HomeMy WebLinkAboutELMORE #1 BLK 4 LT 1Elmore #1
Block 4
Lot 1
#018-171-36
. Municipality of Anchorage
On-Site Water and Wastewater Program • (907) 343-7904 Page 1 of 2
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: DSP171079 PID Number: 018-171-36
Dwelling: ❑■ Single Family (SF) ❑ Duplex (D) ❑ Multiple (SF and/or D) Project: ❑ New ■❑ Upgrade
Name.
VICTOR BAER ABSORPTION FIELD
Address
❑ Deep Trench ❑■ Shallow Trench ❑ Bed 1=1 Mound
4750 SHOSHONI AVE ❑ Other
Phone Number of Bedrooms Soil Rating Total depth from original grade
4 1.2 GPD/SF 7.0 Ft.
LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe
Subdivision Block Lot 3.0 Ft.4.0 Ft.
ELMORE #1 BLK 4, LOT 1 Fill added above original grade Gravel length
Township Range Section 0.5-1.0 Ft. 50' Ft.
Gravel width Beds.Number of Lines Distance between lines
SEPARATION DISTANCES 5.0 Ft Ft
To- Septic Absorption Holding Sewer Total absorption area Number of trenches Dist.between trenches
Tank Field Lift Station ; Tank Line 2
From 500 Ft 1.0 Ft.
Well 100'+ 50'+ TANK ❑ra Septic ❑S.T E.P. ❑ Holding ❑ Other
Manufacturer Capacity
Surface Water 100'+ ANCH 1250 Gal
Material Number of compartments
Lot Line 0 NA STEEL 2.0
Foundation 20'+ LIFT STATION
Manufacturer Capacity
Curtain Drain UN Gal
Pump on level at Pump off level at High water alarm at
Remarks
in. in. in.
Pump make and model Electrical Inspections performed by
PIPE MATERIAL House to tank Tank to
Installer drainfield 3034
MIKE N. ANDERSON,P.E. Drainfield3034 CO/MT3034
Inspector MIKE N. ANDERSON, P.E. BENCH MARK (Assumed elevation) 105.2 ft
Inspection ection 1• 5-9-17 2"° 5-9-17 Location and description
3" 4Th GARAGE SLAB
COMMUNITY DEVELOPMENT DEPARTMENT APPROVALEngineer s Stamp
Conditional Approval: Date P�*' /. C•';'-I
er. 49TH f/k 4:7*I1#,
tl, �� r
to
rA MICHAEL N. ANDERSCN ;
,--
r
, •• CE 719
6.:N.
Approveve—� .•,,4 rr— ( 7 f��tF,p4D•• jy��
Date
Inspection Report_9-1-12.doc
Permit No. OSP 171079 Page 2 of 2
• 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
Legal Description: LOT 1, BLK 4 ELMORE #1 S/D PID No.: 018-171-36
MARK A B = _
VALVE 55 106 SHOSHONI AVE
Col , 57 108 --
MT
MT
CO3 70 92== SLOPE > 25%,
C04 68 128
i
i
I DIVE,A(TER VALVE
S5
/ / \ %; /
\1 r }
COI3\ EXISTING 1250 GALLON TANK
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'� / �� ASBUILT
i' i/� ��\ .. SCALE: 1"=30'
00,..r»A II i a
VAL4E C01 C07 co, MT CDI `��,{ OI f+
aft C"),." * '''..L.:rf._..
Ill
F1u51MG 1.250 -' OM/pl 1.; ;
0�uL0rl 1�
sTra ru.
f. t�MICHAEL N. Ah:.
* No. CE 9469
... c.......;..
.200 67 MAY 2017 t+ \ +4'
SEPTIC SECTION 86
+rM� ESS\1 ES�'+
4,s3,00PAtry'.o, MUNICIPALITY OF ANCHORAGE ,mCII t(
,
On-Site Water&Wastewater Program �J S.•,
PO Box 196650 4700 Elmore Road A
,.
I Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax: (907)343-7997 y
�, http:J/www.muni.orglonsite �+r
Ji' epartment
On-Site Wastewater Disposal System Permit
Permit Number: OSP171079 Effective Date: 5/9/2017
Work Type: Septic Upgrade Expiration Date: 5/9/2018
Tax Code Number: 01817136000
Site Legal Address: ELMORE #1 BLK 4 LT 1 G:3036
Site Mailing Address: 4750 SHOSHONI AVE, Anchorage
Owner: BAER VICTOR J &VICKIE L Lot Size in Sq Ft: 31937
Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING Total Bedrooms: 4
This permit is for the construction of:
El Disposal Field ❑ 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
Received By: Date: r
Issued By: ity, l�C��iz.,x/V-7.-7_,
Date: 5,/ar
0°FS1k
MUNICIPALITY
OF ANCHORAGE
Community Development Department V 4iroy Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On-Site Water& Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 018-171-36
Property owner(s) VICTOR BAER Day phone 3.1-1 5 --,$"4-6
Mailing address 4750 SHOSHONI AVE.
Site address SAME / (
Legal description (Sub'd., Block & Lot) ELMORE'BLK 4, LOT 1
Legal description (Township, Range & Section)
Lot Size 31937 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(®all that apply)
Absorption Field FR1 Initial ❑ Single Family (SF) ❑X
(w/wo ADU)
Septic Tank ❑ Upgrade , .7
Duplex (D) ElHolding Tank ❑ Rene .fi `, fi1,9
44643)15,
'O Multiple Dwellings ❑
Privy Li ,:1- /1•14),
. (SF and/or D)
Private Well ❑
Water Storage 111Z0j?
a
�
THIS APPLICATION INCLUDES A VARIANO� T,', . IVV Z-14EQUEST FOR:
LOT LINE (2') AND SLOPE 25' Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
m A
(Signature of property owner or authorized agent)
Permit/Rush Fees: 5G 9. r 3t ri`ib Waiver Fees: 2.15 i- 10,9-
Date
- f0,9-
Date of Payment: 6lgll? Date of Payment: 5I03'
Receipt Number: � 1 u1 qZ Receipt Number: C.40 /0/42
Permit No. OSPI-7"/07-43 Waiver No. OS V 1 9"1U
Permit App_:- :_...c
clef
Municipality of Anchorage
ok-p.ir multi
P.O. Box 196650 • 4700 Elmore Road
Anchorage, Alaska 99519-6650 •J907) 343-7904 a Fax (907) 343-7997
http:/fwww.muni.org/Onsite
Development Services Division
On-Site Water and Wastewater Program
**** VARIANCE/WAIVER REVIEW ****
Waiver#: 08V171028 COSA#: Permit#: OSP171079
PID#: 018-171-36
Legal Description: Elmore#1 B4 L1
Engineer: Mike N. Anderson
Applicant: Victor Baer
Your request for a waiver of the required 10 feet horizontal separation from the absorption field
to the property line has been approved. The approved separation distance is "C�'feet. In addition,
the field may be 25 feet from a slope 25% or greater. D �✓
This waiver approval applies to the proposed absorption field only. Any future upgrade to the
on-site wastewater disposal system will require all separation distances be met or another
approval from this department.
