HomeMy WebLinkAboutLAKE O THE HILLS BLK 3 LT 4Lake 0 th
Hills
Block 3
Lot 4
#015-331-25
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
Pump Installation Log
Well Drilling Permit Number: _______________ Date of Issue: ____-____-____
Parcel Identification Number: ____-____-____
Legal Description Block Lot Property Owner Name & Address:
Pump Installation Date: _____-_____-_____
Pump Intake Depth Below Top of Well Casing: __________ feet
Pump Manufacturer’s Name: ___________________________ Pump
Model: _____________________________________
Pump Size: ____________hp
Pitless Adapter Burial Depth: _________ feet
Pitless Adapter Manufacturer’s Name: _________________________
Pitless Adapter Installer: ____________________________
Well Disinfected Upon Completion? XX Yes No
Method of Disinfection: _____________________________
Comments:
Pump Installer Name: __________________________________
Company: ___________________________________________
Mailing Address: ______________________________________
City: ___________________ State: __________Zip: _________
Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation.
Development Services Department :'~ [-~:
Building Safety Division
On-Site Water and Wastewater Program. 4700 S. Bragaw St.
P.O. Box 196650 Anchorage. AK 96519-6650 Page of
www.ci, anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
tltt~.~ F{~,]~[td. LAI~-._ ~r-:~-~t ABSORPTION FIELD
LEGAL DESCRIPTION
Well: [] New [] Upgrade ~ F,. {~'I J ~ 't' n.
TANK
SEPARATION DISTANCES ~[septic [] Holding [] S.T.E.P. [] Other.
~ Septic Absorptior Lift Holding Publ~,/Pfi~at~ l~an~c~
~.~w.,, "lo t'il° V LIFT STATION
~' BENCH MARK
Engineees Stamp
Inspections pedormed by: ~ ~ Dates: 1"~/~lt
Approval
Reviewed and approved by: Date:
TOTAL Lkc'PIH I0 IT
TOTAL I. ZT~,r# 80 ri'
ETrL'c ~eOCK
$
17
A6 ~4.0
AR 133
I250 6AL
~ TANK
SY/~17~
AC l&O IT
BC 28.0
AD 30.0
BE 255
A~ 84.0
B~ 48.5
Al:' 12.2
i~ 49~h
II
I[OeBEN SPURKLANO P.E.
205 W 15Ttl. AVENUE
ANCH. AK. ~9501
(907) 279-3916
PE£HIT # SVflflf1476
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"LAKE O'THE HI:
LOT 4 BLOCK 3
SIEGFRIED TESS~tER
1oo
PI:~ # 015-331w25
1.5o
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SEPTIC SYSTEM AS BUILT
DATE: SEPT. 11, 2001
SHEET: 2/$ GRID: 26:79
L TlqOSO4£.Bh/6
.,~ 00~0 0 0
Xtandard Trenche~
~' Vide
48' Long
10' ~eep
Monlgor Oeanouts
3' Cover
SII~ B~rrler
7.8 ~ o~ Septic Rock ~
NO SCALE
~03 VlS~h 6ye LOT ~ BLOCK J ~at[, 5EPT. I1, ~081
Anchorage Ak 99501 ~
T.SPURKLAND P.E.
203 WEST I STI I. AVENUE SUITE 203
ANCI lOP, AGE, ALASKA 99501
~',.u 7127't-3'i i0
Fax (907)276-6OI3
January l6,2002
Municipality of Anchorage
Development Services Department
Buildine Safety Division
On-Site Water and Wastewater Program
P.O. Box 196650 Anchorage AK. 995169-6650
Subject: "Pink Sheet" Lake O'The llills, Block 3 Lot 4
The discrepancy between the shown location of the test hole on permit drawing and the As
Built is caused by inaccurate location on the permit. He location of the permit drawing was
"eyeballed" while the as built location was established with swing ties. The tree location ofthe test
hole is approximately 25 feet distant from the location shown on the permit drawing. The one trench
was also rotated to save existing trees.
