HomeMy WebLinkAboutT12N R3W SEC 15 LT 73TI2N W · 15 Lot 73 #015-053-09 Municipality of Anchorage On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP211132 PID Number: 015-053-09 Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New FE -1 Upgrade Name WEINMEISTER ABSORPTION FIELD El Deep Trench El Wide Trench [:1 Bed ❑ Mound ❑ Other Site Address 9701 Elmore Rd Phone Number of Bedrooms Soil Rating Total depth from original grade 561-2227 3 GPDiSF Fl. LEGAL DESCRIPTION Depth to pipe invert from original grade Gravel depth beneath pipe Ft. Ft. Subdivision Block Lot T12N R3W Sec 15 L73 Fill added above original grade JGravel length Tov:nship Range Section Ft.i Ft, Gravel vridth Ft.l Beds: Number of Lines Distance between lines - Ft. SEPARATION DISTANCES To Septic From an Absorption ;lift Station Holding I Sewer. Field Tank Line Total absorption area Ft= Number of trenches Dist, between trenches Ft. Well 100,+ nor nor ;nor TANK © Septic ❑ S.T,E.P. ❑ Holding ❑ other h-lanufacturer Greer capacity 1000 Gal. Surfacehvaler100'+! nor nor h-laterial Number of compartments Lot Line 10'+1 na na NA Plastic 2 Foundation 10'+ nor nor LIFT STATION Manufacturer Capacity Remarks Septic Tank Replacement Gal. Alarm location Electrical installed by Installer Dean PIPE MATERIAL House to tank D3034 drainfiold Tank to D3034 Drainfield coiMT D3034 Inspector NOrthRlm Eng. BENCH MARK (Assumed elevation) 100 ft Inspection 1,15/26/21 5/27121Location dates: 3.11 ll� and description Deck ON-SITE WATER AND WASTEWATER SECTION APPROVAL Engineers Stamp Conditional Approval: Date +++~ �14k �Q • IS"i��♦ ,s * .-49 ILL * >s •f f.�. St. s ff� CE-a2W �A? ����a % 21`'+ Septic System _ r Approve 1 �— 1= �,V� Date �-Z �Z Note: this approval does not include well permit requirements. Cp a rq� v x,0 (D Z� ° n10 Z� `} v 0 IF A f :0 pql" g: ' � oro D 5 � rp :3'*I O N •. �� C+ i O 3 �, < O P -0 00 � <+ O � FTI Q � roe Q o n T� —I X- < ro cCin r<o Q Q H Q � ro :3 0 c C+ Ln m Q M< F-9 h F z o 0 A - oho F00 o�R 00 WCC) CO 05 Q W o rU 0 z v LA ro r�l r�i rp ( rD R O n W (� ro n cn ro H Q D z 9 ro O :3 ro w :3- W y m CS LA d ot- to t- U 0 � UEUZD 4> o -P 3 a u a. ry vaiwO,w R Lr R ma 0 0 V z Q oi qn� `� CC) �o oo U o o O ZLLJ J uj � W Lei MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Bax 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: OSP211132 Work Type: SepticTank Upgrade Tax Code Number: 01505309000 Site Legal Address: T12N R3W SEC 15 LT 73 G:2436 Site Mailing Address: 9701 Abbott Loop RD, Anchorage Owner: TONN NATHANIEL & Design Engineer: NORTH RIM ENGINEERING This permit is for the construction of: Effective Date: Expiration Date: co�ment h� f Q rk v e[�arimc�tt Lot Size in Sq Ft Total Bedrooms: 5!612021 5!612022 46214 ❑ Disposal Field 0 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 (2417). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Co red, sealed, and heated to prevent freezing Special Provisions: This property sold without a COSA in 2021. A COSA is required to be submitted no later than the expiration date of this permit. Received B}=_< Issued By: - Date: C5, Is Z 0 I Date: 5 °20' I MUNICIPALITY OF Development Services Department On -Site Water & Wastewater Section Parcel I. -D. 015-053-09 ON-SITE SEPTIC/WELL PERMIT APPLICATION Property owner(s) WEINMEISTER Mailing address 9701 Elmore Rd Site address same Phone: 907-343-7904 Fax: 907-343-7997 Day phone 561-2227 Legal description (Sub'd., Block & Lot) T1 2N R3W Sec 15 L73 Legal description (Township, Range & Section) Lot Size 46,214 Sq. Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field ❑ Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank El Upgrade F1 (D) El Holding Tank ElRenewal ElDuplex 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: 2 25 Date of Payment: (o 6 2 Receipt Number: 0 l Permit No. 05P)- ) I 3 2 Waiver Fees: Date of Payment: Receipt Number: Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc SteveEng.com Steve Eng, PE, PH 907-694-7028 SteveEngPE@gmail.com Date: 5/5/21 Number of Pages: To: MOA On-Site Services Subject: T12N R3W Section 15 Lot 73 Septic Tank Failure The subject septic tank has failed- a new tank will replace the old one. The existing seepage trench appears to be working OK. Please issue a permit so the tank can be replaced. Please review as soon as possible. This is a large