HomeMy WebLinkAboutTIMBERLUX #2 BLK H LT 13./
Timb
rlux
Block H
Lot 13
#018-271-42
Municipality of Anchorage ,.
Development Services Department..:
Building Safety Division
On-Site Water & Was~water Program, 4700 South Bragaw SL
P.O. Box 196650 Anchorage. AK 99519-6650 ~ :.~
www.d.anchorage.ak.us (907) 343-7904 Page I of
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number:. SW010008 PID Number;. 018--271--42
N°me:TERRY ROWRER Wastewater System: [] New · Upgrade
P.O. BOX 414 WHrrE SALMON. WA 98672 ABSORPTION FIELD
Phone: No. of B~drooml: *
(:509) 49,3-2052 ,3 n Deep Trench · Shotlow Tr, nch [] Bed [] Mound · Other
LEGAL DESCRIPTION ~' ~ *2.0 ~/~.
1,3 H TiMBE:RLUX #2 **3.02 MAX DEPTH
- - - SEE DWG.
WELL: [3 New [] Upgrade 6+
r~ r~ 225+
rL EAGLE MOUNTAIN EXC. 2/14-16/01
SEPARATION DISTANCES []s. puc [] Holdlng · $.T. Ep. []Other
~'o s~puc Ab~qe°~dU°n St~onl'~t ~o~d~,g~.an~ ~,~ ANCHORAOE TANK 1250
From Tank
Well 100'+ 100'+ 100'+ -- 25'+ STEEL 2
s.,ooo ~Voto. 10o'+ loo'+ loo'+ - - LIFT STATION
Lot Une 5'+ *"1'+ 5'+ -- - 1250 ANCHORAGE TANK
Foundation 5'+ 10'+ 5'+ -- -- TIMER T MER 45"
Curtain Omen N(~NE KNOW ' 20 051 05 HHF M.O,A.
.e~a~=: *TH~S ~S AN ~N.OVAT~ ~OWOML~SS BENCH MARK
INTERM~TrENT SAND FILTER. BOTrOM OF SIDING ~ FCO
· ,2.13' OF M.O.~. APPROVED SAND FILTER TOP OF MH UD == 92.28
ADDED TO TOTAL DEPTH. 89.94
· W.OlOOO
OLD SEPTIC TANK ABANDONED PER EAGLE MOUNTAIN EXCAVATION
2nd 2/15/2001
SW010008 - 018-271-42
10' UTILrrY EASMENT / c
--~., I
EXISTING DRNNnELD ~ I
,',B~ONa) N PL,~C£ ~ i I'~(' -(J ml~ I
~ I ~AJR LINE
~ / U I / ,,,--OLD DRAJNF'ID. , (?)
i / / PIPE. i
\ r----... I '/ STXnO, WAS
/B / / COMPLETELY
NOTE: WHAT WAS ORIGINALLY NOTED / ~ / ~"i ~DO.Eo m
AS A CURTAIN DRAIN PIPE ON THE L.~ ~ ,, ~EXI~N¢ SEFI~C
~ WAS COMPLETE Y
11/23/83 INSPECTION REPORT WAS /
EXPOSED AS PART OF' THIS j .//,/ ABANDONED
UPGRADE. IT APPEARED TO BE A /~'t~/,'t" .....
BOOTLEG TRENCH, SEVERAL FEET /.o/"// / .......
WIDE. WITH ABOUT 18 INCHES OF ~ -- ~ "' /I
DRAINROCK. THE SOIL AROUND IT ~ ~ ~ j k /
WAS DISCOLORED. GIVEN ITS -- ~1 ~ / I,~
CONSTRUCTION AND LOCATION IT ~ ~ ~ J~ I
WOULD NOT HAVE BEEN FUNCTIONAL r ' ~' ~ ~ '
AS A CURTAIN DRAIN. ALL PiPE AND J ~ (/30
DRAINROCK WITHIN 30 FEET OF THE ~ ~ ~j
NEW ISF WAS REMOVED AND ~ EX~nNO -- 0
BACmLL~D W,H NAT~ SO~ ~ ~ ~%~o..~. X
A B C ~::'~::1111111 ~
~co ..1~ 1~,o~ - :~~111111
ALASKA WATER & WASTEWATER ~ !t-": .... ~'i I(fl~ ...........
CONSULTANTS, INC. 1 # = 50~
~RE. PARED FOR: PHONE NUMBER: PAGE NUMBER:
TERRY ROWRER (509) 495-2052 2 OF ~ r,, ~,/~f~rev A.
TIMBERLUX SUBOIVISION 1~2; LOT 1~, BLOCK H, ~h e. .........
AS-BUILT DRAWING OF' SEPTIC SYSTEM UPGRADE (BOTTOMLESS I.S.F.)
"_~
W 12¢,0 ~L. bOl,,I
~ a, m,~ 5,'r,l~,P, TANK
- .~.~3 ~.)
~/~o/~oo~ ~ O~..A~'~ ~
C.J.g,
, CONSULTANTS, INC.
TERRY ROWRER (509) 493-2052
TI~BERLUX SU~DIVISION ~2; LOT 13, ~LOCK H,
~K OF WORK:
PROFILE AS-BUILT OF SEPTIC SYSTEM UPGRADE (BO~OMLESS I.S.F.)
· MUNICIPALITY OF ANCHORAGE - BIIrI,DING SAFETY DMSION
4700 SOL'TH BRA,CAW STREET, ANCIIORAGE, AI.,ASI~
INSP£CTIOSt~: V,,~ee: fgO?) ~,~-~3~ Fax~. fg{;F; 343.4235 IA"FORI~4TIOA'.. (907)
~D~: 4935 ~~ A~ DA~: ~l/Oi
PHO~
LOR 13 BLOCg: H
--- m...,--'U:ri' STA~6N .....
COM;WENT~
IA~P2?C~OA.': EtecrH~I Rough
COMMEz .xT~:
z'~PECTOR:
{F'HE,;¥ COPJ, LECI31ON$ ~IRA' MADE, PLF..4~E CALl. FOR INSPF. C';7 0N
353~
TO
AWOX3 NIVANfl0~ '~5903 6L~SP69 gg:Lg
MUNICIPALITY OF ANCHORAGE
Depa~lment of Health end Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WASTE~NATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jan 11, 2001
Expiration Date: Jan 11, 2002
Permit Number: SW010008
Legal Description: TIMBERLUX#2 BLK H LT 13
Design Engineer: 0041 AK Water & Wastewater Consultant
Owner Name: TERRY ROWER
OwnerAddress: PO BOX 112369
ANCHORAGE, AK 99511-2369
Parcel ID: 018-271-42
Site Address: 004935 HILLANDALE AVE
Lot Size: 33242 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
[] D sposa Fie d [] Septic Tank [] Ho dingTank [] Privy
[] Private Well [] Water Storage
All construction must be In accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Date:
Date: /
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Waslewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
Waiver Review Worksheet
WR#: WR010003 PID~: .01827142 HA#:
Permitg: SW010008
Date Received: 01111/01
Legal Description: TIMBERLUX Ir2 SUBDIVISION LOT 13 BLOCK H
Engineer:. ALASKA WATER & WASTEWATER CONSULTANTS~ INC.
