HomeMy WebLinkAboutSCIMITAR #1 BLK 3 LT 8imitar
Block 3
Lot 8
#051-132-32
Municipality of Anchorage
On-Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP201293 PID Number: 051-132-32
Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑ Upgrade
Name
SPRINGHILL ROBERT & REBECCA
ABSORPTION FIELD
❑ Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound
Site Address
19920 Tulwar Drive Chugiak AK 99567
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
4
filter sand 0.7 GPD/SF
5 - 7 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
4.5-6.5 Ft.
Gravel depth beneath pipe
0.5 Ft.
Subdivision Block Lot
SCIMITAR #1 BLK 3 LT 8
Fill added above original grade
-0.3-0.9 Ft.
Gravel length
58 Ft.
Township Range Section
Gravel width
15 Ft.
Beds: Number of Lines
5
Distance between lines
3 Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist, between trenches
From
Tank
Field
Tank
Line
870 Ftz
Ft.
Well
> 100
87'
NA
(
NA
TANK HSeptic ElS.T.E.P. El Holding El Other
Manufacturer
greer
Capacity
1250 Gal.
Surface Water
> 100,
I > 100'
NA
NA
Material
Number of compartments
Lot Line
> 10'
> 10'
NA
I NA
NA
plastic
2
Foundation
> 10'>
10'
NA
C NA
Ulf-T STATION
Manufacturer
Capacity
Gal.
Remarks undocumented well on lot 14 was
discovered during construction of field
Alarm location
Electri I-",S Iled by
PIPE MATERIAL House to tank 3034Tank to 3034
drainfield
Installer
Dean Excavation
Drainfield 3034 CO/MT3034
Inspector Curtis Townsend
BENCH MARK (Assumed elevation) 100 ft
Inspeection 9/29/2020
1m 9/26/2020
Location and description
ction 2�d
3'd 10/3/2Qj 411 10/12/2d
top of rear concrete step
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval: Date
0 A/_
: >..........
f
.... ^. .. ....
'U
Septic System u
Ltrld lvo
to
esL.T vm nd`Approved
`��is'.
Date 1`f
No.0 11 aw�v
�l�c�FOPROr,
EWr Q P�'°F.�
PROF-•
Note: this approval does not include well permit requirements.
trtev uo/uzr i o)
fro
ti
NEIGHBORING WELL IS >100'
FROM PROPERTY LINE
ABANDON, EXISTING 20' x 43'
x 6" EFFECTIVE DEPTH BED
1�
SCOPE OF WORK
1. NEW 1250 GALLON SEPTIC
TANK HAS BEEN INSTALLED
AND PROVIDED WITH A
MINIMUM 20" 0 MANWAY RISER
SERVING THE FIRST
COMPARTMENT.
2. NEW BED HAVING DIMENSIONS
OF 15' x 58' x 6" EFFECTIVE
DEPTH HAS BEEN
CONSTRUCTED. MAX DEPTH
BELOW SEWER ROCK IS 7'. 2'
SAND FILTER LAYER WAS
PROVIDED.
3. ALL CONSTRUCTION WAS IN
ACCORDANCE WITH ALL
REQUIREMENTS SPECIFIED IN
ANCHORAGE MUNICIPAL CODE
CHAPTERS 15.55 AND 15.65.
LOCATION OF 24' x 8'
EFFECTIVE DEPTH TRENCH
WAS CONFIRMED DURING
INSTALL. SEPTIC ROCK
REMOVED AND REPLACED
WHEN TANK WAS INSTALLED.
NEIGHBORING
SEPTIC IS
10' FROM PROPERTY LINE
aM T
.H M To
100'
P�
O
100'
00
�O
FC
\SLOPE <1 % C01,
TH a
020 TH®
POWER POLE
NEIGHBORING SEPTIC IS
>10' FROM PROPERTY LINE
DESIGN PARAMETERS
BEDROOM: 4 (600 gpd)
SOIL RATING OF FILTER
SAND: 0.7 GPD/SF
AREA REQUIRED: 858 S.F.
SYSTEM TYPE: BED
15' x 58' BED PROVIDES 870
SF OF ABSORPTION AREA
GARAGE 100'
/87' UNDOCUMENTED
WELL, LOT 14
15' x 58' x 6" EFFECTIVE
j DEPTH BED HAS BEEN
INSTALLED
NEW 1250 GAL SEPTIC TANK
WITH DOUBLE CLEANOUTS
DOWNSTREAM OF TANK
w�
993 TH ®��,
4�
Septic As Built Drawing Prepared for
REBECCA AND ROBERT SPRINGHILL ��t7 OF q�Is��♦
19920 Tulwar Drive Chugiak, Alaska 99567 C?�`�
SCIMITAR #1 BLOCK 3 LOT 8 ; 49TH
OSP201293%.....e..�..........................::.....%
...........................................
..�
EKLUTNA ENGINEERING, LLC DATE: 10/12/2020 :CURTIS TOWNSEND;i
DRAWN: CLT ���% No. C 11904
19162 MOUNTAIN ROAD �� (b
CHUGIAK, ALASKA 99567 50
.. ...... .. . •W
SCALE: 1"
(907) 406-1058 = ' %1/�NCFESS\
PID: 051-132-32 SHEET 2 OF 3 ItVA11 ���
MARK
A
z
ST1
54'-6"
23'-10"
Q
57'-8"
28'-6"
z
w
�
MT2
Q
J
�
46'-6"
w
U
O
69'-5"
J
W
O
m
O
Y
Q
w
Z
Z I
Q 1
O
O J
O U
z Q
101_._0 �— O
r,
MARK
A
B
ST1
54'-6"
23'-10"
ST2
57'-8"
28'-6"
C01
45'-6"
29'-8"
MT2
53'-6"
41'-0"
MT3
46'-6"
75'-10"
C04
36'-7"
69'-5"
Septic As Built Drawing Prepared for
100.3 - 102.9
100.0 - 102.0
2
I—
O
N
O
N
BM IS TOP OF REAR CONCRETE STEP, ASSUMED
ELEVATION 100'
REBECCA AND ROBERT SPRINGHILL
19920 Tulwar Drive Chugiak, Alaska 99567
SCIMITAR #1 BLOCK 3 LOT 8
EKLUTNA ENGINEERING, LLC
19162 MOUNTAIN ROAD
CHUGIAK, ALASKA 99567
(907) 406-1058
OSP201293
DATE: 10/13/2020
DRAWN: CLT
SCALE: 1 1/2" = 1'
PID: 051-132-32 SHEET 3 OF 3
101.0
PIPE INVERT ELEV 95.5 PERC
HOLE
JBOTTOM OF DEPTH
96.5
SEPTIC ROCK 95.0
—BOTTOM OF SAND 93.0
TEST HOLE DUG 7/29/2020
88'0
7 DAY GROUNDWATER STUDY
CONCLUDED 8/5/2020, NO
GROUNDWATER FOUND
BM IS TOP OF REAR CONCRETE STEP, ASSUMED
ELEVATION 100'
REBECCA AND ROBERT SPRINGHILL
19920 Tulwar Drive Chugiak, Alaska 99567
SCIMITAR #1 BLOCK 3 LOT 8
EKLUTNA ENGINEERING, LLC
19162 MOUNTAIN ROAD
CHUGIAK, ALASKA 99567
(907) 406-1058
OSP201293
DATE: 10/13/2020
DRAWN: CLT
SCALE: 1 1/2" = 1'
PID: 051-132-32 SHEET 3 OF 3
F
b Municip ali
of Anchorage
P.O. Box 196650 0 4700 Elmore Road
Anchorage, Alaska 99519-6650 • (907) 343-7904 • Fax (907) 343-7997
http://www.muni.org/Onsite
Development Services Department
On -Site Water and Wastewater Section
r�cnr
Department
* * * * VARIANCE/WAIVER REVIEW * * * *
Waiver-#: OSV201065 COSA#:OSC201562 Permit#:OSP201293
PID#: 051-132-32
Legal Description: Scimitar #1 Block 3 Lot 8
Engineer: Eklutna Engineering
Applicant: Robert & Rebecca Springhill
Your request for a waiver of the required 100 feet horizontal separation from the absorption field
to the undocumented private well on Scimitar #2 B3 L14 has been approved. The approved
separation distance is 87.0 feet. See engineer's waiver request for justifications.
This waiver approval applies to the existing absorption field and private well indicated above
only. Any future upgrade to the on-site wastewater disposal system will require all separation
distances be met or another approval from this department.
■■rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr a rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr■
Waiver is Granted: X Waiver is not Granted:
Date: Approved by:
Name of Reviewer
■rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr■
**** VARIAN C E/WAIVER REVIEW ****
P=KSO.
