HomeMy WebLinkAboutSHENANDOAH HILLS LT 6Shenandoah
Hills
Lot 6
#015-212-43
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3
ON -SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP221430 PID Number: 015-212-43
Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ❑® Upgrade
Name
TAMMY KASSNER
ABSORPTION FIELD
❑ Deep Trench El Wide Trench ❑Bed ound
Site Address
12020 SHENANDOAH *ANCHORAGE, AK
❑ Other
Phone
Number of Bedrooms
Soil Rating
depth original grade
907-229-3470
4
GPD/SF
JTotal
Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grad
Ft.
Gravel depth beneath pipe
Ft.
Subdivision Block Lot
SHENANDOAH HILLS; LOT 6
Fill added above original gr
Ft_
Gravel length
Ft.
Township Range Section
Gravel width
Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION
DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total orption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
I Ft2
Ft.
Well
1 00'+
25'+
TANK 0 Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer Capacity
GREER TANK 1250 Gal.
Surface Water
100'+
Material
Number of compartments
Lot Line
5'+
NA
H D P E
2
Foundation
1 0'+
LIFT STATION
Manufacturer
Capacity
Remarks PER CONTRACTOR OLD TANK DECOMMISSIONED PER UPC
Gal.
Alarm location
Electrical installed by
Installer
PIPE MATERIAL House to tank D3034 Tank to D3034
drainfield
NORTHERN EXCAVATION
Drainfield 03034/EXISTING CO/MTD3034
Inspector GEG AND MOA
BENCH MARK (Assumed elevation) 98.49 ft
Inspection t9I 4/5/2023 -
Location and description
2n
dates:
TOP OF MH
3r° - 41h -
ON -SITE WATER AND WASTEWATER SECTION APPROVAL
Enginee►'s Stamp
60
Conditional Approval: Date
" •'9S,4Q
oo
4 00 P ...... .
Septic System
Approved Date Z 2C2
reA. Hess.mop
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•->t�i'-Z coo
Note: this approval does not include well permit requirements.
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PERMIT NUMBER; PARCEL ID NUMBER:
OSP221430 RECORD DRAWING 015-212-43
A I B
DBL1
62.0
55.6
DBL2
62.9
56.1
MH
64.8
57.3
ST1
69.2
59.7
DBL3
71.1
61.4
DBL4
72.5
62.4
NOTE: SWING -TIES TO HOUSE CORNERS
WERE GENERATED IN AUTOCAD FROM
TALUS WEST #1;
BLOCK 7, LOT 4
El
THE .DWG FILE FOR THE AS -BUILT
SURVEY BY ROBERT 0. LUMPKIN, PLS
\� 1
100' WELL RADIUS WAS FLAGGED BY \
A PLS DURING CONSTRUCTION
GENERALLOCATI I DBL1&
ON OF 100' MH
WELL f2gpfUS ' ST
SHENANDOAHJ C
HILLS; LOT 7 / M
EXISTING FIELD
TALUS WEST#1;
BLOCK 7, LOT 5
i
EXISTING 4
BEDROOM HOUSE
e
a ..e
NEW 1250 GALLON
HDPE GREER TANK
s` SHENANDOAH
HILLS; LOT 5
.7 SHENANDOAH ROAD \I N
GARNESS ENGINEERING GROUP, Ltd
a ENGINEERING -SALES- CONSULTING �
3701 E. TUDOR ROAD, SUITE 101'ANCHORAGE. AK 99507 • PHONE (907) 337-6179 • FAX (907) 33"246' WEBSITE: vrvrx.pamessenpinaerinp.com
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
TAMMY KASSNER 907-229-3470 2 OF 3
LEGAL DESCRIPTION: DRAWN BY:
SHENANDOAH HILLS; LOT 6 D.J.G.
TYPE OF WORK: DATE:
III,_ SEPTIC TANK RECORD DRAWINGS 5/25/2023
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'PERMIT NUMBER: PARCEL ID NUMBER:
OSP221430 RECORD DRAWING 015-212-43-'
TOP OF TANK AT INTLET =
INVERT OF BUNG AT INLET = 92.32
TOP OF MANHOLE = 98.49
GRADE = 98.03-98.14
TOP OF TANK AT OUTLET = 92.96
INVERT OF BUNG AT OUTLET = 92.11
NEW 1250 GALLON H.D.P.E. SEPTIC TANK
ENGINEERING ® SALES 4 CONSULTING
J707 E. TUOOR ROAD, SUITE 101 •ANCHORAGE, AK 99507 • PHONE (907) 337L179 • FAX (907) 338-3246 • WEBSITE:—.pam -s pneenng—
PARED FOR:
PHONE NUMBER:
PAGE NUMBER:
TAMMY KASSNER
907-229-3470
3 OF 3
LEGAL DESCRIPTION:
DRAWN BY:
SHENANDOAH HILLS; LOT 6
D.J.G.
