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HomeMy WebLinkAboutBIRCH TREE ESTATES BLK 1 LT 3Birch Tree
Estates
Block 1
Lot 3
#017-141-48
Legal Description
ck, L3
Development Services Department
Pump Installation Date: .� /itr-11 -a
Building Safety Division PGE e�
Pump Manufacturer's Name: 1AY j1/lL app aSCd'
On -Site Water & Wastewater Program s "
az
%- ==
4700 Elmore Road z
P.O. Box 196650 aWE
Pitless Adapter Manufacturer's Name: la
S A E T Y
Mark Begich
Anchorage, AK 99507
Mayor
www.muni.org/onsite
.� ANCHORAGE, AK 99518
(907)343-7904
AWPS.COM
Pump Installation Log
Well Drilling Permit Number: SW Date of Issue:
ParrPl Identification Number: b 11 - 1 LAI - Li S
Legal Description
ck, L3
Property Owner Name & Address:
L-14 C< 5 -r I Ah—t* (� Z wi Awr
,�2,-0 Jr R�t-o�T
,-,e,1, S� G
Pump Installation Date: .� /itr-11 -a
Pump Intake Depth Below Top of Well Casing: $ t% feet
Pump Manufacturer's Name: 1AY j1/lL app aSCd'
Pump Model: A i ✓k 50 F 3 % ` — ! V
Pump Size �Z hp
Pitless Adapter Burial Depth: O feet
Pitless Adapter Manufacturer's Name: la
Pitless Adapter Installer: /) A
Well Disinfected Upon Completion? 2 .Yes ❑ No
Method of Disinfection:
Comments:
„ Cio4a,_ ANCHORAGE WELL & PUMP SERV.
Pump Installer Name: !'7 �� 330 EAST 76TH AVENUE
.� ANCHORAGE, AK 99518
PHONE: 907-243-0740
AWPS.COM
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water d Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519.6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Feb 12, 2010
Expiration Date: Feb 12, 2011
Permit Number: SW100012 Parcel ID: 017-141-48
Legal Description: BIRCH TREE ESTATES BLK 1 LT 3
Design Engineer: 0855 GARNESS ENGINEERING GROUF Site Address: 005250 RIVERTON AVE
Owner Name: CHRISTINE WITZMANN Lot Size: 27767 SQ. FT.
Owner Address: 5250 RIVERTON AVENUE Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE. AK 995164230
This permit is for the construction of:
❑� Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be In accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each Inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
5. The following special provisions.
The permit was issued with a pdf copy of the maintenance agreement. On -Site will need a maintenance agreement
bearing the owner's notized original signature prior to final approval of the septic system.
Received
Issued
Date:
B . Date:
Municipality of Anchorage
• Development Services Department
Building Safety Division J•, ,,,
Onsite Water & Wastewater Program
4700 Bragaw St.
P.O. Box 196650
Anchorage, AK 99519.6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 017- 14I - 4 S
Property owners) CHRISTINE WIT71JANN Day phone 575-8534
Mailing address 5250 RIVERTON AVENUE ANCHORAGE AK
Site address
Legal description (Sub'd, Block & Lot ) BIRCH TREE FSTATFS, BLOCK 1. LOT 3
Legal description (Township, Section & Range) N/A
Lot Size 02-2-s7,67 Sq.Ft.
THIS APPLICATION IS FOR ( ®all that apply):
Absorption Field
❑
Septic Tank
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
Number of Bedrooms
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 Family Dwelling and is in accordance with applicable Municipal codes.
CARNESS ENGINEERING CROUP, Ltd.
(6ignature ef property owner or eulheFized agent)
Permit/Rush Fees:�S 3 O au
Date of Payment: is y
Receipt Number:
(Rev. 11/05)
Waiver Fees:
Date of Payment:
Receipt Number:
GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS & GENERAL CONTRACTORS
February 5, 2010
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650,
Anchorage, Ak 99519-6650
(907)343-7904
Ref: Proposed Septic Upgrade for Birch Tree Estates S/D; Block 1, Lot 3.
To whom it may concern:
The existing 3 bedroom house is served by private well and septic system. The septic system is in a state
of failure and needs to be upgraded. Our original intent was to rebuild the existing bed given the limited
area in the backyard. Per you direction, since the previous design did not have percolation test
information, you required us to perform a test hole, percolation test, and take groundwater readings.
Based upon our findings, the soils between I to 2 feet had a percolation rate of 80 minutes/inch and the
soils between 2 to 9 feet had a percolation rate of 30 minutes/inch. Assuming a 0.3 gpd/sq.ft. application
rate, we would be required to have a 1500 sq.ft. drainfield be installed. Given the limited usable area
outside the well radius and without removing the shed, it appears that there is limited area available to
install this size of a drainfield. Given the little cost difference between such a large conventional septic
system and an advanced wastewater system; and due to the limited area available for septic system
upgrade, we are proposing that a Quancis Aerocell treatment system be utilized for this property. We are
proposing that a new 1000 gallon "Premier Plastics" H.D.P.E tank, a "Fat Albert" lift station, a Quanics
Aerocell unit, and a bed type drainfield be installed. On 1/28/2010, one test hole was excavated on the
property and groundwater was found to be at 7'4" below the existing ground surface. The drainfield will
be designed around the 30 foot radius of this test hole. We are proposing the new drainfield be installed
over the same area as the existing drainfield. We are proposing that the drainfield be excavated a
maximum depth of 3 feet from original grade. All contaminated material is to be removed and 2.5+ feet
of sand filter is to be added. The new drainfield is to be installed at or higher than the existing bed
elevation. Comments regarding the design are summarized as follows:
1. SOILS: See the attached logs which show the soil classifications, groundwater monitoring, and the
percolation test results.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic system.
4. TOPOGRAPHY: As can be seen on the attached site plan drawing with the topography information
on it, the average slope in the drainfield area is a 5 to 8% slop running from approximately cast/northeast
to west/southewest. In short there are no slope concerns.
3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259
Ph: (907) 337-6179 • Fax: (907) 338-3246 • Website: www.gamessengineering.com
We are unaware'
ny adverse impacts this installation would have on adjacent wells or septic systems.
If you have�1n� c� es ons, please contact us at 337-6179. Thank you for your assistance.
Pjt., M.S.
NOTA• Attached is a site plan drawing, a design drawing, one soil log, which are all part of the design package for
this septic system. (Contact G.E.G. Ltd. for 7page construction specification letter.)
3701 E. Tudor Road, Suite 101 • Anchorage, AK 99507-1259
Ph: (907) 337-6179 • Fax: (907) 338-3246' Website: www.gamessengincering.com
tLIAMNA ACRES S/O:
LOT 7C.
ILIAMNA ACRES S/0:
TRACT 6,
W LL AN M
ON NORTH HALF OF LOT
RIVERTON COURT \
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BIRCH TREE EST. S/0: BIRCH TREE EST. S/D: �$ \\ /!( THJI BIRCH TREE EST. S/D:
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LOT 6. BLOCK 1,� — iLOT S. BLOCK 1, -11W . — LOT 2. BLOCK 1,
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LOT 4, BLOCK 1,
SHE — EXISTING SEPTIC SYSTEM
------L—-------t— ------ -- ------------
----/--------
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BIRCH TREE EST. S/D;
LOT 13, BLOCK 1,
----------
PROPOSED SEPTIC SYSTEM
(SEE DESIGN PAGE 2 OF 4)
I
I
BIRCH TREE EST. S/D;
L T 14. BLOCK 1,
SEMP` �/
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BIRCH TREE EST. S/D:
LOT 1,5. BLOCK 1,
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-------------
BIRCH TREE EST. S/D:
LOT 16. BLOCK 1,
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EAST 145H AVENUE
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GARNESS ENGINEERING GROUP, Ltd.
CONSULTANTS i GENERAL CONTRACTORS
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PREPARED FOR: PHONE NUMBER: PACE NUMBER:
CHRISTINE WITZMANN 575-8534 1 OF 4
LECAL DESCRIPTION: DRAWN BY:
BIRCH TREE ESTATES: BLOCK 1 • LOT 3 J.L.M.
ITYPE OF WORK:
FOR PROPOSED SEPTIC UPC
Mw MM,
2/3/2010
DF BEDROOMS: 3
PER DAY (GPD): 450
ION RATE/S: 30
) APPLICATION RATE: 2.0
DRAINFIELD SO.FT.: 225
MAXIMUM DEPTH: 3 FEET BELOW ORIGINAL
(PRE -MOUND) GRADE (REMOVE
ALL CONTAMINATED MATERIAL)
WIDTH: 10 FEET
LENGTH: 25 FEET
M.OA. APPROVED SAND FILTER: 2.5+ FEET
EFFECTIVE: 0.5 FEET
ACTUAL SO.FT.: 250
LETTER THAT PERTAINS TO THIS DESIGN.
TO OBTAIN A COPA OF THE LETTER
CONTACT CEG. BY PROCEEDING FORWARD
WITH THIS INSTALLATION. THE ENGINEER,
WELL DRILLER. CONTRACTOR AND
PROPERTY OWNER AGREE THAT THEY
HAVE READ THESE SPECIFICATIONS AND
AGREE TO ACCEPT THE TERMS AND
APPROXIMATE
PERIMETER OF
EXISTING BED
PROPOSED 10' BY
25' DRANFIELD (SEI
DESIGN CRITERIA) -
PROPOSED 650
AEROCELL UNIT -
PROPOSED
VALVE E
�ROPGALLON
'FAT
FAT ALBERT'
LIFT STATION-�
C
A
RIVERTON COURT
NOTE: THE CONTRACTORSHALL HAVE THE
100 FOOT WELL RADIUS ANO THE WEST
UT LINE FLAGGED BY A REGISTERED LAND
SURVEYOR PRIOR TO CONSTRUCTION
?DOUBLE
0PROPOSED 1000 GALLON
e � PLASTIC SEPTIC TANK
EXISTING SEPTIC TANK AND
OUTS LIFT STATION TO BE
COMPLETELY ABANDONED
_ _ _ _ _ _
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CHRISTINE WITZMANN 575-8534 2 OF 4 OQ a
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BIRCH TREE ESTATES BLOCK 1, LOT 3 J.L.M. OD sip ••��,lD�'I�oo
TYPE OF WORK: SLE° REVISEDPtofessLo
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OUTS LIFT STATION TO BE
COMPLETELY ABANDONED
_ _ _ _ _ _
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i
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CHRISTINE WITZMANN 575-8534 2 OF 4 OQ a
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LEGAL DESCRIPTION: DRAWN BY: CE -7953 O.P, '•, •• �d'G
BIRCH TREE ESTATES BLOCK 1, LOT 3 J.L.M. OD sip ••��,lD�'I�oo
TYPE OF WORK: SLE° REVISEDPtofessLo
DESIGN DRAWING FOR SEPTIC SYSTEM UPGRADE 2/10/2010
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(Rs,. 01AS)
NOTE: THE MOUND (S REOUIRED TO
BE TOPSOILED AND
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CONSULTANTS A GENERAL CONTRACTORS
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TYPE Of WORK: DATE: � Op Oressio�D`e
PROFILE DRAWING OF PROPOSED DRAINFIELD 2/3/2010 �04000��00
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P EPAREO F R: P 0 NUMB ACE NUMBER:
CHRIS INE W MA N 5 -85 F 4
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GAL DESCR TION: DRA
s p�
IN CE-79 ,• fipp
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BIRCH TREE E ATE ; BL K 1, T L•
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DALE:
TYPE OF WO
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SITE LAN F R PRO SED S IC G E 2/3/2010
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GARNESS ENGINEER ING�GROUP, Ltd. &:4 T y�0
ONCTORS
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION: BIRCH TREE ESTATES; BLOCK 1, LOT 3 s f CE 779 3 es.:pO
PERFORMED FOR: CHRISTINE WITZMANN DATE: 1/28/2010 r •' SFO
r e4- -6 •Q
DEPTH ooslol,
(feet) 333 ORGANICS ITEST HOLE 1 UPPER
ML SOIL CLASSIFICATIONS
2
a'^o GW ====Z ORG Nn
• : •. GP ML
3
GM CIL 1
4 GC OL N i
°• • a o SW MH f
5 '• •'• : SP CH
GM SM OH .r
1
6 SIC
7 DEPTH TO DATE
GROUNDWATER
g DRY 1/28/10
7'-4" 2/4/10
9 TtNERfON'-----�-seA6c
ML
t O
B.O.H.
tt
12
13
14
15
16
17
18
PERCOLATION RATE 80 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
19
TEST RUN BETWEEN 1 FT. AND 2 T.
