HomeMy WebLinkAboutHOGGARD LT 1Hoggard
Lot 1
#018-182m=25
Municipality of Anchorage Page 1 of 3
Development Services Department
Building Safety Division/On-Site Water and Wastewater Program
4700 South Btagaw Street
P.O. Box 196650 Anchorage, AK 995196650
www.d.anchorage.ak.us (907) 3437904
ONSITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT
Permit Number: SWO10454 PID Number: 018-182-09
Calvin Ho and
Wastewater System: New
410 0 W. 142nd Ave. Anchorage, AK 99502
410
ABSORPTION FIELD
P" :rA.oea a oo n:
345-1615 Fourtiee 4
Deep Trench
Sd Ra V.
Taal Depin holo org.W 9F W .
LEGAL DESCRIPTION
1.2 owe
10.5 F1.
abfl' IAL SWdWlal:
DVM b P7e DOaPn km arww VF :
Grant depM DtlMaN P":
1 Ho and
4 Ft.
6 FL
To- ahp: narge: Sxpoll:
Fa.eeee aeo-w VVgoes:
Gravel Largft
42
.5 Fl.
Ft.
Well: New
Craw w ;
3
N bwj eras:
Dwaw eaPwaen rte.:
-
Ft.
FL
Clsswfi on (Pmvla. A 5. C):
Torr Dean:Cued p:
Tort apeaeon.rea
p.
504 Fe
Alpe N.Iwal.
ASTM D3034 PVC
Private
142 n. 142 n.
Deer.
Alpine Drillin
Dow Drove: S a W.ler law:
1/5/02 74 FL
hYaaar.
S inell Homes
Dove eal.Pee.
12/3-4/01
Ya :
I
PVlrosaal
1
` V Hoght AD Gr .
TANK
7 Gov
Fl.
>2 n
SEPARATION DISTANCES
S.T.E.P.
To
Flan
Septic
Tank
Absorption
Field
Lift
Station
HoldingidPrWate
Tank
sewert)ne
er'
Anchorage Tank
1,500
W.1
>100,
>100'
N/A
N/A
>25'
an.l.
Steel
Darerieela:
3
sat.pew.er
>100'
>100'
N/A
N/A
LIFT STATION
LdUW
>5'
>10'
N/A
N/A
e.
250 Ga.
a.
Anch. Tank/Orenco
Foffd m
>5'
>10'
N/A
N/A
43 h
p
43 ti
45 u
c..ao.e
None
Noted
P p�e`�
Orenco
EM " al.per>'oee pwkawd er
Muni. Of Anchorage
"""'Aa'
BENCH MARK
Front Deck — Southwest Corner
100.0 FL
Engineees Stamp
()F trjoit
•/'
Inspections performed by: Mike Anderson Dates: 1`t 12/3/01
1. _49!h A
2n° 12/4/01
"
: k rICNAEL'E.'ANDERSON 4�
k:
Department of Health and Human Services approval
•,c%i Nu. CE 4381
• sf C
Reviewed and approved by: !/. //� Date: --,5%2--0Z
••0044,
,5,�����:•
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Municipality of Anchorage Page 2 of 3
DEVELOPMENT SERVICES DEPARTMENT
4700 South Bragaw, Street Anchorage, AK 99519-6650-343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number SWO10454 PID No. 018-182-09
111=40'
MICHAEL E. ANDERSDN
i, No. CE -4381 1
0
757
DAVENUE
8"E 150.00'
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HOGGARD SUBDIVISION
LOT 1 ;
49,913 S.F.
