HomeMy WebLinkAboutP & S LT 4P&$
Lot 4
#015-142-40
Municipality of Anchorage Page
Department of Health ahd Human Services
Division of Environmental Services
On-Site Services Section 825 "L" Street Room 502
P.O. Box 196650 Anchorage, AK 99519-6650
www. ci.anchorage.ak.us (907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: ,~ /.,¢/ c::,O0 ~_~'~ PIDNumber c::~t,~ -
Name: ~ ~ ~ ~ ~ ~ ~ ~ Wastewater System: ~ New ~Upgrade
Address:s~ ~ /Z z +~ ~. A~c4. ~e~/~ ABSORPTION FIELD
Phone: Number of Bedrooms: ~ Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other
~oil Rating: Total Depth from original grade:
LEGAL DESCRIPTION o, ~ ~.D~ ~.~' F~.
Brock Lot: Subdivision: Depth to pipe bosom from original grade: Gravel depth beneath pi~:
Township: Range: Section: Fil~ added above original grade: Gravel Length:
I,~ Ft. ~.5-~ +q9.5-~ Ft.
Gravel Width: Number of Lines: Distance between lines:
Well: E~T ~New ~Upgrade ~.~' Ft. Z ~ /Z Ft.
Classification (Private, A, B, C): Total Depth: Cased to: Total absorption area: Pi~ Material:
Driller: Date Ddlted: Static Water Level:Ft. Installer:(~I ~ ~ ~ ~ Date Insta[led:
Yield:GPM:~ Pu~p Set at: Ft. [ C~ing H~ight A~ow ~ou~a:Ft. TANK
SEPARATION DISTANCES Ds~pti~ D~o~a~n~ ~S.T.E.P. ~h~:
Septic Absorption Lift Holding Public/Private Manufacturer: Capacity: GaL
Tank Field Station Tank Sewer Line
Material: Number of Compa~ments
We, I ~ IOD' -
LI~
STATION
~Y
Size: Manufacturer:
LOt Line ~ j ~ ~ -- GaL
"Pump On" [ever at: "Pump off' lave} at: High water aIarm at:
~ound~bo, I ~ O' U~' -- in.
Pump Make & Model: Electd~l Ins~ctions pedormed by:
Cu~ain Drain -- --
Remarks: BENCH MARK
~ ~/ ~ ~ ~ Lo~tlon and Description
- Assumed Elevation:
, Engineer's Stamp
Inspections performed by: F~ ~4, %~c. Dates: 1st ~/y~
Depadment of Health and Human Services approval
Reviewed and approved by: ~ ~ ~ate: ~- ~- O I
72-013 (Rev.
I
PERMIT NO: SW000269
PID NO: 015-142-40
SWING TIES:
FROM: PT. "A" PT."B"
TO:
TR. M.T, "C"
TR. M.T. "D" 44.5' 6'
TR. M.T. "E" 53' 47'
TR. M.T. "F" 69' 49'
VALVE "G" 65' $2.5'
BED M.T. "H" 70' 82'
BED M.T. 'T' 30.5' 50'
NEW 495' LONG SOIL
ABSORPTION TRENCH --
WITH 5.8' EFF, GRAVEL
EXISTING
500 GAL.
LIFT STN.
EXISTING
1000 GALLON
CONCRETE
SEPTIC TANK
LU
.<
E
LOT 4
P&S S/D
WELL
POINT ON FENCE "B"~
NEW 50.5' LONG SOIL
ABSORP3
WITH 5,5' EFF. GRAVEL
T.H.
#1
CHAIN LINK FENCE
17.6'
POINT ON FENCE"A"~
PAGE 2 OF 3
T.H. #2
SHUT-OFF
VALVES
SOIL ABS. BED
LOT 4 P & S SID
SEPTIC SYSTEM UPGRADE - PLAN VIEW
AS-BUILT INSPECTION REPORT
FLATTOP TECHNICAL SERVICES
14530 ECHO STREET
ANCHORAGE, ALASKA 99516
SCALE: 1" = 30'
DRAWN BY TFM
DECEMBER, 2000
PERMIT NO: SW000269 PAGE 3 OF 3
PID NO: 015-142-40
INV.
105.4'
BOT.
99.9'
50.5' LONG TRENCH
W. 5.5' EFF. GRAVEL
BOTTOM T.H. #1
-- ELEV. 88,4'
M.T. [DRY 8/4/00
-- MONITOR TUBE----~
1.25" DIA. SCHED. 40
PVC DISTRIB. PIPE
INV.
105.2'
BOT
99.4'
49.5' LONG TRENCH
W. 5.8' EFF. GRAVEL
LOT 4 P & S SID
SEPTIC SYSTEM UPGRADE CROSS-SECTION
AS-BUILT INSPECTION REPORT
FLATTOP TECHNICAL SERVICES
14530 ECHO STREET
ANCHORAGE, ALASKA 99516
SCALE: 1" = 5'
DRAWN BY TFM
DECEMBER, 2000
BLM LOT 26
112th AVENUE
IFT STN.
EXISTING
1000 GALLON
CONCRETE STING
'SEPTIC TANK HSE.