20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES ❑ NO
SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ANDREW GRAY
COMMENTS:
PERFORMED BY CEG. Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PE FORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: 2
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
1/29/10
1
2:55
—
6"
—
2
3:25
30
5 5/8"
3/8"
3
3:25
—
6"
—
4
3:55
30
5 5/8"
3/8"
5
3:55
—
6"
—
6
4:25
30
5 5/8"
3/8"
ell*�� o��F �O�o
........ �gSpO
GARNESS ENGINEERING GROUP, Ltd. '` `r00
CONSULTANTS & GENERAL CONTRACTORS
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SOIL LOG — PERCOLATION TEST , ........ .•••,•...�
LEGAL DESCRIPTION: BIRCH TREE ESTATES; BLOCK 1, LOT 3 e 'J f E-7 53 ess: •��
PERFORMED FOR: CHRISTINE WITZMANN DATE: 1/28/2010
e'L/S .l0 `6ov
DEPTH 44��040��to
(reef) ___= ORGANICS TEST HOLE 1 LOWER
1
ML SOIL CLASSIFICATIONS
2 GW ORG I `
RN TON COURT,
3
:.•. GPML `
GM CL
4 GC OL N
IILLLLH
•�.: SW MH T
5 '. �•.: SP CH
GM SM OH �.
6 SC
7 DEPTH TO DATE "
GROUNDWATER
g DRY 1/28/10
7'-4- 2/4/10
9 SCALE:
ML
10 B.O.11.
tt
12
13
14
15
16
17
18
PERCOLATION RATE 30 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
19
TEST RUN BETWEEN 2 FT. AND 3 FT.
20 A FOUR HOUR PRESOAK WAS PERFORMED: N YES [_-]NO
SOILS LOGGED BY: ROB CAMPBELL PERCOLATION TEST PERFORMED BY: ANDREW GRAY
COMMENTS:
PERFORMED BY CEG, Ltd. I, JEFFREY A. GARNESS, CERTIFY THAT THIS WAS PE FORMED IN ACCORDANCE
WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE: D
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
1/29/10
1
2:55
-
6'
-
2
3:25
30
4 3/4'
1 1/4'
3
3:25
-
6'
-
4
3:55
30
5'
1'
5
3:55
-
6'
-
6
4:25
30
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wTL: RAWN BY. . , � °... ................°v.�0
2/3/2010 J.L.M.
LEGAL DESCRIPTION: re A. G ness?
BIRCH TREE ESTATES; BLOCK 1, LOT 3 GARI�ESS ENGINEERING GROUP, Ltd. C :o
TYPE OF WORK: CONSULTANTS AGENERALCONTFACTOFS a e^''•Z r ,.•'•cq p�
DESIGN OF SEPTIC SYSTEM UPGRADE ». .m A» �� » ^» ^�• ^^^+ •••^�� ron i. w •...R -�. -.+ a "" o
6
�p�olasS�o�000
PREPARED FON: PHONE NUMBER: PAGE: °�°ppppOpo
CHRISTINE WITZMANN 1 575-8534 3 OF 4
ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND
REPAIR AGREEMENT
MEMORANDUM OF UNDERSTANDING
BETWEEN MUNICIPALITY OF ANCHORAGE
A.'YD 3'ra' HEN 4 L114Lct4hw 4nT2A16wr.r 4-rjb
C4f1%1J%r7Mr 94ST2 M 4+dnJ
THIS MEMORANDUM OF UNDERSTANDING made and entered into as orthis
Jj_Day of,& j e, a of 2010• by and between SIV;f a [-kAIP-1 TI-JI-ZMA-4J
herein the "OWNER." and the Municipality ofMchorage, herein the
"MUNICIPALITY." In consideration of the mutual covenants contained herein, the
parties to this Memorandum of Understanding agree as follows:
I. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality
grants permission to Owner to utilize and operate an Advanced Wastewater
Treatment System (AWWTS), des�crribed as a( rnni et ii« IIlocated
at 8'(4-k Tiff ES 1. ! J L 3 . Mehonge, Alaska.
2. Definitions.
A. Alteration. Any change to the design or function of an AW WVTS that
Includes the Installation or removal of any parte, components or pieces ant
included in the original construction permit and design. Prior to
performing any alterations to an AW 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 of On -Site Systems Approval. An approval by the
Municipality of existing water and wastewater disposal systems given at
the time ofproperty 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 lime 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 AW WTS that were included in
the original design which would allow the A W WTS to continue to
perform as designed
E. Permit (Construction) An Onsite Wastewmer Disposal System
Construction Permit as defined by AMC 15.65.
F. Permit (Operating) An AdvancedWattewaterTreatmentSystem
Operating Permit. An annual permit, issued by the Municipality, that
allows the Owner to operate an AW WTS, upon meeting all the
requirements of this agreement, the conditions of Operating Permit, the
requirements of the On -Site Wastewater System Construction Pcrnit and
all relevant provisions of AMC 15.65
7. F—m– Owner shall pay to Municipality an annual fee of 0
(SQ.00), payable on or before the issuance of the operating permit and annually
thereafter. The armual 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 Understtnding shall be for the life of the
AW WTS.
The term begins on the date of approval by the Municipality of the instated system and
shall continue while the A W WTS system is In use or operational or until the property is
sold or title U trarufemd by owner and a new certificate of On -Site approval is Issued to
the new owner or transferee of the property.
3. Altentions. Installatioo and Removal of Additional £llotpment. Owner agrees
not to make any aherations, removal of parts or additions to the AW WTS without a
Construction Permit from the Municipality.
6. Maintenance and Reoain.
A. Throughout the term of this Memorutdum 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
mrnewals thereof, at the owner's sok expense, to pay for any and all: (I) m*r(s), (2)
maintenance, (3) adjustment(:), (4) replacement costs, and (5) inspection costs.
Further, Owner agrees to comply will all applicable ordinance, laws, regulatimm
rules and orders for the AW WTS.
D. Owner agrees to provide the Municipality a written schedule orroutine
maintenance and repairs which have been performed on the system pursuant to the
terms and conditions contained In the Owner's AWVM 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 A W WTS
OperatingPermhis:_1Luir�_
C. Owner acknowledge that the fine schedule for failing to maintain aid repair an
AWWTS arc codified In AMC 14.60.
D. Owner agrees that only maintenance, repair personnel certified by the
Municipality will inspect and nuke 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 bours written notice.
F. Owner agrees that any We or transfer of title of the property will not occur
without a new Certificate of On -Site Systems Approval.
0. Owner agrees that the relevant provisions of the standard specification guidebook
for A W WTS is the governing professional guidelines for the construction,
maintenance and repair of the Owner's AW WTS.
7. Nonwalrer. The faihue 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.
S. Ameadmeat.
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 atmched to this Memorandum of Understanding as an amendment.
H. 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 —54rpliebt `f (,IfWSYlise �.%/�2L1/eYG1�i
Anchorage: Purchasing Ofri
C. Any attempt to amend, modify, or change this contract by either an
unauthorized representative or unauthorized means shall be void.
9. jurisdiction! Choke of liw. Any civil action arising from this Memorandum of
Understanding shell be brought In the Superior Court for the Third Judicial District of the
State of Alaska at Anchorage. The Iaws of the State ofAlaska shell govern the rights and
obligations of the parties under this Memorandum of Understanding.
10. Severability. Any provisions of this Memorandum ofUnderstanding decreed
Invalid by a court of competentJurisdiction shall not invalidate the remaining provislons
of the Memorandum of Understanding.
OWN R,_ 2/;" 2"0:—/ ' " MUNICIPALITY:
By (�/�LQ Wl�N1Gll�Ja By
Title:
Date: � Date:
STATE OF ALASKA )
)u
THIRD JUDICIAL DISTRICT
The foregoing Instrument was ae]rnowkdpd before me this M day of oz
201 Q, by TJ1: 1.4 4—n A.,4.j .
64zow E 164a4a k
NOTARY PUBLIC FOR ALASKA [ -co tc—r T&,t ftQ jOpt..C.t 4,<
My Commission expires
nPA�.1 c r i SYC f NST?}rt,y
p�ttG
L
Name
Address �1
Phone(s)
MUNICIPALITY OF ANCHORAGE r) •('� n ^ �"
DL RTMENT OF HEALTH AND HUMAN SEF, ;ES V i f`' 4
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
� l� 0 T E DISTANCES
TO SEPTIC I ABSORPTION
,9-77-7S
Lot Block
3 1 /
Township, Range, Section
7_42-P/ , R 3
Permit No.
R6 0
TANKS
FROM
o. of Bedrooms WELL
LOT LINE
�S FOUNDATION
❑ SEPTIC ❑ HOLDING
Manufacturer Capacity in gallons
E7 t '
Material No. of Compartments
Installei
Date Installed:
water
WELL
3.2 3n
(Show location of well, septic system, property lines, foundation,
rol
iz
REMARKS:
-7/46 16
-© Scale:'FER
-4r-/e bust
' L t
V V" bV H 0 f Inspections Performed by.
.10 � , ; t • w is.,
Date.
8/mY If I
I certify that this inspection was performed according to all y JUN, 2' r
Municipal and St guidelines in effect ont ' ate:Z�• L
,,,Health Department Approval: Date: e
rc-u 1,) toioof
TYPE OF SYSTEM
❑ TRENCH
BED
❑ W. DRAIN ❑ OTHER
Depth to pipe bottom from
Total depth from original grade
original grade
FT
FT
FIII added above original
grade
Gravel depth beneath pipe
FT
O, 5
FT
Gravel length
Gravel width
FT
A 6
FT
Total absorption area
Distance between lines
6 % 3
SO FT
FT
Number of lines
Soil rating
Pipe material
/ 50
SO FT
Tv�
Installer
Date Installed
WELLS
❑ PRIVATE
❑ OTHER (Identifv)
Classification (A,B,C)
Total Depth
to
JCased
FT
FT
Installei
Date Installed:
water
WELL
3.2 3n
(Show location of well, septic system, property lines, foundation,
rol
iz
REMARKS:
-7/46 16
-© Scale:'FER
-4r-/e bust
' L t
V V" bV H 0 f Inspections Performed by.
.10 � , ; t • w is.,
Date.