❑ The affected adjacent property owner(s) have been given a 7 day notice regarding this
waiver.
E Notarized letter(s) of nonobjection have been received from the owner(s) of the affected
adjacent property.
® Adjacent properties are not affected by this waiver.
Waiver is Granted: X Waiver is not Granted:
Date: W7 Approved by: '� / /t
Name of Reviety-
**** VARIANCE/WAIVER REVIEW ****
Michael N. Anderson, P.E.
Civil/Structural Engineering & Construction
4661 Natrona Avenue
Anchorage, Alaska 99516
Phone 727-8864
Fax 345-1391
May 8, 2017
Municipalities of Anchorage
Departments of Health and Human Services
P.O. Box 196650
Anchorage, Alaska 99519-6650
Fax 249-7847
Re: Elmore#1 Lot I Blk 4
To Whom it may concern:
This is a request for a new leach field permit on the above lot. The lot size is 0.9 acres,typical for the area.
The old system will not pass a COSA and needs to be replaced. The new test hole showed silty gravel GM
for the entire depth of 14 feet with water at 13 feet. The new system will be a 5-wide with a maximum depth
of 7 feet. We are also requesting a lot line and slope waiver for the new system. The new trench will be 2'
off the west property line and there is a small cut slope on the NW corner of the lot which has a slope of
greater than 25 percent, see the cross section. The shallow ditch will not be an issue.
All of the lot has a gentle slope of about 2 to 4 percent from the south to the north, as shown on the plan.
The neighboring lots will not be impacted by this new addition due to the large lot size.
If you have any question please call me at 345-3377
Sincerely/14A_
Michael N. Anderson. P.L.
re0*ru, v+, ,f-0 5 p ' P zs rS ? (7 l - ,pro rofrcl ,era,
c4 4) Lvwti r
EXISTING GRADE
25.0'
•
16.3' -eider _
_� - - =�% — r.,.. a#e
yi
NORTH SIDE `- ,�+ 1.10
OF ROAD 111111,211._ �
�r Ill PROPOSED TRENCH W/ 5
.0001111111111111111111111.11.- ��� I COVER, MAX DEPTH 12'
_ — SLOPE OVER 25%, ., ,�
' BACK AT ROAD ELEVATION ________
SLO4 CROSS SECTION A-A
SCALE: 1:=20'
- SHOSHONI AVENUE - /'
/
\`• P EXISTING 1,25(3/
`\ \30% 30z GALLON TAM<
•
1 •\ /
/
•
\\ \30% r ti 4 r f/ D
/ �,�1
� , ! . Fl? • /
1 \FLAT ._-?. _M. . ./E.O.
OALVE- .0 •
\1111 '- \1-3%
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\�C.O.` -- r _5 r! I� /
14'X18'X6' EXISTING Jam'" r -�Ekls NG W
TI
CRIB `�.\ \ EL( 700,
FENCED !GARDEN F- I----1 • \\ RADItiS
AREA 1 1 I e;\
1 .7., 1 • \ ‘
24' EXISTING LEACH 1 L__ __J ,'. ��� �L ./o
w 1 FIELD 1 �� `,.\C.0.
U..1 r 1 '_ =-_--7.----'3
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J 3 BEDROOM RESIDENCE
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Septic Design Prepared for ��iiix�ms><iiii,R
VICTOR & VICKIE BAER ++,A.��•vf ��. •���
;
ELMORE , BLK 4, LOT 1 : x : 49 H ,j, :-#*0
Anchorage, Alaska ; • •
•
Michael N. Anderson, P.E. DATE: 5/8/2017 ' ,;�
.
I�;%:MICHAEL N. ANDERSON: .. so�� No. E 469
ANCHORAGE,ALASKA 99516 4601 NATRNA AVE DRAWN: DJR •�j I
(907) 727-8864/FAX: (907) 345-1391 SCALE: 1"=30' iIIii ;���+4*
DESIGN CRITERIA: MOUND OVER
' (TH#1) ? r��GRADE
4 BDRM X 150 = 600 GPD Mr
SOILS = 600/1.2 = 500 GPD 1.0 •ORG } FILTER FABRIC
500 GA/5X(0.50) = 50' _3 O 4"0 PIPE
(1 ) TRENCH GM/SM SEWER ROCK
7.0' DEEP
4.0' EFFECTIVE -7.0 5.0 I
5.0' WIDE
50' LONG 12
SEPTIC FIELD SECTION
,_OT 3A LOT 4A LOT 5 LOT 6 I
I
rhl // `•
--_ / `• _.
11
r?-- \\LOT 11
r LOT ldi, 1
If 1 '1 11I
I
1
1
r
Ai //
/
/
VACANT LAND
NO PRIVATE OR PULBIC WELL WITHIN 200' ---
Cfa?T,IC.
- S H S S H-Q N I AVENUE - ----
/ • /
,'
/ • r
// I i\\ �• i EXISTING 1250 G�LLON�
r• L' •1 \\ _ f TANK \ f
C 1� 1
I • J II I_J I \� . • I \
119 I \ NOrr \: 11
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:` I ` � -,�%a/ "OPERT .\BINE ),cN�
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Septic Design Prepared for +,611sy1111l�
VICTOR & VICKIE BAER .•'``�� `�r 1,
VICTOR �i.
,j..• A ' 5 •.1i
ELMORE , BLK 4, LOT 1 . 49 'H "� ..t..* vo
Anchorage, Alaska : ',ix/7N - ••
•
Michael N. Anderson, P.E. 0 MICHAEL N. ANDERSON: st
DATE: 5/8/2017 �I���; No. 469
14-a
4601 NATRONA AVE �1 \
DRAWN: DJR � :,�,�,.. {,�
ANCHORAGE,ALASKA 99516 �-it' ' r�"•' '�'1c\.- -�,
(907) 727-8864/FAX: (907) 345-1391 SCALE: 1 / , 04.x: ��44
+�_..
-a.- -
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Municipality of Anchorage ,,,,, fcr�NatDlEER'-$, 6EAlI,,
Development Services Department �;••• •``•i: 'l i
/ • \ Building Safety Division r h.' •
, )�, On-Site Water and Wastewater Program * •
•4 9 T- IA 1; r4• ' .!.
6 ti
i 1� 4700 Elmore Road •••'' , :•• ,f4
P.O.Box 196650 Anchorage,AK 99507 04
www.cii anchorage_ak us I +
�� (907)343-7904 0� �• AUCHAR ft �fpm ft
Soils Log - Percolation Test t� :�,. CE S/ -, `7f• .
Performed For: U t y [-IN— 1(22‘`e ✓ Date Performed: ' Y
Legal Description lel►rv. e 41( M L( r "Fownship. Range.Section:
Slope Site Plan
Depth
(Feet) o J cr
1-`�f g r /11-k .
2:--- 42-c---
3- f On
4-
5- !!
/17 n/k • ' • . . - ' '-
7
8-
WAS GROUND WATER
9- ENCOUNTERED?
