HomeMy WebLinkAboutKNIK VIEW ESTATES BLK 3 LT 11Knik View
Estates
Block 3
Lot 11
#0§1-043-13
Municipality of Anchorage Page
Department of Health and Human Services
Division of Envir~me~tal Se~ices
On-Sde Se~qces Section 825 9.' Sb'eet Room 502
P.O. Box 196650 A~chorage, AK 99519-6650
www.ct.anchorage.ak.us (907) 343-4744
ON-SITE WASlEWATER DISPOSAL SYSTEM AND/OR WELL INSPECllON REPORT
Permit Number: SW010481 PlO Number: 051-043-13
Spinell Homes, Inc. WastewaterSystem: New
9210 Vanguard Drive, AK 99507 ABSORPIION FIELD
,,~,: N~,~, a ~ 5' Wide Shallow Trench
344-5678 Four (4)
LEGAL DESCRIPTION
3 1! Knik View Estates
1 n. 51
Wolh Community Water 5 n. 3.
Class A n.I F~ 53.0 F? ASTM D3034 PVC
I
,. Spinell Homes 3./12-15/02
¥'" c.-,, I~""'s~''F,. ic..,,~, ,~,,~.,,G,,~,~:,, TANK
SEPARATION DISTANCES El Septic n Holding FI S.T.E.P. FI Other,
Sepllc Absorption Uft Holding ~ltc/Pdvate ~.
Tar~ Field Station Tank S~,~U,. Anchorage Tank 3.,250
,,,, >200' >200' N/A N/A >25' Steel Two (2)
~'~*" >3.00'>5, >100'>10, N/Agi/Agi/Agi/A / ,.,. LIFT~STAIION,~.,~,~.. - NONE ON LOT
F,.~.~., >5' >3.0' N/A N/A
o~.~,-,None Noted
"'~"~: BENCH MARK
Top o! Foundation Wall - Finished Floor.
J.00.0
Engineer's Shamp
Inspections peaormed by:. Tim Kimbrough Dates: 'm" 1/12/02 - / 49th ~
3./3.5/02
Department of Health and Human S?~,rvicgs approval
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
Page 2 of 3
Permit Number SW010481
PID No. 051~43-13
'W
Z
~ A B
IS1 17.1 32.2
S2 24.4 36.5
C4 44.0 35.3
M1 36.2 43.5
M2 83.9 82.2
C5 86.9 84.5
C5
~ltern~
Site
~H2
/~,0 t,90,00 N
M1
Fou=
Bedroom
Ho~e
KNIK VIE-W ESTATES
LOT 1 1, BLOCK
40.025 S.F.
PLAN AS-BUILT
SCALE 1" = 4~'
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. SW010481
_Fr ~oo.oo ,--9~.4
Page 3 of 3
PID No. 051-043-13
O~
51.0'
Municipality of Anchorage ~~r ...............
Department of Health & Human Services
825 L Street, Anchorage, AK 99502-0650 ~, %.. C~ - ~.:~]
SOILS LOG - PERCOLATION TEST ~'~'.~:,~'.. - .."~,?,~"
Performed For: Spinell Homes Date Performed:
Legal Description: Lot 11. Brock 3. Knik View Estates Subdivision
11
12
13
14
15
16
17
21
OGIOL
Loose Well
Graded
Gravel with
Sand
GW
;LOPE SITE PLAN
North
South
No
See Site Plan
Bottom of
Hole
Was Groundwater
Encountered?
If Yes, What Depth?
Depth to Water
After Monitoring
Date:
S
L
O
P
E
Reading Date Gross Net Depth To Net
Time ,Time ~ater Drop
15-Jan 10:20 1'
10:30 5 Dry 8"
10:31 1.25'
10:41 5 Dry 7.75"
10:42 1'
10:52 5 Dry 8"
Perc. Rate: <1 MinJInch Perc. Hole Diameter. 6'
Test Run Between 7 Ft. and 8 Ft.
Comments: Te~t Cavity was Presoaked Prior to Test. More than 50% of Material Passes No. 4 Sieve.
