HomeMy WebLinkAboutAUDUBON HILLS TR A2Audobon Hills
Tract A- 2:
#015-231-65
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 40*r
ON-SITE WASTEWATER INSPECTION REPORT
NOS`
Permit Number: OSP191374 PID Number: 015-231-65 '2019
Dwelling: 0 Single Family (SF) ■❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New X Upgrade
Name
Todd &April Erickson
ABSORPTION FIELD
❑ Deep Trench 0 Wide Trench ❑ Bed ❑ Mound
Site Address
12101 Audubon Dr. Anchorage, AK 99503
❑ Other
Phone
Number of Bedrooms
Soil Rating
depth from original grade
444-5577
4
1.2 GPD/SF
JTotal
1.91 /1.86 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
1.41 /1.36 Ft.
Gravel depth beneath pipe
0.5 Ft.
Subdivision Block Lot
Audubon Hills Tract 2A
Fill added above original grade
1.39/1.74 Ft.
Gravel length
2 @ 50 Ft.
Township Range Section
Gravel width
5.0 Ft.
Beds: Number of Lines
Distance between lines
Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
5500 Ft2
2
>6 Ft.
Well
>100 '
> 1 00'
N/A
N/A
>25'
TANK I9 Septic ❑ S.T.E.P. ❑ Holding E:1 Other
Manufacturer
Greer
Capacity
1,250 Gal.
Surface Water
>1
>1 00'
N/A
N/A
Material
Number of compartments
Lot Line
>5'
>10'
N/A
N/A
NA
Plastic
2
Foundation
>10'
>1 0' .
N/A
N/A
LIFT STATION
Manufacturer
Capacity
Gal.
Remarks Tank and trenches are insulated.
Alarm location
Electrical installed by
PIPE MATERIAL House to tank D3034 Tank to D3034
drainfield
Installer
A+ Home Services
Drainfield D3034 cO/MT D3034
Inspector J. Millette / J. Williams
BENCH MARK (Assumed elevation) 100 ft
Inspeection 10/16/19
15` 10/15/19
Location and description
2nd
ction
Nail located on corner fence post near ADU.
aro 41h
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
OF
'° ®�
Conditional Approval: Date
�.�P,°•••""" °°••:9S
49th
......° .°.. .. ...2T..'b.....�
..................................... .n....�.�
��n e MICHAEL E. ANDERSON
�0®�sJ':° No. CE -4381 • `�®
a°•.°°
Septic System
Approved �f1L'"
Date �20�0
11/25/19 .°''�r�
��
Note: this approval does not include well permit requirements.
�Q�q�®®���
(Rev 05/02/18)
// // // // // // // // // // // // // // // // // // // // 895890885 // // // // // 100500
FEET
1"=50'
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
FD - FLOW DIVERTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
LEGEND
PERMIT # OSP191374 PID # 015-231-65
AUDUBON HILLS, TRACT A-2
A B
2CO1 31.4
MH1 36.7
SV1 41.5
A
B
2CO2 43.3
FD 44.3
MT1 50.5
CO1 49.0
30.9
35.4
36.8
37.9
55.0
53.5
11/25/19
1 BDRM A.D.U.
COVERED
STORAGE
GREENHOUSE
SHED
WOOD FENCE
10' UTILITY EASEM
E
N
T GRAVEL ROADTH1
NEW 1,250 GALLON SEPTIC
TANK w/20" MANWAY
2-50' LONG X 5' WIDE X .5
EFFECTIVE DEPTH
ABSORPTION TRENCHES
EXISTING WELL
CO2
MT3
CO4
CO1
CO3
MH
SV
2CO1
PLAN AS-BUILT
MT2 69.8
CO2 70.5
61.3
62.2
MT3 66.2
CO3 63.4
72.4
69.7
MT4 72.0
CO4 73.5
66.7
68.5
26.5
2CO2FD
MT1
MT2
MT4
3 BDR
M
H
O
M
E
GARAGE
PROFILE AS-BUILT
(NO SCALE)
92.0
86.9
92.6
96.2
94.1 FINISH GRADE
50'
DRAINFIELD ROCKMTFCO 2CO1250 GAL
GREER TANK
TH#1NO GROUNDWATER 8/9/19
90.8
91.3 COCO84.71
90.8
91.3
91.8
92.71 ORIGINAL GRADE
PERMIT # OSP191374 PID # 015-231-65
AUDUBON HILLS, TRACT A-2
11/25/19MT91.0 FINISH GRADE
50'
DRAINFIELD ROCKMT
TH#1NO GROUNDWATER 8/9/19
87.4
87.9 COCO81.26
87.4
87.9
89.26 ORIGINAL GRADE MTMHSV2CO2" INSULATION
2" INSULATION
2" INSULATION
WEST TRENCH
EAST TRENCH
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MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 3434997
http:l/www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP191374
Work Type: Septic Upgrade
Tax Code Number: 01523165000
Site Legal Address: AUDUBON HILLS TR A2 G:2739
Site Mailing Address: 12101 AUDUBON DR, Anchorage
Owner: ERICKSON APRIL L & TODD E
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
0 Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy
Effective Date:
Expiration Date:
8/28/2019
8/27/2020
Lot Size in Sq Ft: 65611
Total Bedrooms:. 4
❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
.:lA,;i11.,/' �i itcLt:ZOO
Date: Lqr
Date: 0g /
f�rk�
MUMUF ° UTY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 015-231-65
Property owner(s)
Mailing address _
Site address
Todd and April Erickson Day phone 907-444-5577
12101 Audubon Drive Anchorage, AK 99503
Same
Legal description (Sub'd., Block & Lot) Audubon Hills, Tract A2
Legal description (Township, Range & Section)
Lot Size 65,611 Sq. Ft. Number of Bedrooms Four
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑x
Initial ❑
Single Family (SF) ❑X
(w/wo ADU)
Septic Tank
❑X
Upgrade
pg �
❑
Duplex (D)
Holding Tank
❑
Renewal ❑
Multiple Dwellings ❑
Privy
❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 95q 5
Date of Payment: 912-1 110
Receipt Number: 60 Llo J�)
Permit No. ose I I 0-714
Permit App__- : :'-._'c
Waiver Fees:
Date of Payment:
Receipt Number:
Waiver No.
