HomeMy WebLinkAboutELMORE #2 BLK 8 LT 5Onsite File
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Dec_23.2022 12:08 PM Anchorage Well & Pump Service Inc 9072430742
#4843 P 1/ 1
MUNICIPALITY OF ANCHORAGE
Development Services Department * Phone: 907-343-7994
On -Site Water & Wastewater Section Fax: 997-343-7997
Pump Installation Log
Well Drilling Permit Number: Date of Issue:
Parcel Identification Number: 018_172 _ 38
Legal Description Block Lot Property Owner Name & Address:
OVERSTAD, LINDA R & GARY L
ELMORE #2 8 5 4$60 RIVERTON AVE
ANCHORAGE AK 995163658
Pump Installation Date: 12 - 22 - 2022
Pump Intake Depth Below Top of Well Casing: 104 feet
Pump Manufacturer's Name: A.Y. MCDONALD MFG CO
Pump Moral: 23075V3LB
IPump Size: '75 hp
Pitless Adapter Burial Depth 12 feet
Pitless Adapter Manufacturer's Name. MARTIN ON
Pitless Adapter Installer.
I
Well Disinfected Upon Completion? Yes ❑ No
Method of Disinfection: PELLETS
I Comments:
Pump Installer Name:
Company:
Mailing Address:
City:
ANCHORAGE WELL & PUMP SERVICE
7640 ICING STREET
ANCHORAGE, AK 99518
907-243-0740
State:
Attention: The puinp installer shall provide a pump installation log to On-site within 30 days of pump installation,
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
htta://www. muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP191302
Work Type: Septic Upgrade
Tax Code Number: 01817238000
Site Legal Address: ELMORE #2 BLK 8 LT 5 G:3036
Site Mailing Address: 4860 RIVERTON AVE, Anchorage
Owner: OVERSTAD LINDA R & GARY L
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
Effective Date:
Expiration Date
Lot Size in Sq Ft:
Total Bedrooms:
7/25/2019
7/24/2020
41548
2 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
L
l Provisions: A confirmation percolation test shall be performed prior to construction of the proposed
ld to confirm assumed percolation rate. If results require a design change, construction shall stop
g Onsite review and approval of a change order. Please submit results with the inspection report (or
order, if required).
71. RFA 6
ill
- • L!'Il
Date: _ J 2
Date. 7/:Z 5 Z/
4
6PLOS
MUNICIPALITY OF ANCHORAGE
Community Development Department 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. 018-172-38
Property owner(s) Gary and Linda Overstad
Mailinq address 4860 Riverton Avenue Anchorage, AK 99516
Site address Same
Day phone 317-0815
Legal description (Sub'd., Block & Lot) Elmore #2, Block 8, Lot 5
Legal description (Township, Range & Section)
Lot Size 41,548 Sq. Ft. Number of Bedrooms Four (4)
APPLICATION IS FOR: APPLICATION IS AN:
TYPE OF DWELLING:
(M all that apply)
Absorption Field ❑X Initial ❑
Single Family (SF) ❑X
(w/wo ADU)
Septic Tank ❑ Upgrade 0
Duplex
Duplex (D) ❑
Holding Tank El Renewal El
MultipleDwellings ❑
Privy El
and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that
this is in accordance with
applicable Muni`cipalCodes.
L
(Signature of property owner or authorized agent)
Permit/Rush Fees: 6-
`7ls- Waiver Fees:
Date of Payment: /2y://& l f "/ Date of Payment:
[>
Receipt Number: [`Z Receipt Number:
Permit No. �)"PI!9 1 362 Waiver No.
Permit App_:-:• ,-. c
PO BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
July 23, 2019
MOA Development Services
Department of On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Elmore #2, Block 8, Lot 5 – 4860 Riverton Avenue
Septic System Design
Dear On-Site Services Engineer:
The septic system on the subject lot has failed and must be replaced. We are submitting this permit
application for the construction of a new absorption trench system. The existing septic tank will
remain in service. The attached site plan identifies the location of the home and the existing well
and septic system along with the proposed location for the new system. No conflicts exist between
this proposed system and any other well or septic system on this lot or adjacent lots.