,
CAKACL
HOUsE,
ronm
SEK
ALODiATPON Jehz
ASBUILT-NO CORNERS SET THIS DATE. SEWARD& ASSOCIATES LAND SURVEYING 688-4566
IHEREBY CERTIFY THAT HAVE SURVEYED THESCALE
FOLLOWING DESCRIBED PROPERTY:
Scimitar Subd. ,Unit No. 1, Lot 8,B1k. 3
AND THAT NO ENCROACHMENTs EXIST EXCEPT AS
INDICATED. IT IS THE RESPONSIBILITY OF THE
oWNER TO DETERMINE THE EXISTENCE OF ANY1
EASEMENTS, COVENANTS, OR RESTRICTIONS
WHICH DO NOT APPEAR ON THE RECORDED SUBDI
vIsION PLAT. UNDER NO CIRCUMSTANCES SHOULDFE
ANY DATA HEREON BE USED FOR CONSTRUCTION
OF FENCE LINES, OR FOR ESTABLISHING BOUND-
ARY LINES.
1"=40 TATE
49H
OF ALAS
DATE
9-14-92
S
GRID:
NW 1261
Duene Merk Seward
LS-6918ervd Prde 31-77
DRAWN
Land SD
DMS
Psten
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Read
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http:l/www.rnuni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP201293
Work Type: Septic Upgrade
Tax Code Number: 05113232000
Site Legal Address: SCIMITAR ##1 BILK 3 LT 8 G:1261
Site Mailing Address: 19920 TULWAR DR, Chugiak
Owner: SPRINGHILL ROBERT J &
Design Engineer: EKLUTNA ENGINEERING, LLC*
This permit is for the construction of:
Q Disposal Field C1 Septic Tank ❑ Holding Tank ❑ Privy
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
v.
Dopa rtmen r
8/13/2020
8/13/2021
45734
❑ 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 (2417).
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 B,
Issued By:
Date:
Date: % 3�.�d2 c)
4
ZZo
ON-SITE SEPTICIWELL PERMIT APPLICATION
Parcel I.D. 051-132-32
Property owner(s) SPRINGHILL ROBERT & REBECCA Day phone
Mailing address 19920 Tulwar Drive Chugiak AK 99567
Site address 19920 Tulwar Drive Chugiak AK 99567
Legal description (Sub'd., Block & Lot) SCIMITAR #1 BILK 3 LT 8
Legal description (Township, Range & Section)
Lot Size 45,734 Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
(® all that apply)
Absorption Field
Fx_1
Septic Tank
F
Holding Tank
❑
Privy
❑
Private Well
❑
Water Storage
❑
APPLICATION IS AN: TYPE OF DWELLING:
Initial ❑ Single Family (SF) ED
(
Upgrade. Z w/wo AD U)
Renewal ❑ Duplex (D) ❑
Multiple Dwellings ❑
(SF and/or D)
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above inform tion is correct. I further certify that this is in accordance with
applicable Municipal Cocle�.
(Signature of property
or authorized agent)
�/ -Lo 'Z'
Permit/Rush Fees: y� � COvIb_6waiverFees:_
Date of Payment: aq 20,� U Date of Payment:
Receipt Number: 50 %b Receipt Number:
Permit No. 01 S P 2 d) 2_ � 3 Waiver No.
GADevelopment Services\Building Safety\On Site Water and WastewaterTorms\Client FormsTermit Application.doc
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201293, Rebecca Carroll, 08/13/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201293, Rebecca Carroll, 08/13/20
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201293, Rebecca Carroll, 08/13/20
On-Site Water System Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number: OSP101113
Tax Code Number: 05113232000
Work Type: Well Upgrade
Permit Effective Dates: July 14, 2010 to July 14, 2011
Design Engineer:
Subdivision: SCIMITAR #1
Site Legal Address: SCIMITAR #1 BLK 3 LT 8 G:1261
Owner/Address: HUDSON KEITH C & VICKIE G
19920 TULWAR DRIVE CHUGIAK AK 995676354
Site Mailing Address: 19920 TULWAR DR, Chugiak
Lot Size in Sq Ft: 45734
Total Bedrooms: 4
l)epa r tment
This permit is for the construction of:
N Disposal Field N SepticTank N Holding Tank N Privy N Private Well Y 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 wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, Alaska 99507
www. muni.org/onsite
(907) 343-7904
ON-SITE SEWER/VVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
osPtOit/%
Parcel I.D. O S / / 'J~ '~ ~.P~', ,~'
Properly owner(s) ~.¢' ~,~g~ Day phone
Mailing address /¢¢~ ~~~
Site address ~/~/~ ~/4
./
/.
Legal description (Sub'd., Block & Lot) ,~p[~//~¢ '~
Legal description (Township, Range & Section)
,ct S,ze ¢ Sq. edroom
Zip Code
Zip Code
THIS APPLICATION IS FOR ([~ all that apply):
Absorption Field
Septic Tank
Holding Tank
Privy
Private Well
Water Storage
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 ~n~is in accordance with applicable Municipal Codes.
· l I /
(Signature of property owner or authorized agent)
Permit/Rush Fees:
Date of Payment:
Reoe,pt Number:
(Rev. 11/05)
Waiver Fees:
Date of Payment:
Receipt Number:
07/07/2010 03:51 9076942441 KL PLUMBING PAGE 01
Convenient to Fill, Dr~tn Quality 11½~" gate
valve l.~ mounted on 8" PVC extension pipe for
easy draining. Big 10" di. amet.?' flexible sleeve
on top makes tank simple to fin.
, .. '. ~,,~:.,..~'"' ........' ;'... '.. .,. · . . ' .
~',-:..'";' ~ .... I ~ ' . ' . ". · .
..,....: .. .. .'~.:,.. . . .,. ..... './~;. ,, "~:
- ,,. '~,, ;...::,' :,;;.', '.,...-
!!lllil!a
Compact, Easy to Store Even the larges~
Kolaps-A-Tank can be folded up and stored in
an 18" x 1~5" x 1~5" carWn.
SPECIFICATIONS
Approx.
Shipping Wt,
Model No. Approximate Size Gals. Liters Lbs. KG
YDA 50MT 40" x 50" x 12' (102crn x 127cm x 30em) 73 276 11 5
I"L~A 73MT $0' x 73" x 16" (203cm x 185cm X 41cm) 275 1040 23 10.4
I~'DA 98MT 65" x 95" x 18" (165cm x 249cm x 46cm) 525 1087 33 15
~-~A/~X,~0/a'T $' x 10' x 2' (1.83rn x 3.05m x .61rn) 800 3028 42 19.1
114o 4~ 58 26,3
7' x 1',4' x 2' (2,13m x 4.27m x ,.6lin) 1540 29
FDA 714MT 5072 64 __
FDA-approved models meet Food and DrLlg Administration 21CFR121,2514 of 5ubpart F of the Food Additive
,Rel~latlon, making it .~ai'e for drinking water used for human consunuption, ..
From covered wagons to
turkey saddles, . ·
· . Butch Manufacturing has been making
quality textile products for agriculture,
industry, and more for almost 100 years. If a
product you need can be made of canvas or
vinyl coated nylon ~ chances are we can
sew it. heat seal it. or silkscreen it. 5eno1 us
yoLtr specifications and we'll be hetplTy to
pr,.ovide you with a free e~tirnate.
and Service*.
URCH
Fort Dodge, Iowa 50501 Phon¢; (515) 573-~136
BRANCI'I:
2055 Hubbell Avenue
Phone: {515~ 2(t5-3457
Des Moines. Iowa 50317
AOKT 81 Manufaclurers of can~as and sy n th el ir: I exf ile p;r~d L/Ct.S Si nee If152,
Reoeived 07-07-10 Ol:02pm I:rom-O075041441 To-Alaska Anvil, lnG. Page 001
87/87/2818 83:48
BO7BB42441
KL PLUMBING
PAGE 81
KELLER SUPPLY COMPANY
Received 07-07'-10 12:Sgpm
F ram-gOT'Sg42441
To-Alaska Anvil, Inc.
Pale 001
M-W Drilling, l:nc.
+P.O. Box l10378*Anchoroge, AK 99511e
· 907-345-4000 * 907-345-3287 Fax,
Job No.: 01-172 Project No.: NIA
PermitNo.. SW010~45
Groundwater Well As-Built & Log
· P/ell Owner: Mr. & Mrs. Keith Hudson · Use of P/ell:
· legal Description: Lot 8, block 3 Scimitar Subdivision No. I '
Domestic
19920 Tulwar Drive, Chugiak, Alaska
.Construction
· llole Depth: 427' · Casing SI:e: 6" · Cased To: 156.47' · Material: A 53 Steel
· DrlllMethod: Air Rotary
Perf.
· P/ell Cdmpletlon-- Open end '-- X--- Screen -' Perforated - Method:
· Screen/Perforation description: None
· Grout Notes: (7) Sacks- bio. g bentonite granules
· Notes:
Well is currently making less than I/3 gpm and will be hydrofracked this spring.