S
10- IF YES.AT WHAT DEPTH? I 4 t
0 .
Depth to Water After F
1 1- Monitoring? ��
/ � E
12- Late _57/1147--
�I/ '_-
13- �^
14- _ Reading Date Gross Time Net Time Depth to Water Net D,op
IfUivl
r
15 � V1/J/ /Grr, , ,l (J« /
16- /(Jle.
8 s-If
17- (� t� it
-
18- &/r 5�
19-
20-
.
PERCOLATION
0-
PERCOLATION RATE Z— -- _ PERC HOLE DIAMETER fl
TEST RUN BETWEEN F" -- LI FT
COMMENTS (./ '1(---• S 7 L t 'IL.) P tT 404k7-6..
PERFORMED BY: Nit 1\1,41 I CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program, 4700 Elmore St.
P.O. Box 196650 Anchorage, AK 99519-6650 Page / of 2
www.ci.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: 15 d t 0005 PID Number:
Name:
U j;.,aw� e,
Wastewater System: ❑New Upgrade
, r C J.
Address; .
`f D 5k000n.Ave,
3
ABSORPTION FIELD
Phone: Number or Bedrooms:
❑ Deep Trench ❑Shallow Trench ❑ eetl [3 Mound ❑ other:
LEGAL DESCRIPTION
Soil Rating:
Total Depth from on ginal gra
GPDlFI°
Ft.
Block: Lot Subdivision-
Depth to pipe bottom from original grade:
Gravel depth Bath pipe:
lY oc_Q l
FL
Ft.
Township: flange: Section:
Fill added above original grade:
Gravel Length:
FL
F[.
Well: F] New El Upgrade
Gravel width:
Number of lines:
Distance between Imes:
Ft.
Ft.—
t.Class
cation (Private, A, B, C):
Classification
Total Depth:
Cased to:
Total a tion area:
Pipe Material
0
Ft.
Ft.
Fly
%
Driller.
Date Drilled:
Static Water Level:
Installers.e��
Date I nta Z `
Ft.
N l 4U
O
Yield:
Pump Set al:
Casing Height Above Ground
TANK
GPM
FL
Ft.
SEPARATION DISTANCES
Septic ❑ Holding ❑ S.T.E.P. ❑ Other:
To
Septic
Absorption
Lift
Holding
M=Private
Manufacturer:
Capacity:
From
Tank
Field
Station
Tank
Sewer Line
r1 e � Ch /Ti ,
(d0 0 Gal.
Well
•.
100
001 /001
,rl
'v
�
�/
S�'
Material: r
�.YEtt
Number of Compartments:
Z'
Surfacewater
I std 1�
/peri-
LIFT STATION
Lot Line
2.
l
Sire:
Manufacturer.
T'
Gal.
Foundation
^(, J l�
l4.
"Pump orf level at
"Pump oM
High "ter alarm at:
in.
in.
Curtain Drain
Electrical Inspections performed by:
f/
//
Remarks:
BENCH MARK
Location and Description:
�? 4r4 15, (a
Assumed Elevation:
T t t 4 ;:J
(0 D Ft
W.
Inspections by: Dates,: 1st JILT,,
o'l Alai
performed
•. eq j�"kgr
ae)•,,,•,<6
cd
2nd /(L6'/03sew
��..••..
Development Serves Department Approval
0 y 49Twvsl
Conditional Approval Date
MICHAEL N. ANDERSON .•'`�
1 C 9469
7,u
2 /
ls� PBQFgSg d1
Reviewed and approved by: Date: Zo
\y\N-Z
(Rev. MQ
Permit. No. SW080005 Page 2 of 2
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
Legal Description: LOT 1, BLK 4 ELMORE #1 S/D PID No.: 018-171-36
MARK
q
g
ORND
ELEV.
PIPE
ELEV.
FCO
40
47
100.1
98.2
02
—
7
82
97.1
TC01
83
TCO
B5
90
97.1
6
$ 3
2.7
9
7.
i
/
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\ BENCH, CONCRETE SLAB
\ TCO2 TOW
° ° CO2
1 f
1 t T e tvvn°^ ssu ^ 2
1 — —1 \ �onli5
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ASBUILT
' FCO CO2 iC01 TCO2 CO3 CO. •�•�. OF
.• ............gCgs���..i
TM
wg,u,°K.m ............ .. ..............
SM GNLK ♦';MICHAEL N. ANDERSON,-,
S1E0. TMK
NgoC/' 9469 \ r
sEPIC SEMioM KTS.� E551' i••
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4710 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SW080005
Legal Description: ELMORE #1 BLK 4 LT 1
Design Engineer: 0088 ANDERSON CONSTRUCTION & E
Owner Name: VIC BAER
Owner Address: 4750 SHOSHONI AVE
ANCHORAGE. AK 99516 -
Date Issued: Jan 24, 2008
Expiration Date: Jan 23, 2009
Parcel ID: 018-171-36
Site Address:
Lot Size: 31937 SO. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of.
❑ Disposal Field E Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By: / ;�, i Date:
Issued By: _ bZ z,(/(r/L"t4"r _ Date: U t5
Municipality of Xnehorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
www.muni.org/onsite
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 0 L �6=l'7 1 —Z (,
Properh
Mailing
Site address
phone 3y"k& (c,
:ode
Code
Legal description (Sub'd., Block & Lot) b -L Jnr) moi✓ Ili iP� U Q
Legal description (Township, Range & Section)
Lot Size 311 01 31 Sq. Ft.
THIS APPLICATION IS FOR (❑ all that apply):
Absorption Field ❑
Septic Tank
Holding Tank
Privy ❑
Private Well ❑
Water Storage ❑
Number of Bedrooms 3
THIS APPLICATION IS AN:
Initial
❑
Upgrade
❑
Renewal
❑
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.
(Signature of property owner or authorized agent)
Permit/Rush Fees: &%U6?. " Waiver Fees:
Date of Payment: f! /ILOB Date of Payment:
Receipt Number. 0 7 y Receipt Number:
tRev.�iros)
Michael N. Anderson, P.E.
Civil/Structural Engineering & Construction
4661 Natrona Avenue
Anchorage, Alaska 99516
Phone 345-3377
Fax 345-1391
January 11, 2008
Municipalities of Anchorage
Departments of health and Human Services
P.O. Box 196650
Anchorage, Alaska 99519-6650
Fax 249-7847
Re: Elmore #I Lot 1 Blk 4
To Whom it may concern:
This is a request for a new septic tank permit on the above lot. The lot size is 0.9 acres, typical for the
area. The existing tank has started to fail therefore its need to be replaced. A 1250 gallon tank will be
installed per the owner, currently the house is 3 bedroom unit. The existing two tanks will be pumped,
crushed and filled with soil. From the plan it can be seen that both existing tanks are inside the well
radius, this new tank will be relocated outside all well radius areas.
All of the lot has a gentle slope of about 2 to 4 percent from the south to the north, as shown on the plan.
The neighboring lots will not be impacted by this new addition due to the large lot size.
