The URL can be used to link to this page

Home My WebLink AboutTROLL KNOLL BLK 2 LT 1Troll Knoll Block 2 Lot i #051-521-24 Municipality of Anchorage Development Services Department Building Safety Division .. .. On -Site Water and Wastewater Program, 4700 Bragaw SL P.O. Box 196650 Anchorage. AK 99519-6650 Page of www.d.androrage.akus (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number. SW070205 PID Number. 051-521-24 Rr " William and Kim Green Wastewater System: ❑ New ® Upgrade sae... 2D406 Leprechaun Dave Chugiak, AK 99567 ABSORPTION FIELD P" 261A115 N' aa'°°°"'. 3 P (x«p rr.m D swn. T>rw1 p e.a D wow p amr LEGAL DESCRIPTION SWC"TIMM DOM ""'W" w .8 cPo.FP 10 n. BaiL2 LM swNa�Trill Knill Dwm o pq epmnrmm enpnr vaa crm *Wmooe.m P" fl 7 Ft 7M 0V Rww s� FarrOesO.o aq. prw CM lr'YRt 0-1 Ft. 54 Ft. Well: ❑New ❑Upgrade cm. aum gnorae"c DWruprwrlwr, 3 R. 1 - FL Cw4aram (Pn . A a. C) Tar Dam Casa w. Tar acvpoon Ona Pp Mr Community Class A FE FL 756 Fp ASTM D3034 PVC Draer Der pr4n SMa Winn L4Nr Yme44r DaM ewe4ea Ft Stuart Gilbert Construction 915.72007 rra Pvv sr r: c.,.q N"(j4 Aoo.e Grwna DPM F< F< TANK SEPARATION DISTANCES 0 Septic ❑ Holding ❑ S.T.E.P. ❑ other. To I Septic Absorption Lift Holding utxePmate iO1+r. From Tank Field Station Tank Sear Lina Existing 1,000 GAL vw >2W >200' WA WA >25' Mr Concrete M W Cony" One sumo. wr >1D0' >100' N/A LIFT STATION Lau. >s >1(r UWA wA cr Faw41a >$'>10' WA m anal DnIIn None Noted PMr" a Mm EMariol eapa pran"a by Ra Existing Absorption Crib Pumped. Crushed and Backfilled BENCH MARK Eeraem"Da vt.. With Sand. Existing Absorption Trench Abandoned In Place. Bottom of Siding 2' Insulation Over New Absorption Trench. 100.00 n Engineer's Stamp Inspections performed by: A Hada Dates: 11 9/5/2007 2^^ 9/62007 •�..)F 4444 Development Services Department Approval"44•o .•��*1��r�^'''''�'�.,, of �� Conditional Approval Date: 49th' . r . a.. 3�Oti i 1 � 4 MICHAEL E. •NDCRSDN No CE -4381 r,? � �r�• Reviewed and approved PP by: Date: 44444:5:.`'•• Dom) Municipality of Anchorage Page 2 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 Permit Number. SW070205 / / / / Wo / O / Existing II Absorption „11 nmch II„ (AbaTMoned) IIIIIIIII CS 72 S 37 S ce 7 S 5.0 M1 33r 354 M2 72.T .o% Existing Absorption Gib Pumped. Gulled k Filled With Sand. I M1 Three Bedroom Home Garage PID No. 015-521-241 Gravel DAvs I I TROLL KNOLL SUBDIVISION LOT 1, BLOCK 2 35,289 S.F.' 49th PLAN AS -BUILT SCALE V = 40' Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 Onsite Wastewater Disposal System or Well Inspection Report Permit Number. SW070205 PID No. 015-521-24 NOTE: Trench Only Replaced Under This Permit. Concrete Septic Tank Exposed, Inspected and Verified Suitable for Continued Use. 94.3 PROFILE AS -BUILT - No Scale ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) MEMORANDUM DATE: October 28, 2007 TO: Jeff Poet FROM: Mike Anderson, P.E. SUBJECT: Lot 1, Block 2, Troll Knoll Subdivision COSA/Septic System As -Built The excavator was unable to determine the exact limits of the existing absorption crib and absorption trench on the subject property and was required to move the trench to a location closer to the existing septic tank to avoid conflicts with the existing system and to eliminate removal of existing vegetation. A test hole and percolation test was placed and the groundwater monitored for a period of 14 days. No groundwater developed in the hole. The design parameters for the construction of the new trench remained the same as originally permitted. The existing absorption pit was pumped, crushed and filled with sand. The existing absorption trench was abandoned in place. No diverter valve was placed. The existing concrete tank was exposed, inspected and verified suitable for continued use. The cast iron inlets and outlets of the tank were removed and replaced with ASTM 3034 PVC and cemented in place along with the tank lid. Two foundation cleanouts were installed prior to the tank. Two post tank cleanouts were also installed. MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water 6 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Aug 14, 2007 Expiration Date: Aug 13, 2008 Permit Number: SW070205 Parcel ID: 051-521-24 Legal Description: TROLL KNOLL BLK 2 LT 1 Design Engineer: 0014 ANDERSON ENGINEERING Site Address: 020406 LEPRECHAN DR Owner Name: WILLIAM & KIM GREEN Lot Size: 35289 SQ. FT. Owner Address: 20406 LEPRECHAUN DRIVE Total Bedrooms: 3 Permit