[ / WELL'
LOT 3 ' '
1.25" DIA SCHED. 40 PVC __
W. 5/32" HOLES ~ 30" CTR.
CONSTRUCT
(2) 50' LONG
SOIL
W. 5' GRAVEL.
#1
LOT 4
P&S S/D
LOT 5
'~ WELL
i~-- T.H. ~2
iNSTALL WYE
& (2) VALVES
EXISTING
SO LABS. BED,
LOT 6, P&S S/D
(VACANT)
BLM LOT 37
(NO DEVELOPMENT WITHIN 100')
LOT 4, P&S SID
WELL AND SEPTIC SYSTEM
SITE PLAN
FLATTOP TECHNICAL SERVICES
14530 ECHO STREET
ANCHORAGE, ALASKA 99516
1 INCH = 50 FEET
DRAWN BY TFM
JULY, 2000
NOTE: THIS IS NOT A SURVEYED PLAT.
ALL LOCATIONS SHOWN ARE APPROXIMATE.
CIVIL & ENVIRONMENTAL ENGINEERING * ENERGY CONSERVATION & ANALYSIS
THEODORE F. MOORE, P.E. 14530 ECHO ST.
PH: (907) 345-1355 ANCHORAGE, ALASKA 99516
December 29, 2000
M.O.A. Dill-IS
Attn: Dan Roth
P.O. Box 196650
Anchorage, AK 99519
RE: Waiver allowing soil absorption trenches on Lot 4, P&S S/D to be 3 feet from lot line
Dear Mr. Roth:
You may recall our telephone conversation last August~ during which we discussed issuance ora
lot line waiver allowing the new soil absorption trenches on Lot 4 ofP&S S/D to be less than the
normally required 10 feet from the west lot line common with Lot 3. Our As-Built inspection report for
the upgrade project is enclosed.
The reason for the lot line waiver request was to avoid conflict with the existing 2" diameter
HDPE discharge line coming from the lift station. As can be seen on the site plan (copy enclosed) there is
ample room on Lot 3 to construct future wastewater disposal system upgrades, if desired, in the southern
portion of that lot without any adverse impact attributable to the proximity of the newly installed trenches
on Lot 4.
Accordingly, we are now formally requesting issuance of a lot line waiver allowing the new
trenches to be approved in their present location, which is no closer than 3 feet from the lot line. We are
enclosing payment of the $115 Municipal lot line waiver fee, and apologize for the delay in submitting
this request which was attributable to a very busy summer work schedule followed by recently completed
fall travels.
Please give me a call if you have any questions on this submittal and thank you for your assistance
in issuing the requested waiver.
Sincerely,
Ted Moore, P.E.
Municipality of Anchorage
P.O. Box 196650 · 4700 S. Bragaw Street
Anchorage, Alaska 99519-6650 · (907) 343-8301
ht tp://w~v.ci.anchorag¢.ak.us
02~9~1
Ted Moore
Flattop Technical Services
Subject: Waiver Request for PS&A Subdivision Lot 4
Waiver Request #WR010008
Parcel ID #015-142-40
permit#SW000269
Department of
Public Works
Dear Ted Moore:
Your request for a waiver of the required 10 feet horizontal separation from the
on-site wastewater disposal system to property line has been approved. The approved
separation distance is 3.0 feet.
This waiver approval applies to the existing on-sitewastewater disposal system to
property line separation only. Any future upgrade to the on-site wastewater disposal
system will require all separation distances be met or another approval from this
department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
Jeffrey W. Poet
Engineering Technician
On-Site Water & Wastewater Program
Municipality of Anchorage
Development Seryig~s~ Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.¢i.anchorage.ak.us
(907) 3~L3-7904
Waiver Review Worksheet .....
WR~ '010008-" F~!D,~:. 01514240 HA#: Permit~: sw000269
Da'{e Re6eived: 12-29-00
Legal Description: PS&S Subdivision
Engineer: Ted Moore
Flattop TechnlCa.!,se~.i,.ce_.$. _~.
Applicant: Bruce &Ann~,_~ ..----..-Herman
Waiver Requested: Absorption field to lot line of 3 feet.
Criteria: Geology Points:
A. water Table
B. Soil Sorpti0n
C, permeability
D, Water Table Gradient
E. H6riz0'ntal Separation
Total:
Waiver is Granted: Waiver is not Granted;
List Conditions or Reasons_for.above:
Rec~ 115.00 Dar6 Paid~ 12-29-00
MUN/C/PAL/TY OF ANCHORAHE
Department of Health and Human Sen/ices
On-Site Services Program
825 / Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jul 31,2000
Expiration Date: Jul 31, 2001
Permit Number: SW000269
Legal Description: P & S LT 4
Design Engineer: 0019 Flattop Technical Services
Owner Name: Bruce & Ann Herman
Owner Address: 5100 E. 112th Ave.
Anchorage, AK 99516-1614
Parcel ID: 015-142-40
Site Address: 005100 112TH AVE E
Lot Size: 44586 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] SepticTank [] 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 Ddnking 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.
Received By:
Date: ~/'' ! /00
Date: '~' -~ I" O O
CIVIL & ENVIRONMENTAL ENGINEERING * ENERGY CONSERVATION & ANALYSIS
THEODORE F. MOORE, P.E. 14530 ECHO ST.
