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HomeMy WebLinkAboutTROLL KNOLL BLK 3 LT 1Troll Knoll Block 3 Lot 1 #051-521-05 a Municipality of Anchorage Page ► or a 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: SwgS03q 1 PID Number: 051 5 a I OS NameJ Wastewater System: El New J Upgrade 1 Eh i LANAE �Jrl_if� tY Addfe"` �'rji0�1 I•III_L.TO4VR• ABSORPTION FIELD Cr1JbIAK�AIC,�i45ia� Phone:No. of Bedrooms: g$ — q'] � 1 L{ ❑Deep Trench !9'Shallow Trench ❑Bed ❑Mound ❑Other Soil Rating: Total Depth from original grade: LEGAL DESCRIPTION b.tn GPD/Sq Ft. %1 Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe 7J" 'riZ0LI_ KH JOLT. r, I Ft. q I Ft. Township: I Range: I Section: Fill added above original grade: Gravel length: —� —� 6-S 1— DI Ft. 1001 Ft. Gravel width: , Number of Ilnes: Dislance tbtaeen filet WELL:EXtsTl.,a❑ New ❑ Upgrade S IFc Classification (Private. A•B•C): Total Depth: Cased To: Total absorption area,,: Pipe material: AS'tVA SO. Ft. r-9 ID r MO3q Driller. Da 0: Static Water Level: Installer. Date installed: Ft. jtJ£EU esc<. 11-a8-gS Held: imp Set at Icaaing Height Abdre Graand: TANK / GPM I Ft Ft. SEPARATION DISTANCES aseptic DHolding ❑S.T.E.P. To Septic Absompton Litt Holding Public/Prhata Manufacturer. Capacity In gallon From Tank Field Station Tank Welt, 1tS� X001 -- Surface 100-V Water 1001+ Lot 1 Line— Foundation�-- Curtain Drain Remarks: r, Ste ter. Saar Lines f4NGuoa�La.E TALIk /O�v E,r,r;,Jy� S'DD ?.5 Material: Number of Compartments: 1 LIFT STATION Size In gallons: I Manufacturer. "Pump on" level at: 1Pump off I High water alarm at: Pump Make Electrical Inspection$ performed by: BENCH MARK Location and Description: -T2)p o F S-TC"Q C�. &_nTOnn C000_0_rreC STEP Assumed Elevation: 100.0 1 Ft ENGINEER'S SEAL S 3 S ENGINEERING ya,' i, 17034 Eagle River Loop Road, No -204 Inspections performed b �gle Rivay AI•ah 9s77 Dates: 1st ....... ., 2nd 11-29 _q5 _.._ .. 'p T, RDet:RT c eowAN <<iCI:-x801 Department of Healand Huuma Sery•. viices approval +i Reviewed and approved by: r,�c ?� /y�"� Date: /2 -S - 9S 2ttti ° ;:_ c_�i 72-013 (Rev. 9/91) MOA 25 Permit No. SW950391 Page 2 of 2 Municipality of Anchorage 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 Legal Description: LOT 1, BLOCK 3, TROLL KNOLL SUBD. PID No: 05152105 ST: 196.4' J� FINAL ;RADE >,T>r _CO3 69.7' FINAL GRADE NEW 00.0 500 CAL SEPTIC. TANK NEW TR=N SCALE I' - 40' \90.8' 65.7' 31.7- 2 mz EXISTING SYSTEM ABN ED SU TMT R W7 9E USED N T E MORE zc� LOT 1 72-013 A (R«. "I) MOA 25 N ' ... ' 1+ 1,1 S ROBERT C. COWAN / /,�t1 1 i�CE`8801,,s ♦ 76.5' NO WATER FOUN 11-15-95 EXISTING 1000 GAL SEPT C TANK itt VERFlED fl -2a-95 A B RT1 ,fig' 10' ST2 71' 16' ST3 73' 20' GPFtPGF C01 74' 25' CO2 75' 26' V DV 75' 29' CO3 93' 75' p`Z 4i C04127"58' MT1 92' 75' MT2 124'157' N ' ... ' 1+ 1,1 S ROBERT C. COWAN / /,�t1 1 i�CE`8801,,s 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 (UPGRADE) PERMIT NUMBER:SW950391 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:BUTLER TED H & LANAE D OWNER ADDRESS:23707 HILLTOP DR CHUGIAK, AK 99567 PARCEL ID:05152105 LEGAL DESCRIPTION: TROLL KNOLL BLK 3 LT 1 LOT SIZE: 30100 (SQ. FT-) NUMBER OF BEDROOMS: � THIS PERMIT: THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 //-27-r/3 J /.vrv. 10.'aof. 11-27-9_ _ PERMIT DATE ISSUED:11/20/95 EXPIRATION DATE:11/20/96 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: 7� /1 /2i lqs— RECEIVED BY: DATE: ISSUED BY: / ��� DATE: l�/ZOOS i li-22-ys 1QEOESi4.1-1 /rrkFp To Ti-fi1 oFr-iEF_ pkP, pEPROPM, SEF- A7rh-cKep kE D6S/GAS. P -2 -7 -?:r l:N61Aroq Q ro rylr G.Esr PRovecary ZN oR06R TO 0.87,94-AlTKE REa,raCO fO� tEI8r3tp p,�o�„ A JTt6P 04uP sokoq.(.D �w�t�, A or /.uPAGr vpprv,,,,A f November 15, 1995 HEALTHXflHMTy APPRMALS MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 SEWER& WATER &WNEMNSKM REFERENCE: Lot 11 Block 3, Troll Knoll Subdivision ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CMLENGINEERS (907)694.2979 FAX (907) 694-1211 Request you issue a permit to upgrade the septic system SEWER&WATER serving the existing three bedroom house on the referenced WSPECTION property. A test hole was excavated and a percolation test performed in the area of the proposed upgrade. The approximate ENGINEERNGSTUDES location of the test hole is located on the attached site ANOREPORTs plan. At the time of excavation no water was encountered in the test hole and after seven day ground water monitoring, the WELL*4SPECTMH &FWWTEST monitoring tube was found to be dry. Attached is the proposed upgrade design. SITEPLV4 We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. ROAnOESIGN This is also to notify you of a relocation of the proposed well on Lot 4, Ripley SID (permit f 950003). The owner, �a Jim Sullivan, is aware and agrees to this change. Please pqQ reissue a new permit for Lot 4, Ripley SID. W&TEST If you require additional information, please contact us. Sincerely, ERCOIARON TA A TEST /�'�C.