ~ ............. ~ PAD. NO RECORD DRAWING BILL ARNOLD ~ ?eve~ R. Panno~e 2331~ Blue Skies Drive ~,~- cE 814~ -~ PERMIT NO. ~ ~;. .~ sw~ Chugiok, AK 99567 ~.¢~;'.. ..'M~ P L_ A N , i ~ ?Sb~S{~ Sh ~et CO A B "% M1 FC 79.2 //~ ~ __ T1 78.7 ~78~.~ \ ~ .... 78.9/,,~.. u 6~ 79.0 ~74.9 DV 79.~ 74.4 M1 ~5 73.8 M2 ~ 77.2~3.~ ._ SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON- SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS. 5. SCOPE OF WORK: 5--BEDROOM HOUSE, NEW DRAIN FIELD, VERIFY INTEGRITY OF TANK. 4. GROUNDWATER IS NOT EXPECTED TO BE ENCOUNTERED DURING EXCAVATION, AS EVIDENCED BY THE SOIL VEST HOLE INFORMATION ABOVE 16 ET. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 10 FEET BELOW EXISTING GRADE, NOTIFY THE ENGINEER IMMEDIATELY. 5. qHE ENGINEER PERFORMED A SOILS INVESTIGATION &: PERCOLATION TEST PRIOR TO INSTALLATION OF THE PROPOSED FIELD. UPGRADE FIELD ~a" R.L __ 96.5 / 1.5' FILL ~-~_~ter Fabric oR ~.s' ......... ~ ~Gravel above -1.5~-- s' ~ ~~pipeinv, J ~ ~ ~.5 typical owGP/ ~0' ~~4"diam. drain ~ 6.o -~ ~pipe, ~pical GM ~Gravel -1~ ~ GW WATER MONITORED (8o.5) SECTION ~ ~ 8 ~ d ~ ~ 2" R.I. TYPICAL ~ ~/ %4DiaPedPipe ~ ~ d ~ / / 3034PVC d ~oo~ ~ / I SEPTIC ' A B B R EVIATI 0 N S ~-w~s TRENCH 63LFx4'ED CU COPPER PROFILE DiP DUCTILE IRON PIPE TH TEST HOLE DESIGM PARAMETERS LEOEND FC FOUNDATION CLEAN OUT UPGRADE SEPTIC SYSTEM .................... WATER LINE,/ T~ TANK CLEAN OUT NO. NO. BEDROOM: 5 (750 gpd) WELL RADIUS C~ CLEAN OUT NO. TANK SIZE: 1,500 gellon M~ MONITOR ;UBE NO. PERC. RATE: 1-SMPI ~ EXIST'G SEPTIC R.I. RIGID INSULATION SOIL RATING: 1.2 gpd/SF DCO DOUBLE CLEAN OUT AREA RQD: 625 SF DV DIVERTER VALVE SYS. TYPE: 5-WIDE TRENCH, 4'ED, NEW SEPTIC FS FLOW SPLI~TER MiN LENGTH: 62.5 LF USE: o o~ CHAINLINK FENCE (E) EXISTING 63LFxS'WlDE, 4'ED, 6' TD (P) PROPOSED TOTAL AREA: 630 SF (N) N[W ,o~s: P~O~ ENG ~C, LLC ....... -~-~. oF AL~:~.~'.~ ~/~/~o ~.o. ,ox ~00~ ,,c~o,,~. ,~ 9~o~¢,,~,~. ~o,~ (90~):~-a~ ~,x (eo~)~-~ ~*:-' ~ ~--'~~:~'~' ~,~ RE-CO~D PRAW~NC~~~N*."49 __ ~" NO ........... )51-064-34 25516 Blue Skies Drive~,,~*-:. .':~ PERMITswxxxxxxNO. Chugiok, AK 99567 ~. ~ta.. .-~x~ ~ ~ ...... ' ~ Sheet DESIGN NOTES ~c' SOILS LOG - PERCOLATION TEST TEST HOLE 1 OR TOPSOIL SLOPE I / " / %SITE PLAr~ \ 3--21 -- ML___ BrownSiits /( ~ /~ ' SM i Sand. lO HOLE 12 ..... % AETH (E) BOH WAS GROUND WATER SLOPE DATE PERFORMED: 6-14-10 ENCOUNTERED? N IF YES, AT WHAT TH 1 DEPTH? -0-' X DEPTH TO WATER AFTER MONITORING? - Dry - DATE: 6-21-10 WATER RATE READING DATE CLOCK NET TIME LEVEL NET DROP TIME (MPI) READING 1 6/14/10 1:30 3.25" 0" 2 1:40 10 MIN 6.52" 3.27" 3.1 4 1:50 10 MIN 6.35" 3.10" 3.2 5 1:50 3.25" 0" 6 2:00 10 MIN 6.34" 3.09" 3.2 PERO~TION RATE 3.2 (min/inch) PERC HOLE DIAMETER 6 inches · TEST RUN BETWEEN 3 ~ AND 4 FT COMMBN?S: ~est ~o]e excavated by PiJ~tsto~e ~xcavatJ~. Test ~o]e was p~esoa~ed before pe~c test.Test ~a~ for o~e ~our. last t~ee ~eadJ~s ~epo~ted. ~B~PO~M~D BY: Steve~ R. Pa~o~e, P.~. ~ C~RT~PY THAT ?HIS TSS? WAS PB~ORMSD ~N ACCORDANC~ W~TH A~D S~A?S AND MUN~C~PA~ GU~D~]N~S ~N B~CT ON ?H~ DATS OP TH~S -- P.0. B0X 102954 ANCHORAGE, AK 99510 ~,~ ~~,~j 11/10/10 PHONE (907) 272-8218 FAX (907) 272-8211 Scale RECORD DRAWfNG ~ ~ .- ~ ~ ~ ..~ NTS NORTH WOODS S/D BLOCK 18 Lot 11 ~ ........... ~ P.LD. NO BILL ARNOLD - 25516 ~lue Skies Drive PERMIT NO. Chugiok, AK 99567 ~,~'...(¢~ ___.'