8/mY If I
I certify that this inspection was performed according to all y JUN, 2' r
Municipal and St guidelines in effect ont ' ate:Z�• L
,,,Health Department Approval: Date: e
rc-u 1,) toioof
# ���
���� �� "«�������
DEPARTMENT ' HEALTH AND ENVIRONMENTAL ROTECTI0N
' 825 L STREET, ANCHORAGE, AK 99501
-
/ 264-4720
PERIv. I1� NO: 860197 UPGRADE
DATE ISSUED: 06/26/86
APPLICANT: SPOKANE MORGAGE, T. SPURKLAND
ADDRESS: 1:2 W.15
ANCHORA8E, AK 99501
CONTACT PHONE: 279-3916
LEGAL DESCRIP: SUBDIVISION: BIRCHTREE EST. LOT: 3 BLOCK: 1
SECTION: 34 TOWNSHIP: 12N RANGE: 3W
LOT SIZE: 27000 SQ FT. OR ACRES)
I certify that:
1. I am {amiliar with the requirements for on-site sewers and we1ls as set
[orth by the Municipality of Anchorage (MOA) and the State o[ Alaska.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria o{ this permit.
3. I will adhere to all MOA and State of Alaska requirements {or the set back
distances {rom 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 INSPECTION MUST BE OBTAINED; (2) AS-BUILTS
WILL NOT BE APPROVED WITHOU[ AN ELECTRICAL INSPECTION REPORT; AND (3) THE
ELEClRICAL WORK MUGT BE DQNE BY A L�CENSED ELECTRICIAN.
SIGNED DATE:
APPLICANT: SPOK
lSSUED BY IleDATE:
/
�^� ��e
. ~. �� ~
�~ ~� ^�
/'~~� ^U� �^�,xm 7rwnm��^ -761 74"Av-
�.-- ~-4�`
C'
MUNICIPALITY OF ANCHORAGF
DEPARTMENT OF HEALTH & ENVI ROa N
MENTAL PROTECTION m ��-/ 093
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
PHONE
Bruce Lattermore 277-5551
-- _ UPGRADE
MAILING ADDRESS --"—" ---"-- ----- —
P.O. Box 10-33.5 Anchorage, AK
LEGAL DESCRIPTION --
Lot 3 Block 1 Birch Tree Estates Subdivision, Anchorage AK
1 LOCATION TNO. OF BEDROOMS
DISTANCE TO
Well
105
Absorption area
Dwellin
PERMIT NO.
U X
3
1- 2
a I-
Manufacturer
Material
Nm
o, of copartments
wF
y
J
Liq, capp city in gallons
l�(1U IF HOMEMADE:
Inside length
Width
Liquid depth
DISTANCE TO: Well 110,
Dwelling 40,
PERMIT NO.
L`
Manufacturer
Greer
Materi
–
Liquid capacity in gallons
J
w =
DISTANCE TO: Well
Foundation
teel
Nearest lot line
500
PERMIT NO,
J LL z
2w
_Length lines
Length of each line
Total length of lines!
Trench width
Den istance betwelines
~ 1".
Top of the to finish grade
Material beneath til,
_ nches
0
Total effective absorption area
inches
Length
Width
Depth
U1
PERMIT NO.
Q H
UJ a
Type of crib
Crib diameter
�—
Crib depth
—
Total effective absorption area
y
DISTANCE TO
Well
Building foundation
Nearest lot line
J
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
UA
DISTANCE TO:
Building foundation
Sewer line
_
Septic tank
Absorption areas
OTHER
PIPE MATERIALS
1" & 2" PVC
SOIL TEST RATING
Se
A
to
he
A
-B
it
INSTALLER
ORCA Construction
REMARKS
As -Built Inspection Performed
by
R&M Consultants, Inc. on August 23, 198
by Philip R. BAldner
See Attached Mound Design
(r'l+� t i'
APPROVED t1° F Ci4 v"'Vrir DATE
LEGAL
72-013 (Rev.
SIGNED
3 WITH CARBON INTA
Redifprm® 4S 471 SENDPART 3TWILLAND BE RETURNED WITH REPLY.
DETACH AND FILE FOR FOLLOW-UP
DATE
POLY PAX (50 SETS) V 471
INSULAT1oN
YL,('C'Lo It -4 ItRF p \ — SILT GAP OV�FR SAKID ; II_G.-
4 r� "` �` M I N. 12" DEF_ P OVER TKENCHF 5
AN D ON SLCPF_S
- �\ ! \ �, S� SHAPE. FOR G'RA1 hIAC�5
•/.r T�.I't: � I r Opp
// SILT SU5IGI;AAE
Gxc6s . SE:c-rcor• A -A
r
—' 4-'
I
1
Iwo
LIMIT t of
I
r--
L m 4T
?77 �
I
I W f NS 1 A L L! LEVEL
� J
J=
✓ � � J ? PVC.- !
�(sL0rr TU PORCC l?r•IlV
A
\ �'
DWR_ O1G Fe. --�
CKD. GRID.
R&M CONSULTANTS, INC.
DATE. i3- _ � E�.O tifE0• GEOLOOIfITB PIANNEf g SUAVaYOP9 PROJ.NO. 05/0.93
SCALE. ; J DWG.NO,
7RC�164�x�sJ. C-lV-4lvj
'A
VisTRl Svr1 oN Flpr=
'VC 14AS I
i
t
brATION
F
VisTRl Svr1 oN Flpr=
'VC 14AS I
i
t
brATION
Z -11
7v
- RIVERTON
AVE.
�
DWK
CKD.
DATE.
I
u
z
a�
io ' u r« I T Y c: Asp nAAE-ry r- - - - - - - -
r = a 1- ,-.a • 1 43.0'
AS - O LI LT
L 0 F3 51- 0C,& t
su.a J>/v)IS) ON
R&M CONSULTANTS, INC. GRAD.
ENOINEENS OEOLOOISTS PLANNERS SURVEYOR•
PROINO.
DWG.NQ
N
AAA -ry r:i)(I STIN6
13 �D
R��1.�tGG Gi
DWN.
CKD.
DATE. :4 -
SCALE.
O FB.
V
&M CONSULTANTS, INC. GRID.
R&M
CONSULTANTS,
PLANNERS SURVEYORS
PROJ. NO.
DWG.NO.
77-'Xl
To MCUND
7AL. CAP.
500 r
STF- CL 7A P4 I" --
m E Y E k5
F\ m
AWS-! LE\/F-L 5VV I TC -
0
. 4J 1 TA, -4 K s; 2 -IF -V 7-0 PROVtr)E GPf 0AY
SrGRAGE AFTER ALA'RtA,
F Lr LOP
r'AILUR9
-1,4
LARM
7pump ON
(70 E�Z GP!
F- 7 7Z
FLIM P 0 F P7
M Y c-
DWN.
CKD.
DATE. :4 -
SCALE.
O FB.
V
&M CONSULTANTS, INC. GRID.
R&M
CONSULTANTS,
PLANNERS SURVEYORS
PROJ. NO.
DWG.NO.
SPv KA- � T47
cLnut : �.� )4 5 y
AO-tA— . /tea >e A >L 3 Z 7�'
(o 7a
vo (LA, w -it 04" U, V%
(IDX X X!5 y) /0- 7`
db
DESIGN PARAMETERS
ESTIMATED DAILY FLOW (GPD) = 2 BDRMS X 150 GPD/BDRM = 300 GPD
GRAVEL TRENCH BOTTOM ULTIMATE PERMEABILITY = 1.23 GPD/FT2
SILT SUBGRADE PERMEABILITY = 0.24 GPD/FT2
TRENCH BOTTOM AREA REQ'D: AREA (FT 2) 1 300GPD/FTGPD 2 = 244 FT
TRENCH WIDTH = 4 FT
LINEAR FEET OF TRENCH REQ'D = 244FFT2 = 61 FT
NUMBER OF TRENCHES = 61 FT = 2.03 OR 2 EACH 30 FT TRENCHES
30 FT
TRENCH SPACING = 12'
TRENCH DEPTH = 12 INCHES
HEIGHT OF MOUND AT TRENCHES = 3 FT
HEIGHT OF MOUND AT CENTER = 4 FT
THE 1 FT CROWN INSURES SURFACE DRAINAGE OF THE MOUND
SIDE SLOPES OF 4:1 ARE TO BE USED
BASAL WIDTH = 36' BASAL LENGTH = 54'
TOTAL INFILTRATIVE AREA = 36' X 54' = 1944
NECESSARY INFILTRATIVE AREA = 300 GPD 2 = 1250
0.24 GPD/FT
LENGTH OF 2 INCH MANIFOLD = 12'
LENGTH OF 1 INCH LATERIALS = 30' - 6 IN = 14.5 FT (Trench shall extend 6"
2 beyond end of lateral)
NO. OF LATERALS = 2 TRENCHES X 2 LATERALS = 4
DIAMETER OF HOLES 1/4 INCH
NO. OF HOLES PER LATERAL (SPACED 30 INCHES) = 14.5 FT = 6
2.5 FT
FORCE MAIN SHALL BE 2" PVC AND SHALL BE INSTALLED TO DRAIN BACK TO PUMPING
CHAMBER AFTER EACH USE.
Audible or visible high water alarm to be installed within residence per
owners direction.
APPROXIMATE MATERIALS QUANTITIES
SAND - 120 CUBIC YARDS
V TO 2�" GRAVEL - 9 CUBIC YDS
1" PVC PIPE - 58 FEET
2" PVC PIPE - 39 + FEET
1 EACH PVC TEE 2"X2"x2"
2 EACH PVC TEES 1"X1"X2"
4 EACH PVC END CAPS
SILT PLACED OVER SAND MOUND - 75 CUBIC YARDS
TOP SOIL - 36 CUBIC YDS
GRASS SEED
PUMP - MYERS SS411
LEVEL SWITCH AWS -1
BUZZER ALARM CA-SS4
FLOAT SWITCH FLC-20P
500 GAL CAPACITY TANK
960+ FT OF DOW SM STYROFOAM 2" THICKNESS
GRE' ^R ANCHORAGE AREA BOF "GH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME �C�/%� ��'�� MAILING ADDRESS X616'16 .ST PHONE
LOCATION �� 1���.��C�.�G� ZKY LEGAL DESCRIPTION el aCf J % �f� 462���
SEPTIC TANK:
DISTANCE NUMBER OF
FROM WELL/MANUFACTURER P�% MATERIAL �� ���-COMPARTMENTS
INSIDE LENGTH INSIDE
INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY A'759 2 GALLONS.
SEEPAGE PIT:
/
/G ��f el
NUMBER OF PITS �L/ . DIAMETER OR WIDTH_4t1LENGTHL//;; DEPTH /e
LINING MATERIAL ���il'FS CRIB SIZE: DIAMETER --DEPTH DISTANCE FROM: WELL
�y �� TOTAL EFFECTIVE
BUILDING FOUNDATION NEAREST LOT LINEO� ABSORPTION AREA (WALL AREA)( 1, SQ. FT.
ADDITIONAL ABSORPTION
WELL:
TYPE �r,� CONSTRUCTION
BUILDING NEAREST NEAREST
FOUNDATION -,LOT LINE SEWER LINE
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED REMARKS
DISTANCES: -%1t�) "<-/-)
INSTALLED BY: Z � ��� -ZZ1Z-
G,c'c-,U.ri
PIPE MATERIAL:
LOT SLOPE:
REMARKS: .GSL/7
Form No. EQ -031
DEPTH
SEPTIC
TANK_
DIAGRAM OF SYSTEM
DISTANCE FROM:
SEEPAGE
SYSTEM
�?