PO BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
August 22, 2019
MOA Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Audubon Hills, Tract A-2 – 12101 Audubon Drive
Septic System Design and Permit Application
Dear On-Site Services Engineer:
The septic system on the subject lot has failed and must be replaced. We are submitting this design
and permit application for the construction of a new septic system to serve the three-bedroom home
and one-bedroom A.D.U. on the lot. The attached site plan identifies the location of the structures
and the existing well along with the existing and proposed septic locations. No conflicts exist
between the proposed system and any other well or septic system on this or adjacent lots.
The ground surface on the lot slopes to the west. There are no slopes greater than 25% within 50
feet downslope of the proposed site. Topographic contours are shown on the site plan showing the
grade and direction of flow. Storm water drainage will not impact this septic system. The new
trenches will be constructed parallel to the slope as much as possible.
Wells on this and adjacent lots are shown. The new system will be a minimum of 100’ from all
wells and surface water, and more than 5’ away from the septic tank.
Please refer to the attached test hole log and plan and profile sheets for the septic design. If this
design is followed, there will be no adverse impacts to adjacent properties.
Sincerely,
Michael E. Anderson, PE
8-22-19
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191374, Rebecca Carroll, 08/28/19
// // // // // // // // // // // // // // // // // // // //89589088510050 0
FEET
1"=50'
NOTE:
NO SLOPES >25% WITHIN 50' OR SURFACE WATER WITHIN 100' OF THE
PROPOSED SEPTIC SYSTEM
ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS
PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC
SYSTEMS.
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
FD - FLOW DIVERTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
LEGEND
MT
AUDUBON HILLS, TRACT A-2
8/27/19
1 BDRM A.D.U.
2 STORY FRAME
GARAGE
COVERED
STORAGE
GREENHOUSE
WIRE FENCE
SHED
WOOD FENCE
10' UTILITY EASEMENT GRAVEL ROADTH1DECOMMISSION EXISTING
SEPTIC TANK PER MOA CODE.
1,250 GALLON SEPTIC
TANK w/20" MANWAY
2-50' LONG X 5' WIDE X .5
EFFECTIVE DEPTH
ABSORPTION TRENCHES
EXISTING ABSORPTION BED.
EXISTING WELL
CO
MT
CO
CO CO
MHSV
2COFD
FS
3 BDRM HOME
FCO
FCO
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191374, Rebecca Carroll, 08/28/19
AUDUBON HILLS, TRACT A-2
DESIGN FACTORS: SYSTEM REQUIREMENTS:
600 GPD PEAK FLOW
PERK RATE: 1-5 MIN/IN
APPLICATION RATE: 1.2 GPD/SF
5' WIDE TRENCH SYSTEM
1,250-GAL SEPTIC TANK
TYPICAL TRENCH SECTION
(NO SCALE)
5'
NOTES:
1. GRADE AREA OVER TRENCH TO DRAIN AWAY
2. PROVIDE 3' OF COVER OVER TRENCHES AND 4' OVER SEPTIC TANK, OR 2'
WITH 2" OF INSULATION
3. CHECK GROUNDWATER AT TIME OF CONSTRUCTION. IF LEVEL IS HIGHER
THAN PREVIOUSLY OBSERVED, CALL ENGINEER IMMEDIATELY
BOTTOM OF TRENCH: 2.0' BELOW GRADE
FLOW LINE ELEVATION: 1.5' BELOW GRADE
TOP OF TRENCH: 2' ABOVE GRADE
600 GPD / 1.2 GPD/SF /5' WIDE / 1.0 RED. FACTOR = 100 LF TRENCH REQUIRED (100 LF SPECIFIED)
8/22/19
4" PERFORATED PVC (HOLES DOWN)
6"
6"
1.0'
2'
DRAINFIELD ROCK
GEOTEXTILE FABRIC
3
1
4" TOPSOIL & REVEGETATE
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191374, Rebecca Carroll, 08/28/19
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE:
PARCEL ID#:
SOILS LOG AND PERCOLATION TEST
TECHNICIAN:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
DEPTH
(feet)
PROJECT No.:
TEST HOLE 1
SLOPE
SLOPE
SITE PLAN
DATE READING GROSS TIME
(minutes)
NET TIME
(minutes)
DEPTH to
WATER NET DROP
TEST HOLE PRESOAKED PRIOR TO TESTING:
PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH)
TEST RUN BETWEEN: FT. and FT.
COMMENTS:
(inches)(inches)
Tract A-2, Audubon Hills
7/3/19
J. Millette
DATE OF MONITORING:
WAS GROUND WATER ENCOUNTERED?
DEPTH OF WATER AFTER MONITORING:
IF YES @ WHAT DEPTH?-
2.6 6
4 5
015-231-65
April Erickson
10:19/10:29
7/31
1
2
3
4
5
6
4/9 7
16
10:30/10:40
10:41/10:51
10:51/11:01
11:01/11:11
11:12/11:22
OG
Professional Engineers Stamp:
8/22/19
10
No
None
8/9/19
5 7
16
4/812
1610 412
16
4/715
1610 315
16
4/8 1
1610 4 1
16
4/8 3
1610 4 3
16
4/714
1610 314
16
4/713
1610 313
167 11:23/11:33
See Site Plan
ML
DENSE/IMPERMEABLE
GM/GW
GRAVEL w/SILT & SAND
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191374, Rebecca Carroll, 08/28/19
LEGAL DESCRIPTION:
PERFORMED FOR:
DATE:
PARCEL ID#:
SOILS LOG AND PERCOLATION TEST
TECHNICIAN:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
DEPTH
(feet)
PROJECT No.:
TEST HOLE 2
SLOPE
SLOPE
SITE PLAN
DATE READING GROSS TIME
(minutes)
NET TIME
(minutes)
DEPTH to
WATER NET DROP
TEST HOLE PRESOAKED PRIOR TO TESTING:
PERC. HOLE DIA. (INCHES)PERCOLATION RATE: (MIN/INCH)
TEST RUN BETWEEN: FT. and FT.
COMMENTS:
(inches)(inches)
Tract A-2, Audubon Hills
7/31/19
L. Tidwell
DATE OF MONITORING:
WAS GROUND WATER ENCOUNTERED?