PH: (907) 345-1355 ANCHORAGE, ALASKA 99516
July 11, 2000
M.O.A. DHI-IS
P.O. Box 19-6650
Anchorage, AK 99519
Dear Sirs:
The purpose of this letter is to provide the required design narrative in support of our application for
a permit to upgrade the wastewater disposal facilities on Lot 4 of P&S S/D, located at 5100 East 112th
Avenue. The existing soil absorption bed is no longer able to accept the wastewater load generated in
the residence without operating in a surcharged condition. Soils logs, pert test results, a site plan,
design drawings and specifications are enclosed for your review.
The proposed system will be constructed in the vicinity of test hole # 1. As can be seen from the soil
log, the native material between 1.5' and 6' below ground level is a silty sand with a measured perc rate
of 14 minutes per inch. This laver is overlain by a sandy loam, which typically has a perc rate of less
than 5 minutes per inch. Using the' soil application rate of 0.8-gpd/sq. fL specified in the wastewater
ordinance, this 4-bedroom residence requires a total absorption area of(4 x 150)/0.8 = 750 square feet.
The proposed 50-foot long trenches with 5 feet of sewer gravel between 1 and 6 feet below ground level
are conservatively designed to give a total absorption area of 1000 square feet of which 100 square feet
are in the sandy loam stratum.
The topography of the lot in the area of proposed construction slopes downward towards the
northwest at approximately 2%.
The proposed project will have no significant impact on present or future water supply and
wastewater disposal systems serving adjacent properties, nor will it have any significant impact on
reserved space-surface and subsurface, or on drainage.
Please give me a call at 345-1355 if you have any questions on this submittal.
Sincerely,
Ted Moore, P.E.
BLM LOT 26
112th AVENUE
LOT 3
.25" DIA SCHED. 40 PVC
W. 5/32" HOLES @ 30" CTR.
CONSTRUCT
(2) 50' LONG
SOIL
W. 5'GRAVEL.
EXISTING
GALLON
CONCRETE
SEPTIC TANK
#1
HSE.
WELL-
LOT 4
P&S S/D
INSTALL WYE
& (2) VALVES
, SEPTIC SYST. __
.... LOT 5
EXISTING
............. _s_Q LL AB_S: _B _E _D.,
WELL
LOT 6, P&S S/D
(VACANT)
BLM LOT 37
(NO DEVELOPMENT WITHIN 100')
LOT 4, P&S S/D
WELL AND SEPTIC SYSTEM
SITE PLAN
FLATTOP TECHNICAL SERVICES 1 INCH = 50 FEET
14530 ECHO STREET DRAWN BY TFM
ANCHORAGE, AI~SKA 99516 JULY, 2000
NOTE: THIS IS NOTASURVEYED PLAT.
ALL LOCATIONS SHOWN ARE APPROXIMATE.
CONSTRUCT (2) 50'-LONG x 6'-DEEP SOIL ABS. TRENCHES
WITH 5.0' SEWER GRAVEL BELOW DISTRIBUTION PIPES
50
1.25" DIA.
W. 5~32" HOLES @ 30"
~--1.25" SCHED. 40 PVC
50 'A"
PLAN VIEW
SCALE: 1" =
I~_ 2" HDPE PIPE
FROM LIFT STN.
INSTALL"WYE"
INSTALL GATE
VALVES
'~__2"HDPE PIPE
TO OLD BED
3
1 I
MONITOR TUBE
-2' SOIL COVER
GROUND
FILTER FABRIC
"RIGID INSULATION
DIST PIPE
1/2" - 2 1/2' GRAVEL
BO]rOM OF EXC.
CROSS-SECTION "A"
SCALE: t" = 5'
LOT 4, P&S S/D
SEPTIC SYSTEM UPGRADE
PLAN AND CROSS-SECTION
FLATTOP TECHNICAL SERVICES
14530 ECHO STREET
ANCHORAGE, AK, 99516
SCALE: AS SHOWN
DRAWN BY: TFM
JULY 2000
q:lattop Technical Services
14530 Echo Street, Anchorage, AK 99516
Phone (907) 345-1355
Lot 4, P&S S/D
5100 East 112th Avenue
Wastewater disposal system installation
Specifications
1.0 General:
1.1 The scope ofthe project consists ofconstructionof2 parallel, 50-foot long soilabsorption
trenches containing a total of 5.3 feet of sewer gravel.
1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor
deviations from these drawings may be allowed or required by the engineer conducting the inspections.
All construction procedures and material specifications shall conform with Municipal and State
requirements. All separation distances shall be in conformance with Municipal requirements, unless
specifically waived.
1.3 The contractor shall be responsible to obtain any necessary utility locates, and to work around
any buried utilities.
1.4 The contractor shall provide adequate cover material and rough grading over all system
components to ensure that proper drainage is achieved after settlement and that there are no residual
depressions. Insofar as possible the contractor shall minimize damage to trees and existing lawn areas.
1.5 Unless specifically agreed otherwise, the homeowner shall be responsible for finish grading
after the soil is compacted, as well as placement of topsoil and reseeding all areas disturbed by the
construction.