-,Z Robert C. Cowan, P.E. RCC/gk STKX.'TLfm& "ESWNCA` Enclosure HSPECUM ONSITE WASTEWATER DSPOSALSISTEM DESIGN /?eat- I0J0 c�r'r vi - 10,'2 r10;2 sl- c TA e. o 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER, ALASKA 99577 az J CL w N LEGAL I -OT 1, BLOCK 3, TROLL KNOLL S/D �^ DRAWN D.H.L.. I CKD. R.C.C. I DATE 1 1-15-95 I SHT. 1 OF 1OF epunG DESIGNXTERIA: 8DRMGPD / � SOILS = 0.6GPD/SO.FT. 6&,4WI06- •� SO.FT. REO'D. REDUCTION/F`lid OR = 0.50 TRENCH DESIGN: 6' DEEP STRUCTURES. EASEMENTS, OR ENCROACHMENTS SHOWN ON THIS SITE PLAN ARE AS SHOWN ON AN AS -BUILT SURVEY DRAWN BY: IT IS RTHEEBREESPPONSIB RESPONSIBILITY CONTRACTOR TO VERIFY EASEMENTS, REQUIRED SEPARATION DISTANCES. AND PROPERTY LINES FRIOR TO CONSTRUCTION. 4' EFFECTIVETwp Qurc.E1G 5' WIDE �ILONG �9EP= .EEA 'XISTING SY TEM _Z _ _ PROPOSED TR w' mIrY 10' UTRRY EASEMENT LOT 4, RIPLEY S/D PROP. vr, ,. HILLTOP DRIVE O � � W ALL PORTIONS OF SYSTEM / WITH LESS THAN 3.5' OF (s -mc COVER REQUIRE INSULATION. AREA LOT 1 WOODED HOLLOW S/D Rr•• �� 100' TFLL RADrU-S °r I LOT 1 'S 44th .Inn i ROBERT C. COWAN CE -8801 fit CONTRACTOR IS REQUIRED TO OBTAIN UTILITY LOCATES / PRIOR TO ANY EXCAVATION 00 EXISTING 1000 GAL LOT 14 UNE CLIENT T E C. "R wY win M Ci �EN$ S WO 0E P�m W TME FR . MECESS . TO w.ET SITE Coon LEGAL LOT 1. BLOCK 3, IRAWN D.H.L. I CKD. Z 5 EL w I- V) :XISTING DESIGN CRITERIA: BDRMS = 450 GPD OILS = 0.6 GPD/SO.FT. 50/06 = 750 SO.FT. REO'D EDUCTION FACTOR = 0.50 TRENCH DESIGN: / 6' DEEP 4' EFFECTIVE 5' WIDE 75' LONG �EVIIC. ARBA ` 10' UTILITY 10' uTIUTY EASEMENT ---------------------------- LOT 4, RIPLEY S/D PROP. WELL TROLL KNOLL S/D R.C.C. I DATE 11-15-95 I SHT' 1 OF 1 _ HILLTOP- DRIVE II _ ALL PORTIONS OF SYSTEM %ITH LESS THAN 3.5' OF �s�cric COVER REQUIRE INSULATION. ARCA J / LOT 1 WOODED HOLLOW S/D A' -,TT 100' U'ELL RADIUS STRUCTURES, EASEMENTS, OR ENCROACHMENTS SHOWN ON THIS SITE PLAN ARE AS SHOWN ON AN AS—BUILT SURVEY DRAWN BY: ROBERT C. JOHNSON IT IS THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY EASEMENTS, REQUIRED SEPARATION DISTANCES, AND PROPERTY LINES PRIOR TO CONSTRUCTION. PROPOSED TR IJ \r LOT i OF n i ROBERT C. COWAN CE -8801 CONTRACTOR IS REQUIRED TO OBTAIN UTILITY LOCATES /PRIOR TO ANY EXCAVATION WORK. ING 1000 GAL ROW I ,v M MAY 1 /�wa7ER UNE CLIENT THE E VIEER wY VNtY T Ew OWNS S MD OESGM KCCESWM . TO LRT UTE CO O47 s • (EN�([1j{(�l) OF 3^� ... Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES �'L S • » »01 j� 825 "L" Street, Anchorage, Alaska 99502-0650 r.. » .. SOILS LOG — PERCOLATION TEST %........ _.., l.............. %.n ROSERT C. COWAN ? Ct-8801 i'• PERFORMED FOR: �J'<tiE-L- DATE PERFORMEL�I�i•1s^�rtT�••'•��`� LEGAL DESCRIPTION: L,,,r �3 ��s.l. V_,�,Township, Range, Section: b� SLOPE 1 ' / S✓% 2 T 8 4 = J, A �M l/ 5— 6 _y 7—.x 8 —,, 9�Q_O_ 10 —. WAS GROUND WATER I ENCOUNTERED? 11 s IF YES. AT WHAT f L 12 - ' DEPTH? p - E Pj. Depth to Water er 13 O Monitoring] Oats SITE PLAN -C-e�i ac1-s -N 51 -re -- 14— e-- ?L OR\ T N 14 — Reading Date Gross Net Depth to Net Time Time Water Drop 15 - 16- Z' 17 - 18 - (. N19- 20- PERCOLATION RATE A (mmutesnnch) PERC HOLE DIAMETER q,, t / TESTRUNBETWEEN __L FTANO "I FT COMMENTS 5 & 5 LNGINEERING PERFORMED BY: 117n'td Eagle River LOOP Road N& *4 F%1A..sd D CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH F L9STATE A%DiMUSNI99577 PA GUIDELINES IN EFFECT ON THIS DATE DATE 72-008 (Rev. 4185) HEALTHARHORITY APPRWA S SEWER 8 WATER MAME7(TENSIONS GENERAL: ON-SITE WASTEWATER DISPOSAL SYSTEM and MATERIAL SPECIFICATIONS Lot 1, Block 3, Troll Knoll SID November 15, 1995 ROBERTC.COWAN, P.E. ROBERTA. SHAFER, P.E. CML ENGINEERS (907)694-2979 FAX (907) 694-1211 SEPTIC TANK INSTALLATION: STRUCNRALS &4ECHA+r& 1. A septic tank is to be constructed by a certified NSPECTIONS septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. ONSITE WASTEWATER 09SPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP - SURE 204 -EAGLE RIVER. ALASKA 99577 1. The scope of this project includes the installation of a five foot wide drainfield to serve the existing SEWER&WATER three bedroom residence on the referenced property. NSKcnON The existing septic tank is to be excavated to verify integrity. If of poor integrity, the tank is to be pumped, crushed and abandoned. The existing leachfield is to be abandoned such that it may be used ENCANEERINCSTUCHES in the future. ANDREPORTS 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all WELL WSPECTION &FLOW TEST applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any SNEPIA+S necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas F4ADMS,a, subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. SM TEST 5. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the PERcounoN ,EST Municipal Health Department. SEPTIC TANK INSTALLATION: STRUCNRALS &4ECHA+r& 1. A septic tank is to be constructed by a certified NSPECTIONS septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. ONSITE WASTEWATER 09SPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP - SURE 204 -EAGLE RIVER. ALASKA 99577 Page Two Lot 1, Block 3, Troll Knoll SID November 15, 1995 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (roughed -up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Page Three Lot 1, Block 3, Troll Knoll S/D November 15, 1995 5. Backfill over the final gravel layer must not be less than twenty -f our (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pine Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the $200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. Page Four Lot 1, Block 3, Troll Knoll S/D November 15, 1995 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre -construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. Page Five Lot 1, Block 3, Troll Knoll S/D November 15, 1995 S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER December 4, 1995 WALTHAMHORTY APPROVALS Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street SEWERaWATER P.O. BOX 196650 MAN D(TEWONS Anchorage, Alaska 99519-6650 SEWERAWATER REFERENCE: Lot 1 Block 3 Troll Knoll Subdivision F4SPECTION ROBERTC. COWAN. P.E. ROBERTA. SHAFER PE. CML ENGINEERS (907)694-2979 FAX (907) 694.1211 Request you issue a Health Authority Approval on the mNEERwGsTLoEs referenced property and grant a waiver for the horizontal AND REPORTS separation distance between the leachfield and the property line at 1 ft. We do not anticipate any adverse affects on the adjacent i>ESTCTON properties. The property line is adjacent to Lot 4 Ripley Subdivision and the owner has no objections. If we may be of further service please contact us. SITE RAMS Sincerely, ROAD DESIGN &X? Robert C. Cowan, P.E. SOILTEST PERCOLAnoN TEST STRUCNRALa MECHAwICAL wSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER. ALASKA 99577 4 �-� Municipality of Anchorage (\ _ Department of Health and Human Services 825 "L" Street Rick Mystrcm, P.O. Box 196650 Anchorage, Alaska 99519-6650 Mayor December 7, 1995 Robert C. Cowan, P.E. S & S Engineering 17034 Eagle River Loop Road Suite 204 Eagle River, Alaska 99577 Subject: Waiver Request for Lot 1 Block 3 Troll Knoll S/D Waiver Request #WR950067, PID #051-521-05, HA950559 Dear Mr. Cowan: Your request for a waiver of the required 10 foot separation between a septic system and a lot line has been approved. The waived distance is 1 foot from the west property line. This approval applies to the existing septic system lot line separation only. Any future upgrade to the septic system will require all separations be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services DJR/ljm n �'1 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR# WR950067 PID# 051-521-05 HA# uJ1q4CY,ec� Permit # Date Received: December 5, 1995 Legal Description: Lot 1 Block 3 Troll Knoll Subdivision Engineer: Robert C. Cowan, P.E., S & S Engineering 17034 Eagle River Loop Road Suite 204, Eagle River, Alaska 99577 Applicant: Ted Butler Waiver Requested: Lot line waiver of 1 foot from absorption field to west property line Criteria: 1. Geology: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Points: Waiver is Granted: x Waiver is NOT Granted: *4�-- List Conditions or Reasons for above: iN OROLrrP TU ReaplN 0 " Bfca Frtoa srEFP SLOPE ? STILL Err 7mr erownfre Descwvr�o� �R�R k, F5 / l or L i e EA+L1?O4ci4/F'0. I..IC L 47,F AV NE&RT/VF I^ 00W -c T" 7V AOTO /N/�G LGT, Date: 12- 8 -q6 - By: P#A, ?or" Name of Reviewer Rec #: #01514 Amount: $115.00 Date Paid: 12-5-95 n MUNICIPALITY OF ANCHORAGE 1 DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street • Anchorage, Alaska 99501 Telephone 264-0720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAMET &/-64 t (PHONE I �UNEW P RADE MAILING ADDRESS LEGAL DESCRIPTION LOCATION OY DISTANCE T0: Well I Absorption area Dwelling 2 Manufacturer r Material F w gallons g I IFFHOMEMADE: g Liq. capacity in L s ✓ Inside length Width HOI 6 If DISTANCE TO: Well Dwelling —10 Z S?f Manufacturer O W = DISTANCE TO: Well /()r) Foundation LL Z No. of lines Length of each line� Total length of lines� I FZW I ` G ta Top of tile to finish grade Material beneath file o ' Length Width Depth W 0 i I— Type of crib Crib diameter Crib depth Wd lu W Well Building foundation DISTANCE TO: J Class Depth Driller J W ---Tay B: DISTANCE TO: Building foundation Sewer line OTHER PIPE MATERIALS j<G9�n .