Yours truly,
Tobben Spurk!and P.E.
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
5':
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Nov 13. 2000
Expiration Date: Nov 13.2001
Permit Number: SW000476
Legal Description: LAKE O THE HILLS BLK 3 LT 4
Design Engineer: 0007 Tobben Spurkland, PE
Owner Name: Siegfried Tessmer
Owner Address: 11400 Mountain Lake Dr,
Anchorage, AK 99516-
Parcel ID: 015-331-25
Site Address: 011400 MOUNTAIN LAKE DR
Lot Size: 74938 SQ. FT.
Total Bedrooms:,~3' Permit Bedrooms:
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. Ail requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date: //'
203 W 15th. Avenue, Suite 203
ANCHORAGE, ALASKA 99501
(907) 279-3916
Fax (907)-276-6013
SEPTIC SYSTEM DESIGN
LOT 4 BLOCK 3 LAKE O'THE HILLS
SIEGFRIED TESSMER
Municipality of Anchorage
Deparlment of Health and Social Services
8201 Street
Anchorage, Alaska 99501
November 13, 2000
We are submitting an application for the upgrade of the septic system for this lot. The submittal
consists of three (3) drawings showing the present improvements on the lot and the adjoining
properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is
subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil
logs and percolation tests of applicable testholes are also enclosed. The septic system design is
based on the following:
No Ground Water or Impervious Layer to 16 fl.
Use Standard Trench
Soil Rating. From Testhole 10/19/00
27 rain/in -- 0.6 gal per sq.f'dday
No. of Bedrooms 4
Required Area per Bedroom: 15010.6 ~250 sq.ft.
Total area required: 250 x 4-- 1000 sqft
Testhole depth 16 feet
Bottom Rock At 10 feet
Top Rock At 3 feet
Rock Depth 7 feet
Total Trench Length 1000 / 14 = 71.5 ft.
Use two trenches each 40 feet long
SYSTEM CONFIGURATION
STANDARD TRENCII
TOTAL LENGTH 80 FT
TOTAL WIDTtl 2 FT
TOTAL DEPTil 10 FT
ROCK DEPTH 7 FT
COVER 3 leT
SEPTIC TANK 1250 GAL CllECK INTEGRITY OF EXIST. TANK
The installation of this septic system will not prevent wells from being installed on the adjacent lots.
There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots.
The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface
runoffwill not result from this installation.
SPLB'TE£
12§0 GAl.
EXIST. SUNSET PLASTIC
CHECK INTEGRITY
TOBBEN SPURKLANO P.E.
205 I¢ ISTH. AVENUE
PE£MU # SVOOOXXX
II
'~ Il'ell
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LAKE O"IlIA' IIILLS
LOT 4 BLOCK $
SIEGFRIED TESSMER
I
PID # 015-331-£5
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SEPt'lC SYSTEId DESIGN
DATE: OCT 26, 2000
SHEET: 2/3 GRID: 2859
L THO3042.DV6
FLOW SPLITTER
7'0 £XISTING
I250 gol Sept;c
Stond~rd frenche$~
,2' Vide
40' Long
10' Beep
ZO' Sewer rock
$' Cover
NO SCALE
Silt Borrier
7.0 f't of' Septic Rock
Effective
/ Monitor
~- Cleanouts
/ /~ 3' Cover
NO SCALE
.
~......~ ........... ~ ......... ..¢...,,
~ ,."~, .. NO. CE-~BB~5 ... ~
........