~¢~ sw~ Sheet On-Site Wastewater Disposal System Permit Permit Number: OSP101019 Tax Code Number: 05106434000 Work Type: Septic Permit Effective Dates: May 24, 2010 MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Upgrade to May 24, 2011 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: NORTH WOODS UNIT 4 Site Legal Address: NORTH WOODS UNIT 4 BLK 18 LT 11 G:1460 Owner/Address: ARNOLD DONNA J & WILLIAM J 23316 BLUE SKIES DR CHUGIAK AK 995675638 Site Mailing Address: 23316 BLUE SKIES DR, Chugiak Lot Size in Sq Ft: 28421 Total Bedrooms: 5 lal'tment This permit is for the construction of: Y Disposal Field N Septic Tank N Holding Tank N Privy N Private Well N 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 043-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction dudng freezing weather must either. A. Open and Close on the same day.' ' ' ~ B. Covered, sealed, and heated to prevent freezing. Special Provisions: The entire subsurface disposal field and/or alternate is not within a 30 foot radius of a percolation test. The Engineer needs to do an additional pemolation test prior to the construction of the septic field. Please submit stamped and signed results with the As-built Inspection Report. If the results require a design change, construction of the system will stop pending On-Site review and approval. Date: Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519-6650 www.muni.org/onsite (907) 343-7904 0.SPlOtotq ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-064-34 Property owner(s). William Arnold Mailing address23316 Blue Skies Drive, Chu.qtak, AK Site address 23316 Blue SKies Drive, Chu.qlak Day phone 688-0884 Zip Code 99567 Zip Code ..99567 Legal description (Sub'd., Block & Lot) North Woods S/D Addition 4, Block t81 Lot tl Legal description (Township, Range & Section) Lot Size 281421 Sq. Ft. Number of Bedrooms 5 THIS APPLICATION IS FOR ([] all that apply): Absorption Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage [] THIS APPLICATION IS AN: Initial [] Upgrade [] Renewal [] I certify that the above information is correct. I further certify that this application is being made for a Single Famlly Dwelling and is in accordance with applicable Municipal Codes. Pannone Engineering Services, LLC~.~-~~ (Signature of property owner or authorized agent) Permit/Rush Fees: Date of Payment: Receipt Number: (Rev. 11/05) Waiver Fees: Date of Payment: Receipt Number: Pannone En§ineerin§ Services LLC Steven R. Pannone, Principal Re§istered Professional Engineer E-maih ~teve(~oanen~ak.com May 6, 2010 Municipality of Anchorage Development Services Department On-Site Water & Wastewater Program 4700 S. Bragaw Street P. O. Box 196650 Anchorage, Alaska 99519 Subject: North Woods S/D Addn 4, Block 18 Lot ll Septic System Permit Upgrade Request Ladies and Gentlemen: I am writing to request a permit to construct an upgraded septic system be issued for this property. The proposed systems will serve an existing five-bedroom house. Currently the lot is developed. The Owner wishes to construct a garage and 13e location will cause the new driveway to cover the existing bed type drain field. The lot Is served by ~'ater supply. The existing septic system shall be reused. A new drain field will be installed south of the existing field and will be sized to handle a five bedroom waste stream. The surrounding developed lots are served by ly.-b.~ water systems. The~r4va~ wells are located over-t-O0-feet from the proposed soil absorption syste~. ~o~9~C- 1. Soils. Two test holes were excavated by Anderson Engineering in June of 1997. The soil logs are on file with your Department. Ground water was monitored for seven days. No ground water was monitored to a depth of 16 feet below ground level afier the monitoring period. Test Hole 2 is still visible. No water was monitored in that test hole on May 13, 2010. Bedrock was not encountered in the test hole. It is my opinion, based on the results of the percolation tests and overall soils appearance; an application rate of 1.2 gallons/day/square feet should be used, using a conventional wastewater treatment system. 2. Soil Absorption System Design. See Page 2 of the design drawings for Design Parameters. 