HomeMy WebLinkAboutELMORE BLK 2 LT 2Elmore
Block 2
Lot 2
#018-171-07
Municipality of Anchorage
Department of Health and Human Services
Division of EnvinonnwnW Services
Onsite Services Section 8251' Street Room 502
P.O. Box 196650 Andwrage, AK 89519-6650 Page of
www.dAnctoage.akus (907)343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number. W Cl //a PIDNumber. 6/0-/i/-o7
Mhkko &.slyoio Wastewater System: ❑ New 10 Upgrade
M beAes-t „ ,U- q9s/G
ABSORPTION FIELD
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LEGAL DESCRIPTION
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07 17 79
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Ga*V H619N AOVee GMW:
TANK
FL
SEPARATION DISTANCES
Q Septics Q Hol&v ❑ S.T.E.P. Q Other.
TO
Flom
Septic
Absorptionf
S tion
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Inspections performed by: X�� rgphe6rinf Dates: 1'L 07 l7 99 ..*- � 9
....................
3� oy oo 1ENN
Department of Health and Human Services approval X118 j
Reviewed and approved by: t/ Date: /0 ,
I
AS -BUILT SYSTEM DETAILS/SITE PLAN
ELM❑RE S/D , LOT 2 , BLOCK 2
2
O WELL
K � D w WELLO
Pernit SW990167
PID#018-171-07
A -C=59.6'
CDIFVRIR
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B -C=9.5'
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A -D=60.2'
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B -D=13.7'
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A -E=76.2'
B -E=30.3'
A
A -F=39.2'
B -F=41.0'
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ORIGINAL GRADE
SEWER ROCK
93.4
5L9
PREPARED FOR,
MARGO BISHOP
4600 DEARMOUN RD.
ANCHORAGE, AK. 99516
FlELD BOOKS
CDIFVRIR
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GRV. 3036
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SCALEt NTS
1K ID ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
Il iiS:c': d?:i:c:5:':d: 4;:r.. ....... ::... .... ::...:.:., •;:;;. ;.;._.....`
(907)898-8111/FAR (907)898-8111
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
Rick Mysrrom. P.O. Box 196650 Anchorage, Alaska 99519.6650
Mayor
hup.//www.ci.a nchora ge. ak. us
June 7, 2000
Margo Bishop
4600 DeArmoun Road
Anchorage, AK 99516
Subject: Elmore, Block 2, Lot 2
Permit # SW990167 PID # 018-171-07
The subject permit #SW990167 issued by this office for a single family well and/or on-
site wastewater system, is due to expire 365 days after it's issuance on June 30, 1999.
If this is a well permit and you have drilled the well, a well log must be sent to this office
for documentation of the installation and to close the permit.
If this is an on-site wastewater system and a licensed Professional Engineer has inspected
the installation, the original as -built inspection report must be sent to this office for
review, approval and documentation. All inspection reports must be submitted within 30
days of construction completion.
A new permit must be obtained from this office for a well and/or on-site wastewater
system NOT installed by the expiration date. However a new permit can be issued free of
charge for a second year if the application for the renewal is received on or before the
date of expiration of the original permit for which a fee was paid.
When applying for a new permit after the original permit has expired or for more than a
second year, the fees are: $320.00 for an on-site wastewater permit and $120.00 for a well
permit.
If you have any questions, please call this office at 343-4744.
Janfes Cross, PE
Program Manager
On-site Services
enc: Copy of Permit
• MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-SRe Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
aPm ca Lion-.
sei 'l- r)-`t`A
Date Issued: Jun 30, 1999
Expiration Date: Jun 29, 2000
Permit Number: SW990167 Parcel ID: 018-171-07
Legal Description: ELMORE BLK 2 LT 2
Design Engineer. 0070 KND Engineering Site Address: 004600 DE ARMOUN RD
Owner Name: Margo Bishop Lot Size: 43264 SO. FT.
Owner Address: 4600 De Amioun Road Total Bedrooms: 3 Permit Bedrooms: 3
Anchorage , AK 99516-0000
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 ( I SAAC72) and Drinking Water Regulations (18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each Inspection. Provide notification by calling
(907) 343-4744 (24 hours). ( Not required for a Water Supply Permit only).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either. A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
5. The following special provisions.
1.) IF IT IS DETERMINED THAT THE EXISTING SEPTIC TANK IS ONE COMPARTMENT AND/OR CANNOT BE
MOVED THEN IT SHALL BE DECOMMISSIONED PER CODE.