1
L-- - - -- ---- - ----
i 10' T. ec E ESAtT. i
N 89058'40"E 215.94'
PLAN AS -BUILT
SCALE 1" = 40'
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK. 99519.6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
Permit Number. SWO10454
I'sm Gallon
S.T.E.P. Tank
87.7
1.5"
Page 3 of 3
PID No. 018-182-09
42'
PROFILE AS -BUILT
Scale: 1'- 10'
@ 1.S Spacing
'? 49th
MICHAEL E. ANDERSON
's4 No. CE -4381 .j
Aar -26-2002 09:51am From-SPINELL HOLES INC
*PkkfxMUM
Mayor
ALPINE DRILLING
9073441976
FAX N0. : 907 345 0202
T-043 P.001/001 F-646
Rpr•. eo oaho4 v=.cw.uri ra
Municipality of Anchorage
Department of Health and Human Services
5251• street
P.O. Box 196650 Anchorage. Alaska 89519.6650
MtpJAv+r'.ei>nclwrWakus
7•a�
Permit Number: #SW 010454 Date of Lase: V4"l Pared Identification Number. 015-182-09
Dots Started:1-"2 Date Completed: 15.02 Is well located at approved pmak location? ® Yes ❑ No
Legal DtsaVtioo: T1 2N R3W Sec 33 O 33
Property Owner Name 8c Address: Calvin Hoggard
4100 W 142 Ave
Anchorage, Alaska 99516
Borehole Data:
Soll Type, Udcknew & WaW St wa
Depth (ft)
Frac To
Method of Dnl m' g ®air rotary ❑ cable tool
casing type: steer
sbdc-up
0 2
Walt T hk me & 02 inclxs
silty Bobby gravel w/bldrs
2 14
Diameter: 6 inches Depth 142 feet
sk cobby gravel
graveAysW
sdysandygra vel - H2O
14 84
84 137
137 142
Una' Tylm
Diamettr mcbes Depth feet
Casing stielntp above ground: 2 fret
Static water level (from ground leve[): afcct'
Pumping kveL-142 feet after
ii bows pumping 7 "m
Recovery Rata _7 gpm
McWod of Testing is rfr►t
Well Intake Opeming Type:
® Open End ❑ Open. Hole
❑ Screened Start fat Stopped fat
❑ PerfoW ans Start feet Stopped fcd
Groat Type: Berrrontre # & Votame.. jkas
Depth: Start0 feet Stopped ±fat
Pump: Intake Depth feet
Pump size Brand Name
Well Disinfected Upon Completing? ® Yea ❑ No
Method ofDteiafectioa: donne Iftts
Coamments:
WeQ Dnftr. Alpine DAWAng & Enterprises
P O Box 110496
Anchorage AK 99511
Received Time Apr.26. 8:54AM
Attention: The well drMet stun tmrvirte a wro Ina to tt-...—,.....-
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 SEWERIWELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 018.182.09 Permit Number SW
Property owner(s) Calvin Hogaard
Day phone 345.1657
Mailing address (1) 4100 West 1421d Avenue
Anchorage,
AK 99516
Mailing address (2)
Zip Code
Legal description (Lot, Block & Sub'd.)
Legal description (Section, Township & Range)
M2 /J Z 3> w SS C- 3 3
LT 5 3i
Lot Size 4%4H-8-= Acres/Sq.Ft.
Number of Bedrooms Four
i 00,900
THIS APPLICATION IS FOR:
Sewer Only
❑
Well Only
❑
Sewer and Well
®
Water Storage
❑
Sewer Upgrade
❑
THIS PROPERTY CONTAINS:
Hot Tub
❑
Jacuzzi
❑
Swimming Pool
❑
Water Softening Unit
❑
Therapy Pool
❑
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.
R
(Signature of property owner or authorized agent)
Permit
Date of Payment:
Receipt Number:
(Rev. 12100)
Waiver Fees:
9010-31 1 Date of Payment:
CP?)O Receipt Number:
ANDERSON ENGINEERING.,
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 FAX
September 8, 2001
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 1, Hoggard Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties ,
Dear Onsite Services Engineer:
The owner of Lot 1, Hoggard Subdivision intends to construct a four-bedroom home
on the property. We are therefore requesting a permit be Issued for the construction of
a new well and septic system to serve the new 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 is the location of
the proposed well on the lot as well as the adjacent lot and the test hole locations.