3. Surface Water: There is no surface water within 100 feet of the proposed septic tank and the existing drain field. The proposed drain field upgrade will maintain at least 100 feet from all surface water and drainage ditches. 4. Topography: The average topography in the area of the proposed septic system is approximately 7 to 10 percent based on record information within 100 feet of the proposed system. The proposed installation will be greater than 50 feet from the shoulder of the steep slopes. Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 615 East 82nd Ave, Cuite 66, Anchorage, AK 99503 Telephone: (907) 272-8218 FAX: (907) 272-821! Page 2 of 2 5. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On-Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. There are no wells or septic systems within 100 feet of the proposed septic location. If you have any questions or concerns, please contact me at 272-8218. Sincerely, Steven ~. P~nnone, ?.E. Owner/Civil Engineer Attachments: Mailing: P.O. Box 200217, Anchorage, AK 99510-0217 Physical: 615 East 82~d Ave, Cuite B6, Anchorage, AK 99503 Telephone: (907) 272-8218 FAX: (907) 272-8211 . .--"~ ~ WATER MAIN SEPTIC AREA (E)- / BY WATER '~'N,, KEYBOX (E)~ KEYBOX F]'OLISE (E) ~ LOT AWWU WA]' CE TO (P) -TRENCH SAS (E) 63LF×5'W×4'ED TRI P) g SEPTIC TANK (P) SEE NOTE 5 GARAGE (P) MAINTAIN LINE AND DRAINFIELI ROAD SIDE DITCH 12" DEEP W4:1 SIDE SLOP REMOVE EXIST'G DRAINFIEL W/IN 10 OF PROPOSED WATER SERVICE TO GARAGE. 30NNECT GARAGE FLOOR DRAIN TO NEW SEPTIC TANK AETH (E) (P) MAIN (E) LO~T SERVED BY AWWU WATER SERVICl PUBLIC WATER SYSTEM NO WELLS W/IN 200' BED SAS (E) ABANDON PER CODE PUBLIC WATER SYSTEM NO WELLS W/IN 200' "OTES: PANNONB ENG SVC, [,LC ~EVIsEDSSUED FOR100526CONSTRUCTIONADDED PHONE (907) 272-8218 FAX (907) 272-8211 ~'~c~...~9 _TH_ ~, ".,'~;f~ 1'-60' ;ARAGE WATER SERVICE NORTH WOODS S/D BLOCK 18 Lot 11~~~~'"~'N::~ K'.~ ' BILL aRNOlD o~ ~ 23316 Blue Skies Drive ~I~: CE m49 .-~ PEr~Tsw~NC Plan Chugiak, AK 99567 ~i " " SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITf OF ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF ON-SITE WASTEWATER DISPOSAL SYSTEMS. 2. ALL WORK SHALL BE IN ACCORDANCE WITH THE AT[ACHED SPECIFICATIONS. 5. SCOPE OF WORK: 5-BEDROOM HOUSE, NEW DRAIN FIELD. VERIFY INTEGRITY OF TANK. 4. GROUNDWATER IS NOT EXPECTED TO DE ENCOUNTERED DURING EXCAVATION, AS EVIDENCED BY THE SOIL TEST HOLE INFORMATION ABOVE 16 F'r. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 10 FEET BELOW EXISTING GRADE, NOTIFY THE ENGINEER IMMEDIATELY. 5. THE ENGINEER SHALL PERFORM A SOILS INVESTIGATION &: PERCOLATION TEST PRIOR TO INSTALLATION OF THE PROPOSED FIELD. _,.~ -- :. .L. SECTION Ill A B B R EVIATI 0 N S .~-W,C,~'mE.C. CU COPPER PROFILE DIP DUCTILE IRON PIPE TH TEST HOLE DESIGN PARAMETERS LEGEND FC FOUNDATION CLEAN OUT UPGRADE SEPTIC SYSTEM ..... WATER LINE/ T# TANK CLEAN OUT NO. NO. BEDROOM: § (750 gpd) WELL RADIUS CN CLEAN OUT NO. TANK SIZE: 1.500 §orion MN MONITOR TUBE NO. PERC. RATE: 1-SMPI ......... EXIST'G SEPTIC R.L RIGID INSULATION SOIL RATING: 1.2 9Pd/SF DCO DOUBLE CLEAN OUT AREA ROD: 625 SF DV DIVERTER VALVE SYS. TYPE: 5-WIDE TRENCH, 4'ED, ~ ........ NEW SEPTIC FS FLOW SPLII-FER MIN LENGTH: 62..5 LF USE: .--o o-- CHAINLINK FENCE (E) EXISTING 65LFx§'WlDE, 4'ED, 6' TD (P) PROPOSED TOTAL AREA: 630 SF (N) NEW NO~S: PANNONE ENO SVC, LLC Iit' ,/2¢0 P.O. BOX 100217 ANCHORAGE, AK 99510 ,ssuEo FoR CO.STRUCT, O. ""0"E (90'1 ..S NORTH WOODS S/D BLOCK 18 Lot 11 /.~.~'~PJ.O.2-- ~-"~? '~ NO BiLL ARNOLD ~: 'P ~'n'n'~.~ ~' ~ 23316 Blue Skies Drive '&-~'.. CE 8149 ..