· tf~//Development: Method: Air surge Notes:
· Staticwatertevet(S~YL) 161' (=5c;'c) (betow)topofcaslng(TOC).
· P/ellyleld test at ~ gallons per minute (GPM)/gallons per hour (GPII) for __ Itout~ '
with of drawdown (DD) from static le~,e,I (SWL).
· Method: Air lift · ,-
· Date of drilling: 3 0 August, 2001 · Pump Install: -
· Date of Fracl~ & Development:
· "' ' Well Log
Depth In feet from
top of casing. Details of formations penelratedy slz~ of material? color a nd hardness.
0 TO 2 Casing stickup
2 TO 20 Cobble gravel: brown, clean, sandy
20 TO 29 As above: damp
29 TO 35 Siltysand: brown, damp
35 TO 37 Boulder
37 TO 42 Gravelly silt: brown, wet
42 TO 135 Gravelly silt: gray, dry
135 TO 140 Gravelly sand
140 TO 155 Gravelly silt, asabove
155 TO 161 Bedrock: gray/black, siltstoneargillite, trace ofwater in surface fractures
161 TO 427 Asabove: no obse~able fractures carbonaceous streaks at 240' and 26Y, quartz
TO seam at 255'. -
·
To
TO Na,V'~,g,t~r t flied Contractor
TO Certificate No's. $14 & 9?$
MUNICIPALITY OF ANCHORAGE
Development Sen/ices Department
On-Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WATER SUPPLY PERMIT
Upgrade
Date Issued: Mar 28, 2001
Expiration Date: Mar 28, 2002
Permit Number: SW010045
Legal Descr pt on:~C~.,~:~-'~I.-'B~L~(.-'3-~T'--~8 .~"
Design Engineer: 0000 None Required
Owner Name: KEITH HUDSON
Owner Address: 19920 TULWAR DRIVE
CHUGIAK, AK 99567-6354
Parcel ID: 051-132-32
Site Address: 019920 TULWAR DR
Lot Size: 45734 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] SepticTank [] Holding Tank [] Privy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. Ail requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ),
3. The engineer must notify 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.
.eceived By:
Issued
Date: ~ '- 2~ -01
Municipality of Anchorage
Development Services Department
Budding Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWEPJVVELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D.
!
Property owner(s)
Mailing address (1)
Mailing address (2)
Legal description (Lot, Block & Sub'&)
Legal description (Section, Township & Range)
Lot Size .~"',,0..~ ~' Acre Sq~.~.F
Permit Number SW {21004.,t-
~..~/~y phone Zip Code
Number of Bedrooms
THIS APPLICATION IS FOR:
Sewer Only
Sewer and Well
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub
Swimming Pool
Therapy Pool
Well Only
Water Storage
Jacuzzi
Water Softening Unit
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is i~n accordance with applicable Municipal Codes.
(Signat6re of property owner or authorized agent)
Waiver Fees:
Date of Payment:
Receipt Number:
Municipality of Anchorage Page / of_
DEPARTMENT OF HEALTH AND HUMAN SI:RVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewaler Disposal System and/or Well Inspection Report
Permit Number: .%1,¢ ~ ¢- O.~ O/-¢ PID Number: OG/ - /~-
N~me: Wastewater System: D New ~Upgrade
Address: ABSORPTION FIELD
Phone: I No. el B~rooms:
~_ ~%/ ~ Deep Trench ~ Shallow Trench ~Bed ~Mound ~Other
Lo~: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe
WELL: D New ~/5¢. ~ Upgrade/ Gr~vel~e¢~/~ Numbero~gnes: UisUnc~hv~e,U,es:
Classification (Privale, A,B,C): Total Dep~ Cased To: Total absorption area: Pipe material:
Driller: Date Drilled: Slatic Waler Level: Installer: Date inslalled:
Pump Set at: Casing Height Above Ground:
SEPARATION DISTANCES u Septic ~ Holding ..... U S.T.E.P.
To Septic Absorplion Llfl Holding ~/Prlva~e Manulacturer: ~~ Capacity in gallons:
From Tank Field Slotion Tank Sewer Lines
Surface
Lot z / Size in gallons: Manufacturer:
"Pump on" I~vel at: "Pump off" level at: bitch water alarm al:
Curtain ,*-//~ k//~ ~//~ ~/4 //~ Pump Make & Model Electrical ,nspeolions pe?ormed by:
Assumed Elevation:
Department of Healtb~d H~oervices approval ~.~% :"~
72-013 (1/91) MOA 25
Permit No. SW920304 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: Scimitar #1 Lot 8, Blk 3
PIDNo.: 051-132-32
TIES
A - C = 105'
]3 - C - 138'
H - E = ~8'
)TE, LEACIdFIELD PIPING
1.25' DIA. WITId ~/&' DIA.
)LES SPACED AT 2.07' C.C.
EXISTING
SEPTIC
ABANDONED
/
/
PBWER PBLE
ELEVATIONS
(NOI TB SCALE)
/
/
/
/
/,
/
/
/
SCALE 1' = 60'
MONITOR TUBE
SEWER CLEANOUT
WELL
EASEMENT
ENGINEER'S SEAL
,,,~o ~ 9TH ~ ". q~ ¢~
.... ; .>. ~:~_ . ;'
'?S "LOUIS A. BU]ERA .'
72-013A(2/91) MOA25 Revised 10/22/92
'[ALMAR ELECTRIC
~Contractor ~
ELECTRICAL CONTRACTOR LIC, #601 P.O. BOX 771745 * EAGLE RIVER, AK 99577
694.9993
TO:
Hamann Construction
Po. Box 770617
Eagle River AK 99577
Date:
Inv:
Ph:
10-14-92
Legal: Lot 8,Blk. 3 Scimitar # 1
This is to confirm that on site sewer lift station
has been wired according to code and MFG. speci-
fication. System was electrically tested and per-.
formed 'to MFG. specifications.
MUNICIPALITY OF ANCHORAGE
ENVIRONM~NTA/ SERVICES DIVISION'
RECEIVED
Tom Fink,
Mayor
2 lunicipality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
October 27, 1992
Lou Butera, P. E.
Eagle River Engineering Services
PO Box 773294
Eagle River, Alaska 99577
Subject: Waiver Request for Lot 8 Block 3 Scimitar #1
Waiver Request #WR920068, PID ~051-132-32, SW920304
Dear Mr. Butera:
Your request for waiver of the required 10 foot separation
between a septic system and a lot line has been approved.
waived distance is 6 feet.
The
This approval applies to the existing septic system lot line
separation only. Any future upgrade to the septic system will
require all separations be met or another approval from this
department.
Sincerely,
Robert Wo Robinson
Civil Engzneer
On-site Services
'Concur: /f l
.~rogram ~a~ager
On-site Services
ljw#7
MUNICIPALITY OF ANCHORAGe.
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR# I~q~r~l~ PID# 051-132-32 HA#
Date Received: October 16, 1992
Legal Description: Lot 8 Block 3 Scimitar Subdivision #1
Engineer: Lou Butera, P. E., Eagle River Engineering Services
PO Box 773294, Eagle River, Alaska 99577
Permit #SW920304
Applicant: Keith C. Hudson
Waiver Requested: Lot line waiver - 6 feet
Criteria: 1. Geology: Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3. Other:
Waiver is Granted:
Waiver is NOT Granted:
List Conditions or Reasons ~or above:/
· ~ame of Reviewer
Rec #: 24164/444 Amount: $ 70.00 Date Paid: 1Q-~-9~
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "I," STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW920304
DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES
OWNER NAME:HUDSON KEITH C &
OWNER ADDRESS:SR Z BOX 117 TULWAR
CHUGIAK, AK 99567
PARCEL ID:05113232
LEGAL DESCRIPTION: SCIMITAR #1 BLK 3 LT
SEC 10, T15N, R1W, SM
LOT SIZE: 45734 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
DATE ISSUED: 9/23/92
EXPIRATION DATE: 9/23/93
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 (iSAACS0).
3. THE FOLLOWING SPECIAL, PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY:
ISSUED BY: '~/~///~/~/~~ DATE:
DATE:
Louis Butera, P.E,
Regislered Civil Engineer
September 21, 1992
John Smith, P.E.
Manager, On-Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: Scimitar #1, Lot 8, Block 3
Narrative
Dear Mr. Smith:
The proposed septic upgrade will have very limited impact on adjacent properties for the
following reasons:
1. The area has large lots allowing sufficient room for septic sites.
2. Immediate neighboring septic systems are all +30' distance.
3. Reserve space is adequate, due to absorption capacity.
4. Drainage will not be effected and is not a major consideration in our design.
This upgrade is an attempt to improve the Nitrate concentration in the subject lot's well. The
new field location will require a waiver to lot line of 5' distance due to the existence of a small
area outside of the 100' well radius, and the need to relocate a driveway to allow sufficient room
for the leachfield. The location of the leachfield to the north side of the lot will hopefully place
the effluent down gradient of the well location. The new system was designed as a dosed bed
with 2' sand filter layer.