lot with no nearby neighbor conflicts. Elevations in vicinity flat. If there is need for additional information or clarification please give me a call. Thanks-Steve Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211132, Rebecca Carroll, 05/06/21 SteveEng.com T12N R3W Sec 15 L73 SPECIFICATIONS & DESIGN GUIDELINES Wastewater System Sizing: The current septic tank has failed- the seepage trench still functions. This lot is small with nearby wells drawn on plan sheet. No adverse impacts are expected from tank replacement. The easements are depicted on the lot. The slope is indicated in the area of the septic system. No conflicts to neighbor properties. Specification Requirements: All components and work must comply with the Municipality of Anchorage Specifications (AMC) & State of Alaska Drinking Water Regulations and Wastewater Regulations.  New 2- compartment, 1000 gallon septic tank. Watertight couplings on inlet & outlet.  5 minimum between the tank and trench. 5  to property lines & 10  to house.  4 of cover or insulation is required for tank; an equivalent of 1  insulation for 1 foot soil cover. Tank & solid pipe must be set on well compacted, stable soil.  No large rocks for tank bedding. Plastic/fiberglass tanks require special bedding per MOA- sand or pea gravel.  4 diameter cleanouts with airtight caps are required 1  to 4  from foundation wall, prior to any 90 degree bend in 4 inch line, in 2 nd tank compartment, and two adjacent opposing cleanouts between the tank and the absorption field, not more than 10  from the tank positioned to provide cleanout access towards the tank and towards the absorption field. Manhole Riser required in 1 st tank compartment.  All cleanouts must extend to at least ground level.  In solid pipe runs, ASTM D-3034 may be used in lieu of cast iron.  Insulation must be placed over any pipe installed under driveways or parking areas.  Approved pipe materials include cast iron, PVC ASTM D3034, PVC ASTM F789, ABS ASTM D2661,  Sewer Service Line is minimum 2% slope.  Septic Tank to be pumped every two years or when required.  Insulation board to be extruded direct burial polystyrene (Dow Styrofoam HI/equal) Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211132, Rebecca Carroll, 05/06/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211132, Rebecca Carroll, 05/06/21 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP211132, Rebecca Carroll, 05/06/21 0 0 Iy L- 0 R N 0 0 U-3 CID 3. 0 0 LO a 0 0 z 50.0' N90'00'00"E 330.07' 06 Shed N 0 N90'00'00"E 330.03' Lot 72 01 42.3' Existing N House wn s� Lot 73 ' 54,458 sf Lot 80 20' x 5' Utility Easement Book 203 Page 669 N fV O) ... za.z, 74.1' �V tp Shed 124E 7th Avenue Survey Certification: Anchorage, Alaska 99501 1 hereby certify that a Mortgagee's Inspection was performed (907) 306-8104 on the described property. Notes: mail@S4AK.com It is the owner's responsibility to determine the existence of any easements, covenants, or restriction which are not on the recorded subdivision plat. This asbuilt shall not be used for construction or for establishing property lines. Checked by. BH Scale 1" = 40' Drawn by: CB Grid SW2436 Job 2021-09 Field Book: 150 Date: 2/4/2021 0 0 L6 0 0 0 0 z �4 pF �uwo� 0 Lot 74A Awl Q� �1...... ..... Ordered by. Thomas Strapko Legal Description: Asbuilt T 12N, R3 W, SECTION 15 LOT 73 BLM Plat Section 15, T12N, R3W, SM, Section 15, 1955 min C. HfllmBtrorr LS -118708 essiork& �ac Legend: Rebar with Cap OO AL. Monument Rebar O Monument Well Septic QS 0 Overhang Wood Deck Gravel Fence a 0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchora~.le, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEIVi AND/OR WELL INSPECTION REPORT NAME MAILING ADDRESS LEGAL DESCRIPTION Manufacturer ____ [] UPGRADE LOCATION OF o-r iNo. Absorption ar~a ~ ] Dwelling DISTANCE TO: /~/ :5 / IF BOMEMADE: Inside length,,~ JWidth Well Dwelling PERMIT NO. DISTANCE TO: Manufacturer Material Liquid capacity in gallons Well DISTANCE TO: No. of lines ILength of e_~L2¢e Top of tile to finish grade Length Width Foundation No, of compartn~s Liquid depth Trench width ance betweep ines Material beneath tile Depth Total effective absor )tion area inches PERMIT NO. Type of crib Crib diameter Crib depth Total effective absorption area Well Building foundation Nearest lot line DISTANCE TO: Class Oepth