2.0 Septic Tank:
2.1 The existing 1000 gallon concrete septic tank and 500 gallon steel lift tank shall be retained in
service.
3.0 Soil absorption system:
3.1 The soil absorption system shall be constructed by excavating two parallel, 50'long soil
absorption trenches to a total depth of 6 feet below ground level. A wye shall be installed in the existing
2" diameter HDPE discharge line from the lift station along with gate valves allowing septic tank
effluent to be switched back and forth between the new trenches and the old bed as desired by the
homeowner to promote longevity of the soil absorption system.
3.2 The bottom of the excavations shall be level and the minimum separation between the two
trenches or the trenches and the existing soil absorption bed shall be 10 feet. Any compacted or smeared
surfaces shall be raked to allow proper infiltration.
3.3 A total of 5.3 feet of approved sewer gravel shall be placed in the bottom of the excavation with
the 1.25" diameter schedule 40 PVC distribution pipes laid level such that the pipe inverts are no less
than 5.0 feet above the bottom of the sewer gravel. The distribution pipes shall have 5/32" diameter
holes drilled into their bottoms spaced 30 inches on center. Sewer gravel shall be 0.5" - 2.5" screened
gravel, with less than 3% passing the #200 sieve.
3.4 Monitor tubes shall be of 4" diameter and installed in the locations shown on the design
drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated.
3.5 Approved filter fabric shall be placed over the entire top surface of the sewer gravel. A
minimum of 2 feet of soil cover is to be placed over the filter fabric. If the soil cover thickness is less
than 3 feet, two inches of rigid, burial type insulation is to be placed over the entire top surface of the
gravel, in addition to the filter fabric.
3.6 The top surface of the cover material shall be raised a minimum of 12 inches higher than the
surrounding terrain to allow for subsequent settlement, and shall be graded to smooth contours. Fill
slopes shall be no steeper than 3:1.
3.7 Unless specifically agreed otherwise the homeowner shall be responsible for arranging to have
the site finish graded after the backfill material has stabilized, and for placement of adequate topsoil and
seed to promote rapid revegetation of all areas disturbed by the construction.
4.0 Inspections:
4.1 A minimum of 4 engineering inspections will be required during the course of the project: (1)
initial stakeout with the contractor to establish the location of the system and to discuss the plans,
specifications and construction procedures, (2) after the native material has been excavated to expose the
infiltrative surface to ensure that it is level and at the right elevation, and conforms with the soil test
information, (3)) after the sewer gravel is in place and the distribution pipes have been laid and
connected up to the septic tank, but prior to placement of insulation or filter fabric, and (4) after rough
backfill and grading is complete.
4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in
advance to ensure the availability of the engineer.
TEST HOLE
LEGAL DESCRIPTION:
DATE PERFORMED:
PERFORMED FOR:
DEPTH
(~et)
8-
9-
10-
11
12-
13-
14-
16-
COMMENTS:
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALASKA 99516
SOILS LOG -- PERCOLATION TEST
Lot 4, P & S S/D
May 23, 2000
Bruce Herman
Pt.
SM Reddish sandy loam
SLOPE
SP/SM Gray gravelly silty sand
Variable silt content
Generally loose material
SM/ML Gray, very fine silty sand
Becomes gradually cleaner w. depth
SM Grayfinesand
Somewhatsilty
Indistin~ ~ansition
Lenses of ML
Depth to Groundwater Date
No groundwater 5/23~00
Monitor tube dry 5/30/00
SITE PLAN
o,
Clock Net Time Percometer Net Drop
Date Reading Time (minutes) Reading (inches)
5/23 12" Presoak 27 1/2
5/24 12" Resoak 27 1/2
Add water & start 3:22:20 23 1/2
#1 3:52:20 30 21 1/4 2 1/4
Add water 3:52:40 23 1/2
~r2 4:22:40 30 21 1/4 2 1/4
Add water 4:23 23 1/2
#3 4:53 30 21 1/4 2 1/4
PERCOLATION RATE 14 (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~3 25 FTAND 3.75 FT
7**
PERFORMED BY FLA'I-FOP TECHNICAL SERVICES. ) .~"'.~'~,~-,~ CERTIFYTHATTHISTESTWAS PERFORMED IN
ACCORDANCE WITH ALL STATE AN D MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
TEST HOLE
LEGAL DESCRIPTION:
DATEPERFORMED:
PERFORMED FOR:
DEPTH
(feM) --
1
2
14
15
FLATTOP TECHNICAL SERVICES
14530 ECHO ST.
ANCHORAGE, ALAS~ 9~1~
SOILS LOG -- PERCOLATION TEST
Lot 4, P & S S/D
May 23, 2000
Bruce Herman
Pt.
SM Reddish sandy loam
SLOPE
SM Gravelly silt~ sand
Variable w. pockets of SP, ML
SM/ML Gray silty sand
Denser near top
Becomes sandier w. depth
ML Gray silt
B.H.
