HomeMy WebLinkAboutTHOMAS L BOYLE BLK 2 LT 2BThomas e:
Municipality of Anchorage
On -Site Water and Wastewater Section • (907) 343-7904 Page 1 of 3
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP201180 PID Number: 015-282-08
Dwelling: X Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New 0 Upgrade
Name
Steven & Kristie Armbrust
ABSORPTION FIELD
❑ Deep Trench ❑ Wide Trench ❑■ Bed ❑ Mound
Site Address
12040 Cange Street Anchorage, AK 99516
❑ Other
Phone
Number of Bedrooms
Soil Rating
depth from original grade
351-1243
4
0.7 GPD/SF
JTotal
5.5 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
5.0 Ft.
Gravel depth beneath pipe
0.5 Ft.
Subdivision Block Lot
Thomas L. Boyle 2 2B
Fill added above original grade
1.0 Ft.
Gravel length
50 Ft.
Township Range Section
Gravel width
18 Ft.
Beds: Number of Lines
3
Distance between lines
6 Ft.
SEPARATION DISTANCES
To
Septic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
900 Ftz
Ft.
Well
>100'
>1 00'
>100'
N/A
>25
TANK ❑ Septic X S.T.E.P. ❑ Holding ❑ Other
Manufacturer
Greer
Capacity
1,500 Gal.
Surface Water
>100'
>1 00'
>100'
N/A
Material
Number of compartments
Lot Line
>5'
2.9'*
>5'
N/A
NA
Plastic
2
Foundation
>10'
>10'
>10'
N/A
LIFT STATION
Manufacturer
Capacity
Remarks *See Lot Line Waiver.
Greer
250 Gal.
Alarm location
Inside garage
Electrical installed by
Power Lighting & Control LLC
PIPE MATERIAL House to tank D3034 Tank to
drainfield Exist.
Installer
Northern Excavation
Drainfield D1785 CO/MTD3034
Inspector J. Millette
BENCH MARK (Assumed elevation) 100 ft
Inspection 1�t 7/16/20 7/20/20
da:3`d
Location and description
2�c
4,h
Bottom of siding near tank.
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
OF 44',44
Conditional Approval: Date
••.:qS�®®
49 th
s....i........
..i....®®
®....... ._.. �... . o
0 ..............................................
:.I�ICHnEL E. ANDERSON e
Septic System®0
!
Approve Date ,,21-2-0
0, : No. CE -4381 -' �®
°•.. 7/23/20 •'tom®�r
..•'
PRO
Note: this approval does not include well permit requirements.
tot, ESQ
kmuv uoiuu ion
PERMIT rlSP2011v0
104.0
103.0
� 112.5FINISH GRADE +
2i 2
111.5 ORIGINAL GRADE ,
MOA FILTER SAND
TYPE 11 ERS MATERIAL
EXISTING BED SAND
50
PROFILE AS -BUILT
*4 (NO SCALE)
THOMAS L BOYLE, BLOCK 2 LOT 2B
PERMIT # OSP201180 PID # 015-282-08
1
I � I
LOT
WIRE FENCE 0 NEW 1,500 GALLON
T 1A I �I S.T.E.P. TANK TRENCHES ABA ONED I 1993. .
SUBDRAIN
OUTFALL LOT 2� i - - AIH %IH
THREE BEDROO \
10' CHUG491-1 ELECTRORgIN /
LO 1B EASEMENT (BK. 725, P . 989) V
\ / m
!STING 1,250 GALLON S.T.E.P. ETA NG WA �.
TANK DECOMMISSIONED &
I yH D ABANDONED PER MOA CODE.
APPROXIMATE WETLAND SHED ML/CL N
•: BOUNDARY. NO IMPACT
ON PROPOSED SEPTIC C MT1 .I I - PLUG
SYSTEM. EXISTING WELL II
RENCH ABANDONED IN 1987. AL E ER ROCK TO I I T A
ATER TABLE & PIPING UND REMOVED & MHE
BA ED w/ MOA SAND OF EXISTING I
TRE CH WAS PLU D ISTING MUCL MATERIAL. h -1T ` P
\ ALTERNATE SITE: CAT/tiiSYSTEM.
\ 600GPD/5.0 APP. RATE - 30' L%%NG x 5' WIDE,
/ \ 0.5' EFF. DEPTH ABSORATION TRENCH.
LOT 4A I� \ \ ALL CONTE MINATED SOL ON EXISTIDG-
EXISTING ABSORPTION\ \ 18' WIDE/x 36' LgNeABSORPTIAN BED \
BED REMOVED& DISPOSED OF IN I A \ B
�SCGORNANCE WITH MU�CIPAL CODE.
/ B E% EXTENDED 14'.
LOT 3A
EN GINF[RING
LEGEND
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
MH1
1 13.0 35.4
MI -12
17.2 36.3
MT1
74.2
42\2
MT2
87.
60.0
MT3
125.7
712
MT4
116 8
59.E
PLAN AS -BUILT
0 50 0
Illffi :
M FEET1
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 34377997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP201180
Work Type: Septic None
Tax Code Number: 01528208000
'Site Legal Address: THOMAS L BOYLE BLK . 2"L"T " 28. -G:2734
Site Mailing Address: 12040 CANGE ST, Anchorage
Owner: ARMBRUST STEVEN M & KRISTIE D
Design Engineer: FORGE ENGINEERING
This permit is for the construction of:
Q Disposal Field Q Septic Tank ❑ Holding Tank El Privy
Effective Date:
Expiration Date:
�»' c•n r
O:_,�._ c
Dehui-Unl :n t
7/2/2020.
7/2/2021
Lot Size in Sq Ft: 46200
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 (2417).
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
r
Received By: h./, ` i , ) G Date:
Issued By: f/" Date:
iMunicipality of Anchorage
P.O. Box 196650 ® 4700 Elmore Road
Anchorage, Alaska 99519-6650 a (907) 343-7904 a Fax (907) 343-7997
http://www.muni.org/Onsite
Development Services Division
On -Site Water and Wastewater Program
x x x x VARIANCE/WAIVER REVIEW x x x x
Waiver#: OSV201030 COSA#: Permit#:OSP201180
PID#: 015-282-08
Legal Description: Thomas L. Boyle B2 L2B
Engineer: Forge engineering
Your request for a waiver of the required 10 feet horizontal separation from the absorption field to
the property line has been approved. The approved separation distance is 2.0 feet.
This waiver approval applies to the proposed absorption field only. Any future upgrade to the on-
site wastewater disposal system will require all separation distances be met or another approval
from this department.
............................................... ■ ............................. ■ t
Waiver is Granted: X Waiver is not Granted:
Date: Approved by: 4�1�11�lcla�
Name of Reviewer
**** VARIAN C E/WAIVER REVIEW ****
MUNICIPALITY OF ANCHORAGE
Community Development Department Phone: 907-343-7904
Development Services Division Fax: 907-343-7997
On -Site Water & Wastewater Program
ON-SITE SEWERMELL PERMIT APPLICATION
Parcel I.D. 015-282-08
Property owner(s) Steven & Kristie Armbrust
Mailing address 12040 Cange Street Anchorage, AK 99516
Site address Same
Day phone 351-1243
Legal description (Sub'd., Block & Lot) Thomas L. Boyle, Block 2, Lot 2B
Legal description (Township, Range & Section)
Lot Size 46,200 Sq. Ft. Number of Bedrooms
Four (4)
APPLICATION IS FOR: APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field ❑R Initial ❑
Single Family (SF) ❑X
(w/wo ADU)
Septic Tank 19Upgrade FA
Duplex
Duplex (D) ❑
Holding Tank El Renewal El
Dwellings ❑
Privy ❑
(SF and/or D)
Private Well ❑
Water Storage ❑
THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST,FOR:
Lot Line Waiver Distance: 21
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)
I
Permit/Rush Fees: Waiver Fees:
Date of Payment: i �'%� Date of Payment: (0
Receipt Number: Receipt Number: QV
Permit No. o S P06 1180 Waiver No. OSy 961650
Permit App_.:- : c
COVID-19
�� ^'gCOUNT APPLIED
PO BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 (FAX)
June 25, 2020
MOA Development Services Department
On-Site Water & Wastewater Program
4700 Elmore Rd
Anchorage, AK 99507
Subject: Thomas L. Boyle, Block 2, Lot 2B – 12040 Cange Road
Septic System Design
Dear On-Site Services Engineer:
The existing septic system on the subject lot has failed and must be replaced. We are submitting
this permit application for the replacement and upgrade of the septic system to serve a four-
bedroom home. The attached site plan identifies the location of the home and the existing well
and existing and proposed septic system sites.
The new absorption bed will be constructed at the location of the existing bed. The existing bed
will be demolished and all contaminated materials will be disposed in accordance with
Municipal Code. The existing septic system has been in place for more than 18 years. It is
anticipated the upper sand layer has now become plugged and matted and will not allow effluent
to pass to the underlying soils.
No conflicts exist between this proposed system and any other well or septic system on this or
adjacent lots. The ground surface on the lot is virtually flat with no slopes greater than 25%
within 50’ of the proposed absorption bed.
The proposed absorption bed will be within 3’ of the south property line similar to the location of
the existing bed and 5’ from the east property line to provide sufficient separation from the
absorption trench abandoned on the lot in 1987. Little area is available on the lot for the upgrade
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP201180, Deb Wockenfuss, 07/02/20
so the new bed will be constructed at this location. A new lot line waiver is required with the
new absorption system. Underlying soils in the area are good with percolation rates less than 5
minutes per inch. Little or no migration of effluent is expected. We request a lot line waiver be
issued allowing the proposed bed to be within 3’ of the south lot line and 5’ from the east lot
line.
Wells on this and adjacent lots are shown. The new septic tank will be a minimum of 100’ from
the well on this lot and 100’ from all wells on adjacent lots and surface water The tank will be
10’ from the house foundation and 5’ from deck and stair supports.
Please refer to the attached plan sheet for the septic design. If this design is followed, there will
be no adverse impacts to adjacent properties.
Sincerely,
Michael E. Anderson, P.E.
7/2/20
THOMAS L BOYLE, BLOCK 2 LOT 2B Low J
J
/
1
I
WIRE FENCE
DILA
J
/ I
l
LOT O I
NEW 1,500 GALLON TRENCHES ABA ONED IN1993. .
S.T. E. P. TANK
SUBDRAIN
OUTFALL LOT 2B _ -
i -`THREE BEDROO
HO
RA N
LOT 1B SHED \
EXISTING 1,250 GALLON E
S.T. E.P. TANK. DISPOSE
PER MOA CODE.
APPROXIMATE WETLAND /
BOUNDARY. NO IMPACT ® /
'EASEII� ON PROPOSED SEPTIC
LECTRIC SYSTEM. SHED
EASEMENT .725, PG. 989)
EXISTING WELL SHED
TE ABANDONEDIN1987. REMO L SEWER
— / RACK A PIPING TO WATER TABL D ACKFILL
\ WITH S WIT PROP SED BED.
J
MMH\MHINSIJ/ATION O
E I NDER DRII
JU
EN FENCE
REMOVE EXISTING 18' WIDE x 36'LONG
\ ABSORPTION BED WITH ALL CONTAMINATED /
SOIL. DISPOSE IN ACCORDANCE ITH /
/ 'MUNICIPAL CODE. PLACE NEW 18' WID x 47'
\ LONG ABSORPTIO BED. /
LOT 4A 1� EXISTING ABSORPTION
/I BED
LOT 3A /
NOTE:
r` .11LGE NO SLOPES >25% WITHIN 59 OR SU�FACE WATER WITHIN 100' OF THE
�-' ENG 1 N ! E R I N G PROPOSED SEPTIC SYSTE NO CONFLICT WITH PREVIOUSLY
%�®®>s_ PLACED ABSORPTION TRENCHES ON LOT.
ALL WELLS ON SURROUNDING LOTS WITH IMPACTS TO THIS
PROPERTY ARE SHOWN. NO CONFLICTS WITH WELLS OR SEPTIC
SYSTEMS.