( ,3i LC. 0 3031() SOIL TEST RATING U INSTALLER �h-s�Y[L✓1 REMARKS Material Nearest lot lila 1�4- Trench width inches r(% inch" NO. OF BEDROOMS PERMIT NO. No. of compartments Liquid depth PERMIT NO. Liquid capacity in gallons PERMIT NO. n ' Distance between livionlioe //r/ Total effective ebsorsxarreea PERMIT NO. Total effective absorption area Nearest lot line Distance to lot line PERMIT NO. Septic tank I Absorption area(s) ^0I APPROVED �� Y c I DATE LEGAL 7/U_ ' 72-013 (Hev. 3/79r\ //� MUNICIPALITY OF ANCHORAGE DepartmentA Health and Environmenta—?rotection 825 .y Street, Anchorage, AK. 79501 264-4720 Permit # �\ * * * HANDWRITTEN PERMIT WELL AND/OR ON-SITE SEWER PERMIT Applicant: / d L�&t `'IAC Mailing Address:Sl< Location: Phone Number: Legal Description: jd�'/ %j���P/�rco-cYSI� Lot Size: Type of Soil Absorption System Is: Trench: �_4_ Drainfield: __ Seepage Bed: Holding Tank: Maximum Number of Bedrooms: 'Z,_ Soil Rating(sq.ft/br) ISO The Required Size of the Soil Absorption System Is: DEPTH 7 LENGTH GRAVEL DEPTH �� WIDTH A///Td The length dimension is tll: length(in feet) of the trench or drainfield. The 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). * * REQUIRED SEPTIC(Hetl3M) TANK SIZE _ �5 �/�l'' GALLONS Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * *.* TWO(Z) INSPECTIONS ARE REQUIRED Backfilling of any system without final inspection and approval by this departme: will be subject to prosecution. Minimum distance between a well and any on-site sewage disposal system is 100'fel for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3 * * * I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlar ement if the residence s remodeled to include more thatA bedroo Signed: e Issued by: Appli ant Date: S__1r �} SWP/024(1/81) < r�\ e�' 0 & E E� vGINEER/NG & DEVELOPMENT CO. P Y a� Bax 90, Davis St., Eagle River, Alaska 99577 Y 694-2774 or 333-6240 Russell �/r /� D'= 75-0 � / 7 Z� Ear/ E//is zCV = (000 3 0 s -r a // 3rveyin0 Civil Engineering X �p Surveying Soils @ Foundations 3 5-0 iS" Land Development SOIL LOG Performed for: Name: � �XN� Mailing Address: 'aof Legal Description: of 1 �Lacv= 3 Depth (feet) Soil Characteristics 0 JTel . No. LnA -236eA ';9'a-77 1 m�--- �%a So �'� 5.,..-c, •� (�rGc\,J�c. —c-oe�So�� 3 tq 5 6 7 M. 12— C 9- C n - 2 GC'-Gum- 2c)6 SoFz S A��Y C�aAJz►— - W ��\a �Mz ow ��T `teaq-C %-'Ps r t,ZS - S C�, a"7 Gcz�\'tv Ground Water Encountered: Yes No %"� If yes..what depth I • 2 as Proposed Installation: Seepage Pit Y Drain Field ~ " I Comments: knVzA51>•r4r-> ,S'. b'a �-- S\p z�, .� �. �.nc,��+7 � 4AQ>,..y �a 4- � A M2, \\s•.a- /(00 Nc� �r 5s�cznc_\�. �2 ('� rhu•�pwA-.iSa �.� F�tito¢.b� t� �¢FA Performed by: Date: ' 1 / rim 6 j I - n k�Ya� , • L- i/? n t \ \ Cfl�Q GREY^ER ANCHORAGE AREA BORwjGH ( r Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 At, / - INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM �n NAME AL LArSorl MAILING ADDRESS gK SrtN T&-tl✓ RILe+ PHOONEt71q//230q (' LOCATION reFCti CLC -ex LEGAL DESCRIPTION ICT I p�LKK .\ fMLL KNOLL- J14P. SEPTIC TANK: UI," ITyu37 DISTANCE STgCk Src'cL MATERIAL CrEE� COMPARTMENTS 2 NUMBER OF FROM WELL MANUFACTURER INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH I IQUID CAPACITY /000 GALLONS. SEEPAGE PIT: 1 rrr r /, NUMBER OF PITS I DIAMETER tow OR WIDTH1ri, LENGTH -Lb, DEPTH b LINING MATERIAL I-Ccl CRIB SIZE: DIAMETER_LDEPTH OkDISTANCE FROM: WELL 0 r TOTAL EFFECTIVE - BUILDING FOUNDATION39 NEAREST LOT LINE Z ABSORPTION AREA (WALL AREA) SO SQ. FT. ADDITIONAL ABSORPTION WELL.: low,�/uNl� TYPE CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE , SEWER LINE TANK , SYSTEM CESSPOOL , OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES: DIAGRAM OF SYSTEM INSTALLED BY: AL b irsclj PIPE MATERIAL: (asr IQcm'I LOT SLOPE: TC v rk1 REMARKS: Form No. E"31 �f D2tuE DATE NN /6) Wq APPROVE G.A.A.B. Larki.. Performed for: Nene: sit Mailing Address: mint •a�1si k�- * , . Legal Description: 1--c,�+ oc•t 3 ao,s lL.�e.�-� SNp a - Depth (feet) Soil Characteristics D 3 6 U y Sty 0CNIJ GczsNV4- � p4��a-c,cJt�n ` 1jaCb Sc-avi�- il Ground Water Encountered: Yes No _ If yes, what depth i 1 od Proposed Installation: Seepage Pit +� Drain field Comments: $'",'d'Gd �'►-�.- la\C� i`� � � < �-�tGfrj � ��iy '�'a f_ .