HomeMy WebLinkAboutFISCHER BLK 3 LT 2BFischer
Block 3
Lot 2B
#015-292-02
Municipality of Anchorage
Community Development Department 91 43
Onsite Water $ Wastewater Program
4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907)343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP141389 PID Number: 015-292-•92.8- ❑ New ®Upgrade
Name:
FRANK & CINDY PLUID
ABSORPTION FIELD
® Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound
❑Other
Address:
10251 KLINGER STREET *ANCHORAGE 99516
Phone: No. of Bedrooms:
N/A 4
Soil Rating:Id
1.2. Ft.
Total Depth from original grade:
8.82 Ft.
LEGAL DESCRIPTION
Depth to pipe Invert:
Gravel depth beneath pipe:3.72
5.1 Ft.
Subdivision: BIOCk: Lot:
FISCHER 3 2B
Owns Ip: aner
Fill added above oriGravel
SEEFt.
Gravel width:Beds
length:
60 R.
Number of linea: Distance between linen2n.
- -
SEPARATION DISTANCESR.Total
ToSeptic Absorption Lift Holding Public/PrivotaFrom Tank Field Station Tank Sewer Lines
obaorplbn areaumber
61Ft
of benches:
1
Diet. between trenches:
— FL
Well
100'+
100'+
—
—
25'+
TANK ®.E]Holdinq ❑ Other
Surface water
100'+
100'+
-
-
Manufacturer:
GREER
Capacity:
1250 cal.
Lot Line
5'+
10'+
—
—
Material:
Number of comportments:
N/A
STEEL
2
Foundation
5'+
10'+
—
—
LIFT STATION
Curtain Drain
NONE KNOWN
Manufacturer.
Gal.
Remarks: OLD TANK WAS DECOMMISSIONED PER UPC
"Pump on' level at:
"Pump off' Is
Nigh water alarm at
Pump Make k
Electrical Inspections performed by:
PIPE MATERIAL
House to tank D3034 Tank to D3034
drainfield
Installer
WILCO CONTRACTORS
Drainfield D3034 CO/MT D3034
Inspector GEG, Ltd.
BENCHMARK (Assumed elevation)
100.00 Ft
Inspection
Dates: 1st 9/30/2014 2nd 9/30/2014
Location and Description:
3rd 10/1/2014 4th —
BOTTOM OF TRIM NE CORNER OF HOUSE NEAR POINT B
Community Development Department Approval
Conditional approval: Date:
PP
oo�000
o �
....... ..................
0 Je if A. Go ess.' 0�
0�9 —79 dO
Vs�°wo
.1. �; A'
��0 a dprofesslanON
Approved: Date:
�iayo�uvri rtepar0 _lyl—ILgaa
PERMIT NUMBER: PARCEL ID NUMBER:
OSP 141389 AS -BUILT DRAWING 015-292_02
l e0
CO
85.35
33.78
ST1
73.48
'DVIAY:...�....
ST2
66.97
34.23
DBL'
W
�
W
\ �
35.39
MT1
98.1050.20
•4',.
C01
1 I
.
MT2
65.14
57.82
502
66.26
58.28
LD
1 /
1
l e0
CO
85.35
33.78
ST1
73.48
32.80
ST2
66.97
34.23
DBL'
65.63
35.06
DBL2
65.09
35.39
MT1
98.1050.20
C01
98.89
51.27
MT2
65.14
57.82
502
66.26
58.28
EXISTING 4
BEDROOM HOUSE
/ 1
100' WELL RADIUS \
1 \
RAINRELD
JE DRAINFIELD (CAT II)
NEW 1250
GALLON SEPTIC
TANK
NEW ADDITION I //
7
- J
GARNESS ENGINEERING GROUP, Ltd
f CIVIL & ENVIRONMENTAL ENGINEERS -
3701 E M R R - $URE 101 • MCH0RP0E. M 88307 r MME (807) 337-8179 • FM (WA 338-34b � wvxsn<.........�........:.....
PREPARED FOR:
FRANK & CINDY PLUID
3, LOT 2B
113ER: PAGE NUMBER:
A 2 OF 3
DRAWN BY:
DJG
DATE:
10/24/2014
OF
PERMIT NUMBER: PARCEL ID NUMBER:
OSP141389 AS -BUILT D RAW I N G 015-292-020
2" INSULATION PER CONTRACTOR
FINAL GRADE = 99.77-99.80
ST1 ST2
TOP OF TANK TOP OF TANK
AT INLET = 96.32 AT OUTLET = 96.40
NEW 1250 GALLON
INVERT OF BUNG SEPTIC TANK INVERT OF BUNG
AT INLET = 95.96 AT OUTLET = 95.52
TH#1 ORIGINAL GRADE - MT GO I I I I FINAL GRADE = 99.76-99.52
o AT HIGHEST POINT = 99.37
.TER FABRIC
INVERT OF PIPE = 95.65
BOTTOM OF TRENCH = 90.55
RELATIVE ELEVATION OF TH = 84.37
GROUND WATER = DRY
GARNESS ENGINEERING GROUP, Ltd oo .
=Mm CIVIL & ENVIRONMENTAL ENGINEERS
9]01 E TUWRHOAO, SUITE 101'ANEH0P E,AKO&SW'4HONE(.] 33)bt]0'FA EE9 33. VM'WESSITE:xwwgemesttn0lne"M
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
ZACHARY DOSS ( 907) 223-2778 3 OF 3
LEGAL DESCRIPTION: DRAWN BY •y `yqY
FISCHER; BLOCK 3, LOT 2B D.J.G. ���♦ �*< �Z t
SPAS -BUILT DATE:
10/112014 4411 ` ESS
,
On -Site Wastewater Disposal System Permit
Permit Number: OSP141389
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Tax Code Number: 01529246000
Work Type: Septic Upgrade
Permit Effective Dates: September 24, 2014 to September 24, 2015
Design Engineer: GARNESS ENGINEERING GROUP LTD
Subdivision: FISCHER
Site Legal Address: FISCHER BILK 3 LT 2B G:2537
Owner/Address: PLUID CINDY L & FRANK R
10251 KLINGER ST ANCHORAGE AK 995166820
Site Mailing Address: 10251 KLINGLER ST, Anchorage
This permit is for the construction of:
Lot Size in Sq Ft: 62880
Total Bedrooms: 4
Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater
Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80).