Existing drainage patterns are shown and will not be altered by the development of the
lot.
Several test holes were placed near the location of the new absorption trench. These
hole indicated silty sands with cobbles to 12" in diameter. Percolation tests in the
material resulted in rates between 1 and 5 minutes per inch. No groundwater was
found during placement of the test holes, and none was noted during the monitoring
period. We are therefore proposing to place a deep absorption trench system with 6' of
gravel beneath the distribution pipe. The total depth of the trench will be 10'. The
distribution pipe will be placed at 4' below the ground surface. The house will have a
daylight basement and be constructed into the slope at the southern end of the tot. The
septic tank will also be placed in this area and the effluent pumped up to the absorption
trench.
The ground surface on the lot slopes as shown on the attached Site Plan with only
shallow slopes near the proposed septic system site. The new absorption trench will be
constructed on a fairly flat surface in conformance with Municipal requirements and
parallel to ground contours where possible. The lot slopes sharply near the southern
portion of the lot to Rabbit Creek. The slope does not appear to exceed 25% In most
locations. The trench, however, will be constructed at least 50' from the break in grade.
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
4•
Lot 1, Hoggard Subdivision
September 8, 2001
Page Two
In the area or those to be constructed in the future.
2. 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.
3. 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.
4. 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,
,4,,ZJ E at,
Michael E. Anderson, P.E.
Attachments
...•• N
E. pNDE&SCN •,`Y, N
® `� '• CE - 4331
�� ;rte .• v .�
��4rCiiESSC�r�4y
ILOT 32A
LOT 31
1 weft
�I
I
I.
LOT 34 1
1 '
1 `� I THIS PROJECT
SHOSHONI
LOT 32B
rOpOSed SeSypti 1
J Ste
� I 1
00p„ I I L17T1 1
i t _
1 � ................ i
Well
1 0 I I i
l 1 LOT 18 I
I � t
Septic W _NATRO _
1 •4�Iweff$ISS C
_ - 1 v LOT I
' - �' •LOT 64
fso froo tso aro
saw 1' = 100 FT.
• �.� ' • ' • ,� ,•.ter o�,
r
r+; 49D1 !'�1 Tri•
AREA MAP r
V -100 te MICHAZL E. AN -M=4
P. CE -4331 :� a
S-10778
HOGGARD SUBDIVISION
'
LOT 1
F.
14 ND AVENUE
roi
r) 32V
N ' 8
57'38"E 150.00'
316
-
- - --
------
----
30 R.O.W.ESWT.'
o
rroFos
d Well
5
r
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O
O
°'
dP
N
p�6A
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L
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3 .
Alternate S
to
o
TH A
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K
p
'
o
42'
6
Z
Lo X 3'�Wide
•ago
Eff.. th' Ab
h
Four Be o
N
Home
3
5
..
NOTE: Maximum Cover Over
N
STEP Tank -.is 4' for.12 Gauge
'.
1,500 Gal
`
s
and 7.5' for 10 Gauge.
.o
e
STEP Tank
o
o
"
Grade Break Line
;c-
cp
'
'SITE PLAN
SCALE I"= 40' '
N 89°58'40"E 215.94'
270-1290'
LOT 1, HOGGARD SUBDIVISION
DESIGN FACTORS:
Four Bedroom Home
Perc. Rate: 1 MinAnch
Avg. Application Rate: 1.2 GPD/SF
SYSTEM REQUIREMENTS:
Deep Trench System
1,500 Gallon STEP Tank
6' Drain Field Rock
Pressure Distribution System
4 Bedrooms X 150 GPD 11.2 GPD/SF = 500 SF of Absorption Area
500 SF112 SF/LF = 41.7 LF Trench Length
Therefore: Construct An Absorption Trench 42' in Length by 3' Wide With 6' of Drainfield
Rock Beneath the Distribution Lateral. Distribution Lateral to Be Placed 4' Below Existing
Ground. Total Depth of Trench to Be 10' from Existing Surface. Mound Over Trench if
Necessary to Provide Minimum Cover of 3'.
