HomeMy WebLinkAboutELMORE #2 BLK 12 LT 5Elmore #2
Block 12
Lot 5
#018-173-34
' Municipality of Anchorage
• Development Services Department
BuNdIng Safety DINNon
On-Sits Water & Wastewater Program, 4700 South Bragaw St
P.O. Box 198650 kwhorage, AK 99519.8660
www.d.arx*xnge.ak.us (907) 349'7904 Page 1 of 3
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number. SWO10178 PID Number. 018-173-34
Name:
JERRY HANSEN
Wastewater System: ■ New 0 Upgrade
Address:
16645 RANSOM RIDGE RD. a ANCHORAGE, AK 99516
ABSORPTION FIELD
Phone: No. of Bsdroomr.
(907) 344-7780 4
O Deep Trench ■ Shallow Trench O Bed O Mound O other
LEGAL DESCRIPTION
1.0
TOW°'°�' 6
WO,,,.
f (MAXIMUM) Ft
Lot: Block. SubWelon:
5 12 ELMORE #2
DepM to K- bW— ham or%W waft
4 (MAXIMUM)
Grovel depth b—o, p1m
0.5
R FL
Township: Range: Section:
FN awed above w*W waft
purl Nep11e
_ _ —
0 — 0.5
120+ (2 O 60'+) pt
WELL: ■ New D Upgrade
aewDe
crwlJ&WWbabe—
5
Number d fret
wase
pt
2
15+
QaeeNbdkn NNe e. A,e.0 :
TOW Dyth
I Cooed To:
TOW ' IN, ares
P" m0 11*
PRIVATE
121 R
121
600+ �, re
D 3034/ F-810
Drswr:
Dae ori
!lees Mager Lark
buLeren
Dole roLeI '
ALPINE DRILLING
6 27/01
58 m
ACHESON ENTERPRISES
8/1-6/2001
rl.ld
9
fano see ft
UNKNOWN
OeeYp NNghc Ab- oraal*
2
TANK
oPN
m
SEPARATION DISTANCES
■ Septic O Holding o S.T.E.P. O Other
From To
Tata
Fie n
Station
Holding
serer Lk.
NCHORAGE TANK
capeft in
1250
Well
100'+
100'+
—
—
25'+
wetrb* STEEL
wo 601 of am Web w 2
Surface Water
100'+
100'+
-
-
-
LIFT STATION
Lot Line
5'+
10'+
—
—
—
else ti wdbmt
Maodwaaa:
Foundation
5'+
10'+
—
—
_
on" wwl at at
NO .ear darn at
Curtain Drain
NONE KNOW
a.ealea ~v� ter`Remarks:
•2.0 TO 2.74 OF M.O.A APPROVED SAND FILTERBENCH
MARK
ff==
bnADDED
TO TOTAL DEPTH.
OFOUNDATION OF GARAGE AT SOUTHWEST
FINAL GRADING OVER SEPTIC SYSTEM TO BE PERFORMED
CORNER
PRIOR TO COMPLETION OF HOUSE.
Dwoum 100.00
eleea ws.
Inspectlons performed by: AWWC, INC. Dates: 1st 8/1/2001
. *... ... ... .....:.*
2nd-6th 8/2-6/2001
7th 8/8/2001
f
p eaa•�
Department of Health red H e I approval
• E-7953 e�
Q .�,•'•• ..•'
7n
Reviewed and approved by: Date: —��
��pe0le ** ....... "
°proteseto�d`�`'c
(ftv• 12/00)
PERMIT NUMBER: PARCELINUMBER. AS -BUILT DRAWING 018-173-
r FINAL GRADE - 99.52+
FILTER FABRIC
TOP OF SAND
FILTER - 93.01
(AVERAGO
BOTTOM WAS
EXCAVATED TO 9
TOP OF TANK A
INLET - 95.52
INVERT OF BUNG-//
AT INLET - 94.97
ST2
NEW 1250 GALLON
SEPTIC TANK
TOP OF TANK AT
OUTLET - 93.51
INVERT OF
BUNG AT
OUTLET - 94.73
FINAL GRADE FINAL GRADE
97.1+/-
97.3+/-
HIGHEST FILTER FABRIC ORIGINAL
GRADE GRADE 9 .4
�eRXpNAL
WERT OF PIPE -
94.15 (AVERAGE) I
TOP OF SAIN
WERT OF PIPE - FILTER - 93.
93.55 (AVERAGE) N
I
BOTTOM WAS OVER
EXCAVATED TO
90.90 - 91.32
10'
DATE:
8/24/2001 � • fORAWN
BY:
ALASKA WATER & WASTEWATER SCALE- J.L.M.
