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Home My WebLink AboutKNIK HEIGHTS BLK I LT 21Knik H ights Block Lot Z! #017-371-07 Municipality of Anchorage Page Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.cLanchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW010196 PID Number: 017-37333-07 Richard Gelardin WastewaterSystem: New ~;~ Upgrade 3333040 Shelburne Road~ Anch. AK 9953336 ABSORPTION FIELD Three (3) Deep Trench LEGAL DESCRIPTION .8 o,~e 3331 I 21 r Knik Heights 3 F,. 8 1 n. 40 ~,. Well: Existing 3 n. !I N/A n. n. 640 .' ASTM D3034 PVC n. Acreal~e Systems 6/26/01 '"'": o~ I n'~'s":., ic~, ~.,~c.,,.~:. TANK SEPARATION DISTANCES E3 Septic n Holding n S.T.E.P. f-I Other. SepUc Absorption Lift Holding ,ublicJPrlvate Tank Field Station Tank Se,~U,,e ' Anchorage Tank 1,000 w~ >33300' >33300' N/A N/A >25' Steel Two (2) ~..~w... >33300'>33300' N/A N/A ~ / LIFT STATION - NONE ON LOT V ~, >5' >3.0' N/A N/A ~__>5,>ZO, N/AN/A/~"~'p*'--.':"~'.~'"'.': I'~''''-''. c~,.~ None Noted ~o~..,~,~ "'~'~: BENCH MARK Existing Septic Tank Pumped and Removed From Site. Existing Absorption System Connected to New Top of Foundation Cleanout. System with Bull Run Flow Diverter Valve. 100.0 Engineer's Stamp Inspections performed by: Mike Anderson Dates: 1" 6/26/0333 . ~ mh ~ 6/26/0333 Department of44ealth aod I:luman Services approval Reviewed and approved by: Date: $;.~'-~;~'.~ Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK 99519-6650 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit Number SW010196 PID No. 017-371-07 Page 2 of 3 C4 ~Three ]louse A B S1 22.2 63.6 S2 28.4 69.2 C4 57.8 97.1 M1 49.9 84.7 DY 32.8 72.O C5 46.3 72.5 E~ist LEGEND ~V - Septic Vent Bull Run Diverter Valve C - Cleanout M - Monitor Tube PLAN AS-BUILT SCALE 1" = 30' Municipality of Anchorage DEVELOPMENT SERVICES DEPARTMENT 4700 South 8ragaw Street Anchorage, AK 99519-6650 - 343-7904 On-Site Wastewater Disposal System or Well Inspection Report Permit Number SW010196 PID No. 017-371-07 Page 3 of 3 87.3 90.5 Geotextile Drainfield Fabric Rock ~79.3 87.3 MUNICIPAUTY OF ANCHORAGE Development Services Department On-Site Water & Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 90519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 18, 2001 Expiration Date: Jun 18, 2002 Permit Number: SW010196 '.Legal Description: KNIK HEIGHTS BLK I LT 21 Design Engineer: 0014 Anderson Engineering Owner Name: GELARDIN RICHARD Owner Address: 13040 SHELBURNE ROAD ANCHORAGE, AK 99516-2925 Parcel ID: 017-371-07 Site Address: 013040 SHELBURNE RD Lot Size: 24800 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 Ail construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 an~ 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: Issued By: 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 SEWEPJWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 017.371-07 Permit Number~ Property owner(s) Richard Gelardin Mailing address (1) '13040 Shelbume Road Anchorage~ AK 99511-2848 ~-~g address (2) /~D ~/c~ ~ J,.cl [-,~,/-/t~_ '~-~. Zip Code Legal description (Lot, Block & Sub'd.) Lot 2t~ Block I, Knlk Hel.qhts Subdivision Legal description (Section, Township & Range) __,~,, ~'~1:::) Acres/Sq. Ft. Number of Bedrooms Three {3) Lot Size Day phone 345-7787 · 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 