HomeMy WebLinkAboutTIMBERLUX #2 BLK H LT 12Timberlux
Block H
Lot 12
#018-271-43
Municipality of Anchorage
On -Site Water and Wastewater Section - 343-79JUBMITg
(907) 3
ON -SITE WASTEWATER INSPECTION REPO APR 0 92
Permit Number: _OSP231408 PID Number. 018-271-43
Dwelling: r0_1 Single Family (SF) ❑ with ADU El Duplex (D) n Two Single Family Project: E] New N Upgrade
Name
CASEY & PATTY TETZLAFF
b
A ORPTION FIELD HE I Tr F-1
D Trench ❑ Wide Trench F-1 Bed ound
Site Address
d
4901 HILLANDALE AVE, ANCHORAGE, AK
Other Z.PZ
Phone
Number of Bedrooms
Soil Rating "�W/SF
depth original grade
907-440-6530
4
ITotal
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from orig I EXISTING'I-' depth beneath pipe
Subdivision
Block Lot
Ft.
TIMBERLUX #2 H 12
Fill added above original grpff
11000OF Ft.
JG_r11k..I length
N< Ft.
Township Range Section
Gravel width
Ft.
Beds: Number of Lines
Dis%qz,between lines
Ft.
SEPARATION
DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total orption area
��r
Number of trenches
Dist. between ches
N�
From
Tank
Field
Tank
Line
Ft2
—
Well
*501+
**501+
*501+
-
25'+
TANK F-1 Septic N S.T.E.P. El Holding 0 Other
Manufacturer
ANCHORAGE TANK
Capacity
1500 Gal.
Surface Water
*501+
**50'+
*501+
-
Material
Number of compartments
Lot Line
51 +
**11+
5 1+
-
NA
EPDXY COATED STEEL
2
Foundation
10'+
**10'+
10'+
LIFT STATION
Manufacturer
Capacity
Remarks 'THIS IS A CAT ii AwwTs. -THIS IS AN EXISTING DRAINFIELD THAT
ANCHORAGE TANK
500 Gal.
THE DISTRIBUTION LINE WAS REPLACED WITH A NEW 4' GRAVITY SEWER LINE.
Alarm location
INDOOR
Electrical installed by
RISING SON ELEC.
VLOT LINE WAIVER GRANTED TO DRAINFIELD (WR#010076)
Installer
PIPE MATERIAL House to tank D3034 d Tank to D3034
rainfield
ARM SEPTIC SERVICES
Drainfield D3034 CO/MT D3034
Inspector GEG CONSULTANT, JODY MAUS
BENCH MARK (Assumed elevation) 100.00 it
Inspdates: ection 1 st 2/21/2024
Location and description
nd
2
3 rd 4m
BOTTOM OF SIDING AT NW CORNER OF HOUSE (NEART POINT A)
ON -SITE WATER AND WASTEWATER SECTION APPROVAL
Engineers Stamp
o OF A
Conditional Approval: Date
0 �Q T
..
............�y..
. ............. �,7
Septic System
eff arness.:
zy
CE-179�___
Approved Date
Note: this approval does not include well permit requiremenk.
I
#AECC8114
(Rev 05iuzii 8)
A-4^S--5-S "�, c.,yy -5
E_ C-0 /vl/,l s 510 ez
S 77CP 7- 4--- kc,
ln4 a7- 741_,9-c - /,0 fl_
Ctlk-
PARCEL ID
I PERMIT NUMBER: RECORD DRAWING I N G 018-271-43 NUMBER:
OSP231408 I
NOTE: PER THE CONTRACTOR, THE OLD
4,000-GALLON HOLDING TANK AND
1500-GALLON STEP WERE EXCAVATED,
PUMPED, AND DECOMMISSIONED IN PLACE
PER UPC. PER THE CONTRACTOR, THE OLD
LINED IDSF WAS DECOMMISSIONED IN PLACE.
THE WEST LOT LINE WAS STAKED! i
FLAGGED BY A REGISTERED LAND
SURVEYOR PRIOR TO CONSTRUCTION
1'
TIMBERLUX #2; I
BLOCK H, LOT 3
THE RESERVE SITE WILL BE REUILDING
THE EXISTING DRAINFIELD IN PLACE
_.--_----..— I
NOTE: PIPE LOCATIONS ARE
SHOWN PER GEG SHOTS
TAKEN WITH LEICA DISTO
S910 LASER DISTANCE
METER. SWING -TIES TO
HOUSE CORNERS WERE
GENERATED IN AUTOCAD.
11
50' RADIUS (APPROX,)
FOR AW WTS
TIMBERLUX #2; \
BLOCK H, LOT 11
GENERAL LOCATION OF SURFACE
WATERS;NEW TANK, TREATMENT
COMPONENTS AND EXISTING FIELD
ARE 50'+ FROM SURFACE WATERS:
TIMBERLUX #2;
BLOCK H, LOT 2
EXISTING 30' LONG BY 2.5' WIDE \
DRAINFIELD - PRESSURE
DISTRIBUTION LINE WAS REPLACED
WITH 4" PERFORATED D3034 PIPE
AND CLEANOUTS INSTALLED AT
BOTH ENDS OF THE DRAINFIELD.
— 10UTILITY EASEMENT
-,-----------
1
NEW OUANICS NS500
TREATMENT POD
P
NEW 1500 GALLON EPDXY
COATED STEEL STEP TANK
Q
INSTALLED
DOUBLE
CLEANOUTS
(DBL1 & DBL2)
V LOT LINE
\\�
WAIVER
GRANTEDEXISTING
FCO IS
/ NOT ACCESSIBLE.
A EXISTING B
4 BEDROOM
/ HOUSE,,
' .. 'DRIVEWAY;
9
Ltd
ENGINEERING- SALES- CONSULTING ......v ._.,v.�_..._»
3701 EAST TUDOR ROAD SUITE 101 'ANCHORAGE, ALASKA • PHONE (907) 337-6179 • WESSITE: www.nanwssmwinsedna.mm
PREPARED FOR: PHONE NUMBER:
PATTY TETZLAFF 907-440-6530
PROJECT/LEGAL DESCRIPTION:
TIMBERLUX #2; BLOCK H, LOT 12
TYPE OF WORK:
RECORD DRAWING OF SEPTIC SYSTEM UPGRADE
PAGE NUMBER:
2OF3
DRAWN BY:
J.L.M.
DATE:
3/6/2024
TIMBERLUX #2;
BLOCK H, LOT 13
N
SCALE:
1" = 40'
a''�l•`
i
LICENSE
#AECC884
K..`.... ................;
b1f, �, amess : Nmir
C -79 3Ar
®ttPROFaao°�``
C3 YARD LIGHT
O SEINER PIPE
'� . A C.�s44
V.: 49 TH
J
D O
SHANE A. HOLT G
�O P LS-6914 �1
O 54
0
4�0� resslDnal �oo
NILLAl1/DALE_ Al/EVUE AS-BUILTSURYEY f301
``--- No CORNERS SET THIS DATE
I HEREBY CERTIFY THAT I HAVE PERFOR,+tED A SURVEY
OF THE FOLL01WING DESCRIBED PROPERTY
LOT 12 BLOCK H TIMBERL UX2
;r.E INFORMATION HEREON Is FOR THE us of LENDIN I{STIruTIcErS SPECIFICALLY To stoG ANY A}tCHORAGE RECOROIf;G DISTRICT, ALA KA, A: THAT THE
CONFLICTS 8ET-WEEN EXISTING STRUCTURES AN PLATTEa LOT LINES AnDIOR EASEMENTS; AND IS VISIBLE B9PROVEMENfTS SITUATED THEREON ARE U!1HIK
NOT TO 8E USED FOR POSITIONING ADDITIONAL STRUCTURES', 1APROVENENTS, Or FENCELINE'a. THE PROPERTY LINES AND NO VISIBLE EF:CRDACFYFE2TT5
EA SEHE NTS DP n'ECORD, CA ANY LEGAL ENTITY, OTHER THAN THOSE APPEARING ON THE RECORD PLAT EXIST OTHER IlHAN NOTED.
ARE !{OT SHOdN HEREON( UNLESS INa 1 CA TED)
,NOTE: FENCELIN S THAT NAY APPEAR On 'HIS DRAWI �'G ARE "TOT TO SE USED TO DETERHNE DATED AT ANCHORAGE, ALASKA THIS G 7?1 DAY OF
PRGP ERTY LINES GR POSITION AD D 1 T ION AL I N P R O`LENE;iTs. APr^,IL 2024'
ANT PAVING SHOWN HERE079 NAY SE APPROX!MATE DUE TO EXCESSIVE SNOW AND/OR ICE_
D%LY VISIBLE IMPROVEMENTS ARE SHOWN HEREON
HOL T L',1D SUFr''E7%4 G
THE SUR "t DA TA ON 7MVLRA Wh%V 5 PREPARED FOR THE OWNER OfREMWONL Y 9 r_"L-F.D'✓1? ✓'2/:%
ANYCOP IYW OR UMlZkVG THE DATA HERE0)V 6PROHMED UNDER COPYRai)rLAIN AlrCJiO-%GEAX -r,5JT
M-8E15
PEWIT NUMBER: PARCEL ID NUMBER:
OSP231408 R COppD DRAWING
018-271-43REMOTE ALARM UNIT (REMOTE
TIMED -DOSED CONTROL PANEL WITH DRY MONITORING SYSTEM).
CONTACTS FOR REMOTE ALARM UNIT INSTALLED IN HOUSE.
