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Home My WebLink AboutTRAILS END BLK 4 LT 8Troils Ends Block 4 Lot 8 #015-192-13 · Municipality of Anchorage 3" ". Department of Health and Human Services : Building Safety D~vtsion L~ on-site water and Wastewater Program. 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 Page 1 of 3 v,~vw.ci.anchorage.ak.us (907) 34~-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SWSW040277 PID Number: 015-192-13 Hnrry. Mo:ah Wastewater System: [] New [] Upgrade ,tl~nn nnnni,~ nv,, Annh AK _CmglR ABSORPTION FIELD R(~3 RfiR-717; 3 f'l~Tmnch b"] Sha~wT~h r'18ed ~'lldo~nd LEGAL DESCRIPTION 0.~ ~' ~,Pn~,' 0 4 Fi Tralln End +0.5 r~ O.~10.~ r, 414 fl. 75, 75 Exist'a Private ~,. r, 750 re 3034 PVC r, Beeks Contractina 6141200~; SEPARATION DISTANCES I~ septic [] Holding [] S.T.E.P. [] Other. Septic Absorptior Lift Holding ,ubl~Prlvat~ I~,'~u~c Tank Field Station Tank Sewerline Anchorage Tank 1000c~ w,, 106.4 117.4 78.3 Steel 2 ~w~., 100+ 100+ ~ / LIFT STATION 4" rIRld Insulation ove entire field BENCH MARK '~,H~ Eflgine~s Stamp Inspections pedo~ed by: Pannone Eng. Svc Dates: 1"6141200~ __. ~ ~~ p...,. ........... Depa~ment of Health and Human Se~ices approval - .,_.~ev~ ~. ~, ~,~:~ Reviewed and approved by: ~, ,~t~~ Date: , ~[~... No CE 8149 ... .E.M~T.O:O~0=?? RECORD DRAWING ,.,.D..O: 01~-182-18 WASTEWATER DISPOSAL SYSTEM LOT 8 BLOCK 4 TRAILS END S/D xSEPTC~ I I III it ~ AREA~ I I I ~----~ ~ ~ ~ ~ ~ ~; iF_]---~ / ~ ~EXIST[G2 BF ~ II II ~ ~ ~]~ ~ ~~ ~~E ~ /EXIS~G SEPTIC II II ~',~ ~. ~.L~ f ~ J / ~ SEPTIC~ I I I K--~~~ ~ //// ~ ~' ~1 ~ 1064 I UPG~DED II ~;~ I11 I L SAS2TRENCHES,~ii _ _~1 lid I~1o%'-117.4~i 5~x7~Lx 0.5 ED, 0'TD I I ~ I ~ -~1 ~ III ~ EXIS~G~ I ~1 I S i III t WELL 2) Mateflals us~ sha, be In CO A B I m m I a~dan~ses~dfi~ ~ T1 30.9 43.~ I ~C15.65, Waste~ter Dls~saL ~ 33.5 44.4 , I I LOT UND~ELOP~D DC 34.1 44.~ t I 3) Main~in 10' separafi~ ~ all ~t lines DV 35.8 45.~ I I I andpm~sed~terlInes. FS 51.1 57.~ I I I Cl 45.5 48.8 I I I 7 - an exisU~ waiver ~R960026) on file C2 74.1 61.6 m m m waMng ~nk ~ we, distan~ to 85 feet. M2 72.5 59.9 m m C3 63.1 65.~ I I 5) Existing ~nk ~1 be ~spe~ed end M3 ~.3 66.4 repla~d ~Ide ~e 100' well radius. ~ ~ 84.1 72.~ I I requ{~. M4 82.8 7~.~ t t DESIGN CALCU~TIONS ~ I I Number of Bedrooms- 3 ~ ~ Design flow-150 gal~r/day; ~ ...... ;.~,. ..... I, P~ation R~t~ =15 ~n/[~ch ~ ~ J~'%.~ e~ I I I I AppRate-0.8gpdsf Use5-Wde, 05'effe~ve ~q~ ~ $~ I I Il Area Required = 750 sf 150' Long by15' Wide I ~~. - - ..... ~...~. I I II 150LFx5'x0'5'=750SFT°tal ,, ,, ~~~~ PREPARED FOR: PANNONE ENG. SVC, LLC $~ ~. /~ ~..~.o.~ P.o. BOX ~o~ '+:~.~" ~ ~omge, ~ 99516 'ee~ ~'~' ;~ ~* 5o3 868-7175 227-3522 P, 272-8218 Fax ~- ~~ DATE: 6/5~5 I ~ a ~ SCALE: 1~50'~ P~N ,E,M~T,O:0~02Z7 DESIGN DRAWING DETAILS WASTEWATER DISPOSAL SYSTEM LOT 8 BLOCK ,4 TRAILS END S/D z ~ ............ · . ~.. A '"':.~ ~ ,,- .................... .~.....~ ~. ................ [......; PREPARED FOR: PANNONE ENG. SVC, LLC ~:'"~,~ Mr. Har~y Noah P.O. BOX 102954 ,~ ..o ._ ... . 11300 D~gi. Ave ANCHORAGE, ALASKA 99510 ....... 227-3522 P, 272-8218 Fax 'ee.'~ ,--: ........ :-,~.- ~,"' so3 ~68-7175 q'~ ~ ?~I=~S[_f:~,~.q~' DATE: 614/05 m ~'~ SCALE: NTS I DESIGN SOILS PANNONE ENGINEERING SERVICES ANCHO~GE, AK 99510 ~~"'~""~ (g07) 272~218 P ERFO RMED FO R: Mr. Ha~ N~h DATE PERFORMED: ~10~S LEG~ DESCRIP~ON: LOT 8 BLOCK 4 T~ILS END SUBD~SlON SLOPE Jm ~ ~ OR I ~ ..... ~ FS '~u~ ~ · Damp ~e~e I . ~ o BOH I t I I W~ GROUND WA~R SLOPE 14 ~ ENCOUNTERED? Y 15 ~ IF YESt AT ~AT pEPTH? ~.~ X DEP~ TO WA~R ~R 17 ~ MONITORING? -8.0' DATE: 6-2~2005 20 ~ 1 e/m/os i 1:52 6' o" 2 I 2:22 30 3 2:22 6' o' 5 2:52 6' o' 6 I 3:22 PERO~TION ~ 30 (mfn~nch) PERC HOLE DI~R 6 ~es TEST RUN BE~EEN 2 ~ ~D 3 ~ ~ COMMB~: Test bole excavated by ~eeks ~ntractin~. Test Hole was preso~cd before ~rc test. '~ P~RFORMBD BY: Steven R. Pannone, P.E. ] CE~I~ THAT THIS ~ WAS PgRFORMgD IN ACCORD~CE ~ WITH ALL STATE AND MUN[CIPAb GU]DL]NES IN EF~E~ ON THE DATE O~ THIS Tgi. WATER READING DA'rE CLOCK NET TIME LEVEr. NET DROP TIME READING 1 6/10/05 1:52 6' O" 3 2:22 6' 0' 4 2:52 30 M,,I 5' 1" 5 2:52 6' O' MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Jul 21, 2004 Expiration Date: Jul 21, 2005 Permit Number: SW040277 Legal Description:[TRAILS END BI~"-""4-'LT~8 Design Engineer: 0811 Pinard Engineering Owner Name: Harry Noah Owner Address: 1120 E Huff'man #601 ANCHORAGE, AK 99515-3561 Parcel ID: 015-192-13 Site Address: 011300 DOGGIE AVE Lot Size: 22800 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] DisposalField [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage Ail construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to Apd115, 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. 