in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit Fees: Date of Payment: Receipt Number: (Rev. 12/00) Waiver Fees: Date of Payment: Receipt Number: ANDERSON ENGINEERING P.O. BOX~ 240773 ANCHORAGE, AK 99524 r 522-7773 522-6779 (FAX) June 5, 2001 Municipality of Anchorage Development Services Department On-Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 21, Block I, Knik Heights Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer:. The absorption trench on Lot 21, Block I, Knik Heights Subdivision has failed and effluent is currently pooling on the ground surface. We are therefore applying for a permit to construct a new septic system on the lot to serve the throe bedroom home. The attached Site Plan and backup documentation identify the location and configuration of the new septic system and the parameters used in the design. Also identified on the plans ara the location of the existing well along with the test hole and the existing absorption site. Existing dralnage patterns are shown and will not be altered by the development of the lot. We have surveyed the area and the new system will not conflict with other wells or septic systems in the area. A test hole was recently placed on the lot.to determine subsurface conditions. Soils were found to be well graded gravel with varying amounts of silt. A percolation test in the material indicated rates approximating 6 to 8 minutes per inch. No groundwater was found during the excavation and none was found during the monitoring period. We are therefore proposing to place an absorption trench 36' long by 3' wide with a 8' effective depth to treat the septic effluent. The distribution pipe will be placed at 2' below the surface for a total depth of 10'. A Zabel Flow Diverter Valve will be installed and the existing absorption trench tied in for future use. The existing fiberglass septic tank will be abandoned in accordance with ADEC and Municipal requirements. The ground surface on the lot slopes as shown on the attached Site Plan with grades from east to west and flatten in the area of the test hole. The new absorption trench will be constructed parallel to the contours of the surface as much as possible in conformance with Municipal requirements. Grading will be accomplished to assure surface drainage is aw. ay from the new trench. The existing drainage pattern on the lot will not be affected dunng development. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells Lot 21, Block I, Knlk Heights June 5, 2001 Page Two in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments I 22 · IECT '1 · I! I I I 7 8 AREA MAP- SCALE 1" ~= 100' SCOPE OF WORK: 1. Verify Foundation Cleanout 2. Remove and Dispose Existing Septic Tank. '3. Place New 1,000 Gallon Septlc Tank. 4. Place 2 Post Tank Cleanouts. 5. Place Zabel Flow DiverterValve and Tie in Existing AbsorpUon Trench. ~. Construct New 36' Long X 3' Wide X 8' Effective Depth Absorption Trench. 7. Regrade All Disturbed Areas. 