Driller Distance to lot line PERMIT NO. DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOILTE" R ¢gG INSTALLER REMARKS LEGAL APPROVED DATE 72-0~3 (Rev. 3/78) PERMIT NO. DEPARTMENT 17 HEFtLTH AND, ENVIRONMENTAL 'ITECTION 825 "L STREET, RNCHORAGE, AK. D950i 264-4?20 ft~lC. Cll'-l--S I 'TE S#EI.,~ER PE[RI~I ][ T 82081L'.L ) APPLICANT CHARLES A JOHNSON L. OCAT I ON L, EGFIL T:t2NR3!.'J L?'g S 15 7021 CHER9L ~;T 99502 LCIT SIZE ~49-4~22 999999 SQUARE FEET TVPE OF SOIL ABSORPTION SVSTEM IS: DRRINFIELD MRXIMLIM NUMBER OF: BEDROOMS SOIL RATING (SG FT/BR)= 90 THE REQUIRED SIZE[ OF' THE SOIL RB'SORPTION SYSTEM IS: DE:P-r~q= ? L.E f-t mS T t-I = g:2 G R Fi %," IS !_. [>EP1-H:: g THE LENGTH DIMENSION IS THE LFNGTH (IN FEE'r) OF THE TRENCH OR DRFIINFIELD. THE DEPTH OF R TRENCM OR PIT IS ]'HE DISTANCE BETWEEN THE SURFRCE OF THE GROI.JND AND, THE BOTTOM OF THE EXCAVATION (IN FEET). 1-HE TREI'-4(SH L.-I ][ DI"H I S 5;. 0E~3 FEE:T. ]'FIE GRAVEL DEPTH IS THE MINIMLIM DEPTH OF GRFIW:*L BETWEEN THE OUTFF]LL PIPE AND THE BOTTOM OF THE EXCAVFITION (IN FEET). I~-."E ~ tJ I RE~[:. E;EF'T I (:: 'TflF~K S I 2]1_..~. =: :LOOO GriLL_ONE; PERMIT APPL. ICRNT HAS THE RESPIDNSIBIL. IT~ TO INPORM TFIIS DEPARTMENT DURING THE :rNS]'RLLRTION INSPECTIONS OF AN~Z WELLS ADJACENT TO THIS PROPEF'.T~' AND THE NUMBER OF RESIDENCES THAT THE NELL WILL SERVE. Tt--I() < ~: ) I r-IS.~F'EC:T I i.Dr-J.~_~ IBF-:E RE£qU I RED B~CKFILLING OF RNV SVSTEM WITHOUT FINAL INSPECTIf.]N FIND APPROVAL BV ]'HIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SENFtGE DISPOSAL SYSTEM IS :L00 FEET FOR I~ PRIVFtTE WELL OR 1,50 l'O ~0 FEET FROM R PUBLIC WELL DEPENDING OPON THE TVF'E OF PUBLIC WELL. MINIMUM DISTANCE FROM FI PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND TO R COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE RE(;~UIR. ED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAb'S OF THE WELL COMPLETION OTHER REQUIREMENTS MRV RPPLS. SPECIFICATIONS AND CONSTRLICTION D'IRGRRMS ARE RVRIL. RBLE TO INSLI~E PROPER INSTRI~ION. EOEM E : I E. ERTIF¢ TH~'F :1.: I ~M F~MILI~R WITH THE REQUIREMENTS FOR ON-SZFE SEWERS AND WELLS BS SET PORTH B~' THE MUNICIP~LIT'¢ OF ~NCHORAGE. 2: I WILL INST~LI_ THE S'~'STEM IN I~CCORDBNCE WITH THE CODES. 3: I LINDERST~ND 'THAT THE ON-SITE SEWER S'~STEM M~Y REEQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE TH~N 3 BEI}ROOMS. S I GNED: ................................................ RPPLICRNT (.'.HRRLES A ..TOHI'4SON / MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 82.5 L, Street, Anchorage, Alaska 99501 264-4720 SOILS I..OG - PERCOLATION TEST ,~'" SOILS LOG [] PERCOLATION TEST PERFORMED FOR: 1 2 3 4 5 6 7 8 9- SLOPE SITE PLAN 10- 11 13 14 15 16 17 18 19 2O WAS GROUND WATER /~.~ Si_ ENCOUNTERED? pO E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Tirne Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN ~ - FT AND FT COMMENTS./~ (~t:-O ;vvt/v'~ O~_./V(;[ .'~"~.';'~.~ ~ ~-- PERFORMED BY:~ C~- ~ ~l~ I~ CERTIFIED SY: 72-008 [6/79) P O bOX UNIT ) ANCHORAGE. ALASKA 99511 QTY. MATERIALS PRICE AMOUNT I PHONE 344'0526 ~ LEGAL DESCRIPTION - , , ~" ~' /~' /o DEC~-RIPTION Of WORK All charges ehe// be paid in full w/thin ten days unless other arrangements are made prior to drilling. The customer shag pay in- terest at the rate of 1 ~ % per month on any amount not paid with/fl ten days. Failure to pay may result ~ a lien against the property. WORKMAN I)ATE OUT MUNICIPALITY OF ANCHORAGE � $ Development Services Department �' Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel I.D. 015-053-09 1. GENERAL INFORMATION Complete legal description T1 2N R3W Sec 15 L73 Location (site address) 9701 Elmore Rd Current property owner(s) WEINMEISTER Mailing address Real estate agent 2. TYPE OF DWELLING: Fx_1 Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: 3 Expiration Date:. 12 -Z' 2 I Day phone 561-2227 Day phone 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well 0 Private Septic 0 Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: Date: COSA to be released to the engineer, unless otherwise requested by the engineer. COSA Fee $ 55D Waiver Fee $ Date of Payment 30 20.21 Date of Payment Receipt Number Q yq f q D Receipt Number COSA # 0 S C.2 1 1 5 2% Waiver # 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm NorthRim Eng. Phone 694-7028 Address PO Box 770724, Eagle River Engineer's Printed Name Steve Eng Date 8/3/21 OF "01 6. DSD SIGNATURE System #1 Approved for bedroomsSUva Fn9 ' Jr Ar System #2 Approved for bedrooms fy+`� j 21�,+?