HOUSE
?WELL
Depth to Groundwater Date
No groundwater 5/23/00
Monitor tube dry 5/30/00
o,
Clock Net Time Percometer Net Drop
Date Reading Time (minutes) Reading (inches)
5/23 12" Presoak
12" Resoak 31
Add water & start 3:23:30 27
#1 3:53:30 30 21 3/4 5 1/4
Add water 3:54 26 7/8
#2 4:24 30 21 718 5
Add water 4:24:35 27 1/8
#3 4:54:35 30 22 5 1/8
PERCOLATION RATE 6
TEST RUN BETWEEN 3.75
COMMENTS: Test hole dug to assess continuity of soils encountered in T.H. #1.
(minutes/inch) PERC HOLE DIAMETER
FTAND 4.25 FT
7I,
PERFORMED BY FLA'ITOP TECHNICAL SERVICES. I '~,~ '~,.~_ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
MUNICIPALITY OF ANCHORAGE E,~__..~~ ::1~I !
~ DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 %" Street, Anchorage, A~aska 99502, Telephone 264-4720J~'~u-~3~,~ ~-~-__~.
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name DISTANCES
~ ~ ~ { I~ ~ m~ ~ FIELD WELL
Phone(s, I Permit NO. No. of~rooms WELL '~ ~
~[ ~l[O ~ ~l~ L0T LiNE I~ I~
-ot ~ Block_, Subd~S~n~ ~_~ FOUNDATION ~D I~
Township, Range, Seclion
~ ~ ~ I ~ ~ I ~ ~ ~ ddveway.AS'BUILTwaterDIAGRAMbodies, etc.)(Sh°w iocation of well, septic system, properly lines, foundation,
TANKS ~ ~ [ ~A~ N
~ SEPTIC ~ HOLDING
Manufacturer Capacity in gallons
Material No. of Compa~ments
TYPE OF SYSTEM ~ ~,~
~ TRENCH . DRAIN ~ OTHER ~ ,//
:ill added above original grade Gravel depth beneath pipe ~ ~ t~ 7~
~ [ FT ]~11 ~ ~ ? -
Gravel length Gravel width
~ FT I~ FT ~i: ~ '~:~
Total absorption area Distance between lines '" ~ ~C : ~ 3l
FT I,
Number of lines Soil rating ' 'v , Pipe material ~ ~ ~ ~ t ~ ~l
~ PRIVATE ~ OTHER (Identify} ~ -
Installer Date Installed: ~¢ '~ ~ ~ ~ ~- ~
REMARKS:
Municipal and Slate ouidelin~ in effect on lhis dale: SlJd~q '~"~X CE-7760
.ealth Oepadment Approval: L Date: ~¢~0 '~;
72-013 (3/85)
cd,4,y -4/6
MUNICIPALITY OF ANCHORAGE
; DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Heallh Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 L-.I
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name ~. DISTANCES
~¢-UC.P__ jl~3cv~ ~.J'"vv~.~/~ ~ '~T. IC L~r ABSORPTION
Add,ess T,~K ~.'r~ FIELD WELL
~'~o0 6_-~-t II'L.~'1~
Phone(s) P i NO, O drooms WELL [O~
~o, ~ JB,o~ . s.~?~ ~ ~.,~ FOUNDATION ~0
Township, Range, Section
I~ J ~ ] ~ ~ driveway,AS'BUILTwaterDIAGRAMbodies, etc.)(Sh°w location of well, septic system, property lines, foundation,
TANKS N
Manufacturer Capacity in gallons
Material NO. of Compa~ments ~' ~ ~ ~ ~
TYPE OF SYSTEM k ,m~ )~
~ TR;NCH ~ BED ~ W. DRAIN ~ OTHER ~~
Depth to pipe bottom from Total depth from origi.al grade J f ~ ~ 7
original grade FT FT ~ ~
Fiji added above original grade Gravel deplh beneath pipe
FT FT ~ ~ ~
Grave, length Gravel width -- C--~)
Total absorption area Distance between lines ~
S0 FT H
Number of lines Soil rating Pipe material ~
Cla,ification (A.B.C, Total Depth FTcased t°FT ~ ~ .~ ~O' 3~I~'~ ~~~ / // / '.
Inslaller Date Installed: ~ '~ >~
REMARKS:
~ ~S ~ T~aC~~ ~ Inspections Pedormed by:
~,~ ~S~ ceflify t,at I,is inspe~i0n
' ' '
Health DepaAment Approval: _ Date:
72-013 (3/85)
Tom Fink,
Mayor
Municipality Anchorage
Department of Health and Human Services
825 "L" Street
P.O, Box 196650 Anchorage, Alaska 99519-6650
January 8, 1990
Bruce & Anne Herman
5100 East ll2th Avenue
Anchorage, Alaska 99507
Subject: Lot 4 P & S Subdivision
Permit #890147, PID #015-142-40
The subject permit, issued by this office for a single family
well and/or on-site wastewater system has expired as of December
31, 1989.
Permits are issued on a calendar year basis by authority of the
Municipal Code of Regulations. A new permit must be obtained
from this office for an well and/or on-site wastewater system
not installed by the expiration date.
If you have drilled the well, a well log needs to be sent to
this office for documentation of the installation and to close
the permit.
If a private engineer inspected the installation of the on-site
wastewater system, the original as-built, inspection report
(three-part form) must be sent to this office for review,
approval and documentation.