Performed By: Tim Kimbrough. I, ~ Certify That This Test Was Performed
In Accordance With All State and Municipal Guidelines In Effect On This Date: 4/2?/02
ANDERSON ENGINEERING
P.O. BOX 240775
ANCHORAGE, AK 99524
522-7773 522-6779 (FAX)
MEMORANDUM
DATE:
TO:
FROM:
SUBJECT:
Apd123,2002
Jeff Poet
Mike Andemon, P.E./t~'~
Lot 11, Block 3, Knik View Estates Subdivision
Septic System As-Built
Certificate of Health Authority Approval
The absorption trench constructed on Lot 11, Block 3, Knik View Estates Subdivision
runs from west to east rather than from north to south as shown on the design. The lot
is fairly fiat in the area of the new trench and once clearing of the lot was completed it
became apparent the best location for the trench was in its current alignment. A third
test hole was placed to verify the soil conditions near the east end of the new trench.
A copy of the log is included for your review.
The inspector for the construction of this septic system was new to the inspection of
systems constructed under a Municipal permit. He was uncertain of the requirements
to call in inspections prior to their performance apparently did not call in the inspections
for this system as no record exists with the Municipality.. He is now fully aware of this
requirement and has completed the task several times in the past three months, we
apologize for any inconvenience this may have caused the City.
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water& Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Date Issued: Dec 06, 2001
Expiration Date: Dec 06, 2002
Pen'nit Number: SW010481
Legal Description: KNIKVIEW ESTATES BLK 3 LT 11
Design Engineer: 0014 Anderson Engineering
Owner Name: Spinell Homes, Inc.
Owner Address: 95910 Vanguard Dr.
Anchorage, AK 99507-
Parcel ID: 051-043-13
Site Address: 021942 REBECCA CIR
Lot Size: 40025 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] Septic Tank [] Holding Tank [] Privy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. Ail requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/VVELL PERMIT APPLICATION
· FOR A SINGLE FAMILY DWELLING
Parcel I.D.
Permit Number ~
Property owner(s) Spine, Homes, Inc.
Mailing address (1) 9510 Vanguard Drive Anchora.qe, AK 99507
Mailing address (2) Zip Code
Legal description (Lot, Block & Sub'd.) ' Lot tl, Block 3, Knik V~ew Estates Subdivision
Legal description (Section. Township & Range)
Lot Size 40~t31 SF Acres/Sq. Ft. Number of Bedrooms Four
THIS APPUCATION IS FOR:
Sewer Only
Sewer and Well
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub
Swimming Pool
Therapy Pool
Day phone 344-5678
Well Only
Water Storage
Jacuzzi
Water Softening Unit
I certify that the above information is correct. I further cedify 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)
Pem~it 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
522-7773 522-6779 (FAX),
November 27, 2001
Municipality of Anchorage
Development Services Department
On-Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject:
Lot 11, Block 3, Knik View Estates Subdivision
Septic System Design and Permit Application
Iml~acts to Adjacent Properties
Dear Onsite Services Engineer,
The owner of Lot 11, Block 3. Knik View Estates Subdivision Intends to construct a new
four-bedroom home on the lot. We are therefore requesting a permit be issued for the
construction of a new septic system to serve the proposed home. The attached Site
Plan and backup documentation identify the Ioc.ation and configuration of the new
septic system and the parameters used In the design. Also identified on the plans are
the location of the water service line on the lot and the test hole locations. Existing
drainage patterns are shown and will not be altered by the development of the lot. The
subdivision Is currently served by a community water system so no conflicts exist with
wells in the area.
Two test holes were placed near the location of the proposed absorption trench. These
test holes indicate clean well-graded gravel with varying amounts of sand near the
location of the new absorption trench. Percolation tests in the material resulted in rates
of less than 1 minute per inch. The majority of the material in the hole will pass the No.
4 Sieve so no sand liner is necessary. No groundwater was found dudng the placement
of the test holes and none was noted dudng the monitoring pedod. We are therefore
proposing to place a 5' wide shallow absorption trench system with 4' of gravel beneath
the distribution pipe. The total depth of the trench will be 7'. The distribution pipe will
be placed at 3' below the ground surface to provide sufficient drop from the septic tank
to the absorption trench. The total length of the new absorption trench will be 50'.