CONSULTANTS, INC.
0901 MUM ROAD. WTE a • ANCHORAGE. AK V9604 • rNONE (907M74179 • FAX T N.T.S.
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
JERRY HANSEN (907) 344-7780 3 OF 3
LEGAL DESCRIPTION:
ELMORE SUBDIVISION #2; LOT 5, BLOCK 12,
TYPE OF WORK:
PROFILE AS -BUILT OF NEW SEPTIC SYSTEM
PERMITNUMBER: AS—BUILT DRAWING PARCEL INUMBER:
SWO
SW010178018-173-34
EAST 147th AVENUE
I NEW
I
�I
b l I
N 1250 GALLON \
SEPTIC TANK
I 1 1 1 11
11
1 ;11
11 11 �
1
11 111
I 1 1
11 1 1
INSTALLED FLOW
SPUTTER (FS)-
100' SETBACK I
(FLAGGED BY LM
NEW
4 BEDROOM
HOUSE
\ UN CTK)N)
DBL1 ; ; N 1 A B
BL2 1 11 1
11 11
11 11
11 11
ALTERNATE SITE. WILL
REQUIRE BOTTOMLESS
IS.F. SYSTEM AND A
UFT STATION
ST1
41.6
8.8
ST2
49.5
13.9
DBL1
51.1
15.7
DBL2
51.6
16.8
FS
52.4
18.2
MT1
38.3
42.0
MT2
55.0
56.7
MT3
78.7
37.8
MT4
89.8
53.6
C01
39.1
42.3
CO2
55.5
56.1
CO3
79.0
38.2
C04
90.0
53.9
001
ALASKA WATER & WASTEWATER J.L.M.
CONSULTANTS, INC.
Dol DEBAW Roc m • ANCHOWE. Ax 09504 • FHONE (907)337-6179 • FAX 907 1 " = 40'
03ARED FOR: PHONE NUMBER: PAGE NUMBER:
JERRY HANSEN (907) 344-7780 2 OF 3
AL DESCRIPTION:
ELMORE SUBDIVISION #2; LOT 5, BLOCK 12,
'E OF WORK:
AS -BUILT OF NEW WELL LOCATION AND NEW SEPTIC SYSTEM
IF11YA S
Wvj 1.16-74 am
• eGameaa.
10 • C 7953
4f •^�°P�of��sio�d' ��4
FROM : Al P I NE DRILLING
FAX NO. : 907 345 0202 Aug. 28 2001 11:26AM P1
Municipality of Anchorage
Department of Health and Human Services
825 'L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6850
Rlck Mystrom httpJMww.d.an&aw*.ak.us
Mayor
Permit Number: #SW 0101 r3 Date of Issue: 6. UI Pared Identification Number. 010-1 &"4
Date Started: 6-27-01 Date Completed: Q._ 27-01 Is well looted at approved permit location? ® Ya No
Legal Description: Elmore # 2 Blk 12 Lt 5
Property O mer Name & Addrem: Gerald Hanson
Attea►don: The well drilla slull provide a well log to the property owner within 30 days of completion and the property
rn�m�r nr tho wrll rh411rrr 411-11 lln'4AU o andl 1,Wf^ NM T1Pnt n4'F4nw1th Ar Wivrnsn Qsrs o-" ivifh6s An Aron %f r -n v%1P*;^n
76645 Ransom Ridge
Anchorage, Ak 99516
ata:
ickness & Water Strata
Fstic-k-up
Depth (!t)
From To
Method of Drilling ® air rotary ❑ cable tool
Casing type: ,�f
0 2
Wall l bickness: JOL5 inches
gravelly sift
2 18
Diameter: ¢ inches Depth: M fret
water sand & gravel
18 21
Liver Type:
cemented gravelly sift
sandy gravelly silt
water sand & gravel silty
silty grave!