5. The following special provisions. AT THE TIME OF CONSTRUCTION THE ENGINEER SHALL EXPOSE THE SEPTIC TANK TO VERIFY THE INTEGRITY OF THE TANK AND REPLACE IT IF IT IS NOT IN GOOD CONDITION. Received By:. Issued By:. Date: Date: Municipality of Anchorage Development Services Department Building 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 SEWER/VVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. Permit Number SW OI (3 3,~. Property owner(s) Mailing address (1) .~),,'~ ~,/ Mailing address (2) ,~A/~"ffb,~a~, c. Legal description (Lot, Block & Sub'd.) .. Legal description (Section, Township & Range) Lot Size ~ 2. oc ~'O Acres/S.~.F_t. THIS APPLICATION IS FOR: s'5,';-c Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool ,,,)~?~/~,,~,~.?~. ay phone Zip Code Number of Bedrooms .FI Well Only [] [] Water Storage FI [] 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 in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Date of Payment: i 'l I Receipt Number: (Rev, 12/00) Waiver Fees: Date of Payment: Receipt Number: MUNICIPALITY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON.SITE WASTEWATER DISPOSAL SYSTEM PERMIT Renewal Date Issued: Sep 25, 2002 Expiration Date: Sep 25, 2003 Permit Number: SW020371 Legal Description: TRAILS END BLK 4 LT 8 Design Engineer: 0811 Pinard Engineering Owner Name: Harry Noah Owner Address: 1120 E Huffman #601 ANCHORAGE, AK 99515-3561 Parcel ID: 015-192-13 Site Address: 011300 DOGGIE AVE Lot Size: 22800 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: r~ Disposal Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storag.e 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. ~ 5..The following special provisions: ; AT THE TIME OF CONSTRUCTION THE ENGINEER SHALL EXPOSE THE SEPTIC TANK TO VERIFY THE ~INTEGRITY OF THE TANK AND REPLACE IT IF IT IS NOT IN GOOD CONDITION. Received By: _ _, Issued By: ~ Date: .~_./_. I Date: ~._~_~O ~. ~ep-05-02 10:48A Pek~tt Counter 907 343 8250 Municipality of Anchorage Development Services Department Bonding Safety Division On-Site Water and Waste'water Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorag e.ak.us (907) 343-7904 ON-SITE SEWEPJWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING P.01 Parcel I.D. Property owner(s)~~ /L/~),/{'~/C/~"~ Mailingaddress(1) //~ ~ ~~ Mailing address (2) Legal des~iption (Se~ion, T~nship & Range) ;3._- I Permit Number SWO~._~ Day phone Lot Size · ,~'"- AcreslSq. Ft. Zip Code Number of Bedrooms THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therc, py Poc{ Well Only Water Storage Jacuzzi Water Softening Unit I certify that Single F above information is , Dwelling and I I further certify that this application Is being made for a icable Municipal Codes. authorized a ,~,~,j~Permit Fees: mnt Date of Pay e : Receipt Number: (Rev. 1~/00) Waiver Fees: Date of Payment: Receipt Number: MUNICIPALITY OF ANCHORA GE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Sep 25, 2001 Expiration Date: Sep 25, 2002 Permit Number: SW010392 Legal Description: TRAILS END BLK 4 LT 8 Design Engineer: 0811 Pinard Engineering Owner Name: Harry Noah Owner Address: 1120 E Huffman #601 ANCHORAGE, AK 99515-3561 Parcel ID: 015-192-13 Site Address: 011300 DOGGIE AVE Lot Size: 22800 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: ~.~ Disposal Field [] Septic Tank [] 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. Issued By:~ Municipality of Anchorage Development Services Department Building 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 SEWEPJWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING ParcelI.D. 01,.