8. Revegetate Area As Required. i Zabel Flow Diverter Valve New Gallon Tank Three ~ ~ House '~ · . SITE PLAN SCALE1"=30' LOT 12, BLOCK I, KNIK HEIGHTS SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Three Bedroom Home Deep Trench System Perc. Rate: 6-8 MinJInch 1,000 Gallon Septic Tank Application Rate: .8 GPD/SF 8' Drain Field Rock 3 Bedrooms X 150 GPD 1.8 GPD/SF = 562.5 SF of Absorption Area 562.5 SFI16SFA.F = 35~ LF Trench Length Therefore: Construct an Absorption Trench 36' in Length by 3' Wide W'dh 8' of Dralnfleld Rock Beneath the Distribution Lateral. Distribution Lateral to Be Placed 2' Below Existing Ground. Total Depth of Trench to Be 10' f~om Existing Surface. Mound Over Trench if Necessa~j to Provide Minimum Cover of 3'. NOTE: TYPICAL DEEP TRENCH SECTION (NO SCALE) Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 10' Separation From Lot Une. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells in the Area. Maintain 50' Separation From Slope >25%. Municipality of Anchorage Department of Health & Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST Performed For: Richard Gelardin Legal Description: Lot 21. Block I. Knik Heights Subdivision SLOPE North OGIOI.. GW Some Silt 5 6 South Was Groundwater Encountered? No If Yes, What Depth? 1 Depth to Water After Monitoring None P 11 Date: 6/5101 E 14 15 Bottom of Hole 17 18 SITE PLAN See Site Plan 5% 1 5%-20% Reading Date Gross Net Depth To Net Time Time Water Drop 16-May 12:41 2.25" 1:11 30 6.75' 4.5' 1:12 2,125" 1:42 30 6.5' 4.375" 1:43 2" 2:13 30 6.375" 4.375" 21 Pert. Rate: 6.8 Min./inch Perc. Hole Diameter: 6' Test Run Between 4 Ft. and 5 Ft. Comments: Test Cavity was Presoaked Prior to Test. Pedormed By: Mike Anderson. I, Michael E_ Andersen Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 6/4/01 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 21, BLOCK I, KNIK HEIGHTS SUBDIVISION GENERAL: o The scope of this project includes the abandonment of the existing 1,000-gallon fiberglass septic tank and the procurement and placement of a new 1,000-gallon septic tank at the location shown on the site plan. Work also includes the construction of a new 36' long X 3' wide X 8' effective depth absorption trench at the location shown. The distribution line in the trench will be placed at 2' below the existing ground surface. Total depth of the trench will be 10' below the existing ground surface. A minimum of 3' of cover is required above the absorption trench to protect against frost penetration. All components of the septic system must be placed a minimum of 100' from all wells in the area. A Zabel Flow Diverter Valve will be placed and the existing absorption trench tied into the new system for future use. Construction shall be in accordance with 'the approved site plan, design drawings, Municipal Permit with any spe. cial previsions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,000-gallon septic tank must be procured from an approved source and installed at the location shown. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. · · - · Lot 21, Block I, Knik Heights June 5, 2001 Page 2 of 3 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. Grade area surrounding the absorption trenches to drain away. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). · · .Eot 21, Block I, Knik Heights June 5, 2001 Page 3 of 3 5. A permeable geotext!le fabric (Typar, Mimfi or equal) must be installed · between the final dram rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be bacld'illed. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as-built of the completed system. GRE,' ANCHORAGE AREA BOR. : Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTE/~ NAME re ;~F, c ~'" ~!'