6901 DEBARR ROAD~ SUITE 2Br ANCHORAGE~ ALASKA~ 99504
Applicant: TERRY ROWRER
Waiver Requested: LOT ENE SEPARATION OF 1 FOOT FROM BOTTOMLESS I.D.S.F, TO EAST LOT
LINE FROHTING BUFFALO STREET
Cdteda: Geology Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
Waiver is Granted: ~ Waiver is not Granted:
List Conditions or Reasons for above: ~.~_ [AJf_~IJU~.F_.R ~
Date: / - //"~0 By:
Nam~ of Revi~er
Rec~: 0818 Amount: 11~5 Date Paid: 1111101
ipality ,o ----
Munic f Anchorage
o ¢'1~. lluerch, t r
~ ~ Public Works
Ihfildmg Safety Dxxas~on
P.O. Ik>x 1.0C'C~50 · ,-'t700 $. Bra#aw Street
Anchorage, Alaska 00519-GG-50 * {007) B2t3-8301
h t tl~://w~xav.el.m~chomgc.ak.us
01/12/01
Jeffrey A. Gamess, PE
Alaska Water & Wastexvater Consultants, Inc.
6901 Debarr Road, Suite 2B
Anchorage, Alaska 99504
Subject:
Waiver Request for Timberlux #2 Subdivision Lot 13 Block H
Waiver Request #WR010003
Parcel ID #018-271-42
Permit Number SW010008
Dear Mr. Gamess:
Your request for a waiver of the required 10 feet horizontal separation from the
on-site wastewater disposal system to property line has been approved. The approved
separation distance is 1.0 foot. The 1.0 foot separation is from the lot line that fronts
Buffalo Street.
This waiver approval applies to the existing on-sitewastewaterdisposal system to
property line separation only. Any future upgrade to the on-site wastewater disposal
system will require all separation distances be met or another approval from this
department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
Daniel J. Roth
Civil Engineer
On-Site Water & Wastewater Program
NOTE: Application must be §lied out completely
Property Owner Name '"~'('V
/
Mailing Address . ~).0. [~.y.
Legal Description ~
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
On-Site Sewer/Well Permit Application ('~
SINGLE FAMILY DWELLING
Day Phone
Zip Code
Lot Size ,..~,24:~ Acre~.~..Ft. Number of Bedrooms ,"~
will be conducted by: J~'Approved Engineering Firm r-] Municipality (permit fee included
Inspections
Does your house contain any of the following: [] Hot Tub [] Swimming Pool [] Therapy Pool [] Jacuzzi
This application is for:
[] Water Softener Unit
[] Sewer Only [] Sewer and Well [~Sewer Upgrade [] Well Only [] Water Storage
I certify that the above information is correct. I further certify that
this application is being made for a Single Family Dwelling and
in accordance with applicable Municipal Codes.
AbJkJC [
Waiver Fees: '-~/] ~ · '~')¢) Receipt#
72-012 (Rev. 4~J8)°
ALASIG WATER & WASTEWATER
CONSULTANTS, INC.
November 27, 2000
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Septic System Upgrade for Lot 13, Block H, Timberlux Subdivision #2
(Bottomless Intermittent Sand Filter - ISF)
To whom it may concern:
The existing 3 bedroom house is served by private well and a private septic system. The existing
septic system consists of a I000 gallon septic tank, a lift station, and a bed type drainfield. The
existing drainfield is state of failure and must be upgraded for the sale of the house. We are
proposing that a 1250 gallon S.T.E.P. tank and a innovative Bottomless Intermittent Sand Filter
(ISF) system be installed. Comments regarding the proposed upgrade are summarized as follows:
1. GENERAL: A test hole was excavated east of the existing septic system in order to
determine an area suitable for a septic system upgrade. Given the location of the documented
curtain drains, the setback from surface water, and the presence of groundwater; it is our opinion
that a Bottomless ISF system is the most viable option.
2. SOILS: Attached is a log which shows the soil classifications, groundwater monitoring, and
the percolation test results. It is our opinion that due to the overall appearance of the soils, a
application rate of 2.0 gallons/day/ft2 should be used..
3. DRAINFIELD DESIGN: Bottomless Intermittent Sand Filter (ISF)
a. Percolation Rate: 60 minutes/inch
b. Allowable Application Rate for ISF: 2.0 gallons/day/ft2
c. NumberofBedrooms: 3
d. Design Flow: 450 gallons per day
e. Minimum Absorption Area: 225 ft2
f. Effective Depth below pressure pipes: 3.0+ inches
g. Width: 6 feet
h. Length: 37.5 feet.
i. Effective absorption area = 225 ft2
j. Air Supply: Thomas Industries, Model 5070, "Anchorage Tank".
6901 Debarr Road, Suite 2B * Anchorage, AK 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com
k. Air Supply Line: "Wasteflow" emittefline, 1/2 inch I.D, "Anchorage Tank".
1. Sand Material: In accordance with M.O.A. latest standards
m. Pea Gravel: 100% passing 3/8' sieve, less than 20% passing the 1/4" sieve, and
less than 1% passing the #8 sieve.
We are proposing to excavate do~vn to a depth of 6.0 feet (maximum - on uphill side), place a
minimum of 6 inches of sand, install the air supply line, and cover it with 1.5 feet of sand. On
top of the sand, we will place 6 inches (minimum) of 3/8 inch pea gravel, with the pressure
laterals midway in the layer. We will use a conventional lift station (Anchorage Tank), equipped
with a programmable timer so that flow can be intermittently dosed to the ISF.
4. SURFACE WATERS: There are several areas with some surface water within 100 feet of
the proposed septic upgrade. All such areas will be filled with fiver rock, covered with filter
fabric, and than covered with native material.
5. TOPOGRAPHY: As can be seen on the design dra~ving, the drainfield is to be installed on a
25 percent slope that runs from east to west approximately. In short, we do not anticipate any
slope concerns.