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Receive
Issued
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Fax: 907- 343-7997
On -Site Water & Wastewater Program
Mayor Dan Sullivan
On -Site Sewer/Well Permit Application
4& For A Single Family Dwelling
Parcel I.D. 015-292
Property owner(s) FRANK & CINDY PLUID Day phone N/A
Mailing address 10251 XLINGLER STREET *ANCHORAGE, AK 99516
Site address 10251 KLINGLER STREET *ANCHORAGE, AK 99516
Legal description (Sub'd, Block & Lot ) FISCHER; BLOCK 3 LOT 2B
Legal description (Township, Section & Range)
Lot Size
APPLICATION IS FOR:
Single Family (SF)
Gall that apply)
(w/wo ADU)
Absorption Field
Duplex (D)
Septic Tank
Multiple Dwellings
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
Sq.Ft. Number of Bedrooms
APPLICATION IS AN:
Initial ❑
Upgrade
Renewal ❑
Ell
THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR:
TYPE OF DEWELLING:
Single Family (SF)
(w/wo ADU)
Duplex (D)
❑
Multiple Dwellings
❑
(SF and/or D)
Distance: —
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal codes.
GARNESS ENGINEERING GROUP Ltd.
(Signature of property owner or authorized agent)
Permit/Rush Fees: , q
Date of Payment:
Receipt Number: 0.5'1V it
Permit No. 8
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No
(Rev. 01/11)
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGiNEERS�--�^��=�-a--��-
September 10, 2014
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
Ref: Proposed Septic System Upgrade for Fischer; Block 3, Lot 2B
To whom it may concern:
The existing 4 bedroom house is served by private well and septic system. The owner is
proposing to add an approximate 40' x 45.6' addition onto the eastern portion of the house. The
addition will be constructed over top of the existing septic system. We are proposing to pump
and remove the existing septic tank, inspect the structural integrity of the tank and if deemed
viable, re -install it in the new tank location. If the septic tank is not useable a new 1,250 gallon
septic tank must be installed in the proposed location. The old drainfield will be abandoned in
place and a new deep trench type drainfield will be installed. One testhole was excavated on the
property by Michael Anderson in 2001. The drainfield is designed around the 30 foot radius of
this testhole. Comments regarding the design are summarized as follows:
1. SOILS: See the attached 2001 soil log which show the soil classifications, groundwater
monitoring, and the percolation test results. Aghough the soil percolated at 1 min/inch, if it were
to have percolated_fasWr ftrt 1 min/inch; we would have proposed not installing a sand filter
due to the SIS soil layer beneath the GW percolated material.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface water concerns.
4. TOPOGRAPHY: As can be seen on the attached topography drawing, the average
topography around the proposed drainfield is relatively flat.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact us at 337-6179. Thank you for your
assistance. A
P.E., M.S.
3701 East Tudor Road, Suite 101 *Anchorage, Alaska 99507-1259
Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com
FISCHER S/D;
BLOCK 1, ISCH S/D;
LOT 3A6 BLOCK 1,
LOT 3A7
I�
Z
i
FISCHER S/D;�
FISCHER S BLOCK 1, 3
BLOCK JJ LOT 3A7
LOT ----
ti
FISCHER S/D1
BLOCKS 1, \
LOT 3�6 /
\ \ /
,LOT 38T
PRL
FISCHER S/D; FISCHER S/D;
BLOCK 1, BLOCK 1,
LOT 362 LOT 381
i
i
I �
ii
FISCHER S/D;
BACK 3, LOT 2C N
,�'�� T�:�;'-Raz_:`':5„,. ,nh' wnl Dona io �P' I SCALP
100'
AE3/DAe7
S/D;
PTIC
ABLOT 6DAV-DO
I I
--
I DAV-DOR S/D;
LOT 5
I E
\\(I
E� K I I DAV-DOR f /D;
100'100' WFI� `\ I LOT q
I /
�� \\ I �------/--- -
PSCHER S/D;
900 -CK 3, LOT 2A
\ I I
I I I
DAV-DOR 2S/D;
LOTE 104TH AVENUE
GARNESS ENGINEERING GROUP, Ltd
= ' = 1 CIVIL & ENVIRONMENTAL ENGINEERS
3]01 E. T ffl ROI➢. SN 101 • MCH F, M 99501 • RME 07) 337-8170 • FM 907) 335-3218 RE: mr eexn95ueHng.com
IREPARED FOR: PHONE NUMBER: PAGE NUMBER:
FRANK & CINDY PLUID N/A 2 OF 2
.EGAL DESCRIPTION: DRAWN BY:
FISCHER; BLOCK 3, LOT 28 PNB
SITE PLAN 1 9/9/14
CE -
W
II
I
T J
,• e,
100'
AE3/DAe7
S/D;
PTIC
ABLOT 6DAV-DO
I I
--
I DAV-DOR S/D;
LOT 5
I E
\\(I
E� K I I DAV-DOR f /D;
100'100' WFI� `\ I LOT q
I /
�� \\ I �------/--- -
PSCHER S/D;
900 -CK 3, LOT 2A
\ I I
I I I
DAV-DOR 2S/D;
LOTE 104TH AVENUE
GARNESS ENGINEERING GROUP, Ltd
= ' = 1 CIVIL & ENVIRONMENTAL ENGINEERS
3]01 E. T ffl ROI➢. SN 101 • MCH F, M 99501 • RME 07) 337-8170 • FM 907) 335-3218 RE: mr eexn95ueHng.com
IREPARED FOR: PHONE NUMBER: PAGE NUMBER:
FRANK & CINDY PLUID N/A 2 OF 2
.EGAL DESCRIPTION: DRAWN BY:
FISCHER; BLOCK 3, LOT 28 PNB
SITE PLAN 1 9/9/14
CE -
NUMBER OF BEDROOMS: 4
GALLONS PER DAY (GPD): 600
PERCOLATION RATE/S: 1 MIN/INCH
PROPOSED APPLICATION RATE: 1.2
MINIMUM DRAINFIELD SQ.FT.: 500 FEET'
i
CRY DRAINFIELD DESIGN
M DEPTH OF EXCAVATION: 9 FEET
3 FEET
60 FEET
VE: 5 FEET
SQ.FT.: 600 FEET'
GEG, Ltd. HAS A 8 PAGE SPECIFICATION NOTE: THE CONTRACTOR /
LETTER THAT PERTAINS TO THIS DESIGN.