1250 gal. septic tonk
EX/STING
SPURKLAND PY,
P03 ~/15th Ave
Anchor'oge Ak 99501
L4KE O'TtlE tlILLS
LOT 4 BLOCK J
SlEGF£1ED TESs~IER
SEPTIC SYSTEM SCHEMATIC
DATE, OC~ 26, 2000
SHEET, GRID: ~639
# SWOOOOXX PARCEL ID /I 015-3,51-25 LI'tlO,504,5. DWG
203 W 15th. Avenue. Suite 203
ANCIlORAGE, ALASKA 99501
(907) 2?9°3916
Fax (907)-276-6013
SEPTIC SYSTEM DESIGN
LOT 4 BLOCK 3 LAKE O'THE HILLS
SIEGFRIED TESSMER
Municipality of Anchorage
Department of Health and Social Services
8201 Street
Anchorage, Alaska 99501
October 26, 2000
We are submitting an application for the upgrade ofthe septic system for this lot. The submittal
consists of three (3) drawings showing the present improvements on the lot and the adjoining
properties, (sheet 1/3), the proposed improvements of the lot, of which only the septic system is
subject to this permit application, (sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil
logs and pemolation tests of applicable testholes are also enclosed. The septic system design is
based on the following:
No Ground Water or Impervious Layer to 16 ft.
Use Standard Trench
Soil Rating. From Testhole 10/19/00
27 mln/in=0.6 gal persq.ft/day
No. of Bedrooms 3
Required Area per Bedroom: 150/0.6 -- 250 sq.fl.
Total area required: 250 x 3 = 750 sqft
Testhole depth 16 feet
Bottom Rock At 10 feet
Top Rock At 4 feet
Rock Depth 6 feet
Total Trench Length 750 / 12 = 62.5 ft.
SYSTEM CONFIGURATION
STANDARD TRENCII
TOTAL LENGTH 62.5 FT
TOTAL WIDTtl 2 FT
TOTAL DEPTII 10 FT
ROCK DEPTH 6 let
COVER 4 FT
SEPTIC TANK 1000 GAL CllECK INTEGRITY OF EXIST. TANK
The installation of this septic system will not prevent wells from being installed on the adjacent lots.
There are no developed or natural surface / sub surface drainage courses on this or the adjacent lots.
The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface
runoffwill not result from this installation.
PERFORMED FOR:
Munlcll:allty of Anchorage
DEPARTMENT OF .~EALTH & HUMAN SERVICES
825 'L" Street. Almhorage, Alaska 99502-0650
SOILS LOG - PERCOLATION TEST
· , .,: (ENGINEER'SSEAL)
I ' : T,;:, -.'. , ;_-~J
· '" ~t',,'""'"."
DATE PERFORMED: jo/ lq lO O
LEGAL DESCRIPTION: L~'i'~(1 ~V- ~)
Township. Range. Section:
1
2
3
4
5
6
7
8
9
10-
11-
12-
13
14
15
16
17.
18-
19-
20-
SLOPE
SITE PLAN
WASCROUNDWATER
ENCOUNTERED?
S
IF YES, AT WHAT
DEPTH? p
E
Olp~htoWallrAl~ . .
filofliloring? ~ OaTe:
Gross Net Depth to Net
Feeding Date Time Time Water Drop
N:i~ '~o ~ 0 '/'t
1~.o q.: ~-~ ~,0 1~'7,~, I '1~,
PERCOLATION RATE ,~ '''/ (mmules~mch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~ FT AND ~ FT
DISCLAIHFR~ ~rnundwatoe cnndftinns indicated atp fnr the dates shown only.
Past and future presence and/or depth of groundwater can not be predicted
trom these observations,
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4
49th ~
~N :~ pUR'K/AN [I
NO. CE-~2E'5
RECKRIDGE
6
5
DRIVE
0 ! ' ~0 100
i~q~ I~ = I00 FT.
7
JI'OBBEN SPURKLAND P.E.