0 50 100
FEET
1"=50'
LEGEND
CO - CLEANOUT
2CO - DOUBLE CLEANOUT
FCO - FOUNDATION CLEANOUT
FS - FLOW SPLITTER VALVE
MH - MANHOLE
MT - MONITORING TUBE
SV - SEPTIC VENT
TH - TEST HOLE
THOMAS L. BOYE, BLOCK
2, OT 2 C~0
'
Fl��|���J����T(���� ����7-�0YREQUIREMENTS.-
600
��lU|���N�yJT�-
��`_��.�^.` FACTORS: `^� . ~^. `^^. ~^ . ^^ . `_.". . ~^_=^`^.. ~^-=^_.~ . ~�.
G0OGPOPEAKFLOVV 18'VNDEx48'LONGABSORPTION BED
PERK RATE: 2K8|N/|N 1.5OO-GALST.E.P.TANK
APPLICATION RATE:.7GPD/SF W1.O./\.APPROVED SAND
600 GPD /.7 GPD/SF /18'WIDE = 47.6 LF LENGTH REQUIRED (48 LF SPECIFIED)
BOTTOM OFBED: 7BELOVVGRADE
FLOW LINE ELEVATION: 35 BELOVVGRADE
TOP OFBEO:.5'ABOVEGRADE
,�,,",""°','"=,°`'""",`'L-,,`L- LX,L-,�"��
3' 6' 6' 3'
'ROUND
TILE FABRIC
RANF|ELDROCK
RATED PVC
)OWN)
�\METERHOLES PER
NOTE:
REMOVE EXISTING ABSORPTION BED TOUNDERLYING CLEAN
UNCONTAMINATED SOIL. REPLACE WITH TYPE 11AMATERIAL TDWITHIN 2'
OFTHE BOTTOM OF BED. BACKFILL REMAINING 2'VV|THMOA APPROVED
SAND. REMOVE EXISTING ABSORPTION TRENCH PIPING AND SEPTIC ROCK
TDVVATEF(TABLE. BACKFILL WITH TYPE ||ATOWITHIN 2'8FTHE BOTTOM
OFBEO. BACKFILL REMAINING 2'VV|THMOA APPROVED SAND. BDTT{}M{}F
BED TO8E8'A8OVEWATER TABLE AGOF7/2O/2O.
TYPICAL TRENCH SECTION
(NO SCALE)
NOTES:
1. GRADE AREA OVER TRENCH TODRAIN AWAY
2. PROVIDE 3'DFCOVER OVER TRENCHES AND 4'{}VERSEPTIC TANK, DR2'MICHAEL E. A
WITH 2"OFINSULATIONp No. CE -43811p
3. CHECK GROUNDWATER ATTIME OFCONSTRUCTION. |FLEVEL |QHIGHER 7/2012020
'
THAN PREV|{)UGLYOBSERVED, CALL ENGINEER |K8K�EO|ATELY 044.�2F5\_�~
2.5'x5.5'
I I
Lot 1 A Lot 2A 50.0' _
rWIRE FENCE
N 89'59'E 280'
N
O
SEPTIC PIPES
Lot 2B MANHOLE
46,200 S.F. / J RETAINING WALL
Q
/ wo D
W 7o.a'
Z Z
172.2' N
m m
Lot 18 'ASPHALT PIT
ORP."rSEPTIC
� 20.3'x16.3' SHED I 82'x8.2' SHED / r,11
RAMP WOODEN1273.0' BARN7Da, jFENCEjT�WELL=�PROTEg
10' CHUGACH /
ELECTRIC EASEMENT :2.2"x10.2' SHED /
(BK. 725, PG. 989) w/ RAMP
S 89'59'W 280' /
Lot 4A \ Lot 3A / I
PLOT PLAN ___ AS BUILT _X_ SCALE _1= 50__ GRID _ SW 2734__ Project No.
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, in c . (907) 522-6476 Phone 00000p0O
(907) 522-4625 Fax oQ
Professional Land Surveyors kenOlongsurvey.com o (� �F.q.�9�40
jonathan®Iangsurvey.com O S
I hereby certify that 1 have surveyed the following described property: 0 P DO
LOT 28, BLOCK 2, BOYLE SUBDIVISION (PLAT No. P-24413) 0 LOT
Anchorage Recording District, Alaska, and that the improvements situated thereon are 0' " • •' """""'�
within the property lines and do not encroach onto the property adjacent thereto, that
no improvements on the property lying adjacent thereto encroach on the surveyed �'.".;'KENN H..011111LANG oG
premises and that there are no roadways, transmission lines or other visible
easements on said property except as indicated hereon. 00 s�'•..
j{ P '.LS 202.-` gJp�
Dated this the _ '�___ Day of ___�1�r�<<-________- — �-u�-o _, at Anchorage, Alaska 0 �a Ngo
---- 40oRaFESS10NAl 00
It is the responsibility of the owner to determine the existence of any easements, �4ppp000
covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963
30.3
HOUSE
DETAIL
2.1' CANT
Scale:
1" = 30'
DECK
W
U
r o
D-' Z M
w
5.8'x13.9'
w a
N
PORCH
o
(n
ry W
G:
2.5'x5.5'
I I
Lot 1 A Lot 2A 50.0' _
rWIRE FENCE
N 89'59'E 280'
N
O
SEPTIC PIPES
Lot 2B MANHOLE
46,200 S.F. / J RETAINING WALL
Q
/ wo D
W 7o.a'
Z Z
172.2' N
m m
Lot 18 'ASPHALT PIT
ORP."rSEPTIC
� 20.3'x16.3' SHED I 82'x8.2' SHED / r,11
RAMP WOODEN1273.0' BARN7Da, jFENCEjT�WELL=�PROTEg
10' CHUGACH /
ELECTRIC EASEMENT :2.2"x10.2' SHED /
(BK. 725, PG. 989) w/ RAMP
S 89'59'W 280' /
Lot 4A \ Lot 3A / I
PLOT PLAN ___ AS BUILT _X_ SCALE _1= 50__ GRID _ SW 2734__ Project No.
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, in c . (907) 522-6476 Phone 00000p0O
(907) 522-4625 Fax oQ
Professional Land Surveyors kenOlongsurvey.com o (� �F.q.�9�40
jonathan®Iangsurvey.com O S
I hereby certify that 1 have surveyed the following described property: 0 P DO
LOT 28, BLOCK 2, BOYLE SUBDIVISION (PLAT No. P-24413) 0 LOT
Anchorage Recording District, Alaska, and that the improvements situated thereon are 0' " • •' """""'�
within the property lines and do not encroach onto the property adjacent thereto, that
no improvements on the property lying adjacent thereto encroach on the surveyed �'.".;'KENN H..011111LANG oG
premises and that there are no roadways, transmission lines or other visible
easements on said property except as indicated hereon. 00 s�'•..
j{ P '.LS 202.-` gJp�
Dated this the _ '�___ Day of ___�1�r�<<-________- — �-u�-o _, at Anchorage, Alaska 0 �a Ngo
---- 40oRaFESS10NAl 00
It is the responsibility of the owner to determine the existence of any easements, �4ppp000
covenants, or restrictions which do not appear on the recorded subdivision plat. AECC963
Municipality of Anchorage Page 1 of 3
Development Services Department
On-Site 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: SW020400 PID Number: 015-282-08
Name:
Steve Armbrust
Wastewater System: Upgrade
Address:
12040 Can a Street Anch., AK 99516
ABSORPTION FIELD
Phone: Number of Bedrooms:
Raised Bed
345-1900 Three 3
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade:
7
.8 GPD/Ft2
Ft.
Block: Lot: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe:
2 213 Thomas L. Boyle
1 Ft_
.5 Ft.
Township: Range: Section:
Fill added above original grade:
Gravel Length:
2.5-3 Ft.
36 Ft.
Well: Existing
Gravel width:
18
Number of lines:
3
Distance between lines:
6
Ft.
Ft.
Classification (Private, A, B, C):
Total Depth:
Cased to:
Total absorption area:
Pipe Material:
Private
Ft.
Ft.
648 Ft=
ASTM D3034 PVC
Driller:
Date Drilled:
Static Water Level:
Installer:
Date Installed:
A Plus
10/18-19/02
Ft.
Yield:
Pump Set at:
Casing eight Above Ground:
TANK— EXISTING STEP
GPM
Ft.
Ft.
SEPARATION DISTANCES
anu ac urer: Capacity in Gallons:
Anchorage Tank 19250
To
Septic
Absorption
Lift
Holding
ublic/Private
Material: Number of Compartments:
From
Tank
Field
Station
Tank
Sewer Line
Steel Three (3)
Well
>100'
>100'
>100'
N/A
>25'
LIFT STATION - EXISTING
Surface Water
>100'
>100'
>100'
N/A
blZ
250
ua u .
Anchorage Tank
Gal.
>5'
7'
>10'
N/A
`Pump on' level at:
`Pump off" evel at: High water alarm at:
LetL�ne
42 in.
42in. 44in.
> 5'
> 10'
> 10'
N/A
Pump Make & Model
Electrical Inspections performed by
Foundation
0 r e n co
Curtain Drain
None
Noted
BENCH MARK
Remarks:
Location and Description:
Existing Absorption Bed Completely Rebuilt.
Top of Pavement at Stairway Leading to Front
Entrance.
Contaminated Material Removed to Virgin Ground.
Assumed Elevation:
Contaminated Material Disposed On Site.
100.0 Ft.
Lot Line Waiver Issued 10/9/02
.•'�E OF
\
ff 49thDates:
Inspections performed by: MEA 110/18/02
..... ....`.�.�,.
'
2"d 10/19/02
........................•..
' MICHAEL E. ANDERSON• Awl
Department of Health and Human Services approval
�♦�J, ho CE-4381 rJ =
Reviewed and approved by: Gl) Date: /9
#i ......
�O PR�FESS�������
cv
(R. 10199)
111
r' e
Municipality of Anchorage Page 2 of 3
DEVELOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK 99519-6650 -343-7904
Onsite Wastewater Disposal System or Well Inspection Report
Permit Number SW020400 PID No. 015-282-08
• I ! I I I_'_�� � 1 � yI���f I I ! � I i _.J i i i I I ' i
1 1 I ( I
p Aj IL-t-Z.- - ALO Io I I A C
IlTio L' I 119
...-- - -- M1 63.8 1
- �- ' M2 00. 149.6
�L ! ! �•j{ ! I 1 I '
C
y Three Bedroom ' _—� . ' _....--•__-- _-- ---
-- f Home f
---....�- I-- - -----•---..-_......__.1-- - Ole - �-------�-
CIF
WCHAFL r. ANDERSON 14 I
PLAN AS-BUILT-
�♦ No. Cr-.381
f r
/-=--'-- SCALE I"= 30' • ♦1i4.91*4'•
Municipality of Anchorage Page 3 of 3
DEVELOPMENT SERVICES DEPARTMENT
4700 South Bragaw Street Anchorage, AK 99519-6650 - 343-7904
Onsite Wastewater Disposal System or Well Inspection Report
Permit Number SW020400 PID No. 015-282-08
EXISTING
s -
1-11L—T
—
;,r�r CoarseG
Sand
17 1L. I ! —-Elevations
i
Top of Sand - 104.6
Top of Gravel 105.8
NdTE: ExiS_ting_Absorption BedReconstructed.
in Existing Location." _ Contami'nated-- Top of Mound 109.1
Material Removed From Bed Location and TBM - Pavement Fronting
Buried On Site. No Other Work Completed Steps-@ Front
Under This Permit. Entrance - 100.0
PROFILE AS -BUILT
1" =10' VERTICAL
I"= 30' HORIZONTAL
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water& Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SW020400
Legal Description: THOMAS L BOYLE BLK 2 LT 2B
lD// g eo:'o`
IDIMe3fVA
Date Issued: Oct 09, 2002
Expiration Date: Oct 09, 2003
Parcel ID: 015-282-08
Design Engineer: 0014 Anderson Engineering Site Address: 012040 CANGE ST
Owner Name: Steve Armbrust Lot Size: 46200 SO. FT.