~" - / ? Z ' l.?, Permit Number SWO~ Property owner(s) Mailing address (1) Mailing address (2) Harry Noah 1120 E. Huffmant # 601 Anchoraget Alaska Day phone 277-2115 Zip Code 99515 Legal description (Lot, Block & Sub'd.) Lot 8, Legal description (Section, Township & Range) Lot Size 0.52* Acres~ll~X THIS APPLICATION IS FOR: Sewer Only Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Block 4, Trails End Subflivtsion Number of Bedrooms 3 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 in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: 3ZO Date of Payment: Receipt Number: (Rev. 12,'00) Waiver Fees: Date of Payment: Receipt Number: PINARD ENGINEERING Paul E. Pinard Registered Engineer/AK & ID P.O. Box 871347, Wasilla, Ak 99687 (907) 357-ENGR(3647) Dan Roth Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw Street Anchorage, Alaska 995 i 9-6650 September 24, 2001 RE: Lot 8, Block 4, Trails End Subdivision; Wastewater Disposal System Upgrade, Revised Plan Submittal Dear Mr. Roth: Reference is made to my letter of August 3, 2001, which submitted plans for the upgrade ofthe waste~vater disposal system serving the referenced property. Your review comments on the design were received on September 1, 2001. I have considered your comments, discussed them with you during our meeting last week on September 20th and have provided design changes to address them. ' ' I concur with your comment on the use of the reduction factor for the specified "5 Wide Drainfield", though I had felt that some latitude would be given for the upgrade of a failed system, especially since the existing system appears to have a significant watertable separation problem. As xve discussed, to address this problem I have reduced the thickness or depth ofthe sewer rock under the pipe, thereby eliminating the "reduction factor". This obviously requires that the length of the "5 Wide Drainfield" be increased. The revised plans reflect this change. Another concern that you had, pertained to the fact Ihat not all of the new drainfield would be within the 30 foot radius of the testhole and percolation test. As xve agreed, during installation ofthe drainfleld, I will have another testhole dug at a location that will provide the needed coverage. A percolation test will be performed Io confirm the consistency ofthe soils and those results provided to you with the Record Draxvings of the installation. In the event that the soils are significantly different from those in the first testhole, requiring a change in the sizing of the drainfield, I will coordinate those changes with you prior to proceeding further with the installation. Also, as you requested, a manifold will not be used for flow distribution to the two (2) legs of the new drainfield. Rather, a Zabel Z200 Flow Splitter or equivalent has been specified on the plans. The only remaining issue is your comment pertaining to the. need for additional svatertable monitoring through October 15~. We discussed this issue and it was decided that I would not necessarily have to wait until that date to obtain the additional watertable data~ I could immediately obtain data from another monitoring event and if the xvatertable was not higher than the highest level previously reported, you would only require a one foot cushion, equating to a five (5) foot separation between the highest level and the bottom of the drainfield (sewer rock). With this understanding I visited the property that afternoon, after our meeting, to check the watertable level in the monitor tube. I found that the level had dropped significantly and was now at 7.6 feet below the ground surface. As such, my revised plans provide for a 0.5' elevation of the drainfield, which reflects the 5 foot separation that we discussed. Because of the nature of the problem, i.e. a failed system that needs to be immediately replaced, your prompt review of these revised plans would be appreciated. As was noted in my original submittal, the owner is prepared to immediately commence with the upgrade of this system once a permit is issued. Please contact me as soon as a permit is issued so that I can coordinate xvith the owner on this upgrade. Ifyou have any questions, please give me a call at the telephone number above or on my cell phone (232-1347). Thank you ! Sincerely, 1 Encl. (as) cc Harry Noah, w/encl. Paul E. Pinard, P.E. DOGGIE AVENUE ' BROWDER AVENUE [~ TEST HOLE# 1 DATE: 7/7/01 JOB NUMBER:01-087 LOCATION: Lot 8, Bk 4, Trails FIELD STAFF:A, Wlen DEPTH FEET SOIL'TYPE 1-- PT 2 3-- 4-- V 5__ 7/14/01 GM- 6- 7-- 8-- V Seeps 12 BOH PINARD ENGINEERING P.O. Box 871347 WaslIla, AK 9968? (907) 357- ENGR TEST HOLE LOG / PERCOLATION TEST Silty, sandy gravel w/cobbles Denser w/depth End Subd. SL~% 6 - 8% SITE PLAN Existing ~ Lot 9 /--' ST 62, / Existing 3 Bdrm SFR ~ ---Testhole ~ Lot 7 o Was Ground Water Encountered? (.Yes)/No Seeps IfYES, Depth to Ground Water. 