DEPTH OF WATER AFTER MONITORING:
IF YES @ WHAT DEPTH?-
1.95 6
4 5
015-231-65
April Erickson
10:12/10:22
7/31
1
2
3
4
5
6
12/164
16
10:24/10:34
10:34/10:44
10:45/10:55
10:55/11:05
11:05/11:15
OG
Professional Engineers Stamp:
8/27/19
10
No
4 4
16
12/161
1610 4 1
16
12/173
1610 5 3
16
10
12/172
1610 5 2
16
10
See Site Plan
GM/GW
GRAVEL w/SILT & SAND
12/173
16
12/172
16 5 2
16
5 3
16
PERCOLATION TEST ONLY.
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP191374, Rebecca Carroll, 08/28/19
De. 28 :, 11:0,a Anchoi-age 'A'e 18, S -or D072430742 P
DeVOOPMelit Services bepartrnent
BuMing 5cfety bivision
4700 Et -,10-e Road
Box 19
Or -Site Water 4 WCStewater Program
twank soqic,; A ho nj
ge, A K 019507
Ma Vc, f
7) 34---7904
Pump Installation Log
WC-11rilf = Ia n -'Number: Date of Issue:
Parcel 1dendfkation Nt,11.1bel,: 2 3 11 - (- 5
Aftertion: Te P11,117 0
tht DSD wi-,hin _O (if pur"J"
DEPT. OF ENVIRONMENTAL CONSERVATION
TONY KNOWLES, GOVERNOR
ANCHORAGE/WESTERN PUBLIC SERVICE AREA OFFICE
555 CORDOVA STREET
ANCHORAGE, ALASKA 99501
September 18, 1995
Mr. Jim Duggan
200 West 34th, #435
Anchorage, Alaska 99503
SUBJECT:
(907) 269-7519
RECEIVED
SEP 2 1 1995
IViUn~clpai~y o] ~nchorage
Dept, Health & Human Services
Lot A-2 Audubon/Subdivision, Anchorage, Alaska, Class C Public Water
System and Wastewater Disposal System, ADEC Project Number 9621-VVW-
256-123, Review
Dear Mr. Duggan:
I have reviewed your September 13, 1995, submittal regarding the upgrade of your four
bedroom single family home into a three bedroom Bed and Breakfast. Based on this
review, I have the following comments:
From the submitted information and my review of this office's files, it appears that the
existing water system was approved as a Class C Public Water System by this Department
on September 13, 1984. Based on this information and the fact that the demand on the
existing water system will not be increased, it appears that the water system will be able
to meet the demand without modifications. Therefore, the existing Class C Public Water
System serving the three bedroom Bed and Breakfast and the one bedroom single family
home located on the above-referenced property is approved for the concerns of this
Department. The final Operation Certificate issued by the Department on September 13,
1984 is still valid.
The existing four and two tenths (4.20) milligrams per liter (mg/I) of nitrate (as nitrogen) is
above ambient levels for nitrate (.4 to .9 mg/I) normally found in groundwater in the State
of Alaska. Although the nitrate level is above ambient conditions, it is below the maximum
concentration level for nitrate (10 mg/I) set in the State Drinking Water Regulations, but the
existing level does show degradation of the water quality of the aquifer that you are
withdrawing water from for drinking. Due to the possibility of continued degradation of the
aquifer's water quality and to ensure the public health will be protected, annual analytical
results for nitrate (as nitrogen) and total coliform bacteria will need to be submitted to this
Department. I recommend that the water samples be collected during February - March
of each year. If nitrate levels remain over eight (8) mg/I for more than two consecutive
Mr. Jim Duggan
September 18, 1995
Page 2
samples, either engineering plans for the installation of a nitrate removal system or
notification of some other solution will need to be submitted to this office.
Due to the monitoring requirements of the operation approval, please ensure that the
Public Water System Identification (PWSID) Number 218472 is placed on all analytical
results submitted to this Department.
The existing wastewater disposal system was tested on July 14, 1995, to determine if it will
accept the waste flow from the one bedroom single family home and three bedroom Bed
& Breakfast. On the day of the test, the existing wastewater disposal system was able to
accept the minimum amount of water. Thus, the wastewater disposal system is
acceptable. Thus, in accordance with the provisions of 18 AAC 72, Wastewater Disposal
Regulations and the Department's guidelines, the wastewater disposal system serving the
facility on Lot A-2 Audubon Subdivision is approved for operation. The enclosed
"Approval of On-Site Residential Water and Sewer Systems" ..certificate constituting the
final operation approval for the existing wastewater disposal s~/stem.
These approvals do not imply the granting of additional authorizations, nor obligate any
state, federal, or local regulatory body to grant required authorizations.
Thank you for your coordination with this Department. If you have any questions, please
do not hesitate to contact me.
Sincerely,
Keven K Kleweno, ~.1::.
Environmental £ngineer
KKK/pt
Enclosure: As Stated
CC:
Lynn Johnston, ADEC/SCRO/EH/DW, w/o Enc.
Jim Cross,P.E., MOAJDHHS, w/o Enc.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PRO ~ £CTION
ENVIRONMENTAL ENGINEERING DIVISION
' 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
"~*-~'I~"~NE I [] NEW
~l~ -- ~
~'AI LING ADDRESS ~ ~ ~
LEGAL DESCRIPTION
~ NO. OF BEDROOMS
~OCATION
Well ~ Absorption area Dwelling PERMIT NO.
DISTANCE TO: ~ t ~' ~ '
~ ~ Material . No. of c~mpartments
~ Manufacturer ~.~O~ ~" ~
Inside length Width Liquid depth
Liq. capacity in gallons
t ~O IF HOME.DE: . PERMITNO.
Well Dwelling
~ ~ DISTANCE TO:
~ o z Material Liquid capacity in gallons
O ~ ~ Manufacturer
Foundation Nearest ~ot line PERMIT NO.
Well
Q DISTANCE TO: I~ 3 ~' ~
~ ~ Trench width Dista
~ ~ Z No. of lines Length of each line Total length of lines n~e~etween lines
-- ~ ~* Total effective absorption area
Top of tile to finish grade , Material beneath tile
PERMIT NO.
Length Width Depth
~ Total effective absorption area
< ~ Type of crib Crib ~iameter Crib de~th
m Well Building foundation Nearest lot line
~ DISTANCE TO:
C~ass Depth Driller Distance to lot line PERMIT NO.
~ Absorption area(s)
~ Building foundation Sewer line Septic tank
~ DISTANCE TO:
:- OTHER ~~
PiPE ~ATERIALS
G~ t~ 8~~ o~0 ~/N~
SOIL TEST RATING
~E~.~s ~
~ ........ .~.~?,a
~&~..' A ...~.-~ _ t ~ ~ ~. ~- ..