J/ "y. �id
DATE -?/ //% APPROVED }
G.A.A.B.
f//
GREATER ANCHORAGE AREA BOROUGH
4
DEPARTMENT OF ENVIRONMENTAL QUALITY P NO. —
4 3330 "C" STREET ANCHORAGE, ALASKA 99503
TELEPHONE 274-4561
SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT
NAME OF APPLICANT ' "� � d 1` MAILING ADDRESS 71� ST�-- PHONE a? ¢' Q Op
INSTALLATION LOCATION
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK c— SEEPAGE PIT C-- , DRAIN FIELD , OTHER
TYPE AND SIZE OF FACILITY TO BE SERVED
FINANCED THROUGH �`�g-� """v "`"�x' TO BE INSTALLED BY
SOIL TEST—RESULTS NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE ` J�" TYPE SEEPAGE AREA SIZE I ` 1" TYPE
MINIMUM DISTANCES, REQUIREMENTS
FOUNDATION TO SEPTIC TANK
,.,gv
FOUNDATION TO SEEPAGE PIT "ate+ ( DRAIN FIELD
l e- (
SEPTIC TANK TO SEEPAGE PIT WALL Ix J
i
SEPTIC TANK , SEEPAGE PIT, DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK
loot
DRAIN FIELD
WATER MAIN TO SEPTIC TANK V i
DRAIN FIELD t 8 1
`
SEEPAGE PIT /oU,
ALSO CONSIDER AREA WELLS.
—, SEEPAGE PIT 40f f ,
1
SEPTIC TANK, Qy , SEEPAGE PIT G ( DRAIN FIELD ,
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION 5 FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES .ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
G.A.A.B.
OR
LICENSED DESIGNER
DIAGRAM OF SYSTEM
I CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE.
')ATE APPLICANT'S SIGNATUREX�9 i'7� 1
ZM NO. EQ -016 - -
.. 7'--{(EydINkdS; SEAL)
e Municipality of Anchorage L-,oDEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG —PERCOLATION TEST +? -`:. I9/1
PERFORMED FOR: SF0'K+ANL M0QTGA%a DATE PER FOR191I c
LEGAL DESCRIPTION: LICiT 3 �Y�I. Pi9cRTPaifownship, Range, Section:
r-1 SLOPE SITE PLAN
2-0
• W
3 O v
0,
5 V too
6 D^
f
7 d 8
0
10 WAS GROUND WATER
ENCOUNTERED?
11 S
IF YES, AT WHAT L
DEPTH? Z t
12 P
Depth to Water Alter E
13 Monitoring? Date: 'b
14
15
16
17
18
19
Reading Date Gross Net Depth to Net
Time Time Water Drop
20 -{
I
u
PERCOLATION RATE
(minutes/inch) PERC HOLE DIAMETER
COMMENTS " ""�•�
m e-
TEST RUN BETWEEN
by.se.i/i�tcc'�
FT AND � FT
^`y� CV97
PERFORMED BY:
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN
72-008 (Rev. 4/85)
&99f91&ff!1K CERTIFY THAT THIS T WASPERFORMED IN
ON THIS DATE. DATE: D.
a`_
xSOILS LOG
- MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION ❑ PERCOLATION
TEST
/ 825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: SpD 16/.ANG HOOMAdg E DATE PERFORMED: (0/! 7! 16
LEGAL DESCRIPTION: LpT 3?, Sk- I I CAiT EE FESTAT+iF- SIC C. 3 112-N
A SLOPE SITE PLAN—���
PT vi4 �OcCS
1 jj�� SIL.T
2 p c G vU
b d
3 p p G4 rt.v
4
a �
5 J I $o'tTO U" 4 N• o It
6
7
8
9
10
11
12
13
14
Date
`
Net
Time
Depth to
Water
Net
Drop
rj.
18
•
19
20
WAS GROUND WATER S
ENCOUNTERED? n L
O
P
IF YES, AT WHAT E
DEPTH?
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
PERCOLATION RATE (minutes/inch)
TEST RUN BETWEEN FT AND FT_
COMMENT�j 11 0 r "%-CW �'N'
PERFORMED BY: CERTIFIED BY: > DATE:
72-008 (6/79)
m:.>. GRE;ATUF ANCHORF ;. AREA BOROW,H
HEALTH Di PA}•MMENT CASE 0
]ir•� �I �' D 327EAGLI, STREET
ANCHORAGE, ALASKA 99501
B I.bMS'Tr�rTlov► Date Performed _Mck114 1974
Fp,a Dc scription� at Block ��sUc ivision �' �. Q'_ eS --
This Fcrm Reports a: Soils Log ercolation Test
Depth
Eeet Soil Char--cteristics
09ai to,Se; l
0 S i I+ a /
C {-ravel
o
n'
�0
�Z I�00 La, -9e C0661FS - G 'P
s�
\� Was Ground Water Encountered?120 °oo
if Yes, At What Depth
Location Sketch
11
Reading Date Gross Time Net Time Depth To H2O
Net Drop
www
Percolation PaTe V17 M xnu e
Protosed Install.at�' Toni Seepage Pit Drain E'ield
Depth Of Inlet _ _Depth To Bottom Of Pit Or 'french mow.,._...
COMMENT•>: PQ_ cct_u S(-- 7li P /-7 i ,o k >;14
Test Performed B;:w f-�lCIL i�c�9o�o__.�«.I_ �yLs� ate-{ ST+1C,
Data Certified By:� �.
Date:
ENGINE LHING INNOVATION IN Tm:, F=AFi NORTH
ARCTIC ENGINEERS, INC.
I'Ncjir ELv!RHNG SIU(m `, e)E l_ sE7 € .: "t MANAE `Et P !3URVIYlc,
August 19, 1983 AEI# 83-013-19
Mark Schindler
Lot 3, Block 1, Birchtree Estates
Anchorage, Alaska
Dear Mr. Schindler:
On August 3, 1983, an inspection of the individual well on the above
referenced lot was performed by cur firm. The Municipality of Anchorage
requirements for individual wells are:
1) Casing extends 12" above ground.
2) Ground surface around the well is sloped away from the well.
3) Well cap is properly sealed.
4) All wiring is in electrical conduit.
5) Water analysis for Total Coliform is satisfactory.
6) Adequate clearance from septic systems is maintained.
We inspected all of the above and found them to be in compliance.
A copy of the water analysis report is attached. If we can be of any further
assistance, please don't hesitate to contact us.
Sidney CI r
9 °° •°° ��
ARCTICk% PROFESSO
1506 v �..
29 r Pa' !'RIGIA L f, NCi AN ?',> A E t.. A I S' 64 530
August 9, 1983
NGiNF EFON(I INNOtile USN 1N s fll ' M,, N._ PI H
ARCTIC ENGINEERS, INC.
Mr. Mark Schindler
c/o ARCO Alaska
P.O. Box 100360
Anchorage, Alaska 99510
SEPTIC SYSTEM ADEQUACY TEST
LEGAL: Lot 3, blk. 1, Birch Tree -Estates
OWNER: Mark Schindler
HOUSE
TYPE:
2 -Bedroom, single family
WATER:
On -Site Well
SEPTIC
SYSTEM:
From MOA Records
Tank: 1250 gallon, 1 compartment, steel
Absorption System: Mound
Absorption Area: 244 ft.2
Soil Rating: 0.24 gpd/ft.2
Approval Date: August 23, 1980
TEST DATE:
August 8, 1983
PROCEDURE:
500 gallons of water was input
into the absorption system standpipe.
Liquid level rise was monitored
in the mound at the standpipe. No
backing up into the wetwcll was
observed, and the system absorbed
all the water input within 5 minutes after input was stopped.
RESULTS:
The system accepted 1.5 times the daily design flow for a 2 -bedroom
house. The absorption system is adequate by Municipality of
Anchorage requirements.
OF
�
f
?i a
��
yi Q 06`nf'��680®/9OA�Y10���i�p p
® Sidney. C; ,,
t �s�Pmo® CE -156 a
pROFES0,10* 4V
ARCTIC ENGINEERS, INC.
3901 1"A R2 GIA E.. Wf, - Nj(;Hi. RAG( A.hSKA 99504 907/133,9428 F� (L,3'.,tJ 1P1Cz
appliedr sciences
Engineering Geology a Mining a Geophysics a Groundwater a Petroleum
16 July 1974
Greater Anchorage Area Borough
Dept. of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
ATTENTION: Ronnie Kinneen
21�, vi,D
kjL L23 1974 ANI
D plA ER ANCHORAGE
DEPT, OF En BpROU
AREAFNTAt (ilUAkliVM
Re: Soil and Ground Water Conditions, Lot 3, Block 1, Birch Tree Estates Subdivision
Gentlemen:
This letter is to reaffirm and certify our earlier investigation and evaluation of
soil conditions as they affect on-site sewage disposal on the referenced property.
On the basis of our work on the property and previous subsurface exploration in
the general area, we do not anticipate a water level within the upper 20 feet of
surficial soils on this property.
Very truly yours,
ALASKA GEOLOGICAL CONSULTANTS, INC.
Harold J. Moening
HJM:d
3944 Spenard Road 9 Anchorage, Alaska 99503 • Telephones: 277-7601 277-7602 • Telex: 090-25268
Municipality of Anchorage
• '', Development Services Department _ y
Building Safety Division .
OnSite Water & Wastewater Program
4700 South Bragaw SL
P.O. Box 196650 Anchorage. AK 99519.6650
www.d.anchorage.sk.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING c�
Parcel I.D. 017-141-48 HAA# Zh!O 16 3 8 b
1. GENERAL INFORMATION Expiration Date: / 0 ' 2 %' O
Complete legal description BIRCH TREE ESTATES; LOT 3. BLOCK 1
Location (site address or directions) 5250 RIVERTON ANCHORAGE, AK 99516
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
MIKE TAGGART C/O DYNAMIC PROPERTIES Day phone 348-0444
Day phone
CLAIR DALTON w/ DYNAMIC PROPERTIES Day phone 229-1275
3111 'C" STREET, ANCHORAGE, AK 99503
Unless otherwise requested, HAA will be held by DSD for p/ckup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual Well
0
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
0
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 AuthodlyApproval 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 Finn ALASKA WATER & WASTEWATER CONSULTANTS, INC. Phone 337-6179
Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, AWWC Inc. attempted to provide a thorough,
conscientious engineering analysis of the system In accordance with ADEC and MOA
DSD Guidelines 6 Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the kcal 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 theyguarantee that
there are no hidden defects or encroachments. A41WC, Ina can therefore not provide
any warranty or &uture 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 tight whatsoever.
S. DSD SIGNATURE
Approved for _9 bedrooms.
Disapproved.
Conditional approval for bedrooms, with the flowing
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
Date ZS O /
Manitenance Agreements
Supplemental Engineer's Reort
Other
Yt0Fr cn,��
V. gyp.
• ON-SITE
WATER AND ; m-
WASTEWATER
PROGRAM '
By: -7
�. Original Certificate Date: 7 0 /
Municipality of Anchorage
Development Services Department
Bueding safety Olv alon
Onaft water & WasW*u er Progrem
47W south srapaw SL
P.O. Box 198850 Ancfwrape. AK 99519850
wwwx andorape.sk.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: LOT 3 BLOCK 1 BIRCNTREE ESTATES Parcel ID: O 17 - III -'y g
A. WELL DATA
Wen type Pyr If A. S, or C provide PWSIDN NIA
Date completed 1974 Sanitary seal (YIN) -M.
Total depth 93' R Cased to 400+ fL
FROM WELL LOG
Date of test
Static water level fL
Well production —
9 -p.m -WATER SAMPLE RESULTS:
Well Lop (YIN) N
Wines property protected (YIN) YES
Casing height (above ground) 38" in.
AT INSPECTION
7-5-01
50' g
3.09 g.p.m.
Coliform 0 colonies/100 ml. Nitrate 0.5 mgJL. Other bacteria_0 coktnles/100 ml.
Date of sample: 7/5/01 Collected by: AWWC. INC.