205 W ISTH. AVENUE
ANCH. AK. 99501
PERmT # ~WOOOXXX
II
LAAZ' O"JtlE t/ILLS
LOT 4 BLOCK $
SIEGFRIED TESSMER
P1D # 015-$31-a~5
SEPTIC SYSTEkl DESIGN
DATE: OCT 26, 2000
SHEET: I/$ GRID: 2659
L THO3041.Db'G
- /
~ ~ ~. ~ /
TOTAL LENgr~ ~2.5 F ~5 O ~ ~
[F~C. R~K ~ Fr
¢OVER 4 ~
EXIST. SUN$£T £C4STIC
I~O~BE~ SPURK~ND P.E.
203 VZ 15TH. AVENUE
ANCH. AK. 99501
(goz~ 279-3916
PERMIT # SWOOOXXX
N
LOT 4 BLOCK 3
SIEGFRIED TESS~IER
PID # 015-331-£5
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SEPTIC SYSTEI~ DESIGN
DATE: OCT 26, 2000
SHEET: 2/3 GRID: 2639
L THO304£.D WG
Standard Trench:
2' ~/ide
82.5' L on9
10' £eep
6.0' Sewer rock
4' Cover
NO SCALE
Monitor
Si(t £orr;er
6.0 £t of Septic Rock
Effective
I000 gal Septic tank
£XISI'IN~
~ Oeanouts
/ /-- 4'Cover
NO SCALE
: H
1000 gal. septic tank
£XISTIN~
IU~BEN SPUNKLAND P.E,
~03 ~lSth Ave
Ancho¢oge AA 99501
LAKE O'TflE tlILLS
LOT 4 BLOCK 3
$1E~F£1ED TE$SWE£
SEPTIC SYSTEM SCHEMATIC
DATE: OC~, 2~, 2000
SHEET, GRID: £~39
PERI/IT # SWOOOOXX PARCEL ID I~ 015-331-25 LH~O$O43. DWG
Hea~ and Environmental Protec
. L_~,.Fourth Floor West
~ 825 L Street
*' Anchorage, Alaska 99501
279-2511, x 224, 225
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ~'~lJ F~.~'L_.Y)t~L~._ MAILING ADDRESS ...... PHONE ~'_~.~~..
SEPTIC TANK:
DISTANCE 'J 0C.') ~' .'r ..... ~ J)j0.,o~¢--'> _ .~'L.__(~?'_ __~_~ NUMBER OF
FROM WELL. MANUFACTURER ___~- ~- MATERIAL -- % COMPARTMEN~'S
INSIDE LENGTH ............ INSIDE WIDTH ........ LIQUII) E)EP[H ....... lIQUID CAPACITY
TILE DRAIN FIELD: ''~
¢ t , TOTAL LENGTH
D~STANCE r:ROM WELL .... (00 ~ FOUNDATION_ ~0 '~ NEAREST LOT LINE: ................ ~O '~ OFI N~,_ ¢
9 of Lines ..... ~.__ DISTANCE BETWEEN LINES _-- ~--. -rRCNCH WJDTH%~ IN. TOJ-AL EFFECTP/F_
ABSORPTION AREA .... ~_~ SQ. Fl-. LENGTH OF EACH LINE ._2~_~7__~. ~C ~. L9
,A DEPT~I OF FILTER
DEPTIi: TOP OF TILE TO FINISII GRADE ......... ~ MATERIAL BENEATH TILE ......... ~ IN. ABOVE TILE '~ IN.
SEEPAGE PIT:
Log Crib Rings
BUILDING FOUNDATION__
DIAMETER -- OR WIDTH .. , ILENGTH__, DEP1-H
Crib Size: DIAMETER ..... DEPrH .... DISTANCE FROM: WELL
TOTAL EFFECTIVE
NEAREST LOT LINE ..... ABSORPTION AREA (WALl_ AREA) _ ~
,SQ. F'I.
Well
ClassL , O. De h:
Well Distance To: Lot Line iO~
Bldg: ~O~-~ S?wer rLine:
Pipe Materials.
# of Bedrooms:
Installer:
Remarks:
~ERMIT NO.