The ground surface on the lot is flat in the area of the proposed trenches. There are no slopes
greater than 25% within 50 feet down slope of the trenches. Ground surface contours are shown
on the site plan indicating the grade and direction of flow. Storm water drainage will not impact
this septic system. The new trenches will be constructed parallel to the slope as much as possible.
The percolation test completed on subsurface soils indicated an absorption rate faster than 1 minute
per inch. This rate is much faster than that achieved in 1984 as documented in the Municipal File.
We are estimating a percolation rate of 15 minutes per inch in the design of the new system, but
will verify the percolation rate prior to construction. Redesign will be completed if necessary. In
addition, water monitoring this year indicated the highest water table at 10’ below the surface.
This also differs from archive records which state a level of 8’. This may be due to the
development in the area and improvements to drainage over the past 35 years.
The new system will be a minimum of 100’ from all wells and surface water, 10’ from any water
service and more than 5’ away from the septic tank.
Please refer to the attached test hole log and plan and profile sheets for the septic design. If this
design is followed, there will be no adverse impacts to adjacent properties.
Sincerely,
Michael E. Anderson, PE
7-23-19
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191302, Rebecca Carroll, 07/25/19
// // // //
// // // // //EXISTING WELL
TH1
10050 0
FEET
1"=50'
NOTE:
NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE
PROPOSED SEPTIC SYSTEM
ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS
PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC
SYSTEMS.
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
FD - FLOW DIVERTER VALVE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
LEGEND
ELMORE #2, BLOCK 8 LOT 5
RIVERTON AVENUE
7/23/19
10' UTILITY EASEMENT10' UTILITY EASEMENTSHED
SHED
GREENHOUSES
(NO FOUNDATION)
MAY REQUIRE
RELOCATION.
4-BDRM HOME
CO
CO MT
FD
2-53' LONG x 5' WIDE x 2'
EFFECTIVE DEPTH
ABSORPTION TRENCHES
EXISTING 1,250 GALLON
SEPTIC TANK PLACED IN
2017.
FS CO
CO
MT
EXISTING ABSORPTION BED
PERCOLATION TEST REQUIRED
TO VERIFY CHARACTERISTICS
OF UNDERLYING SOIL.
REDESIGN MAY BE NECESSARY.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191302, Rebecca Carroll, 07/25/19
ELMORE #2, BLOCK 8, LOT 5
DESIGN FACTORS: SYSTEM REQUIREMENTS:
600 GPD PEAK FLOW
PERK RATE: ASSUMED 15 MIN/INCH
APPLICATION RATE: 0.8 GPD/SF
5' WIDE TRENCH SYSTEM
EXISTING 1,250-GALLON SEPTIC TANK
TYPICAL TRENCH SECTION
(NO SCALE)
4" PERFORATED PVC (HOLES DOWN)
DRAINFIELD ROCK
5'
6"
6"
2.5'
2'
NOTES:
1. GRADE AREA OVER TRENCH TO DRAIN AWAY
2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2'
WITH 2" OF INSULATION
3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER
THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY
BOTTOM OF TRENCH: 5' BELOW GRADE
FLOW LINE ELEVATION: 3' BELOW GRADE
TOP OF TRENCH: .5' ABOVE GRADE
600 GPD / 0.8 GPD/SF /5' WIDE * .7 RED. FACTOR = 105 LF TRENCH REQUIRED (106 LF SPECIFIED)
7/23/19
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191302, Rebecca Carroll, 07/25/19
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE:
PARCEL ID#:
SOILS LOG AND PERCOLATION TEST
TECHNICIAN:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
DEPTH
(feet)
PROJECT No.:
TEST HOLE 1
SLOPE
SLOPE
SITE PLAN
See Site Plan
DATE READING GROSS TIME
(minutes)
NET TIME
(minutes)
DEPTH to
WATER NET DROP
TEST HOLE PRESOAKED PRIOR TO TESTING:
PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH)
TEST RUN BETWEEN: FT. and FT.