QUANICS AEROCELL GAT. 11 Iy
QUANICS AEROCELL SYSTEM u"
CATEGORY II CONFIGURATION r0i
TOP OF MANHOLE (3 OR 4 BEDROOM SYSTEM) w
TOP OF MANHOLE (MH2) = 97.50 QUANICS NS-500-AC AEROCELL POD � I m c,y C
(MH1) = 97.60 TOP OF POD LID = 100.23 � It LL N
FINAL GRADES PRESSURE VP1 VP2 a d z rn w O
= 97.30 97.32 FILTER a Q p o
4" BY 4' WIDE INSULATION POD
CENTERED OVER PIPE
MH1 MH2 (PER CONTRACTOR)
TOP OF TANK TOP OF TANK
@ INLET @ OUTLET $ Y
= 91.41 PER CONTRACTOR, = 91 Al
2" OF INSULATION flail) `r
Z W
m
40 PVC &
FEED LINE 0
�=
WEEP HOLE 4" DISCHARGE (20°Ia) Z" 0
TO DRAINFIELD pg <
4" RECIRCULATION (06 C9
INVERT OF BUNG INVERT OF BUNG o WE Z
@ INLET = 90.78 -- ip RETURN LINE (80 /")
@ OUTLET (RETURN Q
LINE) = 90.63? 2
INSTALLATION OF 4" z I. —
TIMER OVERRIDE FLOAT FINAL GRADE
HIGH WATER FLOAT GRAVITY SEWER LINE MT2 CO2 98.67-99.wa r
= 34 cv t�l3
IN EXISTING TRENCH ,_
TIMER ENABLE FLOAT Zw
J L PER CONTRACTOR, F W
Itm 2" INSULATION Wa = 0
FILTER FABRIC Y Lu
O
GOULDS PE51M 4 m
1500-GALLON EPDXY -COATED STEEL STEP TANK s `z
� n X LL
O
NOTE: INVERT OF OLD Y w
1.25" DISTRIBUTION E orf a =I
CMU BLOCKS LINE (REMOVED) w m LL 0
= 95.78-95.88 0 ° w
CL
w
INVERT OF NEW 4" Q
DISTRIBUTION o ral�►a ,♦♦
LINE = 95.96 ° o� �G ,
O ``�P...•DF
♦�
p s.8•'6F FFECTIVE AV C9 *+
LIQUID LEVEL ELEVATION °o R- f i l #
IN DRAINFIELD ON °o � ##
3/1/2024 = 91.51 0 f
o ....... ...... ...............
O 0
° Q 0 �. ..�
u ianicb a , :, rey ....... ess :' s
o ## �' CE-7 53 �,AF
##♦ 2 :
BOTTOM OF SOUTH MT (MT1) = 91.28 ♦♦tit% ESS\ +4V
Alaska AuthorizedDealer BOTTOM OF NORTH MT (MT2) = 91.07 LICENSE r»k� ;aa**4% `�
4AECCM4
PROPOSED PUMP TANK FLOAT
SETTINGS
ANCH. TANK MULTI PURPOSE TANK
1500
VOLUME AT INLET INVERT
1572 GALLONS
MIN. OPERATING VOLUME
1241 GALLONS
INLET INVERT
57"
TIMER OVERRIDE FLOAT
45.5" *53.5"
HIGH WATER ALARM
44.5"
TIMER ENABLE FLOAT
38" *46"
FLOAT LEVELS ARE FROM BOTTOM OF PUMP ASSUMING
AN 8" CMU BLOCK HEIGHT FROM BOTTOM OF TANK
('MEASUREMENT FROM BOTTOM OF TANK). NOTE:
MEASUREMENTS ARE WHERE THE FLOAT WIRE ATTACHES
TO PIPING WITH A 3.5 INCH TETHER FROM PIPING TO
FLOAT. ALL FLOATS MUST BE NARROW ANGLE FLOATS.
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program S�,
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
t�cpartment
On -Site Wastewater Disposal System Permit
Permit Number: OSP231408 Effective Date: 12/15/2023
Work Type: SepticTank Upgrade Expiration Date: 12/14/2024
Tax Code Number: 01827143000
Site Legal Address: TIMBERLUX #2 BLK H LT 12 G:3136
Site Mailing Address: 4901 HILLANDALE AVE, Anchorage
Owner: TETZLAFF CASEY H & PATTY A Lot Size in Sq Ft: 31970
Design Engineer: GARNESS ENGINEERING GROUP LTD Total Bedrooms: 4
This permit is for the construction of:
❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions:
• Holding tank to be located and decommissioned at time of construction.
1
may: :Li 5; CA,— -fa r Date:
Issued By: Date:
MUNIUP UTY or- A HO
Development Services Department Phone. 907-343-7904
On-Site Water & Wastewater Section � Fax: 907-343-7997
ON-SITE SEPTICIWELL PERMIT APPLICATION
Parcel I.D. 018-271-43
Property owner(s) PATTY TETZLAFF Day phone 907-440-6530
Mailing address 4901 HILLANDALE AVENUE *ANCHORAGE, AK 99516
Site address 4901 HILLANDALE AVENUE *ANCHORAGE, AK 99516
Legal description (Sub'd., Block & Lot) TIMBERLUX #2; BLOCK H, LOT 12
Legal description (Township, Range & Section)
Lot Size Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN:
TYPE OF DWELLING:
(N all that apply)
Absorption Field
❑ Initial ❑
Single Family (SF) x❑
Septic Tank
RX Upgrade 0
(w/wo AD U)
Holding Tank
E] Renewal ❑
Duplex (D) ❑
Privy
❑
Multiple Dwellings ❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 2 Z Waiver Fees:
Date of Payment: I Z / it/ Z' 2 3 Date of Payment:
Receipt Number: Receipt Number:
Permit No. n SP Z 3 C Waiver No.
GADevelopment Services\Building Safety\On Site Water and WastewaterTorms\Client Forms\Permit Application.doc
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231408, Deb Wockenfuss, 12/15/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231408, Deb Wockenfuss, 12/15/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231408, Deb Wockenfuss, 12/15/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231408, Deb Wockenfuss, 12/15/23
HILL A NDA L E A VENUE
-----------------
THE INFORMATIONHER-ON IS FORTHE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY
COiFLICTS BETWEEN EXISTING STRUCTURES AMD PLATTED LOT A DIOR EASEMEN S; AND ZS
NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES IMPROVEMENTS FENCE-'NES_
N TS 0 E a OR ANY LES;.L
L EUT_TY' a THER THAN OSE APPEARIN OR !ENCE; PLAT
EASE ME F R COM ' �m � ON THE RECORD
ARE NOT SHOWN
OWN HEREONC UNLESS
NOTE_
F , NNE
OT : I CEL IN ES THAT MAY APPEAR
an T41S DRAWING ARE NOT TO BE USED TO DETER,
E I BAR
PIRO P ERTT LINES OR po SITION ADDITIONAL !MR R OVEMENT S
ANY PAVING SHOWN HEREON PAY BE APPROXIMATE DUE TO EXCESSIVE SNOW ANDIOR ICE.
G
VLy VISIBLE IMPROVEMENTS AR S E HCWX HEREON
C3 YARD LIGHT
0 SEWER PIPE
o OF A C"%%
00c
*0..-'49 1-H V.
SHANE A. HOLT
LS -6914
ASBUILTSURVEY I-=,30'
NO CORNERS SET THIS DATE
I HEREBY CERTIFY THAT 1 RAVE PERFORMED A SURVEY
OF THE FOLLOWING DESCRIBED PROPERTY
LOT12 BLOCK H TIMBERLUX2
AN04ORAGE RECORDING DISTRICT, ALASKA, AND THAT THE
VISIBLE IFPROVEEMENTS SITUATED THEREON ARE WITHIN
THE PROPERTY LINES AND ND VISIBLE ENCROACHMENTS
EXIST OTHER 1%4AN NOTED.
DATED AT ANCHORAGE, ALASKA THIS 21ST DAY OF
S0'7V,lEER . 2023
HOL T LAND S&F?Vf)lVS
THE SURVEY DA 7A ONTHIS DRA WAG 15 FR&ARED FOR THE OWNER OF RECORD OM Y 9309 GROVER D)?,E
A fV V COPYWa OR tfT&&WVG 77YE LW TA IZA MN 6 PROHEINS9 LWOE? COPYRIGHT LA W AAl0HO4AGEAN` 2907
1
13932 134-28 223-8515
'
Municipality of Anchorage .r~,~
Development Services Department .-~.
Building Safety Divlslon ~.
On-Site Water & Wastewater Program, 4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650 ~
www.cl.anchorage.alcus (907) 343-7904 Poge 1 of
On-Site Wastewater Disposal System and/or Well Inspection Report
Perm[t Numbe~ SW010577 PID Number:. 018-271-4;3
"°m°:CASEY TETZLAFF Wastewater System: I-I New · Upgr(3de
Address:
4901 HILLANDALE AVE. ABSORPTION FIELD
No. of Bedrooms:
Ph°ne:(9073 333--6776 4 · Deep Trench It-1 Shallow Trench n Bed 1'1Mound · Other*
LEGAL DESCRIPTION *3.0 ~o/s~. n 6.9 MAX
; 12 r H !' TIMBERLUX ~2 2.1 MAX. . 4.8
-- - - SEE DWG. ~ .30
WELL: [3 New I-I Upgn3de 2.5 ~ 1
~--~ n. 288 s~.r~ D 3034/ F-810
n.DENALI SEWER &: DRAIN 9/25/01-10/2/01
~ ~ ~ TANK
SEPARATION DISTANCES =Sep~ =.o,~.~ =s.~.~.,.