The ground surface on the lot slopes as shown on the attached Site Plan with very little
to no slope near the. proposed septic system site. Th.e. new absorption t. rench will be
constructed on a fa~dy fiat surface In conformance with Municipal requirements and
para e to ground contou.rs where possible. All components of the new septic system
will be constructed a mimmum of 10' from the water service line to be constructed on
the lot.
If the system is constructed in accordance with our design the following statements
apply:
Lot 11, Block 3, Knlk View Est. Subdivision
November 26, 2001
Page Two
2.
3.
4.
The system, if constructed as designed, will have no adverse impact on the wells
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.
Michael E. Anderson, P.E.
Attachments
JUDD Circle
2I
22
175.00
/
/
/
/
/
25
I
I
I
I
I
I
w I0.
,/.
PROJECT
/ 8
/' 7
/
.E -43C!
159 91
S89'56'58'£
10' T. & E.
REBECCA
CIRCLE
86-113
KNIK VIEW ESTATES'
LOT 11, BLOCK ,3 ..
40,025 $,F,
N gO"OO'OO"E
,Lona X 5' Wide
Effective Depr~z
Absorption Trench
Four
Bedroom
SITE PLAN
SCALE 1" = 40'
LOT
~te
Site /
Z
RE
LOT 11, BLOCK 3, KNIK VIEW ESTATES
SUBDIVISION
DESIGN FACTORS:
Four Bedroom Home
Perc. Rate: <1 MinJ1nch
Application Rate: 1~. GPDISF
SYSTEM REQUIREMENTS:
5' wide Trench System
1,500 Gallon Septic Tank
4' Drainfield Rock
4 Bedroom~ X 150 GPD J 1~. GPD/SF = 500 SF of Absorption Ama
500 SFI5 LF (Width)°.5 (Red. Factor) = 50 LF Trench Length
Therefore: Construct a 50' Long X 5' wide X 4' Effective Depth Absorption Trench.
Flowline Elevation in Trench to be 3' Below Original Ground Surface. Total ?,epth to be 7'
Below Existing Ground. Mound Over Trench to Provide a Minimum of 3 of Cover or
Provide 2" of Direct Bury Insulation and 2' of Cover.
e. Fabric .
· PVC (liol~"s ·Down)
!iel~ 'Ro6k'. -'
NOTE:
TYPICAL WIDE TRENCH SECTION
(NO SCALE).
Grade Area Over Trench to Drain Away. '
Minimum 6' Separation From Bedrock.
Minimum 4' Separation From Groundwater.
Minimum 10' Separation From Water Service Line.
2--
3
L,
5
7
8
9
PROJECT #: VDt33
PERFORMED FOR:
Municipality of Anchorage
Development Sen/ices Department/Building Safety Division
Onsite Water and Wastewater Program
4700 South Bragaw Street Anch., AK 99519
SOILS LOG -PERCOLATION TEST
II
SPINNEL HOMES
LEGAL DESCRIPTION: LOT 11, BLK 3, KNIK VIEW ESTATES SUBD
TEST HOLE # t
REDISH BROWN
SILTY OL
LOOSE WELL GRADED GRAVELS
WITH SANDS - GW
DATE PERFORMED:
11-01-01
18.
SW LENSE
LOOSE WELL GRAOED GRAVELS
WITH SANDS- GW
SLOPE
0
SITE PLAN
SW LENSE
WAS GROUNDWATER
ENCOUNTERED?
IF YES, WHAT DEPTH? _
DEPTH OF WATER,
J~FTER MONITORING:
DATE:
NO S
L
0
P
None E
11110101
SLIGHTLY EOHPAETED
GROSS NET TiME DEPTH OF NET DROP
READING DATE TIME CHIN) WATER (INCHES)
Start 11-01-01 g 20 12'
I 9.23 3 12"
Recharge 9,23 12"
2 9 26 3 12"
Recharge 9 26 12"
3 9 29 3 12"
SANDY GRAVELS
GP
BOH
PERC RATE: < 1 MIN./INCH PERC. HOLE DIAMETER: 6' ,
'[EST RUN BETWEEN ] S FT. AND /. S FT.