TO OBTAIN A COPY OF THE LETTER SHALL HAVE ALL WELL RADII
CONTACT GEG. BY PROCEEDING FORWARD FLAGGED BY A REGISTERED
WITH THIS INSTALLATION, THE ENGINEER, LAND SURVEYOR PRIOR TO
WELL DRILLER, CONTRACTOR AND CONSTRUCTION.
PROPERTY OWNER AGREE THAT THEY
HAVE READ THESE SPECIFICATIONS AND
AGREE TO ACCEPT THE TERMS AND
"Ry`; PROPOSED DRAINFIELD
1
.•SMI HAEL ANDERSON, P.E. THp
INSTALL DOUBLE C/O'S
2 OF BEDROOMS: 4
S PER DAY (GPD): 600
ATION RATE/S: 1 MIN/INCH
FISCHER S/D;
3ED APPLICATION RATE: 6.0 (CAT3M
BLOCK 3, LOT 2A
4 DRAINFIELD SQ.FT.: 100 FEET'
RVE DRAINFIELD DESIGN:
M DEPTH OF EXCAVATION: 9 FEET
Er
310E
PTI C
FEET
1
VE: 5 FEET
AREA
SQ.ET FEET'
GARNESS ENGINEERING GROUP, Ltd
CIVIL & ENVIRONMENTAL ENGINEERS
Ml E WWR R , SURE 101 • MICHOA/GE, M 99W7 • PHME 90 337-6179 • FM (907) 338-34{8 • YIE6GIE ww.9®,woven Mali
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
FRANK & CINDY PLUID N/A 1 OF 2
LEGAL DESCRIPTION: DRAWN BY:
FISCHER; BLOCK 3, LOT 2B PNB
TYPE OF WORK: DATE:
�, SEPTIC DESIGN UPGRADE 9/9/14
RESERVE DRAINFIELD (CATXZ
C
ey�
PUMP AND REMOVE OLD
SEPTIC TANK AND INSTALL IN
NEW LOCATION. TANK MUST
BE INSPECTED FOR
STRUCTURAL INTEGRITY. IF IT
DOES NOT PASS INSPECTION /
A NEW 1250 GALLON SEPTIC
TANK MUST BE INSTALLED./
/
40' X 45.6' ADDITION I
I
u
t
Municipality of Anchorage e
Development Services Department �0 •A MICHAEL E. ANDERSON :Z r
4700 South Bragaw, Anchorage, AK 99507 ,#"��r CE .4391 ;>Y
SOILS LOG - PERCOLATION TEST 411, OFESS\
Performed For. Paul Palmer Date Performed: 1124/0
Legal Description et 2. Block 3 Fischer C uhdivision
C!7ii
-
0
TESTHOLE NO_ d
Well Graded
Gravel
GW
Was Groundwater
9 Encountered? No
If Yet, What Depth?
10 Well Graded Depth to Water
Sand After Monitoring None
11 Date: 411101
SW
Bottom of
Hole
ant
See Site Plan
Reading
Date Gross
Time
Net
Time
Depth To
Water
Net
Drop
1
24 -Jan 1:00
2'
2
1:10
10
12"(Dry)
10"
3
1:11
2"
4
1:21
10
12"(D )
10"
5
1:22
2-
6
1:32
10
1 12 -(Dry)
100
Pero. Rate:1 MinAnch Pere. Hole Diameter: 6*
Test Run Between 6.5 Ft. and 7.5 FL
Comments: Percolation Cavity Presoaked Prior to Testing.
Performed By. Tim 10mh Wh. I, Certify That This Test Was Performed
In Accordance With All State and Municipal Guidelines In Effect On This Date: 411/01
Municipality of Anchorage
Development Services Department
4700 South Bragaw, Anchorage, AK 99507
SOILS LOG - PERCOLATION TEST
PalmerPerformed For Paul .
te Perform
ivislon
GIFT
Graded
ravel
GW
Was Groundwater
Encountered? No
If Yet, What Depth?
Graded Depth to Water
'and After Monitoring None
Date: 411/01
Sw
Itom of
4ole
•� OF q
� •Yl •i
*: 491ti
IAEL E. ANDERSCN..
CE -4381
FROfE5510N��?'
See Site Plan
Pero. Rate:1 MinAnch . Perc. Hole Diameter. 60
Test Run Between 5.5 FL and 6.5 FL
Comments: Percolation Cavity Presoaked Prior to Testing.
Performed Sy: Tim Kimbmuch- I, Michael E. Anderson Certify That This Test Was Performed
In Accordance With All State and Municipal Guidelines In Effect On This Date: 411101
Municipality of Anchorage
Development Services Department
4700 South Bragaw, Anchorage, AK 99507
SOILS LOG - PERCOLATION TEST
Performed For. Paul Palmar Date Performed:
Legal Description: tot? RI .k'1 Fi«h -r S ubdivi .inn
SLOPE SITE P'
OGlPT
Well Graded
Gravel
GW
Was Groundwater
Encountered?
If Yet, What Depth?
Well Graded Depth to Water
Sand After Monitoring
Date:
SW
Bottom of
Hole
No
None
4/1101
.: aF
...!tt�<qs'.�
..
*; 49�
,.
0 s6*.MICHAEL E. ANOUSCN er
CE -4381
,f ��IFo PROFESSiONp��,�„Y
tt214�Rdoa��-�
See Site Pian
Reading
Date Gross
Time
Net
Time
Depth To
Water
Net
Drop
1
24 -Jan 1:05
2-
2
1:15
10
12 -(Dry)
10-
3
1:16
2'
4
1:26
10
12'(Dry)
10-
5
117
2-
6
1 1:37
10
12'(Dry)
10-
Perc. Rate: 1 MinAnch . Perc. Hole Diameter. 6 -
Test Run Between 5.5 FL and 6.5 Ft.
Comments: Percolation Cavity Presoaked Prior to Testing.
Performed By: Tim Kimbrounh. 1, Michael E. Anderson Certify That This Test Was Performed
In Accordance With All State and Municipal Guidelines In Effect On This Date: 4!1101
M
Municipality of Anchorage Page 2 of 3
DEVELOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK 59519-6650 .343-7904
On -Site Wastewater Disposal System cr Well Inspectxn Report
laernit Number SY"4"OIOM
KUNGER STREET
BEET
CA
f-,
FID No. 095-292-02
49th
iAEI E. AN7ERSON
No. CE -4387
W%I 3
-M
U)
O0
M
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.n o
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z
49th
iAEI E. AN7ERSON
No. CE -4387
W%I 3
MEMORANDUM
DATE: December 7, 2001
TO: Jeff Poet
FROM: Mike Anderson, P.E.