B. SEPTICIHOLDING TANK DATA
Tank Type/Matertal
STEEL
Date instaned
8/23/80
Tank etze 1000 pal.
Number of Compartments 2
Cleanouts (YIN)
YES
Foundation cleanout (YIN) YES Depression over tank (YM) NO High water alarm (YIN) YES
Date of pumping 7/5/01 Pumper NORTHLAND
C. ABSORPTION FIELD DATA Fj5jR REQUIRED FOR S BEDROOMS: ax UNOMMED
Date installed 8/25/ae Son rating .p.d r R'lbdrn)150 System type MOUND
Lerch 39 ft. Width 16 tL Gravel below plpe 0.5 fL
Total depth -12=--ft. Eft. absorption area *624 R' Monitoring tuba YES Depression over field N2
Date of adequacy teat 7/5/01 Results (PasslFan) PASS For 3 bedrooms
Fluid depth In absorption field before teat1.5" 1n. Water added620 gal. New depth 5_5 in.
Elapsed fie: 213 min. Final fluid depth -?L in. Absorption rata x 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN N yes, give date -
• FROM GRADE TO BOTTOM OF MT: COVE
D. UFT STATION
Date Installed 8/80 Size in gallons 509 Manhole/Access (YIN) YEs
'Pump on• level at2VIn. 'Pump off level at -!ILK Hgh water alarm level at 28" in.
Datum BOTTOM TANK Cycles tested MULTIPLE Meets alarm & circuit requirements? Y
E SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAlft station on lot 100.5 TO ST1
Absorption field on lot 90' WAIVER #WR88-006
Public sewer main
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manholeideanout N/A
Sewer /septic service Ane 25'+ Holding tank N/A
*WR88-006
SEPARATION DISTANCES FROM SEPTIC(HOLDING TANK ON LOT TO:
Building foundation 5'+ Property Une 5'+ Absorption field 5'
Water main NSA Water service tine 10'+ Surface water, •100'+
Welts on adjacent kits 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main-----ALA—
Water
ainN/AWater service line 10'+ Surface water '100'+ Driveway, parldnglvehide storage 25'+
Curtain drain NONE KNOWN
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I cerV& that I have determined through field lnspecdlons and
review of MuMdpal records that the above systems are in
conformance with MOA HAA goideiines In effect on this date.
Engineers Pr tyAme JEFFREY A. GARNESS
Date i7 DI
HAA Fee S 300. 00
Date of Payment 71/ a(o 10 i
Receipt Number 7 78 8
atsv.12=)
Wells on adjacent lots 100'+
7
Waiver Fee $
Date of Payment
Receipt Number
fal
07/16/2001 09:10 FAX 9078686770 A+ Rome Services. Inc. 0002
•,•,,1•M I IL y1
� � y
••4I. A IVLL MOJ
A+ HOME SERVICES, INC.
7501 E. 140th Avenue
Anchorage, Alaska 99516
345-1890
CUSTOMER
17,5m 3L
wlte.Amn Ago -
Block Lot
r
INVOICE# 19.818
DATE
DESCRIPTION
AMOUNT
s
14
•
TOTAL
RE RKS
J {�
W
-Ott
CIV Ww�
76 q4
1 of
113 AM I I TI
Gallons Septic Leach Area Holding Tank
❑ PROBLEM AREA—CALL FOR MORE INFORMATION
❑ NEEDS TO BE DONE AGAIN IN 6 MONTHS
❑ Good Shape ❑ sludge buildup on bottom
❑ Jim cap missing or ❑ Cut standpipe to 11 above ground
needs replacing
Standpipes Time
❑ Floater on top
❑ Needs Septictrine
JOL-II-01 19:43 FR0M-CUE ENVIRONKNTAL SRV
L1�/1 G CT&E Environmental Services Inc.
+ rrrrrrrrrrrrrrrrrr�
CT&E ReLM
1014118001
Client Name
AK Water & Wastewater Consultants Inc.
Prof ect Name/N
5250 Riverton L3 Bl Birchtree
Client Sample ID
5250 Riverton L3 B 1 Birchtree
Matrix
Drinking Water
Ordered By
PWSID
0
Sample Remarks:
9075615301 T-850 P.02/03 F-049
Client PON
Printed Date/rime
Collected Date/time
Received Date/17me
Technical Direct�or�
Released By /{ ?.
07/10/2001 12:18
07/05/2001 9:10
07/06/2001 8:15
Stephen C. Ede
fo �Ey�
Allowable Poep Analysis
Parameter Results PQL Units Method limits Dam Due lnit
Natere Department
NitnwN
Microbiology Laboratory
Total Coliform
Y
0.500 U
0
0.500 mg/L EPA 300.0 (<10) 07/06/01 SCL
0 col/100ml. SM189222B (<1) 07/06/01 SKW
JOL-I1-01 19:44
Alld�
FROM-CTLE ENVIRONIENTAL SRV
9075615301 T-850 P.03/03 F-049
ME Environmental Services Inc.
Laboratory Division w
200 W. Potter Drive
Drinking Water Analysis Report for Total Coliform Bacteria TAnch age, z 9618-1606
READ INSTRUCTlONSONREVERSE SIDE BEFORE COLLECTINGSAMPLE Fax: (907)561.5301
MUST BE COMPLETED BY WATER SUPPLIER
O PUBLIC WATER SYSTEM I.U. R
1i PRIVATE WATER SYSTEM
D Seed Results 97 Seed leeofee
YY
PUG. 14. 1 V
•.
My A
V
Sri 0 Rn ihv , SrNd lewire
r., w Y.
Analysis shows this Water SAMPLE to be:
XSatisfactory
O Unsatisfactory
D Sample over 30 hours old, results may
be unreliable
O Sample too long in transit; sample should
not be over31Chours old at examination
to indicate reliable results. Please send
new sample via special del very it.
Date Received '11
Time Received QTl /5
Analysis Began
Analytical Method: Membrane Filter
o MMO-MUG
• Number of colonies/) 00tn1.
r s` -r "- Result* Analyst
SAMPLE DATE: 71FT F07 Fo—�71 1014118 � SctJ
Month Day Year
SAMPLE TYPE:
Routine O Treated Water
13 Repeat Sample (for routine sample ex Untreated Water
with lab ref. no. )
O Special Purpose
Time
Collected
S t NPLE LO ATJON Collected
By
50
flow hr
Comments:
nth Fbks Jun ❑
Faced
Date: Time:
Client notified of unsatisfactory results:
13
Phoonned Spoke with Fa
Date: Time:
BACTERIOLOGICAL WATER ANALYSIS RECORD
MMO-MUC Result: Total Coliform J" Cell
Membrane Filter. Direct Count d - Colopledloo ml
Verincation: LTII BCH COLIFIRM_
Fecal Coliform Confirrnatlun
Final Membrane Filter Results ei Coliform000 ml
Reported 03 Time 14-206) hes
rare-rY'V ' neve
Oe .0th"S#a/i.
WEMS Mamber of the SOS Group (SociN1 (1lnarale de Surveillance)
ENVIRONMENTAL FACILITIES IN ALASKA. CALIFORNIA, FLORIDA. ILLINOIS. MARYLAND. MICHIGAN. MISSOURI. NEW JERSEY. OHIO. WEST VIRGINIA
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. # _i? / 7 –10 — �lHAA # _ tii 1�` 1 ,-
1. GENERAL INFORMATION
Complete legal description Lot 3; Block 1; Bic ,ch Tree E,6 tate.s
Location (site address or directions) 5250 Riverton Avenue
Anchoxa e., AK
Property owner Rai Choudhun t; Day phone
Mailing address CIO Pail(/Ffome.quitu P.U. Box 4039 Conco%d CA 94524
Lending agency
Day phone
Mailing address
Agent _ Jack Baan% Remax PrLopen.ti.e,., Day phone 276-276i
Address 2600 Cordova St. Anchorage., AK 99503
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
3
XXX
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
XXX
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) From MOA M21
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 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.
S & S ENGINEERING G of Y _ } cf -� ci
Name of Firm Phone
4rir1rpcc Eagle River, Alaska 99577
Engineer's signature
6. DHHS SIGNATURE
Approved for bedrooms.
Disapproved.
Conditional approval for
Additional Comments
By:
Date
-a/;�"/j-ia
bedrooms, with the following stipulations:
Date 2 " 2 � _ F�
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 #21
D. LIFT STATION
Date installed
�,l R-0
Manhole/Access ((PN) _
High water alarm level at*
Cycles tested 3
Yo,S
E. SEPARATION DISTANCES
a�
Size in gallons _
"Pump on" level at* a 6
S-00
"Pump off' level at* /t
*Datum 7A —K ?aT7oM
SEPARATION DISTANCES FROM WELL ON LOT TO:
i
S tic holding tank on lot /00 ; On adjacent lots /00 4
Absorption field on lot C O ; On adjacent lots / y 0 t
Public sewer main /4 Public sewer manhole/cleanout N 14
i
Sewer/septic service line -f- Lift station
-16- w 2 TV — O b i
SEPARATION DISTANCES FROM TI /HOLDING TANK ON LOT TO:
Building foundation - -F- Property line S 4- Absorption field
Water main/service line a 9-1 Surface water/drainage IJ0 �t Wells on adjacent lots _
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation a Water main/service line a S7
-,'
Surface water I D
t Driveway, parking/vehicle storage area a �
Curtain drain NO kN nwA� Wells on adjacent lots )0 0 �} Property line > o �t
F. ENGINEER'S CERTIFICATION
1 certify that I have determined thru field inspections and review of Municipal records th aa are
in conformance with H nide ' es in effect on this date.Are
�,........d�f
Signature�[;� map
Engineer's Name �0 Q �� Co uo nJ
J
ROBERT C. COWANt cr
Date a / a o 9 '/ ��+ CE - 8801 rr �
-----__-------------------------------------------------------------- —-------- ------- -------- ---3., J ............. ,.. _.
HAA Fee $ 3 o'a Waiver Fee $
Date of Payment / / Date of Payment
Receipt Number & 5 5 7� l Receipt Number
Rev. 8/95 OSS: haa.wk.doc
L -�3
MUNICIPALITY OF ANCHORAGE
• `� DEPARTMENT OF HEALTH & HUMAN SERVICES AlrM
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. # ()kn - t L11.. Ll R HAA #
1. GENERAL INFORMATION
2.
3.
Complete legal description L.a f 30
Glc,ctc ! ,
l3 irch
Tree Ess) -g
Location (site address or directions)
s- -5-0 R• ,e r)6
A,e nu e
Property owner Pwg'y44('e' ,^ Day phone 269 - 372'
Mailing address � 2so R t v.erkn A, enme , At ch amu: 9�S1�
Lending agency Un k Day phone
Mailing address
Agent Qeh hie Clary, Forkcnl Properl4.el Day phone SK2-76S3
Address 2S 2S �' S14.. AMC'4orc►cyp ,4-k 995-03
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 3 N
TYPE OF WATER SUPPLY:
Individual well +,
Community well
Public water
NOTE: If community well system, provide written confirmation from State AC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: 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. 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 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.
Fl
Name of Firm uffs Tecti n�ca1 Servit•P✓ Phone 3q-5' 1355
Address J1530 macho Sf ^chs. -a Q A- c 9951
or 'Yr4.-� Date Tu" 3 4t i99 y
Engineers signature
(W j
' � • Y 1• �S ll rt r' •• �. •S
��"r?� • 17 �,�, 1 I j �r �,
•
0r••••••••••••••••.. ••.ti011 �' J11",
Li5 h21
1� ?1111 JLJ JSSJ1v.