COMMENTS:
(inches)(inches)
elmore #2 B8 L5
6/19/19
J. Millette
DATE OF MONITORING:
WAS GROUND WATER ENCOUNTERED?
DEPTH OF WATER AFTER MONITORING:
IF YES @ WHAT DEPTH?
NO
-
11'
<1 6
5 6
018-172-38
gary overstad
12:01 / 12:03
6/21
1
2
3
4
5
6
2:00 6" / 12" 6"12:04 / 12:06
12:08 / 12:10
12:12 / 12:14
12:15 / 12:17
12:19 / 12:21
OB
6" SILTY SAND
7/9
Professional Engineers Stamp:
7/15/19
SILT
SILTY GRAVEL
2:21 6" / 12" 6"
2:10 6" / 12" 6"
2:31 6" / 12" 6"
2:01 6" / 12" 6"
2:08 6" / 12" 6"
Soils in perc hole did not match those on soils log. Assumed perc. rate 15 MPI.
Perc rate should be much slower.
GM
SM
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191302, Rebecca Carroll, 07/25/19
RIVER TON A VENUE
NR9 50'47'F71700
------------------------
SHED
�e
0.111
i'
I
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i Q 3
I m
-----------
-- 22.0 .AA ��A i.] _
i
44.0
61.3
O.H CANT.
l _ o_--------- _ _ _ ____
ti 11101 O I
I v
W d E K O 2
W
No
o �I
II
GRN I
it HSE 1
'I
GRN
HSE
O
O TEST
HOLE
--------------------------------------------------
10' UTIL/TYEASEMEN T
N 89 56'17" E 212 00
�00000��O
OF A o�Q
D� 49 TH O
�D
0 .146 a 0
SHANE A. HOLT qjDO
Q� LS -6914
r°fessionak
��DO�oo��
THE INFORMATION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALLY TO SHOW ANY
CONFLICTS BETWEEN EXISTING STRUCTURES AND PLATTED LOT LINES AND/OR EASEMENTS; AND IS
NOT TO BE USED FOR POSITIONING ADDITIONAL STRUCTURES, IMPROVEMENTS, OR FENCELINES.
EASEMENTS OF RECORD, OTHER THAN THOSE APPEARING ON THE RECORD PLAT , ARE NOT SHOWN
HEREON ( UNLESS INDICATED)
NOTE: FENCELINES THAT MAY APPEAR ON THIS DRAWING ARE NOT TO BE USED TO DETERMNE
PROPERTY LINES OR POSITION ADDITIONAL IMPROVEMENTS.
ANY PAVING SHOWN HEREON MAY BE APPROXIMATE DUE TO EXCESSIVE SNOW AND/OR ICE.
AS—BUILT SURVEY 1" = 20'
NO CORNERS SET THIS DATE
I HEREBY CERTIFY THAT I HAVE PERFORMED A SURVEY
OF THE FOLLOWING DESCRIBED PROPERTY
LOT 5 N OCK 8 EL MORE SECOND ADD'N.
ANCHORAGE RECORDING DISTRICT, ALASKA, AND THAT THE
VISIBLE IMPROVEMENTS SITUATED THEREON ARE WITHIN
THE PROPERTY LINES AND NO VISIBLE ENCROACHMENTS
EXIST OTHER THAN NOTED- 19TH
DATED AT ANCHORAGE,ALASKA THIS DAY �
JUNE 2019
14284, FB 197-55
HOLT LAND SURVEYING
9309 GROVER DRIVE
ANCHORAGE,AK 99507
345-5513
SEP 05
Inspection Report _1-1-12.doc
Municipality of Anchorage
Community Development Department Page 1 of 2
On -Site Water and Wastewater Program
4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904
ON-SITE
WASTEWATER INSPECTION REPORT
Permit Number: OSP171256
PID Number: 018-172-38 ❑ New ❑✓ Upgrade
Name:
GARY OVERSTAD
ABSORPTION FIELD
❑ Deep Trench F1 Shallow Trench El Bed E:1 Mound
Address
4860 RIVERTON AVE
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
GPD/SF
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade Gravel beneath pipe
Ft.