From Tenk F~eld Stet[on T(3nk S,..~ U~o ANCHORAGE TANK 1500
Wetl 100'+ 100'+ 100'+ 25'+ STEEL 2
s,,o:o wo~.~ lOO'+ lOO'+ too'+ - - LIFT STATION
Lot Line 5'+ °'1' 5'+ -- -- 1500I ANCHORAGE TANK/ORENCO SYSTEMS
Founder;on 5'+ 10'+ 5'+ - TIMER TIMERI 46"
:urt<31n DroWn ~ NONE KNOWN 20 eSI 05 HHF M.O.A.
~emorks: *THIS IS A LINED (18' x 20') INTERMITrENT BENCH MARK
SAND FILTER SYSTEM WITH AN ORENCO PUMP BASIN NORTHWEST CORNER OF BOTTOM STEP OFF OF
BACK DECK
AND A SECONDARY DRAINFIELD.
**SEE LOT LINE WAIVER ~WRO10076 100,00 n
EXISTING HOLDING TANK WAS ABANDONED IN PLACE FOR POSSIBLE FUTURE USE.
lnspoctions performed by:
:>nd to/t/2oot~ ~F~.~.-~,~rj.~. ..... , .......
Reviewed and approved by Dote: ~o~°,,~oo
AS BUILT DRAWING
$W010557 - 018-271-45
~N~ 18' BY 20' UNED ~ - ' ·
~--I [5 / I~RMmE~ ~ND RLTER
,~ D~INnE~ ~'~O I~1 Il ~ / ~M W~ PUMP VAULT /
~'1 ~ ~ :.~ 100'+ TO SURFACE WATER ~ I A B
~ MH2 ~2 58.9 66.2
II 5~~ll MH1 61.5 68.3
~5~~1 j ,1 69.6 74.2
S.T.E.P. TANK~ . ~ - ~~ ~ ~ ME2 79.0 85.5
~I~NG HO~lN~ ~ ~ ~4 89.8 97.4
T~K ~DONED ~ ~ ~
F~RE USE~ ~ ~ X ~ ~6 90.4 10~.6~
/ 'N~A~D X ~ BEDROOM HOUSE
' "''"'='"m3
.,.,..:., ?.~ .?./',.. /
~S~ WATER & WASTEWATER
PR~ FOR: P~NE NUMBS: P~E NUMBS:
CAS~ 3[Iz~FF (907) 333-6776 2 OF 3
TI~BERLUX SUBDIVISl0N J2~ LOT 12, BLOCK H, ~[.."J...~ ....... ·
As-~u~u or S~.T~C S~ST~ U.0R~ (UN~0 ~.s.r. S~ST~) ';~--
AS BUILT DRAWING p,~,o ~UMB~R:
PERMff NUMBER: 01 8--271 --.43
SW010337 -
nNAL GRADE
-- 101.,~8'1-.-~ MTCO ~..ORIGINAL GRADE
r-2 FEET OF' INSULA'BON 'TO DISPLACE \ I~'~ /. 99.14-100.49
I$OIL BECAUSE OF' STANDARD BURIAL ~ | I I I /
INVERT OF BUN[ ] S.T.E.P. TANK ~--INV[RI OF BUNO
AT INLET - 91.85''~ i1 A~"O~'L~ - 91.97.
LBOTTOM OF TRENCH - g3.6
- OR£NCO/-- F.NAL GRADE
I PUMP / 100.45+
FLUSHING VALVE BASIN // t--INVERT OF OISTRIEIUTION
AN{) COVI[R-,.~ ~.--INSULATION [ / / UN[ I 98.06
F PL~OOD 80×ld'F RL?£R
,:,- //
,,. , .;.~'-,,:.,.:,~; .,~,.,...,, ....,..., ..-.. [ ......... . .... ~ . :.
95,65 ! ~ ~NR LINE - 96,24 --~ - 97 65
C0U.£C~0N P~P£ / ~--80Trou 0F SYST[M '
IN pla GRAVEL--~ - 95 14
- -' J.L.M.
ALASKA WATER & WASTEWATER,~E: , ~.: ~-t~,~ ~'..~.,~
CASEY T£TZL~Fr (907) 333-S77S 3 OF
TIblBERLUX SUBDIVISION #2; LOT 12, BLOCK H 'llff~.~_"a....~ ....... ~,~,~
PROFILE AS-BUILT OF SEPTIC SYSTEM UPGRADE '""~'~',~,:~.,~.~'~.'~
MUNICIPALITY OF ANCHORAGE
Development Sen/ices Deparlment
On-Site Water& Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Sep 18, 2001
Expiration Date: Sep 18, 2002
Permit Number: SW010377
Legal Description: TIMBERLUX#2 BLK H LT 12
Design Engineer: 0041 AK Water & Wastewater Consultant
Owner Name: casey Tetzlaff'
Owner Address: 4901 HILLANDALE AVENUE Total Bedrooms: 4
ANCHORAGE . AK 99516-4148
Parcel iD: 018-271-43
Site Address: 004901 HILLANDALE AVE
Lot Size: 31970 SQ. FT.
Permit Bedrooms: 4
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. 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 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.
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.an~ho~age.ak.us
(907) 343-7904
Waiver Review Worksheet
WRY: WR010076 PID~: 018.271-43 HA#;
Permit~:
Date Received; 9114/01
Legal Descdption: Timberlux ~r2 Block H Lot 12
Engineer. Jeffrey A. Garnees. P.E. - Alaska Water & Wastewater Con;#ltar~t~
9901 Debarr Rd. Suite 2B Anchoraae. AK 99524
Applicant: Casev Tetztsff
Waiver Requested: 1 Foot from trench to lot line
Criteria: Geology
A. Water Table
El. Soil Sorption
C. Permeability
D. Water Tabts Gradient
E. Horizontal Separation
Total:
Points:
Waiver Is Granted: X Waiver Is not Granted:
LlstConditionsorReesonsforabove:.~'~J~'E ~',t~J'yllllE~:~ tS /-ET/'EI~ O.r
=ate: ?- 17-al By:
Name of Reviewer
Rec~: 10115 Amount: $115.00 Date Paid: 9114/2001
Municipality ,of Anchorage
George P. ~ uerch, Mayor
Bttilding Safc~' Di~ision
P.O. Box 196650 * 4700 S. Bragaw Street
Anchorage, Alaska 99519.6650 * (907) 843-8301
h t t p://www.cLanehorage.ak.us
9/I 8/2001
Jeffrey A. Oamess P.E., Alaska Water & Wastewater Consultants Inc.
6901 Debarr Rd. Suite 2B Anchorage, AK 99504
Subject:
Waiver Request for Timbeflux #2 Block H Lot 12
Waiver Request #WR010076
Parcel ID #018-271.43
Permit #SW010377
Public Wor ~ks
Dear Jeffrey A Garness:
Your request for a waiver of the required 10 feet horizontal separation from the
absorption field to property line has been approved. The approved separation distance is
1.0 foot.
This waiver approval applies to the existing absorption field 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, pleas~ call our office
at 343-7904.
Sincerely,
Daniel J. Roth
Civil Engineer
On-Site Water & Wastewater Program
Municipality of Anchorage
Development Services Department
Bullding Safety Division
On-Site Water & Wastewater Program
4700 South Bragaw SL
P.O. Box 196650 Anchorage, Al( 99519-6650
www.cLanchorage.ak.us
(907) 343-7904
Parcel I.D.
ON-SITE SEWER/WELL PERHIT APPLICATION
FOR 4, SINGLE FAMILY DWELLING
018-271-43
Permit Number ~'t,u ~1917 7
Property owner(s) (~AS[Y TETZLArF
Day phone ~33-6776
Mailing address (1)
Mailing address (2) ANCHORACE. AK.
Legal description (Lot, Block & Sub'd.)
Legal description (Section, Township & Range)
Lot Size ~/~ '7' D Acres/Sq. Ft.
4901 HILLANDALE AVE.
Zip Code 99516
TIMB[RLUX ~2 LOT 12. BLOCK H
N,/A
Number of Bedrooms 4
THIS APPLICATION IS FOR:
Sewer Only [] Well Only []
Sewer and Well [] Water Storage []
Sewer Upgrade ·
THIS PROPERTY CONTAINS:
HuE Tub [] Jacuzzi
Swimming Pool [~ Water Softening Unit
II
Therapy Pool
I certify that the above information is correct. I further certify that this apphcation's be'ng made for a
Single Family Dwelling and is in accordance with applicable Municipal codes.
ALASKA WATER & WASTEWATER CONSULTANTS~ INC.
-(Signature-of-properly-owfler-or~lhorized~gent)-
Permit Fees:
Date of Payment:
Receipt Number:.
Waiver Fees: ~.11
Date of Payment:
Receipt Number:.
ALASKA WA" ER . 'WASTEWATER
~ , ,,,, CONSULTANTS, INC. ~'
July 2~, 2001
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, Alaska 99519-6650
Reft Septic System Upgrade for Lot 12, Block H, Timberlux #2 Subdivision
(Bottomless Intermittent Sand Filter - ISF)
To whom it may concern:
The existing 4 bedroom house is served by a 4000 gallon holding tank that was installed in
1994. At the time of the installation there was surface water 60 feet to the northeast of the
holding tank for which a waiver was granted by DHHS. Since that time, the property owner has
diverted the drainage and imported fill so as to eliminate the surface water. The intent now is to
replace the holding tank with a lined intermittent sand filter and a secondary drainfield.