COHMENTS:
HOLE PRESOAKED I NO IMP[RMABI, ES ENCOUNTER[O
TEST PERFORMED BY: T.L. KIMBROUGH
l, MICHAEL E. ANDERSON, CERTIFY THAT THIS TEST WAS PERFORtIED IN ACCORDANCE
WITH ALL STATE AND J'tUNIClPAL GUIDELINES ON THIS DATE:
I
2
3
5
6
7
8--
II
PROJECT #: VDt33
PERFORMED FOR:
Municipality of Anchorage
Development Sen, ices Department/Building Safety Division
Onsite Water and Wastewater Program
4700 South Bragaw Straet Anch.. AK 99519
SOILS LOG - PERCOLATION TEST
SPINNEL HOMES
LEGAL DESCRIPTION:
TEST HOLE
REDISN DROWN
SILTY OL
WELL GRADED
SANDS - SW
DATE PERFORMED:
11-01-01
18,
COMPACTED
SANDY GRAVELS
LOTtl, BIK3, KNIKVIEWESTATESSUBO
2 SLOPE
O%
., 5%/
WAS GROUNDWATER
ENCOUNTERED? NO
IF YES, WHAT DEPTH';'
DEPTH OF WATER
AFTER MONITORING:
DATE:
None
~1~o/o~
SITE PLAN
S
L
O
P
E
'~
B0H
GROSS NET TIME DEPTH OF NET DROP
READING DATE TIME (MIN) WATER (INCHES)
Start 11-01-01 9,&O 12'
I 9 t,S 1S 3.25'
Recharge 9 &S 12'
2 10 O0 15
Recharge 10 15 12"
3 10.30 15 '/.375"
PERC RATE: 2 03 MIN./INCH PERC. HOLE DIAMETER: 6'
TEST RUN BETWEEN 3 5 FT. AND & 5 FT.
COMMENTS:
HOLE PRESOAKED / NO IMP[RMA~LES ENCOUNTERED
TEST PERFORt-IED BY: T.L. KIMBI~OUGH
I. MICHAEL E. ANDE~ON, CERTIFY THAT THIS TEST WAS PERFOEMED IN ACCORDANCC
WITH ALL STATE AND MUNICIPAL GUIDELINES ON THIS DATE:
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
· SUBJECT: LOT 11, BLOCK 3, KNIK VIEW ESTATES SUBDIVISION
GENERAL:
1. The scope of this project includes the procurement and placement of a
new 1,250 gallon septic tank at the location shown on the Site Plan.
Work also includes the construction of a new 50' long X 5' wide X 4'
effective depth absorption trench at the location also shown on the
Site Plan. The distribution line in the trench will be placed at 3' below
the existing ground surface. Total depth of the trench will be 7' below
the existing ground surface. The new absorption trench must be
placed a minimum of 10' from the water service line on the lot.
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 c~)ntractor 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 insta at OhS. Owners installing their own syste.ms must receive
prior approval from D.H.H.S. before beginning system ,nsta ation~
SEPTIC TANK INSTALLATION
.1. A new 1,2,5.0-gallon septic tank must be procured from an approved
source and ,nstalled at the location shown.
......... 2~'"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,
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.
Lot 11, Block 3, Knik View Est. Subdivision
November 26, 2001
Page 2 of 3
7. Final grading over the tank shall be such that a positive slope exists
away from the septic tank.
'DRAINFIELD CONSTRUCTION:
1. The drainfield shall be constructed to the dimensions shown on the
design. The bottom of the trench shall be within 2" of level.
2. Distdbut on piping must be placed leve with perforations down atop a
level bed of drainfield rock. Rock shou d 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 drainfield.
rock and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations
shown on the design. The podion below ground must be perforated.
5. Contractor shall verify the septic tank and drainfield are a minimum
100' away from any pdvate water wells in the area, 150' from a Class
'C" Well or 200' from any community well.
6. Direct bu~3, insulation must be placed over the distribution system if
less than of backfill depth is available. Finish gr.ade over the trench
must be mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trench to drain away.