3'6"
6"
6'
Natural
Backfill
eotextile Fabric
" PVC
rainfield Rock
NOTE:
3'
30 Orifices
3/8" Diameter
1.5' Spacing
TYPICAL DEEP TRENCH SECTION
(NO SCALE) �7y%�.,% = .14 Q A g
NOTE: Grade Area Over Trench to Drain Away.
Minimum 6' Separation From Bedrock.
Minimum 10' Separation From Lot Line.
Minimum 4' Separation From Groundwater.
Minimum 100' Separation From Well on Lot.
F A4 14
i•L j • . �� .•.T
I - MICHAEL E. ANDEMN44
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0� Jam. CE -4331 .���o
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Municipality of Anchorage . '.'%'V,.; . . ..............
Department of Health 8 Human Services i n'. M:aaEL E. ANDERSCN 4 r
825 L Street, Anchorage. AK 99502-0650 E` i '. CE - 4321
SOILS LOG -PERCOLATION TEST dQifgFO., `t�'`�,
pROl ESSWt1 w
Performed For. Ca Win Hoanard Date Performed: &2WMI%"O�
Legal Description: 1 nt 43 Section 33. T12N. R3W
SLOPE SITE PLAN
1
4
17
18
GP
Cobbles '
with
Sand South
Was Groundwater
Encountered? No
If Yes. What Depth?
Bottom of Depth to Water
Hole After Monitoring None
Date: 911101
Pere. Rale: 1 MinAnch Perc. Hole Diameter. 8'
21 Test Run Between 4 FL and 5 FL
Comments: Testhole Presoaked Prior to Percolation Test
Performed By: Mike Anderson. I. Michael F. Anderson Certify That This Test Was Performed
In Accordance With All State and Municipal Guidelines In Effect On This Date: 914101
Municipality of Anchorage
Department of Health & Human Services
825 L Street, Anchorage, AK 99502-0650
SOILS LOG -PERCOLATION TEST
Performed For. Calvin Honaard Date Performed:
Legal Description: lot 33. Section 33. T12N R3W
SI APF SITE PIAN
1
South
See Site Plan
0
3
7
TESTHOLE NO.6A
4
5
6
SW
Well
7
Graded
Sand
11
21
r.k.' x:9111
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f s' •• A';CHAEL E. ANDERSON: "!TO
CE -4381
1It ,ROFESSNI�
822101 4L��`a�'o
North
South
See Site Plan
Was Groundwater
Encountered? No
It Yes, What Depth?
Bottom of Depth to Water
Hole After Monitoring None
Date: 911101
Perc. Rate: 3 MinAnch Perc. Hole Diameter. 8•
Test Run Between 4 FL and 5 FL
Comments: Teslhole Presoaked Prior to Percolation Test
Performed By, Mike Anderson, 1, Michael E. Anderson Certify That This Test Was Performed
In Accordance With All Stale and Municipal Guidelines In Effect On This Date: 914101
0
:V-7.0 KOM
Perc. Rate: 3 MinAnch Perc. Hole Diameter. 8•
Test Run Between 4 FL and 5 FL
Comments: Teslhole Presoaked Prior to Percolation Test
Performed By, Mike Anderson, 1, Michael E. Anderson Certify That This Test Was Performed
In Accordance With All Stale and Municipal Guidelines In Effect On This Date: 914101
Municipality of Anchorage
Department of Health 8 Human Services
825 L Street, Anchorage, AK 99502-0650
SOILS LOG - PERCOLATION TEST
Performed For. Calvin Hoonard Date PerfermCd:
Legal Description: Lot 33. Section 33. T12N. R3W
SLOPE SITE PLAN
6 SM
with Coarse
7 Gravel
South
8
Cobbles Was Groundwater
9 with Sand. Encountered? No
If Yes, What Depth?