We are proposing that a 1500 gallon S.T.E.P. tank and a Lined Intermittent Sand Filter (ISF) a
Orenco Pump Basin and a Deep Trench be installed. Comments regarding the design are
summarized as follows:
SOILS: Attached is a log which shows the soil classifications, groundwater monitoring, and the
percolation test results.
LINED ISF DESIGN:
a. Allowable Application Rate for ISF: 2.0 gallons/day/ft2
b. Number of Bedrooms: 4
c. Design Flow: 600 gallons per day
d. Minimum Absorption Area: 300 ft2
e. Effective Depth below pressure pipes: 3 inches
f. Width: 18 feet
g. Length: 20 feet.
h. Effective absorption area = 360 ft2
i. Air Supply: Thomas Industries, Model 5070, "Anchorage Tank".
j. Air Supply Line: "Wasteflow" emitterline, 1/2 inch I.D, "Anchorage Tank".
6901 Debarr Road, Suite 2B * Anchorage, AK 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com
1. Pea Gravel: 100% passing 3/8" sieve, less than 20% passing the 1/4" sieve, and
less than I% passing the #8 sieve.
We will use a conventional lift station (Anchorage Tank), equipped with a programmable timer
so that flow can be intermittently dosed to the 1SF.
DRAINFIELD DESIGN:
a. Percolation rate of native soils: 15 minutes per inch.
b. Allowable application rate for effluent from a lined ISF: 3 gallons per day per Sq.Ft.
c. Daily flow rate: 600 gallons
d. Minimum absorption area required: 200 square feet.
e. Maximum trench depth: 7 feet (provides 4 feet separation distance to groundwater,
however, only 2 feet is required for effluent from a lined IDSF.
f. Effective depth: 5 feet
g. Trench length: 30 feet
h. Absorption area: 300 square feet
TOPOGRAPtlY: See the attached topography drawing
MATERIALS AND CONSTRUCTION PRACTICES: The materials used, and the
construction practices will comply with the MOA "Intermittent Sand Filter Design, Installation
& Maintenance Manual". The contractor should read this document prior to construction.
Copies are available at the Municipal Onsite Services office (4700 South Bragaw.).
LOT LINE WAIVER: We are proposing to put the new trench 1 foot away from the west lot
line. There are no encroachment concerns with any adjacent wells, septic systems, or structures.
In short, we are unaware of any adverse impacts associated with this encroachment.
CLOSING: I am open to any suggestions from your department, which would be an
improvement to the proposed design. I am unaware of any adverse impacts this installation
would have on adjacent wells or septic systems. If you have any questions, please contact me at
337-6179. Thank you for your assistance.
Sincere~ ~
NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, a soils log,
and a 7page construction specification letter which are all part of the design package for this
septic system.
6901 Debarr Road, Suite 2B * Anchorage, AK 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com
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CASEY TETZ~FF (907) 335-6776 I OF 2 J~:~ _ ~,ef r.y A.~s~;
TIMBERLUX SUBDIVISION ~2: LOT 12, BLOCK H ~,~/e.._ _ ,....~'~ ......... ",~
~ o~ -,: %~,0,...,o~:
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~SI~ ~TER & ~STE~TER
· ~G~rCONSULTANTS'= *~s~ · ~INC'~*o?~7~?*~' F~ ~o?~47~
CASEY T~Z~FF (907) 355-6776
TIMBERLUX ~2, L12, BLOCK H
SITE P~N
~., 20' LONC ·
BOX N~N0 I 1'---2'--- ~3/4 ~ t. AT[P. ALS /SHIELD ,
INTERMITTENT SAND I I I FLUSHING VALV~
~SI~ WATER & ~VASTEWATER ~
PREPPED FOR; PHONE NUMBS: P~E NUMBS:
CASEY TETZ~FF 555-6776 5 OF 4 ~dfff~.
TIMBERLUX ~2, LOT 12, BLOCK H ,'""
DETAIL AND PROFILE OF LINED INTERMI~ENT SAND FILTER (ISF)
ALASKA ~VATER & WASTEWATER g~5~: ~ ~/,'iii,' 'i-.?~
CONSULTANTS, INC. ~:I";': ..... *~'"~' '"(' .........
[SOIl. LOG - PI:'RCOLATION 1£$11 . ~.:....~
LEGAL DESCRIPTION: TIMBERLUX $/D l~2, LOT 12, BLOCK H ~0/~~. , ..e '(~E[r'JY -7953'
PERFORMED FOR: BAT: 7/./0, ' ........
~f[°e~t)~ ORO ITEST HOLE #~1
I IF ATI -TH WAS PURPOSELY DUG
~ GW ,~ ORG ON NEIGHBOR'S PROPERTY.
GM CL
GC OL THi~ 1*
SW NH
SP CH - / '"~
SC LOT ~ ~, "LOC~., ~, I I
DEPTH TO
GROUNDWATER DATE
!
11.0 7/11/011
1,.o 7/1~/Ol
11.0 7/20/01 ~ I~
'- I 1"-1oo' J
10
11 DATE READING CLOCK NET TIHE WATER LEVEL NET DROP
TIHE (HINUTES) READING (INCHES)
12 7/16/01 1 5:25 - 6" -
2 3:5~ 30 4' 2"
15 5 3:55 - 6" _
4 4:25 30 4" 2"
14 5 4:25 - 6- -
6 4:53 30 4' 2"
15
16
17
18
19 PERCOLATION RATE 1,5 (HIN./INCH) PERC. HOLE DIA. §" (INCHES)
TEST RUN BETWEEN 4.5 FT. AND ,5.0 FT.
2
COMHENTS: ON UPHILL SIDE THERE IS A LAYER OF TIOHT OM/ML ABOVE SANDY CM. BENCH SET 4-5'
PERFORMED BY ALASKA WATER &: WASTE'WATER I, JEFFREY A. OARNESS, CERTIFY THAT THIS WAS/PERFORMED
IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEUNES IN EFFECT ON THIS DATE:
4~ ct~m~vp-S '
PROPERTY OWNER MAINTENANCE AGREEMENT
ON-SITE WASTEWATER DISPOSAL SYSTEM
This agreement, dated "~"ol~.~ ~ ,200_1, is made between the Municipality of
Ancho,rage Depa~uhent of Healt~ and Human Services (DHIIS) and the property owner(s) of
This agreement is made for the purpose of maintaining an on-site wastewater disposal system
on the subject property.
The property owner(s) agree to the following:
The property owner(s) will have an annual inspection of the system performed by a registered
professional engineer. This inspection shall verify that all effluent and air pumps, timers, and
alarms are functioning as designed. Any deficiencies shall be corrected and the engineer's
statement that the system is functioning as designed shall be filed annually with the DHHS.
(No~ize ttcrc)
s.:c or
Sudic~.l District $S.
On t~is .%
year :~ e'OI , ~forc me. ~e ~dersi~ ~o~
public, ~rso~ly
· e per~on(s) whose ~e(s)
wl~ ~s~m~t ~d ac~owl~g~ ~at h~shc/~ey
executed ~e s~c for ~e pu~ses ~erc~
In witness whereof. I hereunto set my hand and
official sealI ,
No~t~ ~blic (siZable) .
(No~'s pr~ed
My co~ssion expires:
, Municipality of Anchorage Page
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: ~~RqOOcl? PIDNumber:
Mameff/Ze~r Z'row~g,~,~,~-e~ Wastewater System: ~ New ~ Upgrad~
AOdress~q~/, ~/~& ~ ~¢. ABSORPTION FIELD
~c--O----~ ~- B Deep Trench B Shallow Trench B Bed nd B Other
LEGAL DESCRIPTION soi~.~,~..: GPD/Sq. Ft. ~h from original grade:
Lob Block: Subdivision: Depth to pipe bottom from original grade: Grave] depth beneath pipe
Township: I Range; ISection: Fill added ab°ye °rigim¢ Ft.Gravel length: Ft.
WELL: B New U Upgrade Gravel width:~ Number of lines: I Distance between lines:
Ft. Ft.
Classification (Private, A,B,C): ~ Total Depth: Cased To: Total abs~tion area: Pipe material:
Driller: Date Drilled: Statio Water Level: Installer: Date installed:
Yield: GPM IPumpSeta,: F, Icasing HeightAb°veGr°uno:F'. TANK
SEPARATION DISTANCES u Septic ~olding n S.T.E.P.
TO Septic Absorption Lift Holding Public/Privat~ Manufacturer: Capacityin gallons:
Well ~ ~ ~ t ~ r~ Material: ~ Number of Compartments:
SurfaCewater - ~ ~¢ '. ~ LIFT STATION
Lot ~ ~ /0 ¢¢ ~ ~turer:
Line ·
FoundatioR ~ ~ ~ ~' __ "~um~ °n" lev°l al: I ~'~~" ~r~'~m ~:
Curtain ~0~¢ ~O ~ ,~ Pump Make & Model ~ Electrical Inspections performed by~
Drain~ ~,
BENCH MARK
Remarks:~/~& ~ ~&~ ~
Assumed /OO, OO Fh
Elevation:
ENGINEER,S,SEAL
V;,;.:: 4 ~agle River Loop Road, ~o ~ ~ ;~ .... , ..... ~.,; :
Inspections performed by: ~,¢e~iv*r, Al,~k"~$~ Dates: ~st ~ : .