8.5' on 7/7 4.5' on 7/14 PERCOLATION TEST DATA PM A'13me Measurement C~'opln Level Perc Rate ~me [minCe) (inches) (I~h~) min. I inch C~mems 8:4~ -- 0.68 -- Fill Perc Hole 9:1 30 0.56 0.12 21 Refill Perc Hol~ 9:4~ 30 0.58 0.10 25 Refill Perc Hol~ 0:1~ 30 0.58 0.10 25 Stop Test and ~ FT i~EPTH COMMENTS; ¢erc Hole was presoaked, Size SAS ¢ 250 sf/bdrm b~ed on results of the perc test. "... ~1 Municipality of Anchorage Development Servicss D~partm~nt Building 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 SEWEPJV~ELL SUBMITTAL COMMENT SHEET To: FAUL FINARD Legal dsscription: TI~AIL5 END 5UDDIVISION DLOCK ~- LOT 8 The attached p~-perwork has been reviewed and is being returnad for the follow|rig reasons: [] Original signature or stamp missing on [] Calculation error in design. CANNOT USE A WIDE DF. AINFIELD KEDUv~TTION FACTOK IF THE FKOFOSED ~IDEW^LL ADSOKFTION AKEA 15 NOT INTO AN ACCEFTADLE INSITU 50IL. [] Additional soils information needed. MORE THAN 507, OF THE ADSOKFTION TKENCHE5 ARE OUTSIDE THE 30' F. ADIU5 AF. OUND THE FEKCOLATION TEST, [] Water monitoring results inadequate, WATEF- MONITOK THF. OUGH OCTODEK 15 Discrepancy in information submitted. Topographic information missing or inadequate. [] Incomplete; missing [] Incomplete; missing [] Additional adequacy test information needed, [] Water sample unacceptable. [] Measured/proposed distances/dimensions missing. [] Locations of all soils, percolation and water monitoring tests not shown. [] Proposed system too deep for soils information submitted. [] Well log required. [] Omission in narrative. [] Insufficient fill over tank or field. [] Other. ~:ANNOT USE A HEADEF. FIFE TO 5FLIT FLOW TO TWO ADSOKFTION FIELDS. FLEASE 5FEC. A ZADEL Z2OO FLOW 5FLITTEF-, OK AN AFFK0¥ED EQUAL, Name of reviewer: Date: Please supply the necessary information and re-submit your request. LEAVE THIS FORM ATTACHED TO THE PAPERWORK ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROT~=CTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT MAILING ADDRESS ~ Z Manufacturer ~ r~[~ Material Liq. capacity in gaUons Inside length Width Liquid depth /~g IF HOME.DE: ~O ~ DISTANCE TO: Well Dwelling PERMIT NO. O Z ~ Manufacturer Material Liquid capacity in ~llons ~ TOp of tile 'o finish grade ~ ~ ~ Well Building f~ndation Nearest lot line ~ DISTANCE TO: ~ DISTANCE TO: Bugding foundation Se~r line Septic tank ~/~ ~ Absorption area(s) OTHER 72-013 {Rev. 3~78) r,lLl~-4 I C I PRLI T'T' OF F-lt-ICHORRGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL F'ROTECTION 825 L STREET, RNCHORRGE, RK 995~1 264-472~ U--':r-.I--~_. I TE SEI4ER ~% i.IELL PEAr'11 T PERMIT NO: DATE ISSUED: 840051 03715784 APPLICANT: ADDRESS: CONTACT PHOHE: FEJESDEVELOPMENT PO BOX 11-2009 ANCHORAGE, Al{ 99511 345-5022 LEGAL DESCRIP: LOT.SIZE: MAX BEDROOMS: SUBDIVISION: TRAILS END LOT: SECTION: 24 TONNSHIP: 12N RANGE: 22560 (SO. FT. OR ACRES) BLOCK: 4. LISTED BELOH ARE THE OPTIONS AVAILABLE TO YOU IN DESIGNING YOUR SEPTIC . SYSTEM. CHOOSE THE OPTION THAT .BEST FITS YOUR SITE. \ TO TOTAL DEPTH (FT.) . GRR?'EL WIDTH (FT.) 32. GRR,/EL LENGTH (FT.) · GRAVEL ~OLUME (CU. YDS. ) l,,. 8 ~ 16. i 2~. 7 TANK ~I~E (GRLS) SOIL RATING (SO] FT./BR) · *-T~NK MUST HAVE RT LERz. T T~IO COMPARTMENTS I CERTIFY THAT: i. I Ar'l FAMILIAR HITH THE REQUIREMENTS FOR ON-SITE SEWERS AND HELLS'RS SET FORTH BY THE MUNICIF'ALITY OF ANCHORAGE (MOA) AND THE STATE OF 'ALASKA. 2. I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH ALL MOA CODES AND REGULATIONS, Arid IN COMPLIANCE WITH THE DESIGN CRITERIA OF THIS PERMIT. 