If you have any questions please call our office at 694-5195.
Sincerely,
Louis Butera, P.E.
P.O. Box 773294 · Ea~/[e River. Alaska 99577 · Tdeuho~m (907/694-5195 . Fax/907~ 6~)4-.~2917
EAGLE RIVER
ENGINEERING SERVICES
P. O. Box 773294
EAGLE RIVER, ALASKA 99577
Phone 694-5195
SHEET NO. OF
CALCULATEDBY. ~" ' /"~' DATE
CHECKED BY DATE_
SCALE
Foue Bedroom: Single' Family DWelling
4 .B 600
Soil Perc Rate = 0.7 GPD/ft2 (filter layer)
Absorption area required = 600 .-" 0'.7 = 857 square feet
Bed Dimensions .
, Length = 43'
Width = 20'
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LEGAL: LOT 8, BLOCK 3, SCIMITAR #1
GENERAL
1. The well and septic plan are for a single family residence only.
2. The drawing and or site plan shall be a part of this specification.
3. All materials and workmanship shall meet the Anchorage Department of Health and State
Department of Environmental Conservation requirements.
4. All soil tests are advisory to the design and are to be verified or ~nodified in the field by the
engineer.
5. All excavations and depths are advisory and are to be verified or modified in the field by the
contractor to meet Municipality of Anchorage, Department of Environmental Conservation
requirements.
6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any
adjacent multi-family wells.
7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer
approval.
TANK
1.
2.
3.
The existing tank is to be pumped and removed, due to Nitrate problem. Any effluent
contamination under tank location should be removed from site, and properly disposed of.
The new tank is to be an Orenco Systems lift station at 6' burial depth, wired by a licensed
electrician, receipt to be supplied to engineer.
Sewer line to leachbed is to be 1" HDPE pipe buried 4' minimum depth, and insulated with 2"
35 PSI burial foam, with positive drainback to lift station.
BED
1.
2.
3.
4.
The bed is to be located as shown on plan with driveway relocated to 10' from the bed.
The bottom of the bed shall be level, plus or minus 1.5".
The total depth of the bed excavation to filter layer is not to exceed 6' at any point.
The sewer line is to replace the existing sewer line that leads to the existing tank. The existing
tank and field are to be properly abandoned.
The bed gravel is to be covered with typar fabric material.
Soil or cmnbination of soil and extruded board insulation to a depth of 3' or equivalent is to be
placed over the leachfield.
The area over the bed is to be finish graded to prevent pending of surface water runoff.
The septic tank and leachfield must not be closer than 100' to any existing private well, 150' to
any Class "C" well, or 200 feet to any community well.
RECOMMENDED LEACHFIELD DIMENSIONS:
TOTAL DEPTH == 6' filter, 4' bed gravel
GRAVEL THICKNESS = 1' FILTER THICKNESS = 2'
BED LENGTH = 43' BED WIDTH = 20'
SOIL RATING = 0.7 GPD/ft2 BEDROOM CAPACITY = 4
SEPTIC TANK SIZE = 1,500 with lift station
NOTE: Pressure effluent piping in bed to be 1 IA" PVC with 1/8" holes drilled 2' on center facing down.
Relocate driveway 10' from leachfield location.
Sand for filter layer is to be from an approved ADEC approved filter sand source (Quality Sand & Gravel)
Twenty-four (24) hours notice required for all inspections.
NO WELLS
+100'
LOT 7 LOCATION
lO0'
WELLS
LIFT
TANK
GALLD/~
PRIVATE
WELL +100'
EXISTING
SEPTIC
-FO BE ~
PRIVATE ABANDONS/
//'SEPTIC +30' POWER POLE
REQ, ABSORBTION AREA = 600/0.7 = 857 SQ,FT,
NO KNOWN CURTAIN DRAINS, NO SURFACE WAFER +100'
/
/,
/
/
WELL 125'
NIl WELL +100'
I [] - TEST HOLE
· - MONITOR TUBE
o - SEWER CLEANOUT
4p - WELL
H-H+HH-H-- PROPOSED LEACHFIELD
EASEMENT
SEP-FIC SiTE PLAN
LEGAL: LOT 8, BLOCK 5 SCIMITAR #1
OWNER: KEITH HUDSON
CONTRACTOR: N/A
JOB // 92-1481 DATF: 09/22/921 SCALE 1" = 50'
EAGLE RIVER ENGINEERING SERWCES
A P.O. Box 773294
EAGLE RIVER, Atf. 99577
(907) 694-5195 FAX: (907) 694-3297
Municipality o! Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION 'rEST
(ENGINEER'S SEAL)
LEGAL DESCRIPTION: ~-~7~oc' ,/~¢/','~.J;' _¢c-/',~,lq~FTownship, Range, Section: T/.5-.Ai .FS//..) 5"e.c /~
1
2
3
4
5
O
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED? /'~O
IF YES, AT WHAT
DEPTH7
Depth Io Water Aller ,
Monitoring? /~/~-.~¢-- 0ate:
S
L
O
P
E
Reading Date Gross Net Depth to Net
Time Time Water Drop
I ?/'?/~ '~ .,(¢'" 2~' ~ '~ "~,;~ '/' ~"
~ ~1/~?~ '/ ,, ¢~ ~"
PERCOLATION RATE '~ / (minutes/inch) PERC FIOLE DIAMETER __
TEST RUN BETWEEN zT/ FT AND ,~-- FT
PERFORMED BY: ~r'-,./¢ ~ ~ I ¢¢ ~,';~-~"~""~'~,~ CER1 IFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL S'TATE AND MUNICIPAL GUIDEL,NES ,N EFFECT ON THIS DATE. DATE: ~?/'~..///~:..~
72-008 (Rev. 4185)
FIGURE 7-30
NOMOGRAPH FOR DETERMINING THE MINIMUM DOSE VOLUME FOR A GIVEN LATERAL DIAMETER,
LATERAL LENGTH, AND NUMBER OF LATERALS
4,000
3,500
3,000
2,500
2,000
'~ EXAMPLE 7-3
1,500 uJ'
1,000 ~O EXAMPLE 7-2
· 900 LU /
800
0 :20 /
450 Z
-- '6 u_[
400 ~
350 J 7
250 .,..~ ~' UJ 9
.2 ~ lO1~
200
Z
-10
-15 ,~
-20 ~--
-30
287
PRIVet- ~
NO IKNOWN CURTAIN DRAINS, NO SURFACE WATER +100' EASEMENT
SEPTIC SI'T'E PLAN
LEGAL: LOT 8, BLOCK ~ SCIMITAR #1
~WNER: KEITH HUDSON
CONTRACTOR: N/A ..
£A~L£' RIV~.'IR £NGINE£RING S~RVICES
A P.O. Bo~c 7?3£94
£AGL£ RIV£R, AK. 99577
LEGAL:
A.
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LOT 8, BLOCK 3, SCIMITAR #1
GENERAL
1. The well and septic plan are for a single family residence only.
2. The drawing and or site plan shall be a part of this specification.
3. All materials and workmanship shall meet the Anchorage Department of Health and State
Department of Environmental Conservation requirements.
All soil tests are advisory to the design and are to be verified or modified in the field by the
engineer.
All excavations and depths are advisory and are to be verified o~' modified in the field by the
contractor to meet Municipality of /mchorage, Department/of Environmental Conservation
requirements.
It is the responsibility of the owner to obtain all necessary or easements and to locate any
adjacent multi-family wells.
The excavation is to be exactly in the area shown on the s any deviation requires engineer
approval.
B. TANK
1.
2.
3.
C. BED
1.
2.
3.
4.
The existing tank is to be pumped and due to Nitrate problem. Any effluent
contamination under tank location should site, and properly disposed of.
The new tank is to be an Orenco Systems lift at 6' burial depth, wired by a licensed
electrician, receipt to be supplied to engineer.
Sewer line to leachbed is to be 1" HDPE 4' nfinimum depth, and insulated with 2"
35 PSI burial foam, with positive drainback , lift station.
The bed is to be located as shown
The bottom of the bed shall be level, pi
The total depth of the bed excavation
The sewer line is to replace the exisl
tank and field are to be properly
The bed gravel is to be covered w
Soil or combination of soil and
placed over the leachfield.
The area over the bed is to be
The septic tank
any Class "C" well, or 200
RECOMMENDED LEACHFi
TOTAL DEPTH = 6' filter, 4' bed
GRAVEL THICKNESS = 1'
BED LENGTH ~ 43'
SOIL RATING = 0.7 GPD/ft2
SEPTIC TANK SIZE = 1,500 with
an with driveway relocated to 10' from the bed.
1.5".
filter layer is not to exceed 6' at any point.
sewer line that leads to the existing tank. The existing
material.
board insulation to a depth of 3' or eqnivalent is to be
graded to prevent ponding of surface water runoff.
not be closer than 100' to any existing private well, 150' to
to any community well.