- .': C ,:-: MAILING ADDRESS /';'¢' · .... PHONE -/ LOCATION LEGAL DESCRIPTION /~ --, ,' /-'~'"' --/ , /~ ;'/ ,"/F / 7' SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH , %~' , , _ ,, NUMBER OF MANUFACTURER ~' '., ,'",,~ / MATERIAL / //~9//¢ COMPARTMENTS / __ INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITYz-~-*.--''''' 'GALLONS. TILE DRAIN FIELD: DISTANCE FROM WELL /;/¢ NUMBER OF LINES ABSORPTION AREA DEPTH: TOP OF TILE TO FINISH GRADE [: MATERIAL BENEATFI TILE%~J~__i~!. ABOVE TILE TOTAL LENGTH _FOUNDATION t[-' 7 _NEAREST LOT LINE //fi ¢ OF LINES "/J% DISTANCE BETWEEN LINES /,? //<) _'TRENCH WIDTH ,')~'~'IN. TOTAL EFFECTIVE SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER WFLL: TYPE ~.r/,,/ ' BUILDING FOUNDATION CESSPOOL _ APPROVED _CONSTRUCTION NEAREST LOT LINE OTHER SOURCES DISAPPROVED__ NEAREST SEWER LINE _.__REMARKS DEPTN _ SEPTIC SEEPAGE TANK__, SYSTEM DISTANCE FROM: DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: /~t,,/i' / /i SEWER LINE DEPTH: PIPE MATERIAL: ~J'.? t i;';,¢,'I LOT SLOPE: REMARKS: ,/ G.A.A.B. ) Form EQ-032 GREATER ANCHORAGE AREA BOROUGH / ' / fPi~5~F/I I T NO DEPARTMENT OF ENVIRONMENTAL QUALITY / '~ ' TELEPHONE 274-4561 ~'~ SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT NAME Of APPLICANT INSTAL. LATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK TYPE AND SiZE OF FACILITY TO BE SERVED FINANCED THROUGH SOle TEST RESULTS ~-' - ~OT~:l THl~ PERMIT 1~ NOT VALID WITHOUT 5OIL TE8~ SEPTIC TANK SIZE./~_ 2____.~/,.:.~.~% TYPE ¢/~'?'~-/>/~//¢~:'/ SEEPAGE AREA SIZE FOUNDATION TO SEEPAGE PI~ SEPTIC TANK TO SEEPAGE PIT WALL TO NEAREST LOT LINE. WELL TO SEPTIC TANK //¢//) ~/~ , SEEPAGE Pit DRAIN FIELD ALSO CONSIDER AREA WELLS. SEPTIC TANK, // ~.2 SEEPAGE PI-~ //¢¢/,/J , DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP Of EXCAVATION 5 FEET INTO UNDISTURBED SO[L, 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. TYPE GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. OR LICENSED DESIGNER CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS Of GREATER .~ANC. pKAGE AREA BOROUGH ~prDI O. 28-68 AND THAT THE ABOVE The sediments were fairly compact with ]_ow to moderate moist.. t~_re conte~t~ ~here a moderate cobble and were some erxaeie Gw accounted for less than~ ]~ of the total MUNICIPALITY CF AN'CHORAGE DEPT. :::: , ENVIRON ~, L, MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING "~ ~ ~' ('~, ~ -.. / z' · 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Property owner Mailing Address (c) Lending Institution Telephone: (home) Telephone Mailing Address (d) Real Estate Company and Agent Address 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: 2. TYPE OF RESIDENCE Single-Family~ Number of bedrooms 3. WATER SUPPLY Individual Well'r~ 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 legality 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. Address ~ 7~ ( cd_../. /~ ? ppi ~'Pt/ Date Engineer's Seal 6. DHHS APPROVAL Approved for -~ bedrooms by Approved ~/~ Disapproved Terms of Conditional Approval Conditional The MunicipalityofAnchorage Department of Health and Human Services (DHHS) issues Health AuthorityApproval cerificated based only upon the representations given in