TYPE OF WORK:
DATE:
ASEPTIC TANK PROFILE
4/7/2023
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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
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP221430
Work Type: SepticTank Initial
Tax Code Number: 01521243000
Site Legal Address: SHENANDOAHHILLS LT 6 G:2736
Site Mailing Address: 12020 SHENANDOAH RD, Anchorage
Owner: KASSNER TAMMY L
Design Engineer: GARNESS ENGINEERING GROUP LTD
This permit is for the construction of:
Effective Date
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
11/8/2022
11/8/2023
62976
❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Special Provisions: when a COSA is needed Please confirm separation of trench on property to well on
property. If necessary modifying existing waiver may be necessary
Received By:
Issued By:
Date:
Date: / I `
4
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 015-212-43
Property owner(s) Tammy Cassner
Mailing address 12020 Shenandoah *Anchorage, AK
Site address 12020 Shenandoah *Anchorage, AK
Day phone 907-229-3470
Legal description (Sub'd., Block & Lot) Shenandoah Hills; Lot 6
Legal description (Township, Range & Section)
Lot Size Sq. Ft. Number of Bedrooms 4
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑
Initial
Single Family (SF) []
(w/wo ADU)
Septic Tank
Q
Upgrade ❑
Duplex (D) ❑
Holding Tank
❑
Renewal ❑
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: A
Date of Payment: %
Receipt Number:
Permit No.
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
GMevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client FormsTermitApplication.doc
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
f&TMffiV4Tm&k1und, 11/08/22
7
GARNESS ENGINEERING GROUP, Ltd AeroCell
ENGINEERING, SALES CONSULTING
October 12, 2022
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
Ref: Proposed Septic Tank Upgrade for Shendoah Hills; Lot 6
To whom it may concern:
Per MOA records, the existing septic tank is approximately 39 years old (installed in 1983). Per
MOA memorandum, a septic tank of this age should be physically inspected and/or replaced
prior to COSA approval. Based upon this fact, we are proposing to replace the existing septic
tank. We are proposing to decommission the existing septic tank per UPC and install a new
1250 -gallon HDPE Greer tank. It should also be noted that the existing drainfield may encroach
on the 100' well radius. As can be seen on the attached drawing, the cleanout is adjacent to the
100' well radius. In short, given that GEG was not present during the installation, it is unknown
how much the drainfield encroaches (0-2 feet?). If the department will require a waiver, we
request that be submitted with the COSA application. See attached design drawings for tank
location and other MOA requirements.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact us at 337-6179. Thank you for your
assistance.
3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259
Phone: (907) 337-6179 * Website: www.garnessengineering.com
In
THE DEPICTION OF ALL STRUCTURES SHOWN ON ADJACENT PROPERTIES \ /
ARE APPROXIMATE IN REGARD TO CONFIGURATION/LOCATION AND MAY BE
BASED SOLELY ON PUBLICLY AVAILABLE MOA GIS RECORDS. THE LOCATION
OF ALL WELLS AND SEPTIC SYSTEMS SHOWN ARE APPROXIMATE AND MAY WrLDERNAS DRIVE J
BE BASED SOLELY ON INFORMATION OBTAINED FROM PUBLICLY AVAILABLE r
MOA ONLINE RECORDS AND/OR AS -BUILT SURVEYS lcLl
2
V V�
\ / --
TALUS WEST #1; TALUS WEr
BLO TAWS WEST #1;
Municipality of Anchorage
er and Wajjsh'��
FOR COC}@ COMP
CK 7, LOT 4 BLOCK 7, LOT 5 BLOCK 7, LO
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SHENANDOAH
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6
3701 EAST TUDOR ROAD `SUITE 101 'ANCHORAGE, ALASKA • PHONE (907) 337-6179 • WEBSITE: vmv.gamessen ineerfng.com 0 ••v A
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: • • e G t1e55 :• f
TAMMY CASSNER 907-229-34701 OF 2 6�� f C 79 3 ' _.AV
PROJECT/LEGAL DESCRIPTION: 4 �� �` •
SHENANDOAH HILLS; LOT 6 DRAWN 8Y: �� , p /O ! 3•P<�'®
TYPE OF WORK: DATED J G LICENSE `dHlg ESS`®��+��
SEPTIC TANK UPGRADE 10/13/2022 # LICENSE
4 tia4,a ,w
GEG, ltd. HAS AN 8 PAGE SPECIFICATION LETTER
THAT PERTAINS TO THIS DESIGN. BY PROCEEDING
FORWARD WITH THIS INSTALLATION, THE
ENGINEER, WELL DRILLER, CONTRACTOR AND
PROPERTY OWNER AGREE THAT THEY HAVE
READ THESE SPECIFICATIONS AND AGREE TO
ACCEPT THE TERMS AND CONDITIONS OUTLINED.