FILTER THICKNESS = 2'
BED WIDTH = 18'
BEDROOM CAPACITY = 4
station
NOTE: Pressure effluent piping in be 1 IA" PVC with l/o" holes drilled 1.8' on center facing down.
Relocate driveway 10' from leachfield location.
Sand for filter layer is to be from an approved ADEC approved filter sand source (Quality Sand & Gravel)
Twenty-four (24) hours notice required for all inspections.
EAGLE RIVER
ENGINEERING SERVICES
P. O. Box 773294
EAGLE RIVER, ALASKA 99577
Phene 694-5195
SCIMITAR #1 Lot 8 Blk 3
JOB
92-148.cal
SHEET NO
CALCULATED
OF
DATE 09/21/92
CHECKED BY
DATE
SCALE
Four Bedroom Single Family Dwelling
4: BR = 600 GPD
Soil Perc Rate = 0.7 GPD/ft2 (filter layer) ----.
Absorption area required
Bed Dimensions
Length =
Width = 18'
= 600 +
0.7 ~' 857
feet
EAGLE RIVER ENGINEERING SERVICES
P.O. Box 773294
EAGLE RIVER, ALASKA 99577
To P~
Phone 694-5195
LETTER
[] Please reply
[] No reply necessary
SCIMITAR LB/B3
PUMP Flow ELEV. PIPE Head ORIFICE FI'Iq'lNG Total ORIFICE NUMBER ORIFICE
(GPM) Head (ft) Loss*(FT) HEAD (FT) LOSS (F'D HEAD FI.OW OF SPACING
LOSS (FT) RATE** ORIFICES [FT/
27,0 7 45.68 5 5 62.68 0,42 64 2,30
Constants:
I
Pipe Length (ft) 140
PIPE SIZE IN. 1,
Pipe ID (inch) 1.049
Pipe Friction Coeff, (m) 155
ORIFICE SIZE IN, I 0,13
TOTAL LATERAL LENGTH IN BED 14§
*HAZEN AND WILLIAMS FORMULA
-ORIFICE EQUA110N I
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 I_ Street- Anchorage, Alaska 99501 Telephone 264~4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
MAILING ADDRESS
LEGAL DESCRIPTION
_ 8 /31/4
LOCATION
Inside length
DISTANCE TO:
IF HOMEMADE:
Wel I
Y
DISTANCE TO:
N6. of lines Length of ~ach. l~e
Top of tile to finish §rad~
Length
Dwelling
Material,
IW clth
NO, O F.~,7 DR OOMS
PERMIT NO,
No. of compartments
Foundation
Total length 9f lines
Material beneath tile
Dept~
Liquid deptl]
Dwelling PERMIT NO.
Mafiufacturer Material Liquid capacity in gallons
Well Nearest lot line PERMIT NQ, '~
DISTANCE TO: "/~)¢ /' f~'~
-z __
Trench widt~ ~ -- Distanc~en lines ~
~ inches ~ective~~ ar~
PERMIT NO,
Type of crib
Width
Crib diameter
Well
Crib depth Total effective absorption area
Building foundation Nearest lot line
D.ISTANC E TO:
Class
Depth Driller Distance to lot line PERMIT NO.
DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
REMARKS
DATE
'/
LEGAL
I!iE: I .l: i: !",l [:!i -f !-I [) :I; H!/HT!i; ;i; ON :i;:!il; !"1.!!:::: I..!!NI}~iFI ':: !;H F'!::;!X'I ::, O!::: !! !!ii: i F?I:!?',!CI'I EIFi: Di:;:iFI
'!!!til; I::,I:::F:"I"!"! OF: !::I "I'Fi'Eh41:;X,I Ell:;;: F't:'I" :1;:!:; 'fllli:i; D:[:!:;t'I:::IHE:I:!i: Efl!::'l!,.ll;l:ii;l',! ! ~,'!i iil;I. II:;;;l:.F!I::::!: O!:::' ii'ii::
i}il:;i:l:;'tl..th,l[) !:;:l!",i[:, I'!'IE; I:i',13'!I'QH ElF Till::: I!i;;:':;E:!:::I',IFI'!'!;!:)i'.,I ,:: ?N !':!::i:::
t'l-.li}:F;:l!; I:% i",!O :!;i;ti:'l' !,,.! ]: !::, 'FI..! i:::Eli:;i:
I'i"1~!: 1;;iil:;i:F:l'v'E! !)!!i:F:"fFt :17 :ii!; '!"l.'lli:; H :t: !",I ]7 !'11 ti"1 D!:iZF:'!'!~ EiF' G!:;::!:::V,,,'E! Ii:E{! !.,.ti!! l::!'l',,I !'HE EII .FI'I}: !:::!! ! !:::'
1:::ii",[I:::, Fl"tl:: !:!i',O tTEtI'"i OF "Il-IF: !:i:::':;Cl:::l',,,'l:::l'l :!70i",l ,:: :i: i",1 l::!i:l!::'l
O~ E: GE(:). £CHNICAL [::r DEVEL,,,PMENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Russell Oyster
694-2774 SO'IL LOG
soils ~. Foundations
Performed for: Name: ~,'~_ z~ /:2z/q '['~/'_:/~-_.
Mailing Address: /),
Legal Descrtptlon:_Z ~-~7
.Depth (feet) Sol l Ch~rAc~e~tl
Earl Ellis
Land Development
Tel. No.
].6
Ground Water Encountered: Yes
Proposed Installation: Seepage Pit
Corr~ents:
Dra~n Fte]d~
PERM I T I'.,I0.
DEPRRTMEI'4T '-- HEFILTFI RND EhlV:[RONMEI',ITRL :tOTE[:T I Ot'.,I
825 ",. STREET., RNCHORRGE., RE. 9:. J::L
264-4728
i.,--it E L_ L F:" F2 F: Pl Z
,:: 888526 ::,
RPPL I CRNT
LOCFIT I ON
LEGRL
C:HFIRLE:S MCKENZIE
PETERS CREEK
L; 8 B 3 SCI[,ltTRR $,,'D
P. Ci. E:O',:':: 246 I]HUGIFIK
LCd'
6882991
50000 S[.:¢...IFtF.'.E FEET
MINIMUM DI':;'f'RNCE BETI,.IEEN R I.,ELL RND RN'?' ESI-SITE SEI.,.IFtGE [)ISPO'SFIL SYSTEM IS
:1. E~0 FFET FOR Ft F'RI',,,'FITE HELL OR :t58 'T'O 280 FEET F'ROf'I FI F:'LIE:L. IC WELL DEPENDIhlG
UPON THE T'-r'F'E OF' PLIBLZC HELL.
MII'.,IIMUM [:,ISTRNCE FROM R PRI',,,'RTE WELL TO R F'RI',,,'R]'E SEWER LINE IS 25 FEET FIND,
TO R COMMLINIT'¥' SEWER LINE IS 75 FEE']'.
1.4EL. L LOGS RRE RD..]UZRE[:, RND MUST BE: RETURNED ]'0 THE DEF'RRTMENT WZTFIIN 30 DR'-r'S
OF THE HELL COMPLETZON.
O]'HER RD;!UZREMENTS MR"r' FIPPL"r'. SPECZF'[CRTZONS RN[." CONSTRUCTION £:'ZFIGRFIMS RRE
R",,'RZLRE~LE TO [f',ISLIRE PF..'OPER [NSTRL. LRTZON.
I CER'T'IF'¢ THRT
1: I RM FRMILIFIF.: WITH TFIE REQUIREMENTS FOR ON-SITE SEWERS RN[.', HELLS RS SET
FORTH E:'? THE MUNICIPRLI]"¢ OF FINCHORFtGE.
2: I H:r, LL,. INST~LI... THE '..'!;'-?STEM IN FE:COR[:,RNE:E WITH THE CODES,
SIGNE[:,' ~ ' d~ ¢-¢.-¢¢ ' c,
825 "L" STREET
ANCIqORAGE, ALASKA 99501
(907) 264-4111
GEORGE M. SULLIVAN,
MA
DEPAFITMENI- OF FIEAL-II-I AND ENVIF~ONMENTAL PRO-FECTION
December 31, 1980
Charles Mc Kenzie
Post Office Box 246
Chugiak, Alaska 99567
Permit ~ 800526
Subject: Lot 8 Block 3 Scimitar Subdivision
A permit issued by this department for well and/or sewer
system has expired as of this date.
Permits are issued on a calendar year basist as stated on
the permit, by authority of Municipal Ordinance.
If you have drilled the well, a well log should be sent
to this department to document the installation date.
If an engineer inspected the installation of the on-site
sewer system, please have them send us the as-builts for
our files.
If there are any further questions, please call this
office at 264-4720.
Sincerely, ~,~.
Les N.
