HomeMy WebLinkAboutLAKE RIDGE TERRACE BLK 6 LT 8Lake Ridge
Terrace
Block 6
Lot 8
#051-313-30
()
Municipality of Anchorage .., .....
Development Services Department [~:
Building Safety Division
On-Sita Water and Wastewatat Program, 4700 S. Bnagaw St.
P.O. Box 196650 Anchorage. AK 99519-6650 Page of
www.d.anchorage.ak.us (907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM ANDIOR WELL INSPECTION REPORT
Permit Number:. SW010330 PID Number. 051-313-30
~"~: Wastewater System: [] New [] Upgrade
Larry Witaschek
14828 Terrace Lane. Eaele River. AK 99577 ABSORPTION FIELD
696-3249 3 C~C~,.,T,.,,,,,,~ ..s...~. ne~ n,~.~
LEGAL DESCRIPTION 0.45 G,o~ 2.0
6 $ Lake Riddle Terrace 0.91 & 0.95 ,,. 1.09 & 1.05
1.63 - 3.20 ~,. 190 (100 & 90) ~,.
Well: [] New [] Up 2 ~. 2 10+
Private - Existing,.-.~- r~. ~L lr080 ~e D3034 & F810
rt Green General 10130101
SEPARATION DISTANCES I~ septic I-I Holding I-I S.T.E.P. [] Other.
"~__~'.~o Septic Abscxptior'Lift Holding Put,lc/Privet( ~laa~w:
Tank Field Station Tank Se,,,,r Ur~Anchorage Tank 1000 ~.
w., 100'+ 100'+ NA NA 25'+ Steel 2
s~,w.,, 100'+ 100'+ NA NA ~ / LIFT STATION
L~L~ 5'+ 10'+ NA NA/~ ~" c.,
NA '50'+ NA NA ~ ~"~0"~'~"""
"'"'": BENCH MARK
*none known
Exisitng tank and septic field abandoned per code Door sill
New tank & field Insulated 100
Eno~q~St amp
,-co:.' ..-r.3-~
Inspections performed by: KND Enqineerinq Dates: 1" 1013012001 ~,~,~,.,~,~..,~,.~2~,..-~
2~ 10/3112001 ~ ~'
Developme~ t Services Department Approval B'," !l/Iqjol
Reviewed and approved by: J.-..,~.,/J'~ Date: ~/4'/o7_ ~'4~~,~''''
K
AS-BUILT SYSTEM DETAILS/SITE PLAN
LAKE RIDGE TERRACE S/D, LnT 8, BLrlCK 6
D
A-C: 14.5'
B-C:56.4'
A-D: 19.7'
B-D: 53.9'
A-E: 82.0'
B-E= 30.6'
A-F: 51.0'
B-F= 60.4'
A-G= 68.4'
B-G= 63.1'
A-H= 121.8'
B-H= 53.1'
A-C:118.8'
B-C=48.5'
-- I000 GAL
SEPTIC
TANK
SCALE, NTS
CO
8
0 100° V£LL
Permit SW010330
PLO#051-313-30
SCALE,
1' = 50'
~ 100' VELL RADIUS (EX STING)
FINAL GRADE
SEVER ROCK
TRENCH ]
FINAL GRADE
SEVER ROCK
TRENCH 2
PREPARED FOR:
LARRY VHITASCHEK
14828 TERRACE LANE
EAGLE RIVER, AK 99577
(907) 696-3249
SCALE, NTS
FIELD BOOKS
STMN~ SPANCLER c~tcxt'o: KMD
~ ~ ~ NW653
~ ~: 01073.DWG ~ ~= 01073
696-6111 696-8111
MUNICIPALITY OF ANCHORAGE
Development Services Department
On-Site Water & Wastewater Program
4700 South Bragaw Straet
P.O. Box Ig6650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Aug 22, 2001
Expiration Date: Aug 22. 2002
Permit Number: SW010330
Legal Description: LAKE RIDGE TERRACE BLK 6 LT 8
Design Engineer:. 0070 KND Engineering
Owner Name: Larry Witaschek
Owner Address: 14828 TERRACE LANE
EAGLE RIVER, AK 99577-9243
Parcel ID: 051-313-30
Site Address: 014828 TERRACE LN
Lot Size: 31000 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the constru~on of:.