Reviewed and approved by:Department of Health~~~and Human ServiceSDate: ¢ ' 2 g -¢¢appr°val
72-013 (Rev. 9/91) MOA 25
2 2
Permit No. ~;W940048 Page of
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
LegaIDescription.TIMBERLUX SUBDIVISION #2, BLOCK H, LOT 12 PiD No .01827145
ALARM 6"VENT
NEW 4000 GAL,
HOLDING TANK
CO
wATER
84.9'
DECK
75'
EXISTING
3 BDRM
X~
RADIUS ~x ~LL
A B
FCO 12.0~ 123.0'
COl 130.6; 147.5'
ALARM 136.0 [52.0'
6"VENT 44.0; 158.5'
602 49.5 62.5r
FENCE N
72-013 A (2/91) MOA 25
PAGE
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW940048
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:STONEBRAKER BRENT &
OWNER ADDRESS:4901 HILLANDALE AVE
ANCHORAGE AK 99516
DATE ISSUED: 3/10/94
EXPIRATION DATE:
PARCEL ID:01827143
LEGAL DESCRIPTION: TIMBERLUX #2 BLK H LT 12
1 OF
3/10/95
2
LOT SIZE: 31970 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
HOLDING TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
REFERENCE WAIVER WR940006. THE EXISTING MOUND SHOULD BE
PUMPED AND HAVE ALL LIQUID REMOVED PRIOR TO REMOVAL OF THE M
OUND. CARE MUST BE TAKEN TO ENSURE THAT CONTAMINATED MATERI
AL FROM THE MOUND IS DISINFECTED AND ANY RUNOFF FROM THE MOU
PAGE 2 OF 2
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ND MATERIAL DOES NOT ACCESS THE SURFACE WATER.
RECEIVED BY:
ISSUED BY: ~o~-tS~
DATE:
DATE:
Tom Fink,
Mayor
unk p li y AnchOrage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
March 11, 1994
Robert Shafer, P.E.
S & S Engineering
17034 Eagle River Loop Road
Suite 204
Eagle River, Alaska 99577
Subject:
Waiver Request for Lot 12
Waiver Request ~WR940006,
Block H Timberlux #2
PID #018-271-43, SW940048
Dear Mr. Shafer:
Your request for a waiver(s) of the required 100 foot horizontal
separation of a septic system to the surface water has been
approved. The approved separation distance(s) are a private
holding tank to surface water of 60 feet.
This waiver approval applies to the existing septic system to
surface water separation only. Any future upgrade to the septic
system will require all separation distances be met or another
approval from this department. Should the operation of the
subject wastewater disposal system cause any contamination or
degradation of the subject surface water, this waiver will
become void.
Sinc~erel'_
~ogram
On-site
anager
ervices
JS/ljm#5
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR~ WR940006 PID~ 018-271-43 HA~ Permit
Date Received: February 7, 1994
Legal Description: Lot 12 Block N Timberlux ~2
Engineer: Robert Shafer, P.E.~ S & S Enqineerinq
17034 Eagle River Loop Road Suite 204, Eaqle River 99577
Applicant: Brent Stonebraker
Waiver Requested: Holdinq tank to surface water of 60 feet
Criteria: 1. Geology: Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3. Other:
Waiver is Granted: ~, Waiver is NOT Granted:
List Conditions or Reasons for above:
Date: 3//o~9d~ By:
Name of Reviewer
Rec ~: 25645 Amount: $ 625.00 Date Paid: 2-7-94
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
February 3, 1994
CIVIL ENGINEERS
(907) 694~2979
FAX 694-1211
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOlt~ TEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
Municipafity of Anchorage
DEPARTMENT OF HEAL TH AND HUMAN SERVICES
825 L Street
Anchorage, Alaska 99519-6650
REFERENCE: Timberlux Subdivision #2, Block H, Lot 12
We request you issue a permit to install a holding tank to serve the three
bedroom house on the referenced property and issue a waiver for the
required separation distance to 60 feet from the proposed holding tank to
the surface water.
An adequacy test was performed on the existing system for Health Authority
Approval purposes. During the process of performing an adequacy test we
observed the system to be completely saturated and effluent started daylighting
during the adequacy test.
Due to surface water and an on-site well there is virtually no room on the
property for a conventional on-site wastewater disposal system. Attached is the
proposed upgrade design.
The above stated waiver should be granted for the following reasons:
The area in which the holding tank will be installed will be
constructed such that if any effluent should overflow, the
contaminates would not reach the surface water.
A berm is to be constructed to be used as a mitigating measure to
prevent contaminates from over flow from reaching the surface
water.
We do not anticipate any adverse effects on neighboring properties by the
rnstallation of the proposed holding tank.
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577
If you have any questions, or require additional information for your review,
please contact us.
Sinc~
,rt A, Sharer, P.E.
RA S/L S U/Is u
NVqd 311S ,OS = ,,~
ON--SIT~- WA~I'~'£~ DISPOSAL SYS~f~4
CONSTRUCTION PRACTICES
a~d
MAT~IAL SPECIFICATIONS
P.~'~(f~]CE: Timberlux Subdivision ~2; Lot 12; Block H
The scope of this project includes the installation of a 2000 gallon
Holding Tank to serve the three bedroom dwelling located on the
referenced property. The existing septic tank is to be excavated,
pumped, crushed and abandoned in place. The existing trench is to be
abandoned in place.
e
Construction shall be in accordance with the approved site plan and
design drawings, Municipal permit with any special provisions or
conditions, and all applicable State and Municipal Wastewater Disposal
Regulations.
3. The contractor shall be responsible for obtaining any necessary
underground utiiity locates.
Unless specifically agreed otherwise, the property owner shall be
responsible for final grading areas subsequently depressed from soil
settling.
Contractors installing wastewater disposal systems must be certified by
the Municipal Health Department for system installations. Owners
installing their own systems must also receive prior approval from the
Municipal Health Department.
HOLDING
1.
2o
TANK INSTALLATION:
A holding tank is to be constructed by a certified wastewater holding
tank manufacturer. Construction shall include a 6" cleanout for pumping
access and watertight manholes.
The holding tank shall be sufficiently bedded to prevent settling or
shifting of the tank.
Ail standpipes on the holding tank shall extend a minimum of 12 inches
above final grade.
Holding tanks installed with less than 4' of cover shall be insulated.
Page Two
Timberlux Subdivision #2; Lot 12; Block H
February 1, 1994
o
The holding tank shall be equipped with a high water alarm which
registers both visually and audibly inside the dwelling. The alarm
shall be positioned to allow at least 450 gallons of storage after the
alarm has been activated.
Final grading over the holding tank shall be such that a positive slope
exists away from the holding tank.
MA'£~;KL~L SPECIFICATIONS:
Any holding tank proposed for installation must be constructed by a
Municipally approved holding tank manufacturer.
The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Type of Pipe Perforated
Solid
Cast Iron Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM F810 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
Use of a type of pipe other than listed above must be approved by the
inspecting engineer.
Insulation shall be at least 2" thick extruded direct burial polystyrene
(Dow Chemical Company Styrofoam HI or equal).
Holding tank inlet shall be fitted with watertight couplings (Caulder,
Fernco, or equal).
Page Three
Timberlux Subdivision #2; Lot 12; Block H
February 1, 1994
Typically there will be a minimum of two (2)
installation of the wastewater disposal system.
follows:
inspections required during the
These inspections will occur as
1. The first inspection must be conducted after the tank has been set~
lines, cleanouts, standpipes, and insulation are in place and prior to
backfilling.
2. The final inspection is to occur upon final grading of the property.
Often there will be more than these 2 inspections required, especially with the
installation of multiple trenches, sand filters, pressurized distribution
systems, etc. Thus, the inspecting engineer is to be contacted at least 24
hours prior to the start of construction. If necessary, a pre-construction
meeting will take place on-site. The inspecting engineer will not coordinate,
direct or control in any way the contractor's activities.
The owner shall contract with the contractor to perform the work outlined in
these specifications and plans and in accordance with the attached M.O.A.
permit. There will be no contractual arrangement existing between the
contractor and S & S Engineering. S & S Engineering shall be the owner's
representative and will inspect the work as stated above to document the
contractor's activities. Final acceptance of the contractor's work rests with
the owner and the M.O.A.
S & S Engineering shall have no liability to the owner or to others for acts or
omissions of the contractor or any other persons performing work on this project
or the failure of the contractor to carry out the work in accordance with these
construction documents. S & S Engineering's inspecting engineer will not be
responsible for the construction means, methods, techniques, sequence,
procedures or the safety precautions incident to this project.
CONTRACTOR/INSTALLER
k.r.~~ MUNICIPALITY OF ANCHORAGE
· DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME PHONE [~NEW
MARLING ADDRESS
LEGAL OESCmPT~ON
LOCATION NO. OF BEDROOMS
Absorption area Dwelling ,/ PERMIT NO.