If you have any question please call me at 345-3377
Sincerely
Micha��el N. Anderson, P.E.
DESIGN CRITERIA:
4 BDRM X 150 = 600 GPD, CURRENTLY THE HOUSE IS A 3 BEDROOM
1250 GALLON TANK TYP., OWNER HAS REQUESTED A 4 BEDROOM TANK
EXISTING TANK HAS STARTED TO COLLAPSE
LOT 3A I LOT 4A I LOT 5 I LOT 6
-----�---� \SLOT 11
LOT 10 I �I
I
�• 1 1
I
I
NO PRIVATE OR PULBIC WELL WITHIN 200 �>< ^,,.� \\\--�_ VACANT LAND
—S HOS1♦_O.NI A V E N UE—
I • J I I �J 1
\
ANEW 11,00 GALLON 11 /
TANK
1 I
II
1` - \\ N00-1 / \
OPERTY LINE >
I
1
'Septic, Design Prepared For
VICTOR & VICKIE BAER
LOT 1, BLOCK 4, ELMORE#1 SUBDIVISION
Anchorage, Alaska
Prepared By
DIICIIAEL N. ANDERSON, P.E.
4661 NATRONA DRIVE
(907) 345-3377 / FAX (907) 345-1391
SCALE: 1"=100' JANUARY 15, 2008
:.::...........
' 49M
IAEL N. ANDEF
No. CE 9469
0
(�, y EXISTING SEPTIC +
1 AREA. TYP. /
- S H 0 S H 0 N I A V E N U E-
11' X 18' EXISTING -
I CRIB
24; EXISTING LEACH
FIELD
I
W 1
W
w
0
z
a /
/
J .Y�
/ I /
DOUBLE C.O.
\1-37.
------ ------
/
/
/
/
NEW 1,000 GALLON EXISTING 750 GALLON
TANK / TANK. TO BE
/ IN-PLACE
i
i
/
I
\1
I L..
� 1
I
1 i i
1
1 1 a 1
1 I I
1
1
I 1
�
1 I �
\2-47.
�\
1
\
1
\
1 NO SLOPES GREATER
i > THAN 257. WITHIN
' -
\2-47.
C
106
3 BEDROOM RESIDENCE
Septic Design Prepared For
VICTOR & VICKIE BAER
LOT 1, BLOCK 4, ELNIORE#1 SUBDIVISION
Anchorage, Alaska
Prepared By
MICHAEL N. ANDERSON, P.E.
4661 NATRONA DRIVE
(907) 345-3377 / FAX (907) 345-1391
SCALE: 1"=30' JANUARY 15, 2008
EXISTING 500 GALLON
TANK, TO BE
PUMPED AND FILLED
IN-PLACE
``-------- j
�"49E
MICHAEL N. ANDERS(
No. CE 9469 ,
................
0
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
I ENVIRONMENTAL ENGINEERING DIVISION
825 L Street • Anchorage, Alaska 99501 Telephone 264-4720
ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
GRADE
MAILING ADDR SS
0 3a -
LEGAL DESCRIPTION
LOCATION 1 G ^ ' `���
bl f7 /V
NO. OF BOOMS
D
Well MC
DISTANCE TO: /!9O /
Absorption area
Owelling
PERMIT
Y
62
W
Manufacturer s ` /• . l
Material
NO. of Compartments
N ~
Liq. capacity in gallons
IF HOMEMADE:
Ins -Ida length
Width
Liquid depth
6 le
DISTANCE TO:
Wetl
Dwelling
PERMIT NO.
O z
Manufacturer
Material
Liquid capacity in gallons
jWell
=
DISTANCE T0:
Op
Foundation
Nearest to, line/6 /
-
PERMIT NO
W
LL=
No. Of lines
Length else, line
Total I:V f nes
o��
Trench th�
inches
Distance be n in s
t
RP:
o
Top of tile to finish grade
Material beneath the/
inches
Total el a sgrption area
W
Length
W.dth I
Depth
PERMIT NO.
df
d
Type of crib
Crib diameter -
Crib depth
Total effective absorption area
to
W
DISTANCE TO:
Well
Building foundation
Nearest lot line
J
J
Class
Depth
Driller
Distance to lot line
PERMIT NO.
W
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
PIPE MATERIALS � � A
(� V
SOILTEST RATING
I
0
INSTALLER
—
REMARKS
I
I
APPROVED DATE LEGAL
72.013 (Rev. 3178) t/ V
SEPTIC TANK: 'rG ✓ze ae '�Sp�rcrdofJ��o�ftrj —
DISTANCE „�-Jh0�4tak,:2i nan NUMB R OFj
FROM WELL MANUFACTURER (2�../MATER IALi.0 •�,0 COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITYS GALLONS. -
T / ,TOTAL LENGTH
DISTANCE FROM WELL FOUNDATION NEAREST LOT LINE_OF LINES
NUMBER OF LINES DISTANCE BETWEEN LINES
ABSORPTION AREP
DEPTH: TOP OF TILE TO FINISH GRADE
WELL:
TYPE _
TRENCH WIDTH_ IN. TOTAL EFFECTIVE
SQ. FT. LENGTH OF EACH LINE
DEPTH OF FILTER
MATERIAL BENEATH TILE IN. ABOVE TILE IN.
CONSTRUCTION DEPTH DISTANCE FROM:
BUILDING NEAREST
FOUNDATION , LOT LINE
CESSPOOL , OTHER SOURCES
NEAREST SEPTIC SEEPAGE
SEWER LINE . TANK , SYSTEM_
APPROVED DISAPPROVED REMARKS
DISTANCES:
INSTALLED BY: cc
SEWER LINE DEPTH:
PIPE MATERIAL:
LOT SLOPE
REMARKS
Form EQ -032
DIAGRAM OF SYSTEM
3a�jB0/7J �
o
-
71A d �,
DAT _5,�& J APPROVED
G.A.A.B.
Aq V-
GRU"IANCHORAGE AREA
BORr"' �I
Department of Environmental Quality
--
3330 C Street
Anchorage, Alaska 99503
/
INSPECTION REPORT ON-SITE SEEWpAGEE
DISPOSAL
SYSTEM
3
e' m5
NAME 2 '' MMAI�LIINNNG� ADDRESS �.,'1���,
?
�{PHONE
�
Or
LOCATION L `�-a-l�«' "`""'"?'^"SAL DESCRIPTION r
R�/
� T
:f�
SEPTIC TANK: 'rG ✓ze ae '�Sp�rcrdofJ��o�ftrj —
DISTANCE „�-Jh0�4tak,:2i nan NUMB R OFj
FROM WELL MANUFACTURER (2�../MATER IALi.0 •�,0 COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITYS GALLONS. -
T / ,TOTAL LENGTH
DISTANCE FROM WELL FOUNDATION NEAREST LOT LINE_OF LINES
NUMBER OF LINES DISTANCE BETWEEN LINES
ABSORPTION AREP
DEPTH: TOP OF TILE TO FINISH GRADE
WELL:
TYPE _
TRENCH WIDTH_ IN. TOTAL EFFECTIVE
SQ. FT. LENGTH OF EACH LINE
DEPTH OF FILTER
MATERIAL BENEATH TILE IN. ABOVE TILE IN.
