HomeMy WebLinkAboutDEARMOUN #2 BLK 2 LT 2I)eArmoun #2
Block 2
Lot 2
#018-401-31
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11PARCEL NUMBER:OSP2436 RECORD DRAWING 018-401-31
NOTE: PIPE LOCATIONS ARE
SHOWN PER GEG SHOTS
TAKEN WITH LEICA DISTO
S910 LASER DISTANCE
METER. SWING -TIES TO
HOUSE CORNERS WERE
GENERATED IN Ai TOCAD.
1
NEW 1500 -GALLON CONCRETE
STEP TANK WITH PUMPS AND
CONTROLS FOR AEROCELL UNIT -
GROUNDWATER MONITORING
TUBE INSTALLED ON 5/17/24; GW
AT 2.5' BELOW GRADE ON 5/24/24.
DRY TO 2.83' ON 7/23/24--
APPROXIMATE
LOCATION OF
KEYBOX—
�v 0
NEW A400 /
I
AEROCELL UNIT /
/
NEW DRAINFIELD
9
�� �_��. _ ENGINEERING � SALES CONSULTING
3701 E. TUDOR ROAD, SUITE 101 - ANCHORAGE, ALASKA' PHONE (907) 337&179' WEBSITE: www.gamessenglneering.com
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
KEVIN SMYTH 1 907-350-2104 2 OF 3
PROJECT/LEGAL DESCRIPTION:
DRAWN BY:
GENERAL LOCATION
J.L.M.
I�— OF 200PROTECTIVE
r
WELL RADIUS FOR
CONNECTED TO
COMMUNITY WELL
'
APPROXIMATE LOCATION OF
WATER LINE PROFESSIONALLY
LOCATED BY CONTRACTOR
LINE AND INSTALLED
RETAINED BY HOMEOWNER
'
DOUBLE CLEANOUTS
I
�v 0
NEW A400 /
I
AEROCELL UNIT /
/
NEW DRAINFIELD
9
�� �_��. _ ENGINEERING � SALES CONSULTING
3701 E. TUDOR ROAD, SUITE 101 - ANCHORAGE, ALASKA' PHONE (907) 337&179' WEBSITE: www.gamessenglneering.com
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
KEVIN SMYTH 1 907-350-2104 2 OF 3
PROJECT/LEGAL DESCRIPTION:
DRAWN BY:
r
J.L.M.
TYPE OF WORK:
r
GREEN
CONNECTED TO
HOUSE
EXISTING SEWER
LINE AND INSTALLED
AZf
•�
DOUBLE CLEANOUTS
t %>� i/�
.4 •..
(DBL1&DBL2)
4:
`A
EXISTING
g
?j 2 -BEDROOM
'•a •. i,,;. B HOUSE
�v 0
NEW A400 /
I
AEROCELL UNIT /
/
NEW DRAINFIELD
9
�� �_��. _ ENGINEERING � SALES CONSULTING
3701 E. TUDOR ROAD, SUITE 101 - ANCHORAGE, ALASKA' PHONE (907) 337&179' WEBSITE: www.gamessenglneering.com
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
KEVIN SMYTH 1 907-350-2104 2 OF 3
PROJECT/LEGAL DESCRIPTION:
DRAWN BY:
DEARMOUN #2; BLOCK 2, LOT 2
J.L.M.
TYPE OF WORK:
DATE:
RECORD DRAWING OF SEPTIC SYSTEM UPGRADE
8/7/2024
CF
9.f 3.. ...............
I` •; JOf ft A. GMTTgss
♦ L'bE-79 3
LICENSEt11`iO ESs,
#AEGC884 ,��r"•
EEF CSL
INVERT F" OUTLET
INVERT OF 4" INLETKlls
---------------`--------------------------------------- -- ---- `u---- - - - TU ISI 9
PIPE =94.57
TIMER OVERRIDE FLOAT
HIGH WATERT
35" MIN. LEVEL
TIMER ENABLE FLOAT
GOULDS F 51
1500 -GALLON -C O ESA T F T CCS C ETA TANK l
CONCRETEL PROPOSED PUMP TANK FLOAT SETTINGS
III
i
Rs
_YOLUME AT INLET OPERATING 6GALLONS
INLET INVERT
OVERRIDE FLOAT
r
FLOAT LEVELS ARE
FROM BOTTOM
PIPINGMEASUREMENTS ARE WHERE THE FLOAT WIRE ATTACHES"
TO
FLOAT. O A BE NARROW
PERMIT NUMBER:
0 OSP
REmmCORD DRAWING
!D NUMBER:
018-401-31
TCF OF MH1 = 98.72
FINAL D E
TCF OF MH2= 97.95 P1
VP2
97.67-98.48
MH2
A400 POD
46
jk
ot
0 g A
ot
t
B
m U
PER CONTRACTOR, " FINSULATION
�
� `
W
z t� =) 0
Cc
TOFF OF THE T
(NOT SO FCLARITY)F CE
TOP OFT Ti
_
s
d
CL
Lu sa z
w
Z `�
OVERTHE TOFF OF THE TANK
TET -- 95.47
�
�
0
_ <
�-
INLET = 95.48
0- CL
TO DRAINFIELD
was
EEF CSL
INVERT F" OUTLET
INVERT OF 4" INLETKlls
---------------`--------------------------------------- -- ---- `u---- - - - TU ISI 9
PIPE =94.57
TIMER OVERRIDE FLOAT
HIGH WATERT
35" MIN. LEVEL
TIMER ENABLE FLOAT
GOULDS F 51
1500 -GALLON -C O ESA T F T CCS C ETA TANK l
CONCRETEL PROPOSED PUMP TANK FLOAT SETTINGS
III
i
Rs
_YOLUME AT INLET OPERATING 6GALLONS
INLET INVERT
OVERRIDE FLOAT
r
FLOAT LEVELS ARE
FROM BOTTOM
PIPINGMEASUREMENTS ARE WHERE THE FLOAT WIRE ATTACHES"
TO
FLOAT. O A BE NARROW
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 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: OSP241136
Work Type: Septic Upgrade
Tax Code Number: 01840131000
Site Legal Address: DEARMOUN #2 BLK 2 LT 2 G:2935
Site Mailing Address: 3608 MATTHEWS DR, Anchorage
Owner: MURRAY LEZLIE L &
Design Engineer: GARNESS ENGINEERING GROUP LTD
This permit is for the construction of:
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy
Effective Date:
Expiration Date:
Lot Size in Sq Ft
Total Bedrooms:
6/24/2024
6/24/2025
10800
❑ 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 (24/7).
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. Covered, sealed, and heated to prevent freezing
RegeKsd=9y: hCwecs +CU
Issued By:
Date:
Date: 64N f-
2
ON-SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 018-401-31
Property owner(s) KEVIN SMYTH
Mailing address 3608 MATTHEWS DRIVE *ANCHORAGE, AK
Site address 3608 MATTHEWS DRIVE *ANCHORAGE, AK
Day phone 907-350-2104
Legal description (Sub'd., Block & Lot) DEARMOUND #2; BLOCK 2, LOT 2
Legal description (Township, Range & Section)
Lot Size
'Sq. Ft.
Number of Bedrooms 2
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
([9 all that apply)
Absorption Field
0
Initial ❑
Single Family (SF) El
(w/wo ADU)
Septic Tank
El
Upgrade ED
Duplex (D) D
Holding Tank
F-1
RenewalEl
Multiple Dwellings EJ
Privy
El
(SF and/or D)
Private Well
F-1
Water Storage
M
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: Waiver Fees:
Date of Payment: //I/ Z-OZ�„ Date of Payment:
t
Receipt Number: Receipt Number:
Permit No. y Waiver No.
GADevelopment Services\Building SafetyXOn Site Water and Wastewater\FormsXClient FormsTertnit Application.doc
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241136, Deb Wockenfuss, 06/24/24
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241136, Deb Wockenfuss, 06/24/24
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241136, Deb Wockenfuss, 06/24/24
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP241136, Deb Wockenfuss, 06/24/24
MUNICIPALITY OF ANCHORAGE
ADVANCED WASTEWATER TREATMENT SYSTEM
MAINTENANCE AND REPAIR AGREEMENT
THIS MAINTENANCE AND REPAIR AGREEMENT, herein the "AGREEMENT" made and
entered into as of this 9- Q_ Day of ,T 2.(_yt ,e, of 20.Zq-, by and between
_ , herein the "OWNER," and the Municipality of
Anchorage,�
herein the MUNICIPALITY", in accordance with Anchorage Municipal Code
(AMC) 15.65.365. In consideration of the mutual covenants contained herein, the parties to this
Agreement agree as follows:
1. Advanced Wastewater Treatment Systems. The Municipality grants pennission to the
Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS),
described asj:�, c a yt i
located at (legal description)
9 95-16
2. Maintenance, Repairs and Alterations.
(Owner is required to read, understand and initial each section)
K13 Throughout the term of this Agreement, the Owner shall enter into a service agreement
with an AWWTS service and maintenance provider approved by the Municipality or the
manufacturer's representative. The AWWTS shall be maintained in a satisfactory
condition capable of performing as designed and producing treated septic effluent in
accordance with the equipment's approval for operation in flee Municipality.
It shall be the responsibility of the Owner during the term of this Agreement to pay for all
repair(s), maintenance, adjustment(s), replacement costs, and inspection costs. This
includes an annual maintenance fee (typically $400 to $600).
Owner agrees that only maintenance and repair personnel approved by the Municipality
or the manufacturer's representative will inspect and make any necessary maintenance,
repairs or permitted alterations to the system.
(� Owner acknowledges that regular maintenance of an AWWTS reduces the potential
failure of the system, which could include sewage backup and costly repairs or drainfield
replacement.
(rev. 05/18/2018) Page 1 of 3
Owner acknowledges that the Municipality may request records of maintenance and
f, repairs from the manufacturer's representative or maintenance provider.
t'<.T,. -5 Owner acknowledges that the fine for failing to maintain and repair an AWWTS maybe
p, assessed in accordance with AMC 14.60.030.
Owner agrees to grant the Municipality reasonable access to test and inspect the
AWWTS. The Municipality will give at least 24-hour notice.
Owner agrees that any sale or transfer of title of the property will not occur without a new
Certificate of On -Site Systems Approval.
Owner agrees that the AWWTS installation and maintenance requirements as provided
by the AWWTS vendor/installer and approved by the Municipality are the governing
1 guidelines for the construction, maintenance and repair of the Owner's AWWTS.
KPS Owner agrees to maintain remote monitoring of the AWWTS as required by the
AWWTS approval.
3. Term. The term of this Agreement shall begin on the date of approval by the
Municipality to operate the installed system, or upon transfer of title, and shall continue
while the AWWTS is operational or until title is transferred.