~-ff PERMIT NO. Chugiok, AK 99567~'~ Sheet DESIGN NOTES Municipality of Anchorage. Page 1 of 3 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: SW97O2or) PiD Number: 051 06434 Name: William S. Stock Wastewater System: m New ~ Upgrade ^ddt..: ABSORPTION FIELD Phone: No. of Bedrooms: 688-4112 ~ ~ D~p Trench ~ Shallow Trench ~ Bed D Mound ~ Other I. 2 GPO/Sq. Ft. 6 I Lot: 11 Block: 1 8 ~O~WOO~sSubdivisi°n:~O. ~ De0t~ to pi;e bo,om from2original gra~e: R. Gravel aepth beneath~ pipe Ft Townsni,: I Range: I Section: Fill added above original gra~e: Gravel length: I m. 63 WELL: C New ~ Upgrade Gravelwiat.: Number of lines: Disance~e~een 5 Ft 1 N/A Cl~sificat~on (Private. A,B.C): Total De~t~: Cased To; Total a~sorption area: Pipe materiel: Existinq m. ;t. 625 so.;t. ASTM D3Q~4 Drille~ Date Drilled: Static Water Level: Inataller: Date installS: Ft. Barr Contractinq 10/10/97 Yiela:GPM puma sot at: Ft. Casmg Height Above Gfouna::Ft TAN K SEPARATION DISTANCES = Septic Q Holding ~ S.T.E.P. TO Se~c A~r0~ion Lift Hol~ng Pu~li~P~va/a Manufacture~ Capaci~ in gallons: From T~k Field Station Tan~ S~,U.. Auth. Tank I _ R n n Material: Number ~f Compa~men~: We. >200' >200' N/A N/A N/A Steel Two su,,c, LIFT STATION- N/A Water >100' >100'~ N/A N/A N/A Lot Size in gallons: I Manufacturer: Line >5 ' >.1 O' N/A ~/A ~/A I Remarks: ~i~no Tank Removed BENCH MARK ~o~ ~O~, Location and Description: ~dge Sp~ke ~n ~ee 15' Sou[h o~ Bu[[ ~u~ Valve. I Assum~ 100 ~evatiom Inspections pedormed by: Stuart Gilbert Dates:IHt 10/10/97 2nd lO/11/97 ~: MIOHAELE. ANDERS~.,.;~ -'Depadmen~ of Hoai~an~ ~ma0~Se,ices approval tt~k.. , 438!-E Reviewed and approved by: ~~~' Y~ Date://-'~-~ iA Flow Diverter Valve FIVE BEDROOM HOME Page 2 of 3 \Permit No. SW970200 '5106434 Absorption Trench Existing 24' X 45' Bed PLAN AS-BUILT SCALE 1" = 20~ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES. ENVIRONMENTAL SERVICES DIVISION Page 3 of 3' P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal SyStem and/or Well .Inspection Report Permit Number:. SW970200 PID Number:. 05106434 [='Co PAGE 1 OF 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:SW970200 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:STOCK WILLIAM S OWNER ADDRESS:23316 BLUE SKIES DR CHUGIAK, AK 99567 DATE ISSUED: 7/21/97 EXPIRATION DATE: 7/21/98 PARCEL ID:05106434 LEGAL DESCRIPTION: NORTH WOODS UNIT IV BLK 18 LT 11 LOT SIZE: 28421 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK 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 (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. 1 SPECIAL PROVISIONS: ISSUED BY: ~ DATE: June 30, 1997 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 11, Block 18, NorthWoods Subdivision, Unit Nc). 4 Septic System i~ Design Impacts to Adlacent Properties Dear On Site services Engineer: The existing absorption bed on Lot 11, Block 18, Northwoods Subdivision, Unit No. 4 'has failed and must be replaced. The owner of the property has decided to upgrade the system to serve a five bedroom home so the existing septic tank must also be replaced and a larger size installed. We are therefore applying for a permit to upgrade the system to meet current requirements and serve a four bedroom home. Testholes placed on the property revealed clean poorly graded gravels which percolated at 2 to 5 minutes per inch. Groundwater was not encountered in either of~the testholes nor was any noted during the monitoring period. A testhOle placed in February of 1984 did not indicate groundwater either. We are. therefore surprisec~ a shallow bed was initially designed'on the property. DUe to the history of groundwater in the area however we haVe designed a shallow wide trench system to replace the_ bed. A flow diverter valve will be installed so the bed may be utilized in the future if necessary. The ground surface of the lot slopes from northwest to southeast at varying degrees. The slope at the location of the proposed absorption trench is less than 5%. Property to the west and south of this lot is vacant. The subdivision is currently served by a community water system so separation distances from private wells are not a problem. If the system is constructed as designed the following statements apply: The system, if constructed as designed, will have no adveme impact on the wells in the area or those to be constructed in the future. The subdivision is currently served by a community water .system. 