CONTRACTOR TO HAVE A]100'WELL RADII FLAGGED BYPRIOR TO CONSTRUCT
O� \
Ox
pip SEWER LINE LOPATION FROM
pG �� HOUSE TO TAW IS UNKNOWN—�
Q•
EXISTING1250 GALLON STE L SEPTIC TANK
TO BE DECOMMISSION8D PER UPC—
PROPOSED 1250 GALLON HDPE GREER TANk INSTALL
DOUBLE CLEANOUTS BEFORE AND AFTE+ TANK
,,
/ C
GENERAL LOCATION OF EXISTI GFIELD
PER CLEANOUT AND MONITO NG TUBE
LOCATIONS AND MOA RELORDS
Municipality of Anchorage
REVIEWED FOR CODE CONPUANCI
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munica a-ft� of Anchorage
Department of Health and Human Services
825 "1" Street
RickMystrom, P.O. Sox 196650 Anchorage, Alaska 99519.6650
Mayor
December 10, 1996
Brent P. Eaton, P.E.
11835 Sypglass Circle
Anchorage, Alaska 99515 2707
Subject: Waiver Request for Lot 5 Shenandoah Hills Subdivision
Waiver Request #VTR960067, PID #015-212-42, SW960177
Dear Mr. Eaton:
Your request for waiver of the required 100 foot horizontal separation of an on-site
wastewater disposal system to a private well has been approved. The approved separation
distance is the private well on Lot 6 to the leachfield on Lot 5 of 87 feet.
This waiver approval applies to the existing on-site wastewater disposal system to well
separation only. Any future upgrade to either will require all separation distances be met
or another approval from this department.
If there are any further questions or concerns regarding this waiver, please call our office
at 343-4744,
{'Sincerely,
Daniel J. Roth
Civil Engineer
On-site Services
DJMjm:Eaton
Municl of Anchorage
0* Department of Health and Human Services
825 "l' Street
Rick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519.6650
Mayor
343-4744
December 10, 1996
Jay E. & Tammy L. Kassner
Property Owner's of Lot 6 Shenandoah Hills Subd.
12020 Shenandoah Place
Anchorage, Alaska 99516-2201
Re: Separation Encroachment, Lot 6 Shenandoah Hills Subdivision,
P.I.D. 015-212-43, WR960067
Dear Mr. & Mrs. Kassner:
As a result of the recent upgrade to the wastewater system on Lot 5
Shenandoah Hills Subdivision, the engineer who designed and inspected this
wastewater system discovered that the existing wastewater system serving this
property is being encroached upon by the well on lot 6. The separation distance
is approximately 87 feet. The required separation distance is 100 feet for a
private well to a wastewater system.
The existing wastewater system on lot 5 was constructed in July of 1978 and the
well on lot 6 was constructed in June of 1983. Because the wastewater system
on lot 5 was in place at the time the well on lot 6 was constructed, makes the
responsibility of resolving this encroachment matter the property owner of lot 6.
Be advised that Lot 6 Shenandoah Hills will not be eligible for Health Authority
Approval from this office to obtain conventional financing for purposes of selling
or refinancing the property until the separation encroachment matter is resolved.
If you have questions of the above, feel free to contact me at 343-4744.
Sincerely,
Daniel J. Roth
Civil Engineer
On-Site/Water Quality Program
List Conditions or Reasons for above: 5Pe AF,� uygw
Date: L2 -%- 96 By: Name Qh'�/
of Reviewer
Note: fee waived the drainfield was installed prior to the well on Lot 6 therefore
Rec #: Amount: $ Date Paid:
lot 6 must pay for the waiver fee.
I
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR# WR960067
I
PID# 015-212-42 HA# Permit # SW960177
I
Date Received:
' July 2, 1996
Legal Description:
Lot 5 Shenandoah Hills Subdivision
Engineer: Brent;
I
P. Eaton, P.E.,
11835,
1
Spyglass Circle, Anchorage, Alaska 99515 2707
Applicant: Pe
.ry R & Ardene J Eaton
Waiver Requeste6:
Lot 6 private well to the leachfield on Lot 5 Shenandoah Hills
Pi
offeet.
i
i
Criteria: 1i.
Geology: Points:
i
A. Water Table
B. Soil Sorption
I
C. Permeability
i
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special
Conditions:
3. Other:
—i
I
i
waivar 9.s Granted:
x Waiver is NOT Granted:
List Conditions or Reasons for above: 5Pe AF,� uygw
Date: L2 -%- 96 By: Name Qh'�/
of Reviewer
Note: fee waived the drainfield was installed prior to the well on Lot 6 therefore
Rec #: Amount: $ Date Paid:
lot 6 must pay for the waiver fee.
Xftmii� - of Anchorage s
Department of Health and Human Services
825 "1" Street
Mayor rom.
Rick yP.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
December 10, 1996
Jay E. & Tammy L. Kassner
Property Owner's of Lot 6 Shenandoah Hills Subd.
12020 Shenandoah Place
Anchorage, Alaska 99516-2201
Re: Separation Encroachment, Lot 6 Shenandoah Hills Subdivision,
P.I.D. 015-212-43, WR960067
Dear Mr. & Mrs. Kassner:
As a result of the recent upgrade to the wastewater system on Lot 5
Shenandoah Hills Subdivision, the engineer who designed and inspected this
wastewater system discovered that the existing wastewater system serving this
property is being encroached upon by the well on lot 6. The separation distance
is approximately 87 feet. The required separation distance is 100 feet for a
private well to a wastewater system.