2.) IF IT IS DETERMINED THAT THE EXISTING ABSORPTION FIELD IS DEEPER THAN 6 FEET THEN IT
SHALL BE ABANDONED PER CODE.
Received By:
Issued By:
Date: A//
Date:
W/
O —3� — /
104D ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
1
Performed for:
Project:
Depth
1-
2-
3-
4-
5-
6-
7-
8-
9-
10-
11-
12-
13-
14-
15-
16-
17-
18-
19-
20 -
SOILS PERCOLATION TEST
Margo Bishop Date Perform
Elmore SID, B2, L2 TEST HOLE N
99-1
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Percolation Rate 1.2 (min/in) Perc Hole Diameter 6"
Test Run Between 3.0 feet and 4.0 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
Was Groundwater encountered? YES
What depth?
10'
Depth to water after monitoring? 10'
Date? 9/19/99
to
GP/SP- loose, sandy
Slighty silty gravel,
Reading
Date
Gross
Net
Depth to
Net
w /cobbles, some
Time
Time
Water
Drop
boulders bottom
1
8/19/99
1:00
-
8"
-
2
1:05
5min
3 7/8"
4 1/8"
3
1:06
8"
-
4
1:11
5min
313/16"
4 3/16"
�]
Y
5
1:12
-
8"
-
ML—Gray sandy silt, moist
6
1:17
5 min
3 7/8"
4 1/8"
B.O.H.
7
•
1:18
-
8"
-
8
1:23
5 min
313/16"
4 3/16"
9
1:24
-
8"
-
10
1:29
5 min
3 7/8"
4 1/8"
11
130
-
8"
-
12
1:35
5 min
3 7/8"
4 1/8"
HOLE PRE-SOAKED PRIOR
TO TESTING
•
Water
Added
Percolation Rate 1.2 (min/in) Perc Hole Diameter 6"
Test Run Between 3.0 feet and 4.0 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
CS
I
' QyQ�t`1 3 O I i"�Al.._ ITV Mt— AtVOC-EO=
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
02-5 L STREET, ANCHORAGE, Aft 99501
264-4720
OFti1—O I TE WI=LL
PERMIT NO:
DATE ISSUED:
APPLICANT:
ADDRESS:
CONTACT PHONE:
050006
04/04/05
BARBARA J. GARDNER
4600 DEARMOUND
ANCHORAGE, AK 99516
345-1573
LEGAL DESCRIP: SUBDIVISION: ELMORE LOT: 2 BLOCK: 2'
SECTION: 34 TOWNSHIP: 12N RANGE: 3W
LOT SIZE: 1.25A (SO.FT. OR ACRES)
I certify that:
1. I am familiar with the requirements for 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.
SIGNED DATE:
APPLICANT: LAR ^RA J.
ISSUED BY DATE: ��([�
WATER WELL RECORD
r' �) STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological 8 Geophysical Surveys
• Drilling Permit No. gS( %O SKJ
LOCATION OF WELL (Please complete either to, lb of IC.) A.D.L. No.