3. I WILL ADHERE TO ALL MOA AND STATE OF ALASKA REQUIREMENTS FOR THE SET BACK DISTANCES FROM ANY EXISTING HELL, HASTEWATER DISPOSAL SYSTEM OR PUBLIC SENERAGE SYSTEM ON THIS OR ANY ADJACENT OR NEARBY LOT. 4. I UNDERSTAND THAT THIS PERMIT IS VALID FOR R MRXIMUr'I OF ~ BEDROOMS AND ANY ENLARGEMENT HILL REQUIRE RN ADDITIONAL PERMIT. I'F A THEN WILL ELECTRICAL I,IORK MUST BE DONE BY A LICENSED ELECTRICIAN. LIFT. STATION' IS INSTALLED IN AN AREA COVERED BY MOA BUIL[>ING CODES, (1> AN ELECTRICAL PERIdlT AND INSPECTION MUST BE OBTAINED; (2> AS-BUILTS NOT BE APPROVED I.IITHOUT RN ELECTRICAL INSPECTION REPORT; AND (~> THE S I GNED ~ DATE: ............ APPLICANT: ISSUED BY ~,~4_.~¢ ~ [)ATE: 'MUN..LCIPALITY OF ANCHORAGE Departmen~"~f f 'tlth and Environment~ Pr,'~.ction ~... ... 825 , Street, Anchorage, AK. ~950- 264-4720 * * # HANDWRITTEN PERMIT * * * Permit ~ q5~[oC5~ ..-~ELL AND/~ ON-SITE SEWER PERMIT Applicant: ~ Mailing Address: Location: Lz~ ~- ~-~-$Z~ Phone Number: Legal Description: %~ ,,~-- y/.ZA) Z ..~f.~-" Lot Size: Type of Soil Absorption System Is: Trench: Drainfield: _ Seepage Bed.' ~olding Tank: Maximum Number of Bedrooms: ~ Soil Rating(sq.ft/br) ~"- The Required Size of the Soil Absorption System Is:' DEPTH z~ LENGTH -~ . GRAVEL DEPTH ~' WIDTH /5-/ The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = /~0 GALLONS * * Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * * * TWO(2) INSPECTIONS ARE REQUIRED * ~ * Backfilling of any system without final inspection and approval by this departme~ will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100 fe~ for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a communit, y sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 51, 1 9 8 3 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlarj_ement if Signe~: ~Z~---/~ff"~__~the residence is remodeled~.~_.t~.~ . to includeissuedmOreby: ~~that bedrooms Applicant ''1 Date: swP/024(i/8i) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street. Anchoraga. Alaska 99501 264-4720 SOILS LOG -- PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: LEGAl. DESCRIPTION: 1 2 3 4 5 6- 7 8 9- 10- 13- 15- 16- 17- 18- 19- 20- COMMENTS PERFORMED BY: 72.008 (6/79} 5'//t DATE PERFORMED:. SLOPE WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? P Reading Date Gross Net Depth to Net Time Time Water Drop 6 / 5'.' %, /0 2. PERCOLATION RATE ~' {minutes/inch) TEST RUN BETWEEN ,~,, , FT AND Z//* FT CERTIFIED BY: ALASKA erlUIROl merlTAL COI TROL SI RUICI $, II C. En~in~trin~ & ~nuironm~nl~l SPECIFICATIONS FOR SEEPAGE BED ALTERNATIVE WASTENATER TREATMENT SYSTEM - TRAILS END SUBDIVISION, LOT 8, BLK 1o0 GENERAL 1.1 THE DRAWINGS SHALL E:E A F'ART OF THIS SPECIFICATION. 1.2 ALL MATERIALS AND WORKMANSHIP SHALL MEET THE REQUIREMENTS OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERMIT. 2.0 LIFT STATION (NOT USED). 3.0 SEEPAGE BED 3.1 THE GRAVEL FOR THE BED SHALL BE SIZED BETWEEN 0.5 TO 1.5 INCH AND RELATIVELY FREE FROM SILT OR SAND. 3.2 THE BOTTOM OF THE EXCAVATION SHALL E:E RAKED WITH THE BACKHOE BLADE' TO INSURE THAT THE BOTTOM HAS NOT BEEN COMPACTED DURING EXCAVATION. THE BOTTOM ELEVATION SHALL E:E PLUS OR MINUS 3,3 THE DISTRIBUTION PIPE SHALL BE 4 INCH RIGID PVC OR POLYETHYLENE, THE PIPES SHALL BE LAID LEVEL, 3,4 AN OBSERVATION PIPE SHALL BE PLACED AS SHOWN IN THE. DRAWINGS. IT SHALL BE RIGID F'VC, ASTM 3033 D-303~. THE SECTION SHOWN WITH HOLES MAY BE EITHER DRILLED. HOLES ~ 6 INCH CENTERS ON OPPOSITE SIDES OF THE F'IPE OR A REGULAR SECTION OF REGULAR PERFORATEED DISTRIBUTION PIPE MAY BE CLAMPED TO THE SOLID SECTION WITH A NO HUB COUPLING OR SOLVENT JOINT. A RUBBER RAIN- CAP (JIMCAF' OR EQUAL) SHALL E:E PLACED ON THE TOP THE PIPE. 3.5 THE GRAVEL SHALL BE COVERED WITH A LAYER OF UNTREATED BUILDING PAPER OR A NONNOVEN FABRIC SUCH AS MIRAFAR FIBRETEX 200 GRADE, OR POLY-FILTER X Or EOUAL. 3,6 THE TOP OF THE BED SHOULD BE PLANTED WITH A WHITE CLOVER AND RED FESCUE MiX. i~o IIJcs~ ~sI~ Au,hue · Ancl, orele. Al~sk~ 99503 · (907) 276-1361 ALASKA ENVIRONMEN~I:kL CONTROL SERVIC[-~t 1220 West 25th A ANCHORAGE, ALASKA 99503 Phone 276-1361 6,EET.O t'"'______Z_____/O, / CHECKED BY DA~E ~'--/~' ~/ il! I I ! Box 1369, ~TAR RO'b[.,t'E A Ah'CHORA(IE, ALASKA 99502 344-?714 SIX INCH WATER WELL DRILLED AND CASED OUT TO THE DEPTH OF 26~ DRILLED AT THE RATE OF ~.~.00 PER FOOT. LOCATION OF WELL SITF DRILLER WELL LOG: 0.---22' $,t~ 263 ~ ,3/4 l~otde $~4.~ ~,~, .~a4,ct he ~ 15 ~ o~ hwUto~'' 0~, 300 q.~,l, ar~ og ~ .~ ,~ou.~ ,In. ~ ca,~.~. ~.