Subdivision
Block Lot
ELMORE #2
8 5
grade
Fill added above originalGravel length
Ft. Ft.
Township Range Section
Gravel widthBeds:
Ft.
Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Holding
Sewer
Total ab tion area
Number of trenches
Dist. between trenches
From
Tank
Field
Lift Station
Tank
Line
Ft'
Ft.
Well
109.0
N/A
NA
N/A
TANK p Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
ANCHORAGE TANK
Capacity
1250G,1.
Surface Water
100+
N/A
N/A
N/A
Material
Number of compartments
Lot Line
37.7
N/A
N/A
N/A
STEEL
2
NA
Foundation
8.6
N/A
N/A
N/A
LIFT STATION
Manufacturer
Capacity
Curtain Drain
50+
N/A
N/A
N/A
Gal.
Remarks TANK REPLACE ONLY
Pump on level at
JP.
Pump off level a
in.
High water alarm at
in.
Pump make an del
Electrical Inspections performed by
Installer
PIPE MATERIAL House to tank 3034Tank to 3034
drainfield
ISAACS
Drainfield CO/MT 3()3 4.
Inspector Pannone Engineering Services
BENCH MARK (Assumed elevation) 425ft
Inspection�i
dates: 1 9/12/17
2"d 5/29/18
Location and description
3d
4`h
BOTTOM HOUSE TRIM (Sc-
SECOMMUNITY
COMMUNITYDEVELOPMENT DEPARTMENT APPROVAL
Engineer's Stamp
�'�G ��• A�'QS`{!
Conditional Approval:
Date
rTH
e
• itevn .�. •E�onnoRe•
CE 8149
{�f' \W
Approved
Date 1I aoi$
62
A' :►
Inspection Report _1-1-12.doc
\ 20 8. 71
M 132.00'
_ J
1
WELL \
420 \
425 � 1
4
BDR
SFD
EXISTING DRAIN FIELD'
N� / VV
w \N
i
IL
0 0 0
w
J
07
Z Z
W W D W
J J 0 J
0 OG. FG. 0 o v
425
420.4 1250 GAL
TANK 420.2
PROFILE SCALE: 1"=10'
or-
TRUE
r
TRUE NORTH _1„ SCALE : 1"= 50'
I
DECOMMISSIONED EXISTING 125
SEPTIC TANK PER MOA CODE
\INSIAILILILD NEW 1250g SEPTIC
W/ DCO AFTER
NOTES: PAMONE ENG SVC, LLC Dote
RECORD DRAWING 5/30/18
P.O. BOX 102954 ANCHORAGE, AK 99510 Q'�•" "••.
PHONE (907) 272-8218 FAX (907) 272-8211�. •• Scale
1„ = 50'
'• '• P.I.D. NO
ELMORE #2 38 L5018-172-38
GARY OVERSTAD � �everi II�anrioRe' PERMIT NO.