SUBJECT: Lot 2B, Fischer Subdivision
Septic System As -Built
Certificate of Health Authority Approval
Attached is the Certificate of Health Authority Approval for Lot 2B, Fischer Subdivision.
Please note Test Hole No. 4 on the as -built is shown in the accurate location. The
location shown on the original design was slightly mislocated. All soils found during
excavation were similar to those in the test hole. The trench was extended, however, to
provide additional capacity and absorption area.
The water sample test results will be forwarded as soon as they become available.
Please let me know if you have additional questions concerning this lot.
Municipality of Anchorage Page 1 of 3
Department of Health and Human Services
' Division of Environmental Services
On-Site Services Section 825'L' Street Room 502 '
P.O. Box 196650 Anchorage, AK 99519-6650
v w .cl.anchorage.ak.us (907)343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT
Permit Number: SWO10066 PID Number: 015.292-02
S inell Homes Inc.
Wastewater System: New
��
9210 Vanguard Road Anch., AK 99507
ABSORPTION FIELD
Pv : ""npef °' a`"°""`
Deep Trench
344-5678 Four 4
Soil Raba:
Tar DepM trap ap� rats:
LEGAL DESCRIPTION
1.2 wolve
9 Ft.
&04: Ld: $11DdMfM:
D.Ptr, b P" I,Ixtm tran Prgnr rule:
Gaal depM tlwr pqe:
2 Fischer
3 Ft.
6 Ft.
Taernrvp: Reqs: Seauc
Haululaewa aigeW rule:
2
Gael L*VM:
50.5
Ft.
Fl.
Well: New
Gavr.gW:
5
wnoeratee.:
1
Cwance treMarLros:
-
Fl.
FL
ce sdu (I "W. A. a. e):
Private
Tar DePa:
284 Ft.
c. a:
252 Ft.
Tar *,spear nes:
606 Fe
P" Matenal:
ASTM D3034 PVC
pier.
Alpine Drilling, Inc.
Ems pMed:
9/7/01
Static Wra La el:
256 FL
Inclater:
Spine I Homes
Date k*4. ed:
1 7/13-16/01
rma:
I
Pa Sal r:
1
ca.q I L.9M Aeo a cane:
TANK
10 GPM
Ft.
2 Ft
SEPARATION DISTANCES
®Septic 0Holding 0S.T.E.P. l]Other.
To
From
Field
Lift
Station
Holding
Tank
WPr'rvate
sewerute
-W:yn
Anchorage Tank
'
1,250
WN
>100'
N/A
N/A
>25'
Steel
Two (2)
Solut,wale,
flSepbcAbsombon
>100'
N/A
N/A
LIFT STATION — NONE ON LOT
Lot Lin
>10'
N/A'
N/A
Fpndricn
>5'
>10'
N/A
N/A
p� r.
ti.
p at
W. M.
None
Noted
�PeQ
LIea�Pal lrv.abra xdaew ar:
prtain Drrn
Rae.ka:
BENCH MARK
:
Garage Slab
b.ama:
100.0 FL
Engineer's Stamp
1 -J{ ti ♦�
Inspections performed by: Mike Anderson Dates: 1`t 7/13/01
49th •
' 2ed 7/16/01
.'k,y4lCHeEL E.ARDCRSON
Department of Health and Human Services approval
•� sf, No. CE-4381 f �=
evi�) ed and approved by: Date:
Reviewed
WI
00
rn
m
N
to
to
N
LA
Municipality of Anchorage Page 2 of 3
DEVELOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK 99519-6650 -343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number SWO10066 PID No. 015-292-02
KLINGER STREET
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MICHAEL E. ANDERSON
No. CE -4381e
----- - - - - -;-.---------
10 T. do E. ESMT.
- - - - -j
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N 00006.22'W 210.09'
PLAN
AS -BUILT
SCALE 1" = 40'
Municipality of Anchorage Page 3 of 3
DEVELOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK 99519-6650 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number SWO10066 PID No. 01S-292-02
. i
50:.5'
r
PROFILE AS -BUILT
1"=10'
ALPINE DRILLING FAX N0. : 907 345 0202 Dec. 03 2001 10:35W P1
Municipality of Anchorage
Department of Health and Human Services
825'L' Street clys
P.O. Box 196650 Anchorage, Alaska 99519-6650
Ridr ATOM httplMww el.anehorag*.rkus
Mayor
Permit Number. #SW 010066 Date of Issue: 4-13-01 Parcel Identification Number: 015-292-02
Date Started: 9-"l Date Completed: 9-7-01 is well located at approved permit location? ® Yes ❑ No
Legal Description: Fischer Sub Blk 3 Lt 2
Property Owner Name & Address: Spinnel Homes
9210 Vanguard Drive
Anchorage Ak 99507
Borehole Data:
Depth (ft)
Method of Drilling ® air rotary ❑ cable tool
Soil Type, Thickness & Water strata
From
To
Casing type: steel
stick-up
0
2
WallThickness:.025 inches
organic & slit
siltygravel
gravelly silt
2
4
7
4
7
190
Diameter: 6 inches Depth: 252 feet
Liner Type: steel
Diameter. 4 inches Depth: 281 feet
Casing stickup above ground: 2 feet
silty cobblly gravel
boulder
190
215
215
220
Static water level (from ground levee: 256 feet
Pumping level: 280 ee4 after
s,7ty cobbly gravel w/bldrs
220
278
2 hours pumping 10 gpm
water sand & gravel
278
281
Recovery Rate: 10 gpm
st7t
281
284
Method of Testing: airlift
Well Intake Opening Type:
® Open End I] Open Hole
❑ Screened Start foet Stopped fed
❑ Perforations Startfed Stopped feet
Grout Type: Bentonite # S Volume:
Depth: Start0 feet Stopped ± feet
Pump: Intake Depth feet
Pump size by Brand Name
Well Disinfected Upon Completion? ® Yes ❑ No
Method of Disinfection: Clorine Tablets
Comments: 6" broken @ 160. 4" can be screened from
276.2811fneededorperforated27&281 ifneeded
Well. Driller_ Alpine Dolling 8 Enterprises
P O Box 110496
Anchorage AK 99511
Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property
^' ro flu uR e c e i e d qT i m e"Det . 3 .09 : 3 4 A — tirnf of Hw,1tF, .� Nnmen C....:...c �v:fl.:n (.r neva of i•�vnnl^F:`m
MUNICIPALITY OF ANCHORAGE 3;3aP-H
Development Services Department
On -Site Water & Wastewater Program 1
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT
Initial
Permit Number: SWO10066
Date Issued: Apr 13, 2001
Expiration Date: Apr 13, 2002
Parcel ID: 015-292-02
Legal Description: FISCHER SUBDIVISION BLOCK 3 LOT 2
Design Engineer: 0014 Anderson Engineering Site Address: NHN KLINGLER STREET
Owner Name: SPINELL HOMES Lot Size: 188864 SO. FT.