4. Nonwaiver. The failure of the Municipality at any time to enforce a provision of this
Agreement shall in no way constitute a waiver of the provisions, nor in any way affect
the validity of the Agreement or any part hereof, or the right of the Municipality
thereafter to enforce every provision hereof.
5. Amendment. This Agreement shall only be amended by authorized representatives of
the Owner and Municipality. Any attempt to amend this agreement by either an
unauthorized representative or unauthorized means shall be void.
6. Jurisdiction: Choice of Law. Any civil action arising from this Agreement shall be
brought in the Superior Court for the Third Judicial District of the State of Alaska at
Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the
parties under this Agreement.
7. Severability. Any provisions of this Agreement decreed invalid by a court of competent
jurisdiction shall not invalidate the remaining provisions of the Agreement.
(rev. 05/18/2018) Page 2 of 3
O�VNE
By: nature) Date: C%
9 V t 1\) .P.,,5•,i`" Y TZ!j (print name)
STATE OF ALASKA }
ss.
THIRD JUDICIAL DISTRICT 1
The foregoing instrument was acknowledged before
20 24, by KP_Vt n �?• S�m�a �
NOT P LA�C_o ALASKA
My Commission expires: AtAo. 13, a02 `
me this ?Aday of J Of,
MUNICIPALITY:
By:� a _(signature)
(print name)
Date: y
Title:
(rev. 05/1812018) Page 3 of 3
Municipality of Anchorage Page of 3
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On -Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: !:5�t)elja0107, PID Number: D1i3 — 4u1 -3f
Nam:
SLJs� 1}grca,rja•rovJ
Wastewater System: ❑ New 9 Upgrade
T o$ (A'%'rr6irG.K Okun ArloN. Ak -IgsN.
ABSORPTION FIELD
Phone
�5 _ (iN
No. of Bedrooms:
p Deep Trench D Shallow Trench ;K Bet ❑ Mound ❑ Other
LEGAL DESCRIPTION
Soil Rating: hffrycATre CATE
Total Depth from original grade:
3.-7q �-' 3.US
4. = GPDrs Ft
Lot: Block: �J Subdivision:
Depth to pipe bottom Irom origiMl grade:
(.ZS •
Gravel depth beneath pipe
L+(►RrN6JN
r :..r ` Ft
0.25 Ft.
Township:
Range:
Section:
Fill added agove original grade:
Gravel length: 1
36
1.7-1 — 1.'3a' Ft
Ft.
WELL: New ❑Upgrade
Gravel width:
Number of lines:
�{
Ddtallcabel whr s
2.5
FYI
Iv1 Ft
Fl.
ClaniI tion (Private. A.S.C): Total Depth: o:
Total absorption area:
Pipe material:
A-610
s..1ss NAB L Ft.
.3 Cz So, Ft.
We% 0 g
Driller.ate Drilled: Static water Levee
Installer.
A+- Sax4icits
Date Installed: �'� •I fy
Ft.
Yield,
Pump Set at: I
Casing Height ADM Ground:
TAN
K
GPM
Ft.
Ft.
SEPARATION
DISTANCES
C3 Septic 0Holding XS.T.E.P.
To
Septic
AbsOW n
Lin
Holding
PvbiiWrWatq
Manufacturer.
ANLrt
Capacity in gallons:
From
Tank
Hale
Station
Tank
$awrLlnw
ALF iAa It
fZSG
WeM2co
I{
Z.-wy 1.
1
Ito t
�t 1
2'�
Material: SYEEf.
Number of Compartments:
�
Surface
tern
11
+
foo v
/(colt
--
—
LIFT STATION
Im
Lot
Line
1
22. }
if 1
2
s
ZZ }
'�I
Size In gallons:
7-ATe
Manufacturer.
AtfemexisCE TM -Y. oxetlfl SYSraxs
Foundation
SZ'-*
Wei
I
52 ±
"Pump on- level at:
`11.,
-Pump otr level at:
1.,
High water alarm At:
aJr.+N
CurtainPump
fid.
a V
:k�>'
Make a Model
•Z✓"i 'N
Electrical Inspections performed by:
M.O%A
Drain
Remarks:
r+ls IS A,
BENCH MARK
Itire 91AIT.T'Arlt 00S.06 S/Arsa f IkrEiL.
Location and Description:
c • o%ci.Aer s-rr- Siff Q
�2. to PSa uJ P(�Sf✓( 6LYH60.
(Ak%t3 OOu., tjlfRnrlt6 -r
E �� SI EVi
Assumed Elevation:
1 oo.a Ft
r
� F/L76i _ M47 L I
l[ov vel)
ENGINEER'S SEAL
OFAl;4t`':
s*%tf
Inspections performed byAbska Water & Wastew. ates:1st 'I o
q s
i 49r
i •••• •' ="'/
Anchorage, Alaska 99504 2n C,' ►o- 16
�'Y: •' •"' •""'
I JAMES P WIUJAMS
g; if
Department of Health and Human Services approval
X111 N c.E08,.•'
Reviewed and approved by: 044 p Date: 7'2 - 9g
AV 0
�+���
��\�PR FESSX451,
72-013 (Rev. "I) MOA 25
`I
PERIMIT NO. AS -BUILT DRAWING PARCEL
I31 I
SW980102
LOT 3. BLOCK 3
DEARMOUN S/D
KEY BOX— lL `
1
APPROXIMATE
LOCATION OF \1
WATER LINES.
ttom�,, ELEVATED
�•1/$ 4INSULATION
TING DR/ SAY W/ 2' COVER. A
NH yTZ s. EXISTING 3
1 1/4' HDPE BDRM HOUS
iL Fco i
NEWLY INSTALLED Mil AIR UNE
1250 GALLON I I ELEVATED
S.T.E.P. TANK.
I I
APPROXIMATE ' NEW O1T0� 5
LOCATION OF
PREVIOUSLY I '
EXISRING TANK. I
I
PREVIOUSLY I � 1
EXISTING TRENCH
(ABANDONED) MT4
MT3 1
NOTES: LOT 1. BLOCK 3
1. THE PREVIOUSLY EXISTING SEPTIC TANK
WAS REMOVED AND HAULED OFF-SITE. THE DEARMOUN S/D
EXCAVATED AREA WAS BACKFILLED WITH SAND.
2. THE SOUTH LOT UNE WAS FLAGGED BY A
REGISTERED LAND SURVEYOR.
DEARMOUN SUBDIVISION /2. LOT 2. BLOCK 2
OF WORK:
AS—BUILT OF SEPTIC SYSTEM UPGRADE
SUSAN HARRINGTON 345-6449
6/23/98 I A.C.G. I 1= 20' I 2 OF 3
r_T
ST1
54.00'155.50'
12
60.25
62.00
MH
61.50
63.30
MT1
39.00
36.00
MT2
46.50
45.00
MT3
64.751
48.00
MT4
70.25
56.00
i
49 ....:
bt.0 . .
,JAMES P. WILLIAMS,--
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PERMIT 02 AS -BUILT DRAWING 018-401 -31 I
SW980102
1R
Mi
NSW 00 Ct&LON
Ulf 5f,�P. 5MM
PROFILE VIEW
W4 mil
PROFILE VIEW
ALASKA WATER & WASTEWATER
9
u. w�.nir,vn:
DEARMOUN SUBDIVISION j12; LOT 2, BLOCK 2, 0 ?.
Y. 4
E OF WORK:
S.T.E.P. TANK DETAIL do BOTTOMLESS SAND FILTER (ISF) DETAIL
PARFD FOR: PNONE NUMBER:
SUSAN HARRINGTON 345-6449
L. DRAWN NY: SCALE: PAGE:
6/24/98 J.I.M. N.T.S. 3 OF 3
:S P. WILUAAA$�
NO -96081
7-01-1998 11.14AM FPZ.1 ARCTIC LIGHTS ELECT 907 34S 5381 p.1
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.1..L17 EAST TWOFi FOAL
L^l PF(rT!^•" 5�,i ?�-';13C lr':4pr`G:i�IJ ;:Ak(907)343-,92J INFt] �Zlj
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tin �.erl;^o��?LlAf:CE r1fs�"R:Ew
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t.'(.•MrpENTS.
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M M01 REMOVE TF'IS NOT•^C
I
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM
PERMIT NUMBER:SW980102
DESIGN ENGINEER:ALASKA WATER & WASTEWATER SERVICES
OWNER NAME:HARRINGTON SUSAN E
OWNER ADDRESS:3608 MATTHEWS DRIVE
ANCHORAGE, AK 99516
PARCEL ID:01840131
LEGAL DESCRIPTION:
DEARMOUN #2 BLK 2 IT 2
LOT SIZE: 10800 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
PAGE 1 OF ^1n .�
cY T :til �.o
Ln -\ —�- lA
(UPGRADE) PERMI-F ,d •. 1I) Pry
S 1Lt�S LO' ok-c�&
DATE ISSUED: 5/08/98 ` nn
EXPIRATION DATE: 5/08/99 J \'Lc)
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
THIS PERMIT IS FOR A BOTTOMLESS INTERMITTANT DOSING SAND
FILTER.
A SYSTEM MAINTENANCE AGREEMENT SHALL BE A PART OF THE
AS -BUILT PACKAGE.
RECEIVED ]
ISSUED BY
DATE: �- g / u
DATE: '� `e,
\ Department of Health and Human Services ��
825 "L" Street
Rick afystrom•
Mayor p.0. Box 1.50 0 Ancacrace, Alaska 99519-6650
•.i:•:v.ri.a❑c❑cr<re.ae.us
907-343.4743
May 8, 1998
Jeffrey Garness, P.E.
Alaska Nater and Wastewater
7320 East Chester Circle
Anchorage, AK 99504
Subject: Waiver Request for De Armoun Subdivision Block 2, Lot 2
Waiver Request #WR980016, PID ""018 40131 Permit rSW980102
Dear. 'LIvIr. Gamess:
Your request for a waiver of the required 10 foot horizontal separation from the
on-site wastewater disposal s-, stem to a property line has been approved. The approved
separation distance is 2.0 feet.
This waiver approval applies to the existing on-site wastewater dispcsai system to
property line separation only. Any future upgrade to the on-site wasteaate: disposal
system will require all separation distances be met or another approval from this
department.
If these are any ; _,he: conce.ns or questions regarding this waiver, please call our office
at 343-4744.
