HomeMy WebLinkAboutDALZELL-SCHNEITER BLK 2 LT 9bolzell
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Block 2
Lot 9
#015-291-21
kRuv VJ/VL/ 101
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 1
ON-SITE
WASTEWATER INSPECTION REPORT
Permit Number: OSP201503
PID Number: 015-291-21
Dwelling: 0 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade
Name
Grant and Sharon Klotz
ABSORPTION FIELD
❑® Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound
Site Address
10121 Schneiter Cir Anchorage AK 99507
❑ Other
Phone
Number
of Bedrooms
Soil Rating
Total depth from original grade
3
1.2 GPD/SF
10 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
6 Ft.4
Gravel depth beneath pipe
Subdivision Block Lot
Balzell-Schneiter 2
9
Ft.
Fill added above original grade
0 Ft.
Gravel length
40 Ft.
Township Range
Section
Gravel width
5 Ft.
Beds: Number of Lines
na
Distance between lines
na Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
400 Ftz
1
na Ft.
Well
100'+
1001+
NA
NA
25'+
TANK N Septic ❑ S.T.E.P. ❑ Holding ❑ Other
Manufacturer
GREER
Capacity
1000 Gal.
Surface Water
i 1001+
I 100'+
NA
NA
Material
Number of compartments
I
i
Lot Line
10'+
10'+NA
j
NA
NA
HDPE
2
Foundation
101+
10'+NA
NA
LIFT STATION
Manufacturer
Capacity
I
I
Remarks
Gal.
Alarm location
Electrical installed by
Installer
PIPE MATERIAL House to tank 3034 Tank to 3034
drainfield
A+ Homes Services
Drainfield 3034 cOIMT3034
Inspector Pannone Engineering
BENCH MARK (Assumed elevation) 100.0 ft
Inspection1�t 6/7/21 6/14/21
Location and description
es: 2nd
3`d 6/25/21 4°i
house foundation
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
Conditional Approval:
Date
-SN
OF AC gs�
-
49 THS
--:
.. .. .........:..
Septic System
Approved &16V A,, R, -b«
Carr.11 Date /Z Oa_
Note: this approval does not include well permit requirements.
kRuv VJ/VL/ 101
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RECORD DRAWING
PANNONE ENG SVC LLC (C.I. 1088)
P.O. BOX 1807 PALMER, AK 99645 - �E of
PHONE (907) 745-8200 FAX (907) 745-8201 = �?
DALZELL—SCHNEITER 82 L9
DRAWN MMM GRANT & SHARON KLOTZ
10121 SCHNEITER CIR
SITE PLAN ANCHORAGE, AK 99507
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PANNONE ENG SVC LLC (C.I. 1088)
P.O. BOX 1807 PALMER, AK 99645 - �E of
PHONE (907) 745-8200 FAX (907) 745-8201 = �?
DALZELL—SCHNEITER 82 L9
DRAWN MMM GRANT & SHARON KLOTZ
10121 SCHNEITER CIR
SITE PLAN ANCHORAGE, AK 99507
49t
�.. ...Steven one R. nn
CE -8749 :' r
REVISIONS DATE
/
047r4/2022 03/07/2022
SCALE
1" = 50'
P.I.D. NO
015-291-21
PERMIT N0.
OSP201503
SHEET
1 OF 1
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REVISIONS DATE
/
047r4/2022 03/07/2022
SCALE
1" = 50'
P.I.D. NO
015-291-21
PERMIT N0.
OSP201503
SHEET
1 OF 1
Summit Estates
N89057'00"E 183.00 8498E
10' Utility Easement
LOT 9
Asphalt encroaches 1.4't
Ret. wall (typ)
10' Utility Easement
ca
0
W
0
m
Lot 8
1 W
ca
/ �\Se93s �r Chain Zink fence (typ)
°
7
R,36 4
Sp 00 <�g
3
SCHNEITER h' -8Q O0
�4J \ AS -BUILT
SCALE: 1 "= 60'
of
.49th ••:9 ��
�fiizabeth L. Walatka ; ,o po
��u�F� • 8036 - LS
0
t o.-ESSIONpL•LAN
NO CORNERS SET THIS DATE
I hereby certify that I have performed a Mortgagee's inspection
in accordance with ASPLS Standards of the following
described property: LOT 9, BLOCK 2,
DALZELL-SCHNEITER SUBDIVISION
Anchorage Recording Precinct, Alaska, and that the
improvements situated thereon are within the property lines
and do not overlap or encroach on the property lying
adjacent thereto, that no improvements on the property lying
adjacent thereto encroach on the premises in question and
that there are no roadways, transmission lines or other
visible easements on said property except as indicated
hereon.