21 108
108 110
110 115
11 b 118
Diameter' bwjxs Depth: feet
Casing stickep above ground: 2 feet
Static water level (loom ground level): M feet
Pumping level: -a feet after
Z hours pun4ying I gpm
water sand & gravel
118 121
Recovery Rate: 9 gpm
Method of Testing:"
Well Intake Opening Type:
9 Open End ❑ Open Hole
❑ Screened Start feet Stopped feet
❑ Perforations Start feet Stopped feet
Grout Type: Bentonite # 8 Volume: LAg
Depth: Start.Q fed Stopped ± feet
Pump: Intake Depth feet
LM size Brand Name
Well DWnhcted Upon Completion? ® Yes ❑ No
Method of Disinfection: CWne- Tobidd
Comments:
Will Driller: Alpha Dn71b►g & Enterprises
P O Box 110496
Anchorage AK 99511
Attea►don: The well drilla slull provide a well log to the property owner within 30 days of completion and the property
rn�m�r nr tho wrll rh411rrr 411-11 lln'4AU o andl 1,Wf^ NM T1Pnt n4'F4nw1th Ar Wivrnsn Qsrs o-" ivifh6s An Aron %f r -n v%1P*;^n
)p
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program 3 UUe
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650 3 PAY, f�z :CSU
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM J WATER SUPPLY PERMIT
Initial
Permit Number: SWO10178
Legal Description: Elmore #2 Block 12 Lot 5
Design Engineer: 0041 AK Water & Wastewater Consultant
Owner Name: HANSON, GERALD
Owner Address: 16645 RANSOM RIDGE
ANCHORAGE , AK 99516 -
This permit is for the construction of:
Disposal Field I,/; Septic Tank
All construction must be in accordance with:
1. The attached approved design.
Date Issued: Jun 08, 2001
Expiration Date: Jun 08, 2002
Parcel ID: 018-173-34
Site Address: 4860 E 147th Ave
Lot Size: 86920 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
Holding Tank Privy ✓ Private Well Water Storage
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:
Date: (0 1.
Date: � —6-01
Municipality of Anchorage ••
Development Services Department
Building SW* Division
On -She WOW & Wasiewaiw Program ' " `,
4700 South Bragew St.
P.O. Box 196850 Anchorage, AK 99519-6650
www.d.anchorap.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 018-173-34 Permit Number Swat a1 78
Property owners) JERRY HANSON Day phone 245-4503
Mailing address (1) 16645 RANSOM RIDGE. ANCHORAGE. AK 99516
M address (2) 4860 EAST 1472x -,d VENNE Zip Code y95"16
Legal description (Lot, Block & Sub'd.) ELMORE SUBDIVISION #2. LOT 5. BLOCK 12
Legal description (Section, Township & Range) N/A
Lot size 86.9 2 0 .Ft
THIS APPUCATION IS FOR:
Number of Bedrooms 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 ❑
I 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.
ALASKA WATER do WASTEWATER CONSULTANTS, INC.
Permit Fees: !4x0.00
Date of Payment: 5 Za ! '16 l
Waiver Fees:
Date of Payment:
Receipt Number. 4998 Receipt Number.
ALASKA WATER F& WASTEWATER
,,. .„..........ti.„, ......_., .. .. CONSULTANTS, INC.
May 25, 2001
Municipality of Anchorage
Department of Development Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Well & Septic System for Lot 5, Block 12, Elmore Subdivision #2
To whom it may concern:
The proposed 4 bedroom house will be served by a private well and septic system. The septic
system will be designed around the 30 foot radius of test hole #1. We propose that a 1250 gallon
septic tank and a dual trench type drainfield with a sand filters be installed. Comments regarding
the design are summarized as follows:
1. SOILS: See the attached log which shows the soil classifications, groundwater monitoring,
and the percolation test results. It is our opinion that due to the overall appearance of the soils, an
application rate of 1.2 gallons/day/ft2 should be used; however, the sand filter application rate of
1.0 gallons/day/ft 2 will apply.
2. TRENCH DESIGN:
a. Percolation Rate: <1 minutes/inch
b. Allowable Application Rate: 1.0 gallons/day/ft2
c. Number of Bedrooms: 4
d. Design Flow: 600 gallons per day
e. Minimum Absorption Area: 600 ft2
f. Total Depth: 6 feet (max.), then place 2' of filter sand
g. Effective Depth: 5 feet
h. Width: 2.5 feet
i. Reduction Factor: N/A
j. Minimum Length: 120 feet total length (2 @ 60 feet long each)
k. Effective absorption area = 600 ft2
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed
upgrade.
6901 Debarr Road, Suite 2B * Anchorage, AK 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com
4. TOPOGRAPHY: As can be seen on the attached topography site plan, the average
topography of this property is a 5 to 10 percent running from approximately northeast to
southwest. In short, there are no slope concerns. The trenches are to be installed parallel to the
slope contours.
I am 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.
M.S.
NOTE: Attached is a site plan drawing, a design drawing, a topography site plan, a soils log,
and a 7 page 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
ELMORE S/D
LOT 4, BK 12,
TIMBERLUX S/D /3
LOT 4, BLOCK S.