[] DisposalField [] SepficTank [] 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 Ddnking 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: (~/~'~//
Issued By: Date: 0 ~
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. I)51-313-30
Permit Number SW 0 J0~ Za 0
Property owner(s) Larry Witaschek
Mailing address (1) /4//?~ g'
Mailing address (2)
Day phone. 696-3249
Ag 'q.5'7 7
Zip Code
Legal description (Lot, Block & Sub'd.)
Legal description (Section, Township & Range)
Lot Size 0.689/30000 . Acre~.F~
THIS APPLICATION IS FOR:
Sewer Only r-]
Sewer and Well []
Sewer Upgrade []
THIS PROPERTY CONTAINS:
Hot Tub r'-I
Swimming Pool []
Therapy Pool []
Lake RidgeTerr~ce B6, L8
Number of Bedrooms 3
We~l Only []
Water Storage []
Jacuzzi []
Water Softening Unit []
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.
(Signature of property owner or authorized agent)
Permit Fees:
Date of Payment:
Receipt Number:
(Rev. 12/oo)
Waiver Fees:
Date of Payment:
Receipt Number:
~D ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 995T7-8736
(907)696-61 ll/FAX (907)696-8111
July 31, 2001
Municipality of Anchorage
Development Services Department
On-Site Water & Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Sewer Upgrade - Lake Ridge Terrace B6, L8
Gentlemen:
The owner has requested we proceed forward to obtain a septic permit to upgrade and
replace the existing septic system and tank for the subject lot. The existing septic tank
will be inspected and replaced if necessary to verify its compliance with municipal
standards. On June 29u', 2000 we dug one testhole, and an additonal perc test for the
PThroposed system. The perc test is located on the north side of the lot labeled TH2001-2.
e results of these tests are attached. The general slope of this lot is from east to west
at a grade of approximately 0 - 2%.
We have designed our system, utilizing the testhole we excavated for t.he 3-bedroom
house. The lot is served by an individual well. We propose to install a 5 wide shallow
trench. Water was encountered during the excavation and monitoring.
There are no public or private wells within 2,~0~.' of our proposed system location except
as noted. There is no surface wa!er within 100 of the proposed system and there are no
known curtain drains within 50. We do not expect there to be any adverse effect on
adjacent lots by the development of this system.
If you have any questions, please contact me at 696-6111/FAX 696-8111.
Respectfully submitted,
~i~]l) Engineering
attachments:
On-Site Well and Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
WELL &
K
D
WASTEWATER DISPBSAL SYSTEM DETAILS/SITE PLAN
LAKE RIDGE TERRACE S/D, LOT 8, BLBCK 6
4A
F
I
I
9
DESIGN DETAILS
3 I~DRM X 150 GPD = 450 GPD
450 GPD/0.45 GPD PER SO. FT. (32.0 MIN/IN.)c lO00
(1000/5'¢V)) X .88(RF) (1.0' GRAVEL) = 176 FT. TRENCH
USE ~ TRENCHES - BB (L) X 5' (V) X LO'CD)
Totoi depth oF syste~ is E.O' FrOm opiginol
Totot depth oF graver beiGe d~stributio~ pipe is
NOTES:
1. CONTRACTOR & ENGINEER TO VERIFY INTEGRITY OF SEPTIC TANK AND
REPLACE AS REQUIRED. INSULATE TANK IF <4' COVER.
~. INSULATE TRENCHES VITH 2' HD ~URIAL FOAM.
3. CONTRACTOR VILL ENSUR~ MINIMUH 2X SLOPE INTO SEPTIC TANK.
4. ADDITIONAL FILL VILL BE ADOEO OVER SYSTEM TO ACHIEVE
MIN. 3' COVER ~? REOUIRED.
