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Home My WebLink AboutT&T LT 4T&T Lot 4 #015-163-67 Municipality of Anchorage Page 1 of 3 Development Services Department Onsite Water and Wastewater Program 4700 South Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW000486 PID Number: 015-163-67 Name: Thomas Faulkenberry Wastewater System: New Address: P.O. Box 230083 Anch., AK 99523 ABSORPTION FIELD Phone: Number of Bedrooms: 522-9193 Four 4 5' Wide Shallow Trench LEGAL DESCRIPTION Sol Rating: 1.2 Total Depth from original grade: 6 GPD'Fe Ft. Block: Lot: Subdivision: Depth to pipe bottom from onginal grade: Gravel depth beneath pipe: 4 T and T 2 Ft. 4 Ft. Township: Range: Section: Fill added above onginal grade: Gravel Length: 1 Ft. 51 Ft. Well: New Gravel width: Number of ones: &stance between lines: 5 Ft. 1 N/A FL Classification (Private. & B. C): Total Depth: Cased to: Total absorption area: Pipe Malenal: Private 306 Ft. 96 FI. 510 Fe ASTM D3034 PVC Driller. - Date Drilled: Static Water Level: Installer: Date Installed: Alpine Drillin 11/26/00 1 38 Ft. GS Express 4/18/2001 Yield: Pump Set at: Casing Height Above Ground: TANK 2 GPM Ft. >21`11. SEPARATION DISTANCES ® Septic ❑ Holding ❑ S.T.E.P. ❑ Other: To Septic Absorption Lift Holding bfic(Private anu ac urer: uapac,ly in ions: From Tank Field Station Tank SewerUne Anchorage Tank 1,250 Well >100' >100' N/A N/A >25' at el Steel No panmen45: TTwwo (2) Surface Water >100' >100' N/A N/A LIFT STATION — NONE ON LOT Lot line >5' >10' N/A N/A ze: wznulactufef. Gal_ >5' >10' N/A N/A 'Pump on v al: mp v el: High water alarm SL Foundation h. h. h. None INoted Pump Make &Model Elecincel Inspections performed by: Curtain Drain Remarks: BENCH MARK Lon a- rption: Northeast Corner Concrete Landing Fronting Back Assumed ievatan: Door. 100.0 Ft. Engineer's Stamp '�y♦# Inspections performed by: MEA Dates: 1a` 4/18/2001 asth 2nd 4/18/2001 Department to a Ith and Human Services approval i' MICHAEL E. ANDERSON : lv ; �' MICHAEL E. A •••••• �"""'"' Reviewed and approved by: Date: d rl��/�� 1 ,P :• No. CE-4381 i ♦# e, °cam Fp (Rev. 10,99)♦ / / P ....... M CD N 00'04'44" E 165.11' Z 1N3n3SV3 Amin ,OC +� r-----------------------------------------------�-- CS 1 I CD ' I � i Cl) r � O i o 0 1 P CD 1 o -.. Ln A CJ � i 7 O I Cn0)Cn N) j �O Z A?0)C) CD D , CD C DA 11 W O S 1 Do CD c i Q) Cn W -� -+ I N W m .� N �, www�� coI �� < K; :,j bo 0o W O i O D � I CD i= OCD m7 0 7 2 ^) l y I NCD Z n I j i Alternote Site I p� =3 m r; VJ Cr iZ Im 00 <0 I� CDCcm= ID D 00 mama) CD > CD ' I _CDD I — Ln X I • ' I 1 , In mCD Z "�-� 44 4 Cos �� nil •_. ••••.•s%'•I I - � �: '��i�: i :i) W ilD O,f 1 17 S •H; q� 1 ' , = I I � I ' i O 1 S 074" W 165.19' Z O •D wo o O yIIV8Cn O N i kVMV341H � CA w Cn CD Municipality of Anchorage DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655- 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: SW000486 PID No. 015-163-67 _ ni In U X U PROFILE AS -BUILT Scole: 1 = 10' ._ 4 MICHAEL E. ANDERSON No. CE -4391 FESS ® ,,,e Municipality of Anchorage Department of Health and Human Services 825 Or Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Rick Mystrom http:/A&ww.d.anchorage.ak.us Mayor Permit Number: #SW 000486 Date of Issue: 11-22-00 Parcel Identification Number: 015-163-67 Date Started: 11-25-00 Date Completed: 11-26-00 Is well located at approved permit location? N Yes ❑ No Legal Description: T&T Lot 4 Property Owner Name & Address: Thomas ulkenberry PO Box 083 (a3ceu') Anchorage, Ak 99523 Borehole Data: Soil Type, Thickness & Water Strata Depth (ft) From To Method of Drilling Nair rotary ❑ cable tool Casing type: steel slick -up 0 2 Wall Thickness: .025 inches ' organic & silt 2 7 Diameter: 6 inches Depth: 96 feet gravelly silt silt silty gravel gravelly cobbly silt 7 21 29 34 21 29 34 58 Liner Typc: Diameter: inches Depth: feet Casing stickup above ground: 2 feet Static water level (from ground level): 38 feet Pumping level: 347 feet