The existing wastewater system on lot 5 was constructed in July of 1978 and the
well on lot 6 was constructed in June of 1983. Because the wastewater system
on lot 5 was in place at the time the well on lot 6 was constructed, makes the
responsibility of resolving this encroachment matter the property owner of lot 6.
Be advised that Lot 6 Shenandoah Hills will not be eligible for Health Authority
Approval from this office to obtain conventional financing for purposes of selling
or refinancing the property until the separation encroachment matter is resolved.
If you have questions of the above, feel free to contact me at 343-4744.
Sincerely, /
Daniel J. Roth
Civil Engineer
On-Site/Water Quality Program
2
VER
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THERTON
IHEI_B00
_
MOUNTAIN ENGINEERING
3868 Shannon Circle
Anchorage, Alaska 99508
(907) 562-1500
February 24, 1994
Mr. John Smith
On -Site Services Section
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Regarding: Lot 5, Shenandoah Hills; Insufficient Separation Distance
Dear John:
Recently, Mountain Engineering performed tests and collected the field data required for a
Health Authority Approval at the subject residence. At this time it was discovered that the
well on Lot 6 (the neighboring lot) was drilled at a horizontal distance less than 100 feet
from the monitoring tube for the drain field on Lot 5. The actual distance was measured
at 91 feet.
According to records obtained from your offices, the septic system on Lot 5 was installed
in 1978, the well on Lot 6 was drilled in 1983. A Health Authority Approval for Lot 6
was issued in 1989, on which this separation distance was said to be sufficient.
Because the separation problem was caused by Lot 6, it is our understanding that they will
be responsible for obtaining a waiver. `
Please contact me at 562-1500 if you will need any additional information.
Sincerely,
MOUNTAIN ENGINEERING
Mark Pearson, P.E.
CENTER LINE TRAVERSE WAY
i
S 89 571/
5 E 169.89' REC. \
/ 10' UTILITY & WALKWAY EASEMENT
-------
1
0
r
)K INSTAZVALVE
QO�,�g—LIM�Jtx1T
�SHENANDOAH PLACE
tap
WOOD.DECK
E
NOTES: � �xtsTl*s� 7-zx•rlc� VIILS- n
151J�nt�17 (hbT USEti� INCIL
NO SURFACE WATER +100 � � N�srl .M V"5.
NO KNOWN CURTAIN DRAINS
SEPTIC SITE PLAN
LEGAL: LOT 5
OWN ER/W-STALL
ATE: 08/08/95
BRENT
3801-A
ANCHORAGE, AK
ERRY EATON
•rni C• 1"
/
C '
SwP�
P. EATON, P.E.
WILSON STREET
99503 PH. 229-3777
X
0
H -j -H
O
ONLY
lklunicipali. of Anchorage
Department of Health and Human Services
825 "L" Street
Rick Mystrom, P.O. Box 196650 Anchorage, Alaska 99519-6650
Mayor
343-4744
December 10, 1996
Jay E. & Tammy L. Kassner
Property Owner's of Lot 6 Shenandoah Hills Subd.
12020 Shenandoah Place
Anchorage, Alaska 99516-2201
Re: Separation Encroachment, Lot 6 Shenandoah Hills Subdivision,
P.I.D. 015-212-43, W R960067
Dear Mr. & Mrs. Kassner:
As a result of the recent upgrade to the wastewater system on Lot 5
Shenandoah Hills Subdivision, the engineer who designed and inspected this
wastewater system discovered that the existing wastewater system serving this
property is being encroached upon by the well on lot 6. The separation distance
is approximately 87 feet. The required separation distance is 100 feet for a
private well to a wastewater system.
The existing wastewater system on lot 5 was constructed in July of 1978 and the
well on lot 6 was constructed in June of 1983. Because the wastewater system
on lot 5 was in place at the time the well on lot 6 was constructed, makes the
responsibility of resolving this encroachment matter the property owner of lot 6.
Be advised that Lot 6 Shenandoah Hills will not be eligible for Health Authority
Approval from this office to obtain conventional financing for purposes of selling
or refinancing the property until the separation encroachment matter is resolved.
If you have questions of the above, feel free to contact me at 343-4744.
Sincerely,
Daniel J. Roth
Civil Engineer
On-Site/Water Quality Program
dhhs
MUNICIPALITY OF ANCHORAGE
/ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264.4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
PHONE
EW
// /' /M/�,�n
���'[''�-11�/�t�J❑UPGRADE
MAILING ADDRESS
LEGAL DESCRIPTION
/_" G L..
LOCATION
NO. OF BEDROOMS a
v
Well/+/
Absorption area e
I'
Dwelling J
PERMIT NO.
v
DISTANCE TO:
_Y
M Z
ManufacturerMaterial
�
No. of compartments
w �
KE C'2
`5TGL
Z_
rn
Liq capacity in gallons
Inside length
Width
Liquid depth
IF HOMEMADE:
DISTANCE TO:
Well
Dwelling
PERMIT NO.