Sincerely, /
T)�7*Z!U:'_C_
Donna C. dears r
Civil Eneineer
On -Site Water Quality Program
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR# WR980016 PID# 018-401-31
Date Received: April 27, 1998
HA#
Legal Description: Lot 2 Block 2 DeArmoun 02
Engineer: Jeff Carness, P.E., Alaska Water S Wastewater
Permit #
7320 East Chester Heights Circle, Anchorage, Alaska 99504
Applicant: Susan Herrington
Waiver Requested: Lot line waiver of the bottomless ISF within 2 feet of the
southern property line
Criteria: 1. Geology: Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2. Special Conditions:
3. Other:
Waiver is Granted: Waiver is NOT Granted:
List Conditions or Reasons for above:
Date:
By:
Name of Reviewer
Rec #: 03584/9415 Amount: $ 115.00 Date Paid: 4-27-98
Alaska Water & Wastewater
7320 East Chester Heights Circle — Anchorage — Alaska 99504
(907) 337-6179 — Fax (907) 338-3246
Consulting Engineers
April 23, 1998
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Sewer Upgrade for Lot 2, Block 2, DeArmoun Subdivision #2
To whom it may concern:
The existing 2 bedroom house is served by an onsite septic system, and a community well. The
existing drainfield was deemed to be encroaching groundwater by S & S Engineering in July 10,
1995. This was confirmed by us (AWWS) after digging a test hole near the existing drainfield.
Currently, the house is for sale, and an upgrade is will be necessary in order to obtain an HAA.
Comments regarding the proposed upgrade are summarized as follows:
1. GENERAL: There are a number of site restrictions which limit the available spots to put the
new drainfield. These restrictions are summarized as follows:
• The location of the existing and old septic systems
• The location of the water line serving Lot 1, Block 2, DeArmoun S/D #2
• The location of the existing driveway
• Groundwater was encountered at 6'-T' below grade on 3/30/98. This dictates that a shallow
system be installed.
Given these restrictions, there is limited space on the lot to put the new drainfield; therefore, we
are proposing to install a bottomless, Intermittent Sand Filter (ISF).
2. SOILS: On March 18, 1998 a test hole was excavated and percolation test performed at the
area of the proposed septic upgrade. See the attached soil logs for soils classification and ground
water levels. As can be seen from the soils log, groundwater was monitored at 6 feet 7 inches
below the ground surface. Consequently, we are proposing a design depth (bottom of pea gravel)
of two feet below the ground surface. The monitoring tube was dry on 4/22/98
3. TRENCH DESIGN: Bottomless Intermittent Sand Filter (ISF)
a. Percolation Rate: 15 minutes/inch
b. Allowable Application Rate for ISF: 4 gallons/day/ft2
c. Number of Bedrooms: 3
d. Design Flow: 450 gallons per day
e. Minimum Absorption Area: 112.5 112
f. Effective Depth below pressure pipes: 2.5+ inches
g. Width: 10 feet
h. Length: 36 feet.
i. Effective absorption area = 360 112 (>112.5 ft2 OK)
j. Air Supply: Thomas Industries, Model 5070, "Anchorage Tank".
k. Air Supply Line: "Wasteflow" emitterline, 1/2 inch I.D, "Anchorage Tank".
1. Sand Material: Central Paving Products "Winter Road Sand"
m. Pea Gravel: 100% passing 3/8" sieve, less than 201/o passing the 1/4" sieve, and
less than 1% passing the 48 sieve.
We are proposing to excavate down to a maximum depth of 4 feet, place a minimum of 6 inches
of sand, install the air supply line, and cover it with 1.5 feet of sand. On top of the sand, we will
place 6 inches of 3/8 inch pea gravel, with the pressure laterals midway in the layer. We will use a
conventional lift station (Anchorage Tank), equipped with a programmable timer so that flow can
be intermittently dosed to the ISF.
4. SURFACE WATERS: There are no surface waters within 100 feet of the proposed septic
system.
5. TOPOGRAPHY: See the site plan for slope information. The slope is approximately 2% at
the proposed site for the ISF. In short, there are no slope concerns.
6. MATERIALS AND CONSTRUCTION PRACTICES: The materials used, and the
construction practices will comply with DHHS' "Intermittent Sand Filter Design, Installation &
Maintenance Manual". The contractor should read this document prior to construction. Copies
are available at the Municipal Onsite Services office (5th floor, 9th & L St.).
7. LOT LINE WAIVER: Because of the site restrictions we are proposing to place the
bottomless ISF within 2 feet of the south lot line. There are no wells or septic system that would
be adversely effected by this encroachment. Attached is a check for $115.00 to cover the MOA
lot line waiver fee.
8. CLOSING: Given the site restriction, and the soil/groundwater conditions, I think the ISF is
the most viable option for this lot, short of install a Recirculating Upflow Filter, which would
probably be more expensive. I am open to any suggestions from your department, which would
be an improvement to the proposed design. I am unaware of any adverse impacts this installation
would have on adjacent wells (see notes on 30 scale site plan regarding the well on Lot 1, Bk 2,
DeArmoun #2) or septic systems. If you have any questions, please contact me at 337-6179, or
244-9612. Thank you for your assistance.
LOT E. DK 1.
DEARNOUN *?-
PVT. SEPTIC L
COMMUNITY N20.
KEY BOK IS IN
THE SE CDRNER
OF THE LOT.
I
I
DEETARMOUI 2
I
D .
I
PVT. SEPTIC L
COMMUNITY H26
KEY BOK AT NE
LOT CORNER
I
DtARMMND ROAD
I
I
I
2.
M2.
PVT. SEP IC L
MSG
LOT L SK P.
DEARK" 02.
SERVED BY THE
COW 1420 SYSTEK
AND A PVT. SEPTIC
LOT B. SK 2,
DEARNMIN L2.
SERVED BY THE
CD14MINITY WELL
AND A PRIVATE
SEPTIC SYSTEK
1 1. o..
ALASKA WATER & WASTEWATER
DEARMOUN SUBDIVISION /2: LOT 2, BLOCK 2,
TYPE OF WORK:
SITE PLAN
PREPARED FOR: PHONE NUMBER:
SUSAN HERRINGTON (907) 345-6449
DATE: / / DRAWN BY: S PAGE:
4 23 98 J.LM. 1 = 100' I OF 3
REVISED 5/6/98
'A'
7
795
�d
THE AIR COMPRESSOR SHALL BE LOCATED WITHIN THE CRAWL
PRIOR TO CONSTRUCTION THE CONTRACTOR
SPACE. THE CONTRACTOR SHALL PROVIDE A 0-10 PSI
SHALL HAVE THE SOUTH PROPERTY LINE
PRESSURE GAUGE AT A LOCATIIINI WHICH IS READILY
FLAGGED BY A REGISTERED PROFESSIONAL
ACCESSIBLE FROM WITHIN THE HOUSE. NOTE, A 30 PSI GAUGE
LAND SURVEYOR.
WILL NOT WORK.
fi
THE AIR COMPRESSOR SHALL BE A THOMAS INDUSTIES MODEL
5070. AS SUPPLIED BY ANCHORAGE TANG THE AIR LINE
O
-j0
SHALL BE 1/2 INCH DIA. HDD CI PIECED, INSULATED WITH 1/2
INCH FOAM PIPE WRAP (R3 VALUE). ONSIDE A 2 INCH SCK40
F,O
PVC DEPTHOF 3 FEET. LINE SHALL BE BURIED TO A MINOIJM
�5 �I6I9$
THE CONTROL PANEL FOR THE STEP TANK SHALL BE
INSTALLED IN THE CARPORT WITH A AUDIBLE/VISUAL
INDICATOR WITHIN THE HOUSE.
r
APRO%IMATE LOCATION OF WATERLINE.
THE SEVER SERVICE LINE UNDER THE DRIVEWAY
LOCATED BY KEN DIDE, MFG REP.
SHALL BE INSULATED WITH 4. OF DIRECT BURIAL
014OW #344-2828). EXACT LOCATION
TYPE INSULATION WITH A MINIMUM BURIAL DEPTH OF
IS UKNIVN.
3'. INSULATION BOARD SHALL BE 4' VIDE.
KEY
BOX LOT 3, BLK 2
DEARNOJN f2
PROPOSED 1250 GALLON STEP TANK
AS DESIGNED BY ANCHORAGE TANK
WITH A INTERMITTENT OLD ABANDONED LOG CRIB
DOSING TIMER. CONTROL TIMER TO LOCATION/DIMENSION PER
ABANDONED
SEP IC TANK
SEPTIC TANK PER
BE LOCATED WITHIN THE CARPORT. MOA RECORDS.
��D ATERLDE LOCATION
i
LES INCH HDPE UNE SLOPED BACK
TO LIFT STATION FOR DRAINAGE OF
"
LINE. NO LOW SPOTS WHICH WILL -�
ELEVATED INSTALL AIR COMPRESSOR
ALLOW WATER TO COLLECT. ALL
WITHIN CRAWL SPACE
CONNECTIONS SHALL BE STAINLESS
STEEL WITH STAINLESS STEEL INSULATE➢ AIR INE EXISTING
BANDS. NO HOSE CLAMPS. 2X (SEE NOTE) TWO BORN. H
HOUSE
o
�
ELEVATED
EXISTING SEPTIC TANK
'
TO BE ABANDONED COMPLETELY
I o
AND EXCAVATED AREA TO
BE FO1.Ell WITH SANS
4 INCH DIAMETER
EXISTING SEPTIC
ASTM 1=34 PIPE
DRAINFIELD TO
Fn nffrTOMLEssI SLOPED 1/4 IN/FT
wl
1I
CC'
�„
fi
JK
I
O
-j0
1, BLK 2
31
LOT
#2
W
DEARMOUN
r
S
100' RADIUS
NEIGHBORS WELL
REP1RTEIILY INACTIVE.
ALASKA WATER & WASTEWATER
DEARMOUN SUBDIVISION #2; LOT 2. BLOCK 2. . .....
E OF WORK: ••• !`-
SEPTIC UPGRADE DESIGN
PARED FOR: PHONE NUMBER: Q F Y • fR1E6.
SUSAN HERRINGTON (907) 345-6449 Q OA. C 7953
E 4/23/98 DRAWN BY. PAGE: OedProte.dol,
YISED 5/6/98 J.L.M. 1 = 30 2 OF 3 Op,o
AR LQE COL S' M Af 3/ 41I VIA 501.40 wL LATEM5 10' 1%, BOPfohu% LT.
ATWX. 2 W. OKNCO ( E5.5f.LK AW 11415 WA NO LUR ON WiTOM, PRE5M
IIWASrEfLM M fpRgvm VN.VE5rRomwDDE5m �n VY VAqOiggW 1M
i I
. . . . . . . . .
E– — — — — — — — — — — — — — — — — — — • -
114" VIA Lt FROM 5CH 40 NC 4C.OM MWOMW MIAMNN ZP
STEP iMK MD MMIPOLV OF 5W MV P15iMIt M PPE
INW (VMI/ 4 PKH VIA 1=5)
PLAN VIEW
3/4'IwcLAtm&5(ff.4) Mf /-2"CI`15LAflON
W19.CX1(1E
FLIER AMM.