When applying for a new permit, the fees are: $90.00 for an
on-site wastewater permit; $50.00 for a well permit; $140.00 for
a combined on-site wastewater and well permit.
If you have any questions, please call this office at 343-4744.
Sincerely,
John Smith, P.E.
Program Manager
On-site Services
JW/ljm: 200
enc:
Copy of Permit
"Kids Are Our Future"
Per'mit Number'~ 890147
Up g p md e
!!!!]qg ineep ]:)e:~:L girted
P E R M I 'T
[:)ay F'hor~e ~
26:1,---4 :t. :t.O
B :I. oc k: .....
SEPTIC; 'I"ANI<: M:i.n:i.;num 'L'.c,t. al sept:Lc '[:.ank capac:::J.'t.y~ :L~,()OO gall. ohS, Ei:ach sept:Lc
i. ank mus'L have a'L leasl.. 2 COml:)ar"L. merrLs. Depth to i. cip .'.::~ s.c-:q::H:.ic tank (s) < 4..0
fe(,,::,t r, equ:J.r',,.:~s insulatior~ ov.'.~.:,i" tank(s)~
12NFORM D ~ I'"l. H,, !iii:,, F'RIDF?. TO II'4SF:'EC]"I:ONS BY ENG tN!EER, !F AFTER
OF:'F]:CE FIC!UI::~S, CALL. 34:3'-"468J. AND L. EAVE A I¥1ES,~i:~AGE.
CONSTRLJCT PEI:;?. ENG]:N[~:ERS AT'TACHIED APPROVED DE~S:!:GN.
f'HIS PIERMI'T E:XI:::':[RLES 12'./:3:L/139 AND VALID I::rOR A S:[NGI...E FAMILY
..,IOME ,.
1: CIERT' :[ I:::'Y THAT,',
l,, :[ am f'am:i, liar" with 'Lhe r-equirements f'c:m (::)n.....site sev,lel*S and t.~m~].].s as set
f'cir'th J:)y 1:.he Municipality of' Anchor'age (MOA) and the StaLe (::>f' Alaska.
::':~.I wilt install the system :i.n accapdance wit. h al:L MOA c:c~des and r'egu].a't:.:i.c:tns,
and in COml::,liarJce ,?¢i'Lh the design cr'i'Lecia of this permit,,
::5,, ;!: w:i.].l adher'e t.c:~ all tdOA and State of Alaska r'cac:luiPemer'rt.s for' the se'L back
distances f'r'c:~m any ex:Lst:[FIg t~E.)].].~, was'ta~ater' dispersal sysLem c,r. pub].:i.c
sewer'ag¢:, system C~tq t]"li% (~1' arqy adjacerlt (::~i' neai"by lcrf..~
4. :[ under's1:.and that this
also under'starJd tha'L the capac::i, ty c,{' the t(:)tal system :i,s :]; be(::ir-oc~m~i and
any en].ar'g(amenC [,.~i].], r',equ:Lr'e ar'i ac:h:lit, iona], per'mit,,
(Ih,met') BRUC:E}: 84 AIqNE: I~<RMAN
]: SSL.ted r:,..., ' DATE:
PERFORMED FOR:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION: ~ L~'/ P~'~ .~oc~,'k/~[~tg-c,T°wnship, Range, Section:
SLOPE
SITE PLAN
1
2
7
8
9
10
11
12
13
14
15-
16-
17
18
19
2O
~2~F~-"~ ~, ~v,Z~ WAS GROUND WATER
[fl/'~ r'~ d,'~ ~ ENCOUNTERED? I~
L
IF YES, AT WHAT O
DEPTH? p
"[- E
MonitorinD7 F~T Date: J ¢~
Gross Net Depth to Net
Reading Date
Time Time Water Drop
~ l,[#
PERCOLATION RATE <2;[ (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN L{- FT AND Z~ FT
COMMENTS ~[-~;~]~%~:%'.t ¢~1.~ ;~)~'~'~ =
PERFORMED BY: [~.E~-~,'l,~ ~C~ V'~9_.~,~x~ I ~/~- ~..~'"'x. CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/65)
MOUNTAIN ENGINEERING
10251 CRESTVIEW EAST
EAGLE RIVER, ALASKA 99577
[907] 696-1-700
[800] 478-0101
MOUNTAIN ENGINEERING
10251 CRESTVIEW EAST
EAGLE RIVER, ALASKA 99577
[90'7] 696-1700
[800) 478-0101
~-.~/
MUNICIPALITY OF ANCHORAGE
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, township, range)
Location (address or directions)
Applicant Name
(b) Telephone: Home '~,~ I~'f¢ ~ Business ~.~?
Applicant Address 5~'eO ~'112. ¢-~ "~,0, icao'"-'/( /O,.~'O/
(c) Applicant is (check one): Lending Institution []; Owner/l~Cc~r ~[; Buyer []; Other [] (explain);
(d) Lending Institution Telephone
Address
(e) Real Estate Company and Agent
Address
Telephone
(J) Mail the HAA to the Jollowing address:
TYPE OF RESIDENCE
Single-Family ¢ Multi-Family []
Number of Bedrooms ~
Other
WATER SUPPLY
Individual WellJ~ Community [] Public[]
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsite,~ Public [] Community [] Holding Tank []
Note: if community welt system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025 (11/84)
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA 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 °f this ins~n'~4,~,~~
Name of Firm Telephone
Address
Date
Engineer's Seal
Approved for //'/~,~--~,~,'_ bedrooms by _ .