Owner Address: 9210 VANGUARD DRIVE Total Bedrooms: 4 Permit Bedrooms: 4
ANCHORAGE. AK 99507 -
This permit is for the construction of:
❑✓ Disposal Field ❑/ Septic Tank ❑ Holding Tank ❑ Privy ❑✓ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations (18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 (24 hours). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
oeu Date: C, CA
,
�% / D- '
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel l.D. 015"—Z I z —OZ Permit Number SW0100 6 6
Property owner(s) Sainell Homes Day phone 344-5678
Mailing address (1) 9210 Vanguard Drive Anchorage AK99507
Mailing address (2) /VHAI Zip Code
Legal description (Lot, Block & Sub'd.) Lott Block' Fischer Subdivision
Legal description (Section, Township & Range)
Lot Size /88.84 Acres6D
THIS APPLICATION IS FOR:
Number of Bedrooms Four (4)
Sewer Only ❑ Well Only ❑
Sewer and Well ® Water Storage ❑
Sewer Upgrade ❑
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit Fees:
Date of Payment: J l` a d 1
Waiver Fees:
Date of Payment:
Receipt Number: (30 a i^, ?) "f Receipt Number.
(Rev. 12100)
April 2, 2001
Municipality of Anchorage
Development Services Department .
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650 .
Subject: Lot 3, Block 2,'Fischer Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer
The owner of Lot 3, Block 2, Fischer Subdivision intends to place a new home on the
lot. The parcel is currently being subdivided into three lots as shown on the attached
drawing and this parcel will eventually be known as Lot 3B. We are therefore applying
for a permit to construct a new well and septic system on the lot to serve the proposed
four-bedroom home. The attached Site Plan and backup documentation identify the
location and configuration of the new septic system and the parameters used in the. .
design.. It also shows the location of the existing and proposed lot lines for the parcel .
and the proposed development area of these new lots. .Existing drainage patterns are
shown and will not be altered by the development of the lot. The well location along
with the protective radius Is shown along with those on adjacent properties.
Two test holes were' placed at the proposed location for the new and alternate '
absorption trenches and revealed well graded gravel with minor amounts of silt. Well
graded sand was found under the gravel layer. No groundwater was noted in the test
holes during excavation and none was noted during the monitoring period. The soil
percolated at a rate of 1 minute per inch. Conditions are excellent for an onsite septic
system. We are therefore proposing to place a 3' wide by 42' long by 6' effective depth
absorption trench to treat the septic effluent. The pipe will be placed at 3' below the
existing ground surface and the total depth of the trench will be 9'. ' A minimum of 3of
cover will be placed over the bed to prevent frost penetration and possible freezing.
,The ground surface on the lot slopes as shown on the attached Site Plan with slight..
grades from south to north and east to west. • The area for the new absorption trench,
however, is fairly flat. The new trench will be constructed parallel to the contours of the .
surface In conformance with Municipal requirements. Grading will be accomplished to
assure surface drainage Is away from the new trenches., The existing drainage pattern
on the lot will not be affected during development..
If the system Is constructed In accordance with our design the following statements
apply
o
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TOTS 2A, 213; 2C, BLOCK 3,
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FISCHER SUBDIVISION
SCALE V =100' '
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Ground Surface Slopes on This Property. <<25%
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NOTE:
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�, (�°„�MICKAEL E. .A.tgDERSCH
AREA
MAP
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SCALEI"=80' •
0 RO'F{5
�'� . 6 -;
1 "=40'
U
E
0
ng Lot
L
N 90.00'90'E 299.70'
Proposed Lot. Line
«.ZJtip. 42 Long X .3' Wi
X 6 Effective E
Absorption Trenc
TH4
OrQ tI
1,250 Gallon
our Bed?bbmP eptic Tan
House.
Alternate
Site
® TH
Proposed
Well 2g
Proposed. Lot ine
' N 90.00'00•E ' .09•
low
Existing Lot Line'. ��� �F ,4l\\1�.
*. 49h"
EAST io47H AVENUE 0 .... .... .... ... ::. ,+
SITE .PLAN ;MICHAEL E. ANDERSON .w
�j, Jf• CE -4381 y„w'
SCALE 1"40'44�gf•.,•• ••��r
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LOT 2, BLOCK 3, FISCHER SUBDIVISION
DESIGN FACTORS:
SYSTEM REQUIREMENTS:
Four Bedroom Home Deep Trench System
Pero. Rate: 1 Min.Anch 1,250 Galion Septic Tank
Application Rate: 12 GPDISF 6' Drainfield Rock
4 Bedrooms X 150 GPD 112 GPDISF = 500 SF of Absorption Area
500 SF112SFILF = 41.7 LF Trench Length
Therefore: Construct an Absorption Trench 42' in Length by 3' Wide With 6' of Drainfield
Rock Beneath the Distribution Lateral. Distribution Lateral to Be Placed 3' Below Existing
Ground. Total Depth of Trench to Be 9' from Existing Surface. Mound Over Trench if
Necessary to Provide Minimum Cover of 3'.
TYPICAL DEEP TRENCH SECTION
(NO SCALE)
l
NOTE: Grade Area Over Trench to Drain Away.
�o�ecopo
= �� OF • 4 N)
Minimum 6' Separation From Bedrock
Natural:
Minimum 10' Separation From Lot Line.
. 2 � 6" �. • �
.. .... /
.. Backfill...
�' , . ....... .
....... r
a/.
*0, *.MICHAEL E. ANOERSCN
. _
Geotextile'-.•'
y
Fabric;
4" Perforated ••''.
"PVC (Slots Down)
zz
:'Drainfield
Rock'
pVj a%..lNIY/.il�
'
3.,
TYPICAL DEEP TRENCH SECTION
(NO SCALE)
l
NOTE: Grade Area Over Trench to Drain Away.
�o�ecopo
= �� OF • 4 N)
Minimum 6' Separation From Bedrock
P,••'
Minimum 10' Separation From Lot Line.