6. LOT LINE WAIVER REQUEST: We request a I foot lot line waiver from the proposed
ISF drainfield to the east property line. We are unaware of any adverse effects on the neighboring
property with the granting of this waiver.
7. ABANDON OLD CURTAIN DRAIN: There is a clean-out near the south end of the
proposed trench that was identified on the 11/23/83 MOA inspection report as a "curtain drain
observation pipe". Based upon our site assessment, it is uncertain where the curtain drain
originates or ends, and what purpose it serves. Given that the area looks "undisturbed", it is
almost certain that this curtain drain does not extend into the proposed ISF site. Our design calls
for excavating out any portion of the curtain drain that lies within 20 feet of the propbsed ISF and
filling it with sand or insitu soil. The curtain drain outleta,vill be located (with a transn~itter) and
plugged. ~,~. qn.~..ttf~ ,~ ~,~-"~ ¢
8. MATERIALS AND CONSTRUCTION PRACTICES: The materials used, and the
construction practices will comply with DHHS' "Intermittent Sand Filter Design, Installation &
Maintenance Manual". The contractor should read this document prior to construction. Copies
are available at the Municipal Onsite Services office (5th floor, 9th & L St.).
9. CLOSING: I am open to any suggestions from your department, which would be an
improvement to the proposed design. I am unaware of any adverse impacts this installation
would have on at acent wells or septic systems. If you have any questions, please contact us at
337-6179. Thgn)tf ~ou for your assistance.
JefCq aar ess, P.E., M.s.
Pre§ide/~
6901 Debarr Road, Suite 2B * Anchorage, AK 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akxvxvc.com
tOT 2. ~ H. -- ~ ~: I ~',
r - ~- -- ~ wI I I I I ~ ' I
~T ~. B~K H, % ~MB~ S/O '2 J [ I ~T
.... _ I I
~HO~IN~ "-- ~ ~ l~1~ I : t
T~K~ Illllll ~'~ I t I
-- - IIIIIIl~ ~ ;,
,' ~ ~ ~J ID~IGN P~[ 2 OF 3 /'/~ t
./ ~UB~R~ S/D ~2 ~ ~ r ~ / ~ FOR OD~
.,~?~-~ ~ ~-~_ ~ ~ / , ,'
1 1/27/2000
A~S~ WATER & ~STE~'I'ER ~
'" CONSULIANI$, lNG.
TERRY ROWRER (509) 49~-2052 1 or z
TIMBERLUX SUBDIVISION ~2; LOT 15, BLOCK H, .." _
SITE P~N FOR DESIGN OF SEPTIC SYSTEM UPGRADE
..... SEE PROfiLE AND PI.,~.,
PONDL*D [' V1EW ON PAGE 3 OF
AREA (F~..L 2O00) I I
. . , , ~',\'~',
/-,* CEN1T~R OF A 2 BY1 I I ~
// OEEP DRNNAGE DITCH. I I . ~t1 ~
/ / INSTALL A 1' CULVERT AND ; i ..~ ~ ~ ~ 1' LOT
~V .// BURY WITHNATNi~RIV[RsoiLROCK AND ; ; IIUI" I tl[~ 't/ / W~V[R
~' O[]S[3~/AT~ON PIPE.
s; [XC*VA~O our.
~ ~ I I ,, I I !~ sE; COVER I.["r~R.
- ' ..... 7 / i' '
X ~0. TO B£ COMPL.-rl~LY / i GNJ.ON S.T.F-P. TANK
,,,, O~,U 2' f
DEEP PONDFr. D AREA.~ I ,..--AJR UNE
1. SEE COVER Lf. llER REOARDING THE / --AIR COMPRESSOR
:UR'rAiN D,~N. ~.o SE~C TANK J ~0~.. C/ (S~ .0~)
TO BE COMPLY I ~
2. ALL SURFACE WATER WITHIN 100 FEET OF AaANOCNED'~ ',f
PROPOSED SEPTIC UPGRADE SHALL BE FILLED !
WITH RIVER ROCK AND COVERED WITH FILTER
FABRIC AND NATIVE SOIL ~ D(IST1NC THREE:
,3. THE CONTRACTOR SHALL HAVE THE ':,,"?: !'~" ".'".'?" ::"]llllll \
NORTH AND FAST LOT LINES F'I_AGOED BY A ~-' ~':. "~!,':' ~'"1111111
REGISTERED LAND SURVEYOR PRIOR TO ANY ~.~:.'-. ~,'..*..~,'.:'-:lllllll ~
CON~UC~ON. ': ': ':.' :,'-".~BIIII , / \
/ I ~ ~ r: ',:'~ ,.'-..'.,;/ ~ / j I
P~q[~URC ~ AT A LOCJ~TK~N WHICH ~ READILy ACCE:~gBI..~ './ ~*~.,~ OF' A 3'
-d------, ,'/ 1 /;~":'/
11/27/2000 ~ ~F
~,w. ~,:
AI.~iSIr~ WATER & ~,~STEWATER **,~.. I ~:.~
TERRY ROWRER (509) 493-2052 2 .OF 3 I,, ;.t.'f 'e)~.. Garness:
TIMBERLUX SUBDIVISION #21 LOT 13, BLOCK H ~[... C]:7953 .o.."
DESIGN OF SEPTIC SYSTEM UPGRADE
INTE~~ SAND FILTER
%% ~ ~ ~-- DIS~RIBt~]ON UN~. PiPE SIZE
~- ~ OR[NCO ~S, INC.
~o c~ P~N VIEW
ORIGI~
R~ G~E DI~IB~ON UNES
MOA ~PRO~D '~%~ .. I 4 + FE~ TO
~D RLTER ~' -- GROUNDWA~R
NRUN~ IN~
~s ~.c.~s ~LOW PROFILE VIEW
TOP OF ~D.
, CONSULTANTS, INC.
TERRY ROWRER (907) 495-2052 5 OF 5 ~ ~ ~ ~f~ey~A. Gerness2
TIMBERLUX SUBDIVISION ~21 LOT 1~, BLOCK H ..'"'
DETAIL DRAWING OF PROPOSED ISF DRAINFIELD
ALASKA WATER & WASTEWATER CONSULTANTS, INC.