+� Disapproved Conditional approval for bedrooms, with the following stipulations: ay ac -1 WA -SITE rrt � AST_=v'ATE -� oo AM o , c �JJ��ryTSERVICEs� ��,`. >>> ; By: j tom-, ell Original Certificate Date: ?— Z. Z j The Municipality of Anchorage Development Senices Division (DSD) issues Certificates of Onsite Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Nitrate Advisory Septic System Advisory Arsenic Advisory (Mall Flniai Ari%fi znr\/ nfhar Legal Description: T12N R3W Sec 15 L73 If more than 1 septic system on lot: COSA Checklist # of A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 8116/82 Total depth 244 ft Cased to 244 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) 12+ in. Date of flow test for COSA 5/26/21 Static water level at beginning of test 187 ft. Comments B. TANK DATA Age of tank(s) new years Tank type/material 3.Pt`p!" Measured operating fluid level in septic tank new Al Standpipes/foundation cleanout per record drawing Date of pumping new D. ABSORPTION FIELD DATA 4/18/83 Which system tested (date installed) same ❑ ALL standpipes present per record drawing Total measured depth from grade 9 ft (max) Measured depth to pipe invert from grade 6.5 ft (min) ❑ N/A — pressurized field ❑ Monitor tubes go to bottom of effective. If not, state depth into effective ❑ Code -required soil cover over field ❑ System presoaked (Required if vacant for greater than 30 days prior to date of test) Gallons introduced gallons Comments/Deficiencies: COSA Checklist yellow sheet Parcel ID: 015-053-09 Structure served by this system Well production at time of test 6+ gpm Water storage tank volume 0 gallons Well disinfected for coliform test? ❑ Yes ❑ Nc OR Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by NRimEng Date of Sample 7/13121 C. LIFT STATION ❑ Required maintenance completed Age of lift station years Lift station material Comments: Adequacy test date 5/26/21 Results ❑✓ Pass For 3 bedrooms Fluid depth prior to test 0 in Water added 450 gal New depth 0 in Elapsed time 30 min Final fluid depth 0 in Absorption rate 450 gpd Any rejuvenation treatment (past 12 months) If yes, enter date lim E. SEPARATION DISTANCES From Private Well on Lot to: (Please enter distances if less than required or if community %vell Septic Tank/LiftStation'mnLot >1O0' Yes Community Sewer Manhole/Cleanout 10O (a Yes ifNoft Yon ifNoM [�lYeu i[Noft Neighboring Tank >1Q0' Yeo ifNoft Wells onAdjacent Lots: Private Sewer/Septic Line >25'[_,lYes ifNoft Absorption Field onLot >�100' Yes ifN0ft Holding Tank >1O0` Yes i[Noft Neighboring Absorption Fields > 100' Yes i[WoM Water Main >�1O' Animal Containment > 50' Yes JNoM Yes JNnh Community Wells >2O8' ��Yea ifNoM Water Service Line >�1O' El Yes i[NnD Manure/Animal Exnna\o Stonage> 100' If septic tank isunder driveway comment below Community Sewer Main >75^ Yes i[NnU F-1Yesi[NoM From Septic/Holding Tank on Lot to: (Please enter distances if less than required) Building Foundahoms>�1O' Yes ifNoM Surface VYoh» >1O0' Yon ifNoM Property Line >5' YesJNnM Yes ifNoM Wells onAdjacent Lots: Wells on Adjacent Lots: Absorption Field >5' 0Yeo )fNoft Water Service Line > 10^ Private Wells > 100' Yes i[WoM Water Main >�1O' El, Yes |yNoh Community Wells >2O8' ��Yea ifNoM Water Service Line >�1O' El Yes i[NnD If septic tank isunder driveway comment below From Absorption Field onLot to: (Please enter distances if less than required) Building Foundation >10/ El Yes ifMnft If absorption field ksunder driveway comment below Property Line >10' F-1 YesJNnM Wells onAdjacent Lots: Water Main >1O' Yes i[NoM Private Wells >1OO' Yes ifNoD Water Service Line > 10^ Yea ifNoft Community Wells >2OU' Yea ifNnft Surface VVotnr>1UO^ Yeo ifNo# F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION /uer�M/�hm�/h�vede&x7n/ned/h/0ugh�nk�/nopoc&�na��dreNew ��� '' ----''' ' �������/��� ofh�/n��xn/repJn��that the above e0sksnns are /ncon/hnoancem�h ` ^'' `^' `-^ MOA CO24guidelines 6neffect onthis date. ������­ I.,"� 0 -T v m-0 3 F y — O< _. 0 y m O _ Q m 3 Q. 3 3 3 3 OS m 0 ° m m 01 r � P Uy yCD ° m m m m N o ,0 s o n. 3 O m Q m O 0 V 'c 3 y r'0 O W `G m y CL 0 l< m n 0 I"{'.0 S3-tnn1,- :3O I O- S m O -O Q y Q �- v '.