Bedrooms: 3 CHUGIAK , AK 99567-6275 This permit is for the construction of: Z Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must 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 engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and dosed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. -Engineer needs to do an additional percolation test during construction of septic field. A new soil log needs to be submitted with the inspection report. If the results require a design change, construction of the system will stop pending Onsite review and approval. Received Issued By: (r'\ _ Date: S Date: 8 I`{ Municipality of Anchorage Development Services Department Building Safety Division _ On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, Alaska 99519.6650 www.muni.org/onsite (907)343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 051-521'4 Property owner(s) William and Kim Green phone 261-9115 Mailing address 20406 Leprechaun Drive Chugiak, AK 99567 Zip Code Site address 20406 Leprechaun Drive Chuglak, AK 99567 Zip Code Legal description (Sub'd., Block & Lot) Lot 1, Block 2, Troll Knoll Subdivision Legal description (Township, Range & Section) Lot Size 35,289 Sq. Ft. Number of Bedrooms Three (3) THIS APPLICATION IS FOR (® all that apply): THIS APPLICATION IS AN: Absorption Field M. Initial ❑ Septic Tank ❑ Upgrade El Holding Tank ❑ Renewal ❑ Privy ❑ Private Well ❑ Water Storage ❑ certify that the above information is correct. I further certify that this application is being made for a Single Family /Dwelling and isin accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: Q Waiver Fees: Date of Payment: Date of Payment: Receipt Number. 934F O F Receipt Number. (Rev. 11105) ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX MEMORANDUM DATE: August 12, 2007 TO: Joe Goodall FROM: Mike Anderson, P.E. SUBJECT: Lot 1, Block 2, Troll Knoll Subdivision Septic System Permit Attached is the revised design for the septic system upgrade at Lot 1, Block 2, Troll Knoll Subdivision. We have included a new absorption trench in place of the previously proposed extension to the existing trench. A Flow Diverter Valve has also been added to connect the existing trench for future use. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 FAX August 2, 2007 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 1, Block 2, Troll Knoll Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer. A recent adequacy test on the existing absorption system on the subject lot indicated the system is performing sufficiently to serve a two bedroom home. The owner is selling the house with three bedrooms. We are therefore requesting a permit be issued for the upgrade of the septic system to accommodate the three-bedroom home on the lot. The attached Site Plan and backup documentation identify the location and configuration of the upgrade to the proposed septic system. The existing septic tank will be pumped, uncovered, inspected and verified suitable for continued use. A flow diverter valve will be placed to connect the existing absorption trench to the new system for future use. Also identified on the plans are the locations of the existing water service line. The subdivision is served by a community water system and no conflicts exist between the existing septic system and the systems on adjacent lots. Drainage arrows are shown indicating the current drainage patterns. The drainage patterns will be maintained after construction. The test hole placed on the lot at the time of initial construction indicated silty gravel with some sand (GP). The application rate was determined to be 225 square feet per bedroom. We are proposing to construct a 49' long by T wide absorption trench with 7' of gravel beneath the distribution pipe. The distribution pipe in the trench will be placed at 3.5' below the surface with the total depth at 10.5'. No groundwater was encountered during placement of the original test hole. We are proposing to place a test hole at the time of construction to verify the soil conditions. A design will be submitted for review prior to continuing with placement of the system if conditions are found to be different than those utilized for the initial design. Lot 1, Block 2, Troll Knoll Subdivision August 2, 2007 Page Two The ground surface on the lot is virtually flat in all directions with only slight changes in topography within 100' of the absorption system. The trench will be extended parallel to the contours of the ground as much as possible and in conformance with design criteria. A minimum of 10' will be maintained between all components of the septic system and the existing water service and 100' from any surface water in the area. If the system is constructed in accordance with our design the following statements apply: The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments O\ 13 10 d O` y 11 3A 0 12 2 3 i 0 2 4A G� S 1 �, SUBDIVISION SERVED BY COMMUNITY WATER. 