A
I I
Ito
I�
I \ Ft --`
DRAINFIELDS
I - -I-
WELL IS NEAR THE NORTHEAST
CORNER OF THE HOUSE
� I I
/ I I
/ I ELMORE S/D
LOT 6A, SK 12, I
I I
FIELD VERIFY
WELL AND SEPTIC
I I
EDC
I
I
I
I
I
I
I
1-----------------
TIMBERLUX S/Dt3
LOT 3, BLOCK
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
6901 DEBAM ROAD. SUITE !B • ANCHORAGE. AK 99604 • PHONE (9071, 14179 • FAX (907)S3hSt4
iEPARED FOR PHONE NUMBER:
JERRY HANSON (907) 227-9477
:GAL DESCRIPTION:�2
ELMORE SUBDIVISION; LOT 5, BLOCK 12,
PE OF WORK:
SITE PLAN
TIMBERLUX S/D /3
LOT 2, BLOCK 6
11/3/2000
DRAWN BY:
B.S.G.
1 " - 100'
1 OF 1
T; u
I
I
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I
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ELMORE S/D j
LOT 66, BK 12,
� I
I
I
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►---- ----------
--
----------- 4-
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TIMBERLUX S/D /3 1
LOT 1, BLOCK 6 1
I
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E 7953
C — — —
ELMORE S/D
I
LOT 6. BK 10,
_—�—
/ I
ELMORE S/D j I
I \\
I \ �EprtC
ELMORE S/D
LOT 7, SK 10,
LOT 9, BK 10,E I
I \ r
/
1
!
RADIUS
I WELL ON NORTH
SEPTIC ON NORTH
.102 WELL
I
I I HALF OF LOT
HALF OF LOT
I NO CONCERN
NO CONCERN
\ I
I
ELMORE S/D
LOT 4, BK 12,
TIMBERLUX S/D /3
LOT 4, BLOCK S.
A
I I
Ito
I�
I \ Ft --`
DRAINFIELDS
I - -I-
WELL IS NEAR THE NORTHEAST
CORNER OF THE HOUSE
� I I
/ I I
/ I ELMORE S/D
LOT 6A, SK 12, I
I I
FIELD VERIFY
WELL AND SEPTIC
I I
EDC
I
I
I
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I
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I
1-----------------
TIMBERLUX S/Dt3
LOT 3, BLOCK
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
6901 DEBAM ROAD. SUITE !B • ANCHORAGE. AK 99604 • PHONE (9071, 14179 • FAX (907)S3hSt4
iEPARED FOR PHONE NUMBER:
JERRY HANSON (907) 227-9477
:GAL DESCRIPTION:�2
ELMORE SUBDIVISION; LOT 5, BLOCK 12,
PE OF WORK:
SITE PLAN
TIMBERLUX S/D /3
LOT 2, BLOCK 6
11/3/2000
DRAWN BY:
B.S.G.
1 " - 100'
1 OF 1
T; u
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ELMORE S/D j
LOT 66, BK 12,
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►---- ----------
--
----------- 4-
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TIMBERLUX S/D /3 1
LOT 1, BLOCK 6 1
I
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E 7953
I �
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ELMORE
LOT 6A. BK/ 2,
11 P DOUBLE C/O /
INSTALL IZAB L FLOW SP\ TTE
co \ \ 4 BEDROOM HOUSE
II"T
i �- I
F°° I
TH # 1 ' ' wi�a�iIREn
w
/H#2
PROPOSED 1250
GALLON SEPTIC TANK
PROPOSED DRAINFIELDS. EXCAVATE 100 S K
TWO TRENCHES THAT ARE 5' DEEP. FROM CREEK
BY 5' WIDE. BY 60' LONG EACH.
ADD 2' OF MOA APPROVED FILTER
AND DRAINROCK WITH A 6' EFFECTIVE
DEPTH.
CREEK —
5/17/01
DRAWN BY:
ALASKA WATER & WASTEWATERSCALA
RK B.S.G.
n� --- CONSULTANTS, INC. - 1 " - 50'
6901 DEBAROAD SUITE 20 • ANCHORAGE AK 99604 • PHONE 907 7 179 • FAX 90T
PREPARED FOR: PHONE NUMBER: PACE NUMBER:
JERRY HANSEN (907) 344 7780 1 OF 1
LEGAL DESCRIPTION:
LOT 5. BLOCK 12 ELMOREZ
TYPE OF WORK:
SITE PLAN
e r y A. Ga?ndes:
7953
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ELMORE
ll
•• a
NALF IF
NO C•NC7" ••
Lido
A FEIV
t
7 • • ' Y
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7��
J►
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oil■
' a� • • I •. • �� •�. ��' 11 L1 , 1, 'i
iurll•�Y - - -
�- 1 -
ALASKA WATER & WASTEWATER CONSULTANTS, IN F
8901 DEBARR ROAD SURE 28•ANCHORAGE, AK. 99304 O •• 4
PHONE (907) 337-8179 • FAX (907) 338-3248 ..�
SOIL LOG PERCOLATION TEST .y
LEGAL DESCRIPTION: ELMORE S/D #2; LOT 5, BLOCK 12, ' ""' ' ' ' "' """"
PERFORMED FOR: JERRY HANSON ... .........