~ a~t ~,~t~: t23.oo ~ ~e~ x 265 ~,,t: t6o95, oo COST INCLUDES ALL LABOR AND MATERIAL FOR COMPLETION OF SAID DRILLING. WRITE CHECK PAYABLE TO RAMPART DRILLING WORKS FOR THE SUM OF ~609.~e00 THANK YOU VERY MUCH. DATE BERNIE CLAUS OF RAMPART DRILLING WORKS aERVICE CHARGE O P lYa% PER MONTH WILL. BE ASSESSED ON PAST DUE ACCOUNTS. Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 wwvv.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEHS FOR A SINGLE FAHILY DWELLING Parcel I.D. 015-192-13 1. GENERAL INFORMATION APPROVAL Expiration Date: Complete legal description TRAILS END S/D; BLOCK 4, LOT 8 Location (site address) 1 1280 DOGGIE AVENUE * ANCHORAGE, AK * 99516 Current Property owner(s) NOAH HARRY & CLAIRE MCLAUGHLIN Day phone 346-4453 Mailing address 11280 DOGGIE AVENUE * ANCHORAGE, AK * 99516 Lending agency Day phone Mailing address Real Estate Agent BRIAN BRODERICK W/ PRUDENTIAL JACK WHITE Day phone 273-7261 Mailing address 5801CENTERPOINT DRIVE, #200 * ANCHORAGE, AK * 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well · Individual On-site · Individual Water Storage [] Individual Holding tank [] Community Class Well [] Community On-site [] Public Water System [] 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 of 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 samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of AnchOrage is not responsible for errors or omissions in the professional engineer's work. 4, STATE~4ENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I veri~v that my investigation, based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application, sho~ t.hat the on-site water supply and/or wastewater disposal ss~tem is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify t,ffat based on the information obtained from t,he Municipality of Anchorage files and ~'om 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 GARNESS ENGINEERING GROUP, Ltd. Address 5701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Phone 557-6179 Date Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE i,--'~'' Approved for ~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulatio_fl~ ~, COSA Checklist Septic System Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Repod Original Certificate Date: (Rev. 11/05) Municipality of Anchorage Development Services Department Building Safety Division Co CERTIFICATE OF On-Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.muni.org/onsite (907) 343-7904 ON-SITE SYSTEMS ,b, PPROVAL Legal Description: TRAILS END S/D; BLOCK 4, LOT 8 CHECKLIST WELL DATA Well type PRIVATE If A, B, or C provide PWSID# N/A Date completed 4/4//1984 Sanitary seal (Y/N). YES Total depth 265 ft. Cased to 26,3 ft. Parcel ID: Date of test Well Log (Y/N) YES FROM WELL LOG 4/4/1984. Static water level 35 Well produCtion 3 WATER SAMPLE RESULTS: Coliform I~ colonies/100 mi. Arsenic: ~_~ ug./L. SEPTIC/HOLDING TANK DATA g.p.m. Nitrate'~, ~ C,~-ng./L Date of sample: 3/1 1/2011 Wires properly protected (Y/N) Casing height (above ground) AT INSPECTION ,3/11/2011 ,37 ft. 6,5 g.p.m. Tank Type/Material SEPTIC/STEEL Tank size, 1000 gal. Numberof Compartments 2 Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO Date of pumping 3/10/2011: Pumper, I'BELOW EXISTING GPA, DEl Soil rating ~or ft2/bdrm) 0.6 Width 5/5 ft. Other bacteria Collected by: __ colonies/lO0 mi. GEG Ltd. ABSORPTION FIELD DATA I EAST/WEST~ Date installed 6/4/2005 System type DUAL SHALLOW TRENCH (2 e 75) Length 15o TOTAL ft. Gravel below pipe 0.5/0.5 ft. Total depth '5.1/3.2 ft. Eff. absorption area 750 fi2 Monitoring tube YES Depression over field. NO Date of adequacy test **,3/11/2011 Results (Pass/Fail) PASS For ,3 bedrooms Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 0 in. Elapsed Time: - min. Final fluid depth 0 in. Absorption rate >= 4.50+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date - **TESTED EAST TRENCH ONLY. WEST TRENCH WAS DRY AT TIME OF TEST. NOTE: BOTH TRENCHES ARE INSULATED PER 2005 INSPECTION REPORT. 