paragraph S 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 DHHSdonotconductinspections 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 Well C~s~ t'td a~'i o n Well Log Present (Y/N) ~ MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST- FEBRUARY 1984 343-4744 Legal Description: Date Completed Total Depth / ~ ? Static Water Level ... Cased to / ~7 Depth of Grouting _ Casing Height Above Ground _ Electrical Wiring in Conduit (Y/N) ,~/ SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot iL~ To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line _ To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Pump Set At '~o Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) /'"/ To Nearest Public Sewer Cleanout/Manhole ; On Adjoining Lots ; On Adjoining Lots ; Date Comments B, SEPTIC/HOLDING TANK DATA w/~ ~.7~27~76~ Date Installed / Size ID. fro No. of Compartments Standpipes (Y/N) O k~ ~ Air-tight Caps (Y/N) ?' Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm (Y/N) Foundation Cleanout (Y/N) [)ate Last Pumped .~¢--~¢'~ ?~) /.~ / ;for Temporary Holding Tank Permit (Y/N) SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well To Property Line To Water Main/Service Line To Stream, Pond, Lake or Major Drainage Course Comments To Building Foundation To Disposal Field IVo ~ ~ 72-026 (Rev 7/88) Fronl Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed ~///¢Z~:;% Width of Field ~:~ ri Type of System Design Length of Field Depth of Field Square Feet of Absortion Area Depression over Field (Y/N) Gravel Bed Thickness /¢' Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well To Building Foundation Lot To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments fO ~ To Property Line 1.~ ~ To Existing or Abandoned System on ; On Adjoining Lots .> ~.5'o ~ ~5' To Cutback (if present) /%/¢-~ e. D. LIFT STATION Date Installed Size in 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 Vent (Y/N) Pumping Cycles during Adequacy Test. **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA guiCelines,.~i,n effect on the date of this Signedinspecti°n'"~? ' ~ -=.~-~----' ~ .~_~ ~'~'-~ F;:..', . '" ;' -- ~,, Company Date MOA No. 72 028 (Rev. 7/88) Back ,r: ";-., Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 Engineer's Seal At~CHORAGE, tll. hSKA ?9502-.ti~0-q (907} 248-509,5 RES ]:DENT I ~qL W_~_.L_L_ LEE~AL: LOC~T I Obi: OWNER: TYPE OF WELL: WELL LOG AVAIL. ABLE: Yes I NSTALLAT 101',1 REQU I REMENT~ MET: Y(:,~ WE::LL. YIELI) F'F,:I]Pl WELl_. LOG: PtJMP YIELD FROM TES'I: DA'I'IF. OF INSPECT I []hl: TEST PROCEDURE: pi, okic.:,. At L'.he b(.:.:,c.!ir'w~ir%} c).f tha, 'Ll~sk iht::.? ~-,~,a'ki:.)r' ]l.a, vt:?l was .{:l::)und a'L t:)t:;.~l.''' mil~u'ke? tht.) wa'kEq'" ]. <~, v e? ]. dr'c)t:)[]a)d 'kc) :l.l:].:}~ .~:(.?ux)'k a.~:'l'.i.~H ;[l'l(.J~ a'.'~rl a'tdd:~.'k:ic~lh~,;~]. 66 minutt:~s, A tcrkal o{: 500 ga]lc:,ns TEST FOR E.t~I]L]: AND '¥rATAL NITROGEN: I,,Ja'L:(?n,- ~.~a!;:. 'Le~;ta, d .{.c)r I~:.Co:!:i. kotal n J kri::Kj(.:~r~ or'~ /}e.~(::: ,, ',?.2, 1990 E. C(::O. :i, (). 'f'~::rka~]. I~]J. 'kr(:)cjJm'l O..'45mF}/1 ,, Max. a]. :1. o~ab i e 'll'r(~? IYh.ui:i, (::::i. pal rei::lUi r{{..xne.~,nt .for ~a~.CI, ]. ,{: :[ i::)w :i s :i 50 qa]. per" I::~e(::lr"ocml per' day,, This ~.,,~...~].1 exceed t.'.l~J.s r'i,:-x:luJreme:rL. c:ondJ, kJ.c~ns ag; o'f: kl"[a~ clay Li~)!