Approved ~" Disapproved Conditional
Terms of Conditional Approval
CAUTION
The Muncipatity 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
ehgineer 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 o! 2
wELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
MdN~CIPAUTY CW ANCtlO~GE
DEPT. OF HEALTH &
ENVII~:JNN~NTAL pRoTECTION
264-4720 ~A]~EC E tV Eo
Legal Description:
Well Classification '~'~ ~
Well Log Present (Y/N)
Total Depth '~ ~O Cased to
Static Water Level '~ ~
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
if A, B, C, D.E.C. Approved (Y/N)
Date Completed I,~ ~,'~ ~c~..~,'[ Yield
~, c¢ ~ Depth of Grouting ~ ON ~'
Pump Set At
/~ Sanitary Seal on Casing (Y/N)
y Depression Around Wellhead (Y/N)
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
Comments / ,,".L.4X..~ ,/,~1 ?-.. L:t ..~ ~.2-/Z..4- -1 '/
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on
; Date
SEPTIC/HOLDING TANK DATA
Datelnstalled /~?-,~l~&~ Size
Standpipes (Y/N) ~;)~ I~ Air-tight Caps (Y/N) ~ Foundation Cleanout (Y/N)
Depression over Tank (Y/N) N Date Last Pumped
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well
To Property Line
To Water Main/Service Line
Course
; for
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field
N
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026(1 f/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date 'installed
Width of Field ~,)t,,t.~'~.~
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well //~
To Building Foundation ~/~
Lot ~ O &J ~'-
To Water Main/Service Line .~ / ~
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness (~~
Standpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if present)
D, LIFT STATION NONP---
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify tha~ I have checked, verified,,e,r conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed ' ,~'~,~/.~.,~.~¢(.~/,~,.~,7,~ Date N~c,/ ~, J¢'~
Company {' ~~ ~ MOA No. '--~0 C)/(
Receipt No. ~'~
Date of Payment
Amount: $
Page 2 of 2
72-026 (11/84)
Engineer's Seal
~..~.,v203 W. 15th AVE "C" SUITE 203
ANCHORAGE, ALASKA 99501
TELEPHQNE: (907) 279-3916
CONSULTING ENGINEER
SEPTIC SYSTEM ADEQUACY TEST
LEGAL: LOT 4, P&S
LOCATION:
5100 E ll2TH. AVENUE
OWNER:
CAROLYN EVANS
RESIDENCE:
SINGLE FAMILY, THREE BEDROOMS
WATER SYSTEM:
ON SITE WELL
SEPTIC SYSTEM:
FROM MUNICIPAL RECORDS:
TANK: 1000 GAL.
ABSORPTION SYSTEM: TRENCH
ABSORPTION AREA: UNKNOWN
SOIL RATING: UNKNOWN
INSTALLATION DATE: UNKNOWN
DATE OF PUMPING: NOVEMBER 1, 1985. ANCHORAGE CESSPOOL PUMPING
DATE OF TEST:
NOVEMBER 1, 1985
TEST PROCEDURE:
290 GALLONS OF WATER WAS ADDED TO THE TRENCH
WHILE THE WATER LEVEL IN THE STAND PIPE WAS
BEING MONITORED. THE ABSORPTION RATE WAS THEN
MONITORED FOR 50 MINUTES. 150 GALLONS WAS
ABSORBED IN THIS TIME PERIOD.
TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF
THE MUNICIPALITY OF ANCHORAGE.
The operational life of all septic systems depends on the local
soil conditions, 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 this septic system. We can therefore not give any estimate of
how long the system will continue to meet the operational requi-
rements of the Municipality and State.
CONSULT{NG ENGINEER
203 W. 15th AVE "C" SUITE 203
ANCHORAGE, ALASKA 99501
TELEPHONE: (907) 279-3916
RESIDENTIAL WELL INSPECTION
LEGAL .-
LOT4, P&S
LOCATION:
5100 E ll2TH AVE.
OWNER:
CAROLYN EVANS
TYPE OF WELL:
SINGLE FAMILY
WELL LOG AVAILABLE:
NO
INSTALLATION REQUIREMENTS MET: YES
WELL YIELD FROM TEST: 3 GPM
PUMP YIELD: 5 GPM
DATE OF INSPECTION: NOVEMBER 1, 1985
TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE WHILE THE
PRESSURE WAS MONITORED. AT 3 GALLONS PER
MINUTE THE PRESSURE DID NOT DROPP.
TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON
OCTOBER 31, 1985. TEST WAS NEGATIVE.
TEST RESULT:
THIS WELL MEETS THE REQUIREMENTS OF THE
MUNICIPALITY OF ANCHORAGE.
The Municipal requirement for well flow is
150 gallons of water per bedroom per 24
hours.This well surpasses this requirement.