LNB/ljw
enc: Copy of Permit
SWP/057
ft.
McKay WeJl Dr h. g
P.C';. Box 557
Wasilla, Alaska 99687
Phone 376-5058
Size Casing .....~ ......... Depth of, Iolo _,~ -~' ' '
Static Water Level ~ ~'feet-
Date "~ /-/" ?:' ....
Phone
£
Cased to _,,,z~ --, _ ,. feet
Well Tgst .... 2,~__/~,lltl~¢~f~lM'(nt;l~e~ldDg~,.~ Hours
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
WELl_ LOG
FEB 6 1987
E, E C -ELV_E I) _
.r t ~, ¢ ' .,' , ' /" , . . i ; / / . ¢,...'.;I .~ ? : ,,~ t/,. _-., / ' ~ ' ' ¢ ' /
.,, ' t/ ,7 /'/§./ : {"' ' .... *. 7 i '- ' ;'/ f
' ;//-;/ .-,," ,. ' AUTHORIZATION TO DRILL .~' - ,
· _ ,, ¢., /- ' ' .¢.-" t ¢ ~ ~';? '¢
I hereby autherize McKay Drilling to pr~'¢eed with the'above work'/ Payment shall be ~ade in
the following manner:
Rig up Mlnlmum.,..~.2~,;i~,~ feut. (~ .... -
~Jalance due upon completion.
In the event it is nece,~ary to institute legal proceedings to collect any amounts duo on this con-
tract I ,agree ire pay an additional sum of Ten percent (10%) of the original contract price as
attorney's fees, phis costs, for legal proceedings.
Date ~._..: ~. Address
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Etmore Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.mun[..org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D.. 051-1 32-32
GENERAL INFORMATION
Complete legal description
Location (site address)
Expiration Date:
Lot 8, Block 3, Scimitar Subdivision #1
19920 Tuiwar Drive Chugiak, Alaska 99567
Current Property owner(s) Keith Hudson
Mailing address 695 N. Tiffany Dr.
Day phone 529-2763
Palmer~ Alaska 9964,5
Lending agency
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4.
TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class ~
Public Water System
Well
TYPE OF WASTEWATER DISPOSAL:
[] Individual On-site []
[] Individual Holding Tank []
E]~ Community On-site []
[] Public Sewer []
The Municipality of Anchorage Development Services Department (DSD) issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems 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 COSAs upon request to homeowners. Certificates bf On-Site Systems 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 sample results. (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.
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 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 Pinard Engineering
Address PO Box 87134?
Wasiiia, Alaska
Engineer's Printed Name Paul E. Pinard
DSD SIGNATURE
~ Approved for ~
Disapproved.
Conditional approval for
bedrooms.
Phone (907) 357-3647
99687
bedrooms, with the following stipulations:
By:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
X
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date: ~ - ~ -/'O
(Rev. 11/05)
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Elmore Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: Lot 8, Block 3, Scimitar Subd ~1
Parcel ID: 051-1 ,;32-32
A. WELL DATA
Well type Private
IfA, B, or C provide PWSID # t~/t
Date completed . .
5/26/85?
Total depth ../4.2_?___ft. Cased to 1 56
70
FROM WELL LOG
8/~J0/01 Sanitary seal (Y/N) Yes
Yes
ff.
Date of test R/3n/nl '~
Static water level 1 61 ? ff.
Well production 1/3 ~
' g.p.m.
WATER SAMPLE RESULTS:
Coliform ~ colonies/100 ml.~?~ Nitrate O. ?55mg/L
Arsenic: ND ug/L date of sample: 5/13/10
Well Log (Y/N) Yea
Wires properly protected (Y/N) Yes
Yes
Casing height (above ground) 1 8+ in.
18+
AT INSPECTION
10/13/09
33 ft.
3.0
g.p.m.
Other bacteria Ne~ 'colonies/100 mL
Collected by: Pinard Engineering
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel
Date installed 10/3/92
Tank size1 500 gal.
Foundation cleanout (Y/N)Yes
Number of.Compartments 2 ,+, Lif'lCleanouts (Y/N) Yes
Station
Depression over tank (Y/N) No High water alarm (Y/N)
Yes
Date of pumping 5/22/10
Pumper Sanitary Pumpers
Gm
ABSORPTION FIELD DATA
Date installed 1 0/3/92 Soil rating (g.p.d./ft2 or ..~.~) O o '7
Length /+.3 ft. Width 20 ft.
Total depth 3.5 ft. Eft. absorption area 860 ft2 Monitoring tubeYes
Date of adequacy test 1 0/1/09 Results (Pass/Fail) Pass
Fluid depth in absorption field before test 0 in. Water added~O0 gal.
Elapsed Time: 1 80 min. Final fluid depth 0 in. Absorption rate >=
Any rejuvenation treatment (past 12 mo.) (Y/N & type) None knoem
System type Seepaffe Bed
Gravel below pipe 0 o 5
Depression over field No
For /+ bedrooms
New depth 0 in.
60'0+ g.p.d.
If yes, give date
LIFT STATION "STEP" Tank/Lift Station
Date installed 10/3/q2 Size in gallons1 500 STEP
Tank
"Pump on" level at ~ in. "Pump off" level at ~ in.
Datum Cycles tested 4+
Manhole/Access (Y/N) Ye a
High water alarm level at
Meets alarm & circuit requirements?
Yes
in.
S~_.f..,t .S.~t.a.t~$~o_n...i~s~inside s,epti~c ,tank - was found to
,-~-A~.~/,um u,~Am~,-~ sa~lszac~ory. Did not climb
pump "on" or "off" settings.
SEPARATION DISTANCES FROM WELL ON LOT TO:
SePtic tank/lift station on lot 100 '
Absorption field on lot 1 O0 ' +
Public sewer main NA
Sewer/septic service line ;;{ 5 ' +
Animal containment areas NA
~e.op?wrFtSng
mn~o ~an~ ~o measure
On adjacent lots 1 O0 ' +
On adjacent lots 100 ' +
Public sewer manhole/cleanout
Holding tank
Manure/animal excrete storage areas
Building foundation · 5 '
Water main 10 ' +
'Wells on adjacent lots 1 O0 ' +
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Property line 10 ' +
Water service line 10 ' +
Property line 6' *
Water Service line 10 ' +
Curtain drain None Known
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Building foundation 10 ' +
Surface water 100 ' +
Wells on adjacent lots 1 O0 ' +
Absorption field 10 ' +
Surface water 1 O0 ' +
Water main 10 ' +
Driveway, parking/vehicle storage 1 0 t +
Waiver Fee $
Date of Payment
Receipt Number
COSA Fee $
Date of Payment
Receipt Number
(Rev. 11/05)
F, COMMENTS
SAS MT was checked, on. 5/13/101 no measurable
* See MOA itt of 10/27/O2 which ~rants a senaratia~?~.~A
distance waiver for ~his separation.
G. ENGINEER'S CERTIFICATION
I ce~i~ that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance w~th MOA COSA guidelines ~n effect on this date.
Engineers Printed Name P~,~ ~. P~,a~d
~ --
Date / /
D. LIFT STATION "STEP" Tank/Lift Station
So
Date installed 10/3/92 Size in gallons,!~..~ Manhole/Access (Y/N) Yes
"~uuuu~ on" level at '~-in~ ' 1'~ ~'~ Tank
"Pump off' level at//- in. High water alarm level at
Datum ~!'~/l~'~to[~/~:~Cyclestested 4+ Meets alarm & circuit requirements? Yes
Lift Station is inside septic tank - was found to be ope~rating
SEPARATION DISTANCES ' satmsfactory. Did not climb into bank to measure
pump "on" or "off" settings.
SEPARATION DISTANCES FROM WELL ON LOT TO:
SePtic tank/lift station on lot 1 O0 '
Absorption field on lot 1 O0 ' +
On adjacent lots 1 O0 ' +
On adjacent lots 1 O0 ' +
Public sewer main
Public sewer manhole/cleanout NA
Sewer/septic service line. ;;;{ 5 ' +
Holding tank
Animal containment areas ~ Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation ~ ' Property line 10 ' + Absorption field 1 0 ' +
Water main 10 ' + water service line 10 ' + Surface water 100 ' +
~Wells on adjacent lots 1 O0 t +
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 6 ' * Building foundation 10 ~ + Water main 1 0 ' +
Water Service line 10 t + Surface water 1 O0 ~ + Driveway, parking/vehicle storage 10 ' +
Curtain drain ~one K'~own Wells on adjacent lots 100 ~ +
COMMENTS
checked
On
SAS
MT
was 5/13/10; no measurable
* See MOA 3tr nC 10/27/92 wh~nb ~rants a
dzstance wamver for thzs separatzon.
ENGINEER'S CERTIFICATION
I ce~i~ that I have dete~ined through field inspections and
of M ni i a/ . ow
conformance with MOA COSA guidelines in effect on this date.