8. A minimum 2' of accepting soil is required below the drainfield rock for
a 5' wide trench. Contractor shall vedfy this condition pdor 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 ma[~ufacturer.
2..'rhe following pipe materials are approved for use in septic sy.stem
installations in the Municipality of Anchorage: '
Cast Iron (perforated and so d), ASTM D3034 or P.V.C. (perforated
and solid), ASTM F810 or H.D.P.E. (perforated, but not sold) and
ASTM D2662 or A.B.S. (perforated and solid).
3. Insuiation 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 11, Block 3, Knik View Est. Subdivision
November 26, 2001
Page 3 of 3
5. A permeable geotext e 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 inspectior~s. 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 fabdc, 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.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 (FAX)
MEMORANDUM
DATE:
December 5, 2001
TO: Dan Roth
FROM: Mike Anderson, P.E.
SUBJECT: Lot 11, Block 3, Knik View Estates Subdivision
Septic System Construction Permit
A dimension has been added indicating the distance between the new house and the
proposed absorption trench. I have also added the water monitoring results and
changed the information on Test Hole No. I to indicate the percolation rate is less than
1 minute per inch. All of your comments from our initial submittal have been addressed.
We are hopeful the septic system construction permit can now be issued.
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
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 0~; 1-04;~-1 3
1. GENERAL INFORMATION
HAA# ('~C) C~''~'~
Expiration Date: ~ -./? '- (~ '_5r'''
Complete legal description Knik View Estates: Block 3: Lot 11
Location (sit, e address or directions) 21 94;) Rebecca Circle: Chugiak.. AK 99-=;67
Curr~nt PrbPe'rty owner(s) Randy Rose Dayphone 688-7673
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
Day phone .....................
Les Raile.~- Prudential Vista Day phone 689-R464
166:~5 Centerfield Drive= Eagle River~ AK -q9~;77
· .. Unles's otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class
Public Water System
Well
TYPE OF WASTEWATER DISPOSAL:
[] Individual On-site
[] 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 4 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. (Cedificates 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.
Lega, I ,Descir~
WELL DATA
Well type c
Date" (~ompl~ted
Total depth"
Dar 0f test ~
Sta{ic'wate~: level
Well ProduCtion
Municiphlity of Anchorage
Development SerVices Department . :~
; ' , ~ !Build!nY Safety Division : ·
· ' :On-Sit6 Water[& Wastewater ,,,uOrk"ram- ' " ~ :i..!
~* " ~:i;4700',South Bragaw St. ~ ·
'~ P.O? Box!~96650~ Anchorage, AK3 99519-6650' ' ii. ' :·
HEALTH A~THORI'I'Y APPROVAL CHECKLIST ii
)tion-' Knik'view Es~t~te-~' Block 3. LOt 11 ; "'l~a ,,el ID:
WATER SAMPLE RESULTS:
Coliform
~ , , :..'~
Arsenic:
FROM WELL;LOG
:. ~'i ;;' .* ': . , ~' : :i'*!. :
,. g.p.
051-043-13
Wires properly ~ i-stected (Y/N)
i'i' . :CaSing heigh, t (above ground)
i~,,, AT INSPECTION . ;i
'~ :: ? g.p.m.
!!? SEP, TICIHOLDING TANK' DATA
[!i Tani< Type/Material Septic/steel t i" ,~L!",
' '
I!; i ! : ':.;i,i,, ': .' :,.:1 ' ,,, ~1~*,'ii,,,i ' "~ ~ ~'"' Cle~nouts' '~' :' "" ' i' .
Tank size '=; 1;)50 . gal:, :',~ ,;; Number,0fiCom[ ~men~
Fou darien cleanout
Date of pu~Ping
1' * ' '~ .... "~ '.~ ..... : [ [' " '~ ,, '
ABSORPTION FIELD DATA .... ,~ , ,,, . ,1,, : ,
, ~ ' ' ' ',L~:;"",~,'': { ~r .I i ;; .~ *:i."''. I I ~;~' · -' .1. t' ~" ;i ' ~'i'''~ '
Dat~ installed O1/ls/O~',,';~: :;. S0il f ~tih~ i/{g.~.d./~o~r:~/bdrm)~Ys n type Trench
~. i .... , ,..... .... . ., .......