Owner Address: 12040 CANGE STREET Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE. AK 99516-2031
This permit is for the construction of:
❑ Disposal Field ❑ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 (24 hours). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date:
a Date: U U Z
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. 015.282.08 Permit Number SWOZ on
Property owner(s) Steve Armbrust Day phone 345.1900
Mailing address (1)12040 Cange Street Anchorage, AK 99516
Mailing address (2) Zip Code
Legal description (Lot, Block & Sub'd.) Lot 28, Block Z eav*SobdiWaien 7 how4_,, L . Rtyle-
Legal description (Section, Township & Range)
Lot Size46,200 SF Acres/Sq.Ft. Number of Bedrooms Three (3)
THIS APPLICATION IS FOR:
Sewer Only ❑ Well Only ❑
Sewer and Well ❑ Water Storage ❑
Sewer Upgrade
THIS PROPERTY CONTAINS:
Hot Tub ❑ Jacuzzi ❑
Swimming Pool ❑ Water Softening Unit ❑
Therapy Pool ❑
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: P lldCO • " Waiver Fees:
Date of Payment:
/O- 44 -OL
Date of Payment: /D -'/-o of
Receipt Number: Receipt Number: r!o sy
(Rev. 12/00)
(O �aaonl �l
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 (FAX)
October 4, 2002
Municipality of Anchorage f
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 213, Block 2, Boyle Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer.
The absorption bed on Lot 213, Block 2, Boyle Subdivision has failed. It was originally
constructed in 1993 and replaced in 1996. Unfortunately, no other location on the lot is
available for an upgrade so it must again be replaced in the same location. The
attached Site Plan and backup documentation identify the location and configuration of
the new absorption bed and the parameters used in the design. Also identified on the
plans are the well on the lot, test hole location, subsurface drain system and facilities on
adjacent lots. This design is identical to that approved in June of 1996.
The existing bed will be constructed in its entirety. All contamination and biomatted
material will be removed and disposed in accordance with State and Municipal
requirements. Clean coarse sand will then be hauled to the site to reconstruct the
absorption bed. Test Hole information indicates silty sand and silt to a depth of 7'
below the surface. This material is underlain by clean well graded sand with a
percolation rate of 2 minutes per inch. The water table was found at 12.5' below the
surface on May 15, 1993 and remained at that elevation throughout the monitoring
period. The bed will be constructed atop the clean sand layer with the distribution
piping nearly 5.5' above this level to provide sufficient separation from groundwater,
which is known to be shallow in the area.
The ground surface on the lot slopes at shallow grades from east to west. The
absorption trench will be constructed parallel with the slope as much as possible in
conformance with Municipal requirements. All components of the new septic system
will be constructed a minimum of 100' from the well on the lot and on the adjacent lot.
The system will also be constructed a minimum of 100' from any surface water in the
area.
If the system is constructed in accordance with our design the following statements
apply:
Lot 26, Block 2, Boyle Subdivision
October 4, 2002
Page Two
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.
2.
3. 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.
4. 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.
5. 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,
EOV4 -
Michael E. Anderson, P.E.
Attachments
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VICMAEL E. ANDERSON
k, No. CE -+191 j
,DEBT �, zDa
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*MEET NO. OF
CALCULATED By A. y DATE B Yz qs
CHECKED aY DATE
Nmpp1&Y� tF IY NDI
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Legal Description: Lot 2B Block 2, Boyle Sub. PID No.:
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SITE PLAN -002y,
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MICHAEL •E. ANDERSON ,..'
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Remove and Dispose of All
- Material to Clean Material
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As Follows:
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ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 (FAX)
October 4, 2002
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
P.O. Box 196650
Anchorage, AK 99519-6650
Subject: Lot 2B, Block 2, Boyle Subdivision
Separation Distance Waiver
Absorption Bed to Lot Line
Dear On Site Services Engineer.
The drainfield on Lot 213, Block 2, Boyle Subdivision was placed as close to the
southern lot line as possible to provide a 50' separation required from the subsurface
drain system. Placement of the drainfield at this location will have no impact on the well
or septic system located on the adjacent lot. The field will not encroach into the 100'
separation radius from the well located on the lot nor will it affect the septic system
which is located more than 100' away. Furthermore, no utility easement exists along
this lot line to conflict with the drainfield.
A waiver was previously issued for this location in September of 1993. The system will
be reconstructed in the same location as previously approved then. We therefore
request a lot line waiver be issued allowing placement of the absorption bed within 7' of
the lot line.
Sincerely,
Michael E. Anderson, P.E.
L
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i 49th
WLNAEL E. ANDERSON
% No, CE -4381 j
George 1. 11'uerch,
Mayor
10/9/2002
Anchorage
DZunieipality of Aneliorage k a AA
All -America City
Building Safety Division III I lar
2002
Michael E. Anderson, P.E.
Anderson Engineering
PO Box 240773
Anchorage, AK 99524
Subject: Waiver Request for Thomas L. Boyle Block 2 Lot 2B
Waiver Request #WR020074
Parcel ID 4015-282-08
Dear Mr. Anderson:
fr
Your request for a waiver of the required 10 feet horizontal separation from the
absorption field to property line has been approved. The approved separation distance is
7.0 feet.
This waiver approval applies to the existing absorption field to property line separation
only. Any future upgrade to the on-site wastewater disposal system will require all
separation distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
Daniel J. Ro
Civil Engineer
On -Site Water & Wastewater Program
P.O. Box 19fY050 • Anclhorage, Alaslai 99519-66550 • Telephone: (907) 343.8301 • Fax: (907) 3.13-5200
4700 South Brig= Strcel • Anchorage, Alaska 90007
lit ryh://a���c.ci.hnhchohngr.tticus
Municipality of Anchorage
Development Services Department
� Building Safety Division
On -Site Water and Wastewater Program
4700 Bmgaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
Waiver Review Worksheet
WR#: WR020074 PID#:015-282-08 HA#:
Date Received: 1014102
Legal Description: Thomas L. BovieBlock 2 Lot 2B
Engineer. Michael E. Anderson. P.E.
Anderson Ennineertna
Applicant: Steve Armbrust
Waiver Requested: 7 feet from absorption field to Drooertv line
Criteria: Geology
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
Permit#:
Points:
Waiver is Granted: X Waiver is not Granted:
List Conditions or Reasons for above: 5V37 -e.44, O E IAI & u ,P6R,4pFV
7 * Fpaom L xtAA,&#_= R a+" /0-1 No /H PACT- to 9&r
5UXR0UW,01#V& OR ROJo/Ai/•.(� f�/2dPEllT/FS
Date: 10 9/O2 By: OAA/
Name of Reviewer
...................■............................... as*... ease.................,
Rec#: 26649 Amount: $150.00 Date Paid: 10/7/2002
Municipality of Anchorage Page of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: s1'ki9lopo2 .F3 PID Number: O1r282t9E,
Name Wastewater System: 0 New VJpgrade
7�N�, �l�rN1� V��-��/� y
Address: _~
1204-o G46c.\16i Re ABSORPTION FIELD
Phone No of Bedrooms
✓2 El Deep Trench C Shallow Trench Bed O Mound ❑Other
LEGAL DESCRIPTION Soil Rating:
4 GPD/Sq Ft Total Depu,from original grade 1
I- J.;
Lot „./„. Block 2/ Subd�vis�on_ Depth to pipe bolt om from ong;nai grade Gravel ueptn beneath pipe M
TllJ)I/ILfti/ fi ,I Ft , ' i=s
Township Range. Section. Fill added above original grad Gravel length.
3i. Ft a4, Ft
G�Y�L,/� O New O Upgrade Gravel width Q Number of lines Dista,Ice between lines
WELL: /V JrV'
IF' Ft 3 6 Ft
Classificatior (Private.A,B.C). Total Depth: Cased To. Total absorption area/ �! e material
(IVA'f/ Ft Ft L ' r F' SO H fir/ 5C-1< a1,r.- 4Q
Drill Date Drilled Static Water Level Insta er Dat mstai ed
Neff'' 7rJ ,ml 1,1 Ft '+ Fame#iIM *1 .IDip
Yield. ump Set at Casing Height Above Ground
(o.5GPM UNKN Ft Z Ft TANK
SEPARATION DISTANCES Septic C Holding V.T E P
To SepI c Absorption Litt Hording -atrill Pnvate M nufactu^reerr 'IfA Capacity in gallons.
From Tank Field Station Tank Sewer Lines t`�.�16” IKW( 1150
10
r e 1 01 r 10O 1 Materials' I { Number of Compartments:
Well tee
SWaere ?I1/5 'I�io --0 / >I,K' LIFT STATION
Lot // 1 r le 1 Size in gallons M ulacturer
�
Line 7% 1 1./ �J� _ 41 /oo
n 1 , "Pump on"level at. "Pump off"level at High water alarm at
Foundation la
� I O if
I,I LII I, q�n
Curtain I�/ �O1 11�f Pump Make&Model Electrical Inspections performed by
Drain LI} pl �60
,
Remarks: trim ,7l.lnkf .I5 NmodU GO BENCH MARK
�
Location and Description 1 20 Osl 05 4N - C s'..ki� jo-Ker,j s iia
Assumed Elevation
J00% Ft
ENGINEER'S SEAL
Inspections performed by: 41- Dates: 1st_ 1?•PIUD >,
2nd 5 57 t�
t"• ,„:. . . ' tvulorsan <<tl
''$d,*1 433-E �.er `6
Department of Healt. and Human Services approval
Reviewed and approved by: /GG ,� /� Date: S 3/ �� i, da �
72-013{Rev 9.'911 MOA 25
Permit No. Page of
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: PID No.:
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Permit No. Page of
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Legal Description: PID No.:
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PAGE 1 OF 1
1m
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650 , 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519 -6650
ON- SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER: SW960088 DATE ISSUED: 5/24/96
DESIGN ENGINEER:ANDERSON ENGINEERING EXPIRATION DATE: 5/24/97
OWNER NAME:WEAVER JOHN D & CATHY J
OWNER ADDRESS : 12040 CANGE ST
ANCHORAGE, ALASKA 99516
PARCEL ID: 01528208
LEGAL DESCRIPTION:
BOYLE BLK 2 LT 2B
LOT SIZE: 46200 (SQ. FT. )
NUMBER OF BEDROOMS : 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD SYSTEM
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 343 -4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT)
4 . FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5 . THE FOLLOWING SPECIAL PROVISIONS .
SPECIAL PROVISIONS :
RECEIVED BY: /yIA/ldA.t.C, E. DATE: 512'4 ) Q6
ISSUED BY: 2%42 DATE: 2 1 - /(o
•
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
563-7155 563-5389 (FAX)
May 24, 1996
Municipality of Anchorage
Department of Heath & Human Services
825 "L" Street
Anchorage, AK 99502-0650
Subject: Lot 2B, Block 3, Boyle Subdivision
Septic System Design
Impacts to Adjacent Properties
Dear On Site Services Engineer:
The absorption bed on the subject lot is currently in a state of failure. Recent excavation
into the bed indicates the sand utilized during construction to elevate the bed has
completely plugged with biological material to a depth of approximately 3". The sand
material below the matting is dry. Effluent, however, cannot pass through the matting t o
the absorptive layer below. We are therefore proposing to remove the matted sand and all
remaining sand in the bed and replace it with Municipality approved Lake Otis Gravel. The
septic rock and distribution piping will be replaced in the same configuration as i t
currently exists.
1 . The system, if constructed as designed, will have no adverse impact on the community
well in the area.
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 reserved
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, +�
74-atm sr •
Michael E. Anderson, P.E. G� _ _�•�
A� S4 t`.
MUNICIPALITY OF ANCHOwaVt ^cr',`�+w_i,a 4C. ,. >^••
Attachments ENVIRONMENTAL SERVICES DIVISION 3tll E
3
1996 �n��'
RECEIVED
JOB I,2,43 152 Boni-g .
ROCKFORD CORPORATION SHEET NO.