5. CONTRACTOR VILL ENSURE ALL SEPARATIONS TO ADJACENT
~ELLS ~ SEPTICS.
PREPARED FOR:
LARRY VHITASCHEK
14828 TERRACE LANE
EAGLE RIVER, AK 99577
C907) 696-3249
~" SPANCLER ecrm: VBG
l'r~*o- SPANCLER ~cx[~. KMD
~' SPANGLER o~ 8/22/01
~ et~ cee NW653
a~on~ 01073,DWG' ~e ~.~ 01073
Sc,He: 1'= 100'
PAGE 1 DF ;2
]~) ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
¥/ASTE~ATER DISPF1SAL SYSTEM DETAILS
LAKE RIDGE TERRACE S/D, LOT 8, BLOCK 6
IMARY
PRnpn$ '-~L~__.....~ TXISTIN~ SEPTIC TRENCH
III I'lq ~ ~ ~ i,KXIS~G ,3 BD~
~111 I I~X~PROPOSED S ~LITTE/co~._.~
(907) 696-3~49 PAGE 8 OF 2
~~"~-~"'~
' · -~..~,,~' . '-~~.~ ~ ,,~os~s ~ ~ ENGINEERING
~.~'~ "~ SPANCLER ~.,m ~ 20441 PTARMIGAN BLVD.
--~~~ .... L~V~~ *~' SPANGLER ~: 7/9/01 EAG~ RIVER, AK 99577-8736
- .,,,....,....,.,,,.,.,,,,,,,.,,,,,.,,,.,.,..,...
~:01075.DWG~= 01075 ~907~696-6111~F~ (907)698-8111
']~) ENGINEERING _.~b, ..... :....~;.B
20~4! PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
so Ls 'ERCOI ATION
Performed for.Larry Wita$¢hek Date Per formed:~~..,.}'.,~
Project: Lake Ridge Terrace B6, 1.8 TEST HOLE # 2001-1
2-
3-
4-
5-
6-
7-
8-
9-
10-
11-
12-
13-
14-
15-
16-
17-
18-
Depth
(Feet) I
Org/SM - brown, sandy gravelly
silt w/organics, moist
Seeps at 6.5'
SM - reed dense, grey, clay
w/cobbles & boulders, wet
B.O.IL
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
WasGroundwaterencountered? YES Whatdepth? 6.5'
Depth to water after monitoring? 6.$' Date? 7/9/01
Reading Date Gross Net Depth to Net
Time Time Water Drop
I 6/29/01 2:45 9 4/16"
2 3:15 30 rain 7 12/16" 1 8/16"
3 3:45 30 rain 6 13/16" 15/16"
4 4:15 30 rain 5 14/16" 15/16'
5 4:45 30 min 4 13/16' 15/16"
* Water Added
,9. I
Percolation Rate 32.0 (mM/in) Perc llole Diameter
Test Run Between 2.5 feet and ~.:5 feet
1, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
Performed for. Larry Witaschek Date Performed: 7126/01
Project:. Lake Ridge Terrace B6, L8 TEST HOLE # 2001-2
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
3-
4-
5-
6-
7-
9-
10-
11-
12-
15-
16-
18-
IWas Ground water encountered?
D..epth to water after monitoring?
What depth?
Date? 7/26/01
Reading Date Gross Net Depth to Net
Time Time Water Drop
1 7/26/01 2:15 8 2/16"
2 2:45 30 min 7 6/16" 14/16"
3 3:15 30 rain 6 10/16" 10/16"
4 3:45 30 rain 5 15/16" 11/16"
5 4:15 30 rain 5 5/16' 10/16"
· Water Added
,9. ]
Percolation Rate 48.1P (min/in) Perc Hole Diameter 6" ]
Test Run Between 2.0 feet and ~.0 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
~. ,~UNI C IPALITY OF
and Environmental Prot 'on
Fourth Floor West
825 L Street
Anchorage, Alaska 99501
264-4720
........... i~,J-~ECTION REPORT ON-SITE SEWAOE DISPOSAL SYSTEM
SFPi'IC TANK:
(]1 5'i ANCJ- ~
I~lbl~JE LE i(]TII ..... INSIDE '71Dltt ..... LIqUiD DEPTH
NUMBER OF ,~_
COMPARTMENTS
LIQUID CAPACITY /DO %ALLON$.