after silty sandy gravel small amt water , 58 66 24 hoursP P t;um in 2 gpm gravelly silt 66 81 Recovery Rate: 2 gpm bedrock 81 347 Method of Testing: airlift Well Intake Opening Type: H2O 303 306 ❑ Open End N Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet Grout Type: Bentonite # 8 Volume: I he Depth: Start0 feet Stoppcd + feet, Pump: Intake Depth feet Pump size hp Brand Name Well Disinfected Upon Completion? ® Yes ❑ No Method of Disinfection: Clorine Tablets Comments: Well Driller: Alpine Drilling & Enterprises P O Box 110496 Anchorage AK 99511 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property mwn. r nr IhA wall Ar;11" chgII nrm,;,U o w.1 Inn /n /hA FUnI of ITA* IIh R. 1h,man Qnnru•nc ur:tihin (n Auac nrPmmnIa6;^n i3G$ SGS Ref.# 1031729001 Client Name Anderson Engineering Project Name/# NA Client Sample Ill L4 T & T S/D Matrix Drinking Water Sample Remarks: All Dates/Times are Alaska Standard Time Printed Date/time 04/08/2003 15:30 Collected Date/time 04/02/2003 12:15 Received Date/Time 04/02/2003 12:40 Technical Director Step. E e Released }� Allowable Prep Analysis Parameter Results PQL Units Method Limits Date Date Init Waters Department Total Nitrate/Nitrite Microbiology Laboratory Total Coliform 1.00 U 1.00 mg/L EPA 300.0 48 OB, No Coli col/100mL SN118 92228 /� (<=1) j?-c*t-csr- 4II X b 3 I'✓ EDI 04/06/03 JS 04/02/03 SKW 4-15-03:17:31 :CT and E Antler Son Enaln. :6615301 0 2/ 2 CT&E Environmental Services Inc.. 200 W. Potter Drive Ol age, AK 99518-1605 hone: (907) 562-2343 s mile: (907) 561-5301 200 W. Potter Drive drinking Water Analysis Re ort for Total Colifo= Bacteria Ahchorage, AK 99518-1605 y p Tel: (907) 562-2343 g$,gp,I]yS TIIRTIIINSONItl'XL'RS$51�,�$F..�'ORECOLLECTINOS 4 1 ' • F=1907).561-5301 MUST BE COMPLETED BY WATER SUPPLIER TO BE COMPLETED BY LABORATORY 0 PUBLIC WATER SYSTEM I.D- # n PRTVATE WATER SYSTEM p Sendltesults 0 . SenAlnvoice aur Ytlun amWpy '!"° n�a a one NuMer F4&1wy A4dcua >a p 0 XcndNesu�Its � 0 Sendrnvolce ,(] \//•+(]1L+ O /••� CNG/ -j =?U 1jL egad aama ya me JJ � ,� a �.-73 . ., ,q-cs✓ QS Sy—y � �'�•Ew � v ' 4 SAMPLE DATE: �'Iontp SAMPLE TYPE: A Routine 0 Repeat sample (for ropfine sairiple withlab reL ho. 0 Special Purpose SAMPLE,LQCATIOlY tT 4 TAT s�'=:Nh Comments: .=1. O 3 Day Year' O Treated Water ' 11ptrlated-Water Time Collected Collected $} lO=oUAIA n1 Gk Pletse Print Analysis shows this Water SAMPLE to be: Satisfactory O 'Unsatisfactory 11) Sample.over3.Ohours old, results may be unreliable O• Sample too I'dbg in.transit; sample should not beove>t ours dld'at examination to ndieate reliabjo rssults. Please sp ct Incesample vias ecial de]ivery.mail. Date Red6;Ved Time Received Analysis Began ��y `• Analytic -Ii Method: Mcmbrane Filter o MMM MUG _ ... � %o ml. +N-/' 1031979 ` Re��sult11* Analyst qq``uugqppqq .i_J.�CJ NN ``II�I��IIIIIUiII� •• ' I�II�NIII a.cuawa, n.4..G.1.. Mch Fbks Jun 0 Fazejd Date: Time: Client notified oftsatts£tte—FvTy resulis: Phb❑ned Spoke with Xzx Date: Time: BACTERIOLOrYICAt WATER ANALYSIS RECORD hn,1O-MUG Result: Total Coliform B. Coli Membrane Filter: Direct Count___ C61on1e51100 ml -Verification: LTB SGB COLIFIRM TNTC- Too NuIn"ur To count os-Odse'Rea"ta Fecal Coliform Confirmation Final Membrane Filter Results Coliform/100 ml Reported By `--Date U3 Time t r.OSD hrs' Received Time-4iir.la• 4:374 �4yw—"":�1I�7'•�'C ►�.....6n. ..t .,... nnn n...._.n _-u.. n• . . n ... OZaa moo N = 0Apr opo r mOz Ill N U r V1� ry N zn x amo z ' i°' c II W DSA O W O � pWO MMM A C) N VI . I N D N l0 Z O z m N O VI Ln x I m z rn c-) I Z rn m r N A L 01 VI 0. I� a) C 0a r- O 1 m; •- n eR m I'J Z s�or� oc t4 ^^-x lc ^ A A O M �Qcs^A c p nnp JK n Naz a C o,= �N L n nAO a 2 s.O ry'1 00 n D .. �•a" f 4�, 0• � vO7-, it O _ N .