APPLICANT SIEGFRIED TESSMER
LOCATION MT.~L. AKE DR
LEGAL L4 8~LAKE 0 THE HILLS SD
[:,EPF~F.:TMENT HEALTH AN[:, ENVIRONMENTAL.
,=,~._ "L" STREET., ANCHORAGE., AK. DD~,¢):L
27'~-25'.1..~..
~-~ E L L A ~4 E:, CI ~4 -- S Z T E ~1 E ~4 E ~:
..... _..., TEF.:RY PLACE
:OTEE:T I ON ~ ~' '
PEP-.,---, :,: '-r A.,EEbp/XL
LOT '_-SIZE ,.'4~.:~L. ld 'SQUARE EEET
TYF'E OF SOIL RBSERETION _.,T=TEM IS: [)RRINFIELD
E,E[.F..U_I~= = 4 =,JIL RATING ,:;SD FT,-."BR)= ±~..-
MAX I MIJM NIJMBER OF ', ' - n ', "-
THE REQUIRE[:, SIZE OF THE SOIL RE,=,~FTION SYSTEM IS:
[)EF']-H=
THE LENGTH DIMENSION IS THE I_ENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF ]'HE
GROUND AND ]'HE BOTTOM OF THE EXCRMATION (IN FEET).
THE TRENCH WIDTH FOR DRAINFIELDS IS 2: FEET.
THE GRAMEL DEPTH IS THE MINIMUM DEPTH OF GRRYEL BETWEEN THE OUTFALL PIPE
AN[.', THE BOTTOM OF THE E>:',CAMATION (IN FEET).
F"AC:~-::A~3E F'LAI-~]- CIF'T I C~-~
R PACKAGE PLANT MAY BE INSTALLED AT THE PERMITTEE'"S OPTION SUBJECT TO THE
FOLLOWING CONDITIONS:
'1. EITHER A CLASS I OR II NSF APPROMED PLANT MAY BE INSTALL. ED.
2. A CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF A MAINTENANCE
AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL
ABSORPTION SYSTEM AND/OR YOU MAY BE SUBJECT TO PROSECIJTION.
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN R WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
±00 FEET FOR A PRIMATE WELL OR 200 FEET FOR R PUBLIC WELL..
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ]:E~ DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F'EF~-':I'-I I T E:~-(F" I F.'.ES [:.EC:EI"IBER S:::.t... :]L.:Bi---'?
I CERTIF"r' THAT
=,EWEF..=. AN[:' WELL'=] FrZ, '~' ....
· 1: I AM FRMILIRR WITH THE F.!EQUIREMENTS FOR ON-SITE '- "- =.El
FOF.:TH BY THE MI_INICIPRLITY OF HNL. HUF. H_~E.
2: I WILL INSTFtLL THE: ~-r_,TEM IN ACCORDANCE WITH THE CO[:,ES
~:: I UN[.EE=,TMN[. THAT THE ON-SITE _,EWEF.. SYSTEM MAY REQUIRE ENLHF..~EIIENT IF THE
RESIDENCE ,,IS REMODELED TOAINC:LUDE MCgeE THAN 4 BE[:,ROOMS.
................ ........................... ,,.,
PERFORMED FOR:
LEGAL DESCRIPTION:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
Pouch 6-650, Anchorage, Alaska 99502 276-2221'
SOILS LOG- PERCOLATION TEST
[] SOILS LOG
PERCOLATION
TEST
?- ?o-7¢
6
7
8
9
10
11
13
14
15
16
17
18
19
2O
COMMENTS
;LOPE
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH7
SITE PLAN
Gross Net Depth to Net
Reading Date Time Time Water Drop
~. ~ ' r z : o ..( ,4 ~ iff I, ~
PERCOLATION RATE / ''/ /q 0 e
~ (minutes/inch)
TEST RUN BETWEEN '7 FT AND ?' ''~ FT
PERFORMED BY: G~'/'I,--Y ._T ~ E~'/~'~77
DATE:
72-008 (7/76)
· TESTING · EXPLORATION · CHEMICAL · MATERIALS · INSPECTION
279-258[
{940 pOST ROAD
ANCHORAGE, ALASKA
9950{
Dickinson-Oswald-Welch-Lee, Engineers
800 Cordova Street
Anchorage, Alaska 99501
June 19, 1974
W.O. 16757
Attn:
Mr. Lewis Dickinson
· Subject:
Seepage Pi/Analysis
Lot 4A, Blk 3, Lake O' The Hills Subd.