Of •
P.O. Box 111706
ANCHORAGE, ALASKA 99511 CALCULATED BY DATE
(907) 344-4551 CHECKED BY
., FAX (907) 344.2130 DATE
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Municipality of Anchorage Page / of s�
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: 5kI 93.9302 PID Number: GSI 1.8ZOr
Name (krIG,I 717,6.w. Wastewater System: ❑ New Upgrade
Address: ABSORPTION FIELD
12 040 !iAcNGt�. ISD•
Phone 341.03-1
I No of Bedrooms
$ 0 Deep Trench 0 Shallow TrenchBed 0 Mound 0 Other
t
Total De
Soil Rating. o from originalrade:
LEGAL DESCRIPTION I,2Ir J 1V g
GPD�Sq Ft
Lot 2 , Block: 7./.
Subdivision Depth to pipe bon.m from original grade Gravel ueput beneath pipe
►yii(!- .5-I Ft L-t. IntAlt4 .
Township. Range: Section Fill added fbove original grade: Gravel length /
2/y Ft 32 ✓ Ft_
WELL: 0 New 0Upgrade Gravel math / Number of lines Distance betseen Ines
�)51�. Ie, '/ Ft 3 L. Ft
Ctasstttcatto (Private,A,B,C): Total Depth: Cased To Total absorption area PipeGmaterial
1 r/
6VA'e/ Ft Ft ;76 SO Ft Sul uul,� 4o
Drill IDaIeDr
illed: Static Water Level Insla 1 r / Date nstalled 1
HtHy V7riIIll _ 1/I Ft W It ? l Nb thI _ , Zro/LIti23`c)
Yield Pump Set at: Casing Height Above Ground TANK
{p GPM I 4NKN Ft Z Ft
SEPARATION DISTANCES G Septic ❑Holding V/s.T.E.P.
To Septic Absorption Lilt riota.ng -fe,prwePneate M nutacturer�� Capacity(i ri gallons.
From Tank Field Station Tank Sewer Lines 1 ' i • � K I Z- c7
Well l cl e -1177' 101r I
Material Number of Compartments:
tive kl _
WaerSe ?I1.5� 'IraO ?:11/(/ >I'K' LIFT STATION
Lot �`I 1 1 Size in gallons M +utacturer
Line 77 7r 1/5 r 1/5 390 �1 Gf P. k_iaKPALO
Foundation 1/�1 �r r IOr "Pump on"level at 'Pump off'level at Nigh water alarm at
G/ % i}l' _ __- 4 t_r�__ _ -45' - __
Curtain ��/ / / ,t 91 Pump Mace(1 Moe, Electrics&Inspections performed by
Drain �fjt/// {1{ �,1`�GO 11
Remarks: Gf i1it1 ruhr is 061.1t0 mule BENCH--MARK
Location and Description.
20 Cil of 144 — jeagi� 6idb
4o-/- //4e /./....V/ke-6.— W//.... 113 e6Sg
f// /�� I Assumed Elevation
t
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ENGINEER'S SEAL.
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Inspections performed by: � Poe19TD3 mp_ ` '
Dates: 1s .y0to°ea. 00.2t..9 ....•••0
2nd $j 23 °� a..e ...
`r `Michael E. Anderson �+�
Department of Hea a d Hu n- -•err�ices appro al �1)s,•. X81 E ,toile
Reviewed and approved b , '/, Date: / 97=3 `.�'°,,oFESS10®�
1 ..
12-0t3(Rev 9/91)MOA 25
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Municipality of Anchorage Page of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: 93030, PID Number: OI572n/(1%'
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Municipality of Anchorage Page -'-: of '----
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: `44 930 3o, PID Number: 0152,52-06
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Municipality of Anchorage Page ' of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
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Municipality of Anchorage ,---Page - of S
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: $.A,/ )30 309 PID Number: 0152,1!)20£5
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PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650 , 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW930309 DATE ISSUED: 8/19/93
DESIGN ENGINEER:ANDERSON ENGINEERING EXPIRATION DATE: 8/19/94
OWNER NAME:EDGELL JEFF
OWNER ADDRESS: 12040 CANGE ST
ANCHORAGE, AK 99516
PARCEL ID: 01528208
LEGAL DESCRIPTION: BOYLE BLK 2 LT 2B
LOT SIZE: 46200 (SQ. FT. )
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK SYSTEM
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 343-4329 OR 343-4681 AFTER BUSINESS HOURS
4 . FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5 . THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
THE SAND USED IN THE FILTER LAYER MUST BE A COARSE CLEAN
SAND WITH 4% OR LESS PASSING A #100 SIEVE AND 2% OR LESS
PASSING A #200 SIEVE. A SIEVE ANALYSIS MUST BE PROVIDED TO
THIS DEPARTMENT ON SAND USED.
RECEIVED BY: Z4ifi-7/
DATE: / /93
ISSUED BY: Alga VII2A1DATE: /q3
/c5eIV/7- G /" '7/0/0
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, ALASKA 99524
August 12, 1993
Municipality of Anchorage
Department of Heath & Human Services
825 "L" Street
Anchorage, AK 99502-0650
Subject: Lot 2B, Block 2, Boyle Subdivision
Septic System Design
Impacts to Adjacent Properties
Dear On Site Services Engineer:
The septic system on the subject lot was constructed four years ago prior to the
shutdown of the C.A.U. wells on the hillside. Since that time the water table has risen
and flooded the system requiring an upgrade. A subdrain was installed as an attempt
to lower the water table and salvage the system, but to no avail. All remaining areas
of the lot have been explored for the combination of acceptable soils and a sufficiently
low water table. Only the area in the southeast corner of the lot appears suitable. At
the time of the exploration and testing the water table in this area was found at 12'.
The system has been designed, however, to function with a much higher water level.
All material will be removed to the coarse sand layer and replaced with a similar
coarse sand. The drainfield rock and pressure distribution system will be placed at
the elevation shown on the drawings.
If the system is constructed in accordance with the attached design the following
statements can be made:
1. The system, if constructed as designed, will have no adverse impact on the wells
currently in use or those to be constructed in the future.
2. The system, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The system, if constructed as designed, will have no adverse impact on reserved
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.
�► O
Sincerely, .Az'o •e..... °,'.4� 1
it E
etal
Michael E. Anderson, P.E. d t••.•v•• CGnd : ®
0 ••Michael E. Anderson
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Street,et, A cho age, Alaska 99502-0650 SERVICES •
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14 —, Reading Date Gross Net Depth to Net
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COMMENTS Moruife/r ILt,e, fib., 12?e,(d. an, 1 1_5195 ki!' it .,b / .2t 14 L21\- 7J3 93
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ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE. o/'L�y3
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Come N 4 ,-,.L-t S/ Sy-EM Pv m P CuK.v v 5 HbuJS 771-t . A V M P &l ik. /4c-CTIA Lt,/ . i
OF rn.arcT . R T' ti 3 0 a.6 PM L-4 -rux- No 51Avn/G 'S o .
Nii •
unic,�pality o! Anchirage � �,.�
�} Department of Health and Human Services •
Tom Fink, 825 "L" Street
Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
September 10, 1993
Michael E. Anderson, P.E.
Anderson Engineering
PO Box 240773
Anchorage, Alaska 99524
Subject: Waiver Request for Lot 2B Block 2 Boyle Subdivision
Waiver Request #WR930058, PID #015-282-08, HA930528
Dear Mr. Anderson:
Your request for waiver of the required 10 foot separation
between a septic system and a lot line has been approved. The
waived distance is 6 feet.
This approval applies to the existing septic system lot line
separation only. Any future upgrade to the septic system will
require all separations be met or another approval from this
department.
Si �r ere ,
Robert W. Robinson
Civil Engineer
On-site Services
ljw#7
, MUNICIPALITY OF ANCHORAGE
. Department of Health and Human Services
On-site Services Section
Waiver Review Worksheet
WR# WR930058 PID# 015-282-08 HA# HA930528 Permit #
Date Received: September 8, 1993
Legal Description: Lot 2B Block 2 Boyle Subdivision
Engineer: Michael E. Anderson, P.E. , Anderson Engineering
PO Box 240773, Anchorage, Alaska 99524
Applicant: Jeff Edgell
******
Waiver Requested: Lot line waiver oflfeet
"it
Criteria: 1 . Geology: Points :
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
TOTAL:
2 . Special Conditions :
3 . Other:
X:
******
Waiver is Granted: Waiver is NOT Granted: /
List Conditions or Reasons for above: /4/c..( /s ..77,0 QcZe
.7, Ge-di i0-7 -am ! l2/ Gr (.c�/,G ),;2 ►,- /62).. a 4 6C.) r .r a/ i• G O
... i /
% / c
Date: , BY: �..�1�. .. !r _
ame of Revie er
******
Rec #: 25120/9956 Amount: $ 115. 00 Date Paid: Sept 8, 1993
mm
ANDERSON ENGINEERING v, zz n-
P.O. BOX 240773 n o
ANCHORAGE, ALASKA 99524 rn °
cp (4,,
LO ?
September 6, 1993 rn w
C7 c
Municipality of Anchorage o
Department of Heath & Human Services Z
825 "L" Street ebb
Anchorage, AK 99502-0650 S_ aA a -®CS
Attention: Robbie Robinson lJ aq sO Sad
Subject: Lot 2B, Block 2, Boyle Subdivision
Septic System As-Built
Lot Line Waiver
Dear Robbie:
The drainfield on the subject lot was placed as close to the southern lot line
as necessary to provide the 50' separation distance required from the
subsurface drain system. Placement of the drainfield at this location will
have no impact on the well or septic system located on the adjacent lot.
The field will not encroach into the 100' separation radius from the well
located on that lot nor will it affect the septic system which is located more
than 100' away. Furthermore, no utility or any other easement exists
along this lot line to conflict with the drainfield.
For the aforementioned reasons we respectfully request a separation
distance waiver be granted to allow the field to be placed closer than 10'
from the southern lot line. Please advise if you need additional
information or have further questions.
Sincerely,
-04x1A-041- oF 414. Atl
g� */4
Michael E. Anderson, P.E. •� •aoo ..n ° ••••
0..0 sosoom•
VAMichael E. Anderson
s�,
° 4381.E :.4,4100`�9 Q••..•N,°°.a•eF��
'!, '°AOFESS10N'4PIP
aS-0 9cc ) °o
MUNICIPALITY OF ANCHORAGE
DE 1TMENT OF HEALTH AND HUMAN SER ES
Environmental Health Division D/ S 7-8 a 0 F
825"L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name DISTANCES
4L..5xA Woos/. / JA/4/-/C C'o,e /o-v TO SEPTIC ABSORPTION
Address FROM TANK FIELD WELL
235 47 64h .,4l%E. .4/) d&,'41 , ,,Ae q9�b/
Phonels) Permit No No.of Bedrooms WELL /02 /D7
2 76-557 870221 3 LOT LINE
LEGAL DESCRIPTION 33 /JC 3g
Lot Block Subdivision '
ZB I 2 Bop-z_- FOUNDATION 5 20 `fid
Township.Range.Section
AS-BUILT DIAGRAM(Show location of well,septic system,property lines,foundation.
7'/2 A/ /g h/ 5 2/ driveway.water bodies.etc.)
TANKS N
g SEPTIC ❑ HOLDING f
Manufacturer Capacity in gallons
67RE,E,Q MOO S
Material No.of Compartments
STEEL 2
TYPE OF SYSTEM /N.,PEC,r744/
X TRENCH ❑ BED ❑ W. DRAIN ❑ OTHER 6.6"
cosIv I et, yo
Depth to pipe bottom from Total depth from original grade Z. f
original grade (a FT /0 FT 5Td1¢ _ re
//471/&4.- r- i
Fill added above original grade Gravel depth beneath pipe 4'/ 76
5 FT FT •' y,r ,
Gravel length Gravel width V5
�b -I .
FT 5 FT ��
Total absorption area /',/'/' M i Distance between lines , ��
4 7�Y SQ FT /0 FT
Number of links
wArw Soil rating Pipe material C Apt E.