Liq. capacity in gallons inside length Width Liquid depth
/ ~l I F HOME.DE:
~ ~ DISTANCE TO: Well Dwelling ./ PERMIT NO.~
,O ~ ( Manufacturer Material Liquid capacity in gallons
Well Foundation Nearest Jot line PERMIT
~ iJ DISTANCE TO: /0~~ ~ /O ~
}~i; No. of lines ~ Length of each~ &) line/ Total length of lines~ ~ ~ Trenc~dth inches Distance between lines ~
~ ; Top of tile to finish grade Material beneath tile z -
Length Width Depth PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot llne
~ DISTANCE TO:
~uildin9 foundation Sewer line ~/~ Septic tank Absorption area(s)
~ DISTANCE TO: NffT - I~ ~ /0~ ~
OTHER
REMARKS I ~ ~
72-013 (Rev. 3/78]
AS- BUILT
1984 Construction
NOTES
I, 3:1 Slope on Mound
2. Septietonk tobepumped a m~mmum of I time
a year for general maintenoce
Cleonout
Il Il ~Cleanout
il
~J-F Wash Rock
/ 3/4% 2-1/2"
II II (~' Deep)
71' 35' II II 4" Per[ Pipe
II
II II
II II
II II
II
-- ~% _-~-11 14
18'
~8' II CLEANOUT
II
II
II
i[~- To ki[t-Holdin~ Tonk System
Mound to be seeded · I i ·
z~. Lit t - Holding Tank System ( Sleet ) ~,, 2 Rigid_ Insulation / P
Top So I(Turf or other eroston rotechon
and effluenfpump shQII be Myers f3----~ ~ "% /~Cleonout
or equlvelont. P.~.q~- ~_.~..____~
/~////~////Nahve Ma I//z///~z/~/~~ Nahve Insulated
/ ~~ ~ ~ -- -~' ~ ~ Material I'
PIQstic Layer ~~ ~,~¢k/ Peri Pipe/ tF4'Med. Send '~
//
G~nd
El~ati~
Existing Seepage 3'~I ~TO ~
Flow
Tank Sys~m
July 25, 1984
MUNICIPALITY OF ANCHOI%AGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTIOJ~
Municipality of Anchorage
Department of Health
825 "L" Street
Anchorage, AK 99501
9Ul 2 7
RECEIVED
Attn: Keith Bandt
Re: Timberlux Lot 12, Block H Mound System
Dear Mr. Bandt,
The following are the sizingcalculations for the proposed
mound system:
Design Flow
150 gpd/bdr (3) = 450 gpd
Size Absorption Bed
Wash rock bed area = 450 gpd
1.2 gpd/ft2
10' Wide 38' Long
= 375 ft2
Basal Area Required
Ab = 450 gpd = 900 ft2 .5 gpd/ft2 *
· .5 gpd/ft2 = EPA design loading recommended for perc
rates up to 60 min/inch.
Ab = I + W = 900
L
I = 900-W
L
900 - 10 = 14'
38
Check 3:1 Slope
(4 + 1 + 1) x 3 = 18
Use 18'
Mound Length = 74'
Mound Width = 46'
ENGINEERING, PLANNING, SURVEYING
2220 E. 88th Ave./Anchorage, Alaska 99507/Telephone 907-349-6451/344-1352
"Providing a quality personalized service to those building Alaska's future"
Mr. Keith Bandt
July 25, 1984
Page Two
The ~und will be dosed by an effluent pump from a STEP system
(septic tank effluent pumping) system. The lot must be graded
so that all surface water drains away from the structure and
away from the mound.
If you have any questions, please do not hesitate to contact
Sincerely,
Dale R. Merrell, P.E.
~ e~~
~ngineer
RPW/lbs
Attached: Plan/Profile of Mound
Soils/Perc Report
PERMIT NO:
DATE ISGUED:
MU~'~ t C ][ f:-'~tL 1' T'¥' OF' ¢~,~(.-d4OF,.'.~] (~E
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
G25 _ STREET, ANCHORAGE, AK 99501
264-4720
840374 ENGINEERED DESIGN3~
05/23/84
APPLICANT:
ADDRESS:
CONTACT PHONE:
BRENT STONEBRAKER
3909 REGURRECTION DRIVE
ANCHORAGE, AK 99502
276-4282
LEGAL DESCRIP: SUBDIVISION: TIMBERLUX _OT: 12 BLOCK: H
SECTION: 34 TOWNSHIP: 12N RANGE: 3W
LOT SIZE: 31970 (SQ.FT. OR ACRES)
LOT LOCATION: HILLANDALE OFF LONGBOW DRIVE
I certiry that:
1. I am £amiliar
2.
with the requirements £or on-site sewer's and wells as
¢orth by the Municiaality of Anchorage (MOA) and the State o£ Alaska.
I will instal] the system in accerdance with al) MOA codes and regulations,
and in compliance with the design criteria o£ this permit..
I wii1 adhere to all MOA and State o£ Alaska requirements £or the se{ back
distances from any existing well, wastewater disposal system or pubIic
sewerage system on this or any adjacent or nearby lot.
IF a
]'HEN
WILL
ELECTRICAL
SIGNED
APPLICANT:
LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES~
(1) AN ELECTRI(~,AL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-BUILTS
NOT BE APPROVED WITNOUT AN ELECTRICAL INSPECTION REPORT; AND (3) 'THE
WORK MUST BE DONE BY A LICENSED ELECTRICIAN.
BRE..y ~TONE~RARER
ISSUED BY DATE:
PERFORMED
LEGAL DESCRIPTION:
1
4
5
6
7
8
9-
12
13
14
15
16
17
18
19
20-
COMMENTS
MUNICiPALi i Y OF ANCHIJRAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
82B L, $~treet, Anchorage, Alaska 99501 264-4720
SOILS I~OG - PERCOLATION TEST
SLOPE
L~ PERCOLATION
TEST
DATE PERFORMED:
SITE PLAN
WAS GROUND WATER S
ENCOUNTERED? ~/z~'~ (,~c~[~ L
E
IF YES, AT WHAT
DEPTH? ~,~ /
Gross Nat Depth to
Reading Date Time Time~['~/'~1" Water ~) DropNet
PERCOLATION RATE ~-~O (minutes/inch)
TEST RUN BETWEEN ~ O , FT AND -~.*0 ET
72-008 {6/79)
CERTIFIED BY:
DATE:
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SOILS LOG'
JPERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3-
4-
5
6
7
8
9.
10
11
12
13
14
15-
16-
17-
18-
19-
20-
SLOPE
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
SITE PLAN
Cross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE :~"-//~ ,~1/~:-/-~ (minutes/inch)
72-008
PERMIT NO.
DEF'FIRTMENT I.,_~'~IERLTH RN['., Ef.',,,'I~':NMEMTRL -~,x~I'ECTION ...~,6 (~u2
825 "L" STREET, RNCHORRGE., FIK. ~5(~t
264-4720
8%8722 )
~E,E, LI_'~].'Bf.~T RLFRE[:, R. h:ETZLEF.
.OCP / 1L r.~
LEGRL L12 BL. H TIMBERLUX
T'¢PE OF SOIL. RBSORPTION S'¢STEhl IS:
','-" ~- ST q¢1]0\ 4,~2-.::2P;1
· 1_4.3:t LB ER~..E FE,~,: - . -
LOT 'SIZE ]:BC~E~D L:;QURRE FEET
TRENCH
MBXIMUM NUMBER OF BEDROOMS
SOIL RRTING (SQ FT,.-'BR)= 3¢.5
TNE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS:
[:, E: F' 1- ~-~ == :--.4 [_ E f'4 ~3 T' ~-~ := zl_ :~ .:~ t] F:: R %,' E L [:" E F' -r ,"'4 :: 5
THE LENGTFI DIMENSION IS 'TltE LENGTH (IN FEET:..' OF THE TRENCH OR DRRINF'IEI_.D.
THE DEPTH OF' FI TRENCH OR PIT IS THE DtSTRNCE BETWEEN THE SURFFICE OF TFIE
GROUND RND THE BOTTOM OF THE EXCR',,,'Ft]'ION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
]'HE GRR',?EI. DEPTH IS THE MINIMUM DEPTH OF GRFI',,,'EL BETHEEN THE OU]'FFE. L PIPE
FIND ]'HE BOTTOM OF THE E;<CFI',,,'RTION (IN FEET).
PERMIT RPPLICRNT HFIS THE RESPONSIBIL. IT'?' 'TO INFORM THI$ DEPRRTMENT DURING THE
INSTFILLFI'FION INSPECTIONS OF RN'T' WELLS, FtDJRCENT TO THIS PROPERT'¢ FiND THE
NUMBER OF RESIDENCES THRT 'THE WELL WII.L SERVE.
BRCKFILLING OF RN~r' S'¢STEM WITHOUT FINRL INSPECTION RND RPPROVRL B'¢ THIS
DEPRRTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMLIM DISTFINCE BETWEEN FI WELL RN[:' FtNY ON-SITE '_--]EWFIGE D!SPOSFIL SYSTEM IS
1Es3 FEET FOR FI PR!',,,'FITE P.IELL OR 15F_'l TO 2E~EI FEET FROM R PUBL. tC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL
MINIMUM DISTFINCE FROM FI PRI',,,'FITE WELL TO R PRIVRTE SEWER LINE IS 25 FEET FIN[.',
TO R COMMUNIT'¢ SEWER LINE IS ?5 FEET.
WELL LOGS FIRE REQUIRED FIND MUST BE RETURNED TO THE DEPFIRTMENT WITHIN 3:C4
OF THE WELL COMF'LETION.
OTHER REL.-.!UIREMENTS MFI'¢ FIPPL'¢. SPECIFICRTIONS FIND CONSTRUCTION DIFIGRFIMS FIRE
RVFIILFIBLE TO INSURE PROPER INSTFILLFITION.
~=' EF:--:I'.! Z T E2::-::F> Z F:E~; [:,EC:E f'!E:E:[~: 3:1...
I CERTIF,¢ THRT
±: I BM FFIMILI~71R WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS FIS SE]-
FORTH B'¢ 'THE MUNICIPFtLIT'¢ OF FINCHORFIGE.
2: I WILL INSTFILL THE S"r'STEM IN RCCORDRNCE WITH :'HE CODES.
3.: I UN[:ER.S~RND ~:1~1" ~H~ ]N-SIT~:.S~z~EF~ 'SY'.~TE~z~ f,t~' ~:~QI=IF'.E ENLRRGEMENT IF THE
RES I[:,ENCE Zb REMuDELED TO,INCLUL:,E MuRE THFIN 4. E,E[.,RuuM.:,.
....