> A M2 - /(00//2 Performed by: �� `) Date: Q X11 r LG, pal llel y'aszGtlJL Municipality of Anchorage •-- Development Services Department Building Safety Division Onsite Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcell.D. 051.521-05 HAA# 0 Expiration Date: 10 — 6 — 0 G 1. GENERAL INFORMATION Complete legal description Lot 1, Block 3, Troll Knoll Subdivision Location (site address or directions) 23707 Hilltop Drive Current Property owner(s) Blaine Anliker Day phone 5294193 Mailing address 23707 Hilltop Drive Chuniak, AK 99567 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Four 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding tank ❑ Community Class A Well ® Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given In paragraph 5 by an independent professional civil engineer registered In the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also Issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation, based on procedures outlined In the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system Is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my Investigation and inspection, the on-site water supply and/or wastewater disposal system Is(are) In compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of installation. Name of Firm Anderson Enalneerina Phone 522.7773 Address P 0. Box 240773 Anchoraae. AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 1013/2005 0 MICHAM G MURStN 5. DSD SIGNATURE __jZ Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's Report Other By: . / � Original Certificate Date: �O - 0 Jr (R«. 12W) Municipality of Anchorage •., Development Services Department Building Safety Division ` On -Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 190050 Anchorage, AK 995198050 www.d.anchorage.ak.us (907)343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 1. Block 3. Tro0 Knoll Subdlvition Parcel ID: 051321-05 A. WELL DATA Well type A If A, B, or C provide PWSID f/ jam);@ Well Log (YIN) Date completed _ Sanitary seal (YM) _ Wires property protected (YM) Total depth R Cased to R Casing height (above ground) in. FROM WELL LOG AT INSPECTION Data of test Static water level R R Well production g.p.m. 9 - p.m -WATER SAMPLE RESULTS: Collform colonies/100 mi. Nitrate mg./I. Other bacteria colonies/100 ml. Date of sample: Collected by. B. SEPTICIHOLDING TANK DATA Tank Type/Material SeptiNSteet Date installed 1112SM995 5/1974 Tank size 500fl.000 gal. Number of Compartments ja Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression over tank (YIN) y High water alarm (YIN) N Date of pumping 10rl1 3 Pumper Chuasch Pumping C. ABSORPTION FIELD DATA Date installed 111IM995 Soil rating (g.p.d./fls or fe/bdnn) A GPDISF System type S Wide Trench Length 100 R Width 6 R Gravel below pipe 4 R Total depth j R Eff. absorption area j ft' Monitoring tube y Depression over field jy Date of adequacy test 9116=5 Results (Pass/Falq Pass For 4 bedrooms Fluid depth In absorption field before test aj in. Water addedjj¢)' gal. New deptIQ in. Elapsed Tom: 11 min. Final fluid depth 21 in. Absorption rate >- 600 g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date D. LIFT STATION Date installed 'Pump on' level at _ in. Datum Size In gallons 'Pump ofr level at _ M. Cycles tested Manhole/Access (Y/N) High water alarm level at In. Meets alarm li drouit requiremeMs7 E. SEPARATION DISTANCES .SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot _NIA On adjacent lots WA Absorption field on lot _ WA On adjacent lots WA Public sewer main WA Public sewer manhole/deanout WA Sewer /septic service line WA Holding tank WA SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation W Property One -?I Absorption field >S Water main MOO Water service One >10' Surface water >1OQ Wells on adjacent lots >2W SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property One 1' Building foundation >10' Water main Mir Water Service line MW Surface water _MOV Driveway. parking/vehicle storage >5' Curtain drain _None Noted Wells on adjacent lots >2W F. COMMENTS 0. ENGINEER'S CERTIFICATION I ceMly 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. 1 Ma7MEl L Engineer's Printed Name Mchael E Anderson. P.E. a Date _10/J12005 �ai� � HAA Fee $ V(30 Waiver Fee $ _ Date of Payment /0-4-09- Date of Payment Receipt Number L�$�_ Receipt Number, (Rev. 12000) 0 0 i d U b a p E U �o �C, ga U) ~�3 g N 3 U 8 m a� U ❑ ❑ w �NI�NI IV 39 p 4 m w � E r p q u N U) � aU U LL F� 00 f N In N N ~ ❑Q p ¢ wU W Z w m Y IL m� N 2 O IL ? b a p E U �o �C, ga U) ~�3 g N 3 U ) c. a� U ❑ �NI�NI 39 p 4 m w F- 'S E ❑ w 3 q u N U) LL f N In N N ~ ❑Q Z niLn Z 9 m� N 2 O F a .y Z t�iul N FM] 1$ � ❑■ ❑ z°z° z° ❑❑ ❑ M I - a a E U �o �C, ga U) ~�3 g N IL s ) c. U W �NI�NI m N q N N U) f N In N N M mono ��mnm �maao unnn j YII � 1$ � ❑■ ❑ z°z° z° ❑❑ ❑ M I - a a E U �o �C, ga U) ~�3 g N IL s ) c. C 0 7 1 O m URIN d E U) U W m N q N N U) f N In N N M a P 30� •-: 'A 'v:'.i'irL•.'y�('YA':a gtii`..••�:xi.,Ui:�. t...'�:^^.'V�: ij„Gf}. � to 1 • i�;..,y�. �7 r "�^..ir%:11, J" 'il'SiiwJi+' 'T' �f) ,- 1 't�. a •c . R� 11 ••\. r7"'4�,�,µµ�j�1'1i: Slr• l'.V 'y i/_��_O'r gi Ix Al 1 I .•f�iT�• ti.0 •+ a;•.t'P r• J>! V'�1;Ya\a'.:' .. q 'WC •.' . ..i dJi': ^' :• •r },dtry' ` +y�.'�r: ;'•r 30lax( C /(lG'`Y.. \Il'N k� 1'j•y,}j:li,w i� •�+fir � �? v�•,..�.'yli: t:�.>''•�:; e f, � t•s .: y.n,�it1 q MOO. fy.: d.