6901 DIFBARR ROAD, SUITE 2B * ANCHORAGE, AK. 99504
PHONE (907) 337-6179 ' FAX (907) 338-3246
I SOIL LOG - PERCOLATION TESTI
LEDAL DESCRIPTION: T~UBERLUX S/D ~2; LOT 13, BLOCK "H"
PERFORMED FOR: TERRY ROWRER
DATE PERFORMED: 10,/9/00
ORGANICS
I TEST HOLE
SM/ML
CV/ML
I I I
GP ML
GM CL
GC OL
SW MH
SP CH
SM OH
SC
DEPTH TO DATE
3ROUNDWATER
DRY lO/9/oo
10' 10/12/00
9.5' 10/22/00
DATE READING CLOCK NET TIME WATER LEVEL NET DROP
TIME (MINUTES) READING (INCHES)
10/12/0o I 2:38 6' __
2 3:08 30 5 1/2" 1/2'
3 3:08 ~ 6' ~
4 3:38 30 5 1/2' 1/2'
5 3:38 -- 6' __
6 4:08 30 5 1/2" 1/2'
PERCOLATION RATE. 6._~.0 .(HiN./iNC, vl/i~ PERC. HOLE DIA. 6.~" (INCHES)
TEST RUN BETWEEN 6.0. ~FT. ~ I 6.5 FT.
PERFORMED BY A~ ,WATER A W~ATER I, ~ ~ ~ [ ) , CER~ T~T
~IS W~ PERFOR~D I~ ACCORD~CE WITH ALL S~E~A~D MUNI~ GUIDEUNES IN EFFECT ON
DATE. DATE: 1115~1oo I J
Sent By: A~aska Water and Wastewater Con; 907 335 3246; Dec-30oO0 12:19; Page 1/1
PROPERTY OWNER MAINTENANCE AGI~:MENT
ON-SITE WASTEWA'I'EK DISPOSAL SYSTEM
This agreement, dated. ,200_, b made between the Municipality of
Anch,..~p, ge~ .I~_ .)r? .c~, of Health and_ .Human Services (D.HHS) aM the p~'op~y owner(s) of
This a~'eement is made ~or thc purl~se of maintnln[ng an on-sim wastewater disposal system
on the subject property.
The property owner(s) agree to the following:
The property owner(s) will have an nnmlnl inspection of the system performed by a registered
professional engineer. This inspection shall veri~ that all effluent and air pumps, timers, and
alarms are functioning as designed. Any deficiencies shall be corrected and the ~ngineer's
statement that the system is functioning a.s designed shall be filed annually with the DHHS.
In witness whcrco~ [ hereunto sci my hand and
~'i'f~;ials~l. '~ (/,.- -,..,~ '
flo~. Pub.lie (~ig~a_ ture) __ . ,_.,,
(Nogary's primed na~e)
My cc~nn~slon e~p~,,es:
MUNICIPALITY OF ANCHORAGE
· DEPAR-~MENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME PHONE ~NEi/V
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION NO. OF BEDROOMS
]Well I Absorption area Dwellin9 PERMIT NO.
O ~ ~ Manufacturer Material Liquid capacity in gallons
Q DISTANCE TO: Well Foundation Nearest lot Hne PERMIT NO,
~ m Z No, of lines Length of each line Total length of lines Trench width Distance between lines
~ ~ Total effective absorption area
OTHER
PiPE MATERIALS
REMARKS ? ~ '~
72-013 IRev. 3/78)
'x../ WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological 8, Geophysical Surveys
OriJ[ins Permit No,
LOCATION OF WELL (Please complele either la~ lb or lc.) A.D,L, No,
Io-o~..I8orough~ Subdivision Lot Block [b~.I, I/4qtrs. Section NO. Township Nr~ Range E[~ Meridian
2. WELL LO~ Surfece / 0 ~ ft -- ....
"~ ~ ~ ~ ~ ~:; D'~: ~<? ~ ~" :,~ ? ~ Auger O~etted ~Bored
,f'~,=~ '~ .~:;tC'"?~,.~' ~ ,~ j ~/ (~ 7. USE: ~'D°mestlc ~ Public Supply ~ Industry
' ~ * ..... ~ F d~em. ~ in, to /. ~*~ft. Depth Weight
I0. STATIC WATER LEVEL: :~/ /;[' ft.
0 Subm. 0 Jet 0 Centrlfic~l 0 Other
Permit
, // ,
_ ~ ~./ ~ MUNICIPALITY OF ANCHORAGE( >
~ ~) ~/Department~r,~f Health and Environmental~'rotection
~/ 825 L Street, Anchorage, AK. 99501
\~ / 264-4720
~.~ * * * HANDWRITTEN PERMIT * * *
~ ~~ WELL AND~-ON-SITE SEWER PERMIT
Applicant:
,ocation:
Legal Description:
Mailing Address
Phone Nur0ber: ~
Lot Size:
Type of Soil Absorption System Is:
Trench: Drainfield: Seepage Bed; ~ Holding Tank: C~f>)
Maximum Number of Bedrooms: Soil Rating (sq. ft/br)
The Required Size of the Soil Absorption System Is:
DEPTH ~Q L~H GRAVEL DEPTH ~ '~
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SiZE = /OC) C~ GALLONS * *
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 1 9 8 2 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I undar~tand that~the on-site sewer system may require enlargement if
the~s~denc~remodf~o, include more that 3~ ~bedr°°ms'
Applicant
SWP/024 (i/81)
ALASKA eI1UIROIlm6nTA COI TROL SeRUICe$, Inc.
June 5, 1981
Judy Lamb
Remax Properties
2702 Gambell Street, Suite
Anchorage~ Alaska 99503
201
Dear Judy:
Here are the soils tests for lot i3, block H, Timberlux
Subdivision. Three holes were drilled on the north portion of
the lots. It appears possible to place a house on the lot and
have an on-site system in this location. The silty sand (SM)
encountered here appears to be the same as on the front of the
lot. We therefore reco~nend a design of 257 sqft per bedroom.
As in our letter of April 22, 1981 to Dianne Lund, I can not
over emphasize ~e importance of the diversion of water off
the lot by reestablishing the drainage along the south side
Hillandale Avenue.
Another option to improve the drainage would be to install a
curtain drain along the lot lines at the NE corner of the
lots. This would probable lower the water table very
significantly.
Here also is the consolidated bill for the original work
(Carol Black) and the last work.
If i can be of further service please let me know.
Sincerely,
l'.eroy (2. Reid ,Jr. ~ PhD~
President
PE
1220 UJcst 25t~ Auenue · Anchorage, Alosko 99503 · [907) 276-1361
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
~/'SOrLS LOG
PERCOLATION
TEST
1
2
9
15
16-
17-
18-
19-
20
SLOPE
SITE PLAN
WAS GROUND WATER S
ENCOUNTERED? ~--~ L
O
Reading Date Gross Net Depth to Net
Time ,Time Water Drop
PERCOLATION RATE (minutes/inch)
TEST RUN BETWEEN FT AND FT
72-008 (6/79)
LOT
DEPTH
2
3
4
5
7
d
14
1~-
20.