Len'nth
lot~l denth' ~0 ~ E~ abso~tion aroa 5~0'It~ Momtonn~ tubeCX: Depross~on ~ ~rf[eld ~ ·
[:~ Date of adequacy test; 2/Z/04' "~ :: ': ':' Resul,,~ (Pass(Fad) .Pass: ..
F0rr4 bedrooms
~ Fluid depth, inabsorpti0n:'field'beo~ete~(~[n.:.~:~ .:;Wfi~r,,Added640 ~ ga!.: ' ~.. New depth 10 in.
~"~ ' ~ · ~;:~i,'~* .'~' 't" ," ~' ' : ~ ". ~' ~:~ ' :~".,' :. , ,
Cl.k.ga Ti~. q~ rain :i' :',:. ,,: 'Final fluid deDth~in;' '~ ,, ~{ ',,: ' ~Absorpbon rate ,, >=600 g.p.d.
[,, .... . ,~:.: , : . ~ ...... 1,, ~,,,,~ _ ,~,~. , ,,,.,, ~: ,, ~...I.,, , _.
An~ rejuvenat on treatment (past ,12 mo:) ~/N'& type) N ;~;:~' ..... :', ~ , ~1~ yes,,: gwe cam _
~": : , ; ' i:' ~, ~, ~: :' [ ~ ~ ~ , ''r ! ' ;' ' ''~ -: ': ' IF ':' -
" ' ' ~ ' , · ' ; : ~ . ~1 '
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
CERTIFICATE OF' HF_.ALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051-043-13
Expiration Date: /7~ -,,~. ~ 0 3
1. GENERAL INFORMATION
Complete legal description Lot 11~ Block 3, Knik View Estates Subdivision
Location (site address or directions) Rebecca Circle
Current Property owner(s) Spinell Homes
Mailing address 9210 Van.quard Drive
Lending agency
Day phone 344-5678
Anchoraqe, AK 99507
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested. HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: Four(4)
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class _.A Well
Public Water System
TYPE OF WASTEWATER DISPOSAL:
Individual On-site ~
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.
Legal Desoript~:
A. WELL DATA
We~ brae 6
Date comp(eted
Total depth
Municipality of Anchorage
Development Services Department
Building Safety DK-ision
On-Site Water & Wastewater Program
4700 Sou~ Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.d.anchomge, ak.us
HEALTH AUTHORITY APPROVAL CHECKLIST
Parce~ ID: 051.043-t3
Lot tl, Block 3, Knlk View
Jrt.
ff A, B, or C provide PWSID #
Sandy se~
Cased to. tl.
FROM WELL LOG
weu Log (Y~N)
W~es prope~y protected (Y~N),
Casing height (above pound)
AT INSPECTION
Date of test '
Static water level
Wdt pmduc~on
WATER SAMPLE RESULTS:
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material $eptlr. JSteet
Tank size ti250 gal.
Date of pumping
C. AB~ORP"r]ON FIELD DATA
Date installed 1/1~2002
Tom depm ~0 11.
Date of adequacy test
ft.
g.p.m.
g.p.m.
celonies/lO0 mi.
Nitrate ~ mgJI.
Callected by:
New depth
Number of C~mpartments 2_
Depression aver tank fi/N)
Pumper New Construction
Date installed
Cleanouts (Y/N) Y
High wator alam (Y/N) N
Fluid depth in absorption field before test , in. Water added gal.
Elapsed Time: min. Final fluid depth in. Absorption rate >=
Any rejuvermtion treatment (past 12 mo.) (Y/N & type) N
Soflrating (g.p,d./fl2or~/bdrm)t.2GPO/Sl~. System type 5'WideShallowTrench
ff. Width $ fl. Gravel below pipe 4 11.
Eft. absorpUon area 510 · Monit~ing tube Y Depression over field N_
Results (Pass/Fail) For bedrooms
in.
ffyes, give date
g.p.d.