/y
1111•• + '
THEODORE F. MOOREso
; �
Q••••••••`,�Q O
6. DHHS SIGNATURE
Approved for bedrooms.
ed
By:
Disapprov . .:
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paas a courtesy o purchasers of homes
ragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this
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 821
Municipality of Anchorage IaL
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: 40 f 3, Black 1, Birch Tllee Parcel I.D.
A. Well Data
Well type Pv f
Log present (Y/N)
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed
19,50 Driller un k
Total depth 93' Cased to 93' Casing height 3(0"
Sanitary seal (Y/N) V Wires properly protected (Y/N) y
FROM WELL LOG
Date of test
Static water level
Well flow
Pump levell
SEPARATION DISTANCES FROM WELL TO:
AT INSPECTION
112�1�y
C_
oZ
r
n
D
Zr
g.p.m. '�
g.p.m.
< o
'
�
5 1+
IT
co
n z
^i.
( 2
0
_y G)
O "'
Z
Septic/holding tank on lot 10 f ` Ir., C. --. ; On adjacent lots > (GG '
Absorption field on lot Sof A- ; On adjacent lots > too'
Public sewer main 4 A. Public sewer manhole/cleanout N• A.
Sewer service line > 2S` Petroleum tank Se-eo
* Seraral4vn �u%tanrc GuG(t�C/ �Izrnfro( t/2B/8b'
WATER SAMPLE RESULTS:
Coliform O co( /toG .n .Q Nitrate 0• t B rn 5� /-e Other bacteria 46-oe
Date of sample: Tan l'9, l99 y Collected by:
B. SEPTIC/HOLDING TANK DATA
Date installed 8180
Cleanouts (Y/N)
Tank size 10d0 Z l Compartments I
Foundation cleanout (Y/N) Y Depression (Y/N)
High water alarm (Y/N) N, 4. Alarm tested (Y/N) N• 4.
Date of pumping l0 1(2 I q3 Pumper RO-r 0 - RoQi & 2
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot _ 10 r ' Az,- c.o_ On adjacent lots -;> t oo, Foundation 3 2 '
To property line 30, Absorption field 34:57' Water main/service line > zs'
Surface water/drainage
72-026 (3/93)' Front CONTINUED ON BACK PAGE
It
«4111114II&3f-All �]►1
Date installed 8 / 23 /90 Manufacturer y ` 16^ y x 5-6" oCia S kei I n L;
Size in gallons 5 OU Aa I Manhole/Access (Y/N) Y
Vent (Y/N) N "Pump on" level at Flu i A "Pump off" Level at I I FL uiD
High water alarm level S F L v CC> Cycles tested �o
Meets MOA electrical codes (Y/N) No non-ro.►l.p1 coin ce o 6 sere ¢of
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot > Cao' On adjacent lots > ►ao' Surface water > (co '
D. ABSORPTION FIELD DATA
Date installed a/ Z3 /,go Soil rating (GPD/Ft2) /. 0
ur9r�ad�! 8/zo/86'
Length 9 Width 19 Gravel thickness
SY ' X °I,S' h e►Jee r a "ca.
/. o'
System type lit oun c(
_Total depth G�yove
Total absorption area 9t9 _Cleanout present (Y/N) C Mo,;k.- Depression over field (Y/N) N
Date of adequacy test I :Z6/1q Results (pass/fail) PA S'S for 3 Bedrooms
Water level in absorption field before test .2 After test 2
Peroxide treatment (past 12 months) (Y/N) Hvn a knocun of -.If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
f Se1,ezr-ocf?vn oCJirn�! Gua iv{r 1-UI41-1 / Z6 /&�
c.
Well on lot X- 90' On adjacent lots > t 00' Property line ? ems'
To building foundation 2 E' To existing or abandoned system on lot NI A-.
On adjacent lots > 30' Cutbank N.4. Water main/service line > Zs'
Surface water > toot Driveway, parking/vehicle storage area > .sa '
Curtain drain none c.een
E. ENGINEER'S CERTIFICATION
I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection
HAA Fee $ —300
Date of Payment 1-31—
Receipt Number a`,5 -(p
72-026 (3/93)' Back
Waiver Fee $
Date of Payment
Receipt Number
c
Signature moi-
Engineer's Name 7-7-7e0 oQo !`-tvo•,e
iiaiaa. a.r•
p ♦aaaae eeeae
THEODORE F. MOORE ;
Date J Ct n ,,tct vy 3 /� l99 Y
•e CE - 3539
e
y.. �4Ariii:t , e „•:i mac! _. _.
HAA Fee $ —300
Date of Payment 1-31—
Receipt Number a`,5 -(p
72-026 (3/93)' Back
Waiver Fee $
Date of Payment
Receipt Number
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES '�i
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL F'1 ?9- CII)
OF ON-SITE SEWER AND WATER FACILITY
264-4744
Application Date ✓ an 220 f96g
1. GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot, block, subdivision, section, township, range)
L.af Z 810,C4 ! . 4 1,ch Trac Etla!
Location (address or directions)
SZSO iwtr'ian JDrt✓e
(b) Property Owner !" tcLetr 44 Q^'pTelephone: Home Business 2 y6 -t717
Mailing Address til (OS Tu rnagain ,C� t'�o(, /} n c har5 yc
(c) Lending Institution P/Ome Savony "LA&C i► Telephone 2 76 - rys'/
Mailing Address 1001 .G. t3eruan Q/viC
(d) Real Estate Company and Agent WA, Le- 4, , - r_evfgm "C_ a y
Address 3 20/ G S+AchorayC fhk 94s�-
Telephone
(e) Mail the HAA to the following address: or: Check here ®, if hold for pick up.
List contact person and day phone number below.
7-ecX t -too re 3 yS - 13 SS-)
2. TYPE OF RESIDENCE
Single -Family 10
Number of Bedrooms 3
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 ® Public ❑ Community 0 Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 (Rev 8/86) Front
NEERING FIRM PROVIDING INSPECTIONS,
TESTS, FILE SEARCH, DATA AND INFORMATION
ENGI
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtaineand/or
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection. w i3SS
Name of Firm � /u
TtGhni�u/ SQrvrc<. Telephone 3 Ys'-
Address !'! 3 0 E cti e S t /417 CA ora r 4
k
Date Januur
o! �+" u��l a1af erP�ian ,{-�tlaI ,s'yo4i'airan,
0 "la ,1jer neem
6. DHHS APPROVAL
Approved for .7 bedrooms by
Ar
IV'4+• ` J
LM
�..........................� gineer's Seal
4 ; THEODORE F. MOORE ; 1�
Q� •°. CE - 3569
Ar
� °%rte '•. • •' $` xr
Approved x Disapproved
Terms of Conditional Approval
Conditional
CAUTION
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 8/86) Back
Page 2 of 2
MUNICIPALITY OF ANCHORAGE (MOA)
TH
APPROVAL
S`C�EA CHECKLIST
- FEBRUARY1984-
264-4744
3 Legal Description: L-vi3; /3lock I
13 trch Trcr Et1aFe1
A. WELL DATA°
Well Classification .`fit" rt vcr E� If A, B, C, D. E.C. Approved (Y/N) /V, A.
Well Log Present (Y/N) N Date Completed :tr 19 as Yield > S• TS' 6-0'rr 1"~ 7
Total Depth 9? Cased to ^ 9 3 Depth of Grouting No 4
Static Water Level Y71 Pump Set At 76'
Casing Height Above Ground 29 .r Sanitary Seal on Casing (Y/N) i
Electrical Wiring in Conduit (Y/N) Y Depression Around Wellhead (Y/N), Al
Separation Distances from Well:
To Septic/Holding Tank on Lot C. ° ; On Adjoining Lots >
To Nearest Edge of Absorption Field o Lot On Adjoining Lots > too,
p /Aoew� t
To Nearest Public Sewer Line To Nearest Public Sewer
Cleanout/Manhole N, To Nearest Sewer Service Line on Lot N�.
Water Sample Collected by 7"1=1`1 ; Date — I I !g 198
Water Sample Test Results $ScttuAaciv!y O cobdorm / lcao r"4 d 4 0.1 P"XI.e N,"tie -'y
Comments We-(( P& W kea f 6X A'MCX 00) 17-1161-97
B. SEPTIC/HOLDING TANK DATA
Date Installed 61180 Size 1000100 No. of Compartments I
Standpipes (Y/N) Y Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N)
Depression over Tank (Y/N) N Date Last Pumped 12 J l6 t67 &y J'scaary
Pumping/Maintenance Contract on File (Y/N) /H. ; for N, 6•
Holding Tank High -Water Alarm (Y/N) N' Temporary Holding Tank Permit (Y/N) A.
Separation Distances from Septic/Holding Tank:
To Water -Supply Well 10! ` draw C. 0, To Building Foundation 32
To Property Line 30` To Disposal Field 36'
To Water Main/Service Line N, A. To Stream, Pond, Lake, or Major Drainage
Course > !u o'
Comments
Page 1 of 2
72-026 (Rev 6/66) Front
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata ISO a,/aa— Type of System Design Mr+•���
Date Installed _8123180., 14n9!rvw(&1( /641� Length of Field 39 (Sy x NS bard c�rtroR�
Width of Field 14 Depth of Field rnocue �C
Gravel Bed Thickness l.0'
Square Feet of Absorption Area 67S r 2yd = 919 Standpipes Present (Y/N) all G
Depression over Field (Y/N) N Date of Last Adequacy Test N- A. Yoto3 bar,-,„
Results of Last Adequacy Test ^ 0 / x/66
Separation Distance fro orption Field�___�
To Water -Supply W �+ c. 90' m �e Property Line ? <U
p mound tlyre
To Building Foundation ' To Existing or Abandoned System on
Lot N, A. ; On Adjoining Lots 7 -7,01
To Water Main/Service Line To Cutbank (if present) Nt �.
To Stream/Pond/Lake/or Major Drainage Course > coo
To Driveway, Parking Area, or Vehicle Storage Area > -V 1
Comments 6t/at'✓ee 7ecol er.! ,for we!/ :xk c& rp A01 -4ila S-944trxvfco1P avAv,e
D. LIFT STATION
Date Installed 8/ 23 18p Dimensions `✓" la -g AS'&"ylcoc _V le(
Size in Gallons Manhole/Access (Y/N) `r
a
"Pump On" Level at 2Y y "Pump Off" Level at
High Water Alarm Level at
Tested for It
Electrical Codes (Y/N)
Comments
3d,"
** Check Permitted Bedroom Rating Against HAA Request **
— Vent (Y/N) N
Pumping Cycles during Adequacy Test. Meets MOA
I certify that I havechecked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed �/�- - f -*� Date Tar+ ZZ 1998
Company l=(uHkp 7*ech .{vcf MOA No. 8 7 ::IS' P_
Receipt No. 1 0 0 l 0 D //
Date of Payment
Amount: $
W *,,\j cam- S'? 6 ,
Page 2 of 2
72-026 (Rev 8/86) Back
AV
/iC07o' `•��A Engineer's Seal
7..f.....9TR ♦o...f f...of os.o®
0. •f.f0.. ......f
o THEODORE F. MOORE ;•
d��`.• CE - 35139 w`AV
Municipality of Anchorage
Department of Health and Human Services
Tom Fink, 825 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
January 28, 1988
Ted Moore, P.E.
Flattop Technical Services
14530 Echo Street
Anchorage, Alaska 99516
Subject: Waiver Request for Lot 3 Block 1 Birch Tree Estates
Waiver Request Number WR88-006
Dear Mr. Moore:
Your request for waiver of the required separation distance of
a well to a mound type absorption field has been approved. The
required 100 foot separation has been waived to 90 feet.