Dated at Anchorage, Alaska
EASEMENTS OF RECORD, OTHER THAN this 31st day of AUGUST , 2021.
THOSE SHOWN ON THE RECORDED FRED WALATKA & ASSOCIATES, L.L.C.
PLAT ARE NOT SHOWN HEREON Engineers and Surveyors
UNLESS OTHERWISE NOTED. FB 21-3, pg 62-64 BE 907-248-1666
This drawing is a representation of conditions found at the 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 preparer is limited to the amount of fees collected for services in preparation of this product.
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: OSP201503
Work Type: Septic Upgrade
Tax Code Number: 01529121000
Site Legal Address: DALZELL-SCHNEITER BLK 2 LT 9 G:2537
Site Mailing Address: 10121 SCHNEITER CIR, Anchorage
Owner: KLOTZ GRANT D & SHARON K
Design Engineer: PANNONE ENGINEERING SERVICES
This permit is for the construction of:
Q Disposal Field R1 Septic Tank ❑ Holding Tank ❑ Privy
Effective Date:
Expiration Date
�a_4
�r U
l
L)CI)Ell'CII7('l7i
Lot Size in Sq Ft:
Total Bedrooms:
5/17/2021
5/17/2022
❑ 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
3
Tb) x 3 �s L —� elx k e 4, e o f
Received By: Date: _
Issued By: -1' f%C� �^ Date:
MUNICIPALITY OF ANCHORAGE
Community Development Departments Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 015-291-21
Property owner(s) GRANT & SHARON KLOTZ Day phone
Mailing address 10121 SCHNEITER CIR, ANCHORAGE AK 99507
Site address 10121 SCHNEITER CIR, ANCHORAGE AK 99507
Legal description (Sub'd., Block & Lot) DALZELL-SCHNEITER B2 L9
Legal description (Township, Range & Section)
Lot Size 50,089 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING:
(® all that apply)
Absorption Field Initial ❑ Single Family (SF) ❑X
(w/wo ADU)
Septic Tank ® Upgrade 0 Duplex (D) ❑
Holding Tank ❑ Renewal El
Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE / 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: $446.25 (COVID-19) Waiver Fees:
Date of Payment: / ZZlgho Date of Payment:
Receipt Number: n�Oq I r Receipt Number:
Permit No. OSP201503 Waiver No.
Permit App_---.. ;:...:c:
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201503, Rebecca Carroll, 05/17/21
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201503, Rebecca Carroll, 05/17/21
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201503, Rebecca Carroll, 05/17/21
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201503, Rebecca Carroll, 05/17/21
]D~te of Issue: __
?~rcel Ideniificadon Number:__
~p ~ke Depth Below Top of~e~ Cas~g: ~ feet
Size /~ hp
piiless A. dap~ar Buriml Depth:/~9 feet
r" ~ MUNICIPALITY OF ANCHORAGE
( ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street o Anchorage. Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
!
PHONE
[] UPGRADE
Material ~._ N°' of compartments
0 z ~ Manufacturer _~ Material ,iquid capacity in ~llons
a = = DISTANCE TO: Well ~ ~ Foundation ~ Nearestlot hne ~5 PEffiMtT NO.
NO. of lin6 L~ngth of each line~ lotal length of lines
= I~ T~ of tile to finish grade ~1 0'1 Matedal beneath tile G~ 0t~ inches
< ~ Type of crib i d, ,m Crib depth Total eff~ti~ absorption area
0
OTHER
PIPE UATERIA~ ~~ O 5 ~ ~
INSTAkLER~T '~ ~ q"
REMARKS
72-013 (Rev. 3/78)
DAILY DRILLING tOG
SYREN BROS. DRILLING, INC.
2701 £sile Street
Anchorsge. Alaska 99503
274-6437
KIND OF FORMATION:
FRO~.........O. ............... rT.
~oM..._...6.!:. ........... rT.
FROM ........ 1.2. ........... rT.
FROM ........ 52 ............ FT.