_ F
Manufacturer rC�
Material
Liquid capacity in gallons
f
Well Foundation / �-
Nearest lot lineU /�
PERMIT NO.
z
DISTANCE TO:
CO _
j J
�
�. Z
No. of lines
Length of each 'i / Total length of I' e?
5j
Trench void
Distance between lines
b
�w
&
inches
cc
L
Top of tile to finish grade Material beneath tile
effective absorption area
!Total
inches
l &
Length
Width Depth
.1
PERMIT NO.
w
(7
Q E—
Type of crib
Crib diameter rib depth
Total effective absorption area
as
w
N
Well Building foundation
Nearest lot line
DISTANCE TO:
Class
Depth Dril er
�. j, /
Distance to lot line
PT NO.
ERMI
J
x
IL
Building foundation Sewer line
Septic tank
Absorption area(s)
DISTANCE T0:
OTHER
W
____E
PIPE MATERIALS
c,fiSr
SOIL TEST RATING Am
INSTALLER
REMARKS
I
93 {l
�9
RI
-
,r .
fpwaM v`1 ;i1u`S%:r rf
9 � t
i
AW V DATE LEGAL0lye%
71-013 (Rev. 3/781 /
-VE LL LOG
Jte Drilled:
Static Water Level 25 — feet Gallons Per Minixte V
Draw Down '/A � feet
Tyne Material Drilled:
Total Feet of Casing. 7r,
0 Feet , to
to
to
? ll T,
m...m..�m,..a.>�..,,m,.e.ee�.,...., to
to
Hefty Drilling,
S.R.A. Box 1553 H
A nchar .go ,in laska
L .-9 4_N v,A _b.. C- L' tl::-. ....:u R_^R `_..� It'll V-4 RT ; rt.....� p-..-. �;�" y':-9 B�::a Ems.'
f.,FPAR:Tr-lE[.J"J" C). Hf.:YIL`rH Al'411 Erd''r'IF:IIYdI'1ErdTFil... I ITECT10hl
825 : L. STREET'.. ANCHORAGE, Al::'. 50 11
@,"..1 E'_. IL... fl _ o- b F-4 F_ -n CR p" -.d(- ... ".E-3 T_ '"T"
E_ _ d I-_ 9.". fl E.' _ 1-" F-"
PERMIT �-40.
AF,PL_ 7 c.Ar-4T �: AF:T'I-I MERR:I L_L SRABO.' - E _:'a. ,=:1_; 'r
L 01:FIT1:0Nd
LEG'AI.. LOT 6 `41E'NAN DOA HILLS I__OT " SIZE 9'-:1'1 9 SQUARE F'F E T
TYPE OF -5011- AE,'E'ORPT I ONS S'r'STEN IS: TREI'CH
MA 'INl_M NUI-IE,EF OF' EIE DRt-OITS •_ q. ,;;OIl_ RATING ;i-1 F"r,!'t,R}=- 2 12-
1-1-AE
a
1-1-AE RECUIR:EC! SIZE OF' THE SOIL_ AEI',ORPTIC1r•d c;'•r' STEN IS:
F=" 9-•-1. , -:.R _ -.=" E__ IE = �,-4 C3 19 Fo =— '-M aT C-9 rP, F�-"R n"" 8--•_ E: -a F'E A = '-If H -A --
THE LENGTH C!T.r-IEP•-15IClN IS. THE LENGTH t:Ih'I FEET? OF THE TR.EN CH OR DR:AINdFIELF...".
THE DEPTH OF' A TRENCH OR PIT IS : THE DISTANCE BETWEEhl THE. SI-IR.F*A :E OF 1"FlE
GF.,O _IN r) At•,ID THE' BOT-TOt'I OF' THE EVCAVAT.T.I_INd "'IN F'E:ET.!,
THERE .T. NO SET WIDTH FOR: TRENCHES.
THE GRAVEL DEPTH IS THE Ml:r•dIHIJ11 DEPTH r'IF GRA'v'EL. BETWEEI'•'I THE OUTFALL PIPE.
AND THE BOTTOM OF THE E: <CAVATIi_ -4 M. -I FEET:!.
F" FL n ==d F._11 19" "' F- C- E--- F, 1"" 1 C1" IF # lr-J I-` I : E :- �_ � �� n =n n � � ='Y 6_._ b _..-. n'_ n V -4R _.w
PERMIT AF'F'L....T.GANdT HFI`'; THE R:E:-POhiSIBILIT'r' TC:I :f.r•'IFI:�iRTI THIS C!Ef-,FIR:Tr'IETI%IT ClURIr.-IQ THE
1:1'•d'STFiLLATII_Itd If•d'�;PEi:TIOP-,Jw' CJF ANY L.lEI_.i_.E; ADJACENT TO 'T'HIS PROPERTY ANC, THE
NUMBER OF' R:E :-'; I DEI-4CE.S TFIA-r THE: WELL.. WILL .";ERNE.