la Borough Subdivision Lel Block* Ip. r/e el ra• Section No. Township N Range Meridian
��•�n. i�, I �.��r,.✓n.l �� 17 I _ef_et_ef �l I :0 Rings
WOI
Ic. DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS S. OWNER OF WELII 17 ( f^
Street Address God Arae of Well Location
2. WELL LOG
Q J11d��
Materiel Typo
♦1'.J(
,tel . .... C:., .: l �•./
1
Fest Below
e. WELL/ (final)
S. DATE OF COMPLETIONrface_
(DEPTH:
�_�• i•_�t
Top
Bottom
.--'-r•—f1'�
jq
6• QCabla teal QRelary QOriven Dug
j,
f{1
13AugurC]JerteO Bored ❑Othol
• �J
Q J11d��
.r,\ '�\'S'a
O"'o
JAI
16. WATER WELL CONTRACTOR'S CERTIFICATION:
12.GROUTING Wall Grouted: Q vas •q No
Material: O Neat Content O Other:
13. PUMP! (If avellable) NP
Length •1 Drop Pipe 11. capacity 6. P.m
O Subm, O Jet O Cenl Nllcal O Other
Ie,PEMARKS:
-rPL :
IS. Water Temperature _• O F O C
TMs well net drilled ends, my Jurisdiction and this report Is true to the beef of my knowledge and belief;
nrl'I--
Registered Butsin/aa Nome Cn•ract Llcinae Number
Address: y •� .i'; { i .r . 1' !�
s;gned:=�! !� V i :- Dale: ,-,_— I
Authorized ReprHnrative
form C2 -*WR (N/en Copy Dletribm+on: WHITE -stet. OGGS, ►INK -Driller• CANARY-Cuslomer
Adore..:
Fest Below
e. WELL/ (final)
S. DATE OF COMPLETIONrface_
(DEPTH:
�_�• i•_�t
Top
Bottom
.--'-r•—f1'�
jq
6• QCabla teal QRelary QOriven Dug
j,
f{1
13AugurC]JerteO Bored ❑Othol
16
J>
T.usE: QDem.alu Q Public Supply Q Industry
1.9
5,7
i
O irrigation [3 Rnharge 11 Commerical
"77
'Ir:
0 Teel Well ❑ Other:
'70
7:=
e. CASING: O Threaded Q Welded
•1'x
{,
diem. fn in. to (lf ft. Depth Weight 117 Ibs.11t.
t) -7
1/a?
diem. 1n. to ft. Depth SNnup ft.
(nf!
J
S. FINISH Of WELL:
1)n
J►r
Type: r- .., .cam♦ �. plom•t.r:
SIol/MNh 11129: Length:
Set holes" ft. and ft.
socknUing Gravel pack
10. STATIC WATER LEVEL: ft.
^n
0 Abor• of p Belo. land surface Date
Eeuip menl used:n-" �1:I.:♦ 11n.1:
11.le UPING LEVEL bolo* lend surface and YIELD
Tfe., fl. after %. hre, pumping LI
T
ft. after bre. pumping
.r,\ '�\'S'a
O"'o
JAI
16. WATER WELL CONTRACTOR'S CERTIFICATION:
12.GROUTING Wall Grouted: Q vas •q No
Material: O Neat Content O Other:
13. PUMP! (If avellable) NP
Length •1 Drop Pipe 11. capacity 6. P.m
O Subm, O Jet O Cenl Nllcal O Other
Ie,PEMARKS:
-rPL :
IS. Water Temperature _• O F O C
TMs well net drilled ends, my Jurisdiction and this report Is true to the beef of my knowledge and belief;
nrl'I--
Registered Butsin/aa Nome Cn•ract Llcinae Number
Address: y •� .i'; { i .r . 1' !�
s;gned:=�! !� V i :- Dale: ,-,_— I
Authorized ReprHnrative
form C2 -*WR (N/en Copy Dletribm+on: WHITE -stet. OGGS, ►INK -Driller• CANARY-Cuslomer
�i_.n Chorage
January 10, 1986
\ P.O. 8Gx 6650
ANCHORAGE. ALASKA 99502-0650
(90') 264-4111
1�
'NY ✓NOVILES
\\
15 P.: YO.R
DEPARTMENT OF HEALTH d HUMAN SERVICES
TO: Permit Applicant
Subject: Permit 6 850086
Lot 2 BLock 2 Elmore Subdivision
A permit issued by this Department for an individual well and/or on-site
sewer system has expired as of December 31, 1985.
Permits are issued on a calendar year basis by authority of Municipal
Ordinance. A new permit must be obtained from this Department for any
well and/or on-site sewer system not installed by the expiration date.
If you have drilled the well, a well log needs to be sent to this
Department for documentation of the installation and to close the permit.
If a private engineer inspected the installation of the on-site sewer system
the original as -built inspection report(three part form) must be sent to
this office for review and approval,and for documentation.
If there are any further questions, please call this office at 264-4720.