FRO~ ........ .65. ........... rT.
FROM ........ 7.0 ........... FT,
FROM ........ 7.~. ......... rT.
ntoM ........ 8.5. ........... rT.
FROM ......................... rT.
TO......:..l.2 ......... rT~nd~...graxrel..
TO ......... 52 ........ FT$.al~. ...........................
TO..'...~5 .......... rT.~,m~t...sLl~c y...s a nd
few gravel
TO .......... 7.0 .......... rT$.il~. .........................
TO ........ ?.~ ......... P~il.~...and...f e~..
gravel
TO ........ -~5 .......... ~T~e.~...graMel .........
TO ......... .8.2 ......... rTgraMel .&...H20..
,E~I, OF W~U- ................... .8.11 .............................................................
STATIC LEVEL OF WATER
DRAW DOWN FT ............................................................................. .' ...................
~Ats. PER .~. ................. .?....g~ll.ons...p~n..minu~.e ...................
X~NV O~ CASINO ........... 6.'.'....l.7lb.....grad~...B ...................................
TO *~0~
FRo,,, .......................... rT .......... ......._.......,~, .......~. ............
FROM .......................... FT. TO ................. .D....,,~iI~ ..................................
~~*°~'~ _ a
.......................... ~. ,o .......................... ~ ~.%:.:..~-.~ .................
FROM
~OM .......................... ~. ~o .......................... ~....-~.~.~%1.%~ .........
.OM .......................... .......................... .............
FROM .......................... ~. TO ........... ~ .............. ~ ........................................
FROM .......................... ~. TO .......................... ~ .........................................
FROM ......................... ~. TO .......................... ~ .........................................
FROM .......................... ~. TO .......................... ~ .........................................
FROM .......................... rT. TO ......................... FT ........................................
FROM .......................... FT. TO .......................... FT .........................................
FROM ......................... FT.
FROM ......................... FT.
FROM .......................... FT. TO .......................... FT .........................................
FROM .......................... FT. TO .......................... FT ........................................
MISCL, INFORMATION:
DRILLER'S NAME .................. ~t ephen...D.~....Syren ...................................
APPLICANT
LOCATION
LEGAL
LIS8 HILLER 1200 W.
SCHNEITER CIRCLE
L~ B2 DALZELL-SCHNEITER
SIMONS SP 1014
LOT SIZE
244 7701
49000 SQUARE FEET
TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH
HAXIMUM NUMBER OF BEDROOMS
SOIL RATING (S~ FT/BR)= 125
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
DEPTH---- lid LENGTH= :~: ::~ GRFI~,.'EL DEPTH= ~..
THE LENGTH DIMENSION IS THE LENGTH (IN FEET> OF THE TRENCH OR DRAINFIELD.
TWE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
REQU I RED SEPT I 0 TI:INK _c; I ZE= ::LOIDID GF:tLLOI'-I$
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AN[) THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
TI40 ( ~: > I NSPEI~T IONS fIRE REQLI I RED
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
HIrIIMUM DISTANCE BETWEEN A WELL Arid ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL; OR
150 TO 200 PEET FROM FI PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DAYS
OD THE WELL COMPLETION.
OTHER REQUIREMENTS HAY APPLY. SPECIFICATIONS 8ND CONSTRUCTION DI8ORAtIS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
PERMIT EXPIRES DEC:EFIBER 31 ~ I_c~.78
I CERTIFY THAT
1: I AM FAtIILIAR WITH THE REQUIREMENTS FOR ON-SITE SELLERS ArID WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
~: I UNDERSTAND THAT THE ON-SITE SELLER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS.
APPL~4~NT ~.ISA MILLER
V-?... 2
CONSULTING ENGINEERS AND SURVEYORS
November 11, 1976
Eileen M. Schneiter &
Bob Dalzell ..
Box 3001
Anchorage, Alaska 99501
Re: Subsurface Investigation
Proposed Subdivision %.:est of Birch Road
Dear Mrs. Schneiter & Mr. Dalzell:
This report presents the results of our soil investigation
for the proposed subdivision of a 30-acre tract located west
of Birch Road. The investigation was conducted on November
2 and 3, 1976. The results of that investigation are included
in this report as follows:
Vicinity Map
Test Hole Location Sketch
Idealized Soil Profiles
Test Hole Logs (Sheets 1 through 14) .-
Summary of Laboratory Test Data
Standard Explanatory Information
Drilling was accomplished utilizing a mobile drill B-50
mounted on a flex track Nodwell vehicle owned and operated
by Denali Drilling; Inc. The test holes were logged and
percolation tests conducted by our firm. Harding-Lawson &
Associates performed the laboratory test data on ~rab samples
taken during the drilling.