TILE DRAIN FIELD:-~,~.~.~-I~-~..~--
I t I TOTAL L.ENGTt~
[)ISl/',['( ', i ROM \','[ LL I.~.0_'~_ __FOUNDAIlON__,.~__O__-- -- '""-- .... NEARLiST LOt LINF__.3__O_ ..... OF LINE
i! of Lines ..... DiStANCE BETWEEN LIP;ES ~./'_'~_ ___TRENCH WIDTt4~ IN. TOTAL EFFECTIVE
/,!;~O ' ON ,-n4f!A _ . ~ ....... SQ. FT. t LNGTH OF E,ICtt LINE
I []EPlt~ OF FILTER
iSFPiil: 'lOP OF lILt I'O t U,ilSII (~RA[)E ¢'~ MAIERtAL BENEATh4 TILE ~ IN. ABOVE TILE ~ IN,
SEEPAGE PIT:
I,og Crib Rings
i}UiL[)INCi FO(K,!DATION.
DIP. MEIER __OR WIDTH___ LENGFH__, DEPTH
Crib Size: Ol;\ME1 E R .... DEPrlt .... DISTANCE FROM: WELL
TOTAL EFFECTIVE
NEAREST LOT LINE___ ABSORPTION AREA (WALL. AREA)
,SQ. FT.
~]_1 ~ [
].ass: ~ Depth:
!/1 Distance To: Lot Line ~'J
i. dg: ~C} Sewer Line: ~
of Beclrooms: ~
-~staller: ~~
,~i/it' t!/I i
F'E~ff"i :[ 't- NO.
FIF'PL ]: C:Ft N T
L 0 E: Ft T 113 N
LEGFIL,
HFIHFtNN CONST
H I M_E:F.:EE;T [:,F.:
LE: E:E; LFIk:EF.: I DGE TERF.:FUZ:E
±6;9:3 E:LI_IE :,FM..I_.E
I..OT S I ZE
2i:0ta00 S;~_RRE FEET
'T"?'F'E I-IF SE IL FIE:SORE:-f':ON :,T.=,FEI1 SS: 'T'F.'.EN[::H
I"IRX]:I'"tLtt"I NIJI"IE:EF~: E~F 'E:EE:,F:00FI:L; =
SI_aiL RFiN"]:N] ':,.:.6~ FT,...'E:F..:)=
"FHE REQUIRED :.=.,IZE: OF THE SOIl.. FtBSORPTION S'T'S'f'EM IS:
EEl iF:" -'F H =: L. E ~'-,JJ ,3 -F H ..... = F~. IP.~ . EEL. tE::, P- F" ""IF' H ....
THE LENGTH D'.[P1ENSZON IS THE LENGTH <If.,I FEET> OF THE TF?.ENCH OR E:,RRINFIEI...D.
THE DEF'"['H OF Fi "FREI'-,ICH L3R F'IT :iS THE DZS'T[~NCE E:E:TP.IEEN THE SI..IRF-FICE OF' THE:
I]if;.':OI.JN[.':, FiI'.,IE:, THE BO'f'TOFI OF THE EXCFi',,,'RTION <IN FEET>.
THERE tS NO SET H]:E:,TH FOF.: TRENCHES.
THE GRFi',,,'EL DEPTH :[:5 THE I"IINIf"ILIH DEPTH OF GRFi',,,'EL E',ETHEEN THE CIUTFRL.L PIPE
RNE:, THE E~OTTOf"I OF' THE E',-',',CFI',,,'FtTION <IN FEE:T>.
BFIE:I.:::FILLING OF laN'.r' .S'T'STEH 14:f. THOUT FINFIL IN:E,F'EIDTION RND FIPF'RE¢,,,'F:IL E."¥' THIS
[)EF'FIRTi,IENT 141 LL. E;E SUEL.¥EC:T TEl PF.:C~S.EC?]- I [IN.