Gentlemen:
Transmitted herein are -the results of the subsur£ace investigation performed on
the above property. Exploration consisted of one 121 testhole drilled by Denali
Drilling Inc. employing Nodwell mounted, mobile B-50 drill, fitted with an 8"
hollow stem, continuous flight auger. A grab sample was taken at 2.5I, by puLling
the auger out of the test hole and removing the sample from the flights of the auger
from near the bit. Standard penetration samples were taken at 5.0 - 6.5 and
10.0 - 11.5. These samples were taken with 2" O.D, split spoon sampler advanced
into the soil by the action of an 1407ound hammer free £alling 30". The blows
required to dr£ve the-s~mpler 12" is, by definition, the standard penetration. The
softs were visually classified in the field in accordance with sheets i through 3,
following the text. This £ield classification was verified by visual review of
s~mples ba'sed on the s~me criteria, in the laboratory. The drilling was supervised
and the test hole was logged by T.N. Huber, geologist of our staff. The test
hole was logged as follows:
Depth in Feet
- FROM TO SOIL ' DE S CR!PTION
0 1.5
1.5 5.0
5.~0 5.5
5.5 12.0
NFS/F-l, Grey-Brown Silty Sandy Gravel with
organic debris (duff, branches, etc.) and man~
Cobbles
F-l, Tan Silty Sandy Gravel with occasional
Cobbles and Boulders, Damp, Medium Density, GM
F-4, Brown Clayey Silt, Damp, Stiff, PI+, Lw-, '
ML-CL '~
NFS, Grey Brown Sandy Gravel with many Cobbles
~nd Boulders and Random Silt Layers,
:Damp, Medium Density, GP
MEMBER
DickinSon Oswald ¥;,~a '~ Lee Page 2 Tune 19, 1974
Bottom of Test Hole: 12 ft.
Frost Line: 4!-+
Free Water Level: None Observed
Sample :Depth
1 2.5
2 5 -6.5
Type of Sample
Grab
Standard Penetration
Standard Penetration
B10WS/6"
13/15/16
11/30/30
Remarks:
2.
3.
4.
Test hole located per attached sketch
Elevation: existing ground·
Date of Exploration: June 16, 1974
Drilling stopped by boulder at 12.0
The seepage area required per bedroom by soil type (per the Greater Anchorage
Area Borough) is as follows:
Soil Type (Unified Classification)
Mn
SM
SP
SW
GM
GW
Soils reqmrir~g
Seepage Area Required
275 ~2/bedroom
250 ~2/bedroom
150 ~2/bedroom
125 ft2/bedroom
225 ~2bedroom
85 ~2/bedroom
greater than 250 ft2/bedroom are not allowed in seepage pit
are~ calculations (per Greater Anchorage Area Borough).
The seepage area required at depth can be expressed as follows:
Depth
Unified SOils Classification Seepage Area Required
0-1.5
1.5-5
5.0-5.5
5.5-12
GM
GM
ML
GP
225
225
Not Allowable
85
D~kin$on Os~vald W~i~/ Lee Page 3 t'
Enclosed are some excerpts from State and Borough ordinances which may
be of value to you. .For further restrictions, particularly with reference
to location of the seepage pit, we call your attention to the Greater Anchorage
Area Borough Ordinance 28-68. ~
Please call if we can be of further service.