825 "1 "SI flEE F
AF!C~[IORA(i[J, ALASKA 99501
(9(0/) 264 4 I Ii
January 4, 1982
Alfred R. Ketzler
1431 Laverne St.
Fairbanks, AK 99701
Permit ~ 810722
Subject: L12 BL. H Timberlux
A permit issued by this department for a well and/or sewer
system has expired as of December 31, 1981.
Permits are issued on a calendar year basis, as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log should be sent to
this department to document the installation date.
If an engineer inspected the installation of the on-site
sewer system, please have them send us the as-builts for our
files.
If there are any further questions, please call .this office
at 264-4720.
Sincerely,
Sewer and Water Program
Enclosure: Copy of Permit
~3~5uF ~AL7~, AN,,)
- L ~T~SET' ~&CNCR.~..' ~. Ak'TAL ~R3T~CT~oN
O~-~TE SE~ER ~ ~ELL
APPLiCaNT:
~909 fiESU~ECTIo~J OR[V~
CONTACT PNO~¢'. 276-q282
LEGAL /Esc~Ip: ~,.
~U~D/~S~ON: TI~dERLux
LOT S~ZE~ SECTION: 34
~0
LZSTED ~ ' q~VE
SE~T~C
T~= '~
-~RAVEL OEF~TH (~r.)
q.O ~-o - - - -
TOTA~ pEpT~ (FT.) - 5..O
GRAVE~ NZ~Tp (FT.)
GRAVEL LE.~ 9.0 ~-o 0.5
GRAVEL A~I~ .(FTc) 2.~ 4.5 3.5
VOLuA, E (CU.yDS.) 730.0 ~/o~
TANK SIZE (GALS) 66.2
SO~L RATz~G (SQ.FT./~)
~* GRAVEL ..- 431 ~/3/ 1'000.0 ** ~03.7
- - - . _ ' '~ LEAST
1. ~ nAT.
-'~NCES FRn~ ~ ~LL HCA A~:~ ~s CRZT~RT~ n..~L ,~OA ron~ ~r ~LASKA.
' :XZSTlh,. .Z''~/c OF ~t~,. ~S PE~,~-- ~u REGUL~
'-~,~r r .- n~l THr c
, ~ ~:RENT STo~EgRAKE,q ' - ................
74'
IS' Il ~"'"'~ ~Cleonout
II
s' I,I 4' IIL 3'~ Wash Rack
II It (l' Deep)
II II
II II
II II
~1 II
,e' II CLEANOUT
II
II
A~'- IJ __To Step System
NOTES ir~
I. ~ :1 Slope on Mound !
2. Sept~tanktobepumped a minimum of I fime
a year for general maJntenoce
CJeanout
3 Mound to be seeded .....
· ~'- ~,, ...... Top Soil ( Turf or other erosion protechon
4. Holding tank shall be polyethylene /_, ~ R~g~_~nsulahon
and effluent pump shall be Myers .~3~:~ ,-'-~,
or equiveJont. ~~,~ ~ ~,, ~ ~~ Native Insulated
/ ,
Plastic Layer ~~Perf. Pipe/ l~4 Mad. Sand
- S CT O, ,
' Existing Seepage ~J NTS
Step S~lem
MUNICIPALITY OF ANCHORAGE
MEMORANDUM
DATE: March 27, 1991
TO: File for Timberlux #2
FROM: Daniel J. Roth, Civil
SUBJECT: Final Approval Of
21, 1984
Lot 12 Block H
Engineer, On-Site Servic~
The Mound System Constructed August
On March 24, 1991 Brent Stonebraker approached me to obtain a
certified approved copy of the as-built in our files for his lot
mentioned above. Upon review of the as-built, it was realized
that this office disapproved his as-built on November 26, 1985.
The reasons for disapproval were; 1) No specs for lift station
and; 2) date of inspection.
The engineers design plan called for a S.T.E.P. lift station.
1984 the S.T.E.P. was still not an approved lift station. The
final lift station shown on the as-built document describes a
1000 gallon holding tank with a pump in it. This tank was
located immediately after a 1000 gallon septic tank.
I told Mr. Stonebraker that if he brought me indisputable
evidence that this 1000 gallon holding was indeed installed as
the lift station and the date of inspection, I would give his
as-built document an approval.
Attached is photographs of the septic tank and lift station at
the time of construction before being backfilled and notes
proving the exact date of inspection.
RECEIVED
Municipality, of Anchorage
Dept: Health &'H. um~n Services
STATE OF' ALASKA
DEPARTMENT OF NATURAL
Division of Geologicol e Geopl~icol Surveys
Drilling Permit No.
LOCATION OF WELL (Ple~31e complete either la, lb or lc.) A.D.L. NO.
~'JJO~S~AUCE A"00IRECTIOU FROM ROAD INTER~ECTIONS 5. OWNER OF WELL: :-;ten[ S~o,ebrt~er'~ /
HtlJendaia Pr, ad 1 blec:: .... ~ of Lon,~bow
Grey Clay '"'2" ~3 ' ~ ~,,, w~. ~
lO: STATIC WATER LEVEL:
I%LkL V E~ I~. PUMp: (if avoHeble) HP
Dept. Health &Hqi~an Se'wces D~a-x ,:o,m~ ' :o 7~ ........
LEGEND
0 LOT CORNERS
FOUNDATION
[.t'~ ,~,."~,.*'%_*'%~.*~'~.., -- DRAINAGE ARROWS ~'' -'
I ·
SURVEYOR'S CERTIFICATION
I HEREB'~ CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DESCRIBED ON THIS PLAT ANO THE
IMPROVEMENTS SITUATED THEREON ARE LOCATED
AS SHOWN ON THIS PLAT.
IT RHALL RE THE RESPONSIRILITY OF THE BUILDER OR OWN{:R TO VERIFY THAT
BUILDING LOCATION SHOWN MEET8 ALL SUBDIVISION COVENANTS ANO ZONING
· ~.'~/~ ;
BESSE, EPPS 8~ POTTS
2220 E,'BSth. AVE.
~49-6452 ANCHORAGE, ALASKA 99507'
349:645,~
;lao-cY ',. : : . ' ne
iViailing address,' ':;~''; /'; ' '' -: ' ' "'- ':
- . D:,ay:::: phone
Agent
,,::-'~:,,-, !?,,., .-i:,--~?.,
Address.
IMBER OF 4
,.TYPE;OF:WATER SUPPLY:')
Indivi'd'~i~l
C'~mr~r~it~ Well
Public r
r' '.':N'oTE: If'communi'~y
in§
Unless otherwise requested, HAA will be held for pick,up. .' ;~ .
5. STATEMENT OF INSP~TION:BYENGINEER'-~
AS certified by my seal ~ff'i~e~ i~r~o ~r~d ~S Of the validation date'shown below, I verify that my
investigation of this Health'Author application shows that the on-site water supply
and/or
pality
.'suppl~, and/or
ordinances, and r,
Name
Xxxx Appr0~/ed fo'¢
Disapproved~
AdditiSnal Co~'~86~S;' 'If~there;~are.',an!~ questzons!i please, call us at .-
By:
Date May 2; 1994 ~' ' ' ¢ r
The MUnicipality of Anchorage Department of HeaRh and HUman sen/ices (DHHS)~issues Health Authority
Approval Certificates based only Upon the rePresentat 0nsg ve'n n paragraph 5 ablY0 by an independent
pr0fesSiona eng neet registered' n the state of A aska The DHHS does this as a courtesy to PurchaSers of homes
and their lending institutions in order to sat sf,] certa n fedOra and state requ rement~.'EmployeeS of DHHS do n0t : ;i
~'~ 88nd~ct ns ecti0ns or' anh e data;bef°re::a oerfifiE~te :is ssbed · Th6;:Mun cipaiity Of,Anchorage
~; responmb e for errors or omlss~onsmthe professional eng~neer's,w0(k,~ :,:. :: ,; . ~ ;
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Divisic n of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SI NGLE FAMILY DWELLING
Parcel I.D. # /""1\ ~- --'~''~ \ - L'\ ~O} NAA#
GENERAL INFORMATION
Corn plete'legal description
Lot :12-; :Blbck' "H"i Ti~berlu~ ~2
Location (site address or directions)
4901 HZllandale Street
Property owner Bre~ Stonebraker Day phone 345-6569
Mailing address P.O. Box 110412 Anchorage, AK 99511
Lending agency
Mailing address.
Day phone
Agent Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOE~S: 3 '4
TYPE OF WATER SUPPLY:
Individual well XXX
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
IndiVidual on-site
Holding tank
Community on-site
Public sewer
XXX
NOTE:
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
5, STATEfVIENT OF INSPE~.rlON BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that-my
investigation of this Health Authority Approval application shows that the on-site water ~'OcJply-
and/or wastewater disposal system is safe, functional and adequate for the number of,~)Sdroor~s
aha Type of structure indicated herein. I further verify that based on the information obtained.f~'o'm
the Municipality of Anchorage files and from my inves_ti_gation and inspection, the on-site ,water
suppty and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm
Address
Engineers signa~fi're
DHHS SIGNATURE
Approved for ~
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
Date~ -2~ -~'~
The M~n¢cipality of Ar{chorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificate~ based only upon tl~e representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lendin9 institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:-7~F7 ~-TZ/--'-/--J ~' ¢:~ !