2 ,.(FAP EN J15 SQ FT ASTg1 FB/O f'As/7' 78 J
''�1 5-t;c r
Installer Date Installed
DAN /y'4 (!onsr 9-2 -87 10 WELL
WELLS
XI PRIVATE ❑ OTHER (Identify)
Classification A.B.C.ITotal Depth Cased to
_ 70 FT 7D FT
Installer Date Installed.
//EFT y L7 /L L//r/L> a-/-S/ 5
REMARKS: OLD .•4/3s;',,z/'riot/ S/STF/t1
4.8.44/0o, 'E1t L/ir s 4T/oA/ ,C'EMOVED
Scale: /"=glp' •
aInsp . ,T ' 1 �
ections ertormed by
i/,F,-(/A/ -cE.:...: t�
8
/"k .• ` •• r •
•',
Date. n • � ••
Si.f/ .9 3®� mR :* THi a •Or so •• .•o •s .••. :
7
1 4ic.#4-1-1._ L `tlV I Gall(% certify that this inspection was performed according to all 9Y? ;Michael E. Anderson �rv,�
Municipal and State guidelines in effect on this date: 9/4/1 7 e •
�o 0c4 4• 4381 -E ����
I
Health Department Approval: rbi `�`�� `-0e Date -g-B 7 U�Vvre� ®��
72-013(3/85)
-t. ^
' M U N I C ��� A L I T Y O F ANC( DRAGEG E /�
Department o� Health & Human Services / ' ��`-
'
825 L Street, Anchorage, Alaska 99501 343-4720 9-A'S-7
ON - SITE SEWERPERMIT i \U��"
Lj
Permit Number : 870225 Upgrade \
/
Date Issued: 08/25/87
Owner Name: ALASKA HOUSING FINANCE CORPORATION Day Phone:
Owner Address: 235 EAST 8TH AVENUE 276-5599
ANCHORAGE, AK 99501
Parcel Id: 015-282-08
Lot Legal : Subdivision: BOYLE SUBDIVISION Lot: 28 Block: 2
Section: 21 Township: 12N Range: 3W
Lot Size 46200 (sq. [t. or acres)
Max Bedrooms: This Permit: 3 Total Capacity: J
SEWER SYSTEMS: Listed below are the options available to you in designing your
sewer system. Choose the option that best fits your site.
Depth to Pipe Bottom ({t ) :
Gravel Depth ( ft ) :
Total Depth ({t ) :
Gravel Width ([t) :
Gravel Length (ft) :
Gravel Volume (cubic yds) :
Soil Rating Used (sq ft/brm) :
LIFT STATION: If a lift station is installed, a high water alarm must be
connected to the residence.
SEPTIC TANK: Minimum total septic tank capacity: 1, 000 gallons. Each septic
tank must have at least 2 compartments. Depth to top of septic tank (s) < 4. 0
feet requires insulation over tank (s) .
INFORM D. H. H. S. PRIOR TO 1ST & 2ND INSPECTIONS BY ENGINEER
I CERTIFY THAT:
1. I am familiar with the requirements /or on-site sewers and wells as set •
forth by the Municipality of Anchorage (MOA) and the State of Alaska.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria of this permit.
3. I will adhere to all MOA and State of Alaska requirements for the set back
distances from any existing well , wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot.
4. I understand that this pe it is valid for a maximum of 3 bedrooms. I
also understand that thejtapacity of the total system is 3 bedrooms and
any enlargement will rf.Aire an additional permit.
Signed: �� DATE: m�~ ��
��
-�n ��
�� �_�� ~' -__________________ __ -�__� �� __
(Owner ) HOUSIN6 FINANCE CORPORATION
Issued By: DATE: �� - �� '�— �'�
��� ___�,�� �+� C/ � � c/^___
1057 WEST FIREWEED LANE, SUITE 230
ANCHORAGE, ALASKA 99503-1736
(907) 276-3770III
DATAFAX NO. (907) 279-5092 • 1
ANCHORAGE • JUNEAU • BETHEL • FAIRBANKS ENGINEERING, INC.
August 19 , 1987
Municipality of Anchorage
825 'L' Street
Anchorage, Alaska 99501
Subject: On-Site Wastewater Improvements, Lot 2 , Block
2B, Boyle Subdivision
Gentlemen:
This letter represents our written request to obtain permission
to install a new drain field on Lot 2 , Block 2B, Boyle Subdivi-
sion. The existing system does not currently operate as
designed and must be replaced (see attached letter dated June
22, 1987) .
Included for your review are soil logs, percolation test
results, a site plan and trench section drawings. Since the
percolation rate of the soil in the proposed drain field area
is less than 5 minutes per inch we intend to use a wide trench
disposal system. We hope this meets with your approval.
If you have any further questions, please contact me at
276-3770 .
Sincerely yours,
.74/keltAt,eMichael E. Anderson, P.E.
MEA/jb
1057 WEST FIREWEED LANE, SUITE 230
ANCHORAGE, ALASKA 99503-1736
(907) 276-3770
DATAFAX NO. (907) 279-5092 •4111104.1. 111
ANCHORAGE • JUNEAU • BETHEL • FAIRBANKS ENGINEERING, INC.
June 22 , 1987
Mr. Paul Wilson
c/o AHFC
8400 Hartzell Road
Anchorage, Alaska 99507
Subject: 12040 Cange Street
Dear Mr. Wilson:
This letter is a follow-up to our recent meeting at the subject
property and addresses improvements required to make the
wastewater system operate correctly and meet current require-
ments established by the Municipality of Anchorage for single
family residences.
The existing lift station for the sewage system is operating
incorrectly. Sewage is being pumped from the lift station, and
due to broken pipes, is surfacing and running on the ground
creating a health hazard. To correct the situation the lift
station basin needs replacement since it is not watertight and
all groundwater is being pumped into the existing drainfield.
All plumbing connections also need to be inspected and replaced
as required. This should cure the current problem at a cost of
approximately $2 ,500 . 00 . However, operation and maintenance on
the system would still exist and be the responsibility of the
new homeowner. The existing drainfield and driveway location
create a conflict of code since the driveway and turnaround are
located over the drainfield. A letter of record regarding the
system was obtained from the Municipality of Anchorage files
and is enclosed for your review. Apparently problems with the
lift station have existed for several years now.
I strongly suggest the following improvements to the system
based upon field inspection with a backhoe. These improvements
will bring the system into Municipality of Anchorage code and
make the property more saleable.
The lift station should be removed and the existing drainfield
abandoned. A new drainfield should be installed directly east
of the septic tank. It will be necessary to raise the septic
tank three feet to accommodate the drainfield. The cost
Mr. Paul Wilson
June 22 , 1987
Page 2
breakdown to design and install the new system which would
eliminate the lift station altogether is as follows:
Engineering design and inspection $ 850 .00
Municipality of Anchorage Permits 65 . 00
Materials and Construction 4 , 500 .00
$5, 415 .00
Please call me at 276-3770 if you have any questions regarding
the existing system or recommended improvements.
Yours truly,/
Wayne McFadden
WM/jb
0 SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
Q., r iv
TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG — PERCOLATION TEST
PERFORMED FOR: /L7,49e1L /A/7404/- �c4iry/ GEN7E1? DATE PERFORMED: 6 - /7-8 7
LEGAL DESCRIPTION: GDT ZB ecc,64 8c642 ee JI LE Ve.--:4) /ZD 70 C J6
SLOPE SITE PLAN
DEPTH
(FEET)
1 - OR-441J IC s ,‘
2 - _ C� y6Pri IpI
y
¢
S .(/`
a4 Pl I
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SAti1p 1 Xpd�E N6\--L - •
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6 - Iu/,eoGK-
7 - --- E)c,sr--/A/¢
/4-B,se zePr70A/
t/ s'rF 1 —37
8 -
9 -
10 - / �/ 4 /
WAS GROUND WATER S
11 - SA.m b (51A) ENCOUNTERED? r to L ��J0
12 - E �-��.
IF YES,AT WHAT
DEPTH? NOA+E 6-26-87
13 - PEA wq„v F_ fl' pDtli '
k 2f-s-7
14 --.------- Gross Net Depth to Net
eangaeTime Time mi 0 Water Drop
. r-r:��F 1%
15 :r�I�
16 f�c ..•' ~.:„�.6 'rL
.9/A
I I I 2 2 ` 7 S. /, z S I,
s. s z. s 7s
18 .•.•.•.
T �1
- �.t�Michael E. Anderson ,” 11 ,r 't
4 'ti• 4381-E : ? O /D.G Jr 2
19 - O��J� •..�•
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a��F�pAOFESS'00P.��” /ill 3 I
20 - ,i�lAA46140" '
PERCOLATION RATE 3. 5 Iminutes/inch)
TEST RUN BETWEEN JO FT AND /Z FT
COMMENTS A/O Si 6/.1 O F SEA St1114L- UJ ATF. R. TA SLE /AArK 1AJ "5A--t\1 n
PERFORMED BY:J2CF DOE/V/ 0AD2A CERTIFIED BY:�Ciali L..�i.4�1 TE: s//716/
72-008 (6/79)
rSOILS LOG
MUNICIPALITY OF ANCHORAGE
• t r, `\ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
TEST
/'j 825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERFORMED FOR: / AUG i.//GZO/V- PEI LT l CEA/7 Z DATE PERFORMED: e.0 -/9- 7
LEGAL DESCRIPTION: LOT 2 8 ECoG le 2 .60V 4E. SLIgl./ /2O 'O C..3"/6
SLOPE SITE PLAN
DEPTH
(FEET) i
1 - D,264,U/e 5
2 -
3 - _ Cl� � SES
4 -
5 - cA �� _ S/ T
w/eoCK
6 -
7 -
8 -
9 Tn #z
10 -
1 1 — S A kI.DM
(( ) WW
AS GROUND ATER 4/0L
ENCOUNTERED?
0
P
12 - E
IF YES,AT WHAT �� -2647
DEPTH? �0G
13 - PER w9✓Pe M'PADPfp
14 _- ---'` ro -17 Net Depth to Net
Reading Date Time Time Water Drop
•.�'`"`'°�rs
15 - .„IPA«O' OFX44M
...«...•••.qs, .1 / i - /9-87 a 0 '7
16 4 I'~•'f �i4t" •••�9�7
�* :49TA ti *iI 2 z,6 2.6- 5. 7$ /. 2S
` l//
17 pp•• 1I• talar• 0.••.:• �» 3 Go 3. 4.50 1,25
18 $0+;Michael E. Anderson : W AI
����J�, 4391.8 0.".
;���,/ 3 11 // 5 ,?, Z� 2 C7
19 - t F9 •..,•••... \,,ter 1 1,
-aupROFESStONa.,► Jr /�,cj 3,5 Z.5 ,7 5
2C1--
PERCOLATION
PERCOLATION RATE 7• (minutes/inch)
TEST RUN BETWEEN UFT AND /2- FT
COMMENTS Sr4/1/D U1,4 S and/$T £LdT NO T W ET
PERFORMED BY: /rJC,-(41v4)E.e,/AZ5a,4I=/4'1 - CERTIFIED BY:i4. 4.LFaliCL(.tATE: c/l9/1
72-008 (6/79)
114 • . • • PROJECT 7 Z o S
AIAMILNINAANA
LJOB NO. / SHEET OF
ENGINEERING, INC. CALCULATED BY Vet 0/04e-- DATE B - �7-A 7
ANCHORAGE • JUNEAU • BETHEL • FAIRBANKS CHECKED BY DATE
SUBJECT IZO q G4,/G�
LOT 2,5 QLOCK Z
43D y« 5 v.B.o. SCALE : I" = 4-0'
,,,--'f--
i N.
A
J
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28o' J
1
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3 8D / •• •
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\ FUTURE_
'N r— CX/Sriw( EXPAtisson!
T SE,OriG AEA
1 /000 6A4 /
_ �,✓sr4 G
EXisr/A/6 _' 4IEW T2ENc!!
TQENeti 5 WJOE
75 '.v,u6
'p-7 Nt1ikri.