1 . w 49th ;.............._ . . ..........� -n'�-� . :NICNAEI. E. ANDERSON i = O. CE -1381 AREA M A P N'.�� t,,%%"E��:•�� SCALE I' = 100' TROLL KNOLL SUBDIVISION LOT 1, BLOCK 2 rho SCOPE OF WORK: 4n 1. Uncover, Inspect and Verify the Integrity of thi Existing 1,000 Gallon Concrete Septic Tank. 2. Place Two Post Tank Cleonouts After Septic To 3. Place Flow Diverter Valve 4. Construct Absorption Trench 48' Long x 3' Eff 5. Place Test Hole and Perforin Percolation Test to Verify As Built Soil Conditions. Depth. 35,289 S.F. SITE PLAN SGIE t' - ra' LOT 1, BLOCK 2, TROLL KNOLL SUBDIVISION DESIGN FACTORS: Three Bedroom Home Perc. Rate: 6 to 15 Min./Inch Application Rate: 225 SFBDRM 3 Bedrooms X 225 SFBDRM= 675 SF Absorption Area 675 SF/14 SF/LF= 48.2 LF Additional Trench Length SYSTEM REQUIREMENTS: Deep Trench System Existing 1,000 Gallon Septic Tank r Drainfield Rock THEREFORE: Construct an Absorption Trench 49' Long x 3' Wide x r Effective Depth. Flow Line Elevation in Trench to be 3.5' Below Original Ground Surface. Total Depth to be 10.5' Below Existing Ground. Verify Existing Septic Tank for Continued Use. Place New Test Hole to Verify Soil Conditions. Redesign if Necessary. Place Flow Diverter Valve and Connect Existing Trench to New System. ra' 3' TYPICAL DEEP TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. �, ; '• ,� Minimum 6' Separation From Bedrock. C ; µ4stn ' rift r Minimum 4' Separation From Groundwater. r.........._ .. ......... ....... Minimum 100' Separation From Wells in the Area. �$ MMIMELE/w0ER90N � Minimum 100' Separation From Surface Water or Streams. �� %+, No. Me , ,. Natural Backfill 3'a' Geotextile Fabric 6" O 4" Perforated PVC (Holes Down) Drainfield Rock ra' 3' TYPICAL DEEP TRENCH SECTION (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. �, ; '• ,� Minimum 6' Separation From Bedrock. C ; µ4stn ' rift r Minimum 4' Separation From Groundwater. r.........._ .. ......... ....... Minimum 100' Separation From Wells in the Area. �$ MMIMELE/w0ER90N � Minimum 100' Separation From Surface Water or Streams. �� %+, No. Me , ,. Russell Oyster 694 2771 CW Engineering Sols It Foundations 0 Ft E EIvGINEERING & DEVELOPMENT CO. Boa 90, Davis SG, Eagle River, Alaska 99577 6942774 or 310.6240 SOIL LOG Performed for: Name: It&c/q,u .Coc3He6,c •!/=• Mailing Address: Legal,Descripiion: Z07 / � FLd Depth` (feet) D' 1 �1L Sicr Tyr 1 n 2 J3%, n (P 4 L J N 6 2, 7-4,,,c e. Soil Characteristics :5111F.9- 7 L brl slis 333-5240 Surveying Land Development Tel. No. 6 SS /K,vvc� Sc%s. ;zcDQXP.4. )2 Ground Nater Encountered:\ Yes �) No +� If yes, what depth Proposed Installation: Seepage Pit +' Drain Field s^.2 s,Q/�. R. Nbc! Comments: -;5N1icc. i7,tfvzl",— 0/-- Performed rPerformed by: / /L( ;4a, Date: Vir-1 a % /�77• U ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 1, BLOCK 2. TROLL KNOLL SUBDIVISION GENERAL: 1. The scope of this project includes the pumping, exposing, inspection, testing and verification that the 1,000 -gallon concrete septic tank is suitable for continued use. Work also includes the placement of new post tank cleanouts between the existing tank and absorption pit and a Flow Diverter Valve to connect the existing absorption system to the new septic system. A new absorption trench will then be constructed with a length of 25' and a width of 3' with an effective depth of 7'. A test hole must be placed prior to construction of the trench to verify the subsoil conditions. Redesign of the new trench may be necessary. The distribution line in the trench will be placed at 3.5' below the existing ground surface. Total depth of the trench will be 10.5' below the existing ground surface. The new absorption trench must be placed a minimum of 10' from all water service lines and 100' from any surface water in the area. A minimum of 3' of cover is required over the absorption trench. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. The Contractor must also verify the location of wells in the area and assure that the separation distances are met. 4. Unless specifically agreed otherwise, the contractor shall be responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION — Verify Existing Tank For Continued Use. An existing 1,000 gallon concrete septic tank is currently on site. It must be exposed, inspected and tested and verified suitable for continued use. Lot 1, Block 2, Troll Knoll August 2, 2007 Page 2 of 3 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill. 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trench to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. Lot 1, Block 2, Troll Knoll August 2, 2007 Page 3 of 3 MATERIAL SPECIFICATIONS: 1. Septic tanks 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: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No backfill should be in place at the time of inspection. Contractor shall provide a copy of all field survey layout and construction notes for use in preparing the certified as -built of the completed system. r MUNICIPALITY OF ANCHORAGE I 00�j DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264.4720 ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME I/ H ❑ NEW I/a, f / ��/' �v,1 1jgy.3S/3 I XUPGRADE MAILING ADDRESS � O Box 3-ts�Z LEGAL DESCRIPTION' ` c LOCATION �f ^� NO. OF BEDROOMS ^f II l/J Absorption} real1 Dwelling /,{- PERMITY7. L•� Uy DISTANCE TO: �� I !!�' 7- �j/ '4— F•ZQ Manufacturer y C_ / 7- Mateyy No. of to partm- .yrs to liq, capacity in gallons -.,,� renglh Width Liquid depth IF HOMEMAUr. b ie DISTANCE TO: Well Dw Ili g PERMIT NO. ..10Z 0 Manufacturer Material Liquid capacity in gallons = Wrll Foundauoryij/ / TL Nearest Ip� n0 PEFj7T �� W DISTANCE TO: tom' 7 / rJ [4 J LL Z No. of lines Length 1 ea I e Total I �nC��N' o nes Tre h widt , Distance m e;, s- +: W �].!� inches / /� 2 Top ofti to fin' h rade h7/,,_teripj beneath : N ��es Total effe i sorption area f]~ -S — g /lam LC L Ninch Length Width Depth PERMIT NO. W d t– Type of crib Crib di ate J� i d Total effective absorption area a DISTANCE TO: Well Buildpt Building foundation Nearest lot line J Class De Driller Distance to lot line PERMIT NO. J yy,V/ W it lou au A' -1 Sewer ne Septic tank Absorption area (s) 3 DISTANCE TO: p OTHER PIPE MATERIALS SOIL TEST RATING ALLE REMigQs REMARKS 74 DG- G -e IA I ; tipbbrt A. ti" J, • X10. 1157 Z. A 'H•y �.o DATE LEGAL C••.w."'•'.. v 0TROFES':� 72 1 v. 3/7 1 Q L X. u''C F- S S Encfne:rfng MIJM I (-_ I F=>'F L_ I TY OF Fit-ICHRRFIGE DEPARTMENT f"'�L HEALTH AND ENVIRONMENTAL.OTECTION 825 'L STREET. ANCHORAGE. RK. 99501 264-4720 01r -4—S I TE SELJER F=ERM I T PERMIT 140. 6 800554 ) APPLICANT CARROLL RUHKICK P.O. BOX 3-582 688-3513 LOCATION PETERS CREEK,.--- LEGAL REEK,.--__LEGAL PLOT I-BLK 2 TROLL KNOLL SUB. LOT SIZE 20000 SQUARE FEET TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT/BR)= 225 THE REQUIRED SIZE OF THE SOIL ABSOP,P TEM IS: DEPTH= E L_EMGTH= �r_� C3FZn aL_ E7EF�'TH= THE LENGTH DIMENSION IS THE 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 CIN 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 CIN FEET). REQIJ I REO SEPTIC TF rJIC S I ZE= 1E�E�0 GFIL_L_OMS 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. --- TLJO <:22> I MSPECT I OMS FIRE FSEQIJ I REE} --- BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET 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. OTHER. REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. PERM I T EXP I RES E?ECEME3:ER 31s I CERTIFY THAT 1: I AM FAMILIAR, WITH THE REQUIREMENTS FOR ON-SITE SEWERS FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS. SIGNED ISSUED 1!PSE3 AND WELLS AS SET ENLARGEMENT IF THE V4. 0 GRE'' -';ER ANCHORAGE AREA BOI"'JH Department of Environmental Quality f 3330 C Street Anchorage, Alaska 99503 INSPECTION REPORT ON-SITE Q SEWAGE DISPOSAL SYSTEM NAME W1r0'4M1 kOeAllrL MAILING ADDRESS 6&A i 79 ChG�%C/�/�I/Q K PHONE LOCATION If4V15 C)"OeeL LEGAL DESCRIPTION Ll V 2 rrOII knv/% 5116 SEPTIC TANK:DISTANCENUMBER OF I. J %% ,J FROM WELL MANUFACTURER A �i'll '1 C X MATERIAL ��"1C.AC l"'� COMPARTMENTS INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH 1 (QUID CAPACITY POD GALLONS. SEEPAGE PIT: NUMBER OF PITS I. DIAMETER OR WIDTH,i, LENGTH�� DEPTH i LINING MATERIAL l^0 f CRIB SIZE: DIAMETER L DEPTH DISTANCE FROM: WELL J TOTAL EFFECTIVE BUILDING FOUNDATION_, NEAREST LOT LINE ABSORPTION AREA (WALL AREA) T�S SQ. FT. ADDITIONAL ABSORPTION SD/l zzs-47 Cl�HL WELL:It)I//l