f e Gamessi
DATE PERFORMED: 10/30/00 7953
QIwo. '
DEPT
ee ORGANICS TEST HOLE # 1 �r ,��''''••......'�,
_ �� 04
1 �4p� rofe•stoo°\
13
14
15
16
17
18
19
20 '
COMMENTS:
DATE
- II1111111
10/30/00
9.5
ML
9.7
2
9.3
11/21) 00
0
4
v.•o•
5
6
GW
7o-.
8
9.3 ON
5/24/01
0
10
r . c".
12
13
14
15
16
17
18
19
20 '
COMMENTS:
DEPTH TO
GROUNDWATER
DATE
- II1111111
10/30/00
9.5
10/31/00
9.7
11/15/001
9.3
11/21) 00
0
DEPTH TO
GROUNDWATER
DATE
10.0
10/30/00
9.5
10/31/00
9.7
11/15/001
9.3
11/21) 00
I I
I 1
I 1
I 1
I 1
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I I
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I I
I 1
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1 I
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----------- --------
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1
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1
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TH#2
I
SITE POLAN
DATE READING CLOCK NET TIME WATER LEVEL NET DROP
TIME (MINUTES) READING (INCHES)
10/31/00 MSN
G
PERCOLATION RATE <1 (MIINJINCCHH)) PERC. HOLE DIA. 6' (INCHES)
TEST RUN BETWEEN 4.0 A F7J.:� 14.5 FT.
PERFORMED BY ALASKA WATER & WASTEWATER I,
THIS WAS PERFORMEV IN �CCORDANCE WITH ALL STATE
DATE. DATE: < / ZA�/O/
, CERTIFY THAT I
IDELINES IN EFFECT ON THIS
ALASKA WATER & WASTEWATER CONSULTANTS, INCO.
6001 DEBARR ROAD, SUfTE 28 • ANCHORAOL AK. 99504
PHONE (907) 337-6179 • FAX 907) 338-3246
SOIL LOG - PERCOLATION TEST
LEGAL DESCRIPTION: ELMORE S/D #2; LOT 5, BLOCK 12,
PERFORMED FOR: JERRY HANSON
DATE PERFORMED: 10/30/00
DEPTH TEST HOLE 2
(feet) ORGANICS
1
Rail rl ARSIP*Ir4��1?��
ML GW". ••
011111111:iG PIIIIIIIIIML
GM CL
NIIN •
13
14
15-
16-
17-
18-
19-
20
51617181920
COMMENTS:
IIIIIIIII
MORI
DEPTH TO
GROUNDWATER
DATE
10.0
10/30/00
9.0
10/31/00
10.9
11/6/00
9.5
5/24/01
i
i
I
GW
8
a. >
104
12
13
14
15-
16-
17-
18-
19-
20
51617181920
COMMENTS:
IIIIIIIII
MORI
DEPTH TO
GROUNDWATER
DATE
10.0
10/30/00
9.0
10/31/00
10.9
11/6/00
9.5
5/24/01
`. r-1
9
f y A Gameee;'
• E 953 `
LTH# 1
SITE PLAN
I 100'
-71 F -----
DATE READING CLOCK NET TIME WATER LEVEL NET DROP
TIME (MINUTES) READING (INCHES)
10/31/00 MSN
Q�RCi
PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6" (INCHES)
TEST RUN BETWEEN 4.5 . OT. AND lit 5.0 FT.
PERFORMED BY ALASKA WATER do WASTEWATER I, V , CERTIFY THAT
THIS WAS PERFORMSp IN ACCORDANCE WITH ALL STA D UNI GUIDELINES IN EFFECT ON THIS
DATE. DATE: p CAO/
i
i
I
DATE READING CLOCK NET TIME WATER LEVEL NET DROP
TIME (MINUTES) READING (INCHES)
10/31/00 MSN
Q�RCi
PERCOLATION RATE <1 (MIN./INCH) PERC. HOLE DIA. 6" (INCHES)
TEST RUN BETWEEN 4.5 . OT. AND lit 5.0 FT.
PERFORMED BY ALASKA WATER do WASTEWATER I, V , CERTIFY THAT
THIS WAS PERFORMSp IN ACCORDANCE WITH ALL STA D UNI GUIDELINES IN EFFECT ON THIS
DATE. DATE: p CAO/
C
0
1 11=50'
69-96
SECOND ADDITION TO ELMORE
LOT 56 BDLOCK 12
147TH AVENUE
0
M
N 69056'17"E 212.00'
10' UTIL ESMT.