Subdivision
A,E,C,S,, INC,
1220 W, 25-~1, AVENUE
ANC~DRAGE, AK, 99501
SupplernenLal Soils InFormation.
~m ~/-~ Block ~ -~--~&~,(V~ ~ '
LO1
2
3
4
7
8
10
13
14
17
18-
20-
LOI
TH
1
2
3
4
?
8-
10
12
14.
20-
LOT
TH
OEPTH
2
3
7-
8-
10
13.
14 -
15 -
~?
20
Municipality of Anchorage
Development Sentices Department
Building Safety Division
On-Site Water & Wastewater Program
4700 South Bragaw SL
P.O. Box 196850 Anchorage, AK 99519-6850
www.ct.anchorage.ak.us
(9O7) 343-79O4
RELEASE OF CONDITIONAl.' HA010055
CERTIFICATE OF HEALTH ,&,UTHORITY .&,PPROVAL
FOR A SINGLE FAHILY DWELLING
Parcel I.D. 018-271-42
1. GENERAL INFORMATION
H.Z~t~. HA010055
Expiration Date:
Compfetelegaldescription TIMOERLUX.SUBOM$10N ~2; LOT 15, BLOCK H,
Location (site address or directions) 4955 HILLANDALE DRIVE ANCHORAGE, AK 99516
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
TERRY ROWRER
P.O. BOX 414
Day phone
WHITE SALMONt WA 98672
Day phone.
(509) 495-2052
NEILTHOMAS w/ COLDWELL BANKER Day phone
2525 "C" STREET ANCHORAGEI AK 99503
265-9106
Unless otherwise requested, HAA will be held by DSD forplckup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Indivi,~ual Well
Individual Water Storage
Community Class Well
Public Water System
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
Community On-site
Public Sewer
The Municipality of Anchorage Development Services Department (DSD) Issues Ce~ficates of Health Authority
Approval (HAA) based only upon the representaUons 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 propertJes served by a single family on-site wastawatar 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 data 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.) Cer'dficates 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 enginem's work.
Note: Alaska Water and Wastewaler Consultants, Inc. shall be paid $256.25 a~ or prfor -.
to closing for the engineering san, ices provided. "
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the valida#on dale shown below, I ve#~y that my
investigation, based on procedures ou#ined ln the Health Authorify Approval Guidelines for this application°
shows that the on-site water supply and/or wastewatsr disposal system Is(are) safe, funcfional end adequate
for the number of bedronms and ~e of structure lndicated berein. I further verify that besed on the
information obtained frem the Munidpalib/ of Anchorege f~les and fmrn my investigation end inspection, the
on-sits water supply and/or wastewatsr disposal system is(ere) in compliance with all applicable Municipal
and State codes, ordinances, and mgulalions In effecf at the time of lnstallation.
Name of Firm ALASKA WATER &: WASTEWATER CONSULTANTS. INC.
Address 6901 D£BARR ROAD. SUITE 2B * ANCHORAGE. AK 99504
Engineer's Printed Name. JEFFREY A, GARNESS. P.E.
Engineer's Comments:
In conduc~g thie evatue~on, AWWCo Inc, attempted to provide · thomngh,
¢~nsctentious engineering enalyale of the sysfem/n accordence ~ ADEC end MOA
DSD Guidelines & Regulatlcm& The reposed msulte desctfbed the perto~rnenca of the
~ under the condi~one encountered et the ~me of the ~ end ~eperatton
distances measured to mad~Ty Identifiable features. The operational life of all wells end
=epEc systems depend on the Iocal soils condlffon, gmundwater lewl$ that may
#ucfuale du#ng the year, and the wator usage of the family being served by the system.
These cond/ffons ~ outalde the conbo/of the evalualor of the sy~em. Sa#sfac~ test
msulte do not guarantee futura performance of ~he system, nor do they guarantee that
them am no hidden dofec~ or encroachment. A WWC, Inc. can therefore not provfde
eny warranty or futura e~Jmate of how long the system wiff c~n#nue to meet the
operaff~lat mqulramente of the ADEC or MOA DSD. The content of thl~ report la for
the sole benefit of the ownor ll~nd ebove. Any mSence upon or uca of thi~ mpoct by eny
other peraon or parly Is not euthoHzed, nor v~71 It c(mter eny legal dght whatsoever.
DSD SIGNATURE
~ Approved for "~ bedrooms.
Phone 357-6179
Disapproved.
Conditional approval for __
bedrooms, with the fllowlng stipulations:
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
Manitenance Agreements
Supplemental Engineer's Reort
Other
Origlnal Certificate Date:
Municipality of Anchorage
Development Sewices Department
8uaclTng Safety
o~.81te water & wa~valer Program
4700 S~ulh aragaw ~
P.O. Box 196650 Anchorage, AK 99519-6650
www. cl.anc~mage.alcu~
A. WEU. DATA
We~ type ~aVA~
HEALTH AUTHORITY APPROVAL CHECKLIST
TIIdBERLUX S'/D ~2; LOT 13, BLOCK H, Parcel ID: 018-271-42
If A. B, or C proqdde PWSID~
Da~ gx~mpleted 10/30/82
TotaldepUt 106 It.
Date of test
b"taUc water level
Welt producUon
WATER 6AMPLE RESULTS:
~tO 106 ft.
FROM WELL LOG
lo/`3o/82
46 fL
40 g.pj~.
Wires propedy pn:~ec:md (Y/~)
Casing height (above ground)
AT INSPECTION
2/~5/Ol
50 fL
5.8 g.p.m.
YES
12+
Collfmm 0 colonles/lOOml. Nllmte 0.5 mg./L.
Date of ~ample: 2,/14,/01 Collected by:.
B. $EPTIC/HOLDING TANK DATA
Tank~ze 1250 gal. NumberofCompm'm~nts 2
Found~de~noutCflN) Y~S Depmsslonovermnk(Y/N) NO
Date of pumping NEW
C. AB~ORPllON RELD DATA
Otherbacte~, ,o colonies/lO0 mi.
AWWC, INC.
Date Insbdled ~ 2,/16,/01
Ckmnout~ (Y/N) Y~s
Hlghwaterelarm(Y/N), ,, N,/A
Pumper -
*BELOW FINAL GRADE, 2.13' OF M.O.A. APPROVED
SAND FILi~J< ADDED BE/OW TOTAL DEPTH.