� n -01� 3 0 m :- m Q m o n.: cn Sg O 0 o o D--i� CL 7 -r. -CDlni7 N 00 I -'o- 3 xZ m °33'0° 0 n n_ - I, y Q W ° Q. 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C3 a f C m OW 93.8' 0 n N 'o m - Ln r o mN Orn w ON ax Z Ni z ? m \ Q C: 0 0 1- 303.9' O W cOD D W m r \ m \ �O m D � O O - Ln r o mN Orn w ON ax Z Ni z ? m \ Q 0 0 1- 303.9' o � - Ln r o -.I- rn oo o\ N W cOD D W m W G7 � m CO K: v m Z o� O ,00'991, 3„00,90.00 S O f*I v N W W O v 10 0 r Z /i MUNICIPALITY OF ANCHORAGE ~lm~Tll ~. DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage. Naska 99519-6650 (907) 3434744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILLY DWELLING Parcel I.D. # 015-053-09 HAA#' H.~r ~ I O0 ~ 1. GENERAL INFORMATION CompletelegaldescdpUon T12N. R3W. SECTION 15: LOT 73 Location (site address or directions) 9701 ABBOI-F LOOP ROAD ANCHORAOE AK 99,507 Property owner co/ RON WEST Day phone (907) 522-1312 Mailing address 3210 RACKET CIRCLE' ANCHORA(~E AK 99~Q7 Lending agency, Day phone Mailing address Agent ED SHELTON w/ PRUDENTIAL VISTA Dayphone (9073 273-7210 Address 4241 "R" STREET ANCHORAGE AK 99503 Unless otherw/se requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: : Individual well xxx Community well · ' Public water NOTE: If community well system, previde wfitten confirmafion frem State ADEC attest. lng to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site xxx Holding Tank Community on-site Public sewer NOTE: If community wastewater system, provida written confirmation frem State ADEC lng to the legality and status of system. 72-025 (Rev. 1/91) Front MOA ir21 Computer Version Note: Alaska Water and Waste. water Consu. ltants, /n.c.. shall be paid or prior to, closing for the engineering servTces prowc~ea. 5. STATEMENT OF INSPECTION BY ENGINEER · As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation of this Health Authority Approval application shows that the on-sita 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 Insp~ tion, the on-site water supply and/or wastawater disposal system Is In compliance with all Munlctj~ d State codes, ordinances, and regulations In effect ' on the date of this Inspection.~ , ///// Name of Firm AL,~sKA/~T~R~8/ ~,F~AJA'~, LA' ~ CONSULTANTS, INC. Phone ¢907) 337-6179 Address 6901 DEBARR/ROAD. S[J .=2B~AN( ,RAGE. ALASKA 99504 / / Engineer's Signature ~ ~.~ ]d ~/ ~ : ~ate/J oJ / system In accordance wfth ADEC and MDA1D~ ~ Guidelines & R~julations. The reported results descdbod the performanceofthesystemundorthecendition ~ncounteredattheb'meofthetest, andset~.arationdistances measured to readi~y identifiable features. The ¢ ~erational life of ail wells and septic systems depend . · on the local soils condition, ground water le~Is that may fluctuate during the year, and the water usage of the faml~' being served by the system. These conditions are outs/de the control of the evaluator of the system. Satisfacto/y test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Inc. can therefore not prevfde any warranty for future estimate of how long the system ~11 continue to meet the operational requirements of the ADEC or MOA DHHS. 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 pady is not authorized, nor wfll It confer any legal fight whatsoever. 6. DHHS SIGNATURE ~, Approved for .~ Disapproved Conditional approval for. bedrooms ........... · be~i?o~ms, with the following stipulations: ~-.~ ,. .,- Additional Comments _ . .... Date 2 -22 -~! The Municipality of Anchorage Department of Health and Human Services (DHHS) Issues Health Authority Approval Certificates based only upon the representations given In paregreph 5 above by an independent professional engineer registered In the State of A~aska. The DHHS does this as a courtesy to pumhasers 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 cortificats Is issued. The Municipality of Anchorage Is not responsible for errors or omissions In the prefesslonal engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Computer Version MuniciPality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Env~onmental Services Dlvlalon 825 'L" Street, Rm 602 Anchorage, AJaska g9501 (g07) 343-4744 Legal Dasatption: A. 1NELL DATA Well Type PRNATE Log present (Y/N) Tote] depth Sanltmy ~eal (Y/N) Health Authority Approval Checklist T12N~ RSWr SECTION 15~ LOT 7.3 ParcelLD.: Date of test Stetlc water level Well production 10 WATER SAMPLE RESULTS: Coliform 0 Date of ~ample: 1,/18/2001 B. SEPTIC/HOLDING TANK DATA Date installed 4/18`//85 Tank elze Foundation deanout (Y/N). *YES Date of Pumping 1/10/2001 C. AB$ORPTIOH FIELD DATA Date installed 4/18/83 015-055-09 D.ate completed Cased te YF:S FROM WELL LOG 8`/16/87 g.p.m. 8/le/82 Casing helgnt (above ground) Wires pmpe~ protected (Y/N) AT INSPECTION 1,/12,/2001 I~}Z' 5.6 Nitrate 0.5 * INSIDE HOUSE. 