,.:' .ate �. -F 4.: /ZO o C u 11 Ate'' /J
-!rx-kroo . ... •
® . 49I * /OA/fracy.•• ...iv..."***t''..I�.... ••.,$ 7"I/B65
r teittai
i co •Michael E. Anderson •iv 40
♦ P '•� 4381 =-E ', t�E -
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i►'►•0 A 0 u t iviaili0, 000 Gr.'
04 • • • PROJECT 7- - D S
JOB NO. SHEET - OF 2
ENGINEERING, INC. • yy� /
CALCULATED BY 111 p�C A/ DATE
ANCHORAGE •• JUNEAU •• BETHEL •• FAIRBANKS CHECKED BY '/ DATE
SUBJECT /ZO 'lo CANCEL
' �
/
1 NAT/ VE
/ 5.4,-ID
r ^ 1
- r /
i r 1
_ - FILT-Fla
FA$2 I C-
tIC� 0 0 0 q 0 p 04 T
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T 'ENcN FRGIL E.
SCALE : AS Si•1Ov.1ill
WELL LOG
Date Drilled: I ' `, -%/
/
Static Water Level l feet Gallons Per Minute /t)
Draw Down feet Total. Feet of Casing r-70
Type Material Drilled:
0 feet to 3
Y
to 1--/D -f Sa-d
qo to 65 hailP an
a
to 70 3 ra v 2( (.4_,/,„a-lee-
to
to
.
Hefty Drilling
S.R.A. Box 1553 H
Anchorage,Alaska
99507
CNGRPGE
M Fp1 T.-104
• 22192
M-C°v E)
TpoYl,C 5/ -0 •
MUNICIPALITY OF ANCHORAGE
171‘40 � DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
lc _ ► i. i ENVIRONMENTAL ENGINEERING DIVISION
\---_j 825 L Street-Anchorage,Alaska 99501 Telephone 264-4720
ONSITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME PHONE JEW
1\ On a a7y- 7929 ❑UPGRADE
MAILING ADDRESS
.Pt 36) 2S--- a-`_-
LEGAL DESCRIPTION a
LOCATION / \C ,\.0 ��Y o.. NO.OF BEDRO
DISTANCE TO:
�0T .Tn3 Absorption area Dwelling PERMIT. ni ,
wW Z Manufacturer c Q ,/ Materit,1 ,I No.of compartments o2.....6I- I
cn Liq.capacityl� gallons IF HOMEMADE: Inside length Width Liquid depth
DISTANCE TO: Well Dwelling PERMIT NO.
J QZ
oZ< Manufacturer Material Liquid capacity in gallons
0 Well Foundation Nearesylp PERMIT NO.
W= DISTANCE TO: fes((
J LL Z No.of lines / Length of c Ijne Total length of 1' e / Trench width Distance between lines
—Z winches
U inches
Qi- Top of tile to finish grade / Material beneath tile Total effective sorption ea
p 3 p Li inches 7FrQ Q
Length Width Depth PERMIT NO.
w
a I— Type of crib Crib diameter Crib depth Total effective absorption area
w ci-
W Well Building foundation Nearest lot line
DISTANCE TO:
J Class Depth Driller Distance to lot line PERMIT NO.
J
W
ij DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER �.�-
AN
PIPE MATERIALS hoos r f3/
' 1--e-e( i- 2lcs-t . ?\Pe , v
SOIL TEST RATING / Q - 0' 0 i
,2 7,3 A pct ,tri , -
�INSTALLER ° fr
REMARKS e . A
Vole,' Wc// c�n/// h &fuse 710 s •s-A^ t�
1. C a 7e 4‹ f/711 12-d e..,-/ 0li,
L „ . ._
, _
....
n v -
APPROVED DATE LEGAL
//zy --I/ L 1 8 2 3oyk sG
72-013 (Rev.3/78)
��111.
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�� �vCA
��
���� � � � L. 01r1 ��� �� �� �0(\j"`..-1/4
-. . ��� .~�
DEPARTMENT OF HEALTH AND ENV IRONMENTHL PROTECTION
-^V 825 'L' STREET, ANCHORAGE.. HK. 99501
254-4720
�1-4 E7. r-A—:FS F: .F: 11--
PERM I T
1--PERMIT NO. ( 810971 )
APPLICANT WILL'S CONSTRUCTION SRH BOX 2522 ]45-2506
LOCHTION CANOE ST.
LEGAL BOYLE S/D LOT SIZE 54450 SQUARE FEET
TYPE OFSOIL ABSORPTION SYSTEM IS : TRENCH
MAXIMUM NUMBER OF BEDROOMS = SOIL RATING (SQ FT/BR)= 273
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS :
g1:7 a-7F' EIT 1-4= 2:17 Fi E El=
THE LENGTH DIMENSION IS THE LENGTH ( IN FEET) OF THE TRENCH OR DRHINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION ( IN FEET)
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE
AND THE BOTTOM OF THE EXCAVATION ( IN FEET).
F: Cit.J I F: Es*. F"1- C.:7 � r-41 t1-7: �� Cff CI r4�
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL HILL SERVE
___ 1,1 I r-4�:77, I CI F:LE: Cz!ILP I F: In" ___
BACK FILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTIOq
MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR A PRIVATE WELL OR 150 TO 200 FEET FROM A PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL
MINIMUM DISTANCE FROM A PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN 30 DAYS
OF THE WELL COMPLETIW
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION!.
�F F IN/ F- CD' IF: � So: -I_
I CERTIFY THAT
1 : I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2 : I HILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
] : I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS.
SIGNED . ____
APPLICANT WILL'S CONSTRUCTION
t.
ISSUED B Y _______DATE /511M.12/
/fk
Q le SOILS LOG
E
\ •
MUNICIPALITY OF ANCHORAGE
\ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
I+ `f q TEST
825 L. Street, Anchorage, Alaska 99501 264-4720
/ SOILS LOG - PERCOLATION TEST
PERFORMED FOR: VI ( I (are, Tz rnu,n DATE PERFORMED: (1 3/ -8)
LEGAL DESCRIPTION: 5 KA OOX d-5 a,). LO r 1 OIk P. Vo yI e, 54,
SLOPE SITE PLAN
DEPTH
(FEET)
1 . PEA T
2 -
3 -
4 /11 L. Aryp 3 .� n N
5 -
6 -
7
/
8 /
/
'
9 - i
10 -
1 1 - WAS GROUND WATER S
ENCOUNTERED? YeL
O
P
12 - / E
IF YES,AT WHAT DEPTH?DEPTH? `T !----
13 - /
14 _ "' L W'E'T '' Gross Net Depth to Net
Reading Date Time Time Water Drop
15 - I53'131/g� I - 4-O 19- a. 35- -19-
16 - # // 1o1' 3-6) Id ' 1 o , ._.5.-
17 -
s17 - 3 ), 1 0n / A, U3 .67
18 - // I ; l0 10 I •I6 , 07
19 -
S // I �o i0 I g9, 5* .06 s-
20 -
PERCOLATION RATE `7 7 (minutes/inch/
z / TEST RUN BETWEEN C.' O FT AND �J FT
COMMENTS :3 D�/ [,
111 '
PERFORMED BY: CERTIFIED BY: _ ` �—�- i DATE: J —$/ -Y-/
72-008 (6/79)
MUNICIPALITY OF ANCHORAGE
c a; ,
Development Services Department ' Phone. 907-343-7904
On -Site Water & Wastewater Section Fax: 907-343-7997
Certificate of On -Site Systems Approval
Parcel I.D. 015-282-08
1. GENERAL INFORMATION
Expiration Date: 10 -2-S - ZO
Complete legal description Thomas L. Boyle, Block 2, Lot 2B
Location (site address) 12040 Gange Street Anchorage, AK
Current property owner(s) Steven & Kristle Armbrust Day phone (907) 351-1243
Mailing address 12040 Cange Street Anchorage, AK 99516
Real estate agent
Dave Windsor
2. TYPE OF DWELLING:
0 Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
Day phone (907) 727-3300
3. NUMBER OF BEDROOMS:
4
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Private Well
0
Private Septic
❑■
Water Storage
❑
Holding Tank
❑
Community Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver request for: Distance:
Received by: Date:
COSA to be released to the engineer, unless otherwise requested by the engineer.
COSA Fee $ 33�; G U V 1 p Waiver Fee $
Date of Payment %,--�_ t( ZJ Date of Payment
Receipt Number C)'2- G 2�_-Receipt Number
COSA# QS G2D136Z 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 Engineering Phone (907) 522-7773
Address 1399 W. 34th Ave Suite 101, Anchorage, AK 99503
Engineer's Printed Name Michael E. Anderson, P.E. Date 7/23/20
OF gC�SQ�®m
e 49th •' z ®��
6. DSD SIGNATURE ®1i' ' ..t�
.......,.... .... .
�............ ......... ..�.............:;�,$
_ System #1 Approved for bedrooms �'; FAICHAEL E. ANDERSON
®®C� No. CE -4381
System #2 Approved for bedrooms ®®s�F�•.. 7i23i20 ..•��r�a
Disapproved��� ES®®�®®®®®�
Conditional approval for bedrooms, with the following stipulations:
VPyInf 0-
v
``�1Y toF(�'�i�
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ON -SIT m%
_ �nroT€R AND
WASTE'v)JATER o
tT P OLiKAMJ�
V FNT
By: 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 X Nitrate Advisory �'
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA Checklist blue sheet
Legal Description: Thomas L Boyle, Block 2, Lot 2B Parcel ID: 015-282-08
If more than 1 septic system on lot: COSA Checklist # of
A. WELL DATA
❑ Well log is filed with Onsite (or attached)
Date drilled 12/1/81'"
Total depth 70** ft
Cased to 70** ft
❑ Sanitary seal is functioning correctly
❑ Wires are properly protected
Casing height (above ground) >l8 in.
Date of flow test for COSA 6/9/20
Static water level at beginning of test 11.9 ft.
Comments "*Per Hefty Drilling well log in MOA File.
B. TANK DATA
Age of tank(s) <1 years
Tank type/material S.T.E.P./Plastic
Measured operating fluid level in septic tank New
❑ Standpipes/foundation cleanout per record drawing
Date of pumping New Construction - 7/16/20
D. ABSORPTION FIELD DATA Raised Absorption Bed
Which system tested (date installed) 7/16/20
❑ ALL standpipes present per record drawing
Total measured depth from grade 6.5 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 NA gallons
Comments/Deficiencies:
COSA Checklist yellow sheet
Structure served by this system
Well production at time of test 4.5 gpm
Water storage tank volume None gallons
Well disinfected for coliform test? ❑ Yes ❑ Nc
❑ Coliform bacteria is Negative
Nitrate 6.12 mg/L ❑ Nitrate less than MRL (ND)
Arsenic ug/L ❑ Arsenic less than MRL (ND)
Collected by FORGE ENGINEERING
Date of Sample 7/7/20
C. LIFT STATION
❑ Required maintenance completed
Age of lift station <1 years
Lift station material Plastic
Comments: New Construction - 7/16/20
Adequacy test date New Construction
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
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,/J
Yes
Community Sewer Manhole/Cleanout > 100'
Q Yes
if No
ft
0 Yes
if No
Neighboring Tank > 100' M Yes
if No
ft
Private Sewer/Septic Line > 25' 17771 Yes
if No
Absorption Field on Lot > 100' F� Yes
if No
ft
Holding Tank > 100' 0 Yes
if No
Neighboring Absorption Fields > 100'
Yes
if No
Animal Containment > 50' F/1 Yes
if No
M Yes
if No
ft
Manure/Animal Excreta Storage > 100'
Community Sewer Main > 75' FV -1 Yes
if No
ft
0 Yes
if No
From Septic/Holding Tank on Lot to: (Please enter distances if less than required)
Building Foundations > 10' F71 Yes if No ft Surface Water > 100'
ft
ft
ft
ft
ft
Q Yes if No ft
Property Line > 5'
F,/J
Yes
if No
ft
Wells on Adjacent Lots:
Absorption Field > 5'
✓❑
Yes
if No
ft
Private Wells > 100' Yes if No
Water Main > 10'
0
Yes
if No
ft
Community Wells > 200'✓Q Yes if No
Water Service Line > 10'
M
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 2.9*
ft Wells on Adjacent Lots:
Water Main > 10'
0 Yes
if No
ft Private Wells > 100' El Yes if No
Water Service Line > 10'
0 Yes
if No
ft Community Wells > 200' ® Yes if No
Surface Water > 100'
0 Yes
if No
ft
F. ENGINEER'S COMMENTS
*Lot Line Waiver Issued - OSV201030.