2'+ SOIL COVER FOR BOTH TRENCHES.. YES 12+ in. Date installed 6/4./2005 Cleanouts (Y/N) YES High water alarm (Y/N) ISAACS PUMPING D. LIFT STATION Date installed "Pump on" level at E. in. Size in galionsj __----Manh°le/Acces--'"~s ~ ~ "Pump o~ alarm level at ~ - CycleS tested Meets alarm & circuit requirements? SEPARATION DISTANcEs SEPARATION DISTANCES FROM WELL ON LOT TO: 100'+ Septic tank/lift station on lot Absorption field on lot 100'+ Public sewer main N/A Sewer/septic service line 25'+ Animal containment areas, 50'+ in. On adjacent lots 100'+ On adjacent lots 100'+ PubliC sewer manhole/cleanout Holdir~g tank N/A M~nure/~ihimal excrete storage areas N/A 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING YANK ON LOT TO: Building foundation 5'+ Property line 5'+ Water main N/A Water service line 10'+ Wells on adjacent lots 100'+ SEPARATION DISTANCE FROM ABsORiSTION ~IELD ON LOT TO: Absorption field 5'+ SuEaCe water. 100'+ Property line 10'+ Building foundat on. 10'+ Water service line 10'+ Surface water 100'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ Water main N/A Driveway, parking/vehicle storage 10'+ F. COMMENTS G. ENGINEER'S CER~JFICAYION I certify that I have determined through field inSPections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Prin~ed N~me JEFFREY A. GARNESS Date ~ J'Z~"/ J J COSA Fee $ Date of Payment Receipt Number Waiver Fees Date of Payment Receipt Number (Rev. 11/05) Fax # Isaacs Pumping Service 6218 Quinhagak Street Anchorage,, AK 99507 907-563-3300 907-562-5473 Invoice McLaughlin, Claire 1120 E Huffman #601 Anchorage, AK 99515 3/10/11 Due on receipt Pumped Septic Tank ~) 11280 Doggie Circle 165.00 165.00 Total $165.00 SGS Reft# 1110879001 Client Name Garness Engineering Group, Ltd Printed Date/Time 03/23/2011 9:57 Project Name/# Trails End B4, L8 Collected Date/Time 03/11/2011 I 1:30 Client Sample ID Trails End B4, L8 Received Date/Time 03/11/2011 13:10 Matrix Drinking Water Technical Director Stephen C. Ede PWSID 0 Sample Remarks: 4500NO3-F - Total Nitrate/Nitrite - MS recovery is outside of QC criteria. Refer to LCS for accuracy requirements. Allowable Prep Analysis Parameter Results LOQ Units Method Container ID Limits Date Date Init Metals by ICP/MS Hardness as CaCO3 113 5.00 mg/L SM20 2340B C 03/18/11 03/21/11 NRB Waters Department TotalNitrate/Nitrite-N 3.20 0.100 mg/L SM20 4500NO3-F B 03/16/11 AYC Microbiology Laboratory E. Coli Ne~zative I 100mL SM20 9223B A 03/11/11 DLC Total Coliform Negative 1 100mL SM20 9223B A 03/11/11 DLC Private Individual Analysis Alkalinity 95.9 10.0 mg/L SM20 2320B D 03/15/11 SDP Aluminum ND 20.0 ug/L EP200.8 C 03/18/11 03/21/11 NRB Antimony ND 1.00 ug/L EP200.8 C (<6) 03/18/11 03/21/11 NRB Arsenic ND 5.00 ug/L EP200.8 C (<10) 03/18/11 03/21/11 NRB Barium 32.6 3.00 ug/L EP200.8 C (<2000) 03/18/11 03/21/11 NRB Cadmium ND 0.500 ug/L EP200.8 C (<5) 03/18/11 03/21/11 NRB Calcium 32600 500 ug/L EP200.8 C 03/18/1 I 03/21/11 NRB Chloride 1.65 0.100 mg/L EPA 300.0 D (<250) 03/15/11 03/15/11 SDP Chromium ND 2.00 ug/L EP200.8 C (<100) 03/18/11 03/21/11 NRB CO3 Alkalinity ND 10.0 mg/L SM20 2320B D 03/15/11 SDP Conductivity 242 1.00 umhos/cm SM20 251 OB D 03/15/11 SDP Copper 9.24 1.00 ug/L EP200.8 C (<1300) 03/18/11 03/21/I1 NRB Fluoride 0.132 0.100 mg/L EPA 300.0 D (<2) 03/15/11 03/15/11 SDP HCO3 Alkalinity 95.9 10.0 mg/L SM20 2320B D 03/15/11 SDP Iron 289 250 ug/L EP200.8 C (<300) 03/18/11 03/21/11 NRB "~ "~"0 ~ N89° 59' 30"E 190.00' ~ ~' b 30' c (:5 32.0 ~RA ~ VEL c.o.s /! WELL . m UND~ NO ORCUMSTAN~S SH~ AN AS-BUILT BE U~D F~ C~S~UC~ ~ F~ EST~U~ffiG BOUNDARY OR ~ UNES, ~E ~R~YOR TAKES ~ONSIBIM~ F~ ~E INI~ ~SAC~ON ~LY ~D ASSUMES RN~AL EABlU~ ONLY FOR ~E COST ~ ~E SURLY. ES~ DISTilS PREVNL O~R SC~NG. REPRODUC~ON MAY CAU~ ERRORS IN SCA~. ~ LOT ~R~ SURLY T~E S~BOLS ~ RN~F~NDA~O~ILT~LT o SET ~B~ ~ ~ DRNNAGE ~ ASPHALT ~ ~ O FOUND R~AR ~ CON~E~ ~ ~ ~ ~OD ~NCE ~ ~T ~... ~-~LT... LOT ~R~... ~HY ~ A~T... NO C~ ~T ~ ~nCA3~ ~T AS~M~ ~V. METAL ~NCE I//~JI WOOD DE~ PLOT PLANS ~ LOT SUR~YS NO~: IT IS ~E RESPONSIBILI~ OF ~E BUlmER OR O~ER, PRIOR TO ONLY ~OSE IMPRO~MEN~ ABO~ GROUND AND ~SIBLE ~LL BE CONS~UC~ON, TO ~RIFY PROPOSED BUI~INO GRADE RE~ SHO~. FENCES, ~S, SEP~C C~ANOU~, SIDEWALKS, DRI~WA~, TO ~NISHED GRADE AND U~LI~ CONNEC~ONS AND TO DE~RMINE ETC., ARE SHO~ IN ~EIR APPROXIMA~ LOCA~ON, ONLY. SNOW ~E EXIS~NCE OF ANY EA~M~TS, CO~NAN~ OR RES~IC~ONS MAY PRE~T SOME IMPRO~MEN~ FROM BEING SEEN AND LOCA~D. ~ICH DO NOT APPEAR ON ~E RECORDED SUBDI~SION PLAT. ALL DISTANCES ARE RECORD UNLESS OTHER~SE NORD. SURLY CER~FICA~ON _~~, Prepored by Robert E. Johns, Jr. & Assoc. ~.