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Home My WebLink AboutKNIK HEIGHTS BLK H LT 14Knik H ights Block H Lot 14 #017-372 -14 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 hftp://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP241355 Work Type: SepticTank Upgrade Tax Code Number: 01737214000 Site Legal Address: KNIK HEIGHTS BLK H LT 14 G:2836 Site Mailing Address: 12941 RIDGEWOOD RD, Anchorage Owner: ALBERT DENNIS Design Engineer: FIRST WATER CONSULTING This permit is for the construction of: Effective Date Expiration Date Lot Size in Sq Ft: Total Bedrooms: 10/21 /2024 10/21 /2025 43500 ❑ Disposal Field 2 Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: Prior to any future COSA approval, Letters of Non Objection are to be secured from the utility companies for the water well in the utility easement. Received By: is 5 Date: Issued B / y� t t1 �� Date: 4 MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Parcel I.D. 017-372-14 ANCHORAGE ON -SITE SEPTIC/WELL PERMIT APPLICATION Property owner(s) ALBERT DENNIS Day phone _ Mailing address PO BOX 90602, ANCHORAGE, ALASKA 99509 Site address 12941 RIDGEWOOD ROAD, ANCHORAGE, ALASKA 99516 Legal description (Sub'd., Block & Lot) KNIK HEIGHTS BLOCK H LOT 14 Legal description (Township, Range & Section) Lot Size 43,500 Sq. Ft. Number of Bedrooms In Phone: 907-343-7904 Fax: 907-343-7997 16' APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 113 (w/wo ADU) Septic Tank ® Upgrade EA Duplex ❑ (D) Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature-.Qf,property owner or authorized agent) Permit/Rush Fees:1225 Waiver Fees: Date of Payment: 0 Date of Payment: Receipt Number: Permit No. r Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermit Application.doc 13030 Sues Way, Anchorage, AK 99516 907-350-9566 / FirstWaterAK@gmail.com ! !! October 14, 2024 Municipalities of Anchorage On-Site Water & Wastewater Program 4700 Elmore Road Anchorage, AK 99507 RE: SEPTIC TANK UPGRADE PERMIT LEGAL: KNIK HEIGHTS BLOCK H LOT 14 The owner has requested that we obtain a septic permit to upgrade the existing aged steel septic tank on the above referenced lot. For current functionality and future consideration or flexibility, we propose to install a 1500-gallon HDPE deep-burial septic tank per the attached design to serve the existing 4-bedroom residence. Groundwater was not noted in the MOA on-site file and is not anticipated to affect the septic tank installation. If groundwater is encountered during installation that may affect this septic tank upgrade, an epoxy coated steel septic tank or other action may be required. The lot and area are served by private water and any encroaching wells, easements, … must be staked prior to construction. The design will not impact any of the neighboring properties. Please contact us if you have any questions. Sincerely, Curtis Huffman, P.E. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241355, Curtis Townsend, 10/21/24 FIRST WATER CONSULTING KNIK HEIGHTS BLOCK H LOT 14 DESIGN DETAILS: Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241355, Curtis Townsend, 10/21/24 Municipality of Anchorage Page DEPARTMENT OF HEALTH AND HUMAN SFRVICES ENVIRONMENTAL SERVICES DIVISION 1~.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: -4c'J ¢l~'°c'l~f PID Number: o1'/ "3 '7~ N~": C~ ~r,¢~ C. ~u Ce ~¢~ Wastewater System: ~ New ~ Upgrade - Address: ~l ~l ~J ~ ~ ~,0~,,~ ~,,.' A~,o~,~ ABSORPTION FIELD No. of Bedrooms: Phone: .~' ~ ~ ~ ~ '~ ~ ~ Deep Trench ~ Shallow Trenc~ Q Bed ~ Mound B Other Total Depth from original grade: LEGAL DESCRIPTION SoilRating: /' Z GPD/Sq. Ft. ~ot; ~ Block: ~ Subdiv~[on:~]~ ~Et6~T~ Depth to pipe bottom from odginalj~grade: Ft, Gravel depth beneath pipe ~ Ft~ Township: Range: Section: Fill added above original grade: Gravel length: Gravel width: Number of lines: Distance between lines: WELL: ~s-~,a~ New ~ Upgrade / :~> Ft. J - -~ Ft, ~lassification (Priwte, A,B,C): Total Depth: ~To: Total absorption area: Pipe material: ~riller:// ~e Drilled: Static Water Level: Installer~ ~ ~6E ~y~-r~$ Date installed:~ - Ft. - ~ield: ~Pump Set at: Casing..