1~50 Number of Comparlments . Other bacteria. A.W.W.C, INC. Dap _m~__~!on (Y/N) NO High water alarm (Y/N) Pumper McDONALDS · ** SUMP EXTENDS 22" BELOW INVERT rating (g.p.dJt12 o~. g0 System type Gravel INclmess below pipe Z' To~al depth 2 Claanoute (Y/N) N/^ TRI~NCH Effective absorption ama 370 sq Fi' Monlterlng Tube present (Y/N)**YES Depression over field (Y/N) Date of adequacy test 1 / 12,/2001 Results (Pass/Fall) PASS For. 3 Fluid depth in absorption field before test (in.); Ruld depth N,/A (ine) Minutes later:. Pera3dde Imalment (.mast 12 months) (y/N) {~" Immedlatelyafter 2447 gel.'wateradded0n.): _ N,/A ~ rate = 4.50+ NONE KNOWN Ifyes, glvedate g.p.m. If A, B, or C, attach ADEC letter. ADEC water system number N,/A D. UFT STATION ~ D:;=lie/A~__,~ (Y/N) ~'~ "Pump orr *vel at' *Datum _ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Sept]clholdlng tank on lot Abeotpt]on field on lot 101' TO EDGE OF C01 ~ ~ c~g'~l ~/~ Onedjacentlota 100'+ Public ~wer main N/A Public ~ewer manhole/dear, out N/A 25'+ Mit stat]on N/A SewerlsepUe serdce ane On adjacent lots I~ leX3 ~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation 5'+ Property line 5'+ Water maln/servk:e line 10'+ Surface water/dmlnege 100'+ Absorption field Wells on adjacent lots ,5'+ *~ 100'+ SEPARATION DISTANCES FROM ABSORPTION REID ON LOT TO:. Propen'y line Surface water Curtain drain 10'+ Building foundat]on 100°+ NONE KNOWN 10'+ Water male/sendce line 10'+ Driveway, parldng/veh~e storage area 10'+ Wells on adjacent Iota ** 100'+ , /~ ** 150'+ TO CLASS "C' .;/,=~OO~-~,. F. ENGINEER$CERTIF1CAT~I[I WELL ON LOT 72. I ceriEy 6~at I ~jaye c~er~:l~l:hru field inspec~es end review $1gnetum~ Englneet'aNan~.~.___ JEFFREY A. GARNESS WaKer Fee $ ~ ~ ~P-/~JRecelpt Number Municipality .of And oragc George P. II uerch. Mayor Btfilding Safety Dix~ision P.O. Box 1 ~kc~50 · 4700 S. Bragaw Street Anchorage, Alaslm ~)519-C~0 * (~)7) 8~3-~01 02/22/01 ~cpartmcnt o~ Public Works Jeffrey A. Garness, PE Alaska Water & Wastewater Consurltants, Inc 6901 Debarr Road, Suite 2B Anchorage, Alaska 99504 Subject: Waiver Request for T12N R3W Section 15 Lot 73 Waiver Request #WR010009 Parcel ID #015-053-09 Health Authority Number HA010034 Dear Mr. Gamess: Your request for a waiver of the required 100 feet horizontal separation from the on-site wastewater disposal system to private well has been approved. The approved separation distance is 96.0 feet. This waiver approval is for the septic tank and the absorption field. This waiver approval applies to the existing on-sitewastewaterdisposal system to private well separation only. Any future upgrade to the on-site wastewater disposal system will require all separation distances be met or another approval from this department. If there are any further concerns or questions regarding this waiver, please call our office at 343-7904. Sincerely, Civil Engineer On-Site Water & Wastewater Program Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 Bragaw S~rcet P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 Waiver Review Worksheet WR#: WR010009 PID~: 015-053-09 HA#: HA010034 Permit~: Date Received: 2/20/01 Legal Description: T12N R3W SECTION 15 LOT 73 Engineer:. JEFFREY GARNESSr PEr ALASKA WATER & WASTEWATER CONSULTANTSr INC. 6901 DEBARR ROADr SUITE 2Br ANCHORAGEr ALASKA 99504 Applicant: RON WEST Waiver Requested: ON-LOT WATER WELL TO SEPTIC TANK AND WIDE DRAINFIELD OF 96 FEET Criteria: Geology Points: A. Watar Table B. Soil Sorption C. Pen'neability D. Water Table Gradient E. Horizontal Separation Waiver is Granted: ~ Wa ve ListConditionsorReasonsforabove: ~ ff E /) ITIg' ('~./E Z? Rec~: 0942 Amount: 920 Data Paid: 2/20/01 ~.of ,q. ~. E,C.. 2 ~o'- lo' : 22o I /2o =,{~3'/- 7. 