DRAWN ACP CE 8149
4860 RIVERTON AVE OSP 171256
SITE PLAN ANCHORAGE, AK 99516, Sheet
2OF2
/H "°"' �F MUNICIPALITY OF ANCHORAGE ,,,
/' On-Site Water &Wastewater Program ��`'
e PO Box 196650 4700 Elmore Road
Anchorage,Alaska 99519-6650 Phone:(907)343-7904 Fax:(907)343-7997 -
http:llwww.muni.org/onsite11191111
,
I), HITin ,t1
V ryC,I, AC+E
On-Site Wastewater Disposal System Permit
Permit Number: OSP171256 Effective Date: 8/31/2017
Work Type: SepticTank Upgrade Expiration Date: 8/31/2018
Tax Code Number: 01817238000 CI J�L/Il
Site Legal Address: ELMORE #2 BLK 8 LT 5 G:3036 I 2:`l
Site Mailing Address: 4860 RIVERTON AVE, Anchorage
Owner: OVERSTAD LINDA R & GARY L Lot Size in Sq Ft: 41548
Design Engineer: PANNONE ENGINEERING SERVICES Total Bedrooms: 4
This permit is for the construction of:
❑ Disposal Field 0 Septic Tank 0 Holding Tank 0 Privy 0 Private Well 0 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: A double cleanout shall be provided if there is none currently.
L1 '`I11 CJ r
Received By:L.;
,� Date: !
Issued By: I A gt7U7 Wf Date: 0
MUNICIPALITY OF ANCHORAGE
Community Development Department , �/ Phone; 907-343-7904
Development Services Division F 'I. .•• •9- i,
On-Site Water& Wastewater Program `� - -s
ON-SITE SEWER/WELL PERMIT APPLICATION ° AUG 3 0 2017
�
• — , y ,
a,
Parcel I.D. 018-172-38 i` a 3 Z 99^
Property owner(s) Gary & Linda Overstad Day phone
Mailing address 4860 Riverton Ave. Anchorage, AK 99516
Site address 4860 Riverton Ave.
Legal description (Sub'd., Block & Lot) Elmore #2 Block 8 Lot 5
Legal description (Township, Range & Section)
Lot Size 41,548 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(E)all that apply)
Absorption Field ❑ Initial ❑ Single Family (SF) ❑x
(w/wo ADU)
Septic Tank E Upgrade ❑X Duplex (D) ❑
Holding Tank ❑ Renewal ❑
Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE /WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
T
Signature of property owner or authorized agent)
Permit/Rush Fees: A /S Waiver Fees:
Date of Payment: g,31/8. Date of Payment:
Receipt Number: 615/0/7-/
/ Oggqat7 Receipt Number:
Permit No. 615/0 1 257, Waiver No.
Permit App_ - • :: ..c;
Pannone Engineering Services iic
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail:Steve@panengak.com
August 30, 2017
Subject: Elmore #2 Block 8 Lot 5
Tank Replace Permit Request
Design Narrative
This is a design narrative for a permit to install an upgrade 1,250g Septic Tank to replace an existing
1,250g Septic tank to be issued for this property. The existing tank has completely failed. It will be
decommissioned per code. Currently the lot is developed. The proposed system will utilize a replacement
1,250g septic tank that will be connected to the existing drain field. The existing tank is located
approximately 100'+ from the well. The proposed tank will be placed outside the existing well radius. All
required separation distances will be met.
1. Upgrade Tank Design.
A foundation clean out installed if needed.
The tank will be located: 5'+ from any property line or building foundation
10'+ from any water line
100'+ from any surface water
100'+ from any private wells
200'+ from any public wells
The proposed installation will not affect the future development of the surrounding or existing lots.
If you have any questions or concerns, please contact me at 907.272.8218.
Sincerely,
I'
i t Steven R Pannone
Steven R. Pannone, P.E.
Owner/Civil Engineer
Mailing: P.O. Box 100217, Anchorage. AK 99510-0217
Physical: 332 East Manor. Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
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
K'vI c- Jc A L
MAILING ADI~ESS
LEGAL DESCRiPTiON
LOCATION
OF'
Well
DISTANCE TO; I 0 ~ I
Manu,.~t.rer C~Rr.£R
IF HOMEMADE:
Well
DISTANCE TO:
Manufacturer
Well
DISTANCE TO: Length of each
NO, of lines
Top of tile to finish grade
Type of crib Crib diameter
DISTANCE TO:
°a"F~; uar£
we. lOP-*
Depth
DISTANCE TO; Building foundation
Inside length
Dwelling
Foundation
Total length of lines
Material beneath tile
Crib depth
Ruilding ~.~a]ion
Sewer line ~02 /
PHONE
[~UPGRADE
Dwelling
Material
Width
IMaterial
Nearestlotline
Trench width
NO. OF BESOMS
No. of co~.partment$
Liquid depth
PERMIT NO.