10 Depth to Water
After Monitoring None
.11H -
Date: 911101
12
13
14
SW
r.®
with Silt
15
16
Bottom of
Hole
17
18
21
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or
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OrA M.ICIiP:t E. ANDERSON • V ✓i:. CE' 4331 : via
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822/01 � C G l � r eS %%%-
Immm=
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Perc. Rale: 1 MinAnch Perc. Hole Diameter. 8'
Test Run Between 4 FL and 5 FL
Comments: Testhole Presoaked Prior to Percolation Test
Performed By: Mike Anderson. I, Michael F. Anderson Certify That This Test Was Performed
In Accordance With All Stale and Municipal Guidelines In Effect On This Date: 914101
PRESSURE DISTRIBUTION
CALCULATION
Elevation at Highest Discharge Point
316'
Pressure at Highest Discharge Point
5' Head
Liquid Level in Tank (Elevation)
306'
Diameter of Holes in Distribution Line
.1875" (318")
Diameter of Distribution Line
"
Hole Spacing in Distribution Line
Length of Transport Line
60'
Diameter of Transport Line
1.5"
Q=12.4c1;r = 12.4(.1875)(.1875)
..9748 GPM/Orifice
:9748.30
= 29.2 GPM e
�b
TDH = (321-306) + .0192(29.2)(29.2) + .000995(29.2) (60)
(1.551—
= 15 + 16.4 + 4.25
35.65
Therefore 30 Orifices @ 1.5' Spacing
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NET DISCHARGE, GPM
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ORENCOSYSTEMS, INC t
2826COLONIALROAD ROSEBURG,OR97470 (503)6730165
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NET DISCHARGE, GPM
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ORENCOSYSTEMS, INC t
2826COLONIALROAD ROSEBURG,OR97470 (503)6730165
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 1, HOGGARD SUBDIVISION
GENERAL:
1. The scope of this project includes the procurement and placement of a
new 1,500 -gallon combination septic tank and lift station and pressure
distribution system. Work also includes the construction of a 42' long x
3' wide x 6' effective depth absorption trench at the location shown on
the attached Site Plan. The new trench distribution piping shall be
constructed 4' below existing ground level for a total trench depth of
10'. Direct bury insulation may be required to provide the minimum
coverage required over the new trench. In lieu of insulation 3' of cover
may be placed atop geotextile fabric over the new trenches.
2. Construction shall be in accordance with the approved site plan,
design drawings, Municipal Permit with any special provisions or
conditions, and all applicable State and Municipal Wastewater
Disposal Regulations.
3. 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.
4. 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.
5. 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/LIFT STATION INSTALLATION
1. The 1,500 -gallon septic tank/lift station must be constructed by
certified tank manufacturer. Construction shall include an 18" manhole
to provide access to the lift station.
2. The septic tank shall be sufficiently bedded to prevent settling or
shifting of the tank.
3. All standpipes on the septic tank shall extend a minimum of 12 inches
above final grade.
4. Tanks installed without 4' of cover shall have a minimum of 2" of direct
burial insulation.
5. A foundation cleanout shall be installed one to four feet from the
building foundation. Two cleanouts are required between the tank and
the drain field.
Lot 1, Hoggard
September 8, 2001 .
Page 2 of 3
6. Final grading over the tank shall be such that a positive slope exists
away from the septic tank.
DRAIN FIELD CONSTRUCTION: '
The drain field shall be constructed to the dimensions shown on the
design. The bottom of the trenches shall be within 2" of level.
2. Distribution piping must be placed level with perforations down atop a
level bed of drain field rock. Rock should then be placed over the pipe
to provide a minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the drain field
rock and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations
shown on the design. The portion below ground must be perforated.
5. Contractor shall verify the septic tank and drain field 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.
6. Direct bury insulation must be placed over the distribution system if
less than V of backfill depth is available. Finish grade over the trench
must be mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trenches to drain away.
8. A minimum 2' of accepting soil is required below the drain field 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. The lift station must be constructed by a municipally approved septic
tank manufacturer. An Orenco 20 OSI 05 HHF-5 pump is
recommended.