0 7OIL. $ORBTIDA/_ C o l~ C L J~ $1o /i/ R. Z~ 3.6 2.0 2.0 2.8 18,0 " ALASKA WATER & WASTEWATER CONSULTANTS, INC. February 16, 2001 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program P.O. Box 196650 Anchorage, Alaska 99519-6650 Reft Waiver Request for Lot 73; TI2N, R3W, Section 15 The existing 3 bedroom house is served by a private well and septic system. During our site visit it was noted that it was 101 feet from edge of well to the edge of the trench sump and also to the edge of the first cleanout for septic tank. Given the fact that the trench is '5 feet wide, it is reasonable to assume that the edge of the trench is approximately 98.5 feet from the well. To be conservative, we request that you grant a 96 feet separation distance waiver from the well to the septic tank and drainfield on the referenced property. The well that serves the subject property was drilled on August 16, 1982, and the septic system was installed in April 18, 1983. The following items are justifications for the waiver: · The lot is generally flat in the area, There is vegetation between the well and the septic system. If the septic system was to overflow, it appears that the effluent ~ travel toward the well head; but rather towards the ditchline by the road. · The location of the septic system is in a very visible area so that if any effluent was to surface, it would be noticed and the problem corrected. The other path of contamination is subsurface migration. Attached are some partial well logs and recorded well depths (per M.O.A. records). As can be seen on the attached well information, the aquifer is relatively deep. According to the well log for Lot 80; TI2N, R3W, Section 15, there is a confining clay layer at 170 feet deep which should inhibit the migration of untreated wastewater into the aquifer. Recent water sample results indicated non-detectable nitrate levels and no bacteria. Based upon the aforementioned facts, it appears that there is minimal risk associated with the 96 feet separation distance waiver. If you have President v amess, P.E., M.S. ons, please contact us at 337-6179. Thank you for your assistance. 6901 Debarr Road, Suite 2B · Anchorage, AK 99504 Ph: (907) 337-6179 · Fax: (907) 338-3246 · Website: akxvwc.com i i i : .... -I' I I I I I I I I I I I I I I I I I I T12N. R3W, S~'C. 15, LOT 63&, I I I I I I I I I I I ------ t I I I ... ~-" ~' ~ ~ ~""-. I I I I ~ ~1 I I , // I ~ , I , i , I I ~ I I I I I I , ,,X ' r -y .................. I ~ ~ I I II I I T I I ~ / ~ST 98TH AVENUE I 2/14/2001 AIASI~ ~TER & B~STE~TER ~ CONSULTANTS, INC. RON WEST 522-1312 1 OF 2 ~12N, R3W, SECTION 15; LOT 73 .,'"' SITE P~N FOR WAIVER REQUEST \ ~y \\\ \\ HO~ ~ / % AR~ c.J.O. ~ CONSULTANTS, INC. RON WEST TI2N, R3W. SECTION 1~; LOT 73 SITE P~N FOR WAIVER REQUEST GREATER AHCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Time of Inspection Date of Inspection , · oo REqU£ST FOR APPROVAg OF ~NDIV)DUAL S£W~R & ~All~R FACILIT)ES FOR 1. Aoproval Requested By: Address~ ~'f.~O I .~J''~P 2. P~ooerty O~ner: .~U.~ 3. Legnl Description{ ~ ~X/~ 5. Typ~ of Fact]Lty ~o be ~nspected~ Phone{ Phone{ 6. Well Data: A. C. Construction C)~ 7. Sewage Dtaoosal System{ .. ospth ,, D. Seepage Pit: .1. Size 2. Material E. Disposal Field{ To'al Length of Lines /~ Distances: A. ~elL To: Septic Tank__~__O -~-, Absorption Ares /~);'Y-, Sewer Mnes ., Nearest Lot Line , O~her Contamination Fnundation to Septic Tank .1"~ AbSorption Ares · C. Absorption Area to Nearest Lot Line MUNICIPALITY OF ANCHOFIAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4"/20 Application Date GENERAl.. INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) (b) (c) Location (address'or directions) Applicant Name ¢~,~¢~*~O', __Telephone:Home --~/~L¢ Business Applicant is (check one): Lending Institution ~; Owner/builder ~; Buye~ Other~ (explain); (d) Lending Institution Address Telephone (e) Real Estate Compa,ny an~d Agent Address Telephone (f)_......~il the HAA~ to the followir~ddres¢: LI. V,'c4 ¢ TYPE OF RESIDENCE Single-Family ~ MuRi-Family ['1 Number of Bedrooms Other WATER SUPPLY Individual Well J~ Community [] Public [] Note: If corn munity well system, must have written confirmation from tbe State Department of Environmental Conservation attesting to the legality and status. SEWAGE DISPOSAL Onsite ¢ Public [] Community E] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-°25(1~¢841 ENGINEERING FIRM PROVIDII' NSPECTIONS, TESTS, FILE SEARCH, D/ 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 Firm Address Date Approved ~ Disapproved Conditional. ' Page 2 of 2 72 025 (ll/84) CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. ,,O%~ ~5\O¥'' MUNICIPALITY OF ANCHORAGE (MOA) . ~,~- ¢~"~ HEALTH AUTHORITY APPROVAL (HAA) ~'~,O~.