The purpose of the investigation was to provide soils data
for establishing the feasibility of on-site disposal of
sanitary waste using seepage pits. To accomplish this, we
drilled 14 borings distributed across the site as shown on
the test hole location sketch. All borings were drilled to
a depth in excess of 15'. During the drilling, our engineer
was present to log the materials encountered and obtain grab
samples of the soil types encountered. All soils were
9isually classified in the field in accordance'with the
unified soil classifications system as described herein.
GORDON O. UNWIN, P.E. LEO $CHEBEN, JR., I~E.,L.$. EARL
PROJECT TEST HOLE NO. 2-9
CLIENT ELEV. TOP OF HOLE 478+
W.O. DATE 11/3/76
SHEET 6 OF. 14
18" Organic Silty Sand (OL)
Damp, Brown, Gravelly Sand (SW)
2-9 (1.)
(12.2% Silt)- "
2-9 (2)
Bottom, Dry llole
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. OI5.- 2.~11- '~1
1. GENERAL INFORMATION
Complete legal description
Location (site address) IOI
COSA# ! 0
Expiration Date:
Current Property owner(s)
Mailing ~ddress
Lending agency
Day phone
Day phone
'zzz- 3'{53
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise-requested,-COSA will be held by DSD for pickup.
NUMBER OF BEDROOMS: ~
TYPE OF WATER SUPPLY:
Individual Well ..................... [] .......... Individual On:site
Individual Water Storage [] Individual Holding Tank
Community Class ~Well [] Community On-site
Public Water System [] Public Sewer
TYPE OF WASTEWATER DISPOSAL:
The Municipality of Anchorage Development SerVices Department (DSD) issues Certificates of On-Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of On-Site Systems 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 COSAs upon request to homeowners. Certificates of On-Site Systems 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, (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm L 3,m S.~ur~l ~n~
Address ~0~ ~J. ~S~Av~. 5~, '/_o?.. An,~,~'~,. AK
Engineer's Printed Name L A~s ,~'e~¢,,.,~, J '
5. DSD SIGNATURE
~ Approved for ~ bedrooms.
Disapproved.
Conditional approval for
bedrooms. ~th the following stipulations:
By:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
X
Arsenic Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date: J"?/ -//-- t/ ~
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Elmore Street
P.O. Box 196650
Anchorage, AK 99519-6650
www.muni.org/onsite
(907) 343-79O4
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: D~¥z¢ll - 5¢t~fl.~,'t~¢~ ~tl,~"Z ~' (~ Parcel ID: OJ5 -
A. WELL DATA
Well type
Date completed
Total depth ~ ~' ft.
IfA, B, or C provide PWSID if
Sanitary seal (Y/N)
Casedto ~' ft.
FROM WELL LOG
Dateoftest . ,
Static water level U I~ ~ ~ r~ ft.
Well production '-~ g.p.m.
WATER SAMPLE RESULTS:
Coliform ~:~ colonies/100mL Nitrate .~,~/ mg/L
Arsenic: ~ 5,o0 ug/L date of sample: 312/2o~o
SEPTIC/HOLDING TANK DATA
TankType/Materlal 6rear' /Sf{fl
Tank size 10~ gal.
Foundation cle~nout (Y/N)
Date of pumping -3121 20,0
C. ABSORPTION FIELD DATA
Number of Compartments
· Depression over tank (Y/N)
Pumper ,At. ~c,R~
Well Log (Y/N)' Y
Wires properly protected (Y/N)
Casing height (above ground)
In.
Elapsed Time: ~5 min. Final fluid depth Lift in. Absorption rate >= ! q~)
Any rejuvenation treatment (past 12 mo.) (YIN & lype) /~on~ ~o~ ~ If yes, gi'~e dale
Length 33 ft. Width 7- I1~, ~ ft.
Total depth (~,"{' ft Eft. absorption area ~ ~ ft=~ Monitoring tube. "~ Depression over field
Dateofadequacytest ~tZl"ZotO Results(Pass/Fail) Pq% For:~ bedrooms
Fluid depth In absorption field before lest '~} In. Water added HSO gal. i New depth
g.p.d.