^02 T Tr c J A a N z O D n g' N ,o T ai R a N A O O M ��^o in^ D n n 0 -•O sC O O N Q p 0 On. u n ^n c �•a 3 n m 9 3 �- .n'. -•o z SON O N3o W am O n O n i 0-tiMO n 7A o nNo3 '3- €o" ow; 0 C05 Tc r- 0 -4 W 1 1 I 1 1 I 1 1 I rn N 00'04'44" E 165.11' 1N3n3SV3 J.lnun ,ot I I +/ --------------------------------------------i--- i 1 � x I ' r I 1 x r O ' O I I � 1 I 1 I 1 1 I ' z i I i MUNICIPALITY G E Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section Fax: 907-343-7997 Certificate of On -Site Systems Approval Parcel 1. D. 015-163-67 1. GENERAL INFORMATION Complete legal description T&T, Lot 4 Location (site address) 11500 Hideaway Trail Expiration Date: — -� -r- 2.® Zv Anchorage, AK Current property owner(s) Tom & Tina FaUlkenberry Day phone (907) 345-0600 Mailing address 11500 Hideaway Trail Anchorage, AK 99507 Real estate agent 2. TYPE OF DWELLING: ❑o Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) Day phone 3. NUMBER OF BEDROOMS: 4 4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Private Well ❑■ Private Septic ❑■ Water Storage ❑ Holding Tank ❑ Community Well ❑ Community ❑ Public Water System ❑ Public Sewer ❑ Waiver request for: Distance: Received by: COSA to be released to the engineer, unless otherwise requested by the engineer. Date: COSA Fee $ 5550 Waiver Fee $ Date of Payment lq la®O'VJ Date of Payment Receipt Number 01063b Receipt Number COSA # 0,56961106 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. I acknowledge that On -Site staff may visit the site to verify the information submitted. Name of Firm Forge Civil Engineering Phone 907-522-7773 Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 3/19/2020 6.D�IGNATURE System #1 Approved for A_ bedrooms System #2 Approved for bedrooms Disapproved Conditional approval for bedrooms, with the following stipulations: rr �- `� WATER AND a wASTi:V" ATER U', I_ )9)nm) Original Certificate Date: 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 Septic System Advisory Well Flow Advisory COSA Checklist blue sheet X Nitrate Advisory Arsenic Advisory. Other Legal Description: T & T, Lot 4 If more than 1 septic system on lot: COSA Checklist # A. WELL DATA ❑ Well log is filed with Onsite (or attached) Date drilled 11/26/00 Total depth 306 ft Cased to 96 ft ❑ Sanitary seal is functioning correctly ❑ Wires are properly protected Casing height (above ground) >24 in. Date of flow test for COSA 7/9/18 Static water level at beginning of test 79 Comments B. TANK DATA Age of tank(s) 19 years Tank type/material Septic/Steel ft. Measured operating fluid level in septic tank ❑ Standpipes/foundation cleanout per record drawing Date of pumping 10/11/19 Isaacs Pumping Parcel ID: 015-163-67 of Structure served by this system D. ABSORPTION FIELD DATA 5' Wide Shallow Trench Which system tested (date installed) 4/18/2001 ❑ ALL standpipes present per record drawing Total measured depth from grade 7.5 ft (max) Measured depth to pipe invert from grade 3.5 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 NSA gallons Comments/Deficiencies: COSA Checklist yellow sheet Well production at time of test 1.8 gpm Water storage tank volume None gallons Well disinfected for coliform test? ❑ Yes ❑ N ❑ Coliform bacteria is Negative Nitrate mg/L ❑ Nitrate less than MRL (ND) Arsenic ug/L ❑ Arsenic less than MRL (ND) Collected by FORGE ENGINEERING Date of Sample 3/12/20 C. LIFT STATION ❑ Required maintenance completed Age of lift station N/A years Lift station material N/A Comments: N/A Adequacy test date 7/9/18 Results 0 Pass For 4 bedrooms Fluid depth prior to test 26 in Water added 603 gal New depth 29 in Elapsed time 1440 min Final fluid depth 25 in Absorption rate '600 gpd Any rejuvenation treatment (past 12 months) None If yes, enter date 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' F✓ Yes Community Sewer Manhole/Cleanout > 100' Q Yes if No ft 7✓ Yes if No ft Neighboring Tank > 100' F71 Yes if No ft Private Sewer/Septic Line > 25' 7 Yes if No ft Absorption Field on Lot > 100' F/ Yes if No ft Holding Tank > 100' ✓0 Yes if No ft Neighboring Absorption Fields > 100' Yes if No Animal Containment > 50' 21 Yes if No ft 0✓ Yes if No ft if No ft