...F. 6-4 r -R :N: l"-4 ° F-„ F--= N.—D, -Y I Co � N T F it ll�, � F r" �:= R :=R N -_B F 6TM" �.. Ic,
BFICK'FILL..INdG OF ANd'r' S'rSTEl'I WITHOUT F-INAi._ 1: Nd:;F'EI_:'1IOI'd AND FIPPR:CP,411_ E:' -i-' THIS
DE'PART11ENdT 1,111...L BE. SUBJECT TO PR:OSEI_:I_ITIi N.
1111'4 I N Irl E! T: ;T'FINCE BET 14EEN•d 19 WELL FltdE: ANY ON-SITE SEWAGE= DISPOSAL. 'S'r'''";TEI'I 1:'r,
-1.6:0 FEET FOR: FI PR::[''r'A"I-E I'•IELL FIR 150 T'ICI 200 FEET F'RCIM A PUBLIC WELL. ClEPE14D I Ndi
i_IPOr•d THE TYPE: OF' F'LIB1._Ii_: WE:L...L.
tIIPdTf'il_if'I DI ,T't=ir•dI=:E FRiDl,1 A PRIVATE: I'dEIE_I_ TO H PRIW—iTE :;El...IER: LINE IS 25 FEET ANC
1r0 A C011 U P -J T T'•r' E"ENER: LINE IS 75 FE'E:T.
I•'dEcLL. LOGS FIRE REQUIRED ANdC) MUS;'r BE R:ETUR:YdED TO THE C!EPAR:TMENdT WITHIN -:::0
F T'I-IE WELL COMPL.E::TIOP.-I.
IIIhiE"F't RE:I_il.-I.i:f:E IENd`f
11FP,' APDL.','. PE:[::TFT.CI1'rTIIYI ' I=IYdC I I_INI:;rRa_II:":T':C6-II'd C!TA6aE:1111`_ FIRE
FI''r'FIIL...ABLE TO INSURE PROPER INd_:;TALLATION•d.
F=M 0'=-. F":, 9."-0 1 ....R_' F = 49 " I�=aN=::CF:w1.9F3, F.Em*F_: - ":-I..: .1_°=:d„W=,�::
I CERT I F4' THAT
1: 1: AN FAM I L I F=IR: WITH TH THE REI 0I I I R:E MENdTE, FCIR Ohl --SITE SE MER-'; AhID kIELL AS r'E."F
FORTH E;'r' THE h'U_INd I C I PF=IL I T'•r' OF ANCHORAGE.
I b•IT.L_.I_.. IN `5TAI._.L THE: SYSTEM IN AC(OF.DAN ( E WITH THE C;ilC,Eki;.
I LII'IDER S'i"Ah IE! THAI" THE I IP,I S; I "I"E :`EI.'.iE:R: Sli-I '"I"I-t'I r'lAY RE.E'!LI1. R:E. E.t•'IL ARGEr D-1 1" :L' F THE
R:E''_' I GiEhl :E= I'= R:EI IOC E:L.E C! T`I.I I I''I a[;!E i" U If ; - THAN e1 E,EF)RC)Or' S.
FiPPL. L.I. C;AUr GARTH i,IER:F:: l: L..L
ilk
N SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF- HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: �l,�l� l�'l l ll ( _DATE PERFORMED: `,-J� �Y23
LEGAL DESCRIPTION: C)II`� , L p -L Lo
11 •�'' i SLOPE SITE PLAN
.E
7t ) W frD�t
� I
1
OL 50u
2 I C-_1 1 C
-
3
- ---- - 4
5
6
7
8
9
10
11
- 12
13
-•-14
15
16
17
1a
19
20
COMMENTS
Gq�lj �(Y)01 `�1`
Q
2;
``7t mc -N con
ML S\v- WAS GROUND WATER y S
ENCOUNTERED? ��� L
WO
IF YES, AT WHAT I E
DEPTH? )
(nl�o 11 �1rI� /'IiOVVI�aa(-V-
L
leb v Nao
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
f"2c)
5J51Hsv
00
10
��
•5N
()' 1
+Vi -Lo
.5/6/3
2.00
2:00
-
G
,p
-� ---
cob
52
(�
+lig(
�
Sl y l8a
Z I 0
2:zo
ICU
(1' ri
7
011
HzC�
S� �b:3
2: ZO
L:30
C5
/ 0
io(
5y
C��—I
+H2G
�/� ���
7:30
C)
/0
� l�
O w
PERCOLATION RATE Z'yy w (mii�nutes/in h)
TEST RUN BETWEEN FT AND ..L FT � rnl E1 I I n(—,h
PERFORMED BY: 4A) w- �(3(16—c ,� - CERTIFIED
72-008 (6/79)
DATE. -"-
. MUNICIPALITY OF ANCHORAGE
• Department of Health & Human Services �1
r DIVISION'OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D. # (�% ' Z�L� 443 HAA # fi1919 - CE 1.rr1_,�_
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal ascription (include lot, block, subdivision, section, township, range)
Location (address or directions)
(b) Property owner Iephone : (home) Business
Mailing Address
(c) Lending Institution L�C�r�-�- -�--� Telephone
Mailing Address
(d) Real Estate Company and Agent
Address /0
Telephone
(e) Mail the HAA to the following address: (or check here if hold for pick up.)