'Lot 11, Block 18, Northwoods Subdivision, No. 4 June 30, 1997 Page Two The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on reserved space, either surface' or subsurface, on any lots located in the area. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments THIS PROJECT NOTE: AREA MAP SCALE 1" = 100' SUBDIVISION IS SERVED BY A COMMUNITY WATER SYSTEM. LOT 11, BLOCK 18' NORTHWOODS SUBDIVISION, UNIT NO. 4 DESIGN FACTORS: Five Bedroom Home Perc. Rate: 2 to 5 Min./Inch Application Rate: 1.2 GPD/SF SYSTEM REQUIREMENTS: 5' Wide Trench System 1~500 Gallon Septic Tank 4' ,Drainfield Rock 5 Bedrooms X 150 GPD / 1.2 GPD/SF = 625 SF of Absorption Area 625 SF/5 LF (Trench Width).5 (Red. Factor) = 63 LF Trench Length Therefore: Construct a 5' Wide Absorption Trench With One Lateral 63' in Length. Distribution Pipe In Trench Placed at 2' Below the Original Ground Surface. Place 4' of Drainfleld Rock Beneath Distribution Pipe. IL NOTE: TYPICALWIDE TRENCH SECTION (NO SCALE) Grade Area Over Trench to Drain Away. Minimum 3' of Cover over Septic System. j I Municipality of .Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street., Anchorage, Alaslm 99502-0650 SOILS LOG -- PERCOLATION TEST .' .* DATE PERFORMED: Township, Range, Section: sLOPE SITE PLAN 5 6 7 8 9 10 12 WAS GROUND WATER . ./~ ENCOUNTERED?' IF YES, ATWHAT ,. DEPTH? E PERcoLAT~O~I RATE ~' ~ {minute/inch) pERo HOLE DIAMETER ~ uu. ~ Z '/z.. .AND $ '/z.. F'r 72-008 (Rev. 4/85) PERFORMED BY: ~° 61~,~g.-'"~" · ! '~ ~FyTH~TwI~;T~,b-rwAsPERFORME~IN ACCORDANCE WIT. AIL STATE AND MUNICIPAL GUIDEUNE5 IN EFFECT ON THIS DATE. DATE: ~/,.~/? ;7 . MunidpaUty of .Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage. Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: 1 2 3 4, 5- 8 g, 10- 11 12 13 15- 16- 17 18 lg- · ' DATE PERFORMED: Township, Range, Section: - . 8LOPE · 81TE PLAN WAS GROUND WATER,'~ IF YES, AT WHAT Dry', H? AccORDANcE WITH AU. STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~ '~'~) ~ 7 Municipalily of .Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" S~.~ Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: lEGAL DESCRIPTION: ~O"~' 1 2 3 5- 6' 7 8 ~ 1 ~.L .~'I"o C~... DATE PERFORMED ~;~O r~./~ ~J=~H~uo~.Township, Range, Section: WAS GROUND WATER ENCOUNTERED?' · IF YES, AT WHAT DEPTH? ------' pO SITE PLAN Gm '" Net ~ to NIt R,,-~lng D~te Time ' Time W~er ~ ~1 ~//~ g~ 0 ~ .. I~" ~ ~:1~ I~* .~ ~=5~ IO Pe~COLATI0~ ~TE ~ ;.~,~',~ P~C HOLE DmM~rEN, '/'" ACCO~ANCE ~TH A~ ~A~ AND MUNICIP~ GUIDmN~ IN ~FE¢ ON THIS DA~ DA~ ~/~O/9 7 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 11, BLOCK 18, NORTHWOODS SUBDIVISION, UNIT NO. 4 GENERAL: 1. The scope of this project includes the pumping and removal of the existing septic tank and replacing it with a new 1,5000 gallon tank. Work also includes intercepting the distribution line, placing a diverter valve and a new service 'line. A new 63' long X 5' wide X 4' effective depth absorption trench will also be constructed. The existing absorption bed will be left in place for possible future use. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal RegulatiOns. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. ~. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,500 gallon septic tank must be procured from an approved source and installed at the location shown on the Site Plan. Lot 11, Block 18, Northwoods Sub. No. 4 June 30, 1997 Page Two 2. A septic tank is to be construCted by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The. bottom of the trench shall be within 2" of level. 