TYPE Co/NSTRUCTION BUILDING NEAREST FOUNDATION LOT LINE CESSPOOL APPROVED DISTANCES: OTHER SOURCES DISAPPROVED INSTALLED BY: 0M fkrtG hor PIPE MATERIAL: Ce? S4;ra)i LOT SLOPE: ,/ REMARKS: 5y/fem i5 CC/J ti19""/ 1ny u '!;�' howto ffvzzot2 Form No. Ea -031 DEPTH NEAREST SEPTIC SEWER LINE , TANK_ REMARKS DIAGRAM OF SYSTEM DISTANCE FROM: SEEPAGE SYSTEM I 3z �3 1 I ZBc)r,„ I 4 I' 2fo, Vol IS ey I le 2� `a IrAmiyl I DATE ��'�'��— % APPROVE�stgl"'L G. .A.B. r� GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY, 3330 "C" STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4361 SEWAGE DISPOSAL SYSTEM - APPLICATION AND PERMIT NAME OF APPLICANT &III&Z / K " 4 INSTALLATION LOCATION ////fJJJJ� [��'�� LEGAL DESCRIPTION ✓" • / /✓ -'� 2 MAILING ADDRESS 4 27� Tma /t�5G PERMIT NO. PHONE ` 9 D - INSTALLATION OF: SEPTIC TANK ✓ EEPAG�gP(Io�T V DRAG OTHER TYPE AND SIZE OF FACILITY TO BE SERVED6 FINANCED THROUGH TO BE INST LLED BY SOIL TEST RESULTS NOTEI THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: 24,HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE /W TYPE 5x^,fSEEPAGE AREA S12E TYPE MINIMUM DISTANCES, REQUIREMENTS DIAGRAM OF SYSTEM 5 - FOUNDATION TO SEPTIC TANKnn// OR FOUNDATION TO SEEPAGE PIT DRAIN FIELD 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF G ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. ^ _ ,6644 z�i�ly DATE / APPLICANT'6 SIGNATOR i FORM NO. EO -016 ` SEPTIC'TANK TO SEEPAGE PIT WALL ,\ . 1 L -Z2, SEPTIC TANW 1 .SEEPAGE PIT DRAIN FIELD V 1 TO NEARESTLgT LINE. WELL TO SEPTICIANK SEEPAGE PIT DRAIN FIELD ALSO CONSIDER AREA WELLS. 0 WATER MAIN TO SEPTIC TANK SEEPAGE PIT DRAIN FIELD SEPTIC TANK. SEEPAGE PIT DRAIN FIELD TO RIVER. LAKE.`STREAM. CAST IRON INTO AND OUT -OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION B FEET INTO UNDISTURBED SOI}.. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT _ FITTED WITH AIRTIGHT REMOVABLE CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. 1L(e(/ G.A.A.B. OR LICENSED DESIGNER 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF G ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. ^ _ ,6644 z�i�ly DATE / APPLICANT'6 SIGNATOR i FORM NO. EO -016 ` -" 0 & E EivG/NEER/NG & DEVELOPMENT CO. Box 90, Davis St., Eagle River, Alaska 99577 • 694-2774 or 333.5240 Russell Oyster Earl Ellis 694-2774 333-5240 Civil Engineering Surveying Soils & Foundations Land Development SOIL LOG Performed for: Name: 1V11- (14,11 ee0 f/e EP— Tel. No. 6 S-Y-�2/,Zs 17" Mailing Address: LegalDescHption: Zc7 / , )64e 2, 7-4ejz KNo« 5c'-6. Depth (feet) Soil Characteristics 0 /tiL 5/GT TSP 1 2 J --I 5Cf5441,0V I61 ca:5 6 �t 7 8 r, 9 10 � 11 f 6` l 12 � , rl C� \off �Jr Ground Water Encountered-.\ Yes No If yes* what depth V, Proposed Installation: Seepage Pit 1' Drain Field Comments: J.'ri%c c. Ait/pCiNT Crr- f.ge'� ON Tnt' (9 %- / eC 71 T ' G /it/if- Lit /o T E; &00 -11C1 WAI7!/� 1, Performed by: �� iL( ll: Date: ? % /97V' U Municipality of Anchorage ° •��. -.. Development Services Department I Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw 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 h'ei Z5S v� Parcel I.D. 051-521-24 COSA# 0 7 D Lt,')—_7 Expiration Date: 1. GENERAL INFORMATION Complete legal description Lot 1. Block 2, Trois Knoll subdivision Location (she address) 20406 Leprechaun Drive Chugiak. AK 99567 Current Property owner(s) William and Km Green Day phone 261-9115 Mailing address 20406 Leprechaun Drive Chugiak. AK 99567 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Three (3) 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site I] 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 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 titre (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. 1 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 Engineering Phone 522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 12/17/08 ee •At '4...... ...1� '• �' S �'!y Vol MKIML & ANDERSON; -; 5. DSD SIGNATURE j f, CE-4381Approved for V Disapproved. 