Date Imtalled ~ 6olt mUng (i~r tt'/txlrm) 2.0
Length 37.5 fL Width 6 fL
Toted depthe5' +,/- fL Eft. absmpUon area 225 fi' MolII~ tube YES
Date of adequacy test NEW Results (Pass/Fall) -
Fluid depth In al:~orpfion field before test -% In. Water added - gal.
Ehal:~ed~: - ~m Rna] fiuld deplh - In. Absoq~on rate
Any reluvenaUon treatment (past 12 mo.) Cr/N & type)
Symmtype eOTTOMUmS LS.F.
Grovel below pipe 0.,35 fL
DepresMon over fiekJ NO
For 3, bedrooms
Newdepth - In.
- g.p.d.
- ffy~, give d~te ., , - ,
D. UFT 8TATIOH
Oate blM~ed 2/16/01
'Pump on' level atTIMER In.
OatuIll BOTTOM OF TANK
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Size In gallons 1250
'Pump off' level etTIMERIn.
Cy~e~ tested NEW
High water alarm level at 45
Meets alarm & circuit requirements? YES
$epfi¢ tank/lift station on lot 100'+
AbsorpUon field on lot 1 (30'+
Public 6~wor main N/A
~ewer Isept~ sewlce Eno 25'+
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cteanout
Hok g tank N/^
Bulldlng foundafion 5'+ Pmpertyl[no , 5'+
Water main 10'+ Water ~en'lce Ilno lO'+
Wells on adjacent Iota 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
AbsofpUon field 5'+
Sur[ace water 100'+
Property Erie
Water ~ervlce llne
Curtain draln
F. COMMENTS
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
· 1'+ Building foundaUon lO'+
~JYNVER ~WR01000~
Water main 10'+
10'+
50'+
Surface water lOO'+ Driveway, paddng/vehlde atomge 50'+
Wells on adjacent lots 10o'+
O. ENGINEER'~ CERTIFICATION
I cerU~ ~hat I have determined through field Inspecffons and
review of Municipal recoils ~het ~he above eysfems are In
cor~rmance wlth MOA HAA guidelines In effect on ~hls date.
HN~Fee$
Date of Payment
Receipt Numtmr
pz.v. ~oo)
Waiver Fee $
Date of Payment
Receipt Number
ztK CT&E Environmental Sea, Ices Inc.
CT&E Ref. S 10 ! 0?39001
Client Name AK Water & Wastewater C0nsul~ Inc.
Project Nam~ T~berl~
Client Snmp~ ID Lot 13 Bl~k H
Ma~ix ~klng Water
Ordete~ By
PWSlD 0
Sample Remake:
Client PO#
Printed Date/Time 02/21/2001 16:19
Collected Date/Time 02/14/2001 14:30
Received DntuTime 02/I 5/2001 11:05
Technical Director Stephen C.
Rele.sed By
'lqilrat e-N
Results ~L Units Method
0.500 U
0.500
mr,/L EPA 300.0
Allovabta Prep Analysis
Limits Date Date Init
10max 02/15/01 SCL
lticrobioloov Labor& ~ox~
Total Coliform 0
col/lOOmL SMI8 9222B
02/15/01 SKW
l~-J £O/ZO'd riO-! IOt~19~ ]¥1N3MNO~IAN3 313~0~J ZZ:91
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
Febmary23,2001
Municipality of Anchorage
Department of Development Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: CONDITIONAL HEALTH CERTIFICATE: Lot 13, Block H, Timberlux Subdivision #2
(Bottomless Intermittent Sand Filter - ISF)
To whom it may concern:
We have completed the subject septic system installation, however, because of the snow
conditions it is not possible for us to be certain that all of the surface water issues are resolved.
The ponded area noted on the original design submittal as 5' diameter by 2' deep, and the ditch
that flowed from it towards the northwest, have both been filled with bone rock, covered with
filter fabric, and buffed. The ponded area in at the northwest lot comer was not addressed
because its boundary could not be identified at this time. After break-up the contractor (Eagle
Mountain Excavating) will do final grading and deal with (cover with bone rock and gravel) any
other ponded areas identified. In short, we are requesting that you issue a conditional health
certificate at this time. All work will be completed prior to June 1, 2001.
If you have
Sincerely,.
Presi~
an~lons, please contact us at 337-6179. Thank you for your assistance.
rnek~F.E., M.S.
6901 Debarr Road, Suite 2B * Anchorage, AK 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwxvc.com
F£B-22-200! 11.1U 02:33 PM I~TECE/SL'J~R F~ NO, 5616828 P. OI
LOT 2 LOT
S 86'55'04# £ 137,71' 35.0
~'~r
I
LOT 12
~...' ~'~.
~"~9~ '~ /
E.~;!.~ .............
~':C~'~,~ ~,' / ·
~;'.. "'..: .... :...":~ /: :// d
-'-~o'oo. ~
,
~,c.o,,c~. ,~,s~, .~o~ (~o~) ~,~-~, LOT 15, BLOCK H,
~'~"'~"m ~,.~o, m~ ~',o~t, ADDN. NO. 2 ~MBEELUX SUBD.
MdniCipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 A~chorage, AK 99519-6650
~vww.cl.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 018-271-42
'1. GENERAL INFORMATION
Expiration Date:
Completalegaldescdption TIMBERLUX SUBDMSION #2; LOT 13, BLOCK H,
Location (site address or directions) 4935 HILLANDALE DRIVE ANCHORAGE, AK 99516
TERRY ROWRER
P.O. BOX 414
Day phone (509) 493-2052
WH~E SALMON,'V~ 98672
Day phone
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
NElL THOMAS w/ COLDWELL BANKER Dayphone
2525 'C' STREET ANCHORAGE~ AK 99503
Unless 'otherwise requested, HAA will be held by DSD forplckup.
2. NUMBEi~ OF BEDROOMS: 5
3. TYPE OF WA~TER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
TYPE OF WASTEWATER DISPOSAL:
265-9106
Indivldual On-s.}te
Indivldua! Holding tank
The Municipality of Anchorage Development Services Depadment (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 Naska. Certificatas of Health Authority Approval are required for the transfer
of title (except between spouses) for preperties 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 Authoflty
Approval are valid for 90 days from the date of issue for propedJes 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 pedod of
up to one year with valid water samples.) Certificates are valid for one year for properties sewed by Class A or B
wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Note:Alaska Water and Wastewater Coosultants, Inc. shall be paid $2,768.20 at, or prior
to closing for the engineering seMces provided.