Engineers Pnnted Name Pau~ E. Plnard
Date 5/27/10
COSA Fee $
Waiver Fee $
Date of Payment
Date of Payment
Receipt Number
Receipt Number
(Rev. 11/05)
Page 1 of 1
Poet, Jeff W.
From: apw@gci.net on behalf of Jim Sullivan [apw@gci.net]
Sent: Thursday, August 05, 2010 5:35 PM
To: Poet, Jeff W.
Subject: scimitarB3 L8
Jeff
I flow tested this well on 6-17-10 it is producing 108 gal per day
Thanks
Jim Sullivan, CPI
Arctic Pump & Well, Inc.
PO Box 770197
Eagle River, AK 99577
(907) 688-£5'10
(907) 258-2510
(907) 745-2510
8/6/2 010
'o AI
A,
ASBUILT-NO CORNERS SET THIS DATE.
SEt-lARD &
ASSOCIATES UND SURVEYING 688-4566
1 HEREBY CERTIFY THAT I HAVE SURVEYED THE
SCALE:
FOLLOWING DESCRIBED PROPERTY-,
1 4 01
♦OF A
is a Subcl'.,Undt No. 1,1,()t 8,131k,
AND T'IAT NO ENCROACHMENTS
DATE.
k
EXIST EXCEPT AS
INDICATED. IT IS THE RESPONSIBILITY
9-14-92
�; H*
OF THE,;
T
OWNER TO DETERMINE THE EXISTENCE OF ANY
GR I D.,
,
0
EASEMENTS, COVENANTS, OR RESTRICTIONS
,Ntq 12b
op
0
WHICH DO NOT APPEAR ON THE RECORDED SUBDI-
VISION PLAT.
# Duane M." iewa.rd AF
FS,
UNDER NO CIRCUMSTANCES SHOULD
Ls
ANY DATA HEREON BE USED FOR CONSTRUCTION
31-77
4F
0
OF FENCE LINES, R FOR ESTABLISHING BOUND-
DRAWN;
4V
44 lk 40
�t4
ARY LINES.
ARCTIC PUMP & WELL INC.
Jim Sullivan, CPI
Po Box 770197
Eagle River, AK 99577
(907) 688-2510
(907) 258-2510
apw, .~gci.net
Pump Installation Log
Well Drilling Permit Number: SW
Parcel Identification Number:
Date of Issue:
Legal Description:Scimitar # 1
Lot:8
Block:3
Property Owner Name & Address:
Keith Hudson
695 N Tiffany Dr
PMmPr AI~' OO/qAq
Pump Installation Date: 7/14/2010
Pump Intake Depth Below Top of Well Casing:
Feet
Pump Manufacturer's Name:
Pump Size:
Pump Model:
hp
Pitless Adapter Burial Depth:
Pitless Adapter Manufacturer's Name:
Pitless Adapter Installer:
Well Disinfected Upon Completion? Yes
Method of Disinfection: Chlorine
Comments:
Well permanently decommissioned by procedurel 5.55.060L. c.
Well #2
Pump Installer Name:
Arctic Pump & Well, Inc.
Arctic Pump & Well, Inc.
Page 1 o fl
ARCTIC PumP & WELL INC.
]fin Sumv~, C?I
PO Box 770197
Eagle River, AK 99577
(907) 688-2510
(907) 258-2510
apw,~,gci.net
Pump Installation Log
Well Drilling Permit Number: SW
Parcel Identification Number:
Date of Issue:
Legal Description:Scimitar # 1
Lot:8
Block:3
Property Owner Name & Address:
Keith Hudson
695 N Tiffany Dr
Pnlrn~r Al( OO6Aq
Pump Installation Date: 7/14/2010
Pump Intake Depth Below Top of Well Casing:
Feet
Pump Manufacturer's Name:
Pump Size:
Pump Model:
hp
Pitless Adapter Burial Depth:
Pitless Adapter Manufacturer's Name:
Pitless Adapter Installer:
feet
Well Disinfected Upon Completion? Yes
Method of Disinfection: Chlorine
Comments:
Well permanently decommissioned by procedurel 5.55.060L. c.
Well #1
Pump Installer Name:
Arctic Pump & Well, Inc.
Arctic Pump & Well, Inc.
Page 1 o fl
MUNICIPALITY OF ANCHORAGE
Planning & Development Services Dept.
Development Services Division
Mayor Dan Sullivan
July 1, 2010
Phone: 907-343-8301
Fax: 907-343-8200
Charlene N. and Michael T. Corkery
19920 Tulwar Drive
Chugiak, AK 99567
Ref:
NOTICE OF VIOLATION
Scimitar #1, Block 3, Lot 8
Water Wells
COSA #OSC101065
The On-Site Water and Wastewater Program (On-Site) is aware of three (3) water wells located at Scimitar #1,
Block 3, Lot 8. The wells are described as follows:
Well 1.
A well that is no longer in use and is required to be decommissioned in accordance with AMC
15.55.040 F.
Well 2.
A well that was observed on 6/8/2010 to have perforations in the casing at 31 and 32 feet below
the top of the casing. AMC 15.55.060 C.6 requires the well to be cased to 40 feet without any
perforations.
Well 3. A well that is currently in use and appears to be in accordance with the code.
The two (2) wells described above as Well I and Well 2 shall be decommissioned by 7-9-10. Please be aware
that the decommissioning of water wells shall be performed by a certified well driller or well pump installer in
accordance with AMC 15.55.060 L.
Shown below are the code sections referenced above.
Section 15.55.040 F.
Section 15.55.060 C.6.
No person shall allow a water supply well to remain out of service for more than 90
days without permanently decommissioning the well.
Water wells shall be drilled and cased with non-perforated pipe to a minimum depth
of 40 feet.
Section 15.55.060 L.
Wells shall be decommissioned by a certified well driller or a certified pump installer.
If you have any questions, contact us at 343-7904.
Sincerely
Jeff Poet
On-Site Water and Wastewater Program
PINARD ENGINEERING
Paul E. Pinard
Registered Engineer/AK & ID
P.O. Box 871347, Wasilla, Ak 99687
(907) 357-ENGR(3647)
JeffPoet
On-Site Water & Wastewater
Building Safety Division
Municipality of Anchorage
4700 Elmore Road
Anchorage, Alaska 99507
July 15, 2010
RE: Lot 8, Block 3, Scimitar Subdivision #1, Parcel I.D # 051-132-32; Nitrate Sample
Dear Mr. Poet:
This is to confirm our previous discussion pertaining to the recent nitrate sampling from
one of the three wells on the referenced property and provide you with the results of the
analysis. We collected a water sample on June 30, 2010 directly from the well casing on the
deep well that is to remain on this property as its water supply source. Mr. Jim Sullivan, of
Arctic Well & Pump, assisted with the collection of the sample from the well. The sample
was immediately delivered to SGS in Anchorage, where it was analyzed. The lab results,
showing a level of 0.212 mg/1, are attached.
The two (2) other wells on this property were abandoned by Mr. Sullivan earlier this
week and he will be providing you with confmnation of their proper abandonment
separately. The owner, Mr. Keith Hudson, will have the As-Built property survey updated to
reflect the abandonment of these wells. The As-Built will specifically confmn adequate
separation (100'+) between the well and the septic tank.
Mr. Hudson is also having a larger water storage bladder installed next week to meet
the requirements of the Municipality. Confirmation of that installation will be provided by
the licensed plumber.
It is my understanding that with these issues satisfactorily resolved, the COSA should
be able to be issued by your office. If you have any questions, please do not hesitate to call
me.
1 Encl. (as)
cc: Keith Hudson, w/end.
w~rely, ~ -,
Paul E. Pinard, P.E.
PINARD ENGINEERING
Paul E. Pinard
Registered Engineer/AK & ID
P.O. Box 871347, VVasilla, Ak 99687
(907) 357-ENGR(3647)
Jeff Poet
On-Site Water & Wastewater
Building Safety Division
Municipality of Anchorage
4700 Elmore Road
Anchorage, Alaska 99507
August 5, 2010
RE: Lot 8, Block 3, Scimitar Subdivision #1, Parcel I.D # 051-132-32; Water Storage Tank
Installation
Dear Mr. Poet:
This is to confirm the completion of the installation of an additional drinking water
storage tank to serve the referenced property. An 800 gallon bladder was installed two (2)
weeks ago by a licensed plumber with K & L Plumbing and Heating to supplement the
existing 800 gallon bladder tank. I inspected the installation on July 28 and found that there
were a couple of items that required correction. The plumber was in this week to make those
corrections, completing them yesterday. I inspected the installation today and found it to be
satisfactory, appearing to meet the water storage requirements of the Municipality of
Anchorage. The existing tank had been properly plumbed with float switches and a
pressurizing pump to provide the water stored by the original tank for household water
demand. The new tank was added to provide additional storage required by the MOA.