3 bedrooms. e!!l1�1 0: SSII a Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist X Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date: 12 —.Z 2- D� (R. nus) Municipality of Anchorage • Development Services Department -bw ing Sae Durston _ . _ ......._�-_. • - . On-Ske Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsfte ($OD 34 -3 -7904._ - CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Lot 1, Block 2. Troll Knoll Subdivision Parcel ID: 051.521-24 A. WELL DATA Well type EMmunity If A, 8, or C provide PWSID # 210778 Well Log (YM) Date completed _ Sanitary seal (Y/N) _ Wires property protected (YM) Total depthft Cased to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION Date of test Static water level fL ft Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform colonies/100 mL Nitrate mg/L Other bacteria colonies/100 mL Arsenic: mg/1 Date of sample: _ Collected by. B. SEPTICIHOLDING TANK DATA Tank Type/Material SepBdConkxete Date installed 6/10/1974 Tank size 1.000 gal. Number of Compartments OAe Cleanouts (YM) Y Foundation cleanout (YIN) Y Depression over tank [Y/N) N High water alarm (YIN) N Date of pumping 12!11/2008 Pumper Sanitary Pumpers C. ABSORPTION FIELD DATA , Date installed 9/s-er"7 Soil rating (g.p.d.te or ft2/bdrn) •e GPD/SF System type Deep Trench Length 54 ft. Width 3 fL Gravel below pipe 7 ft. Total depth 10 fL Eff. absorption area 756 fe Monitoring tube Y Depression over field N Date of adequacy test New Cont. Results (Pass/Fail) For_ bedrooms Fluid depth In absorption field before test in. Water added gal. New depth in. _____Elapsed Time.depth in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) N If yes, give date D. UFT STATION Date installed Size in gallons Manhole/Access (YIN) 'Pump on' level at _ in. 'Pump off" level at_ in. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES conformance with MOA COSA guidelines in effect on this date. 0 : MpCHAEL E=ANDERSON; v r ,� SEPARATION DISTANCES FROM WELL ON LOT TO: L �zL �e aim. v��f•, °� ,j/.��4 ti,�\\\\SSsto�`�C''' Septic tank/lift station on lot On adjacent lots Absorption field on lot Date of Payment Date of Payment On adjacent lots Public sewer main Public sewer manholetcleanout Sewer/septic service line Holding tank Animal containment areas None Manure/animal excrete storage areas None' SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >s Property tine>5 Absorption field >9 Water main WA Water service line >10' Surface water >100• Wells on adjacent lots >200' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Building foundation >10' Water main >10' Water Service line >10' Surface water >100' Driveway, parkingtvehicle storage >25' Curtain drain None Noted Wells on adjacent lots >200' F. COMMENTS: Y G. ENGINEER'S CERTIFICATION00 ••.'y�0 e,'(,j; �' I certify that I have determined through field inspections and .. ... •}�••••j� review of Municipal records that the above systems are in � ..... �e, .. ....:..... / conformance with MOA COSA guidelines in effect on this date. 0 : MpCHAEL E=ANDERSON; v r ,� Engineers Printed Name Michael E. Anderson, P.E. L �zL �e aim. v��f•, °� ,j/.��4 ti,�\\\\SSsto�`�C''' Date 12/1812008 COSA Fee $ Waiver Fee $ Date of Payment Date of Payment Receipt Number Receipt Number (Rev. 11/05) Municipality of Anchorage • _Development Services _Department _ Building Safety Division Onsite Water and Wastewater Program 4700BragawStreet '" `•• 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. 051-521-24 COSA # Q Q L1 4 1. GENERAL INFORMATION Expiration Date: .16 — 31 Complete legal description W 1• Block Z Tron Knon subdivision Location (site address) 20406 Leprechaun Drive Chugiak. AK 99567 Current Property owner(s) William and Kim Green Day phone 261-9115 Mailing address 20406 Leprechaun Drive Chugiak. AK 99567 Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested. COSA will be held by DSD for pkkup. 2. NUMBER OF BEDROOMS: Thr (3) 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site Individual Water Storage ❑ Individual Holding Tank ❑ Community Class A Well 91 Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) issues Certificates of Onsite 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 Onsite 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 Onsite 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 Onsite 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 Finn Anderson Engineering Phone 522-7773 Address P.O. Bax 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. 5. DSD SIGNATURE _1/Approved for 3 bedrooms. Disapproved. Date 10129r2007 Conditional approval for bedrooms, with the following stipulations: \`fe \\GY OF — ;' ON-SITE - --- --- - :WASTEWATER • GRAM Attachments: COSA Checklist x Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date:10-31-0-7 41A0 rRw 7105) Municipality of Anchorage • Development Services Department Building Safety Division On -Site Water 8 Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 995198650 www.muni.org/onske (907) 3437904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: Let 3, Skier 4. Surae SuedNmm Parcel ID: 051-521.24 A. WELL DATA WOO type Cammli y Date completed Total depth ft Date of test Static water level Wall production If A, B, or C provide PWSID 0 K0_M Sanitary seal (YIN) _ Cased to fl. FROM WELL LOG WATER SAMPLE RESULTS: Coliform coloniesmoo mL Arsenic: _ mgA B. SEPTICIHOLDING TANK DATA ft 9.p.m. Nitrate mg/L Weq Loo (Y/N) Wires properly protected (YAV) Casing height (above ground) in. AT INSPECTION IL 9 -P.M. Other bacteria cobnies/100 mL Date of sample: _ Collected by: Tank TypelMaterial 6epa W"craw Die insW& d eNa1974 Tank sae 1.009 gal. Number of Compartments one Clearauts (YfN) Y FotrtxWOn deanout (YAM v Depression over tank (YAV) N High wader alarm (YIN) N Date of pumping 9 SM" Pumper Swan Pwnpws C. ABSORPTION FIELD DATA Bate instatled 915 AAW Soil rating (g.p.011:2 or fl=Ibdrm) .a GPD/SF System type Deep Tiwsi� Length 54 fl. Width 3 fl. Gravel below pipe 7 1L Total depth t0 fL Efabsorption area ass fl= Monitoring tube Y Depression over field N Date of adequacy test Nsw Covet Results (PSSWFaIQ For _ bedrooms Fluid depth in absorption field before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rade >= g.p.d. Any rejuvenation treatment (past 12 rno.) (YAV 6 type) N If yes, give data D. LIFT STATION Date installed Size in gallons ManholwAc=3 (YM) 'Pump on' level at _ in. 'Pump otr level at _ in. High water alarm level at in. Dates Cycles tested Meets alarm a circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL. ON LOT TO: Septic tank/lift station an lot On adjacent lots Absorption field on lot On ed►acent lots Public sewer main Public sewer manholeideanout Sewer /septic service One Folding tank Animal containment areas Name Manurelanimal excrete storage areas None SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Building foundation >6 Pmperty line>S Absorption field >3 Water main WA Water service One >10' Surface water >1W Wella an adjacent lots >2' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: ProperV One >iV Building foundation >1M Water main >19 Water Service One >10' Surface water >1W Driveway, ptUWV vahide average >25' Curtain drain Nome NOwd Wells on adjacent Iota >2W F. COMMENTS: O. ENGINEER'S CERTIFICATION I cabby that I have determined though Maid a18pectk= and review cf Municipal records. that the above systems are in cadarmance with Mao COSA guidelines in effect on fhb data. Engineer's Printed Name Michael E. Andaman. P.E. Date 10148/1007 COSA Fee E_ Data of Pa"M Receipt Number (aev. 1103) E 50 Waiver Fee $ _ Data of Payment Receipt Number, . A 1 °r 49th 4I^.NAE: E. ANDERSON t." • rj � it .. • I �.' .• 1j Ow-.�.Il;.� I 112 t • 3� 3 L I I W x .�� F _ • AS -BUILT I hereby certify that I have surveyed the following ddesscr�ib�e'd property --L ' I[�..P%[� - - / j"; � � � /'.1�.Y• ,t,r.� r,->ril�LL�X�y-lid-ivy �C��o�. - •• ' `.�r Anchorage Recording Precinct, Alaska, andf that the improvements r. '�•;,.�••�, ' ;:'�. situated thereon are within the property lines and do not overlap or encroach on the `^.' property lying adjacent thereto, that -no improvements on prop- -' e:h• lying adjacent thereto encroach on the premises in _ - - qucation and that there are no roadways, transmission lines or other visible easements on said �,r,([ ,f •,, property except as indicated hereon. ..'c„•. I ,,, Dated at Eagle River, Alaska • this i� -_day o[ QeV, • '^� : •^�->••• �� •: ROBERT C. JOHNSON Z' U SCALE: RegLand Surveyor No. 880 . `,�: -LSistered 1' Box 45;3, Eagle River, Alaska Phone 894.2543, MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 14 4700 SOUTH BRAGAW STREET ANCHORAGE, AK 99519-6650 =`............ •�•i {t a SOILS LOG - PERCOLATION TEST _' ,_49thy .:t'. 0 ..... .... ....... ..„�.... • i� ; MIC71•EL E. w>mesw LEGAL DESCRIPTION: LOT I, BLOCK 2, TROLL KNOLL SUBDIVISION 110, No. cE-4381 PERFORMED FOR: WILLIAM AND KIM GREEN 't ....... DATE: 9/3/2007 PROJECT No.: 11 ... PARCEL ID#: TECIINICIAN: A. HARALA Pmfa m„1 DFPnl TEST BOLE # A 0w) OB/OG I SLOPE SITE PLAN 2 y. 3 • m 4 m N :4 m 5 •:. 5 SEE SITE PLAN • z 6 ;. 7 8 GMTY GRAVEL WITH SAND y ;..• 9 10 •,. t WAS GROUND WATER ENCOUNTERED? No IF YES @ WI IAT DEFTIT! II DEMI OF WATER AFTER MONITORING; Niw DATE OF MONITORING: 9A1i01 SEE SITE PLAN 12- 13— 2 13 •��• 14 .: 15 " .w ' 16 BOH 17 18 19 20 PERCOLATION RATE; I_2 (MINANCII) FERC. HOLE DIA, 6 (INCHES) TEST RUN BETWEEN:: 5_0 FT. and 6_0 F r. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. TEST PERFORMED BY VETECII ENGINEERING TECHNICAL SERVICE. 1, MICHAEL E. ANDERSON CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 10/28/2007 DATE READING GROSS TIME (MINUTES) NET TIME (MINUTES) DEPTH To WATER (INCHES) NET DROP (INCHES) 9/3 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 2:47 2.75' 2 3:17 30 5.50' 2.75' 3 3:18 2.38' 4 3:48 30 4.88' 2.5' 5 3:49 p,PS• 6 4:19 30 4.75' 2.5' INSPECTION APPOINTMEE\\NTS i TIME TIME DATE DATE n DATE RECEIVED TIME DATE q " "' i 0 %1"'N' tt. 1- n INSPECTOR INSPECTOR -.. INSPECTOR MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH & \ DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTOIIRONMENTAL PROTECTION 1 825 L Street - Anchorage, Alaska 99501 • ENVIRONMENTAL SANITATION DIVISION SEP 2 9 1980 Telephone 2644720 R E E I F li REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER' 9I[,TIES DIRECTIONS; Complete all parts on page 1. Incomplete requests will not he processed. Please allow ten (10) days for processing. 1. PROPERTY nact,N K.Uoelc P-.+ MAILING ADDRESS PROPERTY RESIDENT lit different from above) 2. "7 C f� 0 PU M 1C, Ic K. MAILINGADD ESS PO 9Do 3-572- Rsvoaaeafis ,Q*,,.,` 9^/4'9_-:i1 3. LEND}}��G INSTITUTION� �T� l 0 �fi')7 �RGBZ.. MAILIN ADDRESS s PHONE PHONE PHONE L.Q9a�L z7�-573 PHONE /D/ 6 . A)d4T-el -I i,73� AA/C,4499�3 0. REALTOR/AGENTA,/A, MAILING ADDRESS 6. LEGAL DESCRIPTION Lor / 8lout STREET LOCATIIOJ' NFiN ,L B��2ECNRJI�L�� 6. TYPE OFF RESIDENCE 6d- SINGLE FAMILY ❑ MULTIPLE FAMILY 7. WATER SUPPLY ❑ ^IVIDUAL' g/ COMMUNITY ❑ PUBLIC UTILITY S. SEWAGE DIS LSYSTEM INDIVIDUAL/ON-SITE" ❑ PUBLICUTILITY 5U73.- :j. NUMBER OF,BEDROOMS ❑ One ❑ Four 15a_�Two ❑ Five ❑ Three ❑ Six PHONE ❑ Other ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach log if available.) : (7 7`YEAR ON-SITE SYSTEM WAS INSTALLED. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010 (Raw. 6/79) Vitc err �,0. 4-07 Size: --1 0 If Tank is homemade SOILS RATING givedimensions: �- '3oCL✓v\ TYPE OF TANK MANUFACTURER CAJ TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holo.ng Tank IAbsorption Area (Seer Line WELL T0: w Absorption Area to nearest Lot Line 5. COMMENTS ❑---'APPROVEDFOR )-- BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 72010 (Rev. 6/79) INearest Lot Line THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS ❑ SINGLEFAMILY ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ MULTIPLE FAMILY ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY PERMITNUMBER ❑ INDIVIDUAL DEPTH OF WELL ❑ COMMUNITY DATE DRILLED ❑ PUBLICUTILITY Connection Verified LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ❑INDIVIDUAL/ON-SITE DATEINSTALLED ❑PUBLIC UTILITY — 1 Connection Verified INSTALLER ❑SepticTankor❑Holding Tank �pE¢ Size: --1 0 If Tank is homemade SOILS RATING givedimensions: �- '3oCL✓v\ TYPE OF TANK MANUFACTURER CAJ TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holo.ng Tank IAbsorption Area (Seer Line WELL T0: w Absorption Area to nearest Lot Line 5. COMMENTS ❑---'APPROVEDFOR )-- BEDROOMS ❑ CONDITIONAL APPROVAL (letter must accompany certificate) ❑ DISAPPROVED DATE BY 72010 (Rev. 6/79) INearest Lot Line ('--�).".EATER ANCHORAGE AREA SGROUGHe 1 beCart^ent of Envirermental Quality 3330 "C" Street, Anchorace. Alasva 59503 274-4551 Date Received 9/26/74 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & WATER FACILITIES FOR Farmers Home Administration 1. Approval requested by: Myrna Johnson Mailing Address: Phone: 2. Property Owner: William Koehler Phone: Mailing Address: Box 279 Chugiak AK 3. Legal Descriptipn: Lot 1, Block 2, Troll Knoll Subdivision 4. Location: Peters Creek 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 William Koehler C. Septic Tank: 1. Size 1000 gal 2. Manufacturer Wallace D. Seepage Pit: 1. Absorption Area 13'x26'x9'2. Material Loq E. Disposal Field: Total length of lines 8. Distances: 9/26/74 A. Well to: Septic tank , Absorption area Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank 401 Absorption area r,6, _ C. Absorption area to nearest lot line 321 EQ -034 (1/14) Page 1 of t,:o pages 6 I .% 11 1 Page 2 of two pages - Re.;_;st for Approval of Individual ^ r & Water Facilities Legal Description Lot 1, Block 2, Troll Knoll Subdivision Comments Approve f & Disapproved Date 9/26/74 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)