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).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene
(Dow Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Femco, or equal).
Lot 1, Hoggard
September 8, 2001
Page 3 of 3
5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed
between the final drain 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 backfilled.
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.
Muticipality of Anchorage
Development Services Department
Building Safety Division
Onsite Water and Wastewater Program
4700 South Bragaw St. .
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 018-182.25 HAA# 05D301
Expiration Date: / D —a 5--06'
1. GENERAL INFORMATION
Complete legal description Lot 1 Hortaard Subdivision
- - Location (site address or directions) --4088 E. 142nd Avenue - - - --
Current Property owner(s) Calvin Hopaard Day phone 3451657
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
4088 E. 142nd Avenue Anchorage AK 99516
Unless otherwise requested, HAA wr71 be held by DSD for pickup.
2. NUMBER OF BEDROOMS
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
Four 4
Day phone
Day phone
TYPE OF WASTEWATER DISPOSAL:
®
Individual On-site
ED
❑
Individual Holding tank
❑
❑
Community On-site
❑
❑
Public Sewer
❑ .
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority 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 HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with
valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water
system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's
work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-
site water supply and/or wastewater disposal system Is(are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is(are) In compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm _Anderson Enaineerina Phone 522.7773
Address P.O. Box 240773 Anchorage. AK 99524
Engineer's Printed Name _Michael E. Anderson, P.E.Date 7/11/2005
NtpNEL L NGUSM
5. DSD SIGNATURE
Approved for "t' bedrooms. .
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
X Maintenance Agreements
Supplemental Engineer's Report
Other _
By: a 4 It/. �c'^f /( Original Certificate Date: :7
(Rev 12W)
Municipality of Anchorage •�,
Development Services Department
Building Safety Division `
On -Site Water & Wastewater Program
4700 South Bragaw SL
P.O. Box 196650 Anchorage, AK 99519-6(150
www.d.andwrage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Lot 1. Hoeeard Subdivision Parcel ID: 016.18245 s 5�
A. WELL DATA
Well type otaft If A. B, or C provide PWSID # _ Well Log (YIN) Y
Date completed ]SM Sanitary seal (Y/N) Y Wires property protected (YIN) Y
Total depth 142 R Cased to 142 ft. Casing height (above ground) 24 n.
FROM WELL LOG AT INSPECTION
Date of test 11512002 612112005
Static water level 74 ft. 75.6 it
Well production 7 g.p.m. 4.6 9 -
p.m -WATER SAMPLE RESULTS:
Coliform _J_colonies/100 ml. Nitrate _ML mg./I. Other bacteria _L colonies/100 ml.
Date of sample: 6/13/2005 Collected by. AH
B. SEPTICIHOLDING TANK DATA
Tank Type/Materiel SW6dSTEP Data installed 12131!001
Tank size 1.100 _ gat. Number of Compartments Cleanout (YM) Y
Foundation cleanout (YIN).Y Depression over tank (YIN) II High water alarm (Y/N) N
Date of pumping 6117@005 Pumper Isaac's
C. ABSORPTION FIELD DATA
Date installed 1214!2001 Soll rating (g.p.d./flr or fe/bdrrn)1.2 6 System type D"D Trench
Length 42 fL Width ,3 R Gravel below pipe 6 it
Total depth U R Eft. absorption area Mile Monitoring tube Y Depression over field h
Date of adequacy test 611112005 Result (Pass/Fatq PM For I bedrooms
Fluid depth in absorption field before test jj In. Water added= gal. New depths in.
Elapsed Time: IM min. Final fluid depth 22 in. Absorption rate >= 750 g.p.d.
Any rejuvenation treatment (past 12 moa (YIN & type) N If yes, give date
D. LIFT STATION
Date installed 121. MI Size in gallons 250 Manhole/Access (Y/N) Y
'Pump on' level at IQ in. 'Pump or level at !JJ in. High water alarm level at 45 in.