CAJER t
LAM
/� } p /y����ry
)II MILK VI V 811 PgALNIYW yT�:��~v�<tAti ...: r`-r�45,>'': +`a".r '
wtnl wL LA,ERN s eIREV ter, .,.:; .Ir : r, �wtr. •S , , I
MGNlAYINt1i5i12AI M,
(O?AVEI.+)
2 FEEf MIN. OF I'LlU 5W 0' --
�o
TOP or PROFILE VIEW
ALASKA WATER & WASTEWATER o��. of A� a�
AL DESCRIPTION: •
DEARMOUN SUBDIVISION /2; LOT 2, BLOCK 2, Q „?,• , ,• •..... •;'
E OF WORK:
BOTTOMLESS SAND FILTER (ISF) DETAIL Q •••• ••••• •• •••••
e f A. Garness:
PARED FOR: PHONE NUMBER: 0� iC 7953
SUSAN HERRINGTON (907) 345-6449 • ado
•�4
E; DRAWN Ur GIF; PAGE: 40edJorofeeelo�o�
4/23/98 J.L.M. N.T.S. 3 OF 3 OOOpoc��
PERFORMED
LEGAL DESC
t
2
3
4
5
6
313��
>7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
PERFORMED BY
II
ACCORDANCEC
72 -ODS (Rev. 4/86)
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERCOLATION TEST
RIPTION: Vt kmwN ;� , L-2 r W. Township, Range, Section:
r,
QlZ(�kNICS
�OORLY �ppco �ff7At/6L
(bT7Lr- 6aAvF.L
Maltz S^'L/m
WAS GROUND WATER Yes
ENCOUNTERED?
ZS
C6 W1TEI SK IF YES. AT WHAT 'II L
tAw lI DEPTH? I P
PAY k1 2 QE
CEO la W.ler Uhr/� I -� e
o. N. f111MIibring7 _1� WIt 3 30 98
ALL STATE AND MUNICIPAL
1E U !�Ai(F,a7t %ER"S SEAL)
191 M 1.JAk
it .. �1....... �
ES P. WILUAMS
N0.960E
FA:•..:...1..4 �.
PERCOLATION RATE 15 IminutevmCh))PERC HOLE DIAMETER
TEST RUN BETWEEN 5"S FT AND S -H FT
eE�yrRrn 7 / V U�� CERTIFY THAT THIS TEST WAS PERFORMED IN
IN EFFECT ON THIS DATE. DATE —: ho
Name
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division 3�
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
DISTANCES
ovC f144 V TO SEPTIC ABSORPTION
FROM TANK FIELD WELL
Aire,. f,,,re, ,6 •/o w ?t IA 't` vS
/ / �J...r.c ,/sr sa
VnOrMlsl
Permit NO.
NO. of0cdrooms
WELL
�D
-1vo
S 63' 33 3
�y�OEy
/
LEGAL DESCRIPTION
LOT LINE
S/�
�o /
i✓/
LOT
Bioda
=
SubdIwSlOn
Oc Gr ar • ✓ �
FOUNDATION
5'1 4?
,✓/-1
Township, Range, Section
.�
' �'✓ JeG fib-
AS -BUILT DIAGRAM IShow location of well, septic, system, property lines. lours ation.
-S
driveway. water bodes. etc I
TANKS
5Z SEPTIC ❑ HOLDING
Manufacturer
Capacity In gallons
,4,'r4 T•..vft
e04
Mafenal
No. of Companmenls
TYPE OF SYSTEM
N
(R TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER
Depth to pope bottom from
Total depth from original grade
-
Q R y e
original graoe
FT
/a Fi
Fm Addeo Stave original grade
Gravel Depth beneath pipe
FT
% FT
'
Gravel length
Gravel wrath
4'l
;2S' FT
S_ FT
Total absorption area
Distance b,.iween lines
r
iso SO FT
All( FT
er
Number of lines Sod rating
pipe material
/So SOFT
AIT—, 303-1-1--,51e
'ter
Insueer c/ Q -,l I
Ol
Date Installed
CSN .ct.,
6— z -'S '; G r/sy
WELLS
❑-PRIVATE• X OTHER Ildentitvl
Udl tlwhuo IA.B.LI
total Depth
Lased to
FT
FT
Installer
Date Insulted.
REMARKS:
• — /+• civ Yo
/% fftr /-a+,+•/f ��vlr. /.E Yr../ i. •• �» �.: / Scale: 't}�.fbfaEiZti(iL
Inspections Performed by. �• ,� F d�
Sr — 2ES o•�� •v ` Ldp
e� q ae� d�j�t•�:..5.:;�isdill
.4. a
v.9.►-•}—..
eerily that this Inspection was pedormed.aorging to all � z���s � r
f • • r, �lnui:'8u
A.1 if � �LLr/
Municipal and State guidelines in effect on this date: 4/z�lr_ S �� J,••� :CE -6736^ •4Ca
+
Health Department Approval: ��' y Date:3C_Z=/ 8 o00odyry fid
72-013 J&85)
I
I A IJ C H U F; {i G C:
D,-^p�:rkm•_nt of tl p I Iium:,n Serv:ec_;
L Etr r_> -a. Anrh-•: Ia sl:u S'9`���1 7.4:�-->i 72i,
U H -- S I 1 L f tJ F R P F K M I T
t•rr:u t. I'lclr.i •.:;r 1"iirr:lbJUl:,gr al.l e! SLtI cf 00 Cr
l"111;1/Cli LnLI111!>r e1(1ri.;it
I:; ,rt r f.•in •: II. U. L, C/O A3:;UCIATI.D Fr;;01 1) F'hon>
n,It I!lr .A 1 41. h-111 _11111: ttl :._ _....
(s 1: r i ld: r,10-IuI
f (lhdt'.1._:nrl- trM"NIV1'1 t+ ' LUC,- _- L'1w*:11 - !
L.'d1 L: t_1UV1 .'c) lu,+lIt,h:1,: I_:II k< lIcp-::
I.r, i. .-:.1 ,• Will ;u t; ->q. I t. of url e -j
rc,•:r...s.: Thin f'errait: 1 lutal Cafrs,city: 1
IIC 11'JI!.: rhnimimi totnI eey,Lie tan 1. ca,tpecity: 1,i,I,O n,:,IIc,ns. F.a,Ch septi,-:
tcnf. mii,sfhavl.. at- lcne,t r: compirtmlmts. lc,pth to top of=c,pt.ic t..anl: (,a) ' 4.1",
frr t. req -Ii re,s insulation nvc-r tnnl:(F,).
ri:..,n:l,�J c; if, rlt:i; 'rr,rn. Form criiL,.
I .1;;°TT F::;:1'•II;ES 1,E -Cl -HUN : 1. 19, IV.
F U( 11I1:L:F: fill(,T RL'r'cw,i 1:;r ANE) w) Irdsl'cc, f'1or4 Ill -zt .-474•; Ol;
?4 11',1.:1.
L_ll l ILS Cil) IM -C TL. D 1 0 CLASS i1 V -1-L..
1 1 T. 1 1 1 1 `/ T 11;41 :
1. I ,,, falntlior°trith the re.j1_lireiw,rif.s. for nn -site Feu, re .•nd w:�11- ar _:cit
forth by thr Hur,iripaliLy of Anr_horag,> (Mill',) and tho Statc, of Al •e•La.
I i;I.I I iriatz-II thr• eyatc:m in c,ccordanc.r; with all MO.', eodcc, an,I rl--•1, 7, c).- „
.,nu in crn:.l-•12 -ncr., r)it11 tfn_! cl-rr i(In cr itr:•r is of this. pr.-•rmit.
1 o-;1lI 'clh.-•re LC) 11 11"41 and Stat.
. �.-, a 1. o of (cla_:1 -, rfor thc• c1 t i
d I,.. t r..•::r�;[ I rr,m any ox inttrll,l au:l l., uas.t.c ivitc_r dir.po_,a:l r>y:;torri or puhl is
s.t I - Ic l'a, ct:I _.,::,t ria c1, this: or .-•.ny e,cl iocrfit . c ne-ar 1, y, tat.
1 1.mcls.•r=..tared thr,t this. p.,rmIL ie vs,lid for ai raa.:mluo of 1 bodrUrlm-.. I
,l -;i, I-n•1,I,sA;:iid t.11al t.hc. cepa;_ity ul ttw total system is; 1 bed rr;,::-mc. ).!
c:n✓ cnLarr,e•au:nt.. 1•,111 rrrnu:rrr ,:an e•ddi.tlonal pc:•rmit.
.: I r1:1 -•tl:
t fjl.e i --r) H. U. D. C: Lf F1S`.;17C 11'11 I'D NI-:Uf'.
V
IVup
1),"I I U:
DAIE:
to C ! •.''+
Municipality of Anchorage �' .. �'t t + •`•
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650 .. ..
SOILS LOG — PERCOLATION TEST J- Corwin
o�F-iv137
PERFORMED FOR: A SSGY /ATF f1 TS' FPC DATE PERFORMED:
LEGAL DESCRIPTION: L z K7 D AP,NMsV G,,. nTownship, Range, Section: Y4
' DEPTH Boom SLOPE SITE PLAN
6
iFFFYI
18•_ 54ndy �ryre l
2-
3-
4-
5-
6-
7-
8-
0 3 45 6 78O p
9
0
10 WAS GROUND WATER ,,11
ENCOUNTERED? KF,+
O O
11 s
IF YES, AT WHAT L
O DEPTH? O —
12 P
E
el o Depth to Water Alter ¢��7���
13 AbniWlnpT " Date:
0
14 Reading Date Gross Net Depth to Net
15 Time Time Water Drop
O G
c
16--
&A41) DCS
17-
18-
19-
20-
PERCOLATION
7181920PERCOLATION RATE Iminutesnnch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
COMMENTS -y (J /
PERFORMED BY: - LE -PI -4 1C FF Si I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINE IN EFFEC N THIS DATE. DATE: !�/Z % /,Q
72-008 (Rev. 4185)
■■■■■■■■■
0
10 WAS GROUND WATER ,,11
ENCOUNTERED? KF,+
O O
11 s
IF YES, AT WHAT L
O DEPTH? O —
12 P
E
el o Depth to Water Alter ¢��7���
13 AbniWlnpT " Date:
0
14 Reading Date Gross Net Depth to Net
15 Time Time Water Drop
O G
c
16--
&A41) DCS
17-
18-
19-
20-
PERCOLATION
7181920PERCOLATION RATE Iminutesnnch) PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
COMMENTS -y (J /
PERFORMED BY: - LE -PI -4 1C FF Si I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINE IN EFFEC N THIS DATE. DATE: !�/Z % /,Q
72-008 (Rev. 4185)
SP
CLASS -A-
WELL
EXISTING 5Y5TEM)
UeNEWAY - s w
W
TEST,
HOLE
Ul
3
W
T
Q
PROP. lawn TANK TRENI\
W. CH
DEARMOUM
zo�
UNDEVELOPED
c o I \
TRENCH DETAIL
SOIL 9ATIN4 I501t, I6vRI
LENGTH Z2'
DEPTH 10' 6EC:FAEFIC
NAT'S UNDER TILE 7' 3,
O
4•• PERF
PIPE
7'0FCE14E
ROC K
INSTALL C/O AT END OF
TRENCH i MONITOR PIPE 10
AT MIDDLE OF TeENCH
I :SEWER. SYSTEM LOCATION PLAN - I
LOT OLDOX 048DIVIS108
z 2 DEARMOUKI SUED.