Other bacteria .
Cleanouts (Y/N) r :
High water alarm ~/N)
System type~ ~
ft. Gravel ~I~ pi~
g.p.m.
'~'~ ' colonies/100 mL
D. LIFT STATION
Date installed ,/ Size in gallons ·
'Pump on' level/a/ in. 'Pump off level at.._.~.
/
Datum ./ Cycles tested
./
E. SEPARATION DISTANCES
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & circu'_d4~e~uirements?
in.
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on let
Absorption field on lot JOO
Public sewer main
Sewer/septic sen/ice line
Animal containment areas 50' +
On adjacent lots
On adjacent lets
Public sewer manhole/cleanout
Holding tank
Manure/animal excrete storage areas
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation.
Water main ~O~+
Wells on adjacent lets
~; I+. Prope~y line
Water sen/ice line
!
I00 4-
Absorption field.
Surface water
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property ine.
Water Service line
Curtain drain /V, O,
F. COMMENTS
Building foundation
Surface water too
Wells on adjacent lots
Water main I O ~ '¥
Driveway, pa~ing/vehide storage I O ~ ¥
G. ENGINEER'S CERTIFICATION
I cerfify that I havo determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name
Date
COSA Fee $ ~0 eo ..
Date of Payment 3/3o [ ?..o ID
Receipt Number OSa ~3r
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
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
I arcel
Expiration Date:
1. GENERAL INFORMATION
Complete legal description . Lot 9, Block 2, Dalz..ell Schnelter Subdivlslon
Location (site address or directions) 10121 Schneiter..Clrcle
0300 4
Current Property owner(s) Bill and Usa Miller
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
NUMBER OF BEDROOMS: Three (3)
Day phone .346-1164
1012t Schnelter Circle.. Anchorage, AK 99516
Day phone
Dayphone
3. 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 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-sita wastewatar 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 lhe date of issue for properties served by a private or Class C well and may be reissued with
new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with
valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water
system. The Municipality of Anchorage Is not responsible for errors or omissions in the professional engineer's
work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-
site water supply and/or wastewatar disposal system is(are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-sita water supply and/or
wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm Anderson Englneerin,q ,
Address P.O. Box 240773 Anchorage, .AK 99524
Engineer's Printed Name Michael E. Anderson, P.E.
DSD SIGNATURE
Approved for
Disapproved.
Conditional approval for
bedrooms.
Phone 522.7773
Date 3fl712003
bedrooms, with the following stipulations:
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
X
Maintenance Agreements
Supplemental Engineer's Report
Other
(Rev. 12/00)
Odginal Certificate Date:
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Pmgram
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6850
www.ci,an~orage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Lot 9. Block 2, Pal=ell Schnelter Subdiv!stoq
A. WELL DATA
Well type Private
Date completed 8/26/1678
Total depth 87 fl.
IfA, B, or C provide PWSID ft ,
Sanitary seal ~/N) Y
Cased to, 87 fl.
FROM WELL LOG
, 8~r~lg?S
Uqknown fl.
Date of test
Static water level
Well production
g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mi.
Date of sample: 3/10/2003
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material .$eptictSteel
Tank size 1,<100 gal.
Foundation cleanout (Y/H) :~
Date of pumping _3/10/2003
C. ABSORPTION FIELD DATA
Nitrate .3. mg./I.
Collected by: A. Harala
Number of Compartments 2
Depression over tank (Y/N) _N
Pumper isaacs
Parcel ID: 035-291:21
Well Log (Y/N) y,
Wires pmpedy protected (Y/N) y
Casing height (above ground) >24 . in.
AT INSPECTION
. 3/7/2O03
· ,SO,2 ft.
· 6,7.4 g.p,m.
Other bacteria ,9. colonies/100 mi,
Date installed 9/2011978
Cleanouts (Y/N) y
High water alarm (Y/N)
For 3_ bedrooms
g,p.d.