Very truly yours,
ALASKA TESTLAB
John M. Lambe
JML: mm
Enclosure
Approved:
~ ~ert'ltlea ')'Yell ),
· ~or.....~.~. ......... ~-"': ~.~.'i..~.~.~ ........................... ~----:- ................
Location L~~ ....... .t. LI ..:..
D ate completed......~, t~: ;..I ..... :~..~-,...)..~---~--/~- ..................... : ...................... ; .........
r,q.,,, o~,,.d, .... lh~q.!. ~ '.! ...........................................................................
Descrivti~n of Formation ":'.'..; ~: ,- ' from to '
I
RECEIV.fiD
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) 343-79O4
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D, __015- ~l --
Expiration Date:
GENERAL INFORMATION
Location (site address or directions) ~. t t-I,C~:~ }'(CO
Current Property owner(s) ~-ec~.c'~,cc.~ '--~'~.~v,¢('
Lending agency
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless cther, vise requested, HA4 will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: L~
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 Municipalit7 of Anchorage Deve!opment Se.vices Department (DSD) Issues Cadi,'icates of Health Authority
Approval (HAA) based only upon the representations given in para.cmph 4 by an inde;endent professional civil
engineer registered in the State of Alaska. CeP'J~c~tes of He=-[th Authcdl'.¢ Approval ere requ!red for the transfer of
title (except between spouses) for prope~es served by a single-family Ch-Site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to hcmeowners. C¢¢,ificates of Health Authority Approval are
wlid for 90 days from the date of issue for prcperties served by a pdw-te er Class C we!l and may be reissued with
new water sample results. (Certificates may be reissued fcr a pedcd cf up to one year with valid water samples.)
Certific=tes are valid for one year for properties served by Class Acr B wells or a pub!lc water system. The
Munic!pality of Anchorage is nct res.ccnsible for e.,Tcrs cr omissions in the professicnal engineer's wcrk.
4. STATEMENT OF INSPECTION BY ENGINEE~
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Health 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 investiga~Jon and inspection, the on-site water supply and/or
wastewater disposal system is(are) in compliance wit,h all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
NameofFirm T'~[,~...(~,~,.-~..I,r~[~._c2 '~, ~ Phone
Address ~' .~p_.% UZ- {~ J~t ~ [ 0
Engineer's Printed Name "~'~1~1~.~ ~.~ ~,ovV~L~ ~ Date '~'--I~ -0%
Conditional a~proval for - bedrooms, with the fgll6w~ng~t~ulations:
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
X
~_~..' ON-SITE '-.~?
~.~': WATERAND ;
~ : WASTEWATER .'
~ . PROGRAM ..
.....
Maintenance Agreements
Supplemental Engineer's Report
Other
Odginal Certificate Date: "~ - ~. ~z. ~ ...~...
Municipality of Anchorage
DevelOpment Services Department
Building Safety DMslon '
On-Site Water & Wastawater Prngmm
4700 South Bmgaw SL
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage, ak,us
(907) 343-79O4
HEALTH AUTHORITY APPROVAL CHECKLIST
LegalDescrlption: ~r~L~>V~ ~i~.~_ C~"~'~E kJ~[~.L. ParcellD:Ol~-,--':S~,t--,~2~'
A. I/~LL DATA
Totaldep~ )~..~ It.
If A, ii, or C provide PW~ID # t'~'/A
sanitary seal (Y/N) '~/
Casedto )~ ·
well Log (Y/N) ~
Wires properly protected (Y/N) ~/
Casing height (above ground) ~'Z_ in.
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
FROM WELL LOG
¥,
fL
g.p.m.
AT INSPECTION
.ctO fL
g.p.m.
Coliform colonies/100 mL
Amenic: ~ mg./t.
B. SEPTICfHOLDING TANK DATA
Tank Type/Material
Tankaiza 1~..~/,2 gal.