«!. (ei :: •iH ...1a Li'1 S4b1 ::i4 J�,�,• �h�c v;� A • , k` ° R€i 7{ •��,'Y'•,y/2�(d f��n.l'%h';yF�;,f��,•+h N •/F.}h "•1 C let, Y� i, 2•y'�'% 2 7:J,y .fit 6 ' f, 7t �. ; ?? .�`r�" , �:y1 'i��r»ykt +C x,�41'r•1 1D ''*•�' I R � • � gg • � �` � .S*•I{,?_,'tea► �,,''+�i Vr ..�,'.: �,' •r r:; .. to m 69 S 4 R S ° r "'�' • '�`�♦•y ~ S%' j �^•: $' it CL n O � g �. ,. s� • g ��,� � i ri; �•i�� . � � R � g��•�� x ,; i,r-� •mayy SA' Municipality of Anchorage o Development Services Departmentu c'= : Building Safety Division , , On -Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 995195650 www.cl.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-521-05 HAA# Ht9 0106'A0 1. GENERAL INFORMATION Expiration Date: 2— © 3 Complete legal description TROLL KNOLL SUBDIVISION; LOT 1, BLOCK 3 Location (site address or directions) 23707 HILLTOP DRIVE ► CHUGIAK, AK Current Property owner(s) Mailing address Lending agency Mailing address Real Estate Agent Mailing address TED & LANAE BUTLER Day phone (907) 346-1605 9661 CARLSON ROAD • ANCHORAGE, AK 99507 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site N Individual Water Storage ❑ Individual Holding tank ❑ Community Class A Well 0 Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an Independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $'7CO at, or prior to closing for the engineering services provided. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my Investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system Is(are) safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. I further verify that based on the Information obtained from the Municipality of Anchorage files and from my Investigation and Inspection, the on-site water supply and/or wastewater disposal system is(am) In compliance with all applicable Municipal and State codes, ordinances, and regulations In effect at the time of installation. Name of Finn ALASKA WATER & WASTEWATER CONSULTANTS. INC. Phone 337-6179 Address 6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, AK 99504 Engineers Printed Name JEFFREY A GARNESS, P.E. Date 11(7,0/01 Engineer's Comments: in conduWng this evaluation, AWWC, Inc. attempted to provide a thorough, conscientious engineering analysis of the system In accordance with ADEC and MOA DSD Guidelines 6 Regulations. The reported resuks described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operation/life of all wells and septic systems depend on the kcal soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions era outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. AWWC, Ina can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report Is for the sole benefit of the owner11sted above. Any reliance upon or use of this report by any otherperson or party Is not authorized, nor wm It confer any legal right whatsoever. 5. DSD SIGNATURE Approved for L-4 bedrooms. Disapproved. Conditional approval for Attachments: HAA Checklist Septic System Advisory Well Flow Advisory ow.tzao� bedrooms, with the fllowing stipulations: tttllt(((1l(lirrr�� Manitenance Agreements Ur \\ `A�, , • ..... , fin'% �2 : • pN-SITE •-Y�' WATER AND t"- a WASTF`NATER PROGRAM /�CQ 7 ENT tS�l��ll Supplemental Engineer's Reort Other Original Certificate Date: - g Municipality of Anchorage Development Services Department or}sroewater'3waswMa� Program 47M South Bragaw SL P.O. Box 168050 Andwrege, AK 99519$850 www. mchorage.ak us (907)943-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Lagan Description: A. WELL DATA ' Wait type A Date completed Total depth R I 0 TROLL KNOLL SUBDMSION; LOT 1. BLOCK 3 Parcel ID: 051-521-05 IIA. B, or C provide PWSID# 210778 Well Lop (Y/N) Sardtary seal (Y/N)_ 1Mrve p..,y,rry protected (Y/N) cased to R Casing height (above ground) N. FROM WELL LOG AT INSPECTION Date of test State water level R R Well production g.p.m. p.p.m. WATER SAMPLE RESULTS: ColUorm — coloniesl100 ml. Nit W — nVJL Other bacteria — oolonies/100 ml. Date of sample: — Collected by: B. SEPTICIHOLDING TANK DATA I` q5, i�SP• (LFvo�f �loii. Tank TypelMaterlal STEEL Data Installed 11/28/1995 & 5/1974 Tank stae 500/1000 gal. Number of Compartments j1_2 Cleeraub (Y/N) YES Foundation deanout (Y" NO Depreaalon over tank (Y/N) NO High water abnn (Y/N) N/A Date of pumping 11/29/2001 Pumper JR'S PUMPING C. ABSORPTION FIELD DATA Data installed 11/28/1995 Soil rating .p d femrm) 0_6 System type SHALLOW TRENCH Length 100 ft. Width 5 R Gravel below pipe 4 R Total depths + - R Eff. absorption area 1000 fe Monitoring tube YES Depression over geld NO Dans otadequacy test 11/16/2001 Resulb (Pass/Fal) PASS For 4 bedrooms Fluid depth in absorption field before tests? 101n. Water added 850 gal. New dept1121 191n. Elapsed Time: 1205 min. Final fluid depth/? 