Minimum 4' Separation From Groundwater.i
* 49 H
•...
Minimum 10' Separation From Water Service Line.
�' , . ....... .
Minimum 100' Separation From Well
a/.
*0, *.MICHAEL E. ANOERSCN
p �•, CE -4381
Municipality of Anchorage
Development Services Department
4700 South Bragaw, Anchorage, AK 99507
SOILS LOG - PERCOLATION TEST
Performed For. Paul Palmer Date Performed:
Legal Description: tot . Block 4. Rs .h -r S uhdivision
SLOPE SITE P
OG/PT
Well Graded
Gravel
GW
Was Groundwater
Encountered? No
If Yet, What Depth?
Well Graded Depth to Water
Sand After Monitoring None
Date: 4/1/01
SW
Bottom of
Hole
e�ya�ot��
�, tom. • � .✓ .-�, ,.'>,
'*. 491H
...........n
P . MICHAEL E. ANDERSON d
��. CE -4381
ff f �1�� pROfESS10Np��,�Y
1/24�1`6�a`•o
See Site Plan
Reading
Date Gross
Time
Net
Time
Depth To
Water
Net
Drop
1
24 -Jan 1:05
2"
2
1:15
10
12'(Dry)
10'
3
1:16
2"
4
1:26
10
12•(Dry)
10'
5
127
2'
6
1:37
10
12•(Dry)
10•
Perc. Rate:1 MinJtnch Perc. Hole Diameter. 6"
Test Run Between 5.5 FL and 6.5 Ft.
Comments: Percolation Cavity Presoaked Prior to Testing.
Performed By: Tim Kimbrouoh. I, Michael E. Anderson Certify That This Test Was Performed
In Accordance With All State and Municipal Guidelines In Effect On This Date: 411101
.... Municipality of Anchorage ° °O
Development Services Department ♦ p MICHAEL E. AHDERSCN
4700 South Bragaw, Anchorage, AK 99507 ,��c•�i , CE - 4391 : c;
SOILS LOG - PERCOLATION TEST�;' CFESS\
Performed For. Paul Palmer Date Performed: 1/24/0
Legal Description: L nt 2 Block a Fehr S ubdivieion
11 I OG/PT
4 Well Graded
5 1 Gravel
GW
Was Groundwater
9 Encountered? No
If Yet, What Depth?
10 Well Graded Depth to Water
Sand After Monitoring None
11 Date: 411101
SW
13
14
15I I Bottom of
Hole
1
JVG1Ci
See Site Plan
imminvemirn-16
Reading
Date Gross
Time
Net
Time
Depth To
Water
Net
Drop
1
24 -Jan 1:00
2"
2
1:10
10
12'(Dry)
10"
3
1:11
2"
4
1:21
10
12"(Dry)
10"
5
1:22
2-
6
1:32
10
12"(Dry)
10"
Perc. Rate: 1 MinAnch Perc. Hole Diameter: 6"
Test Run Between 6.5 Ft. and 7.5 Ft.
Comments: Percolation Cavity Presoaked Prior to Testing.
Performed By. Tim Kimbrouah. I, Michael . Anderson Certify That This Test Was Performed
In Accordance With All State and Municipal Guidelines In Effect On This Date: 411101
ONSITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 2, BLOCK 3, FISCHER SUBDIVISION
GENERAL:
1. The scope of this project includes the procurement and placement of a
new 1,250 gallon septic tank at the location shown on the site plan.
Work also includes the construction of a new 42' tong X 3' wide X 6'
effective depth absorption trench at the location shown. The
distribution line In the trench will be placed at 3' below the existing
ground surface. Total depth of the trench will be 9' below the existing
ground surface. All components of the septic system must be placed a
minimum of 10' from the water service line on the lot and 100' from the
proposed well.
2. Construction shall be in accordance with the approved site plan,
design drawings, Municipal Permit with any special provisions or
conditions, and all applicable State and Municipal Wastewater
Disposal Regulations.
3. The Contractor shall be responsible for obtaining all underground utility
locates and for the layout of the septic system and verification of the
location of all lot lines.
4. Unless specifically agreed otherwise, the contractor shall be
responsible for final grading areas subsequently depressed from soil
settling. Property owner shall be responsible for revegetation of
affected areas unless specifically agreed otherwise.
5. Contractors installing wastewater disposal systems must be certified
by the Municipal Department of Health and Human Services for
system installations. Owners installing their own systems must receive
prior approval from D.H.H.S. before beginning system installation.
SEPTIC TANK INSTALLATION
1. A new 1,250 gallon septic tank must be be procured from an approved
source and installed at the location shown.
2. A septic tank is to be constructed by a certified septic tank
manufacturer. Construction shall include two 4" cleanouts for pumping
access.
3. The septic tank shall be sufficiently bedded to prevent settling or
shifting of the tank.
4. All standpipes on the septic tank shall extend a minimum of 12 inches
above final grade.
5. Tanks installed without 4' of cover shall have a minimum of 2" of direct
burial insulation.
Lot 2, Block 3, Fischer Subdivision
April 1, 2001
Page 2 of 3
6. A foundation cleanout shall be installed one to four feet from the
building foundation. Two cleanouts are required between the tank and
the drainfield.
7. Final grading over the tank shall be such that a positive slope exists
away from the septic tank.
DRAINFIELD CONSTRUCTION:
1. The drainfield shall be constructed to the dimensions shown on the
design. The bottom of the trench shall be within 2" of level.
2. Distribution piping must be placed level with perforations down atop a
level bed of drainfield rock. Rock should then be placed over the pipe
to provide a minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the drainfield
rock and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations
shown on the design. The portion below ground must be perforated.
5. Contractor shall verify the septic tank and drainfield are a minimum
100' away from any private water wells in the area, 150' from a Class
"C' Well or 200' from any community well.
6. Direct bury insulation must be placed over the distribution system if
less than 3' of backfill depth is available. Finish grade over the trench
must be mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trenches to drain away.
8. A minimum 2' of accepting soil is required below the drainfield rock for
a 5' wide trench. Contractor shall verify this condition prior to
placement of the rock. All pockets of unacceptable materials must be
removed and replaced.
MATERIAL SPECIFICATIONS:
1. Septic tanks must be constructed by a municipally approved septic
tank manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated
and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and
ASTM D2662 or A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene
(Dow Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Femco, or equal).