~¢ A~o,. ero,.,: TAN K ~./~ ~ j Ft. Ft. SEPARATION DISTANCES ~ s~p~ic a Ho~di.g u S.T.E.~. To Septic Absorption Lift Holding ~ublic/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~ ~O~-~ ~ j '~ ~ O -- Number of Compartments: Welk I cot + i°ot 'E ~ '~ ~ ~ ~ Material: ~¢~b s.,.o~ ~ LIFT STATIC N Water ~i~ i ~ol + .... ~ -- LineL°t '~ ~ ~ ~O i ~.~ .~ .~ Size in gallons: Manufacturer: ~~ "Pump on" level at: ~~' level at: High water alarm at: Foundation Curtain -- ¢c~E I~ 4E',¢ ~ ---~ P:~ Electrical Inspections performed by: Drain .. Remarks: BENCH MARK Location and Description: ,~ tV~ Assumed Elevation: Inspections perJorm~lCe~j:(=rk==p.qe~.=~ Dates: 1st E-~z-~lL H~~fl :~'~ ~'' -z~--,',~ ~,, c~ Department of He~It~and Services approval ~. .... . '. ,,.-' ¢.. Permi't No, SW960074 2 2 Page of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 e Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report LOT 14, BLOCK H, KNIK HEIGHTS S/D 017-572-141 Legal Description: PID No.: SEPTIC T~NK~ NEW TREI4CH~ L 5 ~0' UTIL, ESMT. MT2 ...... TH LC'T; ~ INSU~'I'ION~ I liH / NO ~ROUND WATgR .. 72-013 A (Rev. 9/91) MOA 25 '~ ~. C,. ~, MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 PAGE 1 OF 1 ANCHORAGE, ALASKA 99519-6650 ON SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT ~'-~ PERMIT NUMBER:SW960074 DATE ISSUED: 5/14/96 DESIGN ENGINEER:S & S ENGINEERING EXPIRATION DATE: 5/14/97 OWNER NAME:SCHREIBER CRISTINA C OWNER ADDRESS:12941 RIDGEWOOD RD ANCHORAGE, AK. 99516 PARCEL ID:01737214 LEGAL DESCRIPTION: KNIK HEIGHTS BLK H LT 14 LOT SIZE: 43500 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN~ 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (iSAAC80) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: EXTEND MONITOR TUBE TO EXISTING SYSTEM IF IT IS TO BE USED IN THE FUTURE, AND MAINTAIN AMINo HORIZ. SEPARATION/DISTAN~f/fTT.~WEEN TRENCHES. RECEIVED BY~ ISSUED BY:~.~l/~ DATE: DATE: ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE. May 3, 1996 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER &WATER MAIN D(TENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOWTEST SITE PLANS ROAD DESIGN SOIL 'rEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 14,Block H, Knik Heights S/D Request you issue a permit to upgrade the septic system serving the existing four bedroom house on the referenced property. A test hole was excavated and percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation water no was encountered. The monitoring 'tube has been checked and found-to be dry. Attached is the proposed upgrade design. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. The proposed 1250 gallon septic tank is to be placed outside the well protective radius. Attached is a site plan which depicts the location of the proposed tank. If you require additional information, please contact us. Sincer, el_¥ ,__ Robert C. Cowan, P.E. RCC/gk Enclosure 17034 NORTH EAGLE RIVER LOOP o SUITE 204 · EAGLE RIVER, ALASKA 99577 / / RIDGEWOOD SITE PLAN / ~OAD gf]l(IVH 'Iq~A ,OOI F- o .--t UTIL. ESMT. DESIGN F ROBERTC. COWAN, RE. ROBERT A. SHAFER, P.E. CIVIL ENGINEERS ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL iNSPECTION & FLOW TEST SiTE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN REFERENCE: Lot 14, Block H, Knik Height S/D May 3, 1996 GENERAL: 1. The scope of this project includes the installation of a 1250 gallon septic tank and a leachfield trench to serve the four bedroom residence located on the referenced property. The existing trench is to be abandonc~as such that it may used in the fur and the existing 1250 gal septic tank is to be excavated, pumped, crushed, and abandoned completely. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. Ail standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP ' SUITE 204 · EAGLE RIVER, ALASKA 99577 Page Two Lot 14, Block H, Knik Heights S/D May 3, 1996 Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe 'to provide a minimum of 2 inches of cover over the pipe· A silt barrier must be installed between the final gravel layer and the native soil backfill° Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page Three Lot 14, Block H, Knik Heights S/D Mat 3, 1996 Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron ASTM D3034 (PVC) ASTM F810 (HDPE) ASTM D2662 (ABS) Yes Yes Yes Yes Yes No Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield grave], layer and the native soil backfill. Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C· requirements. Page Four Lot 14. Block H, Knik Heights S/D May 3, 1996 INSPECTIONS: Typically 'there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above 'to document the contractors activities° Final acceptance of the contractors work rests with the owner and the M.O.A. Page Five Lot 14, Block H, Knik Heights S/D May 3, 1996 S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for 'the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: V/,.¥' ,,., , ,.,,o ,g,/_ Township, Range, Section: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15-- 16 17 18-- 19 2O COMMENTS SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT -~ ~ DEPTH? p E Depth to Water Alter Moniloring? ,bAY Date: ''~ I Gross Net Depth to Net Reading Date Time Time Water Drop ,hol ' .- z- ~,/ ( ,.,,~ (, ~/~" 3 '. ~ ~ '7 % ~ / ~ ' ~'~ ~"~ PERCOLATION RATE I _ (m~nutes/mch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND (:) _ FT _ ~ ~ - = --. ~ ~..~ ~ - - , CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE ~~;~I::~;IDELINES IN EFFECT ON THIS DATE. DATE: '--/ ~ /`,~ 72-008 (Rev. 4/85) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL. PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAl_ SYSTEM AND/OR WELL INSPECTION REPORT NAME MAI LING ADDRESS LEGAL DESCRIPTIQN kOCATION }-2 ~UL~. DISTANCE TO: I Manufacturer 4~'~¢¢~---~"~' '~ 'Inside length I Liq* capacity in gallons I ,~,,~ DISTANCE TO' Iwell Manufacturer I Well ST*NC. TO:I No. of lines , [ Length of each line Top of tile to finish grade L 4 ~ngth Width I~ss Dept~ I ~TO% ~uild,n~ found,I,o~ NEW UPGRADE NO, OF BEDROOMS PERMIT NO. No. of compartments Liquid depth Dwelling PERMIT NO. Liquid capacity in gallons Material Nearest lot line Fo,nOation~) /=~, /T''ench width Total length of lines ~ r~" '~ "~_O inches Material beneath tile ~~D ~ ~ ~FLinche2 Depth PERMIT NO. Distance between lines /V//~:~ Total effective absorption area ~04- FT'. ,2 PERMIT NO. Crib depth Total effective absorption area Building foundation Nearest lot line Driller Distance to lot line PERMIT NO. Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS ,~.li SOIL TEST RATING INSTALLER REMARKS /.Ct ~';v ,¥c~ LEGAL PERMIT NO. DEPARTMENT : . WEALTH AND ENVIRONMENTAL .ROTEC]'ZON 825 ~1~~ STREET, ANCHORAGE, AK. D950t 264-4720 ( 788;82 ) APPL I CAN]' LOCf~IT I ON LEGAL MOtJNTAI N ENTERPRISES R IDGEWOOD DRIVE Lt4 B H KWIK HEIGHTS SAR BOX t582N LOl' SIZE R I DGEWOOC. 4~500 SQUARE F'EET ]'YPE: OF SOIL ABSORBTION SYSTEM IS'i: TRENCH MA~IMLJM NUMBER OF BEDROOMS SOIL RATING (S~ FT?BR)= 125 THE REQUIRED SIZE OF' THE SOIL ABSORPTION SYSTEM IS: THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIEL. I>. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THIS SURFACE OF' THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCt4ES. THE GRAVEL DEPTH IS THE MINIMUH DEPTH OF GRAVEL BETWEEN THE OUTFRLL PIPE AND THE BOTTOM OF THE EXCAV8TION (IN FEET). F:'ERMII' APPI.