SECTION TOWNSHIP RANOE
SE%4 526 TIZN R3W
SCALE- NOTE -
50, THE ACCURACY OF LOCATION OF EXISTING
DRAWN BYE PROPERTY CORNERS, WELLS, AND SEPTIC
SYSTEMS INDICATED IS NOT EXACT,
NORTH JEEFY KKESS DIMENSIONS INDICATED HAVE BEEN
DETERMINED BY USE OF CLOTH TAPE AND
BY SURVEYING TECHNIQUES.
S a1"�,W0'4 "
(o / T/ A T/ / O ,. PREPARED FOR-
:,, ASSOCIATED 13COKEES
DATE, 4IZ7I89 1 SHEET I OF
G"ATER ANCHORAGE AREA BORO'lr H
HEALTH DEPARTMENT N4 638
' - 327 EAGLE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
MAILING
NAME ��''�/-�' lam' G' /l70!/iS/ ADDRESS-�/�,1'-? !� --res-'Irl PHONE_74"
�';�-
SEPTIC TANK:
DISTANCE FROM WELL �� ��� MATERIAL 15r Z- — NUMBER OF
COMPARTMENTS
1T/1t's� jT Z //� /ly/�!�✓�I IO 7/
LIQUID
LIQUID CAPACITY %`L GALLONS. INSIDE LENGTH INSIDE WIDTH-DEPTH—
SEEPAGE
IDTH DEPTH
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS / OUTSIDE DIAMETER OR WIDTH LENGTH -17 7 DEPTH
LINING MATERIAL DISTANCE FROM WELL/Zt , BUILDING FOUNDATION -
NEAREST LOT LINE ' TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) SO. FT.
TILE DRAIN FIELD:
TOTAL LENGTH
DISTANCE FROM WELL FOUNDATION , EAREST LOT LINE , OF LINES ,
NUMBER OF LINj;Y DISTANCE BETWEEN
AREA SO. FT. LENGTH OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE
WIDTH IN, TOTAL EFFECTIVE
OF FILTER MATERIAL BENEATH TILE IN. ABOVE TILE
V�/ELL: �'v� / �DISTANCE FROM WATER A�
TYPE �'/-/�-�-�-�' DEPTH ,BUILDING FOUNDATION. d� SAMPLE NEAREST
✓NEAREST G�, SEPTIC a *f- SEEPAGE ��O f/E_ OTHER
LOT LINE . SEWER UNE��. TANK , SYSTEM ,CESSPOOL �_. SOURCES_
DISTANCES:
DIAGRAM OF SYSTEM
U � —
ti � 5 • �
a — -
r GREATER ANCHORAGE AREA BOkvLJGH
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO./3S;�
3500 TUDOR ROAD POUCH 6.670
ANCHORAGE, ALASKA 99502
TELEPHONE 279-6686
SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT
NAME OF APPLICANT .y.,�Q MAAILI_NwG ADDRESS Z � A 5
�0 PHONE
INSTALLATION LOCATION / 2 "`��` //�' - ' ^�///� Ae�(,(,4 ylOu Yi � �-j,[.
LEGAL DESCRIPTION `��� ` h/` _7 j" -e "'�' k4 /)etl ���
INSTALLATION OF: SEPTIC TANK SEEPAGE PIT r DRA.W FIELD OTHER
`- L E
TYPE AND SIZE OF FACILITY TO BESERV ED
FINANCED THROUGH 9��I14 2 9 En_{ -1414f/ �7J? ! / TO BE INSTALLED BY l'E LX_ l
Jr
SOIL TEST RESULTS NOTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION, 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION.
SEPTIC TANK SIZE •� �7e_y / TYPE �XWSE AGE AREA SIZE TYPE
MINIMUM DISTANCES. REQUIREMENTS
FOUNDATION TO SEPTIC TANK �r
FOUNDATION TO SEEPAGE PIT 2 / DRAIN FIELD
SEPTIC TANK TO SEEPAGE PIT WALL—
SEPTIC
ALL SEPTIC TANK — �-/ SEEPAGE PIT -Z-0 DRAIN FIELD
TO NEAREST LOT LINE.
WELL TO SEPTIC TANK SEEPAGE PIT
DRAT FIELD/ ALSO CONSIDER AREA WE `S.
WATER MAIN TO SEPTIC TANK /O SEEPAGE PIT /O
DRAIN FIELDS 12)
SEPTIC TANK,.SEEPAGE PIT 1420 DRAIN FIELD
TO RIVER. LAKE, STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION B FEET INTO UNDISTURBED SOIL.
• INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
GRAVEL BACKFILL
CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION.
�ALTH AUTHORITY
OR
LICENSED DESIGNER
DIAGRAM OF SYSTEM
1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 26.68 AND THAT THE ABOVE
DESCRIBED
SYSTEM IS INACCORDANCEWITH SAID CODE.
�
Ze
DATE �• / APPLICANT'S SIGNATURE `� ✓��E�%J V
s
J77 LA 'RM
Arc:iORArl.•, AL.",' KA ^79:1
Perfcrmed Pori garold W..DeArmoun� ,.,t --='ate Fer`.oraed �28(�
Legal Dcscri tion: Lot 2-1 :-1 .i`:.,tc^� mounrSubdivjgjQn #2
This Fcr:: Reports a: x rerc^.atioa [est
Depth Tract A
Feet Soli Cha�:.tesis:ir.s
gray sandy silty gravel
l (GI) with poorly graded
sand seams 4 - 5.5'
2
3
4
5
6 scattered thin gravel
seams from 7' -
7
Locaticn Sketch
Was Ground Water Encountered') no__
If Yes, At Vnat "eprh
Redding
:ate
Grcc:fine }pec Tiac
Depth To'H20
Net Drop
erco atior. Kdtt i
Frcpo:;cd instal s ion'. a,-%! T.'it v Drain :'field
r r�—
ilep'L}� Qf Inlet uP�--';: i0 KG[tOfn OS Yit :'r ': renca 10'
,rOM�:FfiT.i: .
square feet of drain!je area _is �e�r(rgc��et_j j=fZm
a
Test Performed
Data Certified By:Ut-lona_l Tgslino s_.r..ir=s, Inc.
Date:
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COSA Checklist
Legal Description: DeArmoun #2; Block 2, Lot 2
Parcel ID: 018-401-31
If more than 1 well and/or septic system on lot, provide separate checklist. Structure served by this system
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled Total depth ft
Cased to ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above groundin.
Date of flow test for COSA
Static wa evel at beginning of test ft
C ments Public water system
B. TANK DATA
Measured operating fluid level in septic tank N/A
Date of pumping NEW
❑ Required maintenance completed, if AWWTS
Comments:
D. ABSORPTION FIELD DATA
Which system tested (date installed) 7/26/24
X ALL standpipes present per record drawing
Total measured depth from grade *3.2 ft (max)
Measured depth to pipe invert from grade *2.5 ft (min)
❑ N/A — pressurized field.
9 Per record drawings, field is insulated.
❑■ Monitor tubes go to bottom of effective.
If not, state depth into effective
❑ Presoaked required if
(Required if house vacant or field not used for more
than 30 days prior to date of test)
Gallons introduced _gallons date
Any rejuvenation treatment (past 12 months) none
If yes, enter date -
Comments/Deficiencies: *Per Record Drawing
COSA Checklist June 2022
Well production at time o est' gpm
Waterforage4ee volume gallons
for coliform test? ❑ Yes Q No
❑ Coliform bacteria is Negative
Nitrate mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑ Arsenic less than MRL (ND)
Collected by
Date
C. LIFT STATION
❑ Required maintenance completed
Age of lift station NEW years
Lift station material Concrete
Comments:
Adequacy test date NEW
Results ZPass
Fluid depth prior to test n/a in
Water added n/a gal
New fluid depth n/a in
Elapsed time n/a min
Final fluid depth n/a in
Absorption rate 300+ gpd
FIELD STATUS — POST RECOVERY
Effective depth (per record drawings) 0.5 in
Effective depth used 0 in
Effective depth remaining in
E. SEPARATION DISTANCES
From Private Well on Lot to: (Please enter distances if less than required or if community well on lot)
Septic Tank/Lift Station on Lot > 100' Community Sewer Manhole/Cleanout > 100'
❑ Yes if No ft p Yes if No ft
Neighboring Tank > 100' ❑ Yes if No ft Private Sewer/Septic Line > 25' [:]Yes if No ft
Absorption Field on Lot > 100' ❑ Yes if No ft Holding Tank > 100' [:]Yes if No ft
Neighboring Absorption Fields > 100' Animal Containment > 50' ❑Yes if No
❑ Yes if No ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' ❑ Yes if No ft ❑ Yes if No
❑■ N/A — Served by Community Well (not on lot) or Public Water
From Septic/Holding Tank and Absorption Field(s) on Lot to: (Please enter distances if less than required)
Building Foundations > 10' 0 Yes if No ft Surface Water > 100' ❑■ Yes if No
Tank to Property Line > 5'
Field to Property Line > 10'
Water Main > 10'
Water Service Line > 10'
F. ENGINEER'S COMMENTS
*AWWTS
❑■ Yes if No ft
Q Yes if No *5'+ ft
0 Yes if No ft
❑� Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100' Q Yes if No
Community Wells > 200'■❑ Yes if No
If tank or field is under driveway comment below
ft
ft
ft
ft
ft
G. CERTIFICATION & 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, indicates that the on-site water
supply and/or wastewater disposal system appears to comply with applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation, unless noted otherwise.
Name of Firm Gamess Engineering Group, LTD. (GEG) Phone 907-337-6179
Engineer's Printed Name Jeffrey A. Garness Date
In conducting this evaluation, GEG provided an engineering evaluation of the well and/or septic system in
accordance with the guidelines and regulations established by the Municipality of Anchorage and industry
practices. The reported results describe the condition of the system/s on the date/s of the evaluation.