List contact person and day phone number below:
S & S ENGINEERING
17034 Eagle River Loop Road Me 904
Fagie River, Alaska 99577
2. TYPE OF RESIDENCE
Single -Family Number of bedrooms
3. WATER SUPPLY
Individual Well Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legailty and status.
72-025 (Rev. 7/88)
Page 1 of 2
5. 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 on the date of this inspection.
Name of FirmTelephone.
S & S E RING
Road No. 204
Address 17034 Eagle River qqr
Looe
Eagle tver,
Date
4r W
•' it; 4
Nom 0044
E er' eal
MY Yr o .•O �.s •.n�s�� .,
No. 1457-E
6. ,DHHS APPROVAL
Approved for bedrooms by %/ Date ,�—
Approved —Disapproved Conditional
Terms of Conditional Approval
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the State of Alaska. The DHHS does this .as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections
or analyze data before a certificate is issued. The'Municipality of Anchorage is not responsible for errors or omissions
in the professional engineer's work.
72-025 (Rev. 7/88) Back Page 2 of 2
- M • �"Y MUNICIPALITY OF AN
CHORAGE (M
OA)
CHealt�Authorit Approval (HAA)
OF
CLS FEBRUARY 1984 H,E,.CKLIST =
NVI .TALSEKV{
E
343-4744
Legal Description:
��cao�t.l LA S
A.WELLDATA .` RECE-1 ED
Well Classification li S�sb-t If A, B, C, D.E.C. Approved (Y/N)
Well Lo Present - -"
9 (VN) Date Completed �0=23 �g3 Yield � •lo G.�
Total Depth- -1'5,—.Cased to Depth of Grouting
Static.Water Level„
Pump Set At
Casing Height Above Ground 12� Sanitary Seal on Casing (Y?N) `J
Electrical Wiring in Conduit 61N) Depression Around Wellhead (Y/aP_
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot
oining Lots "� -To Nearest Edge of Absorption FieldoLot EDAdj
; On Adjoining LotsTo Nearest Public Sewer Line �` ewer Cleanout/Manhole A
To Nearest Sewer Service Line on Lot u �"
(�,1-011
Water Sample Collected by Date � ;Date � • + �2. Z3 845
Water Sample Test Results
Comments _ _ 1✓ {�, ��E�j ��.
B. SEPTIC/HOLDING TANK DATA
Date Installed __S3 Size_L1_n No. of Compartments .
Z
Standpipes (PN) Air -tight Caps (WN) Y Foundation Cleanoutgl 1) _!Z_
Depression over Tank (Y, W S ate Last Pumped
Pumping/Maintenance Contact on File (Y/N) \ for
Holding Tank High -Water Alarm (Y/N) A' Temporary Holding Tank Permit (Y/N)
,SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
,To Water -Supply Well
To Building Foundat{on
To Property Line 4—
To Disposal Field
To Water Main/Service Line
To Stream, Pond; Lake or Major Drainage Course L ®o �--
Comments
72-026 (Rev. 7/88) Front Page 1 of 2.
C. ABSORPTION FIELD DATA ' - -
Soils Rating in Absorption Strata i �!2��/r'1L
Type of System Design G
Date Installed �-\moi
'Length of Field
Width of Field 2 �� Depth of Field \Z1
' Gravel
Bed Thickness
Square Feet of Absortion'Area
Statndpipes PresentdpN)
Depression over Field (Y)tn),
Date of Last Adequacy Test
Results of Last Adequacy Test
'
SEPARATION DISTANCE FROM ABSORPTION FIELD: t
To Water -Supply Well ��
To Property Line
To Building Foundatigqn
To Existing
- ,, , g or Abandoned System on
- Lot °; On
Adjoining Lots
_ To Water. Main/Service'Line' "'
To Cutback (if present),'
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area,,or Vehicle Storage Area
--
Comments
_ ,. .
D. LIFT STATION
-Date Installed
S)ie4n_Gallons
--"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access'(Y/N)
Pump Off Level at
/N)
Pumping uringAdequacy Test.
"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 tl4;
inspection.
.w
Signed 5 ENGINEERING
Compa17034 Eagle River Loop Road No. 204
ny - �A•S 'ti'�j;�
age gneer''' s a
o...++
Date I "� t
MOA No. a • �;;,K`
r
Receipt No. Cels 'o�f'Jgga c? �'S . Receipt'No
Date of Payment / Waiver.Fee: $.
Amount: $ ���• 00 - _ Date of.Payment
72-026 (Rev. 7/88) Back Page 2'o f 2
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562.2343
IABOAAfo"IE5 FEDERAL TAX ID N 92.0040440
ANALYSIS REPORT BY SAMPLE for Work Order 1 11039
Date Report Printed: DEC 28 88 f 12:37
Client Sample ID:L6, SHENANDOAH HILLS
PWSID :UA
Collected DEC 23 88 a 14:15 hrs.