Datum Bottom of Tank Cycles tested 10 Meets alarm & Bradt requirements? Y
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tanklliR station on lot AW On adjacent lots MW
Absorption field on lot >1W On adjacent lots MW
Public sewer main WA Public sewer mantmle/cleamut WA
Sewer /septic service line >25' Holding tank WA
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation W Property line a,E Absorption field W
Water main WA Water service One MW Surface water MW
Wells on adjacent lots MW
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property fine >10' Building foundation >10' Water main >10'
Water Service One >17 Surface water MW Driveway, parkirQNshide storage >2S
Curtain drain None Noted Wells on adjacent lots MW
F. COMMENTS
G. ENGINEER'S CERTIFICATION
1 car* that I have determined through field inweclions and no 49th W '
review of Municpal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
ragMEL L M U RSOr
Engineer's Printed Name MfMaei E Anderson, RE Ro. a-+xr '
Data TH112005
HAA Fee E X30
Date of Payment
Receipt Number 1 07 % �►CC�
(Rev. 12100)
Walver Fee Z
Date of Payment
Receipt Number
2001-132
HOGGARD SUBDIVISION
LOT 1
49,913 S.F.
FINAL STRUCTURE AS -BUILT
GASTALDI LAND SURVEYING
JEFF A. GASTALDI, R.L.S.
4726 WEST 66TH AVENUE
ANCHORAGE, ALASKA 99502
PHONE 248-5454
GRID DATE
3035 4/2/2002
F.B. JOB NO.
01-17 1 HOGGAROI
1 HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
IT IS THE RESPONSIBILITY OF THE OWNER TO
DETERMINE THE EXISTENCE OF ANY EASEMENTS,
COVENANTS OR RESTRICTIONS WHICH DO NOT
APPEAR ON THE RECORDED SUBDIVISION PLAT.
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
HEREON BE USED FOR CONSTRUCTION OR FOR
ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT, ALASKA
NOTE: NO CORNERS SET THIS DATE.
BUILDING DETAIL
SCALE: 1"=20'
�Ak*
PA ......• AC QS �1
♦'•.
Air• * 649IFi ....640*6 ......... 1
X04.......•+,..
effery A. Ga3,aldl ; I
Ar
LS -6091: • 1
E. 142ND AVENUE
o
M
b
M
N 89057'38"E 150.00'
_'
--------------------3'R.O.W.ESMT.
10' T. & E. ESMT.
Ir
- - - - - - - - - -- -
--
FENCE WX)—.�
"
I
WELL
1
1
® b
� o
,ri O
•'
I
8
I
I
o
I26.0'
8
I
I
Z
I
60.0'
28.0
x
I
EXISTING
I
I
BUILDING
sEvnc VENTS (SEE DETAIQ
1
59.9' ••
a;ic
M O
I
_XI
�I
N
~ I
eLA
-
1 "=40'
1
w�
I
I
�
� �
I
---- ---
---- �--
i� 1007.&I-ES4-
i
N 89058'40"E 215.94'
FINAL STRUCTURE AS -BUILT
GASTALDI LAND SURVEYING
JEFF A. GASTALDI, R.L.S.
4726 WEST 66TH AVENUE
ANCHORAGE, ALASKA 99502
PHONE 248-5454
GRID DATE
3035 4/2/2002
F.B. JOB NO.
01-17 1 HOGGAROI
1 HEREBY CERTIFY THAT I HAVE SURVEYED THE
PROPERTY DEPICTED ABOVE AND THAT NO
ENCROACHMENTS EXIST EXCEPT AS INDICATED.
IT IS THE RESPONSIBILITY OF THE OWNER TO
DETERMINE THE EXISTENCE OF ANY EASEMENTS,
COVENANTS OR RESTRICTIONS WHICH DO NOT
APPEAR ON THE RECORDED SUBDIVISION PLAT.