Sincerely,
Susan E. Oswalt
Program Manager
On-site Services
SEO/ljw
enc: Copy of Permit
ICUNID ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
11
(907)696-6111/FAX (907)696-8111
June 21, 1999
Municipality of Anchorage
Dept. of Health & Human Services
On -Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519-6650
Subject: Upgrade Sewer Permit — Elmore S/D, Block 2, Lot 2
Gentlemen:
At the request of the buyers for the subject lot, on June 19, 1999, we excavated one testhole
for the subject property to upgrade the existing system. The existing system is still
functioning but the owner desires to construct a new system due to the age of the existing
facility. A previous testhole was excavated by another engineer but no soils log or
percolation test was conducted for that location. A monitoring tube was installed and
utilized for water monitoring. We installed a monitoring tube and monitored water in the
original testhole. The results of this test and water monitoring are attached.
We propose to install a 5' wide shallow trench with the possible retention of the existing
field for use in the future depending on its location. The testhole registered water during
excavation at 10' which is consistent with the water monitoring of the previous testhole.
We have provided an additional foot of separation for high water fluctuations. The existing
tank will be excavated and its integrity verified. If found satisfactory we will relocate the
tank to a new location or replace as determined during our field verification. Additional fill
will be provided over the system as required. This lot is relatively flat and slopes from north
to south away from the existing field and the house at approximately 5-10%.
There are presently one well on this property. There are no other public or private wells
within 100' of our proposed system location except as noted. There is neither surface water
within 100' nor any known curtain drains within 50'. We do not expect that there will be
any adverse effect on adjacent lots by the development of this system.
If you have any questions, please contact me at 696-6111/FAX 696-8111.
Respectfully submitted,
END Engineering
L
enneth M. uff E.
attachments: On -Site Well and Sewer Application
Wastewater Absorption System Details/Site Plan
WELL & WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLAN
ELMORE S/D, LOT 2, BLOCK 2
LM
I � 197-2i(
_________________________________________________________________
i
LOT 1
LOT 16
NO PUBLIC WELLS WITHIN EN' OF
PROPOSED SYSTEM.
NO PRIVATE WELLS VITNIN 200' OF
PROPOSED SYSTEM EXCEPT AS NOTED.
NO SEPTIC SYSTEMS WITHIN 200' OF
PROPOSCD WELL EXCEPT AS NOTED.
A OF.. ALq �1
j* 491H *�
/ KENN ` ... PUS .....
` - CE -71 4F jo Ir
SSIo'0 -dw
Road
t
a
7'#WELL LOT 3A
899-1 1, LOT
•VCLL LOT 15
2d UM Cat
SEPTIC
Cry,H Hank Eknt
DESIGN DETAILS
3 BDRM X 150 GPD = 450 GPD
450 GPD/1.2 GPD PER SQ. FT. (1.0 MIN/IN.)= 375 SO. FT
(375/5'(W)) X .64(RF) (2.5' GRAVEL) = 48 FT. TRENCH
USE 1 TRENCH - 48(L) X 5' (W) X 2.5'(D)
Total depth of system Is 2.5' from original grade.
Total depth of gravel below distribution pipe Is 2.5' .
NOTES:
1. USE 1000 GALLON SEPTIC TANK. INSULATE TANK IF (4' COVER.
2. INSULATE TRENCHES WITH 2' HD BURIAL FOAM.
3. CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INTO SEPTIC TANK.
4. CONTRACTOR WILL ENSURE ALL SEPARATIONS TO ADJACENT
WELLS 6 SEPTICS.