, ................. , ........ -
APPROVED ------ DATE LEGAL /
72-013 (Rev. 3/78) '
FLATTOP TECHNICAL SERVICES
CIVIL & ENVIRONMENTAL ENGINEERING · ALTERNATIVE ENERGY DESIGN · TRANSPORTATION PLANNING
THEODORE F. MOORE, P.E.
PH: (907) 345-1355
September 5,, t9~4
STAR ROUTE, BOX 7380N
ANCHORAGE, ALASKA 99516
Alaska Department of Environmental Conservation
437 E Street
Anchorage, Alaska 99501
Attn. Jim Hayden
l/ear ?Ir. Hayden:
The enclosed information and plans re,:~ardinq the required
upgrade of the waste disposal system serving Tract A-2 of :\udubon
Hills Sub. in Anchorage, owned by James Du§gan, ~s submitted for
your approval. I understand that your office made a deter~nin-
ation that the house should be classified as a duplex, and that
the existing crib/cesspool serving it's lower floor, but actually
located on Lot 1 was the source of the effluent leaching out of
the recently cut bank.
To ascertain the appropriate corrective action, two test
holes were dug on August 29 in the locations shown on the
enclosed !q.O.A. soils log report form. and logs fron previous
test holes on Lot 1 and Tract A-1 were examined. The soils in
that vicinity shows great variation within very short distances.
In test t~ole #2, the oortion of the G!.! layer where I con.~ucted a
perc test proved to be unsatisfactory, however beneath it is a
layer of clean sandy gravel (GW). Since the water table is at
approximately lj ~eet, I propose that a bed type absorotion field
be ~nstalled in this layer at a depth of 9 feet in accordance
with standard M.O.A. specifications (copy attached).
Ti~e bed will consist of a 6 inch thick ]aver of screened
gravel (1/2"to 2. 1/2") under the absorption o~pe and extended to
2" above the p~pe. Using the corresponding so~l rating of 85
sq. ft./bedrooln for GV and 4 bedrooms, the necessary absorption
area of 340 sq. ft. can be accomplished with 57 lineal feet of
bed which is 6 feet wide. Due to space constraints, the best
configuration appears to be a bed 1~ feet wide by 19 feet ]on.g
with three 19 foot runs of perforated pipe spaced 6 feet apart.
During construction some modification of this configuration may
become necessary to conform to localized soil conditions. . __
' ' t-- ~' -'~ ~ ~
~,11 ~c~ ~ ~Y ,~ ~ .....
We wish to request a waiver o~ vne z3u ~o~t separation
requirement between the well and the wastewater treatment works.
A gas line along the property line separating Tracts A-1 and A-2
is 15 feet north of the test hole. Slopes and probable clay soil
preclude a linear system parallel to the %as line. !t is
possible that the entire absorption field can be accomodated
outside the 150 foot radius, but the septic tank will almost
surely have to be closer. There is not room for any replacement
system outside the radius. We request a waiver of the seoaration
criteria down to 120 f~et, and will endeavor to do slightly
better than that. ~~-~ ~k/ /~~ ~ ~~-~ =~ ~,
Justification of the waiver can be found for tile follo:¢inq
reasons. (1) The house is classified as a duplex only on a
technicality, and it would in fact be unlikely to house more
people than a single family dwelling. (2) The proposed svste,..,n
will in fact serve only the lower floor of the house, although it
is possible that the upper level could be hoo!<ed up to it in the
event of problems with the other disposal field. (3) There
other site available, and (4) The relatively impervious clay o-~
silt soils prevalent on much of the property should serve as a
barrier preventing contamination of tile well.
Please contact me if you have any additional questions
regarding tile proposed construction plan or the waiver request.
We await your response before proceeding with construction.
Sincerely,
Theodore F. )'Ioore
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
8;25 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERCOLATION
TEST
PERFORMED FOR: James
LEGAL DESCRIPTION: "T'RACT
?ER C
fi-VI st f rr
WAS GROUND WATER
ENCOUNTERED?
17
18
SLOPE
19
20
CE. 3589 ..'
COMMENTS
DATE PERFORMED:
SITE PLAN
IF YES, AT WHAT
DEPTH? t¢ /¢"r
S
L
O
P
E
Gross Net Depth to Net
Reading Date Time Time Water Drop
~o ~ : ~ Z ~.o '
5,
fi' g~OMtf E ED
PERFORMED BY:
R ~cc.,w
72-008 (6/79)
RATE ~0''~:~ (minutes/inch)~
RUN BETWEEN Y'~' FT AND ,~,0 FT
v' O~t~ "~ c~At~ I' 3'7'o 13t''
CERTIFIED BY:
PRoP
· 'ERFORMED FOR:
LEGAL DESCRIPTION:.__
1
2
4
5
7
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SLOPE
__ OATE PERFORMED:_.
)1oc 2L
PLAN
PER C~' LATIOFJ
TEST
10
11
12
13
14
15-
16
17
· 18 -
19
2O
COMMENTS
PERFORMED BY:
72-008 {6179)
WAS GROUNDWA~
DEPTH}'
i--tole.--- ~;' X' D" '
Reading Date Gros~ Net I Depth To Net
Time Time! Water Drop
J2.~Z.S' ~0 2.?9
~.~7
,t~ ~ Z:5-S- lO Z ,q~
*Hzo ,:ob- -~ ,3~
PERCOLATION HATE .............
TEST HUN II[IWEFN '~- i' T AND '~ FT
//
CERTIFIE[)
SOUTMCENTRAL RF~'I'ONAL OFFICE
437 'E' STREET, SUITE 200
ANCHORAGE, ALASKA 9950t
September 14, 1984
274-2533
Flattop Technical Services
Star Route, Box 7380N
Anchorage, Alaska 99516
SUBJECT:
Class 'C" Well to Septic Ta,~k and Leach Field Horizontal
Separation Waiver Tract A-2, Audubon Hills S/D
8 521-WA-032
Dear Sirs:
The Department has evaluated the subject waiver request and hereby
waives the horizontal separation between the well and septic tank to
120 feet and well to soil sb~orption syste~ to 130 feet. This waiver
is valid provided that the proposed absorption arp. a be increased by a
factor of 1.5, that a Fernco c~upling or e~utvalent be installed on
the pipe connections to the septic tank, that ABS schedule 40 or ductile
iron pipe be used from footing to septic tank and that satisfactory
water samples are taken for a period of six months as required on the
enclosed Certificate to Operate.