~ICAN'r HAS THE RESPONSIBILITY TO INFORM 'THIS DEPARTMENT DURING ]'HIS INSTALLATION II',tSPECT]ONS OF ANY WELLS ADJACENT "FO THIS PROPERTY AND THE NUMBER OF RESIDENCES THFIT 'THE WELL WILL SERVE. BFICKFILLINC~ OF' Fti'.,IV SYSTEM 14ITHOUT FINRL IN'.F,.PEC, TION AND F:IPPI~O',,,'f~I. BY THIS [:,EPRRTMENT 14ILL BE] SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS iE'~O FEET FOR A PRIVATE WELL,~ OR ,'1.50 TO 200 FEET FROM A PI..IBLIC HELL DEPENI)ING UPON THE TYPE OF PUBLIC HEEL.I,,.. 14EL. L LOGS ARE REQUIRED AND MUST BE RETURNED TO TI4E DEPARTMENT HITHIN 30 OF THE WEL. L COMPLETION OTHER REQUIREMENTS MflY FIPPL't'. SPECIFICATIONS AND CONSTRUCTION C, IFIGRRMS ARIS FIVfl[LRBLE TO ~NSURE PROPER [NSTRL.L..RT[ON. I CERTIFY 'THAT 1: I FtM FAMILIAR WITH THE REQUIREMENTS FCIR ON-SITE SEWERS AN[.', WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SMSTEM IN ACCORDANCE WITH THE CODES. 2~:: I UNDERSTAND ,~THRT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE I$ REMODELED l'O INCLUDE MORE Tt4RN 4 BEDROOMS. /-, APPLICRNT MOUN]'~IN EN'FERPRISES ' ""' ..... . .... BAT F V3 "'2: I .z,z, UED DY_ [~] SOILS LOG PERFORMED MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99602 276-222~[ SOILS LOG - PERCOLATION TEST ~'-~/-r~42 l~.t .'S~ (*I~UO .~'z-'{~- ~;):.'~'~ DATE PERFORMED: [] PERCOLATION TEST LEGAL DESCRIPTION: SLOPE SITE PLAN 10 11 '12 13 14 15 16 '17 18 19- 20- WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND -- FT /~'~ df, It--l/~,rofJt/J ~'*~.tnfJ /tll'~r,~,~f~ 0~: /~-~ CERTIFIED BY; (~U:q(~-~2~/ ~. DATE: 72-008 (7/76} WELL OWNER WATER WELL LOG FOSS DRILLING 1336 Ingra Street Anchorage, Alaska 99501 ,J ~_~r) USE OF WELL~~ SIZE OF CA~ING.~ 'j DEPTH OF HOLE~T. CASED TO /_~/~ oF D AWOOW . FT. REMARKS DATE COMPLETED_ ~PUMP TO BE SET AT ~_t o~ ~_t o ~.t O__ ~_t O~ ~to~ ___to. ___t O__ ~t O~ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-665~~,~ ~ www.d.anchorage.ak, us (9O7) 343-7904 CERTIFICATE OF HEALTH ,AUTHORITY ,APPROVAL FOR ,A SINGLE FAHILY DWELLING Parcel I.D. 017-,372-14 GENERAL INFORMATION Expiration Date: Complete legaldescription KNIK HEIGHTS Lo'r 14 BLOCK H Location (site address or directions) 12941 RIDCEWO00 Current Property o,~ner(s) Mailing address Lending agency 'k~ailing address Real E. state Agent Mailing address LARRY BIGALKE Day phone 250-7618 12941 RIOGEWOOD ROAD .ANCHORAGE AK. 99516 Day phone BARBARA BLOCK W/PACIFIC RIM PROPERTIES Day phone. 762-5417 3000 'C" ST. ANCHORAGE AK. 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank [] Community On-site [] Public Sewer The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid far 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. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $1000.00 at, or pdor to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto end as of the validation date shown below, I vedfy that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and b/pe of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm ALASKA WATER &: WASTEWATER CONSULTANTS, INC. Phone Address 6901DEBARR ROAD, SUITE 2B ° ANCHORAGE, AK 99504 Engineer's Pdnted Name JEFFREY A. GARNESS, P.E. Date 337-6179 o Engineer's Comments: In conducting this eva/ua§on, A WWC, Inc. attempted to provide a thorough, · conscientious enginee~fng analysis of the system in accordance with ADEC end MOA DSD Guidelines & Regulations. The reported results descrfbed the performance of the system under the conditions encountemd at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may #uctuate dudng the year. and ~he water usage of the family being served by the system. ' These conditions are oufside the cent/el of the evaluator of the system. Safisfactory test results do not guarantee future performance of the system, horde they guarantee that there are no hidden defects or encroachments. AWWC, Inc. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner listed above. Any re/ianca upon or use of this report by any other person or party is not authorized, nor will it confer any legal #ght whatsoever. ess." '~',~. ... ~, ..' ..~ DSD SIGNATURE ~ Approved for Lit' bedrooms. Disapproved. Conditional approval for bedrooms, with the fllowing stipulations: .t({((.l~f/.