PREPARED FOR,
MARGO BISHOP
4600 DE ARMOUN ROAD $C0.121 1'= 100'
ANCHORAGE, AK 99516
(907)345-4172 PAGE 1 OF 2
FIELD BOOKS COMPUTED:
BWNDARr.. S.HOLT
p'AM'
KMD
STAXINC:
S. HOLT
CmECXCO,
KMD
ASBU'LT'
S. HOLT
DATE'
6/21/99
D, FILE:
DR'D:
3036
ACRD na:
99050.DWG
JOB Nom`
99050
JSP d) 1) ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-0736
(907)606-6111/FAX (007)606-0111
K�
I
WASTEWATER DISPOSAL SYSTEM DETAILS
ELM❑RE S/D, LOT 2, BLOCK 2
89042'30"E '2ZQ8.999
OF. AL4
,Of TE*1
!z
KENNETH af
CE -711 , D,a
\�' srssloll" dw
lk `_-':qo"
PREPARED FOR:
MARGO BISHOP
4600 DE ARMOUN ROAD
ANCHORAGE, AK 99516
(907)345-4172
FIELD BOOKS cw XD:
BOUNDARY. S HOLT DRANK:
KMD
BTAING S. HOLT CHECKED:
KMD
Awuti': S. HOLT DAM:
6/21/99
m. nRE: MID:
3036
AM r": 99050.DWG 'IDB N'
99050
Scale: 1'= 20'
PAGE 2 OF 2
END ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(007)600-6111/FAX (907)600-0111
Municipality of Anchorage •
On-Site Water and Wastewater Program
(907) 343-7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
Parcel I.D. 018-171-07 Expiration Date: 7 - 0
1. GENERAL INFORMATION
Complete legal description Elmore Block 2 Lot 2
Location (site address) 4600 De Armoun Rd
Current Property owner(s) Reynolds Day phone 244-1930
Mailing address Same
Real Estate Agent Cindy Wilson Day phone 244-1930
6 '7 8 9 70
77
2. TYPE OF DWELLING:
® Single Family (w/wo ADU) cl;i i 3
❑ Duplex
j,'Multiple Dwellings (Single Family and/or Duplex) OL 6 8 L
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well ® Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class C Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
Received by: / � ` Date:
0 ///
COSA to be released to the engineer,unless; herwise requested by the engineer.
COSA Fee $ 7 Date:
Date of Payment LI H 2i-4 Date of Payment
Receipt Number (:301 Receipt Number
COSA# OC- 11�) Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On-Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information
obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm NorthRim Engineering Phone 694-7028
Address PO Box 770724,Eagle River
Engineer's Printed Name Steve Eng Date 4/11/2018
h
6. DSD SIGNATURE v`= ems ` •
System#1 Approved for --i bedrooms. 'I
System#2 Approved for bedrooms. = °•
Disapproved. a ;�.% _ "•: '�
`Conditional approval for bedrooms with the following s i ulations 1' ��s'N '. : ''
QP�•c's OF klv<'/),• U
SITE G)
pry cr.
AN
� WASTEWATEK o
NI)
2. PROG "
By Original Certificate Date: L' —1 (1 —Lc
The Municipality of Anchorage Devlopment Services Division(DSD)Issues Certificates of On-Site Systems Approval(COSA)based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska.The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet_9-1-12.doc
f
If more than 1 septic system is on the lot:
COSA Checklist# of
Structure served by this system
Certificate of On Site Systems Approval Checklist
Legal Description: EZ../iof4 is 2 L Z Parcel ID:Di g/ 71 o7
A. WELL DATA
Well type P If A, B, or C provide PWSID# Well Log (Y/N) 7/
Date completed lZ/if0 S Sanitary seal (Y/N) Wires properly protected (Y/N) /
/ Y
Total depth /// ft. Cased to /// ft. Casing height (above ground) 2 y in.
FROM WELL, LOG AT INSPECTION
Date of test. /2//9/es 007/eP
Static water level 46 ft. P.S. ft.
Well production C- g.p.m. (4- g.p.m.
WATER SAMPLE RESULTS:
Coliform ! e colonies/100 mL Nitrate �• 1 mg/L
r
Arsenic ug/L Date of sample: L( - 7 r I Collected by: (\( �(
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material -51.f-PriCiST L Date installed 7// 7/1?
Tank size /OO 0 gal. Number of Compartments Z Cleanouts(Y/N) /
Foundation cleanout(YIN) )( Depression over ank .. /N) Al igh at r alarm (Y/N) /V
�(' ( :'/
Date of pumping -1 -Z-0"-(g Pumper ��- ``-k"''`" (9 ��""'"t
C. ABSORPTION FIELD DATA S 4q/
Date installed 7//VT'? Soil rating (,�p.d./ft2 or ft2/bdrm) //, .2 System type T�`e„�i
Length .5 1 .. I ft. Width .5 ft. Gravel below pipe (. 7 ft.