Liquid capacity in gallons
PERMIT NO.
Distance between lines
inches
Total effective absorption area
inches
Total effective absorption ~rea
Nearest lot line .~ ~ &
Distance to lot line
Septic tanktf~)~ /
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
AIEVVTo/d l~X ~' 116
APPHOVE/
DATE LEGAL
724313 (Rev. 3~78)
MUNICIPALITY OF RNCHO. ~GE
'~ DEPARTMENT OF HEALTH AND ENYIRONiqENTAL PROTECTION '
: 825 L STREET, ANCHORAGE, AK ~50£
- 2~4-4720
ON--SITE SEWER & WELL PERI'IT
PERMIT NO:
DRTE ISSUED:
840505 HAND WRITTEN
0¢?25?84
APPLICANT:
ADDRESS:
CONTACT PHONE:
KYLE SCALIS
SAR BOX 1452
ANCHORAGE, AK
334-4~74
~502
LEGAL DESCRIP: '
LOT sIZE:
SUBDIVISION: ELMORE #2
SECTION: 34 TOWNSHIP:
42000 (SQ. FT. OR ACRES>
LOT: 5 BLOCK
RANGE: 3W
I CERTIFY THAT: .
l, I ~M FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE (MOA> AND THE STATE OF ALASKA.
2. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH ALL NOR CODES AND REGULRTIONS~
AND IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PERMIT.
3, I WILL ADHERE TO ALL ~OR AND STATE OF ALASKA REQUIREMENTS FOR.THE SET BACK
DISTANCES FROM ANY EXISTING WELL~ WRSTEWRTER DISPOSAL SYSTEM OR PUBLIC
SEWERAGE SYSTEM ON THIS OR ANY ADJACENT OR NEARBY LOT.
IF R LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES~
THEN (l> RN ELECTRICAL PERMIT AND INSPECTION MUST BE 08TRINED~ <2> AS-BUILTS
WILL NOT BE APPROVED WITHOUT AM ELECTRICAL INSPECTION REPORT; AND (3> THE
ELECTRICAL WORK, MUST 'BE DONE BY ~ LICENSED ELECTRICIAN.
APPLICANT: K
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 I~ Street, Anchorage. Aleska 99501 2~4-4720
SOILS LOG - PERCOLATION TEST
SOILS LOG
PERCOLATION
TEST
DATE PERFORMED: /~--!1--~'
LEGAL DESCRIPTION:
-- ~_ '.-
5-
6
7
8
9
Lo+ ~;, Block
SLOPE
SITE PLAN
/
/
/
/
10
11
13-
14-
15-
16-
17-
18-
19-
20
COMMENTS
WAS GROUND WATER ~
ENCOUNTERED?* ~.~ ~
E
DEPTH?IF YES, AT WHAT 81
Gross Net Depth to Net
Reading Date Time Time Water (.~ Drop
+H~.O ~'[n/~- ~:~'~:~ lo r~,~ o.~°'e'; .0~
PERCOLATION RATE I ~:, 5 ~-' (minutes/inch)
TEST RUN BETWEEN '~ FT AND ~ FT
'TYPE
PER~O.~EDS*: cA/41~A. A.
CERT, ,EO
72-008 (6/79)
~ WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological ~ Geophysical Surveys
A.D.L. leo.
~JolsTA~ti ~ND OIR(CTiON FNOM ~OAO INT[NSECTIONS ~, OWN[~ OF W~L~:
WELL LOG Suffece I I ~ ft.