Sincerely,
District Engineer
BEE/dd
STATE OF ALASKA
DEPARTMENT OF ENVIRONMENTAL CONSERVATION
CONSTRUCTION AND OPERATION CERTIFICATE
for
PUBLIC WATER SYSTEMS
APPROVAL TO CONSTRUCT
Plans for the construction or modification of d/~/~'~'
in
pul~lic water system located
Alaska, submitted in accordance with 18 AAC 80.100
by
have been reviewed and are
[] approved. ~,..~. ~..~-,,<~.~.+... . .
!,~ conditionally approved (see attached conditions). /"l o ~ ~ ~ [ W [~ c ~ - ·, ~ ~ ~
BY TITLE ~ DATE
If construction has not started within two years of the approval date, this certificate is void and new plans and ~_ '~' '
specifications must be submitted for review and approval before construction.
B, APPROVED CHANGE ORDERS
Change (contract order no. or descriptive reference)
C. APPROVAL TO OPERATE
Approved by Date
The "APPROVAL TO OPERATE" section must be completed and signed by the Department before any water
is made available to the public.
The construction of the ~{--/3rS~' ~ ' ~ ~-/- L ~ j~ ~ C.'~- ~ - "7____ public
water system was completed on / ? ~ ~[ (I w I ~ ~7 ~ (date). The system is hereby
granted interim approval to operate for 90 da~,s following the completion date.
BY TITLE DATE
As-built plans submitted during the interim approval period, or an inspection by the Department, has confirmed
the system was constructed according to the approved plans. The system is hereby granted final approval to
~' TITLE DATE
184~07 (Rev. 11183)
DISTRIBUTION: 1. WHITE - ENGINEER (Complete Section C) 2. YELLOW - WATER SYSTEM FILE (Complete Section C)
3. PINK - ENGINEER/MUNI-BOROUGH (Complete Section C)
4. GOLDENROD - MUNI-BOROUGH (Compl®te Section A)
Certificate of On -Site Systems Approval
Parcel I.D. 015-231-65
1. GENERAL INFORMATION
Expiration Date: #",� G 1 , 20-9-
Complete
0.2
Complete legal description Audubon Hills, Tr A2
Location (site address) 12101 Audubon Drive
Currentro ert s Brian Miller (907)299-6555
p p y owner() Day phone
Mailing address 12101 Audubon Drive, Anchorage, AK 99516
Real estate agent Day 11 phone
2. TYPE OF DWELLING:
g Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Private Well n Private Septic no
Water Storage ❑ Holding Tank ❑
Community Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
Waiver request for:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 550 Waiver Fee $
Date of Payment 1 i 1 aoa 1 Date of Payment
Receipt Number Receipt Number
COSA # 0 S L a 1 3 Waiver #
Distance:
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. I acknowledge that On -Site staff may visit the site to verify the information submitted.
Name of Firm Forge Engineering Phone (907) 522-7773
Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503
Engineer's Printed Name Benjamin Schiller, P.E. (M.J.) Date 11 /10/2 1
OF
' ' •'�'A(„� til
oo.•.`P• • •F
49 TH
6. DSD SIGNATURE ..-. .-,.
System #1 Approved for 4
Y pp bedrooms '-'''"', •'•
System #2 Approved Benjarri,�Schiller
S• ��
Y for bedrooms �¢ �sl • CE 12592 AFA
Disapproved ���F�Fo''• •'' �`v*�
pROFESSIONP -®
Conditional approval for bedrooms, with the following stipulations:
By:6zdv Original Certificate Date: / 2O11.2- 0
;z J
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 x
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist blue sheet
It fill((((((((( 111
ON-SITE iq'--
VVATER AND
G–Tr.< .,iER ��
J�
PROGKAM
0,0*
By:6zdv Original Certificate Date: / 2O11.2- 0
;z J
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 x
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist blue sheet
COSA Checklist yellow sheet
COSA Checklist
Legal Description: Parcel ID:
If more than 1 septic system on lot: COSA Checklist # of Structure served by this system
A. WELL DATA
Well log is filed with Onsite (or attached)
Date drilled
Total depth ft
Cased to ft
Sanitary seal is functioning correctly
Wires are properly protected
Casing height (above ground) in.
Date of flow test for COSA
Static water level at beginning of test ft.
Well production at time of test gpm
Water storage tank volume gallons
Well disinfected for coliform test?Yes No
Coliform bacteria is Negative
Nitrate mg/L Nitrate less than MRL (ND)
Arsenic ug/L Arsenic less than MRL (ND)
Collected by
Date of Sample
Comments __________________________________________________________________________________
B. TANK DATA
Age of tank(s) years
Tank type/material
Measured operating fluid level in septic tank
Standpipes/foundation cleanout per record drawing
Date of pumping
C. LIFT STATION
Required maintenance completed
Age of lift station years
Lift station material
Comments:
D. ABSORPTION FIELD DATA ______________________
Which system tested (date installed)
ALL standpipes present per record drawing
Total measured depth from grade ft (max)
Measured depth to pipe invert from grade ft (min)
N/A – pressurized field
Monitor tubes go to bottom of effective. If not, state
depth into effective
Code-required soil cover over field
System presoaked
(Required if vacant for greater than 30 days prior to
date of test)
Gallons introduced gallons
Adequacy test date
Results Pass For bedrooms
Fluid depth prior to test in
Water added gal
New depth in
Elapsed time min
Final fluid depth in
Absorption rate gpd
Any rejuvenation treatment (past 12 months)
If yes, enter date
Comments/Deficiencies:
**Note engineer comments below
Audubon Hills Sub, Tr A2 015-231-65
1.6
UNKNOWN
*50'4"■
*40+■
7.03■
■■
18+ Forge Engineering
11/9/21
25
11/2/21
*(No well log) Depths taken from previous 2014 COSA. Well Camera'd 11/30/21 and verified no perforations above 40'.
2
Septic/Plastic
n/a
■
9/10/21 Drain Masters
Wide Trench
10/16/2019 n/a
■
3.3/3.6
2.8/3.1*
■
■
*2" of insulation present above trench.