[,iEL. L. Fg-A:.~ FiN"r' CIN-'."E; :[ 'I"E SEHFiGE [::' I '.E;I-'OSFtL S .¢::-N"EH I ST,
]:
P1Uhl
E:,
SN"FINCE
13ETP.IEEN
J. OO FEET FOR Fi F'RI',,,'FiTE I,IELL- r~";3F-' ¢.¢~__.~ FEET ¢'OF.: Fi PUE;L. IE: HELL.
HELL LOGS RI;.':E REL:'g...IIF:':ED FiN[..', P1UST BE F.:ETURNEB', TO TFIE [:,EPRF.':'HIEt'-Ff' I4:[N'HIN 7:N:0 DFI"¢S
OF 'I"HE t4ELL CCIP'tF:'LETION.
SPEC:I F'I CFIT:[CINS laND CONSTRUCTIIZIN DIFiISRFIP1S taRE Fi',,,'RIL_FiBI._E: T(]i INSURE PF:OF'ER
]: NSTFiLLJ:IT 1 Ot'.4.
]: E:EF.:'i'iF"r' THFIT
±: I i:lh/ FFtt"IIL. IRR HITH THE IREQUIF,:EP1Ef',ITS F'OR ON--S:[TE SE:HEF4:S FH'qD I.,.IEI_.LS las SET
FORTH BY THE: HLII'.4IC:ZF'FiLIT'T' CIF FtNCHORFiGE:.
2: :[ t4]:LL ]:NSTRLL THE S"r'E;TEI"I ]:t",t RCE.'.'ORDFiNCE [4I'FH THE CODES.
3:: :[ UNDERSN"FiNE:' THRT THE ON-SITE SE['4E:R S'¥'STEH t"1F1'¢ F?.E(.:.'!U ]: RE: ENLRRGEi'IENT it:' THE
RES]:E:'E:NE:E :iS F-:EI"IEIB'ELEB' 'f'O TNC:LIJDE¢ I¥1OF~ THRN _.3':: E~EE:,F.:EIOh'IS.
/./..._/:.//
FIF:'/'L Z I:)~'tNT HFIHFINN C:ONS'T'
s:=". x';: ........... ,. E._,_.:._i::::L:'.'._::._:_'L:_:.._?:_ ................................
-,,,:: · ........
/
Legal Descrlp~"~bn:' Lo-~._~.._Blo~k__~~n Z/)_/_~_~'. ~li~)~~_ ~/~ '..~.
This Form Repomts a: Soils Log.._,._...~_~_.~.. ~ .Percolation Test
Depth
Feet Sell Characteristics
rodeo,z_ -'~ ,q~'~
Was Gmound ;later Encountered?
If_Yes, At. What Dep~h_~ ..
Location Sketch
Minute
: Gmoss Time Net. Time Depth To H20 Net Drop
Pmoposed Instal~Seepage Pit Drain Field
Depth Of Inlet ~ ,, Depth To Bottom Of Pit Or TPe,nch
, .. ~ _ ~'~",1, ..............
Test Performed By:__ ,~ ~ ,
Date: ~/~ -~
a & L DRILLING COMPANY
TELEPHONE 694-2588
BOX 97, EAGLE RIVER, ALASKA 99577 ·
o,_, :: ,S c' ld z: ....
OWNER OF LAND
ADDRESS
DATE- Started c~/~ ,/7 -~' Ended
PERMIT NUMBER "7 7 / 7 0
DEPTH OF WELL /
STATIC LEVEL OF WATER FT.
/
'"DRAW DOwN FT.
GALS. PER HR
KIND OF CASING
KIND OF FORMATION:
From ¢(9 Ft. to c>~ Ft.
From .~) Ft, to .-5~ Ft.