%''t'~ CHECKLIST, FEBRUARY 1984 ~ ¢*,r~¢) ¢,~'~ Legal Description: _ WELL %~(.~ Well Classification /~r-/v ~ ~/.-~ If A, B, C, D,E.C. Approved (Y/N) Well Log Present (y~¢~ ~-~ . Date Completed ~./.4/',4',¢~*~J^.~ Yield Total Depth _' ,;¢'~/~' / Cased to ,~?/5~ / Depth of Grouting ~'-"( Static Water Level /~5' ' Pump Set At ' Casing Height Above Ground /z_ ~/ Sanitary Seal on Casingd'~Y.)N) Electrical Wiring in Condui Yt~) Depression Around Wellhead (Y~) Separation Distances from Well: To Septic/Holding Tank on Lot __~/O '/~ ; On Adjo n ng Lots To Nearest Ed§e of Absorption Field on Lot _,/O 7~ ; On Adjoining Lots To Nearest Public Sewer Line ,'C'f/'~ To Nearest Public Sewer Cleanout/Manhole ~//~ To Nearest Sewer Service Line on Lot Water Sample Collected by ,-¢~$ ~c. · Date Water Sample Test Results B. SEPTIC/HOLDING TANK DATA Date Installed ~¢¢//'¢'-~'¢ Size / Z.J~ No. of Compartments 'Z Standpipes ~) Air-tight Caps') ~ Foundation Cleanout ~/N) Depression over Tank (Y~ Date Last Pumped ?/2~' ~ Pumping/Maintenance Contract on File (Y/N) //~ ;for ~ Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well / ~// To Property Line To Water Main/Service Line _ ~'/O¢/ Course /'U'c,.,,z, Temporary Holding Tank Permit (Y/N) . /f~/,.~.,.z' To Building Foundation 7'~' To Disposal Field To otrearn, Pond, Lake, or Major Drainage Comments Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata _~'/~/3 '/,¢,'z'. Date Installed ~//¢',~ ~ Width of Field ,~- / Square Feet of Absorption Area Depression over Field (Yin. Results of Last Adequacy' Test Separation Distance from Absorption Field: To Water-Supply Well / 0 2- / To Building Foundation ~'~-~ Lot /t) ¢, ~ Type of System Design Length of Field //cZ) / Depth of Field . ~,~-/2¢ Graver Bed Thickness Standpipes Present~/U) Date of Last Adequacy Test_ To Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Property Line To Existing or Abandoned System on ; On Adjoining Lots .~ ~'~D / To Cutbank (if present) To Driveway, Parking Area, or Vehicle Storage Area Comment~'~v/c/ (~/~£~ /~'¢ ~:~¢'-z,.¢_ .~..,_./ D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) ~'J- "Pump On" Level at "Pump~OfCZ--L~ High Water Alarm Level at /~--//¢¢. / / Vent (Y/N) Tested for __ _ ./~ ~ Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) .~' Comments J ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA g uideli nas in effect on the date of this inspection, Signed Date MOA No. ......,...... .... Company Receipt No. Date of Payment Amount: $ Page 2 of 2 72-026 (11/84) _,~ APP!" NT FILLS OUT UPPER HA[ ONLY Phone Prop~,r ty Owner Mailing Address Buyer Zip Code Lending Institution Address Realty Co. & Agent Address Zip Code Zip Code Phone Legal Description Z/~}/;Y.::~' '-~ ......~£'d: Multiple Family No. of Bedrooms Other [] Community [] Public Utility Sewer o' posal [] Public Utility [~ Holding Tank ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available). Year Individual Installed: ~ .... ~ When Connected 1o Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ,) Time Time { / Time Time Date Date Date Inspector Inspector Inspector ecior Field Notes: ~%VED BEDROOMS ( ) DISAPPROVED ( ) CONDITIONAL APPROVAL* DATE ~ ~-~'~- / -- ~ "~ *CONBITIONS OF APPROVAL Soils Rating J Date Sewe~ Installed ¢o J ¥- Well To Absorption Area Well to Tank f/ ¢~ Well Log Received Septic Tank Size ~Permit ~: 820811 January 31, 1983 TO: Permit Applicant Subject: T].2N R3W Section 15 I,ot 73 A permit issued and/or on-~si he ].!}82. by this department for an individual well sewer system has expired as of December 31, Permits are lssued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well. log needs to be sent to this department for documentation of the instal_lation date and to close the permJ_t. If a private engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files and documentation. If t. here are any further questions, please cai]. this office at 264-4720. S incer ely Robert C. Pratt, R.S. Actlng Program Hanager Sewer and Water Program RCP/ljw enc: Cepy of Permit SWP/057