If yes, give date
Date installed 9/20/1978. Soil rating (g.p.d./fl2 or fl2/bdrm) 125_ sF/BDRM System type Deep Trench
Length .33 fl. Width ~8 fl. Gravel below pipe 6
Total depth 10 fl. Eft, absorption ama 396 fl2 Monitoring tube Y Depression over field N
Date of adequacy test 3/'f120p3 Results (Pass/Fail) Pass
Elapsed Time: 1.440 min. Final fluid depth 39 in. Absorption rate >=
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N
LIFT STATION
Date installed
'Pump on" level at
Datum
E. SEPARATION DISTANCES
Size in gallons
"Pump off" level at ~
Cycles tested
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot. 96~
Absorption field on lot >100'
Public sewer main NIA
Sewer/septic service line >25'
in.
Manhole/Access (Y/N)
High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots >100'
On adjacent lots >100'
Public sewer manhole/cleanout N/A
Holding tank NIA
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Property line ...>5,.
Water service line. ~10'
Building foundation >5'
Water main >1.0'
Wells on adjacent lots >100'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line >10' Building foundation >10'
Water Service line >10' Surface water >1.00'
Curtain drain None Noted Wells on adjacent lots >100'
COMMENTS
*' See Well to Seotic Tank Wa'n/er
ENGINEER'S' CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name Michael E. Anderson.
Date 7/3/2003
Absorption field >5'
Surface water >100'
Water main >10'
Driveway, parking/vehicle storage >25'
Waiver Fee $
Date of Payment
Receipt Number
HAA Fee $
Date of Payment ~
Receipt Number
(Rev. 1
in.
Al. ~D o. ~7: O0 "~.
./
I
~tOO D
v
co,Jo.. P,~T~JIVIt,16
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 ,(FAX)
July 3, 2003
Municipality of Anchorage
Building Safety Division
On-Site Water and Wastewater Program
4700 S. Bragaw Street
Anchorage, AK 99507
Subject:
Lot 9, Block 2, Dalzell Schneiter Subdivision
Separation Distance Waiver
Septic Tank to Well
Dear On Site Services Engineer:
The septic tank on Lot 9, Block 2, Dalzell Schneiter Subdivision was originally placed
on the lot in 1978. Documentation completed at that time and a Health Authority
Checklist completed in 1987 state the distance between the septic tank and the private
well on the lot is 100'. A recent measurement, however, indicates the well is only 98.7'
from the septic tank cleanout. We are therefore applying for a separation distance
waiver allowing the septic tank to remain 96' from the well. The attached site plan
shows the current configuration of the well and septic system on the lot.
The well is located approximately 10' upslope from the septic tank with the surface
drainage of the area from south to north at steep grades approximating 15%. Ail
surface water drains swiftly away from the well. The soil on the lot is primarily a silty
gravel, which percolates at between 6 and 15 minutes per inch. The absorption trench
constructed in 1978 is still in fair condition and absorbs water at a rate faster than 450
gallons per day. The flow from the absorption pit appears to be in a northerly direction
and away from the well following the surface slope of the area. The surface slopes at
close to 10% away from the absorption pit on the north side of the property. It is highly
unlikely any effluent escaping from either the septic tank or absorption trench would
flow in the direction of the well.
The log for the well indicates it is 87' deep. The static water level was recently
measured at 50.2' below the surface. The log indicates a lense from 52' to 74' below
the surface, which is either silt or silt with minor amounts of gravel. This lense should
protect the aquifer from contamination from any surface water as it will slow or prevent
percolation. We have evaluated the justification for a separation distance waiver based
on ADEC guidelines. This evaluation is as follows:
Lot 9, Block 2, Dalzell Schneiter
Separation Distance Waiver
July 3, 2003
Page Two
Separation Distance Waiver Guidelines
Water Table 40' Below Tank 5.0
Soil Type Sand & Gravel with Silt 2.5
Permeability Sandy Gravel with Silt 1.0
Water Table Gradient 10% 6.0
Horizontal Separation 96' 2.8
Total 17.3
The conclusion based on the aforementioned point totals is that almost surely no
form of contamination can be expected from household sewage. It is therefore
recommended the waiver be approved to allow the existing septic tank to be 96' from
the existing well.
A recent water sample taken from the well indicated an undetectable concentration
of Nitrates. In addition, no coliform or other bacteria was found in the water. This
compares with the sample taken in 1987. It is apparen{ that neither'the absorption
trench nor the septic tank is influencing the quality of the water from the well.
Sincerely,
Michael E. Anderson, P.E.