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of aWELL
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72.1' 69.9'
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EXISTING BUILDING
(SEE DETAIL)
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72.2' 70.0'
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RABBIT_ CREEK
I 10' DRAINAGE ESMT. - - -
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I LOT 5
I
I
I
10' UTIL. ESMT.
I ------------------
SUBDIVISION -----------------
FINAL STRUCTURE AS -BUILT
GASTALDI LAND SURVEYING
JEFF A. GASTALDI, R.L.S.
4726 WEST 88TH AVENUE
ANCHORAGE, ALASKA 99502
PHONE 248-5454
GRID DATE
3036 1 1/23/2002
F.B. I JOB NO.
01-09 ES2512
0
0
0
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3
0
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KA
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 EASEMENTS,
COVENANTS OR RESTRICTIONS WHICH DO NOT
APPEAR ON THE RECORDED SUBDMSION 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.
SUBDIVISION
COVERED ENTRY
BUILDING DETAIL
SCALE: 1"=20'
OF q
1 o : •. 'F 1
�: TH i 9
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Municipality of Anchorage
Development Services Department
• Building Safety Division ..
On -Site Water & Wastewater Program
4700 South Bragaw SL
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel l.D. 018-173-34 HAA#_(,?/�'
1. GENERAL INFORMATION Expiration Date: "T — 3
Complete legal description 'ELMORE
SUBDMSION #2;
LOT 5.
BLOCK 12
Community Class Well
❑
Public Water System
Location (site address or directions)
16645 RANSOM
RIDGE
RD. ANCHORAGE, AK 99516
Current Property owner(s) JERRY HANSEN Day phone (907) 344-7780
Mailing address 16645 RANSOM RIDGE RD. ANCHORAGE, AK 99516
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: 4
3. TYPE OF WATER SUPPLY:
Individual Well
e
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 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 samples. (Certificates may be reissued for a period of up to one year with valid
water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water
system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's
work.
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid S at, or prior
to closing for the engineering services provided.
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 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 riles and from my investigation and inspection, the
on-site water supply andlor wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm ALASKA WATER & WASTEWATER CONSULTANTS, INC.
Address 6901 DEBARR ROAD, SUITE 28 * ANCHORAGE, AK 99504
Engineer's Printed Name JEFFREY A. GARNESS, P.E.
Engineer's Comments:
In conducting this evaluation, AW WC, Inc. attempted to provide a thorough,
conscientious engineering analysis of the system In accordance with ADEC and MOA
DSD Guidelines 8 Regulations. The reported results described the performance of Me
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. AMC, Inc. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report Is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
otherperson or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for bedrooms.
Disapproved.
Phone 337-6179
Date 119&(C)';1_
Conditional approval for bedrooms, with the flowing stipulations:
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
Manitenance Agreements
Supplemental Engineer's Reort
Other
Ll
or
iQP�• ••Cy0
• ON-SITE • =��
WATER AND
WASTEWATER
By: Original Certificate Date:
(Rn. 12M)
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water 8 Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519.6650
www.ci.anchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: ELMORE SUBDIVISION #2; LOT 5, BLOCK 12 Parcel ID: 018-173-34
A. WELL DATA
Well type PRNATE If A. B, or C provide PWSID# N/A
Date completed 6/27/2001 Sanitary seal (Y/N) YES
Total depth 121 ft.
Date of test
Static water level
Well production
Cased to 121 ft.
FROM WELL LOG
6/27/2001
58 ft..
9 g.p.m.
Well Log (YIN) YES
Wires properly protected (Y/N) YES
Casing height (above ground) 24 in.
AT INSPECTION
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. Nitrate d_�gJL. Other bacteria lb colonies/100 ml.
Arsenic:0199�JL. Date of sample: 1/11/2002 Collected by: AWWC, INC.
►faa�oa
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEEL Date Installed 8/1-6/2001
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (YIN) N/A
Date of pumping NEW Pumper N/A
* BELOW FINAL GRADE. 2.0-2.74 OF SAND
C. ABSORPTION FIELD DATA FILTER BELOW TOTAL DEPTH
Date installed e/1-6/2001 Soil rating .p.d.l r ft%bdmt) 1_0 System type DUAL TRENCH
Length 2 x 60 ft, Width 5 ft. Gravel below pipe 0.5 ft.
Total depth 'a.46-4.25ft. Eff. absorption area 600+ ft2 Monitoring tube YES Depression over field NO
Date of adequacy test NEW Results (Pass/Fail) - For 4 bedrooms
Fluid depth in absorption field before test = In. Water added =gala New depth =in.