2. Distributi'on piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. Lot 11, Block 18, Northwoods Sub. No. 4 June 30, 1997 Page Three 5. Contractor shall verify the Septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trenches to drain away. 8. A minimum 2' of accepting soil is required below the · drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed'and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality ~)f Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be'at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). Lot 11, Block 18, Northwoods Sub. No. 4 June 30, 1997 Page Four 5. A permeable geotextile fabric (Typar, Mirafi or equal)must be installed between the final 'drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve.. INSPECTIONS: A minimum of two inspections are required by Municipal Ordinance. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in. place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for. use in preparing the certified as-built of the completed system. i MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME MAILING ADDRESS LEGAL DESCRIPTION LOCATION DISTANCE TO: Manufacturer Liq. DISTANCE TO: Manufacturer DISTANCE TO: No. of lines 4 Top of tile t~ Inside length Well Dwelling area [ we"( ommlzn i Dwelling Width IMaterial Foundation q il Nearestlotline Total length of ne/~lJTrench Material beneath tile ~ inches PHONE I [~NEW NO. OF BEDROOMS PERM,T NO.fd40 No. of compartments Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO. Distance between lines ! ( Total effective absor Length Width Depth PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO, DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS ' APPROVED DATE 72-013 ('~ev. 3/78~ LEGAL ~ L · ~/ · [:,EF'RRTMENT OF HERLTH FIND EN',,,'IRONMEN"FRL PRZTEEC:TION ,..,':.":' Fi,_ ._ L.. S].'REET., I-- N ..FIL"' .... E.h' - .]E.,-' - RK '97..50:~ 2~4--47'20 F'F_F.!M I T NO: [:,RTE I ...... liED: C" ~"ql ....... .::.,::' ][ -F liE.'.=.. 840:I. 84 ~.t4,. :t-'.,. ,:,4 F'E£RI'.I Z T RF"F'L I CFIN].': R[:,E:,RESS:;: CONTFIOT F'FI'3NE: STEVEN L. SI<RGGS' C:ONST F'O BO::.,: 670690 CF!UGIRK, RK (588-283::1. I.,..EGRL DESC:R t F': LOT SIZE: MR::.:; BEDF.'- :i',lL= - SUBDIVISION: NONR]"HI.,.IOOD 44 SEC:TION: 3: ]'OWNSHIP: 15N 2842:1.. (SL::L FT. OR RCRES) LCIT .~ :21 RRNGE · ::LW E, LOUk.. 18 LISTED BE!-W RRE 'T'NE I]F'TICII'.,IS.; -',,' .... ' "' - H,I'qII_I'-E, LE. "FEI '.,.'jiLl IN [:,E'=;IGNING 'T'CIi_IR SEPTIC: S:,YS,].'E[M. CHOOSE THE OF'I-II.iN ]"FIR]" BEST FITS, Y.]I_IR SITE. "'~" [~:'. ES] ~"-4~ ,2': F~ [:.E: EE fE:. DEPTH TO F'IPE BO]"TOt"i (F:'T.) 4. 0 4. 0 I]RF:IVE[.. DEF' TH ':: FT. > 6: E.~ E.t 5 'TOTRL DEI='TH <F'T. ::, ±0. 0 _4. 5 GRRVEL 1.4IDTH ,::F'T. ) 2. 5 24. ~-' CiRRYEL LENGTH (I::'T. ::, 67. 0 .,~_ 0.~. GRFIVEL VOLUHE (CLI. '¢[.':,S. ) ,.$03: 40. 0 TRNK SIZE ,::GFILS) ±., 000. 9 *:+: :.'L, 800. 0 SOIl.._ RF1TING '-':SQ. FT. ,-'"E:R> 2(58 2]:9 [:. F-: F4I :[_ ~".I 4..El Z.':. 5 7.5 5.0 87. 0 *-*' 64. 4 1., 000. 0 ** 268 :+::+: :~r-.."~,~::L. LENGTFi }. ,-'!::, F:].' REQUIRES MUL. TIPLE RLINS ,::NOT EXCEEDING '"'.=;', ,'._ FT. :*::*: TRNK HU:T:,T HFIVE FIT L. EFIST TWO C:OMF'FIRTMENTS ERCH) I CERTIFY THFI].'. :1...I RM FRMILIFIR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FIND WELLS FIS SET FORTH BY THE MUNICIPF~LITY OF" FtNCHORFIGE (MOR)'RND THE S'TRTE OF' FtLFISER. 2. ]: 1.4iLL INSTFtLL. THE SYSTEH IN RCCOR[:,FINCE 1.4ITH FILL MOFI CODES FIND REGULFITIONS., FIND IN COHPLIRNCE WITH THE DESIGN C:RITERIR OF THIS PERMI"I". c. .7...-':. I WILL FI[:,HERE TO RL:L I'dOR FIND S]"FtTE OF' FIL.