The water in the well appears to be supplied by a confined
aquifer at 88 feet with layers of silt and cemented gravel and
clay between the aquifer and the surface. You also indicated
that solid casing extends to the well bottom which should work
with the clay layers to stop any surface contamination from
entering the water bearing aquifer.
This approval applies to the existing mound/well separation
only. Any future upgrade to either will require all separation
distances be met or another approval from this department.
Sincerely,
Daniel J. Roth
Civil Engineer
On -Site Services
cc: Gus Andress, P.E., Manager
On -Site Services/Water Quality Programs
CIVIL & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS
THEODORE F. MOORE, P.E.
PH: (907)345-1355 January 22, 1988
M.O.A. Dept. of Health and Human Services
Environmental Health Section
P.O. Box 6-650
14530 ECHO ST.
MUPM"9?49t KA 99516
ENVIRONMENTAL SUVICES DIVISION
2 a 1 'r)8
;6
Anchorage, AK 99519 RECEIVED
Re: Well - Absorption field waiver, L3, Bl, Birch Tree Estates
Dear Sirs:
By means of this letter we wish to request a waiver of the
required 100 foot separation distance down to 90 feet, between
the well and the closest portion of the soil absorption mound, on
the subject lot located at 5250 Riverton Drive. A site plan as
well as other relevent backup material is enclosed for your
review.
No well log was located, however the well was undoubtedly
drilled in 19800 at the time of house construction. On January
18, 1988 I measured the static water level to be at 47 feet below
the top of the casing, and the total well depth to be 93 feet
below the top of the casing. On December 16, 1987, A.E.C.S.
pumped 1382 gallons of water from the well at 5.75 gpm, which
caused the static water level to be drawn down an additional 29
feet. The well yield is adequate for a three bedroom residence.
I was able to find a log for the private well on Lot 16,
located approximately 165 feet southeast of the subject well.
This well has a total depth of 91 feet, a static water level of
45 feet, and a yield of 8 gpm. Thus, this well appears to be
very similar in all regards to the subject well, and its log (see
enclosed) should generally apply to the subject well. The log
indicates sandy clay between 6 and 14 feet, and cemented clay and
gravel between 14 and 83 feet in depth. These strata should
provide an effective barrier to prevent surface contamination
from reaching the aquifer. The effectiveness of this barrier is
attested to by the fact that the static water level of the
aquifer in the wells is much lower than the surface groundwater
level observed in several nearby shallow test holes.
Water samples taken from the subject well on January 18 were
satisfactory, showing no coliform bacteria per 100 m1., and a
non-detectable Nitrate -N concentration.
The wastewater disposal system consists of a 1000 gallon
septic tank followed by a 500 gallon lift station, which pumps
the effluent up into a 45' by 54' (basal area) mound. The mound
was originally constructed in 1980 for a two bedroom system, and
despite the fact that it passed an adequacy test in 1985 for
three bedrooms, it was upgraded in August, 1986 with an
additional three bedrooms worth of absorption area.
On January 18, I measured the monitor tube located near the
east side of the mound to be 99 feet away from the well on this
lot. Based on a visual determination, it appears that the well
is 90 feet from the toe of the slope of the mound at its closest
point. Thus, the minimum distance between the well and the
actual absorption area is greater than 90 feet, due to the fact
that the mound's outline is determined by its cover material.
The original R & M mound design in 1980 refered to an
underlying silt stratum, however the 1986 upgrade by Tobben
Spurkland encountered GW material with a water table at 6 feet
below the natural ground surface. Numerous other soil test hole
logs from the immediate vicinity (enclosed) confirm the presence
of generally tight soils with localized pockets of clean material
and a generally high surficial water table. The mound that was
constructed appears to have achieved an adequate separation from
the surficial water table, and the generally tight underlying
soils serve to prevent a free exchange between this and the
underlying potable aquifer.
The topography of the lot slopes to the west at
approximately 5%. In the event of failure of the wastewater
disposal system, this would tend to direct contaminants directly
away from the well. It appears that the gradient of the potable
aquifer parallels the surface topography, making it extremely
unlikely that should any contaminants from the mound system reach
the aquifer, they would then be able to enter the subject well.
All of the above factors lead me to recommend that you grant
the requested waiver. It is my professional opinion that, due to
these factors, the waiver can be granted without incurring risk
of a public health hazzard.
Please give me a call if you have any questions.
Sincerely,
Ted Moore, P.E. .W-. aaA���
cc: John Huber, Marston Property Management
George McCoy, Jack White Co.
AVAr
49'"
s..........................f
.............; ...
. THEODORE F. MOORE ; `Af
®� ••, CE - 3589
too,.• •. : b�
L9
Flattop Technical Service;
14530 Echo .Street
Anchorage, A c ska gn7l r
L OT 1
LO T
(VACANT)
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•. THEODORE F. MOORF.`; X
y %••. CE - 3589
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MUNICIPALITY OF ANCHO?AGE
ENVIRONMCNTAL SEKVICCS DIVISION
5 i ` ")
_,U
RECEIVED
i
�.G7 3, QGlc 1, BIRCH TRcE EST
S /TE pi -4N
SCA>;C; I s S-0
p wN i3 Y. Tteo
NUTe: TYU 11 Nu r
A SctiTw6c eEO AG.Ai
A L I. 40CAr tone
hR$-c APPRoxt i -f ,4ra
WATER WELL RECORD
STATE OF ALASKA
s,
DEPARTMENT OF NATURAL RESOURES
Division of Geotopieal a Geophysical Surveys
v
1
`; Orillfh{ ►•twit No.
LOCATION OF WELL 41110.10 complete either If, If of 1t.) A.0 L Na.
10. B•fer0h rbirisa Lel Sleek 11. 1/001 re. Seeti. No. Towa•hlp Nr .asap m Meeldiah
•
•
[
It. DISTAN E AND DIRECTION FNOM�ROA NTERSECTIONS
3. OWNER OF WELL-
ELL
Address:
Address: 414
Street Address God Are• of Well L•a•tleh
1. WELL Los
Fest Oolow
setteee0new
4, WELL DEPTH: (fledl)
S. DATE OF COMPLETION
Mef•fl•1 Typo
Tap
it.<
--
„r
c3Cahle feel ❑ Rotsty ❑ Orlven ❑ Ors
,�- �{r..�.tw�
�j G
❑ A•oer ❑ Jstod ❑ Bored ❑ Other!
r
.`• r.—.,
i //
T, USE: Q•DewOatle ❑ Pa1Ut Sepplf ❑ ladwtrl
.+r �.•� C.<�.t14. '�7 tw
�/, '� ~
❑ Irriletlen ❑ Recharge ❑ Cemwoflsal
l,�`
Tell Well ❑ Other:
e �:r •r a
•. CASING, ❑ Threaded ❑ Welded
N - 11. Depth Weight ,.�110./ft,
diem. 111. fe ft. Depth Stlokup__;u ,, ft.
G. FINISH OF WELL
Tillie: OIawNOr:
SIot/Mosti Site: Length:
Sot between 1t *ad�� ft..
Bathflfff"s ��•— Gravel path
10. STATIC WATER LEVEL
❑ Above at ❑ Below land serfooe Dole
Earirm.nl atu:
11 . Pu LEVEL ►stew land surface and YIELD
= ft. offer Ors. pempM4 i• e.p.m.
It. offer nus, pumping 4.0.0.
12.OROUTING Weil Oreuted: ❑ Ye• (3 N0
Material: ❑ Hest Covent ❑ Otnet.
13. PUMP: (if erellohle) M/ -tee
LaRsth of Orap 0100 ft. to►eeit f
C3 Srhw. ❑ JN ❑ Caatraleol ❑ of"?
14. REMARKS
19, WATER WELL CONTRACTOR'S CERTIFICATION:
It3. Water temperature e
TSIs well get. drille iin•er rF )•rJsdlstleh *ad his revert Is free to rho tort of m1 hnewhdp eRa NMI;
�. t! /ter, �'/• , I �� / �) �`�
R/p►N•rN BrNMs1 Nelfle Contract License member
'Asilifted �.
• _ r_ DCH: �/ 1
Aethwltea Roprq$ Rsell,*
Form 01 -woo (11/811
Jr
C"? D.sfrisetiM: WNITC . sofa DOGS, PINK • Driller, CANARY CYrtow4f
C
MUNICIPALITY OF ANCHORAGE, - -,L
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 .L1 t 6-7 cc, 1 W �'
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
L'h i %E. F -f TR E - En tr',rAT 3YF l ON- 2C3 `
Location (address or directions)
J5 -2J50 wRI VI~12 TO A,VF—
(b) Applicant Name A - FO K -A N I.. M. C ME Telephone: Home Business :4_77 7 6' 3 1
Applicant Address 'V C L- w, /-/g a tz'a tw G 74T 57- 1 AW 15' t-
(c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ❑ ; Buyer ❑ ; Other K (explain);
(d) Lending Institution Sp.? k:lkN is ",_1)&T 6A 6 0 Telephone 9-7'7— 75-3 if
Address tic? L W/ f= lfl,F ti"k;i a 0 'P/4 T f;'i- / t4 A% �_- 7-
(e)
(e) Real Estate Company and Agent No h/ 1=
Address
Telephone
(f) Mail the HAA to the following address:
2. TYPE OF RESIDENCE
Single -Family Multi -Family ❑ Other
Number of Bedrooms 3
3. WATER SUPPLY
Individual Well `° Community ❑ Public ❑
Note: If commu,'ni``ty well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsit� Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 (1i 84)
5. ENGINEERING FIRM PROVIDINta INSPECTIONS, TESTS, FILE SEARCH, DA i A AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm LLQ t' i� Telephone .27 cf �.Ez
Address
Date j �• %���C'
I�`r•.� y
• � St r N, a� 'l; Ls R
03 , )UNE 25. L971 s Engineer's Seal
6. DHEP APPROVA�
Approved for bedrooms by ate &�i/��
Approved I� Disapproved Conditional
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-025 (11/84)
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
t1 P
264-4720
V86 Legal Description: Aer 3. 13 1. 73/&,,H ?-r2LGi�
rP s F L � �t�T12N, X23 uC/
A. WELL DATA
Well Classification lZaS If A, B, C, D.E.C. Approved (Y/N) IIIA
Well Log Present (Y/N) t4 Date Completed Igeo t Yield ►'+'� X
Total Depth � 7d . Cased to > -7 0 Depth of Grouting NONE
Static Water Level so Pump Set At ,> 70
Casing Height Above Ground �� Sanitary Seal on Casing (Y/N)
Electrical Wiring in Conduit (Y/N) y Depression Around Wellhead (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot 103 ; On Adjoining Lots >
To Nearest Edge of Absorption Field on Lot On Adjoining Lots >
To Nearest Public Sewer Line N oN a To Nearest Public Sewer
Cleanout/Manhole No NA To Nearest Sewer Service Line on Lot / > d
Water Sample Collected by //__ Date
Water Sample Test Results S 4-4 der
Comments -PS4-
B. SEPTIC/HSWNNG TANK DATA
14CDate Installed r7 Size %8'd No. of Compartments ©N�
Standpipes (Y/N) Air -tight Caps (Y/N) Ye Foundation Cleanout (Y/N)
Depression over Tank (Y/N) a Date Last Pumped t117189
Pumping/Maintenance Contract on File (Y/N) �� ; for W%
Holding Tank High -Water Alarm (Y/N) XA Temporary Holding Tank Permit (Y/N) WA
Separation Distances from Septic/Holding Tank:
To Water -Supply Well /b 3 - To Building Foundation' 3 2
To Property Line % 30 To Disposal Field 3
To Water Main/Service Line > /0 To Stream, Pond, Lake, or Major Drainage
Course F40 NE
Comments
Page 1 of 2
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata /.5© Type of System Design _0/el a yew A100,1gl
Date Installed Awuk ya r� A4 Length of Field ✓ 11)4 41 5 84 3110 ' 4ALo.-
Width of Field Depth of Field NSA
Gravel Bed Thickness
4 �J
Square Feet of Absorption Area 6 7 Standpipes Present (Y/N) /® ,v/ e -
Depression over Field (Y/N) N Date of Last Adequacy Test r( �► �� S
Results of Last Adequacy Test 150. 1b.- l 6A4A-. "rC9~ 9
Separation Distance from Absorption Field:
To Water -Supply Well 1 &0 To Property Line > 3 d
To Building Foundation 30 To Existing or Abandoned System on
Lot N Q N C ; On Adjoining Lots 7 750
To Water Main/Service Line To Cutbank (if present) N e5 N
To Stream/Pond/Lake/or Major Drainage Course NA N C
To Driveway, Parking Area, or Vehicle Storage Area > 4: Z>
Comments
D. LIFT STATION
Date Installed fir U-0, l 4 8' y Dimensions 50mD GA L
Size in Gallons O -E3 Manhole/Access (Y/N) y
"Pump On" Level at ,2 y�� "Pump Off' Level at
High Water Alarm Level at - a O �! Vent (Y/N) til
Tested for Pumping Cycles during Adequacy Test. Meets MOA
Electrical Codes (Y/N)
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, orconformed to II MOA and HAA guidelines in effect on the date of this inspection.