UNDER NO CIRCUMSTANCES SHOULD ANY DATA
HEREON BE USED FOR CONSTRUCTION OR FOR
ESTABLISHING BOUNDARY OR FENCE LINES.
ANCHORAGE RECORDING DISTRICT, ALASKA
NOTE: NO CORNERS SET THIS DATE.
BUILDING DETAIL
SCALE: 1"=20'
�Ak*
PA ......• AC QS �1
♦'•.
Air• * 649IFi ....640*6 ......... 1
X04.......•+,..
effery A. Ga3,aldl ; I
Ar
LS -6091: • 1
Municipality of Anchorage
%;I'I�
Development Services Department
Building Safety Division
on -Site water and Wastewater Program *AC
4700 South Bmgaw St.
P.O. Box 196550 Anchorage, AK 9951"650
www.cl.anchorage.akus
(907) 343 7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING/
ParcelI.D.•0464950 HAA# Al U 2p��C7
Expiration Date:
1. GENERAL INFORMATION
Complete legal description Lot 1 Hoogard
Subdivision
Location (site address or directions)
E 142`r Avenue off Jerome
Current Property owner(s) Spineil Homes Day phone 344-5678
Mailing address 921D Vanguard
Drive Anchorage AKS9507
Lending agency
Day phone _
Mailing address
Real Estate Agent
Day phone
Mailing Address
Urdess olhenvise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
Four 4
3. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
® Individual On-site
ID
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 Health Authority
Approval (HAA) based only upon the representations given In paragraph 5 by an Independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
Vile (except between spouses) for properties served by a single family on-site wastewater disposal and/or water
supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with
new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with
valid water samples.) Certifkates are valid for one year for properties served by Class A or B wells or a pubic
water system. The Municipality of Anchorage Is not responsible for errors or omissions In the professional
engineer's work.
Municipality of Anchorage ••.,
,• Development Services Department .
B mbv safety orlon .....
On.Site water 6 wastewater Prowam
4700 South Bragew St.
P.O. Boot 1gO M Anchwape. AK 119fi1"M
www.ci.w cMorape.ak.us
(9D7) 943-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
L"al Doyon: Let ,HomardSubdivision Parcel ID: IItm.1t2�9
A. WELL DATA
Wed type $iM! N A. B. or C provide PWSID 0 _ Well Log (YIN) Y
Data completed 1MM sanitary seal (YIN)i Wkes property protected (YM) Y
Total depth _L4-2fL Cased to —g-2& Casing tWQN (above Wound) -�A—in.
FROM WELL LOG AT INSPECTION
Date of fess il5lm
Static water laud 74 - ft 1L
worm production 7 94).m. --- ---- 9p.m.
WATER SAMPLE RESULTS:
Cotlform -2—ooloniesH00 ra. Nitrate 34_rngA• Other bsderia _L colordes/100 m1.
Date of sample: 4r30@Otl2 Collected by: hilts WOO
B. sUMC1HOLDING TANK DATA
Tank TypdMaWW 10065151001 Date installed 1tP 2M
Tank atze UN gd• Number of Ccmpa Ww3ts 3 Cleanout: (YM) Y
Foundation cleanout (YIN) Y Depression ore► tank (YIN) K High water alarm (YM Y
Daae of pumpkV __ Pumper 19
C. ABSORPnON FIELD DATA
Date installed 12/UM Som ratng (g p•dJfV or f6bdrm)12 OPDW SYaiern IYpe .P4!'-' TNfth
Length 47 R width 3 ft. Gravel blow pipe 4 fL
Total depth ?i fL Efl. absorption area 'W4 R' Monitoring tube Y Depression over Add N
Date of adequacy fest Results (Pass/Fag) For _—beft°r"s
Fluid depth In absorption Said before test _ in. Water added_ gd New depth_ In.
Elapsed Time: _ min. Final fluid depth _. in. Absorption rale x Q-P.d•
Any rejuvenation tnnabnent (past 12 mo.) (YIN b type) N 9 yes, gtn date