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 Authodty Approval Guidelines for this application,
shows that the on-site water supp~/ and/or wastewater disposal system is(are) safe, functional and adequate
for the number of bedrooms and ~ 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 suppO/ and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of Installation.
· Name of Firm ALASKA WATER & WASTE-WATER CONSULTANTS, INC. Phone
Address 6901 D~BARR 'ROA[~. SUITE 2B * ANCHORAGE, AK 99504.
Engineer's Printed Name JEFFREY A. CARNESS, P.E.
Date
357-6179
Engineer's Comments:
In conducting ~hts evaluation, AWWC, Inc. attempted to provide a thorough,
conscientious engineering analysts of the system In accordance with ADEC and MOA
DSD GuldeNnes & Regulations. The reported results described the pefforroance of ~he
system under the conditions encountered at the Erne of the tes~ and separation
distances measured to readi¥1dentiEable features. The operational fife of all wells and
septic systems depend on the local soils cond~on, groundwater levels that may
flucfuate during the year, and the water usage of the family being ca/red by the system.
These condigons are outside the conb'ol of the evaluater of the system. Satisfactoi7 test
results do not guarantee future performance of the system, nor do they guarantse that
thora are no hidden doffs'ts or encreach,'nents. AWWC, Inc. can therefore not provide
any warranty or futura estimate of how long the ~3,storo will continue to moot the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of tho owner #stsd abew. Any reliance upon or use of this report by any
othor peraon or perty ls not aut]~orlzed, nor wiII It confer any legal right whatsoever.
DSD SIGNATURE . . ON-SITE '.
· · WATER , , : -
___ Approved for bedrooms, ' ~ : WAST~-~/~p ~rn=
. . = :
~ *. .* .~
~ "Condi~onal approval for ,~ bedims, w[~ ~e fllowing s~pula~onsY~'' ;~5~"
$2000 shall be p~:c~ esc~o~ ~o comple:e ~o~k o~ su~ace ~a~e~ ts~~tl ~'
Honey in esc=ow shall not be released until this o££1ce has ~iven final approval.
Work shall be completed no later than 6-15-01
Attachments: · .-
HAA Checklist
Septic Sys!em AdvlsoO'
Well Flow Advisory
Manltenance Agreements '
Supplemental E~glneefs Reort
Other
Odglnal Certificate Date::' ~ - ~ '~' '~ O/
Municipality of Anchorage
Development Se ices Department
BulMlng Sa;ely Division
On-Site Water & Wastewater Program
4700 ~OUlh Bragaw SL
P.O. Box 196850 Anchorage, AK 99519*6650
www.d.anch~'age.ak.us
Legal Descrl~on:
A. WELL DATA
BI.
HEALTH AUTHORITY ,PPROVAL CHECKLIST
TIMBERLUX $/D 1~2; LOT 15, BLOCK H, ParcallD:. 018-271-4.2
Well type ~VATE ff A, B, or C provide P1NSID# N/A
Data completed 10/50/82 Sanitary ~ (YIN) YES
Totaldepth 106 ft. Casedfo 106 ft.
FROM WFI I LOG
Date of tsst 10/30/82
Static water level 46 .ft.
Well pmduc~on 40
WATER SAMPLE RESULTS:
Coliform 0 colonla~J100 mi.
Data of sample: 2/14/01
SEPTIC/HOLDING TANK DATA
.g.p.m.
Nllmta 0.5 mgJg
Tank Typa/Matarlal
' Tank size 1250 gal.
Fouedafion cleanout (YIN) YES
Data of pumping NEW
C. ABSORPllON FIELD DATA
Data Installed 2/~4-~s/o~
Length 37.5 It.
S.T.E.P./STEEL
Number of Compartments 2
Depression over tank (YIN) NO
Pumper
well Log (YIN)
Wlres pmpa y protected (YIN)
Casing height (above ground)
AT INSPECTION
2/15/01
50 ft.
5.8 .g.p.m.
YES
YES
12+ In.
Other bects~ 0 colonlas/lO0 mi.
AWWC~ INC.
Date Installed
C~eanouts (YIN)
High watar alarm (YIN)
*BELOW FINAL GRADE. 2.15' OF M.O.A. APPROVED
SAND FILTER ADDED BELOW TOTAL DEPTH.
2/16/01
YES
Soil rating (i~rlt'/txlrm) 2.0 System type BOTrOMLESS LS.F.
Width 6 ft. Grovel below pipe 0.35 .ft.
Depression over field NO
For 3 bedrooms
New depth - In.
Absorption rate >= - g.p.d.
If)ms, give data -
y£~ ~
Total depth *,~' +/-fL Eff. ebscxpfionema 225 It= Monltaringtube YES
Data of adequacy test NEW Results (Pass/Fall) -
Fluid depth In ebeorplJon field before test - In. Water added - gal.
Elapsed Time: - min. FL, mi fluid depth - In.
Any mJuvenafion lmatment (past 12 mo.) (YIN & type) -
D. UFT STATION
Data Installed 2/16/01
'Pump on' level atTIME:R In.
Datum Bo'FroM OF TANK
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WTM ~ ON LOT TO:
Size In gallons 1250
'Pump ofl' level atTIMERIn.
Septic tank/lilt station on lot 100'+
Absoq~on field on lot. 100'+
Publle sewer main N/A
Sewer/sepU(~ eewJce line
Manhole/Access (Y/N). YES
High water alarm level at 45 .in.
Meets alarm & drcult requirements? YES
On adjacent lots 100'+
On adjacent lots. 100'+
Public sewer manhole/deanout
Holding tank N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
At~ori~on field
Surface water
Building foundation 5'+
Water main 10'+
Wells on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 5'+ 5'+
Water ~en4ce line 10'+ **
Property line ,1 '+
Water eewlce line 10'+
Cudaln drain 50'+
F. COMMENT8
*WAIVER ~WR010005
Building foundation. 10'+ Water main 10'+
Surface water ** OflVeWay, paddng/vehlcle storage
Wells on edjacent lots 100'+
**SEE CONDmONAL WAIVER REQUEST
G. ENGINEER'8 CERTIFICATION
I cergfy that I have de~ermlned through field Inspec~on$ and
rm4ewofMunlclpe/mcordsthattheabove,ystemsemin ~~....( ~..:...~
conformance with MOA HAA guidelines in efi~ct on this date.