Lot 2, Block 3, Fischer Subdivision
" April 1, 2001
Page 3 of 3
5. A permeable geotextile fabric (Typar, Mirari or equal) must be installed
between the final drain rock layer and the native soil layer.
6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing
the #200 sieve.
INSPECTIONS:
Municipal Ordinance requires a minimum of two inspections. These
Inspections must be conducted under the supervision of a professional
engineer registered in the State of Alaska. The first inspection must be
conducted after the excavation of trenches, beds or pits and before the
installation of any gravel. A septic tank may be set in place, but may not
be backfilled.
The second inspection must be conducted after the placement of the
geotextile fabric, gravel, distribution piping, standpipes, cleanouts and
insulation. No backfill should be in place at the time of inspection.
Contractor shall provide a copy of all field survey layout and construction
notes for use in preparing the certified as -built of the completed system.
Rite Le- Doov
Municipality of Anchorage
Development Services Department
Building Safety Division
Onsite Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, AK 995191650
www.muni.org/onske
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015.292-46 COSA #____=L0_
Expiration Date: _7=22,L__ 7
1. GENERAL INFORMATION
Complete legal_ description Lix 2B• Mick 3. risdrer subdwwon
Location (site address) 10ss1 nngersbeet Andwrage.AK99516
Current Property owner(s) Philip and Cathy Parasicre Day phone 33449353
Mailing address 102511QQngerstreet Ancborage,AK99516
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, COSA w771 be held by DSD for pickup.
2. NUMBER OF BEDROOMS: Four (4)
3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well y❑ Individual On-site ❑
Individual Water Storage ❑ Individual Holding Tank ❑
Community Class Well ❑ Community On-site ❑
Public Water System ❑ Public Sewer ❑
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems 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 COSAs upon request to homeowners. Certificates of on -She Systems Approval
are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued
with new water sample results. (Certificates may be reissued for a period of up to one year with valid water
The Municipal
ity hoof Anchorage isnot responsible for properties
or n the professional lengineer's work. item.
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 Certificate of Onsite Systems 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 type of structure indicated herein. 1 further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system Is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Finn Anderson Engineering
Address P.O. Hox 240773 Anchorage, AI( 99524 Phone 522-7773
Engineer's Printed Name Michael E. Anderson, P.E.
Date 4123=7
6.
DSD
/SIGNATURE
--1� APProved for brooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
COSA Checklist X
Septic System Advisory Arsenic Advisory
Maintenance Agreements
Well Flow Advisory
Nitrate Advisory mental Engineers Report
Other
Original Certificate Date: _ O 7
MW /1As)
Municipality of Anchorage 4.2
Development Services Department :
Building Safety Division ..
Onsite Water 6 Wastewata► Program
4700 Bragaw Street
P.O. Box 196850
Anchorage, AK 99519 -WW
www.muni.orglonsite
(907) 3437904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
L09W k,n; l.a42a. 8bdc 3. FrrAer Subdlvhion
parcel 1D:01�—
A. WELL DATA Y
Woo type �° If A. B. or C provide PWSID 9 _ Web Log (YM)
Date eompletad
MOW Sanitary seat (YIN) Y Wires property Protected (YM) Y
Total depth
A4—ft- Cased to 252 R. Casing htagta (abOVe ground) >24 in.
FROM WELL LOG AT INSPECTION
Date of test On
Static water level 256
Well Prodi 10 g.p.m.
WATER SAMPLE RESULTS:
CdHorm o colorlfes1100mL Nitrate 1.19 M91L
4/1 VM7
r
24�__ tt
Arsenic: MID MW Date of sample: 4FJ2007
B. SEPT=HOLDING TANK DATA
Tank TypdMateriel ILW
Tank s¢e 1.250 gal. Number of CamPWIrnents Two
Foundation cleanout (YM Y Depression over tank (YIN) N
_.........� m..... Old MaCD0R1W9Pump
32. 9.p.m.
Other bacteria 0 cotonies/100 mL
Collected by: F. LeDom
Date instatled 7n3r2001
cftno its (YIN) Y
High water alarm (YIN) N
Dated pwnpurg
C. ABSORPTION FIELD DATA
Date installed 7115=01 Soil rating (g•P•dJe or felbdrm)1 s GEDrsF System type oseP Tiaidi
g R, Gravel below Pipe s R
SOSfL Width N
cos 1l= Monitoring tube Y Depression over field
Total depth 12 R Fit. absorption area —
Data of adequacy test
4/19W Results (PasslFaiq Pass For 4 bedr00m3
Fluid depth in absorption field before Oast 29.5 in. Water added Bze gal. New depth m•
Elapsed Tic; 340 min. Final fluid depth 30 in. Absorption rate >' son g.p.d.
Any rejuvenation l eatmend (Past 12 mo.) (YIN & type) N N yes, give date
D. LIFT STATION
Date installed_
'Pump on' level at _ in.
Datum
E. SEPARATION DISTANCES
Size in gallons
*Pump ofd level at _ in.
Cycles tested
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankAiR station on lot >toa
Absorption field on lot >tar
Public sewer main wA
Sewer /septic service One >25'
Animal containment areas Nage
Manhole/Access (y/N)
High water alarm level at in.
Meets alarm & orcu t rep ?
On adjacent lots >tar
On adjacent kxs >toa
Public sewer nranhoWdeanout wA
A
Holding tank wA
Manunganknal excrete storage areas Naas
SEPARATION DISTANCES FROM SEPTIGHOLDING TANK ON LOT TO:
Building foundation >8 ppm Unis ,s
Absorption field >s
Water main WA Water service fine >tP
Surface water >tar
Walls on adjacent kis >tar
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line>t= Building foundation >ta Water main >ta
Water Service Nrre >ta Surface water >tar
M%WMy ode ataraye >w
Curtain drain Nana Noted --
Wells on adjacent lots >tar
F. COMMPmT-Q.
G. ENGINEER'S CERTIFICATION
I cert Y that I have determined through rWd irrspecft, and
ar+>�rrnance A cords COSA that the above terns are to
guldellrres b ellect ct on this data.
Engineers Printed Name Michael E. Anderson, P.E.