A. Well Data
Well type ~'~,~ ( V~7:'~r If A, B, or C. attach ADEC letter. ADEC water system number
Date completed / '~Oc'"J~ Driller ~
Cased to
Log present,N)/
Total depth
Sanitary seal~)N)
FROM WELL LOG
Date of test /~' ~
Static water level ~ ~
Pump level1 r~--- r
SEPARATION DISTANCES FROM WELL TO:
~/holding tank on lot ~-~ /
Absorption field on lot
Public sewer main
Sewer service line
///_ ~/ Casi~ng height
Wires properly protecte (~N) '"'-/
AT INSPECTION
Public sewer manhole/cleanout /,-J ~J ~-J/~
Petroleum tank /"-J/~
; On adjacent lots
; On adjacent lots
WATER SAMPLE RESULTS:
Coliform ~
Date of sample: '~/~'//~/'~J-
Nitrate
, /,/~ "t-~,/Z--- Other bacteria ~
Collected by: -~ '~/ -~' ~'/'--)~/~-~ ·
B. ~:~;T4~,IHOLDING TANK DATA
Date installed '~/?~J~/~'~ Tanksize ~~ Compartments
Cleanout~-~N) ~ Foundation cleano~t/~Y~N) ~'~ ..,Depressi°n (Y~
High wate r alt-~a rrna' ,~ ~ Alarm~teste (~N)%
Date of pumping /,_.j(/ . ~ Pumper' /-.-/~'-C~
SEPARATION DISTANCES FROM ~/HOLDING TANK TO:
Well(s) onlot . ~o~'/ Onadjacentlots '~'/'~'
To property line / ~ / -/-- Absorption field
Surface water/drainage ~ / ~ ~ /
72-o26 (3/93)* Front
Foundation ?~"~' /
Water main/service line
CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
Meets MOA electrical codes (Y/~)
Manufacturer
Manhole./Ac~
"Pump on" I~....~~ "Pump off" Level at
Cycles tested
Surface water
D. ABSORPTION FIELD DATA
Date installed
Length Width
Total absorption area
Date of adequacy test
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y/N)
Cleanout present (Y/N) ,./"'~'
Results ~1)~
SEPARATION DISTANCE FROM ABS.~TION FIELD TO:
Well on lot ,.-/ On adjacent lots Property line
To building foundation J To existing or abandoned system on lot
On adjacent lots J Cutbank Water main/service line
Surface water J Driveway, parking/vehicle storage area
Curtain drai~
Soil rating (GPD/Ft2) ~ype
Gravel thickness /"'"' Total depth
Depression over field (Y/N)
for
After test
If yes, give date
Bedrooms
E. ENGINEER'S CERTIFICATION
Signature ~S.&~ ~S ._E-N G ! N..~ .E R N_/6~'~~~ ; :~ ":' :~--'¢' ' ,
Engineer's Name Ba,le I~iver, Alas~Z/ // '.~ ~ ~'~¢: .. ;.
Date ?~' ¢~ / ~ / ' ' "" ' ' ~ "
HAA Fee $
Date of Payment
Receipt Number
Waiver Fee $
Date of Payment
Receipt Number
72-026 (3/93)* Back
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
1. GENERALINFORMATION
Complete legal description ~- / ,~ ~ c-~ z. u x
Location (site address or directions)
Property owner
Mailin~ address
Lending agency
Mailing address
Dayphone ~7¢ ;~'-/~"-/
Day phone
Agent
Address
Unless otherwise requested, HAA will be held for
2ickup.
2. NUMBER OF BEDROOMS: 3 ~
3. TYPE OF WATER SUPPLY: ,~
Individual well v/ .c,: ...
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
. ..: Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72q)25(Rev. 1/91) Front MOA#21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm ¢~,t/~e~.,,~ Phone ~-~.4 z-¢ 2/
Address
Engineer's signature
DHHS SIGNATURE
Approved for , ~
.Disapproved.
Conditional approval for
bedrooms.
Date
bedrooms, with the following stipulations:
Additional Comments
By:
Date
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: /.CT I£
A. WELL DATA
Well type /~vb. ~,~-z. ~- If A, B, or C, attach ADEC letter.
Log present (Y/N) Y' ~":' ? .~¢.-.~'-:~ ~" .r Date completed
Total depth //! FY' Cased to
Sanitary seal (Y/N) Y'
FROM WELL LOG
Date of test /~/
Stat c water level
Well flow 7c~.jo. ~4 g.p.m.
pump level
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot /
Public sewer main ~'/'~
Public sewer service line
WATER SAMPLE RESULTS:
Coliform 0 Nitrate 0./ U
Date of sample: ,47~,~- ~.~ /~f,~/
B. SEPTIC/HOLDING TANK DATA
LUX Parcel I.D.
ADEC water system number
/ ~' ~ ~( ~//~{~t/Driller
///~' Casing height
Wires properly protected (Y/N)
AT INSPECTION
3,7,5' g.p.m.
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
Collected by:
Other bacteria .¢o ,~ ~ P,~e.~ 7-
Date installed / '~ ¢'~' ' Tank size /~ 0¢0 Compartments
Cleanouts (Y/N) Y' Foundation cleanout (Y/N) Y' Depression (Y/N)
High water alarm (Y/N) ¥' Alarm tested (Y/N)
Date of pumping ~,~,te~ 30, /?'~/
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
/ ?0 w~- Foundation
Water main/service line
Well(s) on lot l° ~ F~-
To property line 60 ~7
Surface water/drainage
On adjacent lots I~oFr
Absorption field z/Q
72-0~6 (Rev. 3/9~) Front MOA 21 CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N) ~/
High water alarm level
"Pump on" level at
Manufacturer
Manhole/Access (Y/N)
"Pump off" level at
Cycles tested .2.
Well on lot /oo
D. ABSORPTION FIELD DATA
Date installed /¢~'¢
Length 3~ ~ Width
Total absorption area D/¢
Depression over field (Y/N) /~/
Results (pass/fail)
Peroxide treatment (past 12 months) (Y/N)
Meets MOA electrical codes (Y/N) '¥'
SEPARATION DISTANCE FROM LIFT STATION TO:
On adjacent lots
~? FT
/ .s-¢ ~ r., / ~"~?rSurface water ,d,,/~,
Soil rating , ~2 ,
Gravel thickness ~ ~ _
Cleanouts present (Y/N)
Date of adequacy test
for
If yes, give date
System type
Total depth
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Wellonlot 10~' r=:r On adjacent lots IlOr~') I~£T Propertyline_
To building foundation
On adjacent lots
Surface water
Curtain drain
Cutbank
To existing or abandoned system on lot
Water main/service line
bedrooms
Driveway, parking/vehicle storage area
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on
Signature
Engineer's Name
Date /~PRic 2.. / RR /
HAA Fee $ l ~--~O ~-~'
Date of Payment
72-026 (Rev. 3/91) Back MOA 21
Waiver Fee: $
Date of Payment
Receipt Number
DEPT. OF ENVIRONMENTAL CONSERVATION
ANCHORAGE DISTRICT OFFICE
3601 C STREET, SUITE 322
ANCHORAGE, ALASKA 99503
WALTER J. HICKEL, GOVERNOR
/
I
563.6
- 775
SOO!A~eS ueuJnH "~ q:ll~reT-I-':l~ed
eD~Joqouv .lo
April 4, 1991
t56L 0 L
Mr. Brent Stonebraker G ] A I ] 3 3
P.O. Box 110412
Anchorage, Alaska 99511
Subject: Lot 12, Block H, Timberlux #2 Subdivision, ADEC Project Numbers 9121-
WW-058 and 9121-DW-045; Bed and Breakfast Approval Review
Dear Mr. Stonebraker:
This is in response to your April 4, 1991 submittal, completed by Mr. Jose Vicente, P.E.,
by which you requested Departmental approval for the on-site water and wastewater
disposal systems located on the above-referenced lot due to the proposed change from
a single family residence to a Bed and Breakfast facility. I have completed my review of
the submitted information and have the following comments.
WASTEWATER DISPOSAL SYSTEM
Based on the submitted information it appears that the wastewater disposal system was
installed substantially in accordance with State regulations and guidelines at the time. The
results the recent adequacy test, also verifies that on the day the adequacy test was
performed the wastewater disposal system was accepting the necessary flows. In
addition, there will not be an increase in the volume of wastewater being treated by the
existing wastewater disposal system due to the change from a single family residence to
a bed and breakfast.
Therefore, the wastewater disposal system is approved for the concerns of this
Department. The enclosed signed Approval of On-Site Residential Water and Sewer
Systems, constituting this approval, is enclosed for the existing wastewater disposal
system.
DRINKING WATER SUPPLY SYSTEM
For the information that has been submitted it appears that the water system was installed
substantially in accordance with State regulations and guidelines at the time. Including
the fact that there will not be an increase in the peak flow demand placed on the existing
water system resulting from the change (going from serving a single family residence to
a three bedroom bed and breakfast) and the analytical results for Total Coliform Bacteria
and Nitrate (as nitrogen) returned satisfactory, the water system is approved for the
concerns of this Department. The previously mentioned certificate also constitutes the
approval of the water system.
At this time, the Department is assigning Public Water System Identification (PWSID)
Numbers to all Public Water Systems or Water Systems serving water to the public
(clients) in the State. As a result, the PWSlD Number assigned to this system is 216986.
Since you will be operating bed and breakfast, it is recommended that you have water
samples analyzed for Total Coliform Bacteria and Nitrate (as nitrogen) once a year, just
before the summer season. If you do sample, please place the PWSID Number on the
lab request form so that results will be properly filed.
Thank you for your cooperation with this Department. If you have any questions, please
do not hesitate to call.
Keven K. Kleweno
Environmental Engineer
Enclosure: As Stated
cc: John Smith, DHHS, w/o Enc.
KKK/skpf