Englnee;'s Pdntud.Name _ JEFFREY A. C.A~NESS
Date of Payment
Receipt Number
O~v. t2mo)
Walver Fee $
Date of Payment
Receipt Number
~'~ MUNICIPALITY OF ANCHORAGE L"~41
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
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, t, ownship, range)
Location (address or directions)
(b) Applicant Name ~ ¢'~/P---~¢'¢~---~--~ Telephone: Home ,¢/-//,-~'- ~,~--¢? Business ,.~¢,~
ApplicantAddress ~¢- ~ //~J~ .. ~~' ~
(c) Applicant is (check one): Lending Institution ~; Owner/builder ~; Buyer ~; Other ~ (explain);
(d) Lending Institution ~--~'~ ~,~ ~'~¢'-a-~Telephone
Address
(e) Real Estate Company and Agent
Address
(f) ~ffi~t~-~ HAA to the following a~dress:
?¢,s- ??
TYPE OF RESIDENCE
Single-Family~ Multi-Family
Number of Bedrooms ,~
Other
WATER SUPPLY
Individual Well ~1' 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 [] 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 I of 2 72-025 (11/84)
~ ' SEARCH, DATA AND iNF¢.~.~tATION
ENGiNEERiNG ~IRM PROViDiNG INSPECTIf'~41'~' TESTS, FiLE
Authority Approval shoWS ma~ L. ' ' w I verify the! my investigation of this Health
. ,,' ~,4 h~retO and as of the vai,dat,on date s.h~,n^,b,~el~s°n~saI system ,s safe, funcbonal and adequate
As certified by my seal amX.~,.;~,~ on site water supply and/or wastew,* ......
for the number of bedrooms and type of structure indicated herein. ~ 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 _ Telephone
Name of Firm ~96X
Address E RIVER, AK 99577
Date
DHEP APPROVAL
Approved rot *"~-~- conditional -
"~ __ Disapproved ~
Approved ~
Terms of Conditional Approval
Date
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
of DHEP do not conduct inspections or
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 in the
Municipality of Anchorage is not responsible for errors or omissions
analyze data before a certificate is issued. The .-.
professional engineer's work.
Page 2 of 2
72-025 (11/84)
A. · WELL DATA
MUNICIPALITY OF ANCHORAGE
~ ~ DEPT. OF HEALTH &
MUNICIPALITY OF ANCHORAGE (MO~ENVIRONMENTAL pROTECTION
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Descri_~ion:
Well Classification
Well Log Present~)/N)
Total Depth ~ ~ '
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit (~/N)
Separation Distances from Well:
To Septic/14z;C,d~.Tank on Lot
Cased to
If A, B, C, D.E.C. Approved (Y/N)
Date Completed J.~)_ ~ ~'7..~- Yield
~ ~t~,* Depth of Grouting
Pump Set At I.) ~.
'"¢"~c:~ ~ Sanitary Seal on Casing (~Y~'N)
Depression Around Wellhead
t. ~,~, I Jo' ; On Adjoining Lots
To Nearest Edge of Absorption Field oJ~ Lot ~,,~> t..~ ; On Adjoining Lots
To Nearest Public Sewer Line t~ .1~ To Nearest Public Sewer
Cleanout/Manhole ~ To Nearest Sewer Service Line on
Water Sample Collected by ~--~ "~::~t.~,.,'~=~t~3¢. ;Date
Water Sample Test Results
Comments .t~. ~:¢~..~..~ ,,,.J J ~:~..-~ ~ ~1~ ,~,. ~-~
B. SEPTI'C/H~ TANK DATA
Date Installed
Standpipes (~/N)
Depression over Tank (Y/~
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/J;J~;ldi~j-Tank:
Air-tight Caps
['o
To Water-Supply Well
To Property Line to
To Water Main/Service Line
Course
No. of Compartments
Foundation Cleanout
~ Date Last Pumped
; for ¢3 ,~
Temporary Holding Tank Permit (Y/N)
To Building Foundation [ ~ ~
To Disposal Field t'J¢b
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72 026(11/84}
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed I~ "'~
Width of Field "Z"¢I
Square Feet of Absorption Area
Depression over Field (Y~...~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water:Supply Well
To Buildir~g Foundati~ol
Lot ~
To Water Main/Service Line
Type of System Design
Length of Field
Depth of Field ~
Gravel Bed Thickness [¢, t
~ '~"~"'~ =P Standpipes Present4~'N)
Date of Last Adequacy Test
~ (c'~ To Property Line ~' t
To Existing or Abandoned System on
; On Adjoining Lots ~ f~
~,~ ~ To Cut[~a~lk (if present)
To Stream/Pond/Lake/or Major Drainage Course
To Drivewa~/;'Parking Area, or Vehicle Storage Area
Comments
D. LIFT STATION
Date installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes
Dimensions ~k'~,-O I,.A,
Manhole/Access ~)N)
"Pump Off" Level at
Pumpin~g Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify t~a~l ~a~j~d~e~d, or conformed to all MOA and HAA guidelines in effect on the date of this inspection,
Signed ~[ ~ i~6X Date
Compar~t.~Ll~~~77 MOA NO.
Receipt No, -~(~ ~l'/~ ~
Date of Payment ~ ~ ~" ~ ~
Amount: $ 4~ ,~ ~
Page 2 of 2
72-028 (11/84)
JtCLl
tt~ou
. APPLI~.~NT FILLS OUT UPPER HAI.~ONLY
P;opJrty O~wner D O ~? ~ z'~- /(-~£//~- Phone
Address Zip Code
Realty Co. & ACnl Phone
Address Zip Code
Legal Description ~
Type of Resi~nce
Single Family
~ Multiple Family . No. of Bedroo~
Water Supply
~ Individual A~ACH WELL LOG. A w~l Icg Is required for all wells drilled since June 1975.
~ Community For wells drilled prior to that date, give wail depth (attach Icg if available}.
Sewer Disposal .
~ Individual Year Individual In,tailed:_ // ~ '
~ Public Utility . When Connected to Public Utility:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Time Time Time Time "~'
[;,h.t 2 0 1982
( ) APPROVED BEDROOM8 *OONDITION8 OF APPROVAL
72-023 (3/~2)
December 27, 1982
Don Van Ells
210 E. Potter
Anchorage, AK 99502
Subject: Lot 13 Block H Timberlux
Approval for the individual sewer and water facilities cannot
be granted until the following items have been completed:
o The depression or pit around the well easing needs to be
filled with impervious type soil so that it slopes away
from the well casing.
o The water analysis report needs to be submitted to this
office from the Chem Lab, 5633 B Street, for our review.
Please notify this Department for a reinspection when the
noted discrepancies have been corrected. If there are any
further questions, please call this office at 264-4720.
Sincerer,
Robert C. Pratt
Associate Environmental Specialist
RP256/p/EH