101n, Absorption rata >: 600+ 9.pd. Any rejuvenation treatment (past 12 mo.) (YM ✓t type) NONE KNOWN 0 yes, 91va date - D. LIFT STATION Date Instated Size in gallons Manhole/Arlwv: (Yrt4) 'Pump on' level at--Jn. 'Pump oft' )mml at ----in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements?_ E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOTTO: COMMUNITY WATER SYSTEM Septic tankllilt station on lot On adjacent lots Absorption field on lot On Slvefltt013 Public sewer main Public sewer manholelcleanout _ Rmuer hwpuc service the Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 52+ Property line 5'+ Absorption field 5'+ Water main 101+ Water service the 10'+ Surface water 100'+ Wets on adjacent Ins 200'+ • LAT UNE WAIVER SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: REQUESTED IN 1995 Property line •1' Sutding foundation 10'+ Water main 101+ Water service the 10'+ Surface water 100'+ Driveway, paridt)gfvehicle storage 10'+ Curtain drain NONE KNOWN Wags on adjacent Ins 200'+ F. COMMENTS O. ENGINEER'S CERTIFICATION 1 cer* gtat I have detemrined flrnwgh geld Irtspectlons and review ofMunldpal records that Bre above systems are M conformance wfgr MOA NAIL grddegnes in effect on this date. Engineer's Printed Name Date PA 0/01 JEFFREY A. GARNESS HAA Fee $ Z� .':"3 Date of Payment 1 2-- I LL -0 1 Receipt Number n I A Fi 100 Waiver Fee $ Date of Payment Receipt Number • MUNICIPALITY OF ANCHORAGE r DEPARTMENT OF HEALTH & HUMAN SERVICES t: ' " :.:.... . Division of Environmental Services " On-Site Services Sectldh� t: %7:' i P.O. 86X 196650 -Anchorage;-Alaska 1199519-6650 ' 343-4744 r CERTIFICATE OF HEALTH AUTHORITY., APPROVAL FORA SINGLE FAMILY DWELLING Parcel LD.# OS /... ..., •-- ' HAA# `1�(1�_�"I^ 1 GENERAL INFORMATION _:_._. ;i{l^. I�•,a 'a. �--•DVT F.-71: i+s.T,i, 6�i•3_t•1.�3fL :! ._.. ,t:V .... ... .c.r, _..Complete legal description - Lot 1; . BCoclzP3;'••T'ao.t[�Knot4 Subdivcs ion Location (site address or directions) 23707 H.i,Wop Dtive ChRg.iak. "AK Property owner : Ted Bu.Ltert-•• - Day phone 688-9121 Mailingaddress 23707 Hitttop Da.Eve Chuq.iak, AK 99567 Lending agency_ Y=ti Day phone Mailing address' _: .711 Agent _ Day phone..t: 'Address _'"�.vrn J n Unless otherwise requested, HAA will be held for pickup ' "t - •s " ` `y"f`C IVUMBER�OF BEDROOMS 't'yn`�`"' y_..�- It.3.t.Vb �'t• . �..! .,»nom..^ - . _ - --- 3_ TYPE OF WATER SUPPLY Individual well; - - _— ----- --- t s Communitywell ' e- - u:(x �'. . * t Public water y Y -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 XXX ` L Holding tank t:Ca.. +dna, s ♦ aic. ..£_: ,.r ...4....,h.:: _ r9. �' `- r. '' r,`., r. t Community onsite Public sewer .•: fl r. , :. ,7 y..nl •.a .. ..'.- i_... .Y._. .H:1 'ir F•...-t :......... •h,,�l �•1�'tt_ NOTE `If community wastewater system,'providewritten'confirmationfrom StateADEC attesting to the legallty and status of system.` n-M(R--+,at) rmn= 140A $21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my =; investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verity that based on the information obtained from =' the Municipality of Anchorage files and from my investigation and Inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes ordinances, andregulationsin effect on the date of this inspection - Nam@ Of Flrtrl S i S ENGINEERING _ - 17034 Eag$* Klvar LoW Road No.204 - Phon@ '`.�� y':�� 7 / ' - Address Es91a Ri , Alaska 99577 Engineer's signaturer�i�' ���� Date i;. OF ROP.ERT C. COWAN • l 6 � DHHS SIGNATURE, i,i t140 w �.►*/�'r. _ Y _ leif� �A'pprov_ed for bedrooms Disapproved _ ` !.,a`" r.�Y7J t..it'£-r 1;4%nt^t Conditional approval for r bedrooms wttti the followrng_stipulatlons — . ,.. _ < e 3 -� ...G..1 .::. �._Ar... _:. ... r.l... ..._ . ._ '.r 1. �. w ... L...:.... J - �: u r l> r 4[«^• "tiy Y '( .iia y J S. VC Vfi -T .�Y } ; ✓ IC. V. .:. ..YL 1-j .a". fl.6� rte. ✓l'1..-. y.,.y e: .�5.�,.. LM •.r...• _.I,L .•awn ti..+iWr. _l. ..LLa'(L- —.i.: r'Sw .L� f �fnri J _ - 5vq.. \'•�.--J .'t•:- ' I.I .V ..l.tiq .n (1 ��� _T .. J1' 1... ...V.•_ "S. .f. �.t-(�.w Addltional Comments 1 • :.1 1 Y a - �:.1`�`�tit I .: `.f; .' .`. '�' ,.. h x ✓V2 w2' a iiv%7 i :•,LIQ 1� Jig . -.-a .: �� a - �/iLLfil a .-7 � 1 . 1.:. 