Separation distances were measured to readily identifiable features. Hidden defects or encroachments may
exist that were not identified during the evaluation. The operational life of all wells and septic systems depend
upon a variety of variables, including (but not limited to) soil conditions, groundwater levels (that may fluctuate
during the year), quality of construction (materials and workmanship), and the water usage of the family utilizing
the system/s. These conditions can vary, and are outside the control of GEG. Satisfactory test results do not
guarantee future performance of the system/s; therefore, GEG makes no warranty (express or implied) regarding
the future performance of the well or septic system. GEG makes no representation whether an alternative well
or septic system can be installed on the property in the event either of the current systems fail to perform
adequately in the future. The content of this report is for the sole benefit of the person/party that retained GEG
to perform the evaluation. Reliance upon the information provided in this report by any other person or party
(including subsequent property purchasers) is not authorized, nor will it confer any legal right whatsoever.
COSA Checklist June 2022
#ZE t 84
8508P
30 Lot 3
N89056'00'W 120.00
Water valve I
Lot 2 —1.7
>Greenhouse deck
UJ
ry
0
3.
0 —207T 17, 9
0 2nd Story 0
6 over Stg...
0) el drive
WGravway Co -
r 2 Story
C)
Frame
0
F- < 22 OH House
.- -1-L
0) (0
(0 Manhole deck 2nd Story C14 Lot 8
E
19 over Stg. C) 4) 1
Z-) 00 CO (1) 0
0 20.0 ca 1 .
0 0 W c
0 Z
Z Septic tank --- Chain fink
0 fence (t..)
?C)
Septic vent (typ)S cc
Neighbors carport
encroaches 0.4'±
N89056'00"W co Carport 120.00
30
Lot 1
RECERTIFIED 8-05-24
AS -BUILT NOWOERS SET THIS DATE
IOF A4 I hereby certify that I have performed a Mortgage&s inspection
..:t
AW in accordance with ASPLS Standards of the following
described property: LOT 2, BLOCK 2.
49th DE ARMOUN SUBDIVISION No,.2
Anchorage Recording Precinct, Alaska, and that the
00 ... improvements situated thereon are within the property lines
00 and do not overlap or encroach on the property lying
110 h! adjacent thereto, that no improvements on the property lying
10' izabe;l L latko.: so adjacent thereto encroach on the premises in question and
kv
8036 - LS AW AV
that there are no roadways, transmission lines or other
-f visible easements on said property except as indicated
SCALE: 1"= 30' 1 hereon.
Dated at Anchorage, Alaska
'A % i. this 12th Oay of October 2023.
EASEMENTS OF RECORD, OTHER THAN e>- FRED wALATKA & ASSOCIATES, L.L.C.
THOSE SHOWN ON THE RECORDEDEngineers and Surveyors
PLAT ARE NOT SHOWN HEREON FS 24-3, pg 42 BE 907-248-1666
UNLESS OTHERWISE NOTED. FB 23-4, pg 11 -12 1
This drawing is a representation of conditions found at tie time the mortgage location survey was performed. This document does not constitute a boundary
survey and is subject to any inaccuracies that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to
establish any fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original
client or by others at a later date without the consent of Elizabeth L. Walatka is a violation of Federal Copyright law. Unless gross negligence is discovered,
the liability extent of the preparar is limited to the amount of fees collected for services in preparation of this product.
MUNICIPALITY OF ANCHORAGE
• DEPARTMENT OF HEALTH d HUMAN SERVICES
Division of Environmental Services
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcell.D.# 01840131 HAA#�QgScn�1a.
1. GENERAL INFORMATION -
Complete legal description Lot 2; Block 2; DeArmoun #2
Location (site address or directions)
3608 Matthews Drive
Anchorage AK
Property owner Susan Harrington Day phone
345-6448
Mailing address 3608 Matthews Drive Anchorage, AK 99516
Lending agency
.Mailing address
Day phone
Agent Sallie Nickerson/Jack White R.E. Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
3
XX
229-1148
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site XX
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025(R".1/91) From MOA 121
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-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 furtherverify 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
Engineer's signature
6. DHHS SIGNATURE
Approved for TREF E bedrooms.
Disapproved.
Phone � 37 — E % 79
Date
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
0
SZ/,
Date _7-4- 9 S
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS 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.
mass(A v "I) Beck MOA /21
Im
ar�t�.�+a�+�n,•,n+..r.v---�-------
-.e
Municipality of Anchorage RECEIVED
DEPARTMCK QF HEALTH & HUMAN SE56LC5� 1998
Environmental Services Division
825 L Street, Room 502 • Anchorage, Alaska ?I9VSIRTO�OaZ {Ae
NVIRO AL SERVICES DIVIS1pN
Health Authority Approval Checklist
ttY
Legal Description: Lor Z. Bwcr Z4 DeRCMoutJ Parcel I.D.: 612,- 401 — S I
A. WELL DATA CaAM041Y
Well type CLASS "A' If&LorS, attach ADEC letter. ADEC water system number 2 119 Sa
LTCe�'
Total depth
Data completed
FROM WELL LOG
Date of test
Static water level
Well production 9 -p.m.
WATER SAMPLE RESULTS:
Collfonn
Date of sample:
B. SEPTICfHOLDING TANK DATA
Date installed Tank size
Foundation cleanout (QM) YES
Nitrate
Casing height (above ground)
Wires properly
Collected by:
AT INSPECTION
Other bacteria
g.p.m.
I Z So Number of Compartments Z Cleanouts (21N) RFs
Depression (Y,® IJo High water alanndm Y"
Date of Pumping ECJ Pumper
C. ABSORPTION FIELD DATA
Date Installed 6 -18 - 98 Soil rating .p.d ori)
r a I r
Gravel thickness below pipe 0.5 Total depth :Z•8 — 3.0
4..0 60L.KA-900) AA-M)
m
Systetype gc O
Length 3L Vlfidth IO
Effective absorption area .3t 60 Monitoring Tube presentOT1)-Fs Depression over field (Y6_L6_
Date of adequacy test Results (Pass/Faiq For 3 bedrooms
Fluid depth in absorption field before test (in.). Immediately atter � al. water added (in.): '—
Fluid depth — (ins) Minutes later: _^ Absorption rate > n.p.d.
Peroxide treatment (past 12 months) (Y,® ry d If yes, give date
72.026(Rev.3196)' T#lS LS A WAO A"rioe gorroM/GK 14TEK4I?Y^o/T
0es1r.l& 5,ri0 I; wre.
D. UFT STATION
Date installed (o -j6 4g' Size ip gallons 125'5
W
at 4/ N
Manhole/Access&) Vex 'Pump on" level "Pump off" level t•
High water alarm level at* YS W' -Datum BAT•q
Cycles tested Ate*)
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO: (fph„Uq I -ry
Septic/holding tank on lot .2000+ On adjacent lots
Absorption field on lot 2001+ adjacent lots
Public sewer main
service line
C6 -ASS "A" LJSLI
Public sewer manholetcleanout
Lift station
SEPARATION DISTANCES FROM SEPTICMOLDING TANK ON LOT TO:
Foundation 52''x' Property line 2z 14- Absorption field
Water main/service line __Lo 14 Surface water/drainage 100' Wells on adjacent lots
q' -L-
1040 1
'f
1001 *
SEPARATION DISTANCE FROyM-ABSORPTION FIELD ON LOTTO:
Property line 2 SIg148Building foundation 3wr'1' Water main/service line /0'�'
Surface water Oc P Driveway, parkinghrehide storage area 3
Curtain drain r4 0 ri r. blest hj Wells on adjacent lots
F. ENGINEER'S CERTIFICATION 'e W2 9800 16
I certlly that I havJdetermined i
In conformance th MOA HAA
Signature
Engineer's N$me
Date
HAA Fee $ 300 OO
Date of Payment
Receipt Number. a 376 Y C _262 6)
72-026 (Rev. 31913)•
R and review of Municipal records
on this date. r
W
491H
loo1-4-
`, oVbove systems are
E4FAire.%V
I Lc.r A%Af
- .IIUIESV.IYRlI
•. NO. I1M
Waiver Fee $
Date of Payment
Receipt Number
FROM t.TACW WHITE REAL. ESTATE TO t 19073492032 1998.07-02 11:39AM 8927 P.02/02
_.FROM : PLR504 WRtl L1: a WKS IrWH ICK rrtLIFIC Mo. a -,v, r.,w.x�u ...... ..� ._._......
PROPERTY OWNER AGRERMF.NT
FOR THE MAIN' ENANCE OF AN
ON-SITE WASTEWATER DISPOSAL
SYS17M
This agreement, daiod g 7- 6-` 5 299, is made between The Municipality of
Anchorage Dcptu=cnt of Hcalth and lluman Services (DHHS) and UIc property
owners3 of:
QIVA&
This agreement is made for the purposo of maintaining an On-site wastewater dispotal
system on the sobjcet property.
Tho property owners ogre to tide rollowina:
Submit to the Municipality of Art horage, on an annual basis, an inspeetivn and
operation statement from a registered professional engineer. This inspection and .
operation statement than verify that the engineer bas impectod all effluent and Or
pumps, timers, and alarms, and that any deficiencies have been repaired and that the
system is functioning as designed.
(Sigaaatre) (Signature)
kEyiA/ o. smy
(Prlated Name)
--------------'---_--I ----••Notarito 11pre
State of nI--a, thio -2_rrA
i?o lthn h,.nlf i 5M ^ personally app
who 16 personally known
a
whose identity r prm,l
whose identity I provid
(Printed Name)
--------------
d---------,.�-�»
01 61
eared beforeall
to IDe
oil ti,e basin of AK OL IQ GO 9V IV03
On the bath/offirtat ou O
, a credible witness
to be the signer of the Above document, and he/she orxnowledged that be/she aignad It.
`
Notary
_ — : _My comm166i On expires
J MUNICIPALITY OF ANCHORAGE
lv':UMOFALITY C.- ANC DRAG Department of Health & Human Services
ENVIr:ONMENTAL SEnv._ orvls �= DIVISION OF ENVIRONMENTAL SERVICES
343-4744
Jll'� 12 1°u9
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
R E C E I V E D'SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D. # '\ "A - 2�1 HAA #
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
DeArmoun #2, Lot 2, Block 2, T12N, R2W, Sec.28
Location (address or directions)
3608 Matthews, Anchorage, AK
(b) Property owner x n n Telephone: (home) Business 971 —4 '44
Mailing Address 222 W. 8th Ave. (Box N-64) . Anchorage, AK 99813
(c) Lending Institution
Mailing Address
(d) Real Estate Company and Agent .
Address 640 W. 36th Ave
Telephone
563-3333
Telephone
Associated Brokers
Suite #1, Anchorage, AK 99503-5807
(e) Mail the HAA to the following address: (or check here ❑, if hold for pick up.)