Date A/18fmo7
COSA Fees
Date of Payment T
Receipt Number
(Rev. I IMM
Waiver Fee $
Oats of Payment
Receipt Number
El
Microbioloay Laboratory 04/05/07 DPT
wl/100m1. SM209222D A (<q
Total Coliform 0
Ali Dates/rimes an Alaska Standard Time
SCS ReEM
1071405001
printed Date/time
04/18/2007 15:25
Anderson Engineering
Collected Dateffime
04/05/2007 13:38
Client Name
Project Name/®
Lot 211 D3 Fischer
Received Datelrime
04/05/2007 15:20
Client Sample ID
Lot 213 63 Fischer
Technical Director
Stephen C. Ede
Matrix
Drinking, Water
PWSID
0
Sample Remarks:
Allowuhle Prep Awlysis
Unita Method Container ID
Limits Date Date Init
Results
rQL
Parameter
NetaleC
(<10) 04/06!07 04/12/07 77C
ND
5.00 ug/L EP200.E
Arsenic
Raters Department
R
(<10) 04/06/07 A ZS
1.19
0.100 mglL EPA 353.2
Total NitratJNitritc-N
Microbioloay Laboratory 04/05/07 DPT
wl/100m1. SM209222D A (<q
Total Coliform 0
111=40'
WI
N
30' �
2001-66
FISCHER SUBDIVISION
LOT 2B, BLOCK 3.
62.880 S.F.
m�
AS. BU I L
BUILDING DETAIL
SCALE: 1 "=20'
Wk"AY
FINAL STRUCTURE AS -BUILT
GASTALDI LAND SURVEYING
JEFF A. CASTALDI.•R.L.S.
4726 WEST BOTH AVENUE
ANCHORAGE. ALASKA 99502
PHONE 248-5454
GRIDI DATE
2337 9/13/2001
F.B.I JOB N0.
01-10 FS2B3
I HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
IT IS THE RESPONSIBILITY OF THE OWNER TO
DETERMINE THE EXISTENCE OF ANY EASEMDO
COVENANTS OR RESTRICTIONS WHICH DO NOT
APPEAR ON THE RECORDED SUBDIVISION PLAT.
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
HEREON BE USED FOR CONSTRUCTION OR FOR
ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT. ALASKA
NOTE: NO CORNERS SET THIS DATE.
l
♦*SUMA1 It
OF AZ
49
..NH.ryA. casralai . _
t 1I
'moo • , LS -6091 .4 At
Ldp•••.••..•••• AV
r�
N
N
t0
O
Municipality of Anchorage
C -.1 Development Services Department
U Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
:ate':•
s
3• [i•
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLINIG� n
Parcel I.D. 015.292-02 HAA # / f r 1610
Expiration Date: ' oZ D ` 2
1. GENERAL INFORMATION 4, lock 3
Complete legal description !Lot 28, Fischer Subdivision
Location (site address or directions) Klingler Street near East 104th Avenue
Current Property owner(s) Soinell Homes Day phone 344.5678
Mailing address 9210 Vanguard Drive Anchorage, AK 99507
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
Four 4
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
®
Individual On-site
Individual Water Storage
❑
Individual Holding tank
❑
Community Class - • Well
❑
Community On-site
❑
-Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with
valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public
water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional
engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, 1 verify 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 type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm Anderson Engineering Phone 522.7773
Address P 0. Box 240773 Anchorage, AK 99524
Engineers Printed Name Michael E. Anderson, P.E. Date 12f7101
5. DSD SIGNATURE
._I� Approved for _li- — bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
WATER AND
Attachments:
HAA Checklist x
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
By: Original Certificate Date: ' �'y - 0
(FL,. 1200)
Municipality of Anchorage
' Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Banc 196650 Anchorage, AK 99519-6650
www.ei.anchorage.ak.us
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: -WQB. Fischer Subdivision :9 /ec k >, L4 'o -Z -B Parcel ID: 015292-02
A. WELL DATA
Well type prime If A, B, or C provide PWSID # _ Well Log (YM) Y
Date completed 917@001 Sanitary seal (YIN) Y Wires properly protected (Y/N) Y
Total depth 264 ft. Cased to 252 ft. Casing height (above ground) >24 in.
FROM WELL LOG AT INSPECTION
Date of test 91712001
Static water level 256 ft. ft•
Well production 10 g.p.m. 9 -13 -m -
WATER SAMPLE RESULTS:
Coliform 0 cdonies/100 ml. Nitrate 0.979 mgA. Other bacteria 0 oolonhWI00 ml.
Date of sample: 1216@001 Collected by: MEA
B. SEPTIC/HOLDING TANK DATA
Tank TypelMatenal SeoddSteel
Tank size 2� gal. Number of Compartments 2
Foundation cleanout (YM) Y . Depression over tank (Y/N) N
Date installed 7113(2001
Cieanouts (Y/N)
High water alarm (Y/N) N
Date of pumping Pumper New Construction
C. ABSORPTION FIELD DATA
Date installed 7115@001 Sod rating (g.p.d./ft' or ft'lbdrm)1.2 GPDISF System type Deep Trench
Length 50.5 ft. Width 5 ft. Gravel below pipe 6 ft.
Total depth 12 ft. Eft. absorption area 606 ft Monitoring tube Y Depression over field N
Date of adequacy test Results (Pass/Fa6) For _ bedrooms
Fluid depth in absorption field before test _ in. Water added_ gal. New depth_ in.
Elapsed Time: _ min. Final fluid depth _ in. Absorption rate >= g.p.d.
Any rejuvenation treatment (past 12 mo.) (YM 6 type) N If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at _ in.
Datum
Size in gallons
"Pump air level at _ in.
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tankllift station on lot >100'
Absorption field on IW >100'
Public sewer main WA
Sewer /septic service line >25'
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots >100'
On adjacent lots MW
Public sewer manhole/cleanout NIA
Holding tank NIA
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation >T Property line >T Absorption field >5'
Water main N/A Water service line >10' Surface water >100'
Wells on adjacent lots MW
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line MW Building foundation >10' Water main >70'
Water Service line >70' Surface water MW Driveway. perkirgMihkie storage >25'
Curtain drain None Noted Wells on adjacent lots >100'
F. COMMENTS
.,,..-4. N _ , , ,
G. ENGINEER'S CERTIFICATION
I cedify that ► have determined through field inspections and
review of Municipal records that the above systems are in ,• ••• ... ;.
conformance with MOA HAA guidelines in effect on this dateEL.
Engineer's Printed Name Michael E. Anderson. P.E.v % •. T`1F r� ,1
s .
`
Data 1217101`�4 C `YA `:
:z
HAA Fee $ ~ Waiver Fee S
Date of Payment
Date of Payment
Receipt Number Receipt Number
(Rev. 1200)
in.