'r ♦ r ... ' Y1 f Dat@y^ — � -57 •� .fly, r\�a •.. F fn�t _ tr CAUTION.. :The Municipality,o \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 theirlending 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 engineer's work. ?2-M F. 1Nt) a.n MOAN" Municipality -of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 • Anchorage, Alaska 995010 (907) 3434744 Health Authority Approval Checklist 70 Legal Description: 'f ou Parcel I.D.: USI - S2 - / o CM f'rI A. WELL DATA /� Well type A If A. B, or C. attach ADEC letter. ADEC water system number 2 / 0 *77 Log present (YM) Date completed Total depth Cased to Casing height (above ground) Sanitary seal (YM) Wires properly protected (YM) FROM WELL LOG AT Ih AS CIION Date of test Static water level Well production g.p.m. g.p.m. WATER SAMPLE RESUL Coliform Nitrate Other bacteria Damr-of sample: Collected by: B. SEPTIC/11OLDING TANK DATA Date installed N - z v, '15- Tank sim 5--4, Number of Compartments I_ Cleanouts &N)_4_ Foundation cleanout (Y6l -J Depression (YAP dl High water alarm (Y" J Date of Pumping /°- a /- t>- Pumper 779, P✓M,0,„lS C. ABSORPTION FIELD DATA Date installed /1-1 }.q �- Soil rating (&p.d./R' or ft=/bdrm)y. System type S-d**4.4 aJ rrs ✓c✓ Length /00 r- Width S'1 Gravel thickness below pipe Total depth 81 Fffective absorption area /0X0 Monitoring Tube present&N)-.)(_ Depression over field (Y/& _ / Date of adequacy test 1'!/4 -Ac -J Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test (in.): 'Immediately after_ gal. water added (tn. Fluid de)dt' (ins.) Minutes later: Absorption rate = a.p.d. Peroxide treatment (past 12 months) (YM) -- If yes, give date D. LIFT STATION Date installed Size in gallons Manhole/Access (YM) "Pump on' levrt & Higb water alarm level . • *Datum les tasted E. SEPARATION DISTANCES "Pump oft' level at' SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot : On adjacent lots Absorption field on lot : On adjacent Iota Public sewer main Public sewer manholelcleanout SewWrsseptic service line Lift station SEPARATION DISTANCES FROM SEFTICIHOLDING TANK ON LOT TO: Building foundation a ' Property line /3 ' Absorption field `/8 ' Water main/service line /o' Striate wateddrainage /oil t r Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation 73, Water main/service line Surface water /06 t + Driveway. parking/vehicle storage area Curtain drain w/o- /o- Wells on adjacent lots t v Property line / �.r' 4- '-tA- PBe/♦Yy VJI VA -a. L<-d�rwr F. ENGBVEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records aem in conformance with MOA XM yltide es in effect on this date. �� OF Al Signature Engineer's Name /©t � d,B E T �_ �e a l.✓ M? IlkIm' Date 1 ,. / H 9 V-A ROB c COWAN r HAA Fee S 0601/V Date of Payment / OZ — 3-' iS Receipt Number 16-10 C40&0 , Rev. 8/95 OSS: haa.wk.doc `�+s �CE - 8801 ,�,.�+ N Waiver Fee S // r ?fiiai�� Date of Payment 1p?— S 73 Receipt Number / S/v r are GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 Date Received 9/9/74 Time of Inspection Date of Inspection 9/9/74 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER 8 WATER FACILITIES FOR Conventional 1. Approval requested by: Alan Larson Mailing Address: Box 594, Eagle River 99577 Phone: 2. Property Owner: SAME Phone: Mailing Address: 3. Legal Description: Lot 1. Block 3. Troll Knoll 4. Location: Hilltop Drive 5. Type of facility to be inspected Single No. of bedrooms 6. Well Data: Community A. Type B. Depth C. Construction D. Bacterial Analysis 7. Sewage Disposal System: A. Installed 1974 B. Installer Al Iarcnn C. Septic Tank: 1. Size 1000 gal 2. Manufacturer Stack Steel D. Seepage Pit: 1. Absorption Area 14xl6x8i/2' 2. Material Loa E. Disposal Field: Total length of lines 8. Distances: A. Well to: Septic tank , Absorption area Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank 29' Absorption area 391 C. Absorption area to nearest lot line 281 EQ -034 (1/14) E Page 1 of two pages Page 2 of two pages - R,,-. st for Approval of Individuals er & Water Facilities Legal Description br-0/ ze-6 Udxa Owl '--Cl Comments Approved 4• Disapproved Date 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 and these facilities are operating satisfactorily. SIGNED Date EQ -034 (1/74) c r1 n �,ill�llla. A EXCAVATION WORK April 5, 1982 ReMax ATTENTION: Lorraine Miner P.O. Box 848 Eagle River, Ak 99577 ROBERT A. SHAFER CIVIL ENGINEER 6942979 Dear Mrs. Miner, Reference: Lot 1; Block 3; Troll Knoll Subdivision A sewer system adequacy test was performed on the system located on the referenced property as you requested. The septic tank was pumped and verified to have a capasity of 1000 gallons. The seepage pit was full of water and approx- imately 600 gallons was removed. The system was then charged with approximately 600 gallons of fresh water. After a period of 24 hours, approximately 128 gallons of water had perc- olated out of the crib. It can be concluded from the above test that the septic tank is adequate for 3 bedrooms. However, I regret to inform you that the seepage pit is only adequate for approximately 1 bedroom. It will be necessary for you to have the system upgraded before it can be considered for 3 bedrooms. If we may be of further service, please do not hesitate to call. Sincerely, fc� Robert A. Shafer, P.E. RAS/ss Municipality of Anchorage Department of Health and Environmental Protection SRB 196X EAGLE RIVER, ALASKA