G. ENGINEER'S CERTIFICATION
I certify that l 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.
COSA Checklist yellow sheet
- wwa�f Mtl14
7/23/20 ..•'•�����
B
ft
ft
ft
ft
l�itrate Advisory
Certificate of On -Site Systems Approval # OSC 201362
Subdivision: Thomas L Boyle
A water sample revealed a nitrate concentration of 6.12 milligrams per liter (mg/Q.
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. 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
BM(196650 Alaska 99519'6650 *www mum org
Nitrate Fact Sheet
From Northern Testing Laboratories, Inc.
Nitrate is a negatively charged compound of nitrogen and oxygen, which is very soluble in water. Nitrate
is not readily filtered or otherwise removed in the soil and can pass rapidly into ground water wells.
SOURCE: Nitrate is a major component of fertilizer and wastewater. Often the nitrate is in the form of
ammonia or protein first, which through contact with oxygen and certain bacteria, converts to the
oxidized form known as nitrate. Sources of nitrate from wastewater include urea, ammonia cleaners,
food solids, and bacterial cells. It may also result from the breakdown of organic matter buried in the soil.
TOXICITY: Nitrate is generally not toxic to adults or children over the age of two or three years, but is
associated with a potentially fatal infant disease called methemoglobinemia. In the digestive system of
young children, nitrate converts to nitrite, which can pass through the intestinal wall into the blood
stream. There it combines with the hemoglobin and interferes with the ability of the blood to carry
oxygen. For this reason, methemoglobinemia is referred to as "blue baby" disease. The EPA limits the
concentration of nitrate in public drinking water supplies to 10 mg/L. The standard has been lowered
from a previous level of 45 mg/L set by the US Public Health Service and the World Health Organization.
TREATMENT: due to its solubility in water and negative ionic charge, filtration and other common home
water treatment systems such as softening or iron filtration does not readily remove nitrate. The best
method for limiting nitrate in well water is source control. This can include avoiding overdosing of
fertilizer near the well and maintaining good separation distances between septic tank leach fields and
the well. A special anion exchange filter that contains a media with a strong affinity for negatively charged
ions in water, or by a reverse osmosis treatment system or distillation can remove nitrate.
TESTING: Nitrate analysis is usually done by one of the several "wet chemical" methods using a
spectrophotometer to read the final color endpoint. Specific ion electrodes also can be used to detect
the activity of nitrate in water. This laboratory uses several different wet chemical methods approved
under the public water supply laboratory certification program. They also have test kits available, which
the laboratory uses to perform an inexpensive "screening test", and with which the homeowner can
monitor the change in nitrate levels from their well. They recommend comparing the test kit results
against a certified analysis from the lab occasionally to verify the accuracy of the kit. We recommend
using a specially prepared bottle that has been rinsed in hydrochloric acid for collecting samples.
jx Mailing Address P •O Box 396650 *Anchorage, Alaska 99519�'
�� �, � 50 www muni org
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46,200 S.F. /
172.2'
8.2'x8.2' SHED
12.0'x13.0' BARN
10' CHUGACH
ELECTRIC EASEMENT
(BK. 725, PG. 989)
GRAVEL PARKING ' ..
(ENCROACHMENT)
S 89'59'W 280'
Lot 3A
HOUSE DETAIL
Scale: 1" = 30'
5.8'x 13.9'
PORCH
Lot 2A
N 89'59'E 280'
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M
PLOT PLAN --- AS BUILT _X_ SCALE __1"==50__ GRID _ SW 2734Project No.
11500 Daryl Avenue, Anchorage, Alaska 99515-3049
Lang & Associates, inc. (907) 522-6476 Phone ��000p��
(907) 522-4625 Fax �Q 0
O F
Professional Land Surveyors ken0longsurvey.com o q �p
jonothan®langsurvey.com 9
o P ' • �s�o0
I hereby certify that 1 have surveyed the following described property:
LOT 2B, BLOCK 2, THOMAS L. BOYLE SUBDIVISION (PLAT No. P-2446) 49TH
Anchorage Recording District, Alaska, and that the improvements situated thereon are
within the property lines and do not encroach onto the property adjacent thereto, that i
no improvements on the property lying adjacent thereto encroach on the surveyed.... KE .. ... . G .
premises and that there are no roadways, transmission lines or other visible �Q+c, o�
easements on said property except as indicated hereon. .1 '?�
>N��t.�1 til LS45202.•' c,J4
��o,�
Dated this the _ =--- Day of __ at Anchorage, Alaska Q �OGo
------------- Oa� oFESSIONAL
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 plot. AECC963
• MUNICIPALITY OF ANCHORAGE
• -- DEPARTMENT OF HEALTH & HUMAN SERVICES
i Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage. Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # 015 -282 08 HAA # �� ��{.-(i�;�cl`�
1. GENERAL INFORMATION
Complete legal description Lot 23 , Block 2 , Boyle Subdivision
Location (site address or directions) 12040 Cange Street
Property owner John D . and Cathy J . Weaver Day phone
Mailing address 12040 Cange Street Anchorage , AK 99516
Lending agency Day phone
Mailing address
Agent Beth Simpson Day phone 345-1020
Address 1120 E . Huffman Road , Suite 204 Anchorage , AK 99515
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual well xxxxxxx
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site xxxxxxx
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025(Rev 1/91) Front MOA#21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. 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 inspection.
Name of Firm Anderson Engineering 563 - 7155
Phone
Address P , 0 .
Box2407773 /,Anchorage , AK 99524
Engineer's signature 7'' 2c.tif�.J, E( �� Date 5/25/96
•1
C 4,41.144
2moi •£
6. DHHS SIGNATURE es
X Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
By: ,Z5772:4- 74-32
Date --3•
CAUTION
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska.The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements.Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025(Rev.1/91) Back MOA"21
Municipality of Anchorage
r,,,,, DEPARTMENT OF HEALTH & HUMAN St/ �t V/c D �,*1, ,
411_ Environmental Services Division C
825"L" Street, Room 502 • Anchorage, Alaska 99501• (907) 343-4744 r'--1
T:.
MAY 29 1996 J�
Municipality of Anchorage
Health Authority Approval Checklist
&Human Services
Legal Description: LT' 213, BLa c Z, Doy .€ Parcel I.D.: 05- 18z. - 06
A. WELL DATA
Well type P2+4a.rC If A,B. or C.attach ADEC letter. ADEC water system number
Log present(Y/N) Y Date completed
Total depth Cased to Casing height(above ground)
Sanitary seal (Y/N) Y Wires properly protected(Y/N) Y
FROM WELL LOG AT INSPECTION
Date of test 91/#4%••
'
Static water level Z
Well production g.p.m. , e:,.S g.p.m.
WATER SAMPLE RESULTS:
Coliform 0 Nitrate 3 ..7 n"S/i- Other bacteria CD
Date of sampler 4_ �� Collected by: A, #',
B. SEPTIC/HOLDING TANK DATA
Date installed b f 93 . Tank size /500 Number of Compartments 1. Cleanouts(Y/N) y
Foundation cleanout(Y/N) Y Depression(Y/N) N High water alarm(Y/N) Y'
Date of Pumping Cie 1'9% Pumper A PWS
C. ABSORPTION FIELD/ DATA .7
Date installed s/z T/9 L, Soil rating (g.p.d./ft2 or ft2/bdrm)_ System type 8
izJi
Length Width / Ci Gravel thickness below pipe Q Total depth
Effective absorption area. Monitoring Tube presen�t(Y/N) '1 Depression over field(Y/N) At
Date of adequacy test A/C—LA) Results(Pass/Fail) COO ST. For 3 bedrooms
Fluid depth in absorption field before test(in.); O Immediately after gal. water added (in.):
Fluid depth (ins.)Minutes later: Absorption rate = g.p.d.
Peroxide treatment(past 12 months) (Y/N) Al If yes,give date A/A
D. LIFT STATION
Date installed 0/q3 Size in gallons SOP
`/ 'i
so
Manhole/Access(YM) T "Pump on' level at* 4/ "Pump off' level at* 4/
t! e.
T
High water alarm level at* S *Datum /414/S &ID71 Di' t
Cycles tested 5—
E.
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
I
Septic/holding tank on lot >100 ;On adjacent lots >100
r r
Absorption field on lot _ ^ ) /0 0 ; On adjacent lots >100
Public sewer main /1�1 ) f,C S Public sewer manhole/cleanout /% ''I k
Sewer/septic service line > 50 I Lift station > 10 D
SEPARATION bISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
6 r e
Building foundation '10 Property line >0 0 Absorption field ) 5'D
Water main/service line > 10 a Surface water/drainage >100 Wells on adjacent lots >/0Q e
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
e r
Building foundation > S0 Water main/service line > CO
I
Surface water >/00 Driveway, parking/vehicle storage area > Z49 o
e t i
Curtain drain > SD Wells on adjacent lots )/00 Property line I 4—
F. ENGINEER'S CERTIFICATION * Gth►V CR 1.S"a 614/3
I certify that I have determined thru field inspections and review of Municipal records thaft to a,dtovi s are
in conformance with MOA HAA guidelines in effect on this date. . . __-,,,,..„;06..",,46%,,,h; fl
Signature E '�;_ s� + -o�0A®
>T !:•'r, ..,e .'• • •is S
°o
..,.:c ::oc. ;et,* ••
Engineer's Name /C44 ADZ £ AN LJ2d`0 t t
••w aottro "" ' i �
Date .41/Z-�/�(� it<I.micr�oet E. d:rsa�•: 440
i'• 4351-E
Q
A
HAA Fee $ u, Waiver Fee$ •
Date of Payment e. /,.J' Date of Payment
Receipt Number / Pp a (.d/ Receipt Number
Rev. 8/95 OSS: haa.wk.doc
MUNICIPALITY OF ANCHORAGE
• ' 7 DEPARTMENT OF HEALTH & HUMAN SERVICES rtio
?r
�' Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. # O1/?'Z'a2' HAA # c,vn
1. GENERAL INFORMATION
Complete legal description 17oYL-r� 1--110
Z
Location (site address or directions) I Z0kt9 6P-►u,6- R---
Property owner I t'iJ/IP,Il Day phone Y-}5 —6')3j
Mailing address _ 1204-0 Qiur tZi Ao1 AK .7) 11
Lending agency (ii MAG Day phone
Mailing address
Agent Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3 N
3. TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025(Rev.1/91) Front MOA#21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. 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 inspection.
Name of Firm Av D 1=-1?--v0 J 'CIJ L �nt J G Phone
Address PCS &-,, t Z qo 7 73 AN to 4/L-q q 5 Z/
't,ctcJ 1.(,��-dam- Date cbl S U /92
Engineer's signature
cqz
"*11 `4' 4
R r p ea° e..gno. '4*oa.. .gw•
P lrtiharl r\ dc rson o�u
0,.4°.;;%
o
• A38E.1 -En �,i✓
ouj.•�c09'��•s
6. DHHS SIGNATURE G4� ��(O.Eco,31 ►
Approved for bedrooms.
Disapproved.