~SI<R REQUIREMENTS FOR ]''HE SET BRCK DISTRNCES FROM FINY EXISTING WELL, 1.4FiSTEWRTER DI.SPOSRL S'T'STEH OR PUBLIC SEI,.IERFtGE SYSTEM ON THIS OR FtNY FiDJFIC:ENT OR NERRBY LOT. 4. I UNDERSTRND THRT THIS PERIdIT IS 'v'RL. ID FOR R HFIXIMUM OF ~: BEDROOMS:;.,. FIND FINY ENLFIRGEHENT WILL RE[-]LIIRE FIN RDDI'TIONRL PERMIT. IF Pa LIFT STRTION IS INSTRL. LED IN Rt'.J RREFI COVERED B"r' MOFI BUILDING CODES, TFIEN (2L::, RN ELECTRt~:RL PERMIT FIND INSPECTION HUST BE OBTFIINE[:,.~ (2) FIS-BUtLTS HILL NO]' BE RPPROVE[:, WITHOUT RN ELECTRICRL. INSPECTION REPORT.~ RND (3:) THE ELECTRICRL WORK MUST BE DONE B"r' FI LICENSED EL. ECTRICIFIN. ALASKA/-' UIRO[lm nTAL COIhTgOL Inc, SOILS LOG - PERCOLATION TEST LEGAL DEsCrIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15- 16- 17- 18- 19- 20- C. Reid, Jr. ~/o~/</,~ Z~ SLOPE COMMENTS DATE PERFORMED: ~- ~--'~ ~ /~o /~ sr ~ ~o ~ ~ $~TE PLAN \ \ \ WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop ~t& ;~ -9- ?.,z~ q,. 5q - PERCOLATION RATE ~2 ~" {minutes/inch) TEST RUN BETWEEN --~' FT AND ,~ '~Z._ FT PERFORMEDBY: CERTIFIED BY: DATE: D~PT, OF HEA~TH & ENVIRONMENTAL PROTECTIO[x[ M~CIP~I~ OF ~O~GE D~SI~ OF ~~~ H~ ~', 1. ~ral Inf~tion ~pli~tion ~te (e)'~pplfqan~ is (¢he~ 0~) ~dtng Xnstf~utfon ~ ~ ~r~f1~r ~ ~ (d) ~i~ Institution ~lepho~ Address (e) Real Estate COo & Agent Address Tele phone 2. _Type of l~sidenc~ Single-Family ~-~ Number of Bedrocks 3. Water Supply Multi-Family Other (describe) Note: If cut,,enity well system, must have w~itten confirmation frcm the State Deparhr~nt of Enviror~rental Conservation attesting to the legality and status. Is the well adequate fo~ the number of bedrocms specified in this' EL~A (Y/N) ?~ Sewage Disposal. Onsite ~ Public ~ Cc~m~nity ~ Holding Ta~k ~ Is the wast, water disposal system adequate fc~ the r~mber of bedrocras (Y/N) ?(.05 [Page 1 of 2] 2-15-84 Engineering Firm Providing Inspections, Tests, Data and Information I certify that I have checked, verified, c~ oonformed to all MOA ~A Guid~lir effect on the date of this inspection. Signed ~/~/~'t.. ~1~ ..j~_~.~t~ Date ~-//" ~+ ( ENGINEER SEAL) 6. DHEP Approval Appro~d for ' ~.~ bedrooms Appro~~ Disapproved ~--~ Terms of .Conditional Approval UCondit ional ~-~ The Municipality of Anchorage D~partm~nt of Health and Environmental Protection does' not guarantee the continued satisfactory performance of the water supply and/or the wastewater disposal system. This approval indicates that, as of the validation date shcwn abo~, based on the data and infonu¢mtion furnished by an e~x~ir~eer registered in the State of Alaska, the water supply and wastewater disposal system is safe and func tional four the rnmber of badrocms and type of structure indicated. ( DHEP SEAL) 7. Mail the HAA to the following address: KB2/d5/s [Page 2 of 2] 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption St2rata Date Installed Width of Field Gravel Bed Thickness Standpipes P~esent (Y/N) Square Feet of Absorption A~ea /0~) Depression over Field (Y/N) /~ Date of Last Adequacy Test · Results of Last Adequacy Test -- Separation Distance f~om Absorption Field: To Water-Supply Well ~- ?~/~/~' To P=operty Line To Building Foundation q/; To Existing or Abandoned System cn Lot ~ - ; On Adjoining Lots '~/0(~~ To Water Main/Service Line ~i TO Cutbank(if present) To Stream/Pond/Lake/c~r Major Drainage Ccurse ~ - To Driveway, Parking Area, or Vehicle Storage Area ~ Comments D. LIFT STATION Date Installed Size in Gallons High Water AlarmLevel at Tested for Electrical Codes[Y/N) Dira~nsions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles du~ing Adequacy Test. Meets MOA Co~nts ** Check Permitted Bedrocm Ra~ing Against HAA F~quest ** ~_~ ~.~It~-~'}}7~ certify that I have checked, verified, or confom~ed to all MOA HAA Guidelines in effect on the date of this inspection. KB1/d5/s [Page 2 of 2] ?.-75-84 DEPT. OF ENVIRONMENTAL CONSERVATION / SOUTHCENTRAL REGIONAL OFFICE 437 "E" STREET, SUITE 200 ANCHORAGE, ALASKA 99501 PWS i.D. BILL SHEFFIELD, GOVERNOR Telephone: (907) Address: 274-2533 To Whom t May Concern: _Lj)cording to r, ecords on fi [e in this office the kJL)/~.TJ~l~C)~ J~i\./i~..lOfk.