The assessment of the condition of this well
applies only to the conditions as of this
date. The flow rate of the well may change
due to subsurface conditions that may not be
observed from the surface, and changes in
land use and other factors that may impact
the conditions of the aquifer feeding the
well.
August 16, 1983
Michael K. & Carolyn Lo Evans
P.O. ]aox 103801
Anchorage, AK 99510
Subject: Lot 4 P & S Subdivision
Approval for the individual sewer and water facilities cannot
be granted until the following items have been conlp!eted:
o Exposed electrical wires to the ;~ell head are in violation
of the [~unicipality of Anchorage codes and must be encased
in conduit.
o ~he septic tank pumped with a receipt submitted to this
department.
o An adequacy test needs to be performed on the existing
leaching area. 77his test will determine if tile system is
adequate according to ~ational Standards. A listing of
private firms perforating the test is enclosed. '~his report
needs to be submitted to this office for our review.
Please notify this Department for a reinspection %~;hen the
noted discrepancies have been corrected. .If there are any
further questions, please call this office at 264-4720.
Sincerely,
Enclosure
Robert C. Pratt
Associate Environmental Specialist
? APPLI( NT FILLS OUT UPPER HA!. ONLY
Buyer
Address Zip Code
Phone
Realty Co. & Agent
Address Zip Code
~ "~ ~_,~
Type of ResiCnce
Single Family
~ Multiple Family No. of Bedroo~
~ Other
Water Supply ~.~ ~¢
Individual ~ A~ACH WELL LOG. A w¢l Icg is required for all wells drilled since June 1975.
~ _~.~; For wells drilled prior to that date, give well depth (attach Icg if available).
Community
~ Public Utility~:;;"
Sewer Disposal
Individual Year Individual Installed: (~4~.~¢¢.~ t_~%. ~c~ >/
Public Utility When Connected to Public Utility: A Jr ~
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSlNG CAN BE INITIATED.
Time Time Time Time
Date Date Date Date
Inspector Inspector Inspector Inspector
ML NICI~AL~Y~ Y ~0~6~
DEPT. OF HEALTH
Field Notes: (4 ,~b ENVIRONMENTAL PROTECTIONt
RECEIVED
( ) APPROVED BEDROOMS *GONDIT[ONS OF APPROVAL
( ) CONDITIONAL APPROVAL' ~
.ATE I ( --~ ~ ~
BY:
Soils Rating Date ~wer I~alled Well To Absorption Area Well Log Received
~ S Well to Tank Septic T~k Size ~
72,023 (3182)
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received
Time of Inspection
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
1. Approval'reqUested %
Mailing Address: ~L¢,~_-; ~ L -~. ~ ~ Phone:
2. Property Owner: ~ ~ ~ ~~ Phone:
~Ml~n~ ~ddress:
5. lype of facility to be ~nspected ~/~ ~ ~ ~o. of bedrooms
~. lype g. Bepth
7. Se~a~e ~sposal System:
/~d~ B. Installer
A.
Installed
C. Septic Tank: 1. Size./~¢~ %,~ 2. Manufacturer
D. Seepage Pit: 1. Absorption Area 2. Material
E. Disposal Field: Total length of lines'--'-
Distances:
A. Well to: Septic tank ~'¢¢ ' , Absorption area
Nearest lot line ~'-0 /~ , Other contamination
B. Foundation to septic t~nk /¢ J
C. Absorption area to nearest lot line
Sewer Lines/¢ ~,
/¢/c/¢¢~/¢
, Absorption area
EQ-034 (1/74) Page 1 of two pages
99503 - 274-4561
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" St., Anchorage, Alaska
REQUEST FOR APPROVAL O~
INDIVIDUAL SEWER & WATER FACILITIES
1. Type of Inspection: CMRO
2. Property Owner: JAMBS C. WARWICK
Mailing Address:
3. Name of Buyer:
Mailing Address:
VA' × FHA CONV
Patterson Drive
Day Phone 3~q-9200
Day Phone
4. Name of Lending Institution:
Mailing Address: Phone
5. Name of Realtor or Agent: DYNAMIC REALTY INC./ Mike Messick
Mailing Address:3380 c Street Anch.,Ak. Pho~e279~7611
Legal Description: P' & S. Subdivision, Lot 4
Location: To_~d, East to Our--Road~th to 1st L~Ft t~rn
(Patterson Dr.~ no sign, however) 3rd ho_~se ri_~ht side
7.' Type of Facility to be inspected: Homes
No, BdrmS. 3
o
~ater Supply
Type of Supp.ly: Public Utility Individual x
If Individual, number of dwellings presently served i
If Individual, depth of well ~.
Sewage DispOsal System
Type ~of S~stem: Public Utility
Individual (on-site)
If Individual, date of installation Approximately 1967
Page 2 of two pages - Re~,~St for Approval of Individual S~r & Water Facilities
L~egal Description
Comments
Approved .~ ~/~~. Disapproved Date
Approval Valid for one year from date signed
Greater Anchorage Aria Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I certify that the inf6r~ation contained in this request for approval to be a true and
accurate representation of the s'ubject sewer and water facilities and these facilities
are operating satisfactorily.
Date
SIGNED
EQ-034 (1/74)