Received DEC 23 88 1 14:30 hrs.
Preserved with :4 DEG. C
Client Name S & S ENGINEERING
Client Acct SNSENGP
P.O.# NONE REC'D
Req i
Ordered By
Analysis Completed :DEC 27 88 Send Reports to:
Laboratory Supervis :STEPHEN C. EDE 1)S & S ENGINEERING
Released By 2)
..........................................................................
Special
Instruct:
Chemlab Ref 1: 3803 Lab Smpl ID: 2
Parameter Tested
NITRATE -N
Sample ROUTINE SAMPLE.
Remarks:
Matrix: WATER
Result/Units Method
-----------------------------------
0.15 mq/l EPA 353.2
Allowable
Limits
-------------
10
..........................................................................................................
1 Tests Performed See Special Instructions Above UA -Unavailable
ND None Detected See Sample Remarks Above
NA- Not Analyzed LT -Less Than, GT-Gieater Than
ROBERT A. SHAFER
MUNICIPALITY OF ANCHORA,CDEVIL ENGINEER
A A � June 6, 1989 DEPT. OF HEALTH & 694-2979
ENVIRONMENTAL PROTECTION
JU14 ! 1989
HEALTH AUTHORITY
Mun.ici pat i.ty o6 Ancho,%age
RECEIVED
APPROVALS
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
P.O. Box 196650
Anchoaage, Ataska 99519-6650
SEWER & WATER
MAIN EXTENSIONS
Attention: DanieC N. Botte6
REFERENCE: Lot 6; Shenandoah H.caz Subdivision
Dean. Dan,
SEWER & WATER
INSPECTION
This tettea is to .in6onm you o6 gnoundwateA moniton.ing pen.6onmed on the
,%e6enenced pkopen.ty pr ion. to obtaining Heatth Authon,i.ty Appn.ovat.
On Febnuany 10, 1989, a gnoundvatel monito,%i.ng tube was .inbtatted on
ENGINEERING STUDIES
AND REPORTS
the negenended pnopeAty appnox.cmate.Cy 6.i6teen (15) beet away 6&om the
existing teach6.ietd. This mon i to king tube extends sixteen (16) beet
beeow the ground sun6ace which .is 6oun. (4) beet deepet than the bottom
o6 the teach6.ieed. There wen.e no signs o6 guundwaten dua.ing the
WELL INSPECTION
mon.i toning tube .instatPtation.
& FLOW TEST
The mon-itoning tube was then checked on Ap4a 11, ApAit 29, May 11, and
June 1, 1989. No gnoundwaten, was even encountered within the
gn.oundwaten moni toting tube.
SITE PLANS
We request the Heatth Autho4 ty appkovat which we pn.ev.ious.2y submitted
to your, o6j ice be .issued.
ROAD DESIGN
15 you have y questions, ptease contact us.
r
a.inceneey,
SOIL TEST
SHAFER, P.F.
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN 1 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
C -A14
•
APPLIC�NT FILLS
OUT UPPER HAL,' -!ONLY
Time
Proper'4.Owner!) L . / ljl7/GG
/ V7 � ,' '(
-
Phone
Mailing Address "
, ,� �^ J Zip Code !�
�1fs—
Buyer
Inspector
Inspector
Address
Field Notes:
p
MUNICIPALITY OF ANCHORAGE
DEPT. OF H` t:
L. an`9J
Zip Code
Lending Institution
,A L _ i� /Ilei-..�.�.-�-1� 1��
Phone
Address
RECEIVED
Zip Code
*CONDITIONS OF APPROVAL
Realty Co. & Agent
BY:
Phone
Address
��
Well Log Received
Septic Tank Size s"A
/
Zip Code
Well to Tank
Legal Description
Street Location
f //�
Type of Residence
Single Family
O Multiple Family
No. of Bedrooms
O Other
Water Supply
ipl�lndividual
❑ Community
1
U
ATTACH WELL LOG. A well log is required for all wells drilled since June 1975.
For wells drilled prior to that date, well depth (attach log if available).
O Public Utility
give
Sewer Disposal
,[a, Individual
Year Individual Installed:
TI—Public Utility
When Connected to Public Utility:
O Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
MAIL 77) PnnP_ OU-)A),P � T
Time
Time
Time
Time
Date
Date
Date
Date
Inspector
Inspector
Inspector
Inspector
Field Notes:
p
MUNICIPALITY OF ANCHORAGE
DEPT. OF H` t:
L. an`9J
PROTECTION
ENV IRO\T�1=ivTAL PicOTKTiON
SEP 261983
RECEIVED
(C� APPROVED BEDROOMS
( DISAPPROVED
*CONDITIONS OF APPROVAL
)
( ) CONDITIONAL APPROVAL'
DATE
BY:
Soils Rating
3 Ci
Date Sewer Installed
Well To Absorption Area —O
Well Log Received
Septic Tank Size s"A
k,- 1 3
Well to Tank