-I Water System is in compliance with the State Drinking Water Regulations. Northwood Block 18 Lot 11 #051-064-34 Municipality of Anchorage Developmen{ Servlc ~epdHment Building Safely Divlslon On-Site Water and Waslewater Program 4700 Souih Bragaw SI. P.O. Box 'tg6650/~,nchorage, Al( g95t9-6650 v,~Nw.cLanchorage.ak.tls (907) 34~-7g04 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 0~"/' 0~'~' ~',4-' HAA# .,//,~O~,7-O .~..,.. . .:. -... Expiration Date: 1. GENERAL INFORMATION C?mplele legal des~,ptlon ~ I1~O I ~: MO~O~O$ ~4 ,~o~tion (site address Pr directions) ~5 5)G ~le ~ ~1~ ~ ~a ~CUrrent Prope~y owner{;) ~l~b, ~ ~ Day phone ~;Mailing address ~" Lending agen~ Day phone Mailing address Real Eslale Agent ~' !/._'1-0 r',J Day phone MailingAddress 11'14o r Z z/ Unless othe~ise ~quested, HAA willbe hem by DSD for pickup. NUMBER OF BEDROOMS: ~ 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 Municipalily of Anchorage Developmen{ Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representallons given In paragraph 5 by an Independent professional civil engineer registered In the State of Alaska. Certil~cates of Health Authority Approval are required for the transfer of lille (except between spouses) for properties served by a single family on-sile wastewater disposal and/or waler .mlpply syslem. DSD also Issues HAAs upon requesl Io homeowners. Certificales of Health Aulhorily Approval ere v~lid for 90 days from the dale of issue for properties served by a private or Class C well and may be reissued wilh new water sample resulls less than 30 days old. (Certificales may be reissued for a period of up to one year with valid water samples.) Certitic~,las 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 tn the professional engineer's work. Mnnicipality of Anchorage Development Services Department Building Safety Dhdsion On-Site Water & Wastewater Program 4700 South Bmgaw St. P.O. Box lg6650 Anchorage, AK 99519-6650 www,cLanchorage.ak.us (g0~ HF_ALTH AUTHORITY APPROVAL CHECKLIST Well type Date completed Total depth lt. Cased to FROM WELL LOG Date of test Static water level B, or C provide PWSID # Well Log (Y/N) Sanitary seal (Y/N) Wires properly protected (Y/N) ft. ~--~- Casing height (above ground) ?~ AT INSPECTION Well production j WATER S~ULTS: Coliform /' colonies/lO0 mi. Nitrate mg./I. Dat~/sample: Collected by: g.p.m, g.p.m. Other bacteda colonies/100 mi. B. SEPTIC/HOLDING TANK DATA Tank Ty~e/M;terial ~l~t~ ] ~ Date installed Tanksize /~{'~ gal..' Number of Compartments Foundation cleanout (Y/N) ~ Dep _re,~__~!on over tank (Y/N) Oate.ofpumping 4/'~'//~'"' -- Pumper C. ABSORPTION RELD DATA Date installed ~L~J_L~- Soil rating (g.p.dJft= or ~/bdrm) /. Le. . Total depth ~ It. Eft. ,bso~tion area ~fla Monitoring tube Deteo, Fluid depth in absorption field before test f in. Water adde~)gal. Elapsed Time: I~0 min. Final fluid depth ~' in. Absorption rate >= Any rejuvenation treatment (past 12 mo.) (Y/N & type). Cleanouts (Y/N) '7/ High water alarm (Y/N) System type Gravel below pipe ~¢~ fl. Depression over field For :~'"bedrooms New depth~.'~ in. ~ g.p.d. If yes, give date ""-- o / ~/~ P. ~D2: ASBUILT SEWARD & ASSOCIATES LAND SURVEYING 694-0Rj-. I HEREBY CERTIFY .THAT I HAVE SURVEYED THE SCALE: , FOLLOWING DESCRIBED PROPERTY~ ,,"~.m~ "~'~;F'~-///~"'Z~"~"-C~'~,~'~/~;T'~"~'~'~/~-/',/~'/~'f'/~ DATE, j j .~-.. ~ ..~9,~ INDICATED. IT IS THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY 6RID: .... ~..v ..... EASEMENTS, COVENANTS, OR RESTRICTIONS .-//~..'.-'~/~'~ WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD' FB: ANY DATA HEREON BE USED FOR CONSTRUCTION ~'.~' OF FENCE LINES~ OR FOR ESTABLISHING BOUND- DRAWN~ ARY LINES. ~..~..~.