D Teit W.,[ ~ Oth.,:
i, CA~ING: ~ Threaded ~ Wilded
~1 "~ ~ ~ Above Ir ~ BeloI land lUrfOCt Dot.
· ~ ,,..,,.. ~ ,...,.~,, ~...~
12.GROUTING Well Grouted: ~ YII ~ NO
MUNICIPALITY OF ANCHORAGE
DIVISION O~ ENVIR01~iENTAL HEALTH
DEPARTHENT OF BEALTIt AND ,ENVIRONHENTAL P~0TECTION
APPLICATION FOR ~:~kI,Tlt ADTHORITY APPROVAL CERTIFICATE
1. General Information Application Date . ]~-~-~" '~ ~
(a) Legal Description (include lot, block, subdivision, section,
Location (address or directions)
(b) Applicants Name I~,~,,
Applicants Address ~l~ go~
(c) Applican~ is (check one) Le~i~
Buyer ~ ;' O~her ~ (~plain);
(d) Lending Ins~i~u~ion
A~s
tovnshtp, range)
Telephone - nome Business
4,1~%,~4(.,= ~. 40i'oJ
~--~; O~ner/bui4der ~;
Telephone
(e) Real Estate Co, & Agent
Address
Telephone
(f)
Mail the RAA to the follow'lng address:
2. Type of Residence
Siugle-Pamily~.
~umber of Bedrooms
3. ~ater Supply
Iudividual
Multi-Family
Other (describe)
Public
Note: If co,unity well system, must have vritten con~lr~ation from the State
Department of Environmental Conservation attesting to the legality and status.
Sewage Disposal
Oustte.~'~. Public~ C~m~i~y~ Holdin8 ~ank~
~oce: If community ~11 system, mus~ ~ve ~ttten cogitation from ~he S~a:e
Department of Envito~ental Co~se~ation attesting ~o the legality aM status.
[Page I of 2]
e
En~ineerin~ Firm Providin~ Inspections~ Tests~ File Search~ Data and Information
As certified by my seal affixed hereto and as of the validation ~te shown belov, I
verify that my investigation of this Health Authori~y Approval sho~s that the on-site
rater supply and/or u~s~evatar disposal system is safe, functional and adequate for
the number of bedrooms and tTpe of structure indicated herein.- I further verify that,
based on the information obtained from tha ~nicipality of Anchorage files and from my
investigation ~n~ inspection, the on-site rater supply and/or ~astewnter disposal
system is in compliance with all Municipal a~i State codes, ordinances, and regula-
tions in effect on the date of this inspection.
Name of Fi~m
Telephone
Approved for~,~(~} bedrooms By ~,~ tu~xx'~ Da~e
Approved /~ Disapproved Co~ition~
Terms of Conditional Approval
OAO~ION
-£m~ ItUNI¢IPALITY OF ANCHORAGE ~PARTMENT OF HT. ALTH AND ENVIE01~%ENTAL PROTECTION
: (DHEP) ISSUES I~ALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON TI~ REPEESEFf-
ATIONS ~IVEN IN PARAGRAPH $ ABOVE BY AN INI~PENIIENT PROFESSIONAL ENGINEER ILEGISTEEED
IN TI~ STATE OF ALASKA. T~ill I~EP DOES THIS AS A COURTESY TO PORCHASERS OF ROPIES AND
THEIR LENDING LN~TITUTION5 IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE ILEQUIEE-
HENTS. EHPLOYEES OF IItEP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA BEFORE A
CERTIFICATE IS ISSUED. THE HUNI¢IPALZT~ OF ANCHORAGE IS NOT RESPONSIBLE FOE ERRORS
OE C~ISSIONS IN %'ul~ PROFESSIONAL ENGINEER'S WORK.