COSA Checklist yellow sheet
E. SEPARATION DISTANCES
From Private Well on Lot to:(Please enter distances if less than required or if community well)
Septic Tank/Lift Station on Lot > 100’
Yes if No ft
Neighboring Tank > 100’Yes if No ft
Absorption Field on Lot > 100’Yes if No ft
Neighboring Absorption Fields > 100’
Yes if No ft
Community Sewer Main > 75’Yes if No ft
Community Sewer Manhole/Cleanout > 100’
Yes if No ft
Private Sewer/Septic Line > 25’Yes if No ft
Holding Tank > 100’Yes if No ft
Animal Containment > 50’Yes if No ft
Manure/Animal Excreta Storage > 100’
Yes if No ft
From Septic/Holding Tank on Lot to:(Please enter distances if less than required)
Building Foundations > 10’Yes if No ft
Property Line > 5’Yes if No ft
Absorption Field > 5’Yes if No ft
Water Main > 10’Yes if No ft
Water Service Line > 10’Yes if No ft
Surface Water > 100’Yes if No ft
Wells on Adjacent Lots:
Private Wells > 100’Yes if No ft
Community Wells > 200’Yes if No ft
If septic tank is under driveway comment below
From Absorption Field on Lot to:(Please enter distances if less than required)
Building Foundation > 10’Yes if No ft
Property Line > 10’Yes if No ft
Water Main > 10’Yes if No ft
Water Service Line > 10’Yes if No ft
Surface Water > 100’Yes if No ft
If absorption field is under driveway comment below
Wells on Adjacent Lots:
Private Wells > 100’Yes if No ft
Community Wells > 200’Yes if No ft
F. ENGINEER’S COMMENTS
G. ENGINEER’S CERTIFICATION
I certify that I have determined through field inspections and review
of Municipal records that the above systems are in conformance with
MOA COSA guidelines in effect on this date.
11/10/21
✔✔
✔
✔
✔
Unknown*
✔
✔
✔✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
** System installed 10/16/2019. Both trenches completely dry on 11/9/21
* Well and section of sewer line installed prior to 1983 when 25' separation
code established.
✔
MUNICIPALITY OF ANCHORAGE
DEVELOPMENT SERVICES DEPARTMENT 907‐343‐7904
On‐Site Water and Wastewater Section Fax: 343‐7997
www.muni.org/onsite
Mailing Address: P. O. Box 196650 * Anchorage, Alaska 99519‐6650 * www.muni.org
Nitrate Advisory
Certificate of On‐Site Systems Approval # OSC211663
Subdivision: Audubon Hills, Tract: A2
A water sample revealed a nitrate concentration of 7.03 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 medi a 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.
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
_O
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
Parcel I.D. ORS"- ~ 31 -
1.' 'GENERAL iNFORMATION · Complete legal des~,fiption T'~ ~ c.;- /} -~,3_
· Location (site address or directions) ) ~ I o I
Current Property oWner(s)
FOR A SINGLE FAMILY. DWELLING
Expiration Date: /.,~. - ,.5'-' O ~
Lending agency g,~-~- ~q~4.,z, c.,~,,,' 'r't ~' ~ ~ Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: ~
3. T~PE OF WATER SUPPLY: '
Individual Well
Individual Water Storage
Community Class Well
Public Water System
TYPE OF WASTEWATER DISPOSAL:
Individual On-site []
Individual Holding tank []
Community On-site []
Public Sewer []
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA} based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
suoply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid fcr 90 days from the date of issue for prcperties served by a private or Class C we!l and may be reissued with
new water sample results. (Certificates may be reissued for a pedod 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
Munic!pality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-
site water suJjj~ and/or wastewater disposal system is(are) safe, func*Jonal and adequate for the number of
bedrooms ai~J~e of structure indicated herein. I further verify that based on the information obtained from the
Municil~J"~'"'~'~chorage flies and from my investigation and inspection, the on-site water supply and/or
was!e~/~fisposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,
.~t~fations in effect at the time of installation. ·
":~la~e afFirm $&SENGINEERING Phone I~ c~y_ ,~/7~
i,'u.~4 Eagle K~ver L~p Road No. 204
Address £aqie River, Alaska 99577
Engineer's Printed Name /~ D ~1 ~.,,%7- ~'. C',D ~,~ ~
DSD SIGNATURE
I/ Approved for /.../L.
Disapproved.
Conditional approval for
Date c~ / 3 /o ~--
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date:
: :.
MuniCipo!!ty of Anchorage
Development Services Department
Building ~afety Division
On-Site Water & Wast~vater Program.
4700 8outl~ Bragaw SL
P.O. Box 196850 Anchorage. AK g951g-6650
www. cLanchomge.ak.u$
(907) 3437604
HEALTH AUTHORITY APPROVAL CHECKLIST
A. W EU. DATA
Wen type ~,v4r¢
Date completed
Total dep~ ~'"0
IfA, B, or C provide PWSID #
Wail Log (Y4~) ~, o
Wires propa~ prOtec~) ¥~ /
Casing height (above ground) · ~ q ~- in.
FROM WELL LOG ' AT INSPECTION
Static water level .~ o ft. ~ O ft.
Wail production ~' '+ g.p.m, ill- ~ g.p.m.
WATER ,~o~tPLE RESULTS:
colonies/100 mL . Nitrate mgJI. Ottter becteda colonies/100 nj. '
AmenW-- - . ,,e.n.
B. SEPTIC,qtOI nlNG TANK DATA
Tank ,Ize )~ ~- 0 g~l+ '.,:; .. Number of Compartments
Fo~tdaUon dieanout(~,)N)9j' e'~"~Depresmon'~'"~t* r,,,~over tank (Y~)
Date of pumping ~'/~"/o'3. Pumper ! SeA
C. ArtSORPTION FIELD DATA ~'
Date'installed )~/~.,/~¥' Soilrating (g.p.dJft~or~/bdrm) ~'5'- Systemtype
Lengl~ ~..~//a- ft. Width ~ 9 ft. Gravel below pipe
Totaldepth ~/ ft. Eff. abeorptJonarea 5'0/ ft2 Monltodngtube ~',e~ Depmssionoverfieid
Date of edequacy test ~131/e~" ResultsTi~Fail),P.4$$ For ~ bedrooms
Fluid depth in absorption field before testo~ '~ in. Water added ~o ~T gal. New depth '7 in.