It is my understanding that with the confirmation of the satisfactory installation of this
additional water storage tank, that all issues should now be resolved and therefore, the
COSA should be able to be issued by your office. If you have any questions, please do not
hesitate to call me.
cc: Keith Hudson
~oin.~erely, ~
Paul E. Pinard, P.E.
PINARD ENGINEERING
P.O. Box 871347
Wasilla, AK 99687
(907) 357-ENGR (3647)
ADEQUACY TEST
LOCATION: Lot 8, Block 1, Scimitar Subdivision #1
APPLICANT: Keith & Vickie Hudson
695 N. Tiffany Drive
Palmer, Alaska 99645
SEPTIC TANK TYPE/SIZE: Steel11500 Gallons, per MOA Records
ABSORPTION SYSTEM: Seepage Bed, par MOA Records
DAILY FLOW:
4 BEDROOMS x 150 GAL/BR = 600 Gallons
JOB NUMBER: 10-121
DATE OF TEST: 1011109
FIELD STAFF: PJ Pinard
NUMBER OF BEDROOMS: 4
SCUM: 0.0' SLUDGE: Minimal
NEEDS TO BE PUMPED: Yes No XX
CURRENTLY IN USE: Yes No XX
TEST DATA
Time Flow Volume Cumulative Septic Tank Septic Soil Absorption System Comments
Rate Volume Tank
PM (GPM) (GALs) (GALs) Liquid Level A Level Monitor A SAS Monitor A SAS
* Tube 1 * Level Tube 2* Level
12:00 3.3 4.0' 0.0' - 0.0' - Start Flow- Meter 101770
12:15 3.3 50 50 4.1' 0.1' 0.0' 0.0' 0.0' 0.0' 101820
12:30 3.3 50 100 4.1' 0.0' 0.0' 0.0' 0.0' 0.0' 101870
12:45 3.3 50 150 4.1' 0.0' 0.0' 0.0' 0.0' 0.0' 101920
1:00 3.3 50 200 4.1' 0.0' 0.0' 0.0' 0.0' 0.0' 101970
1:30 3.3 100 300 4.1' 0.0' 0.0' 0.0' 0.0' 0.0' 102070
2:00 3.3 100 400 4.1' 0.0' 0.0' 0.0' 0.0' 0.0' 102170
2:30 3.3 100 500 4.1' 0.0' 0.0' 0.0' 0.0' 0.0' 102270
3:00 - 100 600 4.1' 0.0' 0.0' 0.0' 0.0' 0.0' Stop Test - 102370
RECOVERY
Date Time SAS MT1 SAS MT2
*ALL MEASUREMENTS IN FT.
TEST: PASSED XXX FAILED
COMMENTS: System seems to be functionin[ satisfactorily. There was no measurable liquid in the SAS MTs
prior to or at any time during the test.
Reviewed by: Paul Pinard
Date: 5127/10
PINARD ENGINEERING
P.O. Box 871347
Wasilla, AK 99687
(907) 357-ENGR (3647)
WELL FLOW TEST
LOCATION: Lot 8, Block 3, Scimitar Subdivision #1 JOB NUMBER: 10-121
DRILLER: Frisen Drilling (Well #1) & M & W (Well #2) DATE OF TEST: 10113109
DATE WELL COMPLETED: 51261857 (Well #1) & 8130/01 (Well #2) FIELD STAFF: PJ Pinard
WELL DEPTH: 70' (Well #1) & 427' (Well #2)
STATIC WATER LEVEL (top of casing): 33' (Well #1)
Elapsed Static Flow Cumulative
Time Time Water Rate Gallons Remarks
(Minutes) Level (gpm) Pumped
7:50 PM - 33' 3.3 - Start Test - Meter 109360
7:05 15 39' 3.3 50 109410
7:20 30 48' 3.3 100 109460
7:35 45 59' 3.3 150 109510
7:50 60 41' 3.3 200 109560
8:05 75 47' 3.3 250 109610
8:20 90 38' 3.3 300 109660
8:35 105 52' 3.3 350 109710
8:50 120 41' 3.3 400 109760
9:05 135 54' 3.3 450 109810
9:20 150 39' 3.3 500 109860
9:35 165 52' 3.3 550 109910
9:50 180 45' 3.3 600 109960
10:05 195 38' 3.3 640 110000
10:20 210 49' 3.3 640 110000
10:35 225 56' 3.3 680 110040
10:50 240 48' 720 Stop Test - 110080
RECOVERY
11:30 PM 35' All well protection features are adequate.
Well flow production is supplemented with an 800 gallon bladder storage
tank with a pressurizing pump.
Average Flow Rate: 3.0 gpm
Comments:
DURING THIS TEST, THIS WATER SUPPLY WELL WAS CAPABLE OF
PRODUCING 3.3 GPM. THIS TEST DOES NOT CONSTITUTE A
WARRANTY OR GUARANTEE THAT THE WATER SUPPLY SYSTEM
WILL CONTINUE TO FUNCTION AND PRODUCE AT THIS RATE.
Reviewed by: Paul Pinard
Date: 5127110
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
GENERAL INFORMATION
(a)
Application Date
Legal Description (include lot, block, subdivision, section, township, range).
Location (address or directions)
(b) Applicant Name ~/L-SH~ L'~_~___Z)~IE-~.6. Telephone: Home ~"/¢~--O,O'7~'/' Business 2-'?(~'~;"-/'3'Z-
Applicant Address 'o~_~¢ ~ L--..-~.~- .,~..~i,...)O ~ ,~.1,,..~.4-[,__/ /~,1,~, _,~¢--~_O~.~_
(c) Applicant is (check one): I_ending Institution []; Owner/builder []; Buyer,,~; Other [] (explain); .....
(d) Lending Institution Telephone
Address
(e) Real Estate Company and Agent
Address ~::
Telephone
Ho~i~
(f) M'eil the FIAA to the following address:
TYPE OF RESIDENCE
Single-Family,~ Multi-Family []
Number of Bedrooms
Other
WATER SUPPLY
Individual Well~ Community [] Public []
Note: If commu r ty well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL.
Onsite/~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2 72-025(11.§4)
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
AS certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect or)
the date of this inspection.
Name of Firm ,
Address ~RB 19~}{;
Date ~, 69~2~79
Telephone
DHEP APPROVAls, '~ .. ~-~.~)....~
Approved for /~>/'~' ,(~' bedrooms by //) ' I/C"~ "']/-~(-~_)~t-/~'-~.~ ~'Date
Approved .~' DisapprovedL'/ Condition~a -]
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based ~olely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineerls work.
Page 2 of 2
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
264-4720
Legal Description: ~¢'~" °?'¢
WELL DATA
Well Classification
MUNICIPALITY OF ANc:FIORAoE
DEPT. OF HEALTH &
~NVIRONMENTAL PROTECTION
I:,":,/ '5 0 1985
Well Log Present
Total Depth '~ .~c:> l Cased to ~C,
Static Water Level ~"~'~ *'
Casing Height Above Ground /,,~- "'
Electrical Wiring in Conduit~'~'~N¢~'
Separation Distances from Wel!:
To Septic/Holding Tank on L. ot /"¢~
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line /"J/~
Cleanout/Manhole
If A, B, C, D.E.C. Approved (Y/N)
Date Completed ¢~ ¢2 ,.,.& -' ~, 0 Yield
Depth of Grouting
Pump Set At ~ '/'~-'
Sanitary Seal on Casing~N)"
Depression Around Wellhead ¢¢Y~
Water Sample Collected by
; On Adjoining Lots
; On Adjoining Lots _
To Nearest Public Sewer
~"/4-- To Nearest Sewer Service Line on Lot
~-~"~"' ,~ , ;Date
Water Sample Test Results
B, SEPTIC/HOLDING TANK DATA
Date Installed ~ "''~' ~//- 2'CC'Size /__.,;~..,~'-'~6 No. of Compartments
Standpipes (~N-) __ Air-tight Caps (~l),t.)-'''~ Foundation Cleanot~t~"~.hT
Depression over Tank ~
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well ___/~P ~ /~
To Property Line /'~ ~' r
To Water Main/Service Line
Date Last Pumped
_;for
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field
Course
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field LC'
Square Feet of Absorption Area
Depression over Field--¢~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation
Lot
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present~c~N'~
Date of Last Adequacy Test
To Water Main/Service Line ~"¢~ ~' ~
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots /(3
To Cutbank (if present)
Comments
D, LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
//
Comments
Dimensions
.hole/Access (Y/N)
ump Off" Level at
Vent (Y/N)
,.,~ Pumping Cycles during Adequacy Test. Meets MOA
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed /~ .~ E,. ENGi~EE~{Ii~.r~.
MOA No, ~¢ ~
C~m~a .... 81~B 196X
~ ,~ ,~,~V~, ALASKA ~'
Receipt No, ' ~
Date of Payment _ ~ -~~'
Amount: $ ~ ~
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