~i'k(<,(:J,, 'l'lle f:].o~,J r"at(-:.~ may aclu:/. '{:c)r -f:[,:q::.~dJ n;~] 'l. hl,,.:, va:.;)]. 1 . 675! N, DJHONQ 8LVQ. hNCHQRAGE, ALASKA 99502-5904 (907'/ 248-509',i LEGAL: LOCAT I ON: ti WNER: RE~ I DEN(]E: WELl_: :1. :)!;O/:I.C) SI~c:.~,]. I:::'i'" :i. v a (: e:.:, a (::J~ '~ <..~ :i, t I? SEF"I'IC SYSI'IEM: I::ROM HUI',I I E.: l I::'P,I... I:;:1~;C01::;3:)S: 4 Be{::lr" TANK: Suns~: Plastxic: :!.2D() ABSORF"I' I E)lq SYS'I I:~:H ~ 'l"r c.?~ Icl I ABSOI::II::'T ION AREA= 900 Sq,, F't SO I I... RA '111,tl3: 22',5 II'qSIAI..J..AI']:ON DA]E: July I)A'TE OF: LAST PUMF'IN[-]: Se)l;~'l.'.,, :i. 99C) It~aacs DA1-E OF: TEST: 'rEs'f' PROCEDURE: Sy!~-I:.l:...:,m was :~.~lSl:U:.:.:,ci:l~:,d a~il::l .t.:Ol,' {:'. l'i (a:, {: l" i::~l"t c: h ,, "~'l'l~ clean (::lu'L ~,.¢as ::J.t,.tCll,~6,:,~ '[.["[(:o~ ~il..lllil:3 l'.¢~:~:5 Iii(]Fl.::: [:J-I~'~li ;J.J,.:: -}:e.(,e:,~: (Jt,.]l:.:?f.). The wa'L~;,:,r l(:,:,w,::,:l, was ~7'E}i' I::)~:?]ciw i:(::)p (::l't': p:[p(.:,,, ]:::'j.t::l(..:, 6?xi](;.211i;'lc-:~d t;:;C)C) qal l(:His c:r/: c:].e, an wa['~:?r was thC:,.' b~aL[E'l" ]. (F:,VIF,)]. ti:) r J. ~i(:i;, ~,:~. '..'J :[ I](:;lic.'.~!~i pt,.?l" :t. ()O I. fEi). ~[ (]l'l~i J. I/ the::, ~51,.uiif:) ,, wh:i.]c.:.) i'lo v,Jat(er' rise wa~;~ (.:~bservibd :i.n liJoli:i.i:cH"ecl .i:ol" c20 Ifi:[l'lLt'J;:i.e%. i)t,,tr:i.i]cj 'l:lle '{::~r"~it. t6¢1i fIi:J. FII..Vt:.t~:,~i; '(.'.lie vv,:~ter 1 (.,:,v(-:~l dl"Cll::il::~ed 1 J.¢lc::li, 'tthel'l i t drol:~ped a~t ach::l J. t J (::H'u~l 4 :i. r~(;::lies ,, :i n(::lJ cat :i. ~1(~l Lha'L mc::,Fe.) I:.l~a~i :,'.~'.['i(::) gal I:) E~F" ]. CICJ ,, NOTE ]"l~e I::)pe~,r'a'l.:i. (:)lla:l. I :i. ";:e..~ o.~: a:l. 11. sepk:i. <::: ~ys'Li~:.:,ms de:,t:)i:)ncls [:)t'i t h(.::, ch..u":i, r'lq '(:.l'ic) year ~ i:lr',(::l Lhe:, wai:tz:,F usaqi? o-F ~':.t'~¢~ -i:am:i. 1 y bce:i. ¢1(~1 e~st :i. mate o.t: hot,~ .I. (::~n(:l 't::ilJ s %ysl:em ~¢:t :1 1 .~:unc i: :i. on sat :i s.¢ ac tory .~: C: LIr ~" {:¥1~ ~; (3 I" ~: LI (: t ,I I" (,.¢ I::i (:: C: I,t I:) ~::~ I~ '~: iii. 6751 ~l. I)i)II.)ND 6NCIII]R~BE, F~L~SKI~ 99502--3904 RECEIVED dAH 1 0 19,~1 Municipality of Anc~raqe Dept. Health & Human ~erwces ~ her.by clrtity that I have ~r~'eyed the followlr!g de~eil:~d IOrOperW, Lot~$lock. '~ :~ ~'~//~,//~[~'~[/~ ~D, Ancheraa recording P~eeh~ct, Alaska, and that .ncroach on the pro~rty lying adjacent ih~r~tO, tha~ no Imp~ov~ment~ o~ property ~'~E ' TIME TIM[: DATE DATE DATE ,NSPECTOR ,NSPECTOR ,NSPECTO.~j~ ~ MUNICIPALITY OF ANCHORA(.:~L: MUNICIPALITY OF ANCHORAGE DEPT, OF ','.'Ju;i DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEC'FIq~I~VIRONME[ii,"' ;,'-[,~CTION 825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL SANITATION DIVISION APR 1_ 1_ 1980 Telephone 264-4720 ggr'Fl\/Fh REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWE!I~ ~"A~II~T~'E~~' DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing. 1, PROPERTY OWNER I PHONE I PROPERTY RESIDENT (If different from above) PHONE 2. BUYER PHONE MAI LING ADDRESS 3. LENDING INSTITUTION J PHONE I MAILING ADDRESS 4. REALTOR/AGENT PHONE MAILING ADDRESS 5. LEGAL DESCRIPTION STREET LOCATION o ~ ~ F & I ~ SINGLE FAMILY ~ Two ~] Five ~ MULTIPLE FAMILY ~ Three ~] Six 7. WATER SUPPLY ~ INDIVl DUAL* * ATTACH WELL LOG. A welt Icg is required for ali wells drilled ~ COMMUNITY since June 1975, For wells drilled prior to that date, give wel ~ PUBLIC UTI LITY depth (attach log if available,) ~ C:~E ~)~q~-~ 8. ~EWAGE DISPOSAL SYSTEM ~iNDiViDUAL/ON.SiTE** ~oX~ ~- YEAR ON-SITE SYSTEM WAS INSTALLED, ~ PUBLIC UTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE NITIATED, THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ~ SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO [] FOUR [] SIX PERMIT NUMBER 2, WATER SUPPLY [] INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER [] INDIVI DUAL/ON -SITE DATE INSTALLED I-q PUBLIC UTILITY '-~ Connection Verified INSTALLER []Septic Tank or I-qHolding Tank Size: / 1;~'O If Tank is homemade SO~LS RATING give dimensions: TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank Absorption Area Sewer Line I Nearest Lot Line WELL TO: '¥/~ I Absorption Area to nearest Lot Line 5, COMMENTS ~APPROVED FOR ~ BEDROOMS [] CONDITIONAL APPROVAL (letter must accompany certificate) ED----- DISAPPROV ED ~_~_~ DATE ,~-- I '.~ --8 ~ BY May 13, 1981 Graham Youl Marston Rea 2804 W. Nor1 Anchorage, · ISAACS PUMPING SERVICE (Norm Tibbetts, Owner) 6218 Quinhagak Street ANCHORAGE, ALASKA 99507 Phone 344.Ol14 CUSTOMER'8 ORDER NO. PHONE · OF ANcHOP, AG~: · i . C'[IoN Re: Adequa Lot 21, Block Knik H~ Dear Mr. Yo~ Per your re( ~e sanitary sewer All claims and returned goods MUST be system on th( SERIES 609 During this ;est the liquid level in the septic Lank was monitored as water was added to the system. The measurements are summarized in the following table: Time Liquid Level Below Top of Standpipe Total Gallons Added ]0:45 4.44' 0 10:47 4.44' 20 10:53 4.44' 50 11:03 4.44' 100 1]:14 4.44' ]50 11:23 4.441 200 11:31 4.44' 225 The meter used during the test was a Rockwell 5/8" standard water which had previously been calibrated by R&IVI Consultants, Inc. meter May 13, 1980 Marston Realty Page If the 3 bedroom residence on the property is to house 6 people, the average load on the system can be expected to be 450 gallons per day or .31 gallons per minute. During the test, the system accepted 225 gallons in 46 minutes. This indicates an average efi~luent acceptance rate of approximately 4.9 gallons per minute at the time of the test. We can Lhere'Fore conclude that the system is disposing of efl:luent at an adequate rate for a 6 bedroom residence. We appreciate this opportunity to be of service to you. Please contact us if you have any questions concerning this test or if we carl be of additional service. Very truly yours~ R&M CONSULTANTS, INC. Janlic~e Cecere P rdj~ct Manager JC/dj/AT&SI-E May 13, 1980 R&~'INo. 051001-29 Graham Young Marston Realty 2804 W. Northern Lights Blvd. Anchorage, Alaska Re: Adequacy Test on Existing Sanitary Sewer System; Lot 21, Block I, Knik Height Subdivision, Anchorage, Alaska. For Services Rendered through May 13~ 1980. Dear Mr. Graham: The following is our invoice for professional services rendered on the above referenced project. Invoice No. 051001-29 Professional Services Fixed Fee Total Invoice No. 29 Please note our invoice number on your remittance. questions concerning this invoice, please contact me or the Project Manager, Ms. Janice Cecere. Thank you, R&M CONSULTANTS, INC. C. J. Parisena Anchorage Office Manager CJP/djj/I2-F $175.00 $175.00 Should you have any