Elapsed Time: min. Final fluid depth= In. Absorption rate >= - g•p•d•
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N/A If yes, give date -
D. LIFT STATION
Date installed
"Pump on" level at _in.
E. SEPARATION DISTANCES
Size in gallons
High water alarm level at in.
Cycles tested Meets alarm & circuit requirements?
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot 100'+
Absorption field on lot 100'+
Public sewer main N/A
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N/A
Sewer/septic service line 25'+ Holding tank N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 50+
Water main _ N/A Water service line 10'+ Surface water 100'+
Welts on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
10'+
Building foundation
10'+
Water main N/A
Water service line
10'+
Surface water
100'+
Driveway, parking/vehicle storage 25'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and q��• q ki
review of Municipal records that the above systems are in o.""' ..
conformance with MOA HAA guidelines in effect on this date.
Q Je e G
Engineer's Printed Name JEFFREY A. GARNESS C 7953 .`
X00 ,F
Date t a5 lo of
HAA Fee $ i� ;�-) SJ Waiver Fee $
Date of Payment 1 I G�b f 02- Date of Payment
Receipt Number O j LI q E�AP Receipt Number
(Rev. 12101)
CT&E Environmental Services Ina
Iaboraton DM@1w
zoo W. Putter orb.
Analys
is Report for Total Coliform Bacteria Tat
Drinking Water
UAD iNSfRUCTIONS ON RdYEiSd SIDE dEIORE� OLl1LT(NOSMQLS omrLMD s 1 LABORATORY
p PUBLIC WATER SYSTEMLD.•
o PRIVATE WATERSYSTEM
0
p Send &twee
33 8—
p Sell Rneb O Seeef tle+Ml
�, iz M
SAMPLE DATE: month Day Year
SAMPLETYPE:
p Reutlne
p Repast Sample (for routine sasa'M
with lob reL new
C3 Spec!d Purport
SAMPLE LOCATION
j Lr1cLF LS 6 II
comments:
p Troaed Water
.j Untro"M Wats
TIM
Collected
1:5o?r`
Andysis data" ttus Weer SAMPLE to be
Saustyctory
p UnsatisAcwry
C3 Sample over 30 hours old, MrAts may
be umsbable
0. Sample too lore�{m reser uSamplessh uld
net be ova3kj esus
to indicate reliable tau tL Pery _ Send
new sample via special
Dab Rlaivd z,-> b L
Time Raalvd OeOD
Asdysle UP11 R6 4:;�
I Ash ,kMstfels Membrane filter
p %iMtbMUG
I • Number of colonieal100 MI.
• .� wJ Y.� Andya
1020420 (�]
Ppb JIM ❑
Fated
Collect"
Sw r -k
ptg
Dm .,rims:
CUse weasel st�resdbs
It""
gpebw�"� Fated
Does: z`C re* __a_ -y—D
BACTERIOLOGICAL WATER ANALYSES RECORD
' 6 Ceti'
MMO•MUCResults TotalConform �-
rm ColeeldlMr
Membrane FUton Direct Cssep
flGlt COUFIRM
veritleattaa LTs
Pwe Conform costlrmnW cotltertlta ml
Fled Membrane Filter Roam /loGti> bre
Repertsd 4 Date D2 Time „(�
�� A� ..� p� P.b�V M l.wrnar•tA
Twit•rr.Vr Dcw
0e •00weeer+
ME Et A=unwvW Services Inc.
.Laboratory DhArion
F -A
200 W. Paw DAN
Drinking Water Analysis Report for Total Coliform Bacteria Tot (m � na
�lNvsTeUquomONeeveesasmeetloea.orlccravos�ns BE �F l 'VMD BY e
UM
a PU5LiC WATER SYSTT.M I.D. r
p PRIVATE WATER SYS"
.. e..i r...tm
a ser eeer. a ser rlve+a.
Tr re
+e �
SAMPLE DATE: pay Yar
SAMPLE TYPE:
a . Routine
p Repeat Sample (toe roods* umpl*
with lab t*L tee. 3
p SPeeld Parpou
SAMPLE LOCATION
YLN1�It L� Q (Z
Comments:
p Tr*atad Water
'A Uatroat*d Water
Tim
Collected
:f.70?rt
AWysia show* this Waw SAMPLE to be:
Satubemy
a untatisbcomy
O Sample over 30 hours old. re wts may
be urudubie
Sis too a tbbe over3=01d wtvu eetsaffqeaeoesMuld
not
to indicate reliable resu tLery Please and
sample ple via special dell
DataReeeivd
Time Received Ogol%
Ae&IYle a,w
Aadytlal Matbeds MM brim Filter
I I ' Mumbo of colonias/l00
ml.