CONSTRUCTION DEPTH DISTANCE FROM:
BUILDING NEAREST
FOUNDATION , LOT LINE
CESSPOOL , OTHER SOURCES
NEAREST SEPTIC SEEPAGE
SEWER LINE . TANK , SYSTEM_
APPROVED DISAPPROVED REMARKS
DISTANCES:
INSTALLED BY: cc
SEWER LINE DEPTH:
PIPE MATERIAL:
LOT SLOPE
REMARKS
Form EQ -032
DIAGRAM OF SYSTEM
3a�jB0/7J �
o
-
71A d �,
DAT _5,�& J APPROVED
G.A.A.B.
Aq V-
GRFATER ANCHORAGE AREA BOROILQH
HEALTH DEPARTMENT e
327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING
NAME?U�� GNU �iS�L/N ADDRESS SOX . 7.22 ST`T�_PHONE
IOCATION�%�'/�ld ,- LEGAL DESCRIPTION DT . /fLX
SEPTIC TANK:
DISTANCE FROM
LIQUID CAPACITY 75D GALLONS.
SEEPAGE SYSTEM: SEEPAGE PIT:
OF
"-,"0-) LIQUID
INSIDE LENGTH INSIDE WIDTH DEPTH
NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTH At
/ ,LENGTH, DEPTH 6 /
LINING MATERIALCyZ6/oKZZZ9 <_RI, DISTANCE FROM WELL le!2O / pBBUILDING FOUNDATION4 [zZ_
NEAREST LOT LINE .30 . TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) -?O 44 SO. FT.
TILE DRAIN FIELD:
DISTANCE FROM
NUMBER OF
TOTAL LENGTH
FOUNDATION , NEAREST LOT LINE , OF LINES ,
BETWEEN
FT. LENGTH OF
TOTAL EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE —DEPTH OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
DISTANCE FROMWATE
WELL' TYPEDEPTH ? , BUILDING FOUNDATION. �O'f SAMPLE NEAREST
NEAREST SEPTIC n /SEEPAGE / OTHER
LOT LINE �o �'�'' . SEWER LINE , TANK / , SYSTEM e�/�, CESSPOOL , SOURCES
DIAGRAM OF SYSTEM
DISTANCES:
fl7iZK-=
"¢ "op C=//o'
DATECiC�(it-y'/'O APPROVED
=, nEAUH AUInounr
b nbl-
GRE TE' ANCH}ORALE AREA BORdUG7H
HEALTH -DEPARTMENT;
327 EAGLE ST. ANCHbRAGE, ALASKA 99501 279.251,''
". INSPECTION REPORT ON-SITE'SEWAGE DISPOSAL SYSTEM:•
-MAILING
NAME D /�' '`.��'~�" i " ADDRESS ey"� PHONE•�� - I
d
LOCATION"'.J� �''—�^'��'�✓��^'� LEG
At DESCRIPTION
SEPTIC TANK:
/ . t ... NUMBER OF .. _
DISTANCE FROM WELL / MATERIA 1 COMPARTMENTS
7�t7 GALLONS. INSIDBIENGTH INSIDE WIDTH DEEPTH
ID
LIQUID CAPACITY ` `
- SEEPAGE SYSTEM: SEEPAGE PIT:
_NUMBER OF PITS / OUTSIDE DIAMETER OIR WIDTHt,At" LENGTH �^1' DEPTH'
i
LINING MATERIAL 1 DISTANCE FROM WELL_' '-J - 'T. UILDING FOUNDATION ,
P� NEAREST LOT LINE.:TOtAL EFFECTIVE ABSORPTION AREA (WALL AR
TILE DRAIN FIELD:
1 •' + TOTAL LENGTHti
DISTANCE FROM WELL - ,.FOUNDATION � , NEAREST LOT UNE OF LINES '
NOMem OF LINES 'l .._ DISTNCE BETWEEN IN TOTAL EFFECTIVE
ABSORPTION AREA SO. FT. , LENGTH OF'EACH
C DEPTH TOP,OF TILE TOPINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE—IN.'ABOVE TILE '•
1%• I DISTANCE FROM ` WATER
_ TYPE ' - ••' DEPTH ",BUILDING FOUNDATION. �D T SAMPLE ' /Z�� NEAREST
WELL ;-
• r NEAREST SEPTIC' :+ i.". -SEEPAGE i OTHER
to
YUNE ` ' ' 'SEWER LINE TANK L rl "; SYSTEM_LIL. CESSPOOL 50URCE$'-
1 DIAGRAM OF SYSTEM
1 DISTANCES N 44T/a'
1
Jz
,
4
I
c tttt "
4 Ir i
UF DATE /S� t- .�i �O APPROVED' ^I'--" -
nEAUn AUInOpliv .
MUN I C Ii" FALL. I -rV OF
DEPARTMENT k.- HEALTH AND EN,IIRONMENTAL . AOTECTION
825 'L' STREET, ANCHORAGE, AY,. 99501 ,3(�
264-4720
Cit_j-S I TE SEIJER PERM I T
PERMIT NO. ( 810133 ) (�
APPLICANT VICTOR BAER SRA BOX 321-Y 345-1866
LOCATION SHOSHONI & LANDERS
LEGAL L1 64 ELMORE #1 LOT SIZE 35000 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = SOIL RATING (50 FT/BR)= 125
THE REQUIRED SIZE OF THE SOIL ABOOSORPTION SYSTEM I5:
L?EPTH= S L_MN13_rH= ISZE C3FZn a:L_ DEPTH= 4 -
THE LENGTH DIMENSION
THE DEPTH OF A TRENCH
GROUND AND THE BOTTOM
THERE IS NO SET WIDTH
THE GRAVEL DEPTH IS TI
AND THE BOTTOM OF THE
IS THE LENGTH CIN FEET> OF THE TRENCH OR DRAINFIELD.
OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
OF THE EXCAVATION CIN FEET).
FOP, TRENCHES.
HE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
EXCAVATION CIN FEET).
F�EGtiU I f7E0 SEPTIC TFitJFC S I �E= AL2SE3 GfaLL_4t JS
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
--- T4.10 C 2 ] FIRE REG!U I REO ---
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT !JILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER, LINE IS 25 FEET AND
TO A COMMUNITY SEWER, LINE IS 75 FEET.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER. INSTALLATION.
PERt1I T EXP I RES GECEMCER ZEAL, ALEA81.