List contact person and day phone number below:
Pick-up by Engineer
2. TYPE OF RESIDENCE
Single -Family Q Number of bedrooms 1
3. WATER SUPPLY
Individual Well ❑ Community ® Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site IS Public ❑ Community ❑ Holding Tank ❑
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legailty and status.
72m5(er.7/W) Page 1 of 2
S. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of thevalidation 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 Eagle River Engineering SrvsTelephone 694-5195
Address P -O -B. 773294 Eagle River, AK 99577
Date June 10 1989
6. DHHS APPROVAL
Approved for
is
Louis A. Butera
CE -6736
•�........�- Ver
PROFESSt�NPf
bedrooms by �Zi Date 6 — tf — g9
Approved Disapproved
Terms of Conditional Approval
Conditional
CAUTION,
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval
cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer
registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending
institutions in orderto satisfy certain federal and state requirements. Employeesof DHHS 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.
71425 (Be. neat Back Page 2 of 2
MUNICIPALITY OF ANCHORAGE (MOA)
MUNICI • .. ANCHOaAialth Authority Approval (HAA}
ENVIe�NM evICES DIVIPHECKLIST - FEBRUARY 1984
343-4744, 6,
JUN 12 1959 Legal Description: Oe4 r.-.o...v V64Z
Gtr �//f.2 T/ani
A. WELL DATA RECEI•`I ED
M
Well Classification ekfr %a If A, B, C, D.E.C. Approved (Y/N) Ys�
Ole Man,
Well Log Present (Y/N) Date Completed Yield
Total Depth Cased,to Depth of Grouting
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
To Nearest Sewer Service Line on Lot
Water Sample Collected by
Water Sample Test Results
Comments
B. SEPTIC/HOLDING TANK DATA
Pump Set At
Sanitary Seat on Casing (Y/N)
Depression Around Wellhead (Y/N)
On Adjoining Lots
On Adjoining Lots
To Nearest Public Sewer Cleanout/Manhole
Date
Date Installed /'Py9 Size —/0�_No. of Compartments 4
Standpipes (Y/N) Y Air -tight Caps (Y/N) i Foundation Cleanout (Y/N) i
Depression over Tank (Y/N) N Date Last Pumped
Pumping/Maintenance Contact on File (Y/N) ;for
Holding Tank High -Water Alarm (Y/N) � Temporary Holding Tank_ Permit (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: `
To Water -Supply Weil To Building Foundation y6
To Property Line 33 To Disposal Field Zoe S"
To Water Main/Service Line r/D
To Stream, Pond, Lake or Major Drainage Course
Comments
72-M IR.v. 7/681 FrMl Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata iSo 1�?/2 Type of System Design 722 fn'7
Date Installed b/•yr-7 Length of Field =$' 0
Width of Field ' 3 is Depth of Field
Gravel Bed Thickness 7
Square Feet of Absortion Area�s ° Statndpipes Present (Y/N)
Depression over Field (Y/N) N Date of Last Adequacy Test rid
Results of Last Adequacy Test ^y°'^'
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water -Supply Well +� °7 To Property Line /e /
i
To Building Foundation To Existing or Abandoned System on
Lot '20, ; On Adjoining Lots t3o/
To Water Main/Service Line /O To Cutback (if present) .dlA
To Stream, Pond, Lake, or Major Drainage Course N/•*
To Driveway, Parking Area, or Vehicle Storage Area AO '
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at —
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N) .
"Pump Off" Level at
Vent(Y/N) _
Pumping Cycles during Adequacy Test.
"Check Permitted Bedroom Rating Against HAA Request'
certify that I have checked, verified, or conformed to all MOA and HAA guine6Fn R7
Inspection. -
i4Q(••,.«.....
Signed
v
* 4` 9TH
Company j�PE/ _,
_.
�!
Date 6I&I
.......... ...
I �`•
-Sr ��.r
MOA No.
Louis A. But
I c �
CE -6736
.•*
F•
Receipt No. D S - a Yr/�477
Date of Payment t�Z — A
Amount: $ Vin•
Receipt No
Waiver Fee: $
Date of Payment
n -M (Rw.7/88) Beck Page 2 of 2
the date of this
ineer's Seal
• r
GOVERNOR
E OF -0� R. °
UF.PT.OFENVIHO: MENTAL CONSERVATION
ANCHORAGE/WESTERN DISTRICT OFFICE 563-6775
3601 C STREET, SUITE 316
J,NCHORAGE, ALASKA 99503
t
DATE: June 9, 1989
PWSID: 21193!2
lily a It May Concern:
,':ling to the records on file in this office, the PEAFMOUT-2 Ll 2
gin! c2 oysters is in compliance with the State of Alaska ❑r_r:'.1::.3
:.,tor Regulations.
sincerely,
31" art Q c
VERA E. CRAIG _
Environmental Field c;fficcr
MUNICIPALITY OF ANCHORAGE W.
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION',
DIVISION OF, ENVIRONMENTAL HEALTH .
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
'264-4720
Application Date 1�119E1+
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
LVL: a L3K 2 Let- LI
Location (address or directions)
' 3�o A K arr�lE�
(b) Applicant Name e/Telephone: Home Business
Applicant Address
(c) Applicant is (check one): Lending Institution; Owner/builder ❑ ; Buyer ❑ ; Other ❑ (explain);
(d) Lending InstitutioA S1, *_1W1 tLAMQ 112KTCA*rte Telephone
Address eA -� W e - G Q'A`+ I
(e) Real Estate Company and Agent BONE
Address
Telephone
(f) Mail the HAA to the following address:
90 L._D
2.
TYPE OF RESIDENCE
'
Single-FamilyX Multi -Family❑ Other
o
`
Number of Bedrooms `
3.
WATER SUPPLY
'.
Individual Well ❑ Community Public ❑
.
4
Note: If communitywell system. m . ust havewritten confirmation from the State Departmentof Environmental Conservation
j
attesting to the legality and status.'
4.
SEWAGE DISPOSAL
`.
Onsite' Public ❑ ' Community ❑ Holding Tank ❑
r I i
Note: Ifcommumtywellsystem, must have written confirmation from the State DepartmentofEnvironmental Conservation
t
attesting to the legality and status
; ' S
r
`
� I
+r r
\ '1 ! 7iii- l��l�l ,
Page
_
,1 of 2 t
't.. •��4�
•I
��:
AJ t`.E tl; '� t l.,{ e� • �.
'.ti.p�..'1
Jf4 .)+. !!'1 .T- i .w').• + '`
b. f l
�I
,I •
:u.T.,gLI . 1 ...3. I. .. 't' ..1. 'J.J r !:
.. r
y'fi • 1.
•
_ .. a.. -J�, w♦• -w. �'n.t n'. -Np i?r1'. .'i'i ��:�',i Cihnl ]'; I�lb,/'. .� .w{�•r,..,j i�va,, ^...xi q.i.,v"de
! I` ,�..t. •,. �i 4.. .,1'n.t i. .! ..' . I V •.is :'� t1�. •'/t: 'v � n .' Y.♦ t''.�. :.. I.e. ♦ '.
' ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DAL♦ AND INFORMATION'• ' i
As certified by myseal 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 Telephone 9-74 -191-6
Address fr10 3 uf/ 151 -Lr
Date
6. DHEP APPROVAL
Approved for 9:7AZ > bedroom by _
Approved _ Disapproved
Terms of Conditional Approval
i
I '
91r '
,. t
•r Engineer's Seal
. I.
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 stale requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible jor errors or omissions in the
professional engineers work.
Page 2 of 2
72-025 (I V84)
MUNICIPALITY OF ANCHORAoi
n DEPT. OF HEALTH &
MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL PROTECTION
HEALTH AUTHORITY APPROVAL (HAA) J U I 10 6,1
CHECKLIST - FEBRUARY 1984
284-4720 Ell
Legal �Description: 4 2 !��-g '41 jo �
A. WELL DATA
Well Classification CIA4; A If A. B, C. D.E.C. Approved (YIN)
Well Log Present (YIN) Date Completed
Total Depth _
Static Water Level
Cased to
Casing Height Above Ground —
Electrical Wiring in Conduit jVN)
Separation Distances from Well:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
Cleanout/Manhole —
_ Depth of Grouting
Yield
Pump Set At
Sanitary Seal on Casing (YIN) _
Depression Around Wellhead (YIN)
On Adjoining Lots
On Adjoining Lots
_ To Nearest Public Sewer
To Nearest Sewer Service Line on Lot —
Water Sample Collected by ( ; Date
Water Sample Test Results
Comments4 �1 Zia Zr.&2
B. SEPTIC/HOLDING TANK DATA
Date Installed %1 Size M No. of Compartments
Standpipes (YIN) i Air -tight Caps (YIN) _ Foundation Cleanout(YIN)
Depression over Tank (YIN) ,t/ Date Last Pumped 7'dp�
Pumping/Maintenance Contract on File (YIN) /VA ; for �(/,�
Holding Tank High -Water Alarm (YIN) 4 Temporary Holding Tank Permit (YIN) 41414
Separation Distances from Septic/Holding Tank:
To Water -Supply Well 1 ;"
To Property Line %LS
To Water Main/Service Line
Course
Comments
Page 1 of 2
72-026(11/64)
To Building Foundation
To Disposal Field �n
To Stream, Pond, Lake, or Major Drainage
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata / 7R Type of System Design
I 4M GuAT
Date Installed Length of Field A7 )� / y
Width of Field Depth of Field 'afi
Gravel Bed Thickness
Square Feet of Absorption Area Standpipes Present(Y/N) Y
Depression over Field (Y/N) Date of Last Adequacy Test %A'
Results of Last Adequacy Test
Separation Distance from Absorption Field
To Water -Supply i Z es /
PP Y Well 0 To Property Line _S�1
To Building Foundation To Existing or Abandoned System on
Lot l �A ; On Adjoining Lots
To Water Main/Service Line � To gutbank (if present) a �_
To Stream/Pond/Lake/or Major Drainage Course
To Driveway. Parking Area, or Vehicle Storage Area L
Comments
D. LIFT STATION
Date Installed / Iha/IC Dimensions
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N) _
Comments
Manhole/Access (Y/N)
"Pump Off" Level at
'• Check Permitted Bedroom Rating Against HAA Request ••
Vent(Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
I certify that I have checked. v rifie r conformed to allpOf and HAA guidelines in effect on the date of this inspection.
Signed Date 7 ��
Company MOA No.
`�����
Receipt No. A/02= • nF� /( j; %j
.