Attachments
v
h
ZP. '":..'Y ',
... . ',J/:/,~~/C//")~. . . -
e. ,. .....,-.,,o V.. 'o ~ ,~. ~e~,~.gnslhllity to d0tefmP~e tho
~2~ "~ .."'~'~ ~ or restrictions which do not appear
Sh'~% ~.. ......... .,~ ~__,.,-
l~e0n be u~ for ~ns~on 0r ~
ENGINEERS · PLANNERS - SURVEYORS
440WEST BENSON BLVD.
ANCHORAGE, ALASKA 99503 562-5291
LEGAL DESCRIPTION:
SURVEY CERTIFICATION: I hereby certify that I have surveyed the property shown
Icflbed hereon end that the Improvements situated thereon ere within the property lines
encroachments exist other than noted.
PLEASE NOTE: It Is the contract
-or'~ responsibility to check top
of · foundation In relation to
finish grade end building let-
backs In relation to lot lines
LEGEND: SET FOUND
5/8" REBAR · 0
HUB & TACK
MONUMENT
AL-CAP ~ (~)
PK NAIL X
IRON PIPE - (~ '
I'ELEVS.-DATUM
ASSUMED
Municipality of Anchorage
Development Services Department
Building Saf~y Division
On-Site Water and Wastewat~ Pwgram
4700 Bragaw Street
P.O. Box 196650 An~orage, AK 99519-6650
www. ci.anchorage.ak.us
(907) 343-7904
Waiver Review Worksheet
WRg: 030052 PID~: ~)t5-291o21 HAg:
Permitg:
Date Received: 7/3103
Legal Description: Dalzell $ohneiter
Engineer:. Anderson Enulneerinu
Applicant: Mike Anderson
Waiver Requested: 96, septic tank to well eeperation distance
Criteria: Geology
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Points:
Total:
Waiver is Granted: Waiver Is not Granted:
List Conditions or Reasons for above:
' I Name of Reviewer
Rec~: 37981 Amount: $800 Date Paid: 711012003
~f.~- /(e,)e.. 7'l~e ~o;I o,v tlc z,,/- ;s /or~M.~;/y 2;~//n, ~o~c/.
-- 7'-a,v'l,-.- D~ 4n ---
~ (so
'l
?il
~o.z..)
-II +
E-
· ALASKA ENVIRONMENTAL
CONTROL SERVICE-e-,INC.
1200 West 33rd Avenu~ ;uite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
JOB
SHEET NO,
CALCULATED BY
CHECKED BY
SCALE
DATE
DATE
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4744 Application Date ,~.h ~>/~
GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMI~AL)
Descr~tion (include I~t. block, ~u~division, jectioD, township, range)_
Location (address or direction~
(b, Prope~;w~e; ~/~ ~~Teleghone:Home.~usiness~
Mailing Address
(d),, AddressReal Estate Company.. .and Agent
Telephone
(e) Mail the HAA to the followino address: or. Check here I-I, if hold for pick up.
List contact.person and day, phone number below.
TYPE OF RESIDENCE
Single-Fam. ily j~'
Number of Bedrooms
WATER SUPPLY
Individual Well~) Community I-] Public
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsite~ Public I"3 Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
ENGINEERING FIRM PROVIDh.. INSPECTIONS, TESTS, FILE SEARCH, DA I A AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
AN:~lr~iO~ Firm ...... _
Date ~
DHHS APPROVAL
Approved for ~'/""'"~'Cf'~,,) bedrooms by ~ '~:?' "~
Approved ~ Disapproved Conditional
Terms of Conditional Approval
CAUTION
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
order to 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
engineers work.
Page 2 of 2 ?2-~s m~, ~,86~ SAck
MUN,CIPAUT OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FAClLI~
264~720
Application Date
GENERAL INFORMATION
(a)
Legal Description (include lot. block, subdivision, section, township, range)
Location (address or ~irections)
(b) Applicant Name ~_~,fA }-~/4~[~.~' Telephone: Home ~/("° ~/~"~" Business
Applicant Address ,/'~/~'/ -~'~'/'/'~'~7~'~' ~/~" ,~.~ ,,~'.