Total depth Z.5 ft. Eff. absorption area /105ft2 Monitoring tube 1 Depression over field./V
Date of adequacy testOdf/R Results (Pass/Fail) ! For 3 bedrooms
Fluid depth in absorption field before test £ in. Water added '7" rs0 gal. New depth /5 in.
Elapsed Time: (o. min. Final fluid depth ? in. Absorption rate >_ ''.SQ g.p.d.
Any rejuvenation treatment(past 12 mo.) (Y/N &type) (24/ (e-- If yes, give date
D. LIFT STATION AM
Date installed Size in gallons Manhole/Access (YIN)
"Pump on" level at in. "Pump off level at in. High water alarm level at in.
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot /D 0 'f" On adjacent lots /CIO 1L
Absorption field on lot /00 rf On adjacent lots /6.6 14-
Public
+`Public sewer main /06 (-F Public sewer manhole/cleanout . /0d "f
Sewer/septic service line 2 S'
4- Holding tank /0 6 . -1-
/ / C "
Animal containment areas .;Q �f' Manure/animal excrete storage areas *
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation Property line 61-f— Absorption field
.S /
Water main ! U Water service line / Q i' Surface water (00 &
Wells on adjacent lots 96 / -
ABSORPTION FIELD ON LOT TO:
Property line /�j -+` Building foundation /G Water main / O ('
Water Service line / �T Surface water (G Q /f Driveway, parking/vehicle storage ZC -f—
Curtain drain (9/(l K Wells on adjacent lots ? 7/
F. COMMENTS
* t,4J A/✓E g /116,A RE-C or2.6•-C
G. ENGINEER'S CERTIFICATION � .low$Q�
I certify that / have determined through field inspections and ,n`"'��. • .;�;,•Q �.1
review of Municipal records that the above systems are in ``'S.••'....,.......,.,:to
_�••••4:47k
conformance with MOA COSA guidelines in effect on this date. Mf-:+";'`il`tE':- "�'; I
.. _.ter 7) ° , ;
Engineers Prin ed Name c5��✓� C. '' '. A ---41% o
Date ////(
'�
d-d
COSA yellow sheet 2-6-15.doc
Municipality of Anchorage
-r Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
X_',4700 Bragaw Street
1, P.O. Box 196650
Anchorage, AK 99519-6650-
www.muni.org/onsite
I ,f (907) 343-7904 t'
hp CERTIFICATE OF ON-SITE SYSTEMS APPROVAL
0
S•
FOR A SINGLE FAMILY DWELLING
Parcel I.D. D I A- I I I— O' COSA# �4 7
1. GENERAL INFORMATION Expiration Date: l " 31 — Q A
Complete legal description
Location (site address)
Current Property owner(s)
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
ELMORE BLOCK 2. LOT 2
4600 DEARMOUN RD. 'ANCHORAGE. AK
INGER DEVLIN Day phone 907-398-2326
37145 FUNNY RNER RD. 'SOLDOTNA. AK 99669
Day phone
KATHY FERNANDEZ W/ PRUDENTIAL Day phone 441-9000
3801 CENTERPOINT DR. f 200 *ANCHORAGE, AK 99503
Unless otherwise requested, COSA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual Well
0
Individual Water Storage
❑
Community Class Well
❑
Public Water System
❑
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
0
Individual Holding tank
❑
Community On-site
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems
Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil
engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer
of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or
water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems
Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may
be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water
samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system.
The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
-- --investigation, based on procedures outlined in the 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 riles and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm GARNESS ENGINEERING GROUP, Ltd. Phone 337-6179
Address 3701 E. TUDOR ROAD, SURE 101 " ANCHORAGE, AK 99507
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 1 0 ;0 0
Engineers Comments:
In conducting this evaluation, GEG, LtD. attempted to provide a thorough,
conscientious engineering analysis of the system In accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily Identifiable features. The operational life of all wells and
septic systems depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being served by the system.
These conditions are outside the control of the evaluator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. GEG, LTD. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report Is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party Is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
1� Approved for -:3 bedrooms.
Disapproved.
Conditional approval for bedrooms, with the flowing stipulations:
Attachments:
COSA Checklist
Septic System Advisory
Well Flow Advisory
Nitrate Advisory
bl
Arsenic