(DHEP SEAL)
RRi/eI/D18
[Page 2 of 2]
7-19-8~,
ae
~CmAL~'Y O~ ANC~O~
DEPT. OF HEA~JH &
Legal Descriptio~[~
~11 Cla~ifi~ti~ ~,~qrC If A, B,
Total ~p~ ] } % ' ~d ~ ; ] / ~p~'Of ~ti~ ~.~= --
Static ~ter ~1 ~'
Casing ~i~h% ~ Gr~nd 3 / Sanit~ ~al ~ ~si~ ~)~
Elec~i~l ~ri~ in ~it ~) ~¢7 ~essi~ ~nd ~l~ad (Y~Y-)
~p~ati~ Dis~n~s ~ ~11:
To ~ptic~oldi~ Ta~ ~ ~t /~'
To ~a~st ~ of'~tion Field ~ ~t
To ~est ~blic ~ Li~ 43//%- To ~est ~blic
C~an~le ~.~
~Water S~le ~st ~sults ~a{~%$~%~
SEPTIC/HOLDING TANK 12~TA
Date Installed ~,/~,/~ Size
Standpipes ~N) ~,) Air-tight Caps ~_~,) ~ Fca. Inflation Cleanout ~N) ~_~
Dap~essio~ over TarR (Y~ Do ~te ~st ~d ,~/zg
~ing~in~r~n~ ~a~ ~ Fi~ (Y~)~;//~
Holding Ta~ High--teE ~a~ (Y~) ~//~ ~ra~ ~ldi~ Ta~
~rati~ Distils ~ ~ptic~ldfng Ta~:
To Water-Supply W~ll
To Property Line
To Water MairJServi~e Line
Course
To Building F~ndation 9, .4- t
To Disposal Field ~,~.~ ~
TO Stream, Pond, Lake, c~ Majo~ Drairmge
[Page 1 of 2]
Receipt 9
Date Paid:
Amount:
2-15-84
C, ABSORPTION FIELD D~TA
Soils Ratify in Absorption Strata
Pate r talled
Width of Field ? ~- '
Square Feet of Absorption A~ea
Depression over Field .(Y~ U0
Results of Lest ;~quacy Test
~ Gm ~ Type of System Design
Length of Field
Depth cf Field {~__r
Gravel Bed Thickness ~'
Standpipes Present ('~/N)
Date of Lest Adequacy Test _,, /t
Separation Distanoe from Absorption Field:
To Water-Supply Wall 1~?' To Property Line S~ ~
To Building Foundation ~ ' To Existin~ or Abandoned System
Lot ~;//~_ ; On Adjoining Lots >3~ ~
To Water Main/Service Line A2//~ To Cutbank(if present) A3/[~
To Stream/Po~.d/Lake/c~ Major Drainmge Course ~/~A
To Driveway, Perking Area, or Vehicle Storage Area ;) ~ '
De
"Pump On" Isvel at _ ~-"-~mp Off" Level at __
Tested for / Pumping Cycles durir~4~=quacy Test.
Meets
** Check Permitted Bedroom Rati~ AGairst }{~A Bequest **
I certify that I have checked, ~rified, or oonfcz~ed to all Mfl{ HAA Guidelines in effect
on the date of this im~pection.
KSl/dS/s
[Page 2 of 2]
2-15-84
I IIUIROI I'Iq I'ITAL COI TROL $ RUICI $, II'1C.
~ngin¢¢rin~ ~ Enuirontn~nl(i[ Sfu~ics
August 30, 1984
Department of Health and
Environmental Protection
825 L Street
Anchorage, Alaska 99503
Attention: Kelth Bandt
Subject:
Elmore ~2 Subdivision, Lot 5, Block 8
Dear Hr. Bandt:
On August 7, 1984 this office performed an on-site sewer inspection. The
s~ils were found to be better than original test. An on-site
reclassification of soll was made, and permit modified according to a new
soils log.
If you have any further questions, please feel free to contact me.
Sincerely,
John W. Gates
Engineering Technician
Approved ~y:
R=d~, Jr., Phd, P.E.
1200 ~¢st 33rd /~ucnu¢. Suilc [~*]~,cbora7. Alast0 99503,{907) 561-5040