(c) Applicant is (check one): Lending Institution I-I; Owner/builder'S; Buyer []; Other [] (explain);
(d) Lending Institution /'~'~'W/~t7~'~v//y~- z~,.~.~'~' Telephone
Address
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address:
TYPE OF RESIDENCE
Single--Family~' Multi-Family []
Number of Bedrooms '~
Other
WATER SUPPLY
Individual Well']~. Community [] Public []
Note: If community well system, must have written confirmation from the State DePartment of E. nvironmental Conse,rvation
attesting to the legality and status· "' ' ', ,
SEWAGE DISPOSAL
Onsite/~[~. Public [] Community [] Holding Tank
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page I of 2 72-025
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm Telephone
Address /~/~ ./,J ...~.~1~ ~.~,~c~ ~'lil,t~'~ ,~
6o
Approved for ~ bedrooms by _/_
· ~ D~ v~-'d Conditional
Terms of Conditional Approval ~J ~/~ ~
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2 ~'
A. WELL DATA
MUNICIPALITY OF ANCHORAGE (MO~:~
MUNIO~ALr~ OF Ai'.,~,O~¢~.~.
~ SERVIC~S D~ AUTHORITY APPROVAL (~)
E~I~ CHECKLIST - FEBRUARY 19M
2 6 1987
RECEIVED
Well Classification
Well Log Present'N)
Total Depth fi'
Static Water Level
~),E/~,~-7~- If A, B, C, D.E.C. Approved (Y/N)
Date Completed ~'~°~' -' ? ~' Yield
Cased to 3' ~' · Depth of Grouting
~',','/;P- ~' ' Pump Set At
Casing Height Above Ground
Electrical Wiring in Conduit (Y~)
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
Sanitary Seal on Casing~l) .~z'-z" d~//yz.,/x'$ ~
Depression Around Wellhead (Y~
Water Sample Collected by /'~'-E ~ ; Date
Water Sample Test Results
Comments ~z~ ~',J4-Z'_t /z:.~.J
/P~'~ ; On Adjoining Lots /~"~'~ '~
//~'" ; On Adjoining Lots /~'~ '~'
To Nearest Public Sewer /
To Nearest Sewer Service Line on Lot ~--5' -~'
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes~N)
Depression
over
V
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well
To Property Line
To W;ter Main]Service Line
Size /~''//C~ No. of Compartments ~"~'
Air-tight Caps(~) Foundation Cleanou~N)
Date Last Pumped
; for
Temporary Holding Tank
To Building Foundation
To Disposal Field
Permit (Y/N) ,4///,~
Course
To Stream, Pond, Lake, or Major Drainage
Comments';~,,J~/7~,,~,w.- '73 ,~/z~ ~z,P~'.~$.</~,./ Ix/ $,,~,/~ If,Y?.
Pagelof2 . ' :. :
72-026[11/84)
C, ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed ~- 2o - ?~"
Width*of Field ,.~ · ~'
Square Feet of Absorption Area -'~ ')~' ~
Depression over Field (Y~
Results of Last Adequacy Test ./~'~'/~ 7~E' ,--'"'"
Separation Distance from Absorption Field:
To Water-Supply Well //~-- ·
To Building Foundation _.T~
Lot
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present)
Date of Last Adequacy Test
To Property Line 7~'
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if present) /',/'/,,~
LIFT STATION
Date Installed~'-,.~
Size in Gallons --.,.
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N).
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
~~les during Adequacy Test.
Meets MOA
°* Check Permitted Bedroom Rating Against HAA Request **
I certify that I have phecJ~ed, ye{if ted. or conformed to all MOA and HAA guidelines n effect on the date of this inspection
Signed ~'"~'° /~'CJ/~'''~ Date .~--,/'~ '°C7
Company /~r-~' ,< MOA No.
Receipt No. ./(~ ('¢~/
Date of Payment "-2,/) ~'.~'.,~ ,
Amount: $
Page 2 of 2
SYREN BROS. / 2LLING, INC.
2701 EAGLE STREET
ANCHORAGE, ALASKA 99503
274-6437
8-28-78
STATEMENT
r,IR. & r, IRS. BILL ;,:ILLER
1200 WEST DI~.IOND BLVD.
SP.# 10-14
ANCHORAGE, ALASKA 99502
cased hole $18.50
oer ft ...... · ~160~ .00
well seal N/C
"drive shoe N/C
. ~ ~"~.~ ~,o
?-. L~-'-~7~'~!'-_'~. , ~.T~.~:~~ ~.,,_ ~... ~,:~:~--_ .
Redi~rms 8S872