I CERTIFY THAT
1: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
P.ESIDEFICE _ .EMODELUDE MORE THAN 4 6EDP,OOMop�"3 lf�►h
SIGNED:IPPLi-
--------------------------- `�Jrr
CANT VICTOR BAER
ISSUED------DATE_J1�Pl (S10.t1Q1I% _ V4.0
no
Soli rt �So 1 17
9190, flimt?"'..vK Az
.. � 10,t s
Pawl-'A05
MtJt�t Z �=. L t�F=tL_ L 'T"Y . .Z�F• 't�Nt:,•H��RF�t��E
4+aMTMENr OF' HERLTH ANO e0?lRO lENTNL PROTECTION
325 'L' STREET, AmcHORtia3. W. '9393t
zs�-ins
LIEI_L nr4 >t=7N 3 I TE 1t 'WER f"ERM I r
FSRMIT HQ < sia"t )
H PUCANT ERIC SEW. 3853 COVENTRY 347-4+35
Ln;9rtON L3 87 ZODIAK MF"3R
LEO: L3 87 200IAK MANOR LOr SIZE w"e SOJARE FEET
TOPE OF so m A8•SORPTION Sr5TE1 is:
mV1rmi NUMBER OF SEOROOHS = 3 SOIL RATtM <SO FTIW>- iW
THE REMIRE0 512E OF n-!£ SOIL NSSa wrcam SYSTEM IS:
d�F�TH� ? LENGTF-I� t5e �3RFlVEL i?EP'I t-i� s
17iE LEI#3TH DIMENSION IS THE LEWsTH <1N FEET) OF THC TRENIN OR DRAIPIF•LELO_
THE DCPrH OF R TRE">i OR PIT IS THE DISTPt$X EETHE£M THE 91V OF THE
e3f"-wo ANO THE sorrOM uF rw E7-0a"rifJM <IN FEET).
THERE IS NO SET WIDTH FOR TRErIL>�.
TORAYQ_ OEPrH I5 THE MINIMUM DEPTH 4F 9 L BETWEEN THE OUTFALL PIPE
HE
Am rw 80rrom OF THE p�rION (IN FEET).
Raou I REO SEF?T I T:.`
peMEr FV;,M_IC)=lrlT W; THE Re-SP17N•SIBILIN TO INFORM THIS 00-,MTMENT DMINrs
IIY--TALLaT•It7M L4SpECTtO?l6 OF ANY WELLS ADJAcmr .TO iHls PTNPERTY t�ID THE
NUMBED. OF sus toew -S 4mRf TWE -WELL it ELL Sf12VE
£#faXFILLtW OF ANY SYSTEM WITHOUT FINRL INSPECTIOM ANO WPROYt3L OY THIS
0cp73RrmeNT WILL BE 'SUBJECT TO PRO ecuriOtl
THE
- llINIM►J1 OISTAN X $BTWEEN A WELL ANO fW f)N 31TIE SE34Rt3£ OLS SraTEM i5
109 FEET FOF A PRIYArE WELL OR i59 TA Late FEET FROM A Pusuc tikes -L DEPENDING.
11PON THE TYPE OF PIJOLIC WELL
MINIrrJM otSrawx FROM A PRIVATE WE_L To A PRIVATE S84ER LINE IS 25 FEET AND
To A CCOJN I TY SEWER LINE 15 75 FCC r.
1•IFLi. La}35 ARE REQUIRED FIND MIDST BE RETURNED To THE OEP79RTMENT WITHIN 30 DAYS
iQF THE WELL OOMPl£T I M
OI}IER REQUIREMENTS MiIYAPPI-Y. Spec-IFtcAri s FiNO �?JhrSTRrJ'%rta3li OIrTl3RAtfS f4RE
" At'flfUVO E TO INSURE PROPER INSTrpj-ArtoK
F=*ERM I T EXPIRES tjECEt76+ER 3�.. 3.5390_
i
t CERTIFY rwr
is I AN FAMILIAR WITH THE REW- IREMENTS fl)R OM-StTC SEWERS AND WELLS AS SET l'
FORTH 81 THE HJP41CIPSLETY OF F":3- ffOE
2: I WILL _IUSTALL THE STEM IN AY?7)R0ANCC WITH THE L'OOES_
-1 3: t .5166 rANO . IT r m-iE ON -s t r£ so" S TEM - ram+ REWIRE e4L'w OF1' EKT IF .THE
RE`5iG+Eflr IS £D TO-fNCLiXjE=lmE-• 11rK 3 -eco *7F!s _
str,HEV: --------- ---- --------
APPLICANT ERIC BEM 1 "
4905/c Y4.
/GARB-1ID-2
GREATEnNCHORAGE AREA �'IROUGH Case No.
IIEALTII DEPARTMENT
327 Eagle St. Anchorage, Alaska 99501 279-2511
SEWAGE DISPOSAL SYSTEM - APPLICATION & PERMIT
NAME OF APPLICAN �f1��a M �60 I rAl MAILING ADDRESS 4E4,x PHONE NO.
RESIDENCE ADDRESS 1704e OCATION OF INSTALLATION rG4~* #�
LEGAL DESCRIPTION d / B4./1 4 fz-mOrCF_ Sy/3D
APPLICATION TO INSTALL: SEPTIC TANK 6� , SEEPAGE PIT , DRAIN FIELD , OTHER
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH Se L F TO BE INSTALLED BY 1-I CC
5 £--! A.,
PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETION J -4 -kr No'(7G,�^ �i
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
e -
THIS IS TO SERVE AS L/t"'. M'1 auk A Lid. PERMIT TO INSTALL A W<
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED E I? Atam
SEPTIC TANK SIZE
^V TYPE-S%L SEEPAGE AREA TYPE L O t
DISTANCES:
�wi4AM
2t. �M i,ee �i2GN rs
NE N AUTHORITY
OR
UCCHSED DESIGNER
I certify that I am familiar with the requirements of Greater Anchorage Area`)3orough Ord' nce No. 28-68 and that the
above described system is in accordance with said code. ' v a L d 1fJ pv ,�/ ;7 56r
SATE
S i G APPLICANTS SIGNATURE
r�1
GREATER ANCHORAGE AREA BOROUGH
/
gII�9' w DEPARTMENT OF ENVIRONMENTAL QUALITY
PERMITNO. ]]]0 "C" STREET ANCHORAGE, ALASKA 99303 / o 1I
TELEPHONE 2744361
f SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT A m
PHONE
NAME OF APPLICANT MAILING ADDRESS
Lle
INSTALLATION LOCATION
Lei � � � � _� t=,i<� �/ G"C. Liz%G/ %`� li •,/
LEGAL DESCRIPTION _
DRAIN FIELD OTHER
INSTALLATION OF: SEPTIC TANK SEEPAGE PIT
TYPE AND SIZE OF FACILITY TO BE SERVED ✓ic_ ��/��' ' `/ ` y,v/
FINANCED THROUGH TO BE INSTALLED BY
SOIL TEST RESULTS MOM THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
,FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
'DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION.
/ ✓ G' U I✓
�` — _TYPE SEEPAGE AREA SIZE TYPE
SEPTIC TANK 512E � "
;. .ILL/✓
MINIMUM DISTANCES. REOUIREMENTS \__ DIAGRAM OF SYSTEM
i
: 1 :
FOUNDATION TO SEPTIC TANK
FOUNDATION TO SEEPAGE PIT DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK / SEEPAGE PIT l- DRAIN FIELD -r
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK / SEEPAGE PIT
DRAIN FIELD ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK /G SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK, SEEPAGE PIT DRAIN FIELD
TO RIVER, LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION B FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
/ I �
G.A.A.B.