Date of Payment--r%-�/- ^'1p:•' ;fes
Amount: $ (, � /*. 49Tft , t/ Engineer's Seal
Nc�2225-L ;
Page 2 of 2 `T • 1 ,IE 25. 1971 c,
U(
t,+E �?Si�f 1 a1,
73-026 (11,84) :,l A� - `
3 W, 15th AVE "C" SUITE 203
20ANCHORAGE. ALASKA 99501
' CON"SULTING ENGINEER TELEPHONE: 190712793916
S E P T I C S Y S T E M A D E Q U A C Y T E S T
— — — — — — — — — — — — — — — — — — —
LEGAL: LOT 2, BLOCK 2, DEARMOUN 02
LOCATION: 3608 MATTHEW
OWNER: I. WIEGEL
RESIDENCE: SINGLE FAMILY, ONE BEDROOM
SEPTIC SYSTEM: FROM MUNICIPAL RECORDS:
TANK: 750 GAL. STACK STEEL
ABSORPTION SYSTEM: LOG CRIB
ABSORPTION AREA: 492 SQ. FT.
SOIL RATING: 178`
INSTALLATION DATE: JUNE 1971
DATE OF PUMPING: JULY 11, 1986 ANCHORAGE CESSPOOL
DATE OF TEST: JULY 10, 1986
TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND
WITH THREE FEET OF COVER. LIQUID DEPTH WAS 63.5
INCHES. LOG CRIB # 1 HAD 30 INCHES OF LIQUID, CRIB #2 WAS DRY.
WATER WAS ADDED TO CRIB #1 AT A CONSTANT RATE OF 7 GALLONS. PER
MINUTE WHILE THE LIQUID LEVELS IN THE CRIBS AND TANK WERE
`Pf ffITORED. A TOTAL OF 500 GALLONS WERE ADDED. 350 GALLONS CAUSED
TLE LEVEL IN CRIB H1 TO RISE 9 INCHES. NO WATER SHOWD IN CRIB A2.
THE ADDITION OF 150 GALLONS MORE CAUSED THE LIQUID LEVEL IN CRIB
#2 TO RISE 15 INCHES. AFTER 15 HOURS THE WATER LEVELS WERE
CHECKED. =B #2 WAS AT--1—INCHES. CRIB 92 -AT T2 TNCHFS_ TOTAL
4
II
TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF
THE MUNICIPALITY OF ANCHORAGE.
The operational life of all septic systems depends on the local
soil conditions, groundwater levels that may fluctuate during the
year, and the water usage of the family being served by the
system. These conditions are outside the control of the evaluator
of this septic system. We can therefore not give any estimate of
how lon.g.the,system will continue to meet the operational requi-
rerns•"ts�of9t�ielMunicipality and State.
��n• '.o. 2225-E ^-r
�') �'• JUN: 25. 1971.
� � r
5. LEGAL DESCRIPTION
DATE RECEIVED
_ INSPECTION APPOINTMENTS
/�
& a/rto,.h2—
TIME
TIME
TIME
,ry
DATE
DATE
DATE
Y�
- One ❑ Four ❑ Other
❑ Two ❑ Five
INSPECTOR
INSPECTOR
INSPECTOR n
MUNICIPALITY OF ANCHORAGE MUNICIPALITY O-
IOF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OF HEALTH &
1 825 L Street • Anchoraw, Alaska 99501 ENVIRONMENTAL P..OTECTION
•
ENVIRONMENTAL SANITATION DIVISION
0* APR 9 1981
0*
Telephone 264.4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWE lEtiff. D
DIRECTIONS: Complete aft parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTYOWNER
PHONE
-5 k--'tfokc tf nwtro
1Vsr-2r:o�
MAILING ADDRESS
O.Qa>r Anicitom6c Arclf
PROPERTY RESIDENT (If different from above)
PHONE
2. BUYER
H N
MAILING ADDRESS
3. LENDING INSTITUTION
PHONE
MAILING ADDRESS
4. REALTOR/AGENT
PHONE
MAI LI NG ADDR ESS
5. LEGAL DESCRIPTION
/Jc,C Z
/�
& a/rto,.h2—
STREET LOCATION
6. TYPE OF RESIDENCE
NUMBER OF,BEDROOMS
SINGLE FAMILY
- One ❑ Four ❑ Other
❑ Two ❑ Five
❑ MULTIPLE FAMILY
❑ Three ❑ Six
7. WATER SUPPLY
❑ INDIVIDUAL*
*ATTACH WELL LOG. A well log is required for all wells drilled
COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.)
B. SEWAGE DISPOSAL SYSTEM
k, -
INDIVIDUAL/ON-SITE"
YEAR ONSYSTEM WAS INSTALLED.
❑ PUBLIC UTILITY
,Cy �, N--SSIITE
� (te&
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72010 (Rev. 6/79)
h
'
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE
❑ SINGLEFAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS '
❑ ONE ❑ THREE
❑ TWO ❑ FOUR
❑ FIVE ❑ OTHER
❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLICUTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON -SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
INSTALLER
SOILS RATING
❑Septic Tank or ❑Holding Tank
Size: L-) If Tank is homemade
give dimensions:
TYPE OF TANK
MANUFACTURER
-
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL T0:
Septic/Holding Tank
Absorption Area
Sewer Line
NeareYt Lot Line
Absorption Area to nearest Lot Line -
5. COMMENTS
®APPROVED FOR BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE �[
BY
72.010 (Ret. 6/79)
nac �r-I �lD�
(7
ea -N1 �7ANCHOP.ACA ,M
MUNICIPALITY OF ANCHORAGE Et:'/L'.Ot.!.:_NT L F CT[CTION
DEPARTMENT OF HEALTH 6 ENVIRONMENTAL PROTECTION
D! • y
825 L Street . Anchorage, Alaska 8.501
•
SEP 2 01979
ENGINEERING20DIVISION
ENVIRONMENTAL26-4
RECEIVED
❑ Two ❑ Five
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incompleb requests will not M proceseed. Ploae oRow ton (10) dears for Is no.
1. PROPERTY OWNER
PHONE
R w Ltt)
COMMUNITY
3y -/3i
MAI LINGA D ESS
nJ 1�e t,tt b
? L/ S-- 2 G 8
PROPERTY RESIDENT (If different from above)
"If individual/on-site, dateade )571
PHONE
2. BUYER
Jo r, wt�v a i/nfau.,p ,L'6cL
PHONE
337-�i3Sa
MAILI A DRESS
tif,(
27G-2-ceLV
3. LENDING INSTITUTION
PHONE
wicltC ,ry .vcr�+G
MAILING ADDRESS
4. REALTOR/AGENT
PHONE
I'�oNE
MAILING ADDRESS
S. LEGAL DESCRIPTION A -
STREET LOCATION
t{ to ewS
D! • y
S. TYPE OF RESIDENCE
NUMBER OF SEDROORS
� One ❑ Four ❑ Other
SINGLE FAMILY
❑ Two ❑ Five
❑ MULTIPLE FAMILY
❑ Three ❑ Six
7. WATER SUPPLY
❑ INDIVIDUAL'
*ATTACH WELL LOG. A well log is required for all wells drilled
COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.) 6 tv '�. (,,-
tiS.
S. SEWAGE DISPOSAL SYSTEM
"If individual/on-site, dateade )571
INDIVIDUAL/ON-SITE"
give earsolion
If system is over two (2) years old an adequacy test is required
❑ PUBLIC UTILITY
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-01 oonal
1
THIS SIDE FOR OFFICIAL USE ONLY
INSPECTION APPOINTMENTS
DATE RECEIVED
TIME
TIME
TIME
DATE
DATE
DATE
INSPECTOR
INSPECTOR
INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOM
❑ ONE ❑ THREE ❑ FIVE ❑ OTHER
❑ TWO ❑ FOUR ❑ SIX
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLICUTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAUON SITE
❑PUBLICUTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED
INSTALLER
SOILS RATING
❑Septjc T�L>l or ❑ Holding Tank
Size: -1_ If Tank is homemade
give dimensions:
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL C
4. DISTANCES
WELL TO:
Septic/Holding Tank
Absorption Area
w
Seer Line
eerest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
lb] -APPROVED FOR —Z BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
DATE e�
` 77
Title
LEGAL DESCRIPTION
72-010 1Rev. 3/78)
n
Tobben Spurkland P.E.
8155 Cranberry St.
Anchorage, Alaska 99502
Phone (907) 243-5302
lir. Kimberough Owens
Marston Real Estate
2804 W. Northern Lights Blvd.
Anchorages Alaska 99503
LOT 2 j BLOCK 2 1 DE11 MUN N0. 2
n
SEWER ADEQUACY TEST
MUNICIPALITY C. ANCHOP.A3E
Derr. C, &
ef::::Ot,1..ihUi rFOTCCTION
010T 1 1979
RECEIVED
Sept. 289 1979
Building ; 2 storeys 1 bedrooms can be converted to 3 bedroomsl 2 bedroom convection
planned
Water Community well
Sewer system 750 gal steel tanks two MA log cribs with 492 ft2 wall area
Built in 1971
ff / 04
Teattproeedure
Sept. 25, 1979 Tart: pumped Water depth in cribs 38h in. 21 in.
Sept. 26 38 21
1000 gal dumped 451 34
34
Sept. 27 5 29
Total raise caused by introddeing 1000 gal 26 inches
Total drop in 24 hours 107z inches
Total percolation 418 gallons
Conclusion:
System is adequate for two bedrooms.
All S4&.J r'r`D
Ail a /
S5. l r--L_fzl_ _ __
n .�
1
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3500 Tudor Road, Anchorage, Alaska 99507 279-8686
Date Received
Time of Inspection /D
Date of Inspection
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER S WATER FACILITIES
FOR
Aoproval Requested By:
Address:
2. Prooertv Owner:
r'hZ_G
rnone:
Phone: 3f d rill
3. Legal Description: ,C��, �.'Z/, r /L��rYl�l , N�✓r�/
4. Location: l/l,y/�r//�:
5. Type of Facility to be Inspected:�Ll�i'�
Number of Bedrooms: 7
6. Well Data:
A. Type �jYri�✓y//d/./4/ B. Depth —
C. Construction D. Bacterial Analysis'
7. Sewage Disposal System:
A. Installed
/91/ 8. Installer —
Size ,!0 2. Manufacturer 1�/lf 1I
Size 2. Material
0
Total. Lergth of Lines
C. Septic Tank: 1.
D. Seepage Pit: 1.
E. Disposal Field:
8. Distances:
A. Well To: Septic Tank Absorption Area Sewer Lines
1/0 Nearest Lot Line Other Contamination
,
20 iy
B. Foundation to Septic TankAgl"'.S i, Absorption Area Zr
C. Absorption Area to Nearest Lot Line
i
'ftegjert for Approval of Individual Sewer b Water Facilities
Paso Twin
Approval Valid for One Year From Date Signed
Greater Anchorage Area Borough, Department of Environmental Quality
DIAGRAM OF SYSTEM.
I certify that the information contained in this request for approval to be a true
and accurate representation of the subject sewer and water facilities located at:
Signed Date