ElapaedTime:l~'0 min. Final fluid depth ~' in. AbsorpUonmte >= ~oOO g.p.d.
Any mjuvenatlon tmatment (past12 mo.) (Y/N & type) /~,~e. ~c~o-,,-' Ifyes, givedate
D. UFT STATION
Date installed Size in gallons
'Pump on" level at in. 'Pump off' level at
Datum Cycles tested
E. SEPARATION DISTANCES
Manhole/Access (Y/N)
f-Ilgh water alarm level at
Meets alam~ & ~ax:ult requirements?
irt.
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot I 3 ¥
Absorption field on lot ~ 3 ~'
Public sewer main A///~
On adjacent lots ! ~0 "/'
On adjacent lots /~0 /'+-
Public sewer manhole/cteanout
Holding tank r~//,4
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: '
Building foundation ~ ~ Property line ~' ~f-
Water main A//,4 Water sewice line
Wells on adjacent lots / oo .4-
SEPARATION DISTANCE FROM.aBSORPTION FIELD ON LOTTO:
Property line J 0 ~
Water Service line /0 ~
F. COMMENTS
Building foun.~tion
Surface water
Wells on adjacent lots /00 ~/-
surface water ' ,/o o
Water main '
O~,eway, paWJ.g/ve~de ~rage'
Waiver Fee $
Date of Payment
Receipt Number
Date of Payment
Receipt Number
(Rev. ~2~0~)
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name AD(}~/-~,7 ~'' ~'0 ~-'~,'
jVlunicipality
of
Artchora e
P.O. BOX 196650
ANCHORAGE, ALASKA 99519-6650
(907) 264~1~kx 4 7 4 4
TONY KNOWLES,
MA YOFt
DEPARTMENT OF HEALTH & HUMAN SERVICES
January 8, 1987
Mr. Jim Duggan
3701 Eureka
Anchorage, Alaska
99503
Subject:
Tract A-2 Block 2 -Audubon Hills Subdivision
Health Authority Approval
Pursuant to our telephone conversation this date, this will
furnish official notice of the revocation of the Health
Authority Approval Certificate on your residence located on
Tract A-2 Block 2 Audubon Hills Subdivision. Unbeknown to
the undersigned, Ms. Susan Oswalt advised you (just prior to
her leaving on vacation) that she would issue a letter to your
financing entity that the old crib system had been disconnected
and abandoned as soon as she received a statement to that effect
from a registered engineer. She received a copy of a letter
from Quadra Engineering, Inc. addressed to you dated December
16, 1986, advising that their inspection revealed that a sewer
line had been disconnected (plugged off) on a line which entered
an old crib located near an apparent easement between Lot 1
and Tract A-2. Further discussions between ~Ms. Oswalt and Quadra
revealed that there is no indication or proof that the old crib
was properly abandoned. There are apparently still some unanswered
questions as to the disposition of the wastewater from the upstairs
portion of the house. Last and certainly not least, the original
approval to the Health Authority Approval Certificate was a
conditional approval made for three (3) bedrooms contingent upon
the following conditions: "the old cesspool on Lot 1 must be
properly abandoned and inspected prior to July 1, 1985. Proof
of disconnection of line is required." It has actually been
ninetneen (19) months since Quadra Engineering provided the
inspections, tests, file search data and information in support
of the Health Authority Certificate.
Mr. Duggan
January 8, 1987
Page Two
In view of all of the above, effective this date, this department
is revoking the subject Health Authority Approval Certification
and suggests that you contact Ms. Oswalt if you desire to pursue
this any further.
S~rel~ y. ~,
Program Manager
On-site Services
CC:
Michael Anderson
Quadra Engineering
401 East Fireweed Lane
Anchorage, Alaska 99503
PS Form 3800, Feb. 1982 . U.S.G.P.O. 1984-446-014
. r- ii o~ ~' _~ ~- ~ ~
· o ~ m
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date 5-- £ 8- 8 5
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
Tract A-2 A~u~on Hills Subdivision Se0.23, TWP 12N R3W
Location (address or directions)
L2L'~L Audubon
(b) Applicant Name Jim Duggan __ Telephone: Home 562-7141 Business
Applicant Address 370]_ Eu[aka AB_borage, Alaska 99503
(c) Applicant is (check one): Lending Institution []; Owner/builder k-----I; Buyer I-1; Other [] (explain);
(d) Lending Institution Telephone
Address
(e)
(f)
Real Estate Company and Agent
Address
Telephone
Mail the HAA to the folio,wing address:
TYPE OF RESIDENCE
Single-Family ~ Multi-Family []
Number of Bedrooms 3
Other _Single Family According to owner
WATER SUPPLY
Individual Well [] Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
Onsite [] Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
Page 1 of 2
72-025 [ 11,84)
ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this ins~p~ection. .--..
Name of Firm O/Lltq¢~¢¢- ~. ik~;,i~'-~"'t~1~D Telephone Z. '7/,~," .¢'7 ?f9
Address ~/'0/ '-~, ~IIIL~(.~I ~'I~'"""~ ~,../~(;.,"' /~l~l~¢t~O~L~, ~,~'! t~I~ ,
Engineer's Seal
L~HEP APPROVAL ,
A~areve~for //-~z~-~(,~._/ bedrooms by '
Approved Disapproved Conditional
Terms of Conditional Approval Lr~._~ ~z£%r,f¢c:¢-Z_ 0~/ /. o %'
Date
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independent professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not conduct inspections or
analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-02,~ ( 11184~
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984 q~Jl 264-4720
Legal Description: Trac~Lg~I~d~w~Dj~
Subdivision Sec 23
WELL DATA
Private
If A, B, C, D.E.C. Approved (Y/N)
Date Completed 7/78 (AC&or~inq. _ to
/ ADEC)
33 ' + Deptt'f of Grouting
Private
Yield
Un ]cm o ~'~
Pump Set At Unl~nown
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
Well Classification
Well Log Present (Y/N) No
Total Depth $0' 4" Cased to
Static Water Level 30' 2"
Casing Height Above Ground 18"
Electrical Wiring in Conduit (Y/N) Y
Separation Distances from Well:
To Septic/Holding Tank on Lot 130'
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line Not in Area
Cleanout/Manhole
Water Sample Collected by Mc F,~r/rTcm
Water Sample Test Results s~,~.~,~rp
140'
; On Adjoining Lots 200~
; On Adjoining Lots 175'
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
; Date 5/16/85
N/A __
Comments Probed to find total depth. Pumped at 8 qpm for 30 min- draw down was 3'5".