OR
LICENSED DESIGNER
1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE
DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. -
DATE APPLICANT'S SIGNATURE
l'�SATER ANCHORAGE AREA BOROUGH
HEALTH DEPARTMENT
327 EAGLE STREET
ANCHORAGE, ALASKA 99501
Owner: Mr. John
Performed For W. E. Christy
Legal Description: of 1 B o<
This Form Reports a: S=01.5Log,
Depth
Feet Soil Characteristics
brown silty sand (SM)
2 _
gray sand and fine to coarse
4 gravel with scattered boul-
ders from 6' (SW)
6
�8
Was Ground dater Encountered? no .°oP
If Yes, At What Depth
Performed •7/28/70
.more No.
co ation Test.
Location Sketch
MENEM ■ . .
■U ■M.. . ■
■EMMEM�■
■rM.__ 191 ■ .
■ERNMEM■
■OMMUMM■
MENEM �®
Reading, :ite
Gross :ime Net Time Depth To H2O Net Drop
Frop�sed Initallr,�on; Seepage Pi
Depth Of Inlet De
COMMENTS: 125 emiarn faaf of a,,fnnn .
rain Field
t Or Trench
Test Performed By: R. E. CarliAle These recommendations are computed
• from visual observation and based
on the unified classification systema
Data Certified By: National Testing Services, Inc:
Date:
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received 7— /7
Time of Inspection //j: D d
Date of Inspection '
KtgUtJI rVK /WrKUYHL ur
INDIVIDUAL SEWER & WATER FACILITIES
FOR
1. Approval requested by:
Mailing Address: Phone:
2. Property Owner: hone:
Mailing Address: /� Q
3. Legal Descript n: fL
4. Location:
5. Type of facility to be inspected SF -0g!!0 No. of bedrooms
6. Well Data:
A. Type B. Depth /03
C. Construction ` D. Bacterial AnalysisLIor-
7. Sewage Disposal System: �f7C. �?.�-��J 2��/��
RT-
A. Installed )� B. Installers i7/�a"�
Z 002 t
C. Septic Tank: 1. Size Sud"2�. Manufacturer
D. Seepage Pit: 1. Absorption Area .Ta�Y 2. Material
E. Disposal Field: Total length of lines
S. Distances:
A. Well to: Septic tank Absorption area /// Sewer Lines _.
Nearest lot line Other contamination
B. Foundation to septic tank Absorption area
C. Absorption area to nearest lot line
EQ -034 (1/74) Page 1 of two pages
GREATER ANCHORAGE AREA BOROUGH 7-/7-,S
Department of Environmental Quality
3330 "C" St., Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
1. Type of Inspection: CMRO
2. Property Owner:
Mailing Address: .�
3. Name of Buyer:
VA FHA CONV
E J�h1ri nn�— "/1 /767./i )�h Di 10 )
Phone V-,�7 7 Q0/ J
Mailing Address: Day Phone
4. Name of Lending Institution: CUCko b6 k�i
Ck �irwl� //11
Mailing Address:
5. Name of Realtor or Agent:
Mailing Address:
T6_ry c, %raf�1
V Phone (ymh 27)L!5 7/ ./
140 -1 -Y -4Z 314 5i3a
6. Legal Description: AT Lm /774
Location: a QIP
p twa4 ez
/
7. Type of Facility to be inspected: _,No. Bdrms.
8. Water Supply /
Type of Supply: Public Utility Individual �(
If Individual, number of dwellings presently served
If Individual, depth of well
9. Sewage Disposal System 1
Type.of System: Public Utility
If Individual, date of installation
��'2� co-'ej-t 6�� V_.71't
EQ -037 (1/74) �`f(?j2Q
� ti�tzcL
Individual (on-site)
G"
Page 2 of two pages - Re, "st for Approval of Individual ` ^er & Water Facilities
Legal Description
Comments
Approved
Disapproved
Date 2 �%
Appr&I Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
EQ -034 (1/74)
Date
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" Street, Anchorage, Alaska 99503 274-4561
Date Received /� 7
Time of Inspection h'
Date of Inspection &y7
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER 8 WATER FACILITIES
FOR
1. Approval requested by:
Mailing Address: .S' �%�• 61-Z 3 zz Phone: 3'A`4-08 3 s�
2. Property Owner: �2�—-�� Phone:
Mailing Address:
Y
3. Legal Description: i
4. Location:
5. Type of facility to be inspected A" No. of bedrooms Z
6. Well Data:
A. Type B. Depth /0.3
C. Construction D. Bacterial Analysis
I el
7. Sewage Disposal System:
A. Installed B. Installer —
C. Septic Tank: 1. Size 7"OOJ 2. Manufacturer
D. Seepage Pit: 1. Absorption Area 3 ya 2. Material
E. Disposal Field: Total length of lines —�
8. Distances:
1. A. Well to: Septic tank 0 —, Absorption area �/a , Sewer Lines ie
Nearest lot line is it Other contamination .vox//
B. Foundation to septic tank I3 Absorption area
C. Absorption area to nearest lot line
EQ -034 (1/74) Page 1 of two pages
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 C St., Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
1. Type -of Inspection:CCMRO VA 'SHA CONV
2. Property Owner: 99^'6V Hr /.X/
Mailing Address: +41h s22 Day Phone
3. Name of Buyer:
Mailing Address: Day Phone .
4. Name of Lending Institution:
Mailing Address: Phone
S. Name of Realtor or Agent: 11 /-r_A_D 1:i910PIV'
Mailing Address: Phone
6. Legal Description:
Location:
7.• Type of Facility to be inspected: No. Bdrms. ev
'8., Water Supply. /
-Type of Supply: Public Utility Individual x
If Individual, number of dwellings presently served
If Individual, depth of well /O 3
9. Sewage Disposal System
Type of System:- Public Utility Individual (on-site)
If Individual, date of installation 7
t
a ■
r
Page 2 of two pages - Req^t for Approval of Individual SL r �-dater Facilities
Legal Description
Approved
�isapproved Date Z&1. y
Approval Valid for one year from date signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM
I certify that the information contained in this request for approval to be a true and
accurate representation of the subject sewer and water facilities and these facilities
are operating satisfactorily.
SIGNED
EQ -034 (1/74)
Date
• Municipality of Anchorage r�. �,'e
On-Site Water and Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 018-171-36 Expiration Date: ' 1 [^ I 7
1. GENERAL INFORMATION iJ
l
Complete legal description ELMORE #1 SID BLOCK I. LOT 4r
Location (site address) 4750 SHOSHONI AVE,ANCHORAGE, AK 99516
Current Property owner(s) VICTOR BAER Day phone
Mailing address 4750 SHOSHONI AVE,ANCHORAGE,AK 99516
Real Estate Agent Day phone
,5G55. 749
2. TYPE OF DWELLING: ���.1 `. ':-'
® Single Family (w/wo ADU) ,a
❑ Duplex 2 4Y1
a
❑ Multiple Dwellings (Single Family and/or Duplex) �1J a
!` AI
0
3. NUMBER OF BEDROOMS: 4
"4L951 C'
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ® Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received by: /7/A `` Date: .-7////7---
COSA to be released to the engineer,unless otherwise requested by the engineer.