..� n. w-
Riede! Andyst
1020420
[M
0
Feted
Couettad
BY
SW f`'�
rr. plum
ogee Time:
Cheat seNA*d *fly �dbs
P E3 3Peta"" F" atm
Dace: Time:
IMCTMOI,OGICAL WATER ANALYSIS RECORD
MMO.MUG Reedb TOW C*Mf rm
aur
> celenledloo d
.lembraae Filters Direct Ceps
Z
acs
Veritkatiew LTr
couriRM
Feat coliferva CoaMmades
ee1K*etella ter
Fled Membraae Filter Rua=* D�� bre
Rev*e� BYDate
r.wc • 1...v.r..e re C,..e
Of -o+ S*
JAN -15-02 12:27PM FROM -CUE ENVIRONIENTAL SRV
/It.. ME Environmental Services Inc.
�1a rrrirr�ri�'�rrr�rrr�
ME Rcf-#
1020227001
Client Name
AK Water & Wastewater Consultants Inc.
Project Name/N
Elmore q2, 13, B12
Client Sample ID
Elmore q2, TS. B12
blanix
Drinking Water
Ordered By
PWSID
0
Sample Remarks:
9075615301 T-621 P.02/03 F-914
Client PON
Printed Date/Time
Collected Date/Plme
Received DateITIme
Technical Director
Released BY //7VJ
01/15/2002 10:57
01/112002 10:00
01/112002 13:10
Stephen C. Ede
IF
Alluwable Prep Analysis
Panmaa
Results PQL Units Method Limits Date Date Init
metals Department
Arsenic
0.00200 U 0.00200 mg/L EPA 200.9 (<0.05) 01/14102 JMP
Waters Department
0.225 0.200 mg/L EPA 300.0 (<10) 01/11/02 JDT
Nitmte•N
Microbiology Laborator;�'2
Total Coliform
OB,NoCoIi col/100ml. SM199222D (<1) 01/11/02 KAP
0
�j
JAN -15-02 12:27PM
FROM-CT&E ENVIRONIENTAL SRV
9075615301 T-621 P.03/03 F-914
ME Environmental Services Inc.
Laboratory Division
200 W. Potter Drive
Drinking Water Analysis Report for Total Coliform Bacteria T'ehor.o AK 99676.1606
Fax
READINSTRVCTIONSONREVERSESIDEBEFORECOLLECTINCSAMPLE nuoi FT1
❑ PUBLIC WATER SYSTEM I.D. A
,6tf?RIVATE WATER SYSTEM
❑ Send erurrs O Stn4 Jnrofrt
�i
x.n run. +�.. wN•^r
.9t Y1114.(
❑ Send Rtrurts D Send lnMict
YW[IMM
l uiy.p Nn.
r1.V A •h
.r
91
SAMPLE DATE: Month
® ® Y'r
SAMPLE TYPE:
O Treated Water
❑ Routine
❑ Repeat
with tab ref.noPle .for routine aam; e
Untreated Water
it
❑ Special Purpose Time Collected
SA1t PLE LOCATION
Collected By
UM D: of W I` l
Comments:
A lysis shows this Water SAMPLE to be:
p� Satisfactory
❑ Unsatisfactory
❑ Sample over 30 hours old, results may
be unreliable
❑ Sample too long in transit; sample should
not be over310hours old at examination
to indicate reliable results. Please send
new sample via special delivery mail.
Date Received
Time Received 1 3I0
Analysis Began 1�2—
Analytical Method: VDMM0-MUG Icer
• Number of colnnies/100 ml.
Lab Ref. No. Result* Analyst
102022--q
J u,1
Sentto A.D.B.C. Aach Fbke Jun Fax.
D,tt; Time:
Client notified of unsatisfactory results:
❑
❑3 Spoke with Fax
Pho
Date Timc:
BACTERIOLOGICAL WATER ANALYSIS RECORD
MMO-MUG Result: Total Coliform
E. Coli
q \ n1� �O , Colooles1100 mt
Membrane Filter. Dlreet Count
Verification: LTR
RCB COLIFIRM
Fecal Coliform Confirmation
Co0form/100 ml
Final Membrane Filter
�Results
2Date
�(
Reported By
' V Time �iP�- hn
rnrC.rwN.. ,roC,
oa -Ojh . R..r r..
t VMS Member of tha SOS Group ISociata Ganarale de Survadlancel
ENVIRONMENTAL FACILITIES IN ALASKA. CALIFORNIA. FLORIDA. ILLINOIS- MARYLAND. MICHIGAN. MISSOURI. NEW JERSEY. OHIO. WEST VIR(