~.: ' ~rofession~l ~nd Surveyors ~ ~ 1700 Brink Drip. ~ '~ Rec. Lot S,F. Rec. ~ot Ble No, F~NOA~ AS-B~LT ~" ..... ~ ~ ~ ~t ~ ~ ae ~ Surve~d: Drown b~ ~.~'-~'"~,~ · 3/11/11 REJ ~WL ~ecked :~ ~ ~ ~I 3/11/11 2641 11-47 RNAL S~UC~RE AS-BUiLT I~. '~ .... Legal Descrlptl~: ~ ~ .~. ~ ~ .~i~o,..,~o.o~ ~ ~ Lot 8 Block 4 ~--- ..~* Trails End MUNICIPALITY OF ANCHORAGE DMSION OF I~R~ HEALTH DEPARTMENT OF HEALTH AND ENVIRONMENTAL PR~[ION APPLICATIO~ ~OR }F~%LTH ;~'II{ORITY APPROVAL CERTIFICATE 1. General Infc~,,ation Application Date _~--/~ (a) fe~al ~Pesoription (include lot, b.lock, subdivision, sectice., township, range) Location (addm~ss o~ directior~) Applicants Address ~/~'~ ~/~o~ (c) Applicant is (check one) fendir~ Institution .~'~; Owner/bullde~ Burr ~--~; Other.~--~ (explain); (d) Lending Institution Telephone Address ' ' (e) ~al Estate Co. & AGent Add~ess Te le phone 2. Type of ~sidence Single-Family ~---~. Multi-Family ~-~ Other (describe) 3. ~ter Supply Ncte: If ~,~.,nity %ell system, must have written confirmation fr~ the State Dapartm~-nt of Enviror~ental Conservation attesting to the legality and status. Is the ~ell adequate for the number of ~edrocms specified in this HAA 4. Sewage Disposal ~s the ~rastewate~ disposal s~stem adeguate ~or ~ r~mbe_~ of bedrcx~r~ ~¥/N) [Page 1 of 2l 2-15-84 Ad.ess Signal b~ ~te 6. DHEP Approval Apg~ro~3 d for App~oved~. Engineering. Firm Providing Inspecticns~ Tests, Deta and InfcmTaticn ! c~rttfy that I have checked, verified, c~ confc=~ed to all M3A HAA Guidelines in effect on the date of this inspection. Signed Pate Nam~ of Finn ~./~_'~C~- ._.,7~'~-~--_ Telep~ · ~. ~... ~.~.~.. ,., ~;.] . _- ( [~GIN~ SEAL) ~j., ......... Terms of Conditional Approval The Municipalit~ of Anchorage Department of H~alth and Envirc~Tental Protection dces not gua~rantee the contir~Jed satisfactory perfc~mance of the water supply and/c~ the wastewate= disposal system. This approval indicates that, as of the ~alidation date shc~n abo~, based cn tt~ data and lnfo~nation furnished by an engineer ~egistered in the State of Alaska, the w~ter supply and wastewater disposal system is safe and func- tiorml fop the rnmber of b~droa~6 and ty~e of structure indicated. ( D{-IEP SEAL) 7. Mail the HAA to the following address: KB2/d5/s [Page 2 Of 2] 2-15-84 ae MUNICIPALITY OF ANCH01~E (MO~) MUNICIPALITY OF D~PL O~ H~AL~H &HEALTH AUTHORITY API>~0VAL (HAA) I~IVII~,NENTAL PtlOTECTION ~AY 1.. 01984 ~Er.t. RECEIVED Well ~og ~e~nt (Y/N) Total Depth ~ 6~' J74 Cased to Static 14ater Level Legal Description: if ~, B, ~ C, ~.~.C. ~(Y~) ~te ~d ~-~ Yield Casing Hsi~ht Abo~ G~cund / +~-J Electrical Wi~ing in Conduit (Y/N) ~/ Separation Distancss f~cm Wsll: To Septic/HoldinG Tank cn Lot ~./~ ~r-~ Sanita=y ~eal ~n Casing (Y/N) Det~essio~ A=ound Wellhead' (Y/N) ; On Adjoining Lots SEPTIC/HOLDING ~ I1%TA Date Installed 3-~5'4- Size /~7OO.~/~ No. of Cc~a=tments '?---' Standpipes (Y/N) ~ Aid-tight Caps (Y/N) F Foundation Cleanout (Y/N) Depression ove~ Tank (Y/N) /~' Date Last Pumpsd PumpinG/Maintenance Co~.t~act on File (Y/N) ~//;~; Holding Tank High-Water Alam (Y/N) /~/~ Temporaz~ Holding Tank Permit (Y/N) Separation Distances f~om Septie/l~olding Tank: To Wate=-Supply W~ll im TO Property Line -~ Y~ ~-~ TO Water Main/Se~vies Lir~ Co%~se To Building Foundati~ 3Z4T~- To Disposal Field _~.S'~'~ To Stream, Pond, Lake, cr Major D=airmge Co~ents [Page 1 of 2] 2-15-84 C. ABSORPTION FIELD [~TA Soils ~atin~ in Abso~pti~ St=ats Date Installed g-~4 Width of Field ZO ~t-4 Square Feet of Absorption Area Dap~essic~ over Field (Y/N) Results of Last Adequacy ~st ~epth of Field Gravel ~ed Thickness ~. ~'-~-4- sts. i s ~te .of Last ~l~quacy ~st A7 To D=iveway, l>a=kir~ Area, = Vehicle LIFT STATION · Date Instslled Size in Gallo~s "Pump On" Le~sl at High Water Alarm Level at Dimensions ~anho]a/A~ess (Y/N) "Pump Off' Level at Vent (Y/N) Tested fo= Electrical Codes(Y/N) C~nts l~pirg Cycles ck~ing Adequacy ~sst. ~eets MOA ** Check Pez~dtted Bed~oa~ Rating ;~ainst HAA Bequsst ** I certify that I have aheck~d, verified, c~ oonfc~med to all ~OA HAA Guidelines in effect on the date of this inspection. Signed Km/dS/s Date <//o/~' [Page 2 of 2] 2-15-84