COSA Fee $ oa,..r 7 1( P I - o= (42giC'0 Waiver Fee $
Date of Payment '3 l I 1 1?1 Ck 161°t8" Date of Payment
Receipt Number 6( Y4 21 (-75-5- Receipt Number
COSA# O5C. 1. 1 Lt12 Waiver#
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,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm MIKE N ANDERSON, P.E. Phone 727-8864
Address 4661 NATRONA AVE.
Engineer's Printed Name MIKE N ANDERSON, PE Date 04/11/17
/moi/• '`:a
° •
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JJ***** ° •••^•°•. e o. o e A
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6. DSD SIGNATURE `' '^° MlcHA L N. Ar.�Drhscv ;
' %;'
� CE-9:1159 �:'�
System #1 Approved for Li bedrooms. e{.Tr •, �� ,••,,��
System #2 Approved for bedrooms. �k :',0(£S,S1f>'ti -tiy
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
0t ��C�
Ja
ON-SITE
WATEF� AND m
,n WASTEUVATER z
c PROGRAM \�o .
By: � � � Original Certificate Date: �� /7
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet 10-10-12.doe
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system _
Certificate of On-Site Systems Approval Checklist
Legal Description: ELMORE. 41 S/1) BLOCK I, LOT I f Parcel ID: 018-171-36
A. WELL DATA
Well type Private /}2., If A, B. or C provide PWSID# Well Log (YIN) y
Date completed 'F �RSanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth 103 ft. Cased to 103 ft. Casing height (above ground) 18
FROM WELL LOG AT INSPECTION
Date of test 7 I( - 197_? 512/2017
Static water level 6ar(9 5 ft. 62 ft.
Well production L - g.p m 4+
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate 1.06 mg/L
Arsenic: ND ug/L Date of sample. 4/2112017 Collected by: Mike Anderson
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material SEPTIC /STEEL Date installed 1/2512008
Tank size 1250 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (YIN) N High water alarm (Y/N) N
Date of pumping 54.17 Pumper Alaska Quality Pump
C. ABSORPTION FIELD DATA— 1985 SYSTEM TESTED
Date installed 5/9/2017 Soil rating ....d./ ' or ftz/bdrm) 1.2 System type 5-WIDE
Length 50 ft. Width 5 ft. Gravel below pipe 4.0 ft.
Total depth 7.,qt. Eff. absorption area 500+ ft2 Monitoring tube Y Depression over field N
Date of adequacy test NEW Results (Pass/Fail) NEW For 4 bedrooms
Fluid depth in absorption field before test NEW in Water added NEW gal New depth NEW in.
Elapsed Time: NEW min. Final fluid depth NEW in. Absorption rate >= NEW g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) UNKNOWN If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at in.High water alarm level at in.
Datum Cycles tested Meets alarm& circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 1001+
Absorption field on lot 100'+ On adjacent lots 1001+
Public sewer main 75'+ Public sewer manhole/cleanout 1001+
Sewer/septic service line 50'+ Holding tank 100'+
Animal containment areas 100'+ Manure/animal excrete storage areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main 100'+ Water service line 10'+ Surface water 100'+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line4'0'see waiver Building foundation 10'+ Water main 10'+
Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain 50'+(None Known) Wells on adjacent lots 100'+
F. COMMENTS
"4"OSV 17162$
G. ENGINEER'S CERTIFICATION s�,• C�' �I[ l�
I certify that I have determined through field inspections and p�- .• ••7' 1
review of Municipal records that the above systems are in r*. 49TH ,.' a+
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name MIKE N. ANDERSON, PE f • MICHAEL N. ANL.KSCN ;o-/
CE 469 4'
Date 05111/2017 ,��••• 17--
Z' ` •OfES510�
COSA canary sheet_2-6-15.doc
. (17' _____
S 89'46'30'' E.
1 o SHOSHONI AVE .
O 178.71
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Bobby F. Burnett GRAPHIC SCALE: 1 Inch = 30 Feet
2941 arriage Drive
Anchorage, Alaska 99507 I i
(907) 350-5541 15 0 15 30 60 lik
��\`
Date Scale Legal DescriptionOF Z
5/10/2017 1 1" = 30' Lot 1 Block 4 '�(s� ` -4�
Grid AS-BUILT �A.. \lk
SW 3036 ELMORE SUBDIVION
Drawn by Field Book FIRST ADDITION , 'r` :�
BFB PLAT #P 635A / /
I hereby certify that the property described hereon has been surveyed - /
by me, or at my direction, and that the improvements situated thereonLS'i BOBBY F. B URNELT f
are within the property lines and do not overlap or encroach on the - � ,
property lying adjacent thereto unless otherwise shown. That no 4 X 5 _r(� - �p
improvements on the property lying adjacent thereto encroach on the 416, 1!�•
premises in question and that there are no roadways, transmission "'�S9IDN •�'
lines or other easements on said property except as shown. f
WATER WELL DRILLERS LOG DO NOT FILL IN
Drilling CoM p, � ` 11�� USGS No.
Driller.\ Area
Well Owner 0 tAV\ \tj L\ Use of Well 11\ \�
Location (address of: Township, Range, 4 Section (if known) ; distance from road:
',& L'A. . 1 V) \-,K. V\ O E 3\
Size of Casing (y Depth of Hole\ 63 feet. Cased to \ 0 feet.
Static water level (j 5 feet (above) (1.2tisaaland surface. Finish of well
(check one) Open end CS.) : „seTeen ( ) : 41erflorlit.ted ( ) .
Describe screen or perforations:
Well pumping test at t gallons per (hr) (min) for ` hours with
��-- feet of drawdown from static levels
Remarks ..� �� � � \�1 \iWV-,-T �
‘H QU\AVT.7„, WELL LOG C; ‘A .1‘-‘ .11° ,
__ 'Depth in feet from Give details of formations penetrated, size of material,
ground surface color, and hardness .
0 to . 0 \ 1— (4CiViA - V, 3 \•‘
3 to 1 0 Av' `_ C3• -C cA7 L
' Oto 35 L_ Ov4t‘ C . co
- 5 to 0 Cv
hZV-E-
v\ tocg T- V0\11\il\\ \;V._ CISZ VAV
to \N QOM 4 T'k O t`l - c c.N�$c& %V.. C_iWt4t.1
\ 63 to \i cc- \ `7 \ \tA �-
to C- vk\C oN kLAV__\ v1/4\1&
to R CtC. e: 1 �
to , �rVV � \ STT 0c
to \ ;x \ \ %' \ C`� C 1=. AV_
to t1n\rkc
to
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