F. ENGINEER'S COMMENTS Manure/Animal Excreta Storage > 100' Community Sewer Main > 75' F/ Yes if No ft 0 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 Surface Water > 100' ®✓ Yes if No ft Property Line > 5' F✓ Yes if No ft Wells on Adjacent Lots: Absorption Field > 5' Yes if No ft Private Wells > 100' ❑✓ Yes if No ft Water Main > 10'✓Q Yes if No ft Community Wells > 200' 7✓ Yes if No ft Water Service Line > 10' 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 If absorption field is under driveway comment below Property Line > 10' Yes if No ft Wells on Adjacent Lots: Water Main > 10'✓( Yes if No ft Private Wells > 100' ®✓ Yes if No ft Water Service Line > 10' Yes if No ft Community Wells > 200' E✓ Yes if No ft Surface Water > 10 0' Yes if No ft F. ENGINEER'S COMMENTS G. ENGINEER'S CERTIFICATION 0F (0�� 1 certify that I have determined through field inspections and review :PC °''•��•'' of Municipal records that the above systems are in conformance with MOA COSAguidelines in effect on this date. -9th PP .......... ........................0............ - n MICHAEL E. ANDERSON y 1Q AT No. CE -4381 V 4V F,pFo 3/20/20 COSA Checklist yellow sheet p...............P +� 4arj�� n�S \ �� - Municipality of Anchorage -� Development Services Department Building Safety Division Q On -Site Water and Wastewater Program SAI ETT 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. 015.163-67 HAA Expiration Date: Z7/c:;- 1. c?1. GENERAL INFORMATION Complete legal description Lot 4, T & T Subdivision Location (site address or directions) Current Property owner(s) Thomas Faulkenbegy Day phone 522.9193 Mailing address Lending agency Mailing address Real Estate Agent Mailing Address P.O. Box 230083 Anchorage, AK 99523 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: Four 4 3. TYPE OF WATER SUPPLY: Individual Well ED Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Day phone Day phone TYPE OF WASTEWATER DISPOSAL: Individual On-site ED 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 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Enqineerinq Phone 522.7773 Address P.O. Boz 240773 Anchoraae, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Date 4/1712003 NO r-, N�CHAEI E Atq_RSQN 5. DSD SIGNATURE # No. cE-4381 •f Approved for y bedrooms. ♦�'�,°�rEss��::`� Disapproved. Conditional approval for bedrooms, with the following stipulations: rt(�tt.rrrrrrr,, OF Aive %N.ASTEWATER -tet„rr Additional Comments �'� ' ••c.�_.`� Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other By: ) �/1 Original Certificate Date: 41121 by t v (Rev. 17/30t .,......._._..._............. _........... ....... _... ------------- _. _... Municipality of Anchorage - Development Services Department Building Safety Division `�� On -Site Water & Wastewater Program 4700 South Bragaw St, P.O. Box 196650 Anchorage, AK 99519.6650 www.ci.anchorage.ak.us (907) 3437904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 4, T & T Subdivision Parcel ID: 015.163-67 A. WELL DATA Well type Private If A, B. or C provide PWSID # Date completed 1112612000 Sanitary seal (Y/N))[ Total depth 306 ft. Cased to 96 ft. FROM WELL LOG Date of test 1112612000 Static water level 38 ft. Well production 2 g.p.m. WATER SAMPLE RESULTS: Well Log (Y/N) Y Wires properly protected (YIN) Y Casing height (above ground) >24 in. AT INSPECTION ft. Coliform 0 colonies1100 ml. Nitrate 1.00 mg.A. Other bacteria 0 colonies/100 mi. Date of sample: 41112003 Collected by: MEA B. SEPTICIHOLDING TANK DATA Tank Type/Material SeptIdSteel Date installed 411812001 Tank size 1.250 gaL Number of Compartments 2 Cleanouts (YM) Y Foundation cleanout (YM) Y Depression over tank (YM) N High water alarm (Y/N) N Date of pumping Pumper New Construction C. ABSORPTION FIELD DATA Date installed 41812001 Soil rating (g.p.d./ft? or tt2/bdrm) 1.2 GPDISF System type T Wide Shallow Trench Length 51 ft. Width 5 ft. Gravel below pipe 4 ft. i Total depth 7_5 ft. Eff. absorption area 510 ft2 Monitoring tube Y Depression over field N ii Date of adequacy test Results (Pass/Fail) For _, bedrooms ii Fluid depth in absorption field before test _ in. Water added_ gal. New depth_ in. Elapsed Time: ^ min. Final fluid depth _ in. Absorption rate >= g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date a D. LIFT STATION Date installed "Pump on" level at _ in. Datum E. SEPARATION DISTANCES Size in gallons "Pump off* at ^ in. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Manhole/Access (Y/N) _ High water alarm level at Meets alarm & circuit requirements? Septic tankA ft station on lot >100' On adjacent lots >100' Absorption field on lot >100' On adjacent lots >100' Public sewer main NIA Public sewer manhole/cleanout NIA Sewer /septic service line >2T Holding tank NIA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Absorption field >5' Water main NIA Water service line >10' Surface water >100' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: in. Property line >10' Building foundation >10' Water main >10' Water Service line >10' Surface water >100' Driveway, parking/vehicie storage >2T Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. 0 M CHAEL E. ANDERSON J � Engineer's Printed Name Michael E. Anderson, P.E.sl ; NO. CE -+3=1 ' Z' Date 411712003 .... n;jFE$cla`�••� HAA Fee $ r.; Waiver Fee $ _ Date of Payment JnZ Date of Payment Receipt Number o3n8( Receipt Number (Rev. 12100) Municipality of Anchorage George P. 11711erch,211ayor Department of Public Works Building Safety Dillision P.O. Box 196650.4700 S. Bragaw Strcct Anchorage, Alaska 90519.6650 a (907) 34.3.5301 litti)://%%i%w.ci.anctiorage.ak.us October 8, 2001 Thomas Faulkenberry PO Box 230083 Anchorage AK 99523 Subject: On -Site Water and/or Wastewater Permit. Permit Number: Sw000486 Legal Description: T & T Lot 4 Dear Thomas Faulkenberry: An On -Site Water/Wastewater Permit, number Sw000486, issued by this office for a single-family system, will expire on November 22, 2001. This permit was valid for 365 calendar days. If this was a well permit and the well has been drilled, a well log must be sent to this office for documentation of the installation and to close the permit. If this permit was for a wastewater disposal system, an original as -built inspection report must be sent to this office for review, approval and documentation. This as -built inspection report must be signed by the licensed Professional Engineer who inspected the installation of the system. As -built inspection reports are required to be submitted within 30 days of the completion of the system. If no system was installed under this permit, and you are still planning to install a well or wastewater disposal system, a new permit must be obtained from this office. A new permit may be issued free of charge for a second year if the application for the renewal is received on or before the date of expiration of the original permit. When applying for a new permit, the fees are: $320.00 for a wastewater permit and $120.00 for a well permit. If you have any questions, please call this office at 343-7904. Since y Jame Cross, PE Manager On -Site Water and Wastewater Program Enc: Copy of permit MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On -Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ONSITE WASTEWATER DISPOSAL SYSTEM I WATER SUPPLY PERMIT Initial Permit Number: SW000486 Legal Description: T&T LT 4 Date Issued: Nov 22, 2000 Expiration Date: Nov 22, 2001 Parcel ID: 015-163-67 Design Engineer: 0014 Anderson Engineering Site Address: Owner Name: Thomas Faulkenberry Lot Size: 49469 SO. FT. Owner Address: PO Box 230083 Total Bedrooms: 4 Permit Bedrooms: 4 Anchorage , AK 99523 - This permit is for the construction of: El Disposal Field Q Septic Tank ❑ Holding Tank F� Privy Q 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 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: Date: I (e Date: // — 7 2 -474 ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE; AK 99524 522-7773 522.6779 (FAX) November 15, 2000 Municipality of Anchorage Department of Health and Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 4, T & T Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The owner of Lot 4, T & T Subdivision intends to construct a four-bedroom home on the currently vacant lot. We are therefore applying for a permit to construct a new septic system on the lot to serve the new home. The attached Site Plan and backup documentation identify the location and configuration of the new septic system and the parameters used in the design. It also shows the location of the new well on the lot and its protective 100' radius. The well is also shown on the adjacent lot along with its 100' radius. Two test holes were placed on the lot at the locations shown which indicated clean well graded gravel with some cobbles to depths of 12' and 18'. Seeping occurred at the bottom of the excavation in each hole and was found at 10' below the surface during the monitoring period in Test Hole No. 2. No groundwater was noted in Test Hole No. 1 during the monitoring period. The test holes are approximately 40' apart with a 4' difference in elevation. Test Hole No. 2 is below Test Hole No. 1. We are therefore proposing to place a 5' wide shallow absorption trench system with 4' of drainfied rock beneath the distribution pipe. The pipe will be placed at 2.0' below the existing ground surface and the total depth of the trench will be 6.0'. The length of the trench will be 50'. A minimum of 3' of cover will be placed over the trench to prevent frost penetration and possible freezing. The ground surface on the lot slopes as shown on the attached Site Plan. The area for the new absorption trench, however, is fairly flat. The new trench will be constructed parallel to the contours of the surface in conformance with Municipal requirements. Grading will be accomplished to assure surface drainage is away from the new trench. If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. Lot 4, T & T Subdivision November 15, 2000 Page Two 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Q.� ak Attachments --k-_ '-.f", . tJ. -I tib... f HIDEAWAY TRAIL a 6l'S9l •M„49,90.00S i i i Existing Well lol ---- ----------------r 10' UT ILIITY EASEMENT 3,49,4SSO.00N LOT 4, T & T SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS: Four Bedroom Home 5' Wide Trench System Perc. Rate: 1.25 Min./Inch 1,250 Gallon Septic Tank Application Rate: 1.2 GPD/SF 4' Drainfield Rock 4 Bedrooms X 150 GPD 11.2 GPD/SF = 500 SF of Absorption Area 500 SFIS LF (Width) -.5 (Red. Factor) = 50 LF Trench Length Therefore: Construct a 50' Long X 5' Wide X 4' Effective Depth Absorption Trench. Flowline Elevation In Trench to be 2.0' Below Original Ground Surface. Total Depth to be 6.0' Below Existing Ground. Mound Over Trench to Provide Minimum of 3' of Cover or Provide 2" of Direct Bury Insulation. TYPICAL WIDE TRENCH SECTION (NO SCALE) Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 10' Separation From Lot Line. Minimum 4' Separation From Groundwater. '-Natural Backfill' ` ;(21i.nimumj. . .• '/ ._ .Insulation',. Cover 6 :: :... .6a 4 - ,PVC. hole ( s Down T. • rax "nfiela:.Rbck .: 5��.� .3• tom. _. t .. .. TYPICAL WIDE TRENCH SECTION (NO SCALE) Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 10' Separation From Lot Line. Minimum 4' Separation From Groundwater. Municipality of Anchorage Department of Health 8 Human Services 825 L Street, Anchorage, AK 99502-0650 SOILS LOG - PERCOLATION TEST 6M yy' F Y. Performed For. Thomas Faulkenberry Date Performed: Legal Description: Lot 4. T & T Subdivision r3 �1t\\�►��' SLOPE SITE PLAN 1 OG/01- G/OL2 2 GW 3 TESTHOLE NO.1 4 See Site Plan Perc. 5 Zone Well Graded Gravel 6 7 8 Was Groundwater 9 Encountered? ' No S If Yes, What Depth? L 10 Depth to Water O After Monitoring None P 11 Date: 11/15/00 E 12 Reading Date Gross Net Depth To Net Time Time Water Drop 13 1 15 -Nov 11:20 1' 2 11:30 10 Dry 8' 14 3 11:31 1' 4 11:41 10 Dry 8- 15 5 11:42 1' 6 11:52 10 Dry 8' 16 17 18 Bottom of Hole Perc. Rate: 1.25 MinAnch Perc. Hole Diameter. 6' 21 Test Run Between 4.0 Ft. and 5.0 Ft. Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: Mike Anderson. I, Michael E. Anderson Certify That This Test Was Performed In Accordance With All Slate and Municipal Guidelines In Effect On This Date: 11/15/00 fit ^"•r, T?'•• •'::? {� Municipality of Anchorage C- Department of Health & Human ServicesV.;fl 441401. 825 L Street, Anchorage, AK 99502-0650v,ti+.i:�`+^"I� SOILS LOG -PERCOLATION TESTY Performed For. Thomas Faulkenberry Date Performed: 11/10/001 Legal Description: Lot 4. T & T Subdivision �\�1,-�,�"► SLOPE SITE PLAN 1 OG/OL 2 GW 3 TESTHOLE NO. 2 4 See Site Plan Perc. 5 Zone Well Graded Gravel 6 7 8 Was Groundwater 9 Encountered? Yes S If Yes, What Depth? 12' L 10 Depth to Water O After Monitoring 10' P 11 Date: 11115/00 E 12 Bottom of Reading Date Gross Net Depth To Net Hole Time Time Water Drop 13 1 15 -Nov 12:05 1' 2 12:15 10 Dry 8' 14 3 12:16 1• 4 12:26 10 Dry 8' 15 5 12:27 1• 6 12:37 10 Dry 8• 16 17 18 Perc. Rate: 1.25 MinJlnch Perc. Hole Diameter. 6- 21 Test Run Between 4.0 Ft. and 5.0 FL Comments: Percolation Cavity Presoaked Prior to Testing. Performed By: Mike Anderson. I, Michael E. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 11115/00 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION AND MATERIAL SPECIFICATIONS SUBJECT: LOT 4, T& T SUBDIVISION GENERAL: The scope of this project includes the procurement and placement of a new 1,250 gallon septic tank at the location shown on the site plan. Work also includes the construction of a new 50' long X 5' wide X 4' effective depth absorption trench at the location shown. 'The distribution line in the trench will be placed at 2.0' below the existing ground surface. Total depth of the trench will be 6.0' below the existing ground surface. All components of the septic system must be placed outside the 100' protective radius of the well on this and adjacent lots. 2. Construction shall be in accordance with the approved site plan, design drawings, Municipal Permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The Contractor shall be responsible for obtaining all underground utility locates and for the layout of the septic system and verification of the location of all lot lines. 4. Unless specifically agreed otherwise, the contractor shall be. responsible for final grading areas subsequently depressed from soil settling. Property owner shall be responsible for revegetation of affected areas unless specifically agreed otherwise. 5. Contractors installing wastewater disposal systems must be certified by the Municipal Department of Health and Human Services for system installations. Owners installing their own systems must receive prior approval from D.H.H.S. before beginning system installation. SEPTIC TANK INSTALLATION 1. A new 1,250 gallon septic tank must be be procured from an approved source and installed at the location shown. 2. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 3. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 4. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial insulation. Lot 4, T & T Subdivision November 15, 2000 Page 2 of 3 6. A foundation cleanout shall be installed one to four feet from the building foundation. Two cleanouts are required between the tank and the drainfield. 7. Final grading over the tank shall be such that a positive slope exists away from the septic tank. DRAINFIELD CONSTRUCTION: 1. The drainfield shall be constructed to the dimensions shown on the design. The bottom of the trench shall be within 2" of level. 2. Distribution piping must be placed level with perforations down atop a level bed of drainfield rock. Rock should then be placed over the pipe to provide a minimum of 2" of cover. 3. A silt barrier or geotextile fabric must be placed between the drainfield rock and the natural soil backfill 4. Monitor tubes must be 4" in diameter and installed at the locations shown on the design. The portion below ground must be perforated. 5. Contractor shall verify the septic tank and drainfield are a minimum 100' away from any private water wells in the area, 150' from a Class "C" Well or 200' from any community well. 6. Direct bury insulation must be placed over the distribution system if less than 3' of backfill depth is available. Finish grade over the trench must be mounded to prevent settlement or depressions. 7. Grade area surrounding the absorption trenches to drain away. 8. A minimum 2' of accepting soil is required below the drainfield rock for a 5' wide trench. Contractor shall verify this condition prior to placement of the rock. All pockets of unacceptable materials must be removed and replaced. MATERIAL SPECIFICATIONS: 1. Septic tanks must be constructed by a municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662 or A.B.S. (perforated and solid). 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Co. Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). Lot 4, T & T Subdivision November 15, 2000 Page 3 of 3 5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed between the final drain rock layer and the native soil layer. 6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the #200 sieve. INSPECTIONS: Municipal Ordinance requires a minimum of two inspections. These inspections must be conducted under the supervision of a professional engineer registered in the State of Alaska. The first inspection must be conducted after the excavation of trenches, beds or pits and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled. The second inspection must be conducted after the placement of the geotextile fabric, gravel, distribution piping, standpipes, cleanouts and I insulation. No backfill should be in place at the time of inspection. i Contractor shall provide a copy of all field survey layout and construction I notes for use in preparing the certified as -built of the completed system. Municipality of Anchorage Department of Health and Human Services 625'L' Street P.O. Box 196650 Anchorage, Alaska 99519-6650 Mck Mystrom httpAww.danchorage ek.us - Mayor Permit Number: #SW 000486 Date of Issue: 11-22-00 Parcel Identification Number: 015-163-67 Date Started: 11-25-00 Date Completed: 11-26-00 Is well located at approved permit location? ® Yes ❑ No Legal Description: T&T Lot 4 Property Owner Name & Address: Thomas &ulkenberry PO Box 083 `-2sc°� s % Anchorage, Ak 99523 Borehole Data: Depth (ft) Method of Drilling ® air rotary ❑ cable tool Soil Type, Thickness & Water Strata From To Casing type: steel stick-up 0 2 Wall TWckness:.025 inches organic & silt 2 7 Diameter: 6 inches Depth: 96 feet gravelly silt 7 P1 Liner Type: silt 21 29 Diameter: inches Depth: feet Casing stickup above ground: 2 feet siltygravel 29 34 Static water level (from ground level): 38 feet gravelly cobbly silt 34 58 Pumping level: 347 feet after silty sandy gravel small amt water 58 66 24 hourstun in 2 P P g _ gPm gravelly silt 66 81 Recovery Rate: 2 gpm bedrock 81 347 Method of Testing: airlift Well Intake Opening Type: H2O 303 306 ❑ Open End ® Open Hole ❑ Screened Start feet Stopped feet ❑ Perforations Start feet Stopped feet RECEIVED DEC 08 2000 Municipality of Anchorage Dept. Health & Human Services Grout Type: Bentonite # 8 Volume: 1 br Depth: Start 0 feet Stopped ± feet Pump: Intake Depth feet Plamp size hp Brand *:ame Well Disinfected Upon Completion? ® Yes ❑ No Method of Disinfection: Clorine Tablets Comments: Well Driller: Alpine Drilling & Enterprises P 0 Box 110496 Anchorage AK 99511 Attention: The well driller shall provide a well log to the property owner within 30 days of completion and the property n\\IMP' n! tt\P \4PII 4';llP Aall nrn\n/,P a \.,.It Inn #n fh^ not nf'PYI\h 2, r-I„MOn CPI\„nP0 \\„4t„n Rn .lo\,e nr Pnr\\nlPHnn