From .~3 Ft, to c~ ~ Ft,
From ?t, Ft. to t '~° Ft,
From / ;,'D Ft. to I O7 Ft,
From /o¢'/ Ft. to//~ Ft,
From ! / ~, .Ft. to I~ h. Ft.
From Ft. to.__Ft
From__ Ft. to Ft
From__ Ft. to Ft.
From Ft. to Ft.
From Ft. to--Ft.
From Ft. to Ft.
From Ft. to Ft
From__Ft: to Ft
From__Ft. to__ Ft.
From Ft. to Ft
From
From__
From
From
From
From
From
From
From
From
From
From
From
From
Ft. to Ft,
Ft, to Ft,
Ft, to Ft.
Ft, to Ft,
Ft. to Ft
Ft. to Ft.
Ft. to.__Ft,
__.Ft. to Ft.
__.Ft. to__Ft
__Ft. to Ft
Ft. to Ft
Ft. to Ft
Ft. to Ft.
Ft. to Ft,
_Ft. to .Ft.
__ Ft. to .Ft.
Ft, to Ft.
' MISCL. INFORMATION:
DRILLER'S NAME ': "' ':
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage. AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051.313.30
1. GENERAL INFORMATION
Complete legal description
ExpiraUon Date:
Lake Ridge Terrace Block 6, Lot 8
Location (site address or directions) 14828 Terrace Lane, Eagle River, AK 99577
Curre~,Pr~pert~ 'oWned'is)' LaJ'ry Whitaschek Day phone 696-3249
Mailing address 14501 W. Lake Ridge Dr,. Eagle River, AK 99577
Lending agency
Day phone
Mailing address
Real Estate Agent
Day phone
Mailing Address
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
TYPE 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 supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health
Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well
and may be reissued with new water sample results. (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 welIs or
a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer s work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as 'of the validation date shown below, I verify that my
investigation, based on procedures outlined in the'Health Authority Approval Guidelines for this
application, shows that the on-site water supply and/or wastewater disposal system is(are) safe. functional
and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and
inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all
applicable Municipal and State codes, ordinances, and r~gulations in effect at the time of installation.
Name of Firm KND ENGINEERING, INC,
Address 20441 Ptarmlqan Blvd.. Eaqle River, AK 99577
Engineer s Printed Name Kenneth M. Duffus
Phone (907) 696-6111
Date 09104102
DSD SIG,,LqATURE
~ Approved for
Disapproved.
Conditional approval for
g,....~.:~.;...~..
bedrooms,
bedrooms, with the following stlp~ons:
Additional Comments
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
X
Maintenance Agreements
Supplemental Engineer s Report
Other
Odginal Certificate Date:
{Rev. 01~2}
Development Services Department
Building Safety Division
On-Site Water & Westewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak, us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
A. WELL DATA
Well type ornate
Date completed 09/061t977
Total depth 132 ft.
Lake Rldae Terrace Block 6. Lot 8
Date of test
Static water level
Wall production 10
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 mi.
A~senic: NA regal.
SEPTIC/HOLDING TANK DATA
Parcel ID: 051-313-30
ff A, B, or C provide PWSID #
Sanitary seal (Y/N)[_
Cased to 4~'+ ft.
FROM WELL LOG
09106/'1977
t18 ft.
Well Log (Y/N) Y
ras property protected (Y/N) y
Casing height (above ground) 1~"
AT INSPECTION
03/07/2002
119 ff.
6.53 g.p.m.
Nib'ata ~ mgJI.
Date of sample: 08/'29/02
Other bacteria 0 colonies/lO0 mi.