Foundation cleanout (Y/N)
Date of pumping
C. ABSORPTION FIELD DATA
Date of ~ample: ~_~ ~-
~,T ~E. t
Number of Compartments
Depression over tank (Y/N)
Pumper
Date installed
Leng~t ~U fL
Total depttl I ~C) lt. Eft. absorption area ...
Soil rafing (g.p.d~ a~) ~o ~,
Other bacteria ' coloniea/100 mi.
Datein=talled ~/~/a~/
High water alarm (Y/N) ~
/~.o~ Monitedngtube 'h/
Date of adequacy teat )~'~/_ uO"- Results(Pass/Fall) ~/
Fluid depth in absorption field before test / in. Water added ~gal.
Elapsed TIme: V/min. Final fluid depU1 t~in. Absorption rate >=
Any rejuvenation treatment (past 12 mo.) (Y/N & type) ~,~ 0
System type T.-~..~-~'
Gravel below pipe 7 fL
Depression over field
For L// bedrooms
New depth
~' ~ g.p.d.
If yes, give date
D. UFT STATION
Date installed
'Pump on' level et
Datum
F.. SEPARATION DISTANCES
in.
.,,,~Jglf~r alarm level at
Meets elam1 & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic lank/lift station on lot
Absorption field on lot
· Public sewer main
Server/sep~c sendce line
On adjacent lots
On adjacent lots
Public sewer rnanhole/cteanout
Holding tank '
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation ' . ~ ProPerty line.~ O AbsOrption field ,.~)
Water main ~4/~ Water sendce line -~' 'f Surface water fa
Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
· pmPertyune l (~ '
: water service line ' ~'~- 'f'
Curtain drain · t~;.~ ·
Bulidlng foundation L,l.~. ~ water main
Welis on edjacent lots
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I cerUfy that I have determined through field i~spec~ons end
review of Municipal reco~s that the above systems ere in
conformance with MOA HAA guidelines in effect on this date.
o;te 7-1/- - 02-.
HAA Fee $
Date of Payment
Receipt Number
(Rev. 12/01)
Waiver Fee $
Date of Payment
Receipt Number
in.
68'12'45" F_.
~ 65'47'0g" }'l 377.72 - -
AS BUILT
LEGEND , LOT 4,
.........
=ARr..EL CON'INNS: 74.g,,~,,t: 50. FT.
[AS~MENTS ~ R-'COI~D, OTHER IHAN 1HO5[ S$t0'/d~1 ~
RECORDED PLAT NO, 72-2.~, /-~£ NOT s,,-laWl HEREON.
NO CO~NERS SET THIS DATE
I hereby ce~tlfy thai I ho~e pe~io~med o Ue~tgo~ea's
LAKE O' ~ H#Ic: SUBDIVISION
Anchoroqe Reco'di~g D~It~'I~, Alos~o, cnd Ibot Une ~'n-
p~ovemeflls situated (he~eofl ore ~[h;n the I:.rol:~rly
line ¢~d do col overlap or eflc~ooc~ on the prOl>erty
Yn<l odjace~t the~el.o, Itml no Imp~oveme3~ll o~ pmp-
ertr ly~r~j od;ecenl thefelo enc~ooch on the premises
L~)UNSBURY & AS~;~CIAIES, INC.
723 w. 6th Ave. A~ICI40~G~_., ALA~<A 272-5451
GRID 26.39 FIELD 80OK No. 02-1025
f-056 P.OZ/03
102440200t
Tobbcn -qpurkl~nd P.E.
Let 4, Rk 3, La~ O' t~e I-U~I
Lot 4, ~ 3, La!~ O' I~.c H~
All ~te..fl'lmel Irt Ab.da St&ndatd Time
Printed Date~'lme 07,/2,,7./'2002 l~:~
Tt<hnlcal DIr~ctar
Total
R~ul~
Cn!u Method
1.00 mg/L EPA 3~.G
Inlt
coL"l 0C'."AL SMIB 92228
07/16'02