There is no reason to believe the casing is less than 40 feet-However it was hard,
to determine the casing below the water level.
Date Installed Prior to Size UnknoWn No. of Compartments Unknow~ ~
Standpipes (Y/fN'~967)'- Y Air-tight Caps (Y/N) N Foundation Cleanout (Y/N)
Depression over Tank (Y/N) N Date Last Pumped 7-24-84
Pumping/Maintenance Contract on File (Y/N) N ;for
Holding Tank High-Water Alarm (Y/N) N/A Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank:
To Building Foundation 8,7'
To Disposal Field 7 2 '
To Stream, Pond, Lake, or Major Drainage
To Water-Supply Well 125'
To Property Line 20
To Water Main/Service Line 1 IQ'
Course
Comments
VOl ~7_~me
~oem-c ~o exist however pumuin~ records
Page 1 of 2
72-026(11/84)
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL p~_ ;ON
1985
RECEIVED
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
See below ~ Type of System Design Pit or Tank
Date Installed Prior to 1967
Width of Field Dimensions
No
Length of Field Unknown
Depth of Field Unknown
Gravel Bed Thickness Unknown
N Standpipes Present (Y/N)
N Date of Last Adequacy/est
Adequacy Information on File
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
Unknown
To Water-Supply Well 137'
To Building Foundation 99'
Lot 40'
To Water Main/Service Line 122'
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments Absorption System is a crib.
To Property Line 10'
To Existing or Abandoned System on
; On Adjoining Lots 30'
To Cutbank (if present) 155'
None in Area
30'
Absorption is 85 sq ft/BDR in Area.
D. LIFT STATION -
Non e
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
Signed ~/('F''~I certify that I have clle~ed,~ateVerified, or conformed to all~.%,_./~,~/(~ 5"MOA and HAA guidelines in effect on the date of this inspection.
Company .(~)_~..~)YJ,4~ --~6/~... MOA No. S'~' ~-" ~?
Receipt No..~.
Date of Payment
Amount: $
Page 2 of 2
72-026 (11/84)
Engineer's Seal
· ~ '-~.~' ~ ' MUNICIPAEITY OF ANCHORA(~E ' ' j /~-
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
825 L Street - Anchorage, Alaska 99501 //
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTY OWNER I PHONE
VIAl LING ADDRESS
PROP RESIDENT (If different from above) PHONE
~ff" &/ Y("" ' ' PHONE
2. BUYER
MAILING ADDRESS - ~
3. LENDING INSTITUTION . ' ! PHONE
,---, . _,..?.
4. REALTOR/AGENT ~ . .........~,~ ~,.j~) r~.- ~ ,/,,'~,~ P. HONE
MAI LIN G ADDR ESS
5. LEGAL DESCRIPTION
STR E ET I ON
TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] One [] Four
~ SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY [~ Three [] Six
[] Other
7. WATER SUPPLY
INDIVIDUAL~
[] COMMUNITY
[] 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.) " ; '~ ' ~ ' '
8. SEWAGE DISPOSAL SYSTEM
INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
**If individual/on-site, give installation'~ate ~ '': ~ ~
If system is over two (2) years old an adequacy test is required
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
NUMBER OF BEDROOMS
1. TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
[] ONE [] THREE [] FIVE
[] TWO [] FOUR [] SIX
[] OTHER
2. WATER SUPPLY
[] INDIVIDUAL
[] COMMUNITY
[] PUBLIC UTILITY
Connection Verified
3. SEWAGE DISPOSAL SYSTEM
[] INDIVIDUAL/ON -SITE
[]PUBLIC UTILITY
Connection Verified
I-~Septic Tank or [] Holding Tank
Size: If Tank is homemade
give dimensions:
TYPE OF TANK
TOTAL ABSORPTION AREA
4. DISTANCES
WELL TO:
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
DATE INSTALLED
INSTALLER
SOILS RATING
MANUFACTURER
MATERIAL
Absorption Area to nearest Lot Line
Septic/Holding Tank
IAbsorption Area
ISewer Line
INearest Lot Line
5. COMMENTS
[~PPROVED FOR ,~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[~P'~DISAPPROVED
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
R&M CONSULTANTS, INC. 5024 CORDOVA · BOX 6087 · ANCHORAGE, ALASKA 99502 · PH. 907-279-0483 · TLX. 090-25360
September 18, 1978 R&MNo. 851590
Mr. Gerald Wright
c/o Alaska Pacific Bank
P.O. Box 420
Anchorage, Alaska 99510
ANCHORAGE
Attention: Linda
Re: Adequacy Test on Existing Sanitary Sewer System; Tract A-2, Audubon
Hills~ Subdivision, Anchorage, Alaska
Dear Mr. Wright:
Per your agent's request of September 12, 1978, we conducted a test of the
sanitary sewer system on the above described property.
The septic tank was pumped prior to the performance of the test on the seep-
age pit. During the test the liquid level in the seepage pit was measured
before and after the addition of 1000 gallons of water. Ail liquid levels
were measured from ground level and are shown in the following table:
Initial Water Second 24 hour Total
Reading Added Reading Reading Drop
(gallons)
4.65' 1000 4.15' 5.08' 0.93'
The water level rose 6 inches with the addition of 1000 gallons of water,
indicating a capacity of 166.7 gallons per inch. Twenty-four hours later the
liquid level was again measured and found to be 5.08 feet. It had dropped
0.93 feet or 11.2 inches. This indicates an average effluent acceptance rate
of 1867 gallons per day for the surrounding soils. If the 3 bedroom resi-
dence on the property is to house 6 people, the average load on the system
can be expected to be 450 gallons per day. We can therefore conclude that
the system is disposing of effluent at an adequate rate for a 3 bedroom
residence.
ANCHORAGE FAIRBANKS JUNEAU VALDEZ WASILLA
September 18, 1978
Mr. Gerald Wright
Page -2-
We appreciate this opportunity to be of service to you. Please contact us if
you have any questions regarding this letter or if we can be of additional
service to you.
Very truly yours,
R&M~NSULTANTS, INC.
Gary,S. Smith
Seni~ Geologist
GS/kah/12-C