Signed r Date 19i I 9e6
Company MOA No ZY
Receipt No.OF
/ 11 ••�•-
Date of Payment t b 1
Amount: $ b�'b� d� y►• "'' ••:r Engineers Seal
* • 49TH` '
0 •
2225-L
Page 2 of 2 �� '. JUNE 25, 1971 ' `v
72-026 (11/e4)
APPLI`,j-4NT FILLS
OUT UPPER HALrj ONLY
^ perty Owner Mtvr 4 7, Ae�,ti `p y-
Time
Phone
�
Date
Mailing Address A" � . 04 \
Zip Code
Inspector
Buyer 1\CSV\ Q v\V r
Address
Zip Code
Lending InstitutionI r, 1 L� f�
'T �1
Phone
�
Address
Zip Code
DEPT. OF HFALTH r^.
Realty Co. & Agent o r 0\1\ M
ENVIRONPvLNTAL PROTECTION
Phone
Al)G 1 9 998:
�}
Address
Zip Code'
( ) DISAPPROVED
Legal Description 1
( ) COND TIO`NA APPROVAL`
Street Location
Type of Residence
Single Family
Date Sewer Installed
❑ Multiple Family No. of Bedrooms
Well Log Received
❑ Other
Water Supply
Well to Tank
Individual
ATTACH WELL LOG. A well log is required for all wells drilled since June 1975.
Community
For wells drilled prior to that date, give well depth (attach log if available).
/Ck
❑ Public Utility
V36 r
Sewer Disposal
Individual A � 1 r!�
Year Individual Installed: F
ElPublic Utility t ���a , t �'- 1
When Connected to Public Utility: `
❑ Holding Tank L s• -
NOTE THE IN PECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time
Time
Time
Time
Date
Date
Date
Date
Inspector
Inspector
Inspector
Inspector
Field Notes:
MUNICIPALITY OF ANCHORAGE
DEPT. OF HFALTH r^.
ENVIRONPvLNTAL PROTECTION
Al)G 1 9 998:
RECEIVED
( L) APPROVED BEDROOMS
'CONDITIONS OF APPROVAL
( ) DISAPPROVED
( ) COND TIO`NA APPROVAL`
DATE �74.
BY:
Soils Rating
Date Sewer Installed
Well To Absorption Area
Well Log Received
Septic Tank Size
Well to Tank
72023 (3182)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
❑ TWO Cl FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON -SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
INSTALLER
❑Septic Tank or ❑ Holding Tank
Size: I 4-7� If Tank is homemade
give dimensions:
SOILS RATING
L/0
TYPE OFTANK
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
~
L J
o�
2 APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter u ccompany certificate)
C�ISAPP VED
- -E C
DATE —��-'iv'i 15
S--
BY C
.
July 24,11980
825 "L" STREET
ANCHORAGE, ALASKA 99501
(907) 264-4111
GEORGE M. SOLLIVAN,
MAYOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Carol Lattimore
Post office Box 10-335
Anchorage, Alaska 99511
Subject: Lot 3 Block 1 Birch Tree Estates Subdivision
The adequacy test performed on your sewer system has
failed. Therefore, before an approval can be granted
an upgrade will be necessary.
Prior to the upgrade, a soils test must be obtained so
that a permit may be issued by this department.
If there are any further questions, please call this
department at 2.64-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw
cc: Amfac Mortgage Corporation
401 East Northern Lights Boulevard
Suite 212 99503
FQC� F RIV E R. APS�P
Bruce Lattermore
P.O. Box 10-335
Anchorage, Alaska 99511
Dear Mr. Lattermore,
DAVID A. SLENKAMP
MECHANICAL ENGINEER
694-9055
June 30, 1980
ROBERT A. SHAFER
CIVIL ENGINEER
694-2979
MUNICIPALITY OF ANCHORAGE
DEPT. OF H.ALTH &
ENVIRONMENTAL I✓ OTECTION
J UL 3 1980
RECEIVED
Reference: Lot 3, Block 1, Birchtree Estates Subdivision
At the request of John Russell of Lee Houston Realty, a sewage
system adequacy test was performed on the system located on
the referenced property. The septic tank was pumped and verified
to have a capacity in excess of 1000 gallons. The seepage
pit was checked and found to be completely full of water.
Approximately 700 gallons was removed from the crib. It
was then replaced with approximately 700 gallons of fresh
water. After a period of 24 hours the seepage pit was again
checked. There was no measurable decrease in the water level
in the pit.
It can be concluded from the above test that the septic tank
is of adequate capacity for your two bedroom home. However,
I regret to in form you that the seepage pit is inadequate
and will require upgrading. A permit for the upgrading can
be obtained from the Department of Health and Enviornmental
Protection, 825 L. Street, Anchorage, Alaska.
If we may be of further assistance, please do not hesitate to
call.
Sincerely, .,:7
T A. SHA,F R, P.E.
S/ss
`cc:Lee Hous `n Realty
ATTENTION: John Russell
Municipality of Anchorage
Department of Health and Enviornmental Protection
SRB 196X EAGLE RIVER, ALASKA
O
®f
825 "L" STREET
ANCHORAGE, ALASKA 99501
(907) 264-4111
GEORGE M. SULLIVAN,
MAYOR
DFPARTMENTOF HFAL.TH AND ENVIRONMENTAL PROTECTION
June 13, 1980
Carol/Bruce Lattimore
Post Office Box 10-335
Anchorage, Alaska 99511
Subject: Lot 3 Block 1 Birch Tree Estates Subdivision
Approval for your individual sewer and water facilities
can not be granted until the following items have been
completed:
(1) The water analysis report be delivered to this
department from Chem Lab, 5633 B Street, for
our review.
(2) The depression or pit around the well casing
needs to be fil:Led with impervious type soil so
that it slopes away from the well casing.
(3) Locate and expose the standpipe to the septic tank
for our inspection. It should be raised above the
ground level twelve(12) inches.
(4J The septic tank pumped with a receipt submitted to
,"Y�",Q�,�I1this department.
(5) An adequacy test be performed on the existing leaching
area. This test will determine if the system is
adequate according to National Standards. A listing
,•/� of private firms performing the test is enclosed. This
report needs to be submitted to this department for our
review.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw
T_ ��RNM D
7M
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-test is torwire-d
i
TRIS SIDE FOR OFFICIAL: USE ONLY
'
-
DATE RECEIVED
INSPECTION' APPOINTMENTS'
TIMETIME-:
TIME
DATE _
DATE _
DATE
INSPECTOR
A'
INSPECT-OFr 7
INSPECTOR
DIRECTIONS, -
1 TYPE- O#�RESI I)ENCE
NUMBER OF BEO13OOMS
SIN L> FAI1ll1LY
[:3 ONE ❑ ; THREE
Q FIVE ❑ OT IE!R
-
In MUE FAMILY_
17 TWO ❑ - FOUR-
❑ SIX
2 WAi ER SUPPLY
PERMIT NUMBER
-
11VDC/1bUAL_
DEPTH OF WELL
r
❑ _COMMUNITY
DATE DRILLED
❑ PUBLIC UTI LITY
Connection Verified
L06 RECEIVED
ti
a SEWAGEi3ISPOSAL SYSTEM
PERMIT NUMBE+3
INDIVIDUAL/ON -SITE
DATEINSTALLED
%, `
❑PU13MI LNILITY
- r
-
Connection Verified ;
INSTALLER
'ElSeptid'Tank or ❑ Holding Tank
Size: lay] - = If Tank is homemade
gOLLs RATING
„z�i�re dimensiebns:=` -
TYPEOf-TANK
MANUFACTURER
-
TOTAL 1gSORPTIONAR.EA
MATER L -
4. DISTANCES`
Septic/Holding Tank
Absorption Area
Sewer Line
Nearest Lot Line
WELL TO:
Absorption Area to nearest Lot Line
5. COMMENTS _
❑ ' APPROVED FOR
BEDROOMS -
❑. CONDITIONAL APPROVAL (letter -must accompany certificate)
- _
1SAPPROVED
DATE
BY Title(
LEGAL DESCRIPTION
,72.010 (Rev,3/78)
r.
_ ! MUNICIPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE
DepartmE of Health and Environmen 1 ProtezItionr'-ALT! I &
825 L Street, Anchorage, Alaska 9"jyTNMENTA_1 ';:_: .:CTION
264-4720
FEB 7 19%0
,request for Approval of Individual Sewer, and Water Facilities
RECEIVED
1. Property Owner: -Gregory A. LoForte
Mailing Address: C/O Lattimores Phone:
P.O. Box 10-335, Anchorage, Alaska 99511
2. Name of Buyer: Edward Bruce Lattimore & Carol L. Lattimore
HONE:-
Mailing Address. � g
P.O. Box 10-335 Anchorage, Alaska 99511Phon e:WORK: 272-1322
�
3. Lending Institution: National Bank of Alaska
Mailing Address. Pouch 7-025, Anchorage, Alaska 99510 Phone: 276-1132
4. Realtor/Agent: n/a
Mailing Address: n/a Phone:
5. Legal Description: Lot 3, Block 1, Birch Tree Estates S/D
,Street Location • 000 Riverton Avenue, Anchorage, Alaska 99507
6. Single Family Residence: (X) Number of Bedrooms: 3
Multiple Family Residence: ( ) Number of Bedrooms:
7. Water Supply: *Individual Well (X) Public/Community System ( )
If Individual Well, well depth
If Community System, name of system
8. Sewage Disposal System: "On-site System
(unknown)
(K) Public System ( )
If On-site
System,
date of
installation: 1974
*MRS. LATTIMORE IS
AVAILABLE
FOR.A66&SWTWqFNSPWr
THURSDAY, FEBRUARY 8, 1979 AT 3 PM.
*NOTE.: A well log is required on ALL wells drilled since 6/75.
**If on-site sewer system is over two(2) years old, an adequacy
test is required by this department.
A fee of $25.00 must accompany each request before processing
can be initiated.
3/77
�„�-c-`�.�'vc,J '�t�; I � c�,`�c.4-rte �!�`'``'� .. �'.ri•e�.,-���_