Collected by: KND Engineering
Tank Type/Malarial ~e~c I Steel Date installed t0/30/2001
Tank size ¢~00 gal. Number of Compartments 2 Cteanouts (Y/N) ~
Foundation cleanout (Y/N) y_Depression over tank (Y/N) LHIgh water alarm (YIN)N
Date of pumping NA - New T~flk Pumper
ABBORPTION FIELD DATA
Date installed t0DORI Boil rating (g.p.d./fl2 or f~Fedrm) 0.45 System type Trench
Length tgOTotsI~90&tO0} It. Width ~ fl. Gravel below pipe 1
Total depth 2.0 ft. Eft. stisorption srea 1080 ~ Monitoring tube ~._ Depression over field N
Date of adequacy test ICA - Hew b'~stem Results (Pass/Fail) Pass Far 3 bedrooms
Fluid depth in absorption field before test in. Water added.__ gal. · - · New depth
Elapsed Time: __ min. Final fluid depth in. Absorption rate >=
Any rejuvenation treatment (past 12 mo.) {YIN & type) If yes, give date
D. LIFT STATION
Dote installed NA
Pump on level at rain*
Datum
E. SEPARATION DISTANCES
Size in gollons
Pump off level at
Cycles tested
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tanldllff station on lot
Absorption field on lot
Public sewer main
Sewer/septic sewico line 25'+
Manhole/Access (Y/N)
in. High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots t00'*
On adjacent lots 100'+
Public sewer manhole/cleanout
Holding tank 100'*
t00'*
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Pmpen'y line ~'+
Water main 10'+ Water service line tl0'+
Wells on adjacent lots t00'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line t0'+ Building foundation
Water Service line 1{¥+ Surface water 100'+
Curfain drain 50'+ Walls on adjacent lets
F. COMMENTS
G. ENGINEER S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems ere in
conformance wfth MOA HAA guidelines in effect on this dote.
Engineer s Printed Name Kenneth M, Duffus
Date 09104/2002
Absorption field 5'+
Surface water 100'+
Water main t0'+
D~veway, parking/vehicle storage 25'+
HAA Fee $375.00
Date of Payment
Receipt Number z~ l. $2 o ~ /~ ~.
(F~w. ~o~)
Waiver Fee $
Date of Payment
Receipt Number
SE?-O3-OZ 03:10~ FR01~CT&E E~VIRONI~NTAL SRV
Zt~_- CT,E Envlro.mental Services Inc.
90?5615301
T-223 P.02/03 F-845
CT&E Ref.#
Client Name
Project Name/W
Client Sample
Matrix
Ordered By
PWSID
Sample Remarks:
1025597001
KND Engineering
Lake Pdd~c Ten'ncc LB, B6
Lake Ridge Terrace L$, 136
Drinking Water
0
All Dat,.'~Tlmes are Alaska Stand-~rd Time
Printed Date/Time 09/03/;2002 8:41
Collected Date/Time 08/29/2002 14:00
Received Date/Time 08/29/2002 15:00
Tethntcal Dlrert o_~7....~. Stephe~"~Ede
Mat:era Depa~:tment:
Nitrate-N
0.215
PQL Units
P,~ Au~lysim
Dale I~ate Init
0.200 mg/L EPA 300.0 (<=10) 08/29/02 PLW
Microbiology Labo~rat:o:y
Total Colifmm 0
col/l 0Oral SMIS 9222B
08/29102 KAP
®t AAOIOAt1V1®C
9
PLOT PLAN! ASBUILT %- SCALE I- ® 40' GRID W 65 Project Pio. 02-024
Lang �& Associates, inc. 11500 Daryl Avenue, Anchorage, Alaska 99515
907 522-6476 Phone
Registered Land Surveyors 907) 522-4625 Fax pF •q�
I hereby certify that I have surveyed the following described property.'��,, ...... ••'Qs
LOT 8, BLACK 6 LAKE RIDGE TERRACE SUBDIVISION �Q; = '•.!f
Anchorage Recording DisMat. Alaska. and that the Impcovements situated:�
thereonare within the property lines and do not onto the ............... ..............
adjacent thereto, that no improvements on the lying adjacent thereto
encroach on the surveyed promises and that there are no roadways, transmission
lines or other visible easements on sold property except as indicated .... ... ...........'$ :KENNETH 0. ti
Dated this the 20'';" Day of M , u2 at An , a LS -3202
It Is the responsibility of the owner to determine the existence of any easements,
.••.
covenants, or restrictions which do not appear on the recorded subdivision plat. •