~/-f,. ,.q,~,'.,,. · ..... .. .. ,~- :~,.. .. ,.~ c ~. W^TERAND · Attachments: HAA Checklist Septic System Advisory Well Flow Advisory ~,.'. ...... .' ~_~ Manitenance Agreements Supplemen~l Engineer's Reort Other Original Certificate Date: Municipality of Anchorage Development Services Department On-Site Water & W.~tewa~er Program ,1700 ~outh Bragaw St, P.O. Box 196650 Anchorage, AK 99519-6650 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: WELL DATA Well type Pmv^~ Date completed 6/25/78 Total depth 286 ft. Date of test Static water level Well production 2 WATER SAMPLE RESULTS: Coliform. 0 colonies/100 mi. Date of =ample: 10/15/2001 B. SEFTIC/HOLDING TANK DATA KNIK HEIGHTS LOT 14 BLOCK H Parcel ID: 017-572-14 If A, B, or C provide P1NSID~ N/A Sanitary esal (Y/N) YES Cased to 140 lt. FROM WELL LOG 6/25/78 106 .ft. g.p.m. well Log (Y/N) Wires properly protected (Y/N) Cesing height (ebov~ ground) AT INSPECTION lO/4/Ol 107 lt. g.p.m. 1 Y YES 18,+ in. Nib'ate 1.03 m0JL. Collected by: Other bacteria 0 colonies/100 mi. AWWC, INC. Tank Type/Material STEEL Tank elze 1250 gal. Number of Compartments 2 Foundafioncleanout(Y/N) YES Depresslonovertank(Y/N) NO Dateinstelled 5/22/96 Cleanoute(Y/N) YES Hlghwateralarm(Y/N) N/A Date of pumping 7/13/2001 Pumper C. ABSORPTION fiELD DATA Date installed 5/23/96 Soil rating (~or ~rodrm) 1.2 Length 42 lt. Width 5 lt. ANCHORAGE CESSPOOL PUMPING Total depth ~ ~' e UT ff. Eft. absorption ama 500 ftz Monitoring tuba YES Date of adequacy test 10/4/01 Results (Pass/Fall) PASS Fluid depth in absorption field baforo test 10 in. Water added 855, gal. Elapsed TIme: 754 min. Final fluid depth 24 in. Any rejuveuaUon treatment (past 12 mo.) (Y/N & bjpa) System type 0EEP TRENCH Gravel below pipe 6 It, Depression over field NO For 4 bedrooms 42.5 in. g.p.d. New depth Absorption rate >= 600+ NONE KNOWN If yes, giv~ date O. UFT STATION Oata installed Size in gallons M~_~N~'--~ __ "Pump on' level at in. "Pump n. High water alarm level at in. Datu..._.._m Cycles tasted. Meets alarm & circuit requirements? E. SEPARATION DISTANCES Absorption field on lot Public sewer main Sewer/septic se~ce line SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot 100'+ 100'+ N/^ 25'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5' + Water main N/A Watar sewloe line. 1 O' + Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation 10'+ Watarsewloellne ' 10'+ . Sur~acewatar 100'+ Curtalndraln NONE KNOWN Wells on adJacent lots 100'+ F. COMMENTS On adjacent lots 100'+ On adjacent lots 100' + Public sewer manhole/deanout Holding tank N/A N/A Absorption field. 5'+ Surface watar. 100'+ Water main N/A Driveway, parldngNehlcle storage lo'+ G. ENGINEER'S CERTIFICATION I cerlify that I have determined through field inspections and review of Municipal records that the ebove systems are in conformance wfth MOA HAA guidelines in effect on this date. Engineer's Prlntad. Nan~e Data JEFFREY A. GARNESS HAA Fee $ Date of Payment Io/z-~,'/O / Receipt Number. ! 1"7~') (Rev. Waiver Fee $ Data of Payment Receipt Number BY: PACIFIC RIU PROPERTIE~; 0CT-2-0t 1t:36; PABE 212 C aVO~-J aOOM39Ol~J 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.# ~ [ ? ' ~ ? :z - /~/ 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner C Mailing address ,' ~'94 ~ Ridq~wood ,,,~,.d Day phone 75-3~62 Lending agency Mailing address Agent Address Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual well ,~,,,,:. Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72 025 {Rev I 91) ¢'~t 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. S & S ENGINEERING Name of Firm 1703-!. E=gie River ~ ,'~_,"_ ~_o~ ~n ~n4 Eagle River, Alaska 99577 Address ~ .~ . -~ /' Engineer's signature . Phone DHHS SIGNATURE ~' Approved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments Date C/z ?./¢/_' 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. ']-he 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. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Legal Description: Health Authority Approval Checklist Bz~c I¢ l<,.,~¢c #-¢.~¢,//fJ' ParcelI.D.: A. WELL DATA Welltype PR~v/C T' ¢_. Log present (~¢/N) ",/8 .~ / Total depth 7), ~' (; Sanitary seal ((~N) Date of test Static water level Well production If A, B, or C, attach ADEC letter. ADEC water system number Date completed / Cased to ) '--/O Casing height (above ground) Wires properly protected (~N) FROM WELL LOG AT INSPECTION f ;-% g~p.m. ")' $- g.p.m. WATER SAMPLE RESULTS: Coliform Nitrate Date of sample: ¢, B. TAN .ATA Date installed ~f/;~/~¢6 Tanksize /¢-,,¢-0 Foundation cleanout C/N) ¥ C. ABSORPTION FIELD DATA' Length`· ~ ,)- width EffeCtive absorption area ' ~&~'o Depression (Y/~) Purnper Collected by: Other bacteria $ & S ENGINEI-'RING Eagle Ri~er~ Alaska 99577 Number of Corn ~artments. /,-, o High water alarm (Y/~I Soil rating fF/bdrm) /* 3 / Gravel thickness below pipe Monitoring Tube present(~/N) yc.~r Depression over field (Y/~)~__ System type z- Total depth Date of adequacy test/v//~ - N ¢~ M Results (Pass/Fail) For .~-bedrooms Fluid depth in absorption field before test (in.); ~ Immedia[Cy~fter-"~"gal. water added (in.): __ Fluid depth (ins) M.~~~ Absorption rate = g.p.d. Per, ox~i~ast 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N) ~n_D~Jevet-&t*"'---* "Pump off" level at* High water alarm level at* ~ *Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: olding tank on lot Absorption field on lot Public sewer main Sewer/septic service line On adjacent lots On adjacent lots / o o -/-- Public sewer manhole/eleanout Lift station SEPARATION DISTANCES FROM~.~HOLDING TANK ON LOT TO: / Foundation /v o Property line ~- ~ ¥ Absorption field Water main/service line ~0 /v- Surface water/drainage / co Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line '~- ¢ :' Building foundation lq ~- Water main/service line Surface water 2 o o Driveway, parking/vehicle storage area Curtain drain /v ~ ,v ~ /~ .¥ o w ,¢ Wells on adjacent lots F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records th~ in conformance with M.~O~ideline~p effect on this date. Signature Engineer's Name Date HAA Fee $ ,.~¢2~ Date of Payment Receipt Number 72-026 (Rev, 3/96)* Waiver Fee $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEAl_TH & ENVIRONMENTAL PROTECTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SFWER FAC!LiTiES DIRECTIONS: Complete all paris on page 1. Incomplete requests will not be.~procassed, Please allow ten (10) days for processing, 1. "RO"ERTVOWNE>' L / f i ,ONE 2, BUY~ ~ ~ , PHONE 3. LENDING INSTITUTION MAILING ADDRESS 4. REALTOR/AGENT PHONE MAILING ADDRESS ;TREET LOCATION 6, TYPE OF RES. J~NCE NUMBER OF BEDRO_0~OM..~..~-- [~SING LE [] One ~ Four [] Other FAMILY [] Two [] Five [] MULTIPLE FAMILY [] Three [] Six 7. WATER SUP~.J~Y ~ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled [] COMMUNITY since June Ig75, For wells drilled prior to that date. give well [] PUBLIC U-FI LITY depth (attach Icg if available,) ~' INDIVIDUAL/ON-SITI:** **If individual/on-site, give installation aate ~ If system ~s over two [2) years old an adequacy test is required [] PUBLIC U'FI LtTY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS [~' SI NG LE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY L~"INDIVIDUAL DEPTH OF WELL EZ] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ~ERMIT NUMBER* E~-I~DIVI DUAL/ON -SITE DATE INSTALLED []PUBLIC UTILITY Connection Verified INSTALLER []Septic Tank or E~Holding Tank Size: /~),%' E-) If Tank is homemade SOILS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4~. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line I WELL TO: Absorption Area to nearest Lot Line 5, COMMENTS ~'/'APPROV ED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) [] DISAPPROVED DATE BY~ _~~ LEGAL DESCRIPTION 72-010 (Rev. 3/78)