Conditional approval for bedrooms, with the following stipulations:
Additional Comments
By: , ii .-r% '---- Date •
,e=/02-2/7-- /E 7:;/.1)-fLi 7/.0/9-3
CAUTION
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska.The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements.Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
72-025 IRov 1i91) Back MOA 021
sMunicipality of Anchorage e
r
i. Department of Health & Human Services �'�'�"
HEALTH AUTHORITY APPROVAL CHECKLIST ••i i_
Legal Description: L 7-0, 1,2- / 12o1'! Parcel I.D. 0I5?A:S2 CS
A. WELL DATA
Well typeiV .e` If A, B, or C, attach ADEC letter. ADEC water system number
Log present 9N) Date completed Driller 114y Or lini
Total depth Cased to Casing height /
Sanitary seal 9N) Wires properly protected/N)
FROM WELL LOG AT INSPECTION rn
Date of test el/I3/93
Static water level Z1 lT1 y
(-1 C) D r
Well flow g.p.m. > 6 g.p.m. T 0 m
Pump level U \1KI`1 < co 5
rn W N
SEPARATION DISTANCES FROM WELL TO:
u' G)
s
Septic/holding tank on lot 107; On adjacent lots > Ivy z
Absorption field on lot %I I, ; On adjacent lots > I'if
Public sewer main IJ/' Public sewer manhole/cleanout
Public sewer service line NI/k' Petroleum tank ?f a r ' - "
, h(0,,,
WATER SAMPLE RESULTS:
Coliform 0 Nitrate u. ?)96 Other bacteria o
Date of sample: -,A.7-, Collected by: /441---
B.
441B. SEPTIC/HOLDING TANK DATA
Date installed t5I`w'`Z'I I6')- Tank size I i0 Compartments v
Cleanouts ON) Foundation cleanout O'N) y Depression (Y,&)
High water alarm YN) Y Alarm tested(WN)
Date of pumping NINJ i K
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s)on lot 107 �
On adjacent lots > �� Foundation 10'
To property line ?illi Absorption field (00' Water. /service line )570'
Surface water/drainage I1'
72-026(Rev.3/91)Front MOA21 CONTINUED ON BACK)PAGE
A! r
C. LIFT STATION J .
Date installed 8l2°-1--i / 7 Manufacturer,ANGtf'0,2, HC tie> t4 S1 lai
Size in gallons I1/50 Manhole/Access (Y/N)
Vent 6/N) r "Pump on" levellat rl "Pump off" level at 4"1
4'1 pant, V 17
High water alarm level ,
f' ATl Cycles tested v
Meets MOA electrical codes ON) Y
SEPARATION DISTANCE FROM LIFT STATION TO:
1
Well on lot i 07 On adjacent lots > a- Surface water > 174
D. ABSORPTION FIELD DATA
Date installed n1'2-0-1,11,3 Soil rating 1.21/zJ /pi't" System type heti
Length 32 - Width IYJ Gravel thickness 0 Total depth 1 �v
Total absorption area 511,, Pi'z Cleanouts present 040 td/1-----
Depression
dDepression over field (Y/ N Date of adequacy test —ate /4/4----
Results (pass/fail) tI/k- for bedrooms
Peroxide treatment (past 12 months) (Y/N) /J/A— If yes, give date /1/A---
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot iii On adjacent lots > 132 Property line 7'
To building foundation lo / To existing or abandoned system on lot 7 7nJ
On adjacent lots ? 1�o Cutbank iJ/A--- Water main/service line
Surface water > I90Driveway, parking/vehicle storage area `✓
15'
Curtain drain
5:1'
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
W... ell~.q�4!t'
Signature F s Y "'.� 1.
Engineer's Name A4i C-F/A t c �"7LI0,✓ Y "'•°....:528-147;.1
> ...
®Cao.
/qj
Date - 0 ®�;M'�hael E. Anderson ���
�4;.),at. 4381-E : (4I
HAA Fee$ JO° ` Waiver Fee:$
Date of Payment _ X - 30--- 93 Date of Payment
Receipt Number 2 5 95 (7 ir of 2 Receipt Number
72-026(Rev.3/91)Back MOA 21
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL ) J 7_ t,(.ic .
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date SEPT' 3, /987
1. GENERAL INFORMATION
(a) Legal Description (include lot, block,subdivision, section, township, range)
L.oT ZB 5/Gicg Z ,BDyLE SuSD. S Z/ TIZAi I 3w
Location (address or directions)
/ZOUO CAA/6E 5neEET
(b) Applicant Name ALAS%A MOOS/.VG Telephone: Home Business 2 76- 5-5-9 9
Applicant Address 23S- E. 8 44` Auc NOEA G E/ AIC ?9601
(c) Applicant is (check one): Lending Institution Z; Owner/builder❑ ; Buyer 0 ; Other 0 (explain);
(d) Lending Institution Telephone
Address
(e) Real Estate Company and Agent ETA EALT y CEMTE1 PAUL ltli/SO&I
Address 8*00 NAZTZELL IZS
Telephone 3 yy` O So!
(f) Mail the HAA to the following address:
PCEA£E CALL PAUL Wi/soA/ CO 3s1g-O S0/ ,-02 ,' i - CvP
2. TYPE OF RESIDENCE
Single-Family 511 Multi-Family 0 Other
Number of Bedrooms 3
3. WATER SUPPLY
Individual Well Community 0 Public 0
Note:If community well system,must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite 4 Public 0 Community 0 Holding Tank 0
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(1 1/84)
•
5. 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 inspection.
/�
Name of Firm ''f 04 M4 E.�G/d CZ-IL Al6 Telephone Z 7/0 I770
Address /057 z57' akft1-'11 Scl r'r-c- Z fC�
Date 9/51/4 7
•
d = '•1°
' �o
•�� �9TH . 1t
�•••�Y �•;•••# neer's Seal
•
>/�n1;Michael E. Anderson /
� t.�• . •
4381-E •; ��
6. DHEP APPROVAL ,
Approved for 3 bedrooms by O f?Aa-ZeDate 9- 5 -g7
Approved Disapproved Conditional
Terms of Conditional Approval
•
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
72-025(11/84)
MUNICIPALITY OF ANCHORAGE (MOA)
EALTH AUTHORITY APPROVAL(HAA)
MUNICIPALITY OF ANCHORAGLFI
ENVIRONMENTAL SERVICES DIVISION CHECKLIST- FEBRUARY 1984
4720
SEP 1987 Legal Description: GOT ZB 610cK 2
.S D yGE 5OBa V/S/a.t1
A. WELL DATA RECEIVED
Well Classification f'seiVAI TE If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (Y/N) )' Date Completed /Z-/-B/ Yield 4 t (PN!
Total Depth 70' Cased to 70' Depth of Grouting A/ewe
Static Water Level ZS'0" Pump Set At .t/0T OErge,.'/.veo
Casing Height Above Ground Ly Sanitary Seal on Casing (Y/N)
Electrical Wiring in Conduit (Y/N) y Depression Around Wellhead (Y/N) N
Separation Distances from Well:
To Septic/Holding Tank on Lot /O2 ; On Adjoining Lots /00 ' f
To Nearest Edge of Absorption Field on Lot, , /07 ; On Adjoining Lots /00' t
To Nearest Public Sewer Line ± 1 MALE. 1 To Nearest Public Sewer
Cleanout/Manhole t / MILE To Nearest Sewer Service Line on Lot 60'
Water Sample Collected by /}PF.g,pp.5-,v7Q u4DeA ; Date 9-2-87
Water Sample Test Results SATISFACTORY
Comments $AIC'LL IS ADEQUATE
B. SEPTIC/HOLDING TANK DATA
Date Installed /98/ Size /OOD No. of Compartments Z
Standpipes (Y/N) Y Air-tight Caps (Y/N) x Foundation Cleanout (Y/N) Y
Depression over Tank (Y/N) /V Date Last Pumped 8'2? 87
Pumping/Maintenance Contract on File (Y/N) y ;for 1987
Holding Tank High-Water Alarm (Y/N) iF/A Temporary Holding Tank Permit (Y/N) A�A
Separation Distances from Septic/Holding Tank:
To Water-Supply Well /0Z To Building Foundation
To Property Line 3 3' To Disposal Field Ss
To Water Main/Service Line �9. To Stream, Pond, Lake, or Major Drainage
Course A/oNE /.v /MM6bIATE AZ.EA
Comments 5EPT"I c 'r-AAIK IS A Dec?u ATE
•
Page 1 of 2
72-026(11/84)
•
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata // Type of System Design TRE,uc 1/
Date Installed 9-Z-87 Length of Field 7S'
Width of Field 5 Depth of Field 6 ' -- /o' •
Gravel Bed Thickness
Square Feet of Absorption Area 400.9. L 510 ""`Standpipes Present (Y/N) /
Depression over Field (Y/N) N Date of Last Adequacy Test NEW S/sr.E/'
Results of Last Adequacy Test NEW SysrEM
Separation Distance from Absorption Field:
To Water-Supply Well /07' To Property Line /5
To Building Foundation ZO' To Existing or Abandoned System on
Lot 3 5 ; On Adjoining Lots /OD' 0-
To
To Water Main/Service Line 55' To Cutbank (if present) ./ONE pize-.5 r
To Stream/Pond/Lake/or Major Drainage Course NOME /N /fAMEO SATE AREA
To Driveway, Parking Area, or Vehicle Storage Area 20'
Comments g8SORprioi4 5V TEM as NE W CoA1ST2VGTION
D. LIFT STATION
Date Installed Dimensions
Size in Gallons Manhole/Access (Y/N)
"Pump On" Level at "Pump Off" Level at
High Water Alarm Level at Vent (Y/N)
Tested for Pumping Cycles during Adequacy Test. Meets MOA
Electrical Codes (Y/N)
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked,veri//fi d,or conformed to all MOA nd}BIAA guidelines in effect on the date of this inspection.
Signed ,�/'` __'�c_lele / � O
Company aJ 94/ L:;16/1-Z MOA No. er.87—/95-
Receipt
9fReceipt Na-. 70 0 / 00/0 ..w����At1
Date of Pa ment !� r C,••••• •• .9 ,
Amount: $ z U * j49IM := is Ij Engineer's Seal
Michael E. Anderson
•
Page 2 of 2 11��• •4381-E 2i
72-026(11,84a �,iw��Si~�
APPLIC 'IT FI,.LS OUT UPPER HALE ')NLY
Proper i owet (i(.J�(k...-1 ge-C-.e -RR !_ I TZ m a Phone
Mailing Address 5R1--) 9• > Zip Code �)'v 7 3 .$ J O C
Buyer if AI( c.-,�-'t �--A-'2.-
Address Zip Code
Lending Institution 4 `_e a Phone
Address G ere„....--.-___ Zip Code
Realty Co. &Agent �l_t_ / /7 Phone
Address /� Zip Code
Legal Description _ .2 /3 ,JQ e k._
L.
Street Location a y)v /Dir v,'Si e-2--�
Type of esldence a
OW/tingle Family
❑ Multiple Family No.of Bedrooms
❑ Other
Water upply
Individual ATTACH WELL LOG. A well log is required for all wells drilled since June 1975.
❑ Community For wells drilled prior to that date,give well depth(attach log if available). ,
❑ Public Utility
Sewer/Disposal
Individual Year Individual Installed: S L-
❑ Public Utility When Connected to Public Utility:
❑ Holding Tank
NOTE:THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
C.-------(1.-e_rt Stsu.
Time Time Time Tim DLL . 0
Date Date Date Date CL�XJt
\0-\\-s,a C\'leSN —
Inspector Inspector Inspector Inspectorto�
&&JNICIP tL!f1-1RDANCMORAGE
Field Notes: is OFr'T Cr I-_- '- ' P.
�i'h_e�e to a bm�P.La- �� (o,� ��
Ds is91 l q7 I �N
C�,V IRotV.'_t.,.A.- ;.,;,-'_TION
P .A t u ci- KIe.uuLA IOPi_„_. - n l 1 a.. 611-R Po. n L_,4 it, u L u(_)dl L
L A a b >G i, a - 2,„,�„n„ ter- a-a G V i ? 1982
kle,0,:s1/0,e_il _ E_VED
c . aw — /
( 3) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL
( ) DISAPPROVED
( ) CONDITIONAL APP-OVAL'
DATE /° -1 '-"I,Z--
BY: i ► ,
Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received NO
II-- 8 ( Well to Tank Septic Tank Size /0 CrC)
72.023(3182)