HomeMy WebLinkAboutTONJESS ESTATES BLK 2 LT 14Torijess
Estatess
Block 2
Lot 14
#051-832-17
Municipality of Anchorage 4
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tt
Development Services Department .++.
Building Safety Division
.
On-Site Water and Wastewater Program, 4700 S. Bragaw St.
P.O. Box 196650 Anchorage, Al( 99519-6650 Page'
www.clanchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number -5(AV 9-0306 PID Number: 051-4232-
of 3
17
"'""uoi-tn}amay Lill; le
Wastewater System: ❑NewUpgrade
t5Thox6.'630 Chu9;alc AK'M5(7-06
37 ABSORPTION FIELD
NuIMM a Broom. 5
Phony / 2 (^— q5-y7
6 LLEEGALLDESCRIPTION
Map Trench D Shallow Trench 0 Bed 0 Mound 0 other
a°'R'°"0 I. 2 cpD
TOItlD.DnhpnOnanNlprWa I&FI.
at'
Stock Lolei Subdw.on v /
I Tobi SFSlgTe5
Depth to pabottom from original grade
3 FL
Gravel depth beneath pad
7 FI
Tovwtip Range Section
n t added Wove onpn.l pada D 4
a Ft.
Gravel Length
.7 Fl.
Well: ■New
Upgrade
Gravel wenn
3 Ft.
NumO rrIIMa
(
P,M.nca between nye
— Ft
Cla.rnu°ovn/(Pnvr/,e. A B. C ,
E!' is 1 nq Pi' Vii
TOW Dapm
Ft.
C..ed m
FL
Tdtl absorption NL{} �' /I �%
3il0tR6 S — 6 / „...1„,
141q
P/hD��LM`ara'n/r� n�jyF���
�l 57 j 82/31/ P$l/0
Dour J
Date Dolled
SmucW.I.rL.vtl
FL
�J a,s ., /
TLm ed &eavnaT"inj•
Dime Installed ct�� /'
Cl—'3-t�7
Yield•Sala.
GPM
'c.
FI.
g,,
Ground
FL
TANK
SEPARATION DISTANCES
(/$'Septic 0 Holding 0 S.T.E.P.■ Other.
To
From
Septic
Tank
AbsorptionHolding Lift 'ubiiclPrivate
Field Station TankSewer Line
Minuted"''
Prep, er Picts'/4$
capac.Ir
i vtS d 5�7
Materiel
Number °I Comp.rtmai I.
Well
102'
116' — a5f
N O PE
SwNoa Willa!
I� f.
LIFT STATION
La uneSO
Q`
a 1ar7','Pharhp
i )
Manufaa"er
an NvN a
otr
•
Wpn rear Yarm.t
Foundation
I
Curtain Drain
��
I �nNCI''^O'Xsz.
//�l k0
Pump Men. a
EIaMW F.peaan. DMan.d bT'
/
R.m.d. tk15f1'f115 Sep4-I s fanl Log
BENCH MARK
JJ / / l
p tit o (rushed, 4,44 aka/Lied,
Location and Description (i��
W'tcvri of St i n
ye ,
MWr1Md Ee.ahOn
ae poi•7f- %! tt /00 FL
,r c>,'� 17 f,
5 & 5 ENGINEERING
17034 Eagle River Loop Road, No
Inspections performed by: 'Cares: 1" $-� 3-0�
,' t;` , } !'i
- r ••••••• :
eagle River, Alaska 99a77
2nd 9-13—a4
iri
�. ... • .�.......• .... ,, ,
ran 3 R BERT C. COWAN , ,^
Development Services Department Approval
Reviewed and approved b : L . O
PP Y: .,,,.V. 1 K�1Q,q ()s Date: �)j9/8 j
Tft`g;:e CE-8801 ,/4, 5
�tt4%4';r.,_�•.= ; i--
, / _ _
(Rev lie
PERMIT NO SW040306
PAGE 2 OF 3
Municipalityof' Anchorage
DEPARTMENT OF HEATH 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 LOT 14, BLOCK 2, TONJESS ESTATES
P.I.D. NO. 051-832-17
LOT 7
LOT 6
..-3
NEW 550 GALLON
C---pxt FAT ALBERT SEPTIC TANK
qtt� 3 NEW TRENCH
i NEW 1000 CALLON
C ST3 HOPE SEPTIC TANK
141C01
THSCO�_
DELI & DBL2 STS TBM
FS FLOW SPLITTEORS�j, 03 FCO
OCi
LOT 13
MT2
LOT 15
o.
-A
O
2
of
SCALE: 1- - 40'
S
Ire °,, .. /%CL
1A,% R BERT C COWAN / C if
'0 •• CE -8801 r 11`; i
i Fe♦ r
13/411(17:7Z .AIJ"1�` 44
PERMIT NO SW040306
PAGE 3 of 3
Municipalityof Anchorage
DEPARTMENT OF HEATH 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 LOT 14, BLOCK 2, TONJESS ESTATES
P.I.D. No. 051-832-17
FINAL GRADE
97.7'
ST1 ST2
ST3
97.0'
INSULATION
92.5'
CO1=95.5'
CO2=94.5'
FINAL GRADE
550 GALLON
FAT ALBERT
SEPTIC TANK
CO1=91.0'
CO2=91.0'
NO WATER FOUND
76.0' B.O.H.
DRAINFIELD
93.0'
A
B
FCO
19.0'
23.5'
ST1
25.0'
20.0'
ST2
26.5'
21.0'
ST3
31.0'
22.0'
TMT
25.0'
18.0'
DBL1
33.0'
20.5'
DBL2
34.0'
20.0'
FS
35.0'
19.5'
CO1
40.5'
25.5'
CO2
68.0'
38.5'
MT1
42.5'
26.5'
CO3
37.5'
11.0'
MT2
65.5'
24.5'
N. T. S.
..1-.S , „„.. !Co -.t,I.
4 re ROBERT C. COWAN f4^.
ll c : CE -8801
Jj \ ! r�
i1) CPQ ......_' .^:l C r
Mayor Mark J3cflch
Municipality of Anchorage
I'.O. Dos 19(W.34) • Anchorage, Alaska 99519-0650 • Telephone (907) 343.8301 • Fax (07) 343.82(X)
4700 Brugnw Street • Anchorage, Alaska 99507
www.munl.org
Building Safety Division
5/19/2005
S & S Engineering
17034 North Eagle River Loop, Suite 204
Eagle River, alaska 99577
Subject: Waiver Request for Tonjess Estates Subdivision, Block 2, Lot 14
Waiver Request #WR050032
Parcel ID #051-832-17
Permit # SW040306
Dear Mr. Cowan:
Your request for a waiver of the required 10 feet horizontal separation from the
absorption field to the foundation has been approved. The approved separation distance
is 8.0 feet.
This waiver approval applies to the existing absorption field to foundation separation
only. Any future upgrade to the on-site wastewater disposal system will require all
separation distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
LCItersettec,
Julie Makela, P.E.
Civil Engineer
On -Site Water & Wastewater Program
Comnlunity, Security, Prosperity
t.
/• I ^ die
V M V
zneeRzng
w
SEAMSAUTNCTITY
APPROVALS
SEWERS WATER
WN ECTENSq»4
SEWERS WATER
INSPECTION
ENG l REEFING STUDIES
ANO REPORTS
WELL INSPECTION
S PLOW TEST
SITE PLANS
WAD DESIGN
SOL TEST
PERCCIATION
TEST
STRUCTURALS
MECHANICAL
ISPECRCNS
CN SITE
WASTEWATER
DISPOSALSYSTEIA
DESIGN
ROBERT C. COWAN, P.E.
ROBERT A. SHAFER, P.E.
May 12, 2004
MUNICIPALITY OF ANCHORAGE
Development Services Department
P.O. Box 196650
Anchorage, AK 99519-6650
REFERENCE: Lot Lot 14; Block 2; Tonjess Estates Subdivision
CML ENGINEERS
(907) 694-2979
FAX(907)694-1211
Request you grant a waiver on the referenced property for the horizontal separation
distance between the original leachfield and the new house addition at 8 feet. There is
no daylight basement under the new addition to the house.
We do not anticipate any adverse effect on the property.
If you require additional information, please contact us.
Sincerely,
Robert C. Cowan, P.E.
RCC/ts
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER. ALASKA 99577
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Initial
Permit Number: SW040306
Legal Description: TONJESS ESTATES BLK 2 LT 14
Design Engineer: 0003 S & S Engineering
Owner Name: John & Judy White
Owner Address: PO BOX 670630
CHUGIAK . AK 99567-0637
?bq 16 -CDP ?CO
Date Issued: Jul 30, 2004
Expiration Date: dal -307206e
SEPT IO t 2OOC
Parcel ID: 051-832-17
Site Address: 025249 SCHAFF DR
Lot Size: 40249 SQ. FT.
Total Bedrooms: 5 Permit Bedrooms: 5
This permit is for the construction of:
❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. 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 closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By. �>- Date• 7 / 7o /o r
rIssued By Date: 7/73 4i
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. OS 1-S3a--17
Property owner(s) r--0 ON 4 J' V O y wit IY¢.
Mailing address (1) P • a D X 6 7o 6 3 0
Mailing address (2) Cif u 4-' A K , 4K Zip Code 9 9r6 7
Legal description (Lot, Block & Sub'd.) Lo T 1 `/ 0 LOC
Legal description (Section, Township & Range)
Lot Size 40, a g y Acres/hy.E17.. Number of Bedrooms 5
R{N4uAL
Permit Number SW 0 3 0 3 7#
Day phone 6 7 -isni7
THIS APPLICATION IS FOR:
Sewer Only
Sewer and Well
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub
Swimming Pool
Therapy Pool
a rcN7to es r47€
❑ Well Only
❑ Water Storage
Jacuzzi
Water Softening Unit
0
0
0
I certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
5 & S ENGINEERING
211(7,-- — — 17034 Eagle River Loop Road No. 204
GG ''sem Eagle River, Alaska 99577
(Signature of property owner or authorized agent)
Permit Fees: -tbs. e e
Waiver Fees:
Date of Payment: 7 7a c. Jo y Date of Payment:
Receipt Number:`J SS.7 `7 �. Receipt Number:
(Rev. 12100)
&S
neening
law
AIA4A
I€ALTHAURIORITY
APPROVALS
SEWER II WATER
(MAI EXTENSIONS
SEWER 6 WATER
.sFECRON
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
a FLOW TEST
SITE PLANS
1
ROBERT C. COWAN. P.E.
July 23, 2004
MUNICIPALITY OF ANCHORAGE
Development Services Department
P.O. Box 196650
Anchorage, AK 99519
REFERENCE: Lot 14, Block 2, Tonjess Estates Subdivision
CIVIL ENGINEERS
(907)694-2979
FAX (907)694-1211
It is requested that you re -issue the permit (SW030374) to install a septic system and
revise the permit from 4 bedrooms to 5 bedrooms. At.s o ato...ta r rNar rat
',teen.r at. Rtnrtw4d f4R Aro SHE it vt4ea.
We do not anticipate any adverse effects on neighboring wells, septic systems, reserve
areas or drainage patterns by the installation of the proposed septic system. The
construction of this system will not prevent any future development on any of the adjacent
properties.
If you require additional information, please contact us.
Sincerely,
Robert C. Cowan, P.E.
ROADDESIGN RCC/bjj
Enclosure
SOIL TEST
PERCOLATION
TEST
STRUCTURAL
MECHNMYL
INSPECTIONS
ONSITE
WASTEWATER
DISPOSAL MST EA
DESIGN
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
1" = 40'
DESIGN
SITE -PLAN
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HEALTH AUTHORITY
APPROVALS
SEWER L WATER
SINN mDASIONS
SEWERS WATER
INSPECTION
ENGINEERING STUPES
AND REPORTS
WELL INSPECTION
S FLOW TEST
SITE PLANS
FOAL)CESIGN
SOL TEST
PERCCUTION
TEST
STRUCTURAL&
SIECHANIGAL
INSPECTIONS
CH SITE
WASTEWATER
CSP06ALSYSTEY
DESIGN
ROBERT C. COWAN, P.E.
CML ENGINEERS
(907) 894-2979
FAX (907) 694-1211
ON-SITE WASTEWATER DISPOSAL SYSTEM
'CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
REFERENCE: Lot 14, Block 2, Tonjess Estates Subdivision
August 13, 2003
GENERAL:
1. The scope of this project includes the installation of a 1000 gallon }IDPE
septic tank, a 550 gallon Fat Albert septic tank, and a new trench to serve the
existing five bedroom residence located on the referenced property.
2. Construction shall be in accordance with the approved site plan and 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 any necessary underground
utility locates.
4. Unless specifically agreed otherwise, the property owner shall be responsible
for final grading areas subsequently depressed from soil settling.
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 Municipal Health
Department.
SEPTIC TANK INSTALLATION:
1. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
2. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
17034 NORTH EAGLE RNER LOOP • SUITE 204 • EAGLE RNER ALASKA 99577
•
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SW030374
Legal Description: TONJESS ESTATES BLK 2 LT 14
Design Engineer: 0003 S & S Engineering
Owner Name: John & Judy White
Owner Address: PO BOX 670630
CHUGIAK , AK 99567-0637
Date Issued: Sep 11, 2003
Expiration Date: Sep 10, 2004
Parcel ID: 051-832-17
Site Address: 025249 SCHAFF DR
Lot Size: 40249 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
Disposal Field Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. 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 closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By: OIZAV
p. -ger-
Date: Ili 5 /0 3
Date: 7///,03
Municipality of Anchorage
beveloptnent SeWices bepartmeht
Building Safety Division
On -Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.ancborage.ak.Us
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 3Z� 1�
Property owner(s) Judy 'l' J 1)/1 WA ae,
Mailing address (1) P,OEBoX 670630 r/
Mailing address (2) 614149; elk ,AA' Zip Code eiti b 7
Legal description (Lot, Block & Sub'd.) 1 -at /% &L k�Q Toni 655 Estafes.
description (Section, Township & Range) t� Z`
-\ "I SC v cc 1i r
Number of Bedrooms q
Permit Number SW O 30 374
Day phone Egg— 95-59
Lot Size^' TO) a 9 Acres
CHIS APPLICATION IS FOR:
Sewer Only
Sewer and Well
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub
Swimming Pool
Therapy Pool
0
•
Well Only
Water Storage
Jacuzzi
Water Softening Unit
0
0
0
0
I certify that the above information Is correct. I further certify that this application Is being made for a
Single Family Dwelling and Is In accordance With applicable Municipal Codes.
5 & S ENGINEERING
lir 17034 Eagle River Loop Road No. 204
fj,,,
� £yV 911.u�raa4' 99577
(Signature of property owner or authorized agent)
Permit Fees: $ I/00. Waiver Fees:
Date of Payment: h s' /o ? bate of Payment:
Receipt Number: a y o 1 y5- Receipt Number:
(Rev. 12/00)
16.
Engine nzinq
IttY
HEALTH ACT HORNY
APPROVALS
SEWER& WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STNEES
A 40REPORTS
WELL INSPECRON
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL &
MEGUHICAL
!ERECTIONS
ONSITE
WASTEWATER
DISPOSAL SYSTEM
OESI N
nEBEnT C. COWAN, P.E.
ROBERTA. SHAFER, P.E.
CML ENGINEERS
(907) 694-2979
FAX(907)694.1211
August 13, 2003
MUNICIPALITY OF ANCHORAGE
Development Services Department
P.O. Box 196650
Anchorage, AK 99519
REFERENCE: Lot 14, Block 2, Tonjess Estates Subdivision
It is requested that you issue a permit to install a septic system to serve the existing
four bedroom dwelling on the referenced property.
A test hole was excavated and a percolation test performed. The approximate location of
the test hole is located on the attached site plan. At the time of excavation 8/5/03, water
was not found. After monitoring, no ground water was found.
We do not anticipate any adverse effects on neighboring wells, septic systems, reserve
areas or drainage patterns by the installation of the proposed septic system. The
construction of this system will not prevent any future development on any of the adjacent
properties.
If you require additional information, please contact us.
Sincerely,
crt C. Cowan, P.E.
RCC/bjj
Enclosure
17034 NORTH EAGLE RIVER LOOP • SURE 204 • EAGLE RIVER. ALASKA 99577
1" = 40'
St .A1 F
DESIGN
SITE—PLAN
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Legal Description:
Depth
(Feet)
1�2- . 0
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9-
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14-
15-
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18
Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
47C0 South Eragaw St.
P.O. Box 190650 Anchorage. AK 59519-6650
www.d.anchcraee. ak.u{
(907) 343-7904
Soils Log - Percolation Test
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tor Mi fitOOk2/'
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COMMENTS
i e)\%44 ,INEERtS
��At!'
' Att'h
yi ` ROBERT C. town." 44
hoc CE -860) f>c�• f
f ,••„ tjej�
�� , ,q SStt"
DatePerformed: Tl6/03
Township. Range. Section:
Tow Tess Esr
Site Plan
WAS GROUND WATER NO
E\CCLNTE.RE D? S
L
0
v
E
Dee. 3
IF YES. AT YMAT DEPTH?
Depth to Weer After
Monitoring?
4<
IG
Pini
Reading
Da:e I GrossTime
0/41031. o
1 io
Net Time I Depth to Water
Net Drop
120
1 3a
0 1 6''
/0 110
4
/o 1 /0" 1 4"
4o
5D
/o 1 /0 I 5,/4"
4
/-,
/0 1 ! 3/4"
/0 93/ ' I 37/4 "
/0 937"1 3 74"
6o
FERCCL4i:C+i PATE Z.tesineo PERC HOLE OW.IETER
. l��
ry
TEST F.L'vEETNEE.`I_Fi ANO 4 FT
PERFORMED BY: cis ENCrl til 66 u �� CERTIFY THAT THIS TEST WAS
PERFORMED IN ACCO .DANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
S&S
Engineelting
1
IEALTH MANOR TY
APPROVALS
SEWERS WATER
IMM MTEfSIOtS
SEWERS WATER
INSPECTION
ENGINEERING STUDIES
MO REPORTS
WELLMSPECTION
t PLOW TEST
SITE PLATO
ROAD DESIGN
SOIL TEST
PERMEATION
TEST
STRUCTURAL
MECHANICAL
ISPECTgNS
ONSITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
ROBERT C. COWAN. P.E.
ROBERT A. SHAFER. P.E.
CML ENGINEERS
(907) 694-2979
FAX(907)694-1211
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
REFERENCE: Lot 14, Block 2, Tonjess Estates Subdivision
August 13, 2003
GENERAL:
1. The scope of this project includes the installation of a 1300 gallon IIDPE
septic tank and a new trench to serve the existing four bedroom residence
located on the referenced property.
2. Construction shall be in accordance with the approved site plan and 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 any necessary underground
utility locates.
4. Unless specifically agreed otherwise, the property owner shall be responsible
for final grading areas subsequently depressed from soil settling.
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 Municipal health
Department.
SEPTIC TANK INSTALLATION:
1. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
2. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
Page 2
Lot 14, Block 2, Tonjess Estates Subdivision
August 13, 2003
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 leachfeld 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 Ieachfield. 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 TRENCII/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 (ruffed -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.
5. Backfill over the final gravel layer must not be Tess than twenty-four (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.
Page 3
Lot 14, Block 2, Tonless Estates Subdivision
August 13, 2003
MINIMUM MATERIAL SPECIFICATIONS:
1. Any septic tank proposed for installation must be constructed by a Municipal approved
septic tank manufacturer.
2. The following pipe materials are approved for use in septic system installations in the
Municipality of Anchorage:
Tyne 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, Femco, 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 Tess 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, which ever requirement applies.
Page 4
Lot 14, Block 2, TonJess Estates Subdivision
August 13, 2003
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.
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
r) MUNICIPALITY OF ANCHORAGE f 1
�C4 DEPARTMENT OF HEALTH &ENVIRONMENTAL PROTECTION
-itc.-11 ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT y}
NAME /� `T,
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LEGAL DESCRIPTIQ0 /y a /k re- FS
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NO. OF BEDROOMS
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DISTANCE TO
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Dwelling i
/6
PERMIT BO.
.F10/03
Manufacturer N
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Width
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DISTAG�INCE T0:
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Dwelling
PERMIT NO.
Manufacturer
Material
Liquid capacity in gallons
TILE
DRAINFIELD
TRENCH
DISTANCE TO:
Well
Foundation
Nearest lot line
PERMIT NQ.t..1n/
jjfj ]LV o3
No. of lines /
Length of eas•,hJjn9
Total length of
Trencltyviinches
Distance bet e�rfes
Top of tile to finish grade it
....1, y -C.
Material beneath tie
inches
Total effective absorption area
2 isky
SEEPAGE
PIT
Length
Width
Depth
PERMIT NO.
Type of crib
Crib diameter
Crib depth
Total effective absorption area
DISTANCE TO:
Well
Building foundation
Nearest lot line
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Depth 9
Driller
Distance to lot line
PERMIT NO.
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption weals)3
OTHER
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APPROV //D,/\ illn
72.013 (Rev. 3/78)
' triLlttiiIr�IBHLIT'ti' oF....FrrICF F:Ffi3E 9,r -g•.�
DEPARTMENT ('HEALTH AND ENVIRONMENTAL. .OTECTION
825 'L- STREET, ANCHORAGE, AK. 99501
z 264-4720
ON—LSI-11'E BE1EF= FREF2'1-1 I T
PERMIT NO. ( 830103 )
APPLICANT GEOLAR CONSTRUCTION INCJBOX 1302 E. R. 99577
, LOCATIOtJ
LEGAL L14 B2 TONGESS Estates Subdivision LOT SIZE 999999 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH s y.E
t1AXIMUM NUMBER OF BEDROOMS = 3 SOIL RATING (SQ FT/BR) 85
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: \,
NI A
1>EF*TI-J= 3.e3 LENGTH= 27› GFRFFvEL c.F.1-.)--1147.-1 t ':,• � 1
k.THE LENGTH DIMENSION I5 THE LENGTH (IN FEET) OF THE TRENCH 0R1DRAINFILD �•�;
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN -THE SURFACE.OFXTHE
GROUND AND THE BOTTOM OF 'THE EXCAVATION (IFJ FEET). 1• r
THERE IS NO SET WIDTH FOR TRENCHES. , t
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THEOUTFALLi PIPE, \:\
AND THE BOTTOM OF THE EXCAVATION (IN FEET).
F EG!L_I I FEEL? _EF "TIC T1RNFC 5 12E= a.. -el tit GREECE N1
A, (.
PERMIT APPLICANT HAS THE RESPONSIBILFTY-TO,-INFORM'THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIOFJS.OF ANY WELLS4115JPCENT. TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE ...
--- TWC <2> I 11SF EC -r I 0Ni'S FlF<E I EIMI.J I REGN
BACKFILLING OF ANY SYSTEM I.UTHOUT-.FINAL INSPECTION AND APPROVAL BY, THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL ANDANY ON-SITE SEWAGE DISPOSAL SYSTEM I5 '
100 FEET FOR A PRIVATE WELL OR 15Q;.T0 200:-FFETFROM.A PUBLIC WELL. -DEPENDING';
UPON THE TYPE OF PUBLIC WELL. � ^` `��'.� ..
MINIMUM DISTANCE FROM A PRIVATE WELL TO R. PRIVATE SEWER LINE I5 25 FEET FIND
TO A COMMUNITY SEWER LINE IS 75 FEET';; ,.\.. . ,\•, ,
OTHER REQUIREMENTS MAY APPLY. SPECIFICATI0VJSWAND•CONSTRUCTIONIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F='EF�F1 I T E <F=" I FEE'E DEIGEF1BEFE 3 L.. 1_91
, 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 THE CODES.
3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 3 BEDROOMS.
SIGNED'
AR CONSTRUCTION INC
ISSUED BY_s_DATE_
V4.0
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 2644720
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: C 1'" e &WarFJP rm/v
LEGAL DESCRIPTION:
SOILS LOG
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DATE PERFORMED: 3/2/R J
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PERFORMED BY: 4 C. Ze),-,k' '
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CERTIFIED BY: ,Sr C2,One,,e1474'. DATE: .3/2/8J
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Municipality of Anchorage �A�E
On-Site Water and Wastewater Program "IA i
(907) 343-7904 SA ETY
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 051-832-17 Expiration Date: No\r o�� a a 1
1. GENERAL INFORMATION
Complete legal description TONJESS ESTATES BLOCK 2,LOT 14
Location (site address) 25249 SCHAFF DRIVE,CHUGIAK,AK 99567
Current Property owner(s) JOHN M.WHITE JR Day phone
Mailing address 25249 SCHAFF DRIVE,CHUGIAK,AK 99567
Real Estate Agent Day phone
2. TYPE OF.DWELLING:
® Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 5
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ® Individual
Individual Water Storage ❑ Holding Tank 0
Community Class_Well 0 Community 0
Public Water System 0 Public Sewer 0
WaiverNariance request for: Distance:
Received by: Date: 8/22//0
COSA to be released to t eer,unless otherwise requested by the engineer.
COSA Fee $ 52f Waiver Fee $
Date of Payment $1q `l9' Date of Payment
Receipt Number I PAINS Receipt Number
COSA# 05C.t91465 Waiver#
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,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is (are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm ANDERSON CONSTRUCTION & ENGINEERING Phone 345-3377
Address 4640 SHOSHONI DRIVE,ANCHORAGE,AK 99516
Engineer's Printed Name MICHAEL N.ANDERSON,PE Date 08/08/2018
�r �),• -moi �Cr?.(
6. DSD SIGNATURE
System #1 Approved for 5 bedrooms. O
D D C
MICHAEL N. ArvoEnscN
CE-9 5 ° _
System #2 Approved for bedrooms. l 41(/).D.• �' �•-cf
Disapproved. 0FESS
Conditional approval for bedrooms, with the following stipulations:
o F PN
By: Original Certificate Date: acg -?. 20 1
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet talo-12.doc
If more than 1 septic system is on the lot:
COSA Checklist# of_
Structure served by this system _
Certificate of On-Site Systems Approval Checklist
Legal Description: TONJESS ESTATES BLOCK 2.LOT 14 Parcel ID: 051-832-17
A. WELL DATA
Well type Private If A, B, or C provide PWSID # Well Log (Y/N) Y
Date completed 3118/1983 Sanitary seal (Y/N)Y Wires properly protected (Y/N)Y
Total depth 148 ft. Cased to 58 ft. (INTO BEDROCK) Casing height (above ground) 18+ in.
FROM WELL LOG AT INSPECTION
Date of test 3-18-1983 8/1/2018
Static water level 54 ft. 57 ft.
Well production 1 g.p.m. 1.7 _ g.p.m.
WATER SAMPLE RESULTS:
Coliform NEG colonies/100 mL Nitrate 8.32 mg/L
Arsenic: ND ug/L Date of sample: 8/1/2018 Collected by: FIRST WATER C.S.
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material_SEPTIC/HDPE Date installed 8/13/2004
Tank size 1000+550 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N
Date of pumping 8/2/2018 Pumper JRs
C. ABSORPTION FIELD DATA -TESTED 2004 TRENCH
4 q/03
Date installed 8/13/2004 Soil rating (g.p.d./ft2 or ft2/bdrm) 1.2100 System type DEEP TRENCH
Length 27/aft.ft. Width 3/21'ft. Gravel below pipe 7A.ft.
Total depth 10.8 ft. (Measured 8/1/18) Eff. absorption area 642/ft2 (2004+°RIc.Monitoring tube YDepression over field N
( zby Date of adequacy test 8/1/2018 Results (Pass/Fail) PASS For 5 bedrooms
Fluid depth in absorption field before test 0 in. Water added 750 gal. New depth SO, in.
Elapsed Time: 230 min. Final fluid depth 0 in. Absorption rate >= 750 g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N &type) N If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"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
WELL ON LOT TO:
Septic tank/lift station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main 75'+ Public sewer manhole/cleanout 100'+
Sewer/septic service line 25'+ Holding tank _100'+
Animal containment areas 50'+ Manure/animal excrete storage areas 100'+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation _7'(PER IR) Property line 10'+ Absorption field 5'+
Water main 10'+ Water service line 10'+ Surface water 1001+
Wells on adjacent lots 100'+
ABSORPTION FIELD ON LOT TO:
Property line 10' Building foundation ter* Water main 101+
Water Service line 10'+ Surface water 100'+ Driveway, parking/vehicle storage 10'+
Curtain drain 50'+(None Known) Wells on adjacent lots 100'+
F. COMMENTS
4"WAIvae--
G. ENGINEER'S CERTIFICATION `�aaya�;Z
; •
I certify that 1 have determined through field inspections and '\(L. •• ;`� s a
review of Municipal records that the above systems are in yF'• t�
conformance with MOA COSA guidelines in effect on this date. .:49T 9 F �;( •••*d'
Engineer's Printed Name MICHAEL N.ANDERSON,PE % f
• o% ANDERSON A
N. NDER . r
Date 08/08/2018 MICHAEL No c••• CEN. ANDER `4;
COSA canary sheet_2-6-15.doc
MUNICIPALITY O_ F ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT i" • - ` 907-343-7904
On Site Water and Wastewater Section Fax: 343-7997
www.muni.org/onsite
Nitrate Advisory
Certificate of On-Site Systems Approval # OSC181405
Subdivision: Tonjess Estates, Block: 2, Lot: 14
A water sample revealed a nitrate concentration of 8.32 milligrams per liter (mg/L).
The Environmental Protection Agency (EPA) has established a maximum
contaminant level (MCL) of 10.0 mg/L for public drinking water systems. While
private wells are not subject to this regulation, EPA standards are based on existing
health information and can therefore be used to gauge the relative quality of water
from private wells. Since nitrates are known to slowly increase, we recommend
you monitor the water quality. Please see the attached "Nitrate Fact Sheet" for
important information regarding nitrate.
This advisory must be attached to all copies of the subject Certificate of On-Site
Systems Approval.
Mailing Address: P.O. Box 196650 *Anchorage,Alaska 99519-6650 *www.muni.org
Nitrate Fact Sheet
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids,and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
Mailing Address: P.O. Box 196650*Anchorage,Alaska 99519-6650 *www.muni.org
N Frontier Surveys,LLC Project No: 18-300 Date:August 6th,2018
Ordered By: Morgan Michelsohn Plat:82-59 Grid: N/A
(7,;4\1)
Scale r'.,40'
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Lot 14, Block 2 ,' j Z
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2 Story Wood Frame House ��I
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Legend;_--_.___._.._-_ ___
': Electric Meter/Outside Power °D., Metal Post
Telephone Pole 0 LOT 17
X Gas Meter Deck -0- Fence - f- light Pole
5; Septic ® Water Well Q Mailbox --ow—Over Hanging Power
General yes: 101 20 40 81I0
1.This document is created for the purpose of a single property transaction and is subject to Federal 1 Copyright Laws. 11 f
2.Excepting for gross negligence•the oability or this survey shell not exceed the cost 01 prepwlrug this arvey. Scale in Feet
3.Alt measurementslsetbacks are to the visual/apparent buiding footprint.
4.All dimensions to property lines are plus/minus 0.10.
,,,,,••••\3\111,1 This survey complies with the ASPIS Mortgage Location Standards.The survey represents visible.mpronmrents and
c o F ,q 111 conditions at the erne d the survey.Thus document does not constdute a boundary survey and is subject to any
'0 ... A 111 inaccuracies that a subsequent boundary survey may reveal.It Is the respons:hdey of the Owner to determine the
,`P `r7 ,', existence of any easements,covenants,or restriction which do no appear on the record plat Under no circumstances
r7 '` '.9 /' should this document be used for Construction or for establishing a boundary or fence Lne
I�
' *: 49TH\ '.* As-8ullt Survey of:
`� ; Lot 14, Block 2 Tonjess Estates
S
p rrsa«kw`�I I,Frederic Wagner, certifythat this Mortgage Inspection wasperformed me,or
NO.cs.Jises �: 8 herebySurvey by
8/8/2018 •44,z under my direct supervision on August 6th,2018.
rry i91e0''..
1, Frontier Surveys,LLC FRONTIER
l t t t •
t�;�N% 'uAL ' 650 W.58th Ave.Suite E Anchorage,Alaska 99518 II $t>��•,
907.460.1686-info@frontiersurveys.com �� "'C\
PROFESSIONAL SEAL www.frontiersurveys.com
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On -Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I D # C,A1-Cs - I-1
HAA# W1'1f`-1•'aZ
1. GENERAL INFORMATION
Complete legal description Lot 14; Block 2; Tonjess Estates Subdivision
Location (site address or directions) 25249 Schaff Drive, Peters Creek, Alaska
Property owner John M. white, Jr. Day phone 266-8575 wk
Mailing address
P.O. Box 637, Chugiak, Alaska 99567 688-4547 hm
Lending agency Day phone
Mailing address
Agent Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
xxx
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
Holding tank
Community on-site
Public sewer
xxx
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 )Rev. t/91) Front MOA e2I
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. 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 in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm a . NG1NEERtNG Phone
Address 17034 Eagle River Loop Road No. 204
Eagla River, Alaska 9957/
Engineer's signature Date
alt_ Of 44t `I
lit
•.•...••e.. \q1� 41
. *roe ..... N.Ci..N••• ••. i)y
Y
fid 1 ROGE9 J SHAFER
i S°. No. 215 `j
A , fRoFESs0..,"-
6. DHHS SIGNATURE •r,.4...4..107,'z
Approved for Z` 2J bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
Date h/l
• CAUTION::
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025 (Rev 191) Back MOA 021
Municipality of Anchorage M
Department of Health & Human Services t' '•' 1'tk l+�ABE
HEALTH AUTHORITY APPROVAL CHECK y' 9MON
Legal Description: 1-. Vk 1�-4-'1----n.Jse.5 ' r~.sT. Parcel I D v57-cs3 7"h 77 199 „ 'I
A. WELL DATA
Well type p9%\/ It-ect- If A, B, or C, attach ADEC letter. ADEC water system number
Log presenN)
Total depth I4S'
Sanitary sea(/N)
Date of test
Static water level
Well flow
Pump level
Date completed
Cased to
3-18-83
Se'
FROM WELL LOG,
3-18-g3
S1r
/, O
UR
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main 4,ek. Public sewer manhole/cleanout '414
. 1,1-
Sewer
ySewer service line .S Petroleum tank
Driller 0.11 \.ls.hr
Casing height
!2 'r
Wires properly protected6/N) Y
AT INSPECTION
!O-Lo-yZ
.5-7
gpm L2 -
OK
; On adjacent Tots
; On adjacent lots
`. Se -4 a-g-A4.--
HErvwt�-
M�- 1A .J 4l.rr(
/14, -iJsy'iG.tt- to 4.414.
oEPrrl or✓ PJnP rS
d/✓Kn1o1jd
gpm
Ito"'
160'4-
WATER SAMPLE RESULTS:
Coliform 0 G o N/`o'•"l.
Date of sample:
Nitrate
3.zs "t9�. ✓
R. SEPTIC/HOLDING TANK DATA •
Date installed (`) 83 , //1513
Collected by:
Other bacteria
"Jo/JE
S & S ENGINEERING
17034 Eagle River Loop Road No. 204
Eagle River, Alaska 99577
Tank size l o'o Compartments Z
Cleanouts®/N) '/ Foundation cleanou
High water alarm (YS) ^1 `
N) y Depression (Y®) 1
Alarm tested (Y/N)
Pumper SAi47:4,ey PJ
Date of pumping . /- 21. —9 2 -
SEPARATION
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot X60 r 44- On adjacent lots (06 / ÷ Foundation ..5 -
To
To property line /° r Absorption field !o r f
Surface water/drainage /o a /4-
72-026 (Rev. 7/91) Front
• Water main/service line
CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed Manufacturer
Size in gallons Manhole/Access (Y/N)
Vent (Y/N) "Pump on" level at 'ump off' Ievel at
High water alarm level,Cycles tested
Meets MOA electrical codes Y '
SEPARATIO % TANCE FROM LIFT STATION TO:
on lot On adjacent"lots Surface water
D. ABSORPTION FIELD DATA
Date installed /4193 0,43Soil rating 8S PV5� System type 17
,. Length. 22-1 ` Width 30
Total absorption area
204'
Gravel thickness
Depression over field (Y
•
Total depth
63/—•
/z�--
Cleanouts present Y'N)
Date of adequacy test
Results � fail) PASS --- for 7r./ (3) —
Peroxide treatment (past 12 months) (Y6)
^lode. l,J0„ J If yes, give date
AlA
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot /0o a– On adjacent lots /0O `i Property line pc ,,,,,-
To building foundation , it system'�Z
/ o To existingor abandoned on lot �''
On adjacent lots 3° �� Cutbank rJ�� Water main/service line
Surface water /' a ft
Driveway, parking/vehicle storage area Lc./*
Curtain drain `J<A
,1.
E. ENGINEER'S CERTIFICATION --(3.1 :;;;,';
\ \:. s'. , ; 1L:' ,::l:rt „'!. ..n
I certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in effect on4p to of this inspection.
4i. -1k. OF ALA,„
`, S & S ENGINEERING
17034 Eag!e River Loop Road No. 204 * 149114
• l4
Signature agl3Rtvo_r,Alaska 9YS!!
vS49L'. , #..�
eC
Engineer's Name iv.1
Date 1x-21 X92 4¢tt \ ROGER J. S AFER Iw
J, % No. 82 . r
HAA Fee $
Date of Payment
Receipt Number
‘0-
%.,‘
o-
t'\LI ( N,5 -Yo
72-026 (Rev. 3/91) Back MOA 21
Waiver Fee' $
Date of Payment
Receipt Number
CHEMICAL & GEOLOGICAL LABORATORY
A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO.
5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301
ANALISIS RESULTS for INVOICE 159902
Chemlab Ref .8 92.5884 Sample 1 3 Matrix: WATER
Client Sample ID : L14 82 TONJESS EST. S/D
PWSID : UA
Collected : OCT 20 92 1 15:20 hr,.
Received : OCT 21 92 1 14:30 his.
Preserved with : AS REQUIRED
Analysis Completed : OCT 22 92
Laboratory Supervisor : PHEN C. EDE
Released By :
Client Name :S & S ENGINEERING
Client Acct :SNSENCP
BPOI :
Regl :
Ordered By :R. SHAPER
Send Report, to:
1)S & S ENGINEERING
2)
POI :NONE RECEIVED
Parameter
Results Unite
Method Allowable Limits
NITRATE -V
Sample ROUTINE SAMPLE COLLECTED BI: RAI.
Remarks:
3.25 ag/l EPA 353.2/300.0 10
1 Tests Performed
ND- None Detected
NA- Not Analyzed
• See Special Instructions Above
" See Sample Remarks Above
LT -Less Than. GT -Greater Than
@ SGS
0A -Unavailable
Member of the SGS Group (Societe Generale de Surveillance)
COMMERCIAL TESTING & ENGIN ERING CO. AK DIV
, r
CHEMICAL & GEOLOGICAL LABORATORY
TELEPHONE (907) 562-2343 5633 B Street
Anchorage. Alaska 99518.
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
❑ PUBLIC WATER SYSTEM I.D.
0 PRIVATE WATER SYSTEM
Name
Malkp Addn.e
Pion No.
S & 5 ENGINEERING
17034 ts.01. River Loop Road No. 204
Eagle River, Alaska 99577
Cky
SAMPLE DATE•
t
Mo.
Day
sur
9
2 -
Year Year
bp Cod.
SAMPLE TYPE:
t Routine
❑ Check Sample (for routine sample
with lab ref. no. ) 0 Treated Water
❑ Special Purpose 0 Untreated Water
SAMPLE Time Collected
No. LOCATION Collected By
2 1 /c -bo -S" -P-59 S1D
3
41
51
A.D.E.C. /D -92
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
atisfactory
❑ Unsatisfactory
O Sample too long In transit; sample should
not be over 30 hours old at examination
to indicate reliable results. Please send
new sample via special delivery mail.
Date Received
Time Received
10/211gz
IL -L3
Analytical Method: Membrane Filter
• No. of colonies/100 mL
Lab Ret. No. Result* Analys
9z.sss-y
_q
BACTERIOLOGICAL WATER ANALYSIS RECORD
Coilform/100 ml
Membrane Filter: Direct Count
Verification: LSB
Fecal Coilform Confirmation
BGB
Final Membrane Filter Results // Collfornt100 ml
my
It
Reported By
TNTC = Too Numerous To Count
OB = Other 1
PART ONE OF TWO
REMAINDER TO FOLLOW
Dale
Time:
/0 . 2-2-9
/63-u
'rale de Surveillance)
a.m.
p.m.
`APPLIC"NT FILLS OUT UPPER HAL"-N'ONLY
Pro'$erty Owner. /-r
L.. Owner,
.e- /es vo wA c
Mallirig Address R 7 /3O y" t7 " 2 rj /'F j /e:/7iPPL+ /i Zip Code q 5 57 7
Phone
(?//, ?Kr/
/� Al /11. t(J.4 ;17=
Buyer .%!-/PF
/14113Address ir ' A rJ / /)F //v r/.- j/ ��l Cr F� � it, r/• /1/t�Code 9 9�
Lending Institution /9 /` - 41, e ( 5 ,. �r°,eIF H d / e. E i,T Ge. /1 /of--,
Address 9 / 7 T!., h !, v Zip Code
Phone
2 (-, _. /syn
Realty Co. 8 Agent ' ' J 1 // i cA j 14, (12e 0 /
1:::/ 14 v Li i o P d/ / A.. Zip Code
Address I;(77
Phone
9 71 -06?
.r
Legal Description / o7- (t(_ /3 /, / '7 �"G. /" J ,» 5 ...5Street Location S'' �-. . % r OA.. 4� i,? /'
Type of Residence
Single Family
Oa Multiple Family No. of Bedrooms
❑ Other
Water Supply
Fkl Individual
❑ Community \ I� i
❑ Public Utility
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).
Sewer Disposal
QIndividual
o Public Utility
❑ Holding Tank
Year Individual Installed' / ??"3
When Connected to Public Utility:
Inspector
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Time
Time
Time
Time
Date
Date
Date
Date
Inspector
Inspector
Inspector
Inspector
Field Notes:
U-,�%►/')�/ L
2 cI_DsPir
hiAv---
•
� c. ASi rc,..4cl,
(G�^ , &a,kk`—
lln. CLA.J` Ow
/
�,n n
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH r.
A
`.NVIRONM:NTAL PROTECTION
DEC 2 11953
RECEIVED
) APPROVED BEDROOMS
APPROVe.
( / 1 .J Jc.j
(nJ1-i\n7
{ 0
!e^�'�CMJ.
CD Lo.KJ 3 c t-
-
( ) DISAPPROVED
( ) CONDITIONAL
DATE I 2 - '2.
..cu, -1,,
BY: r
Sovwa
Soils Rating
Date Sewer Installed
Well To Absorption Area
Well to Tank
Well Log Received
Septic Tank Size
72-023 13/M
DaTe l P--. 1-553
To: /1u,tcipol,1y o.P Auclioreve
porTv,rtir oP Nrol fh cNd pro7-el';ovt
AHcl+ovave., AK 99So1
From; Jo,frAP5 L. Thode, RE.
1546 a9le. River
Fag le River, A K 94s77
SA, ect On site wciPer supply o&d s ewo9e c(%;;posa
I115/0e01/1.
Legal DescripT,orz:
261- l 4- BIA Tooj ess
Pate e - To spec'i"; o n : 12- /9 -"..3 3
The -�'d I)ow; v► i Techs we r. noted ;IA 1-1%-e
sur -Pace ;VI specT,ovl 042 the r.e-PQveHced sire:
1. The cv•ell casing c --POS seal -ed 01Aci wall r
tiglnfi. The w•e,ll casikz e.xi J g4-11 a170 e. The
grovvt d stn. -Race,
E. Ttiere. was In 0 depre551evl ctrouvtd
well casing ai►c) The g routed sloped away
-Prom T! -e. CoSi l
.3. The eoptip
t✓ir•cs w- re ploceci 111
( 2. ,
4, A e,,JaTer
5441, sv„ TI' -ed
27ATe. I2 - I -s3
L.co1 Lal` /'f 6/K 2 Toc ess
,sample wos to/-evt ciI el
r *esti h9
5 Two c.Ieavt oats
are co c:1 014 Tti e.
sep7�G Tornk wll% One. ILA pec( lOri1 p, Pe
) ocaTecd ovt Al) pipes
had cops.
6, T/, r o u v1 cl over 7' h e s e ctd e s ys Dem wet s
graded To provide d railAo4 , away
-Prow, 7-h e sysTem .
Tile Cm Srl"e (,,,aTQr
sysT,eki s
app eared
�/,cE OF A(.q —
........ S,t„�•
AS
• •
- 49th
mes L Thode; ,
*+•.�S,,. •CE 5035 'r
.4,_ p. • •+' •lc\
av,ci sewa0e cpl'sPo.mt
to be, jv< s7afled correct ly
,rderk_
kW`
James 1.. Thoda, 8E,
December 19, 1983
To: Municipality of Anchorage
Department of Health and Environmental Protection
Environmental Engineering Division
:'Pouch 6-650
Anchorage, Alaska 99502-0650
From= James L. Thode, P.E.
JLT Engineering
1546 Eagle River Road
Eagle River, Alaska 99577
Subjects Well to Onsite Disposal System distance
Legal Description: Lot 14 BLK 2 Tonjess
The distance between the well and the Onsite Sewage Disposal
System was measured with the following results:
Well to Septic tank distance is 129 ft.
Well to seepage trench distance 142 ft.
Please contact me if you have any questions.
lames L Thode .•
• 1
CE 5035 . • '�
- <op •••.....•••• �� .''
Z►� PROFESSIONAL' //
6(0-373
p.71 47 $s-
S incerelyA�
James L. Thode, P.E.,
MUNICIPALITY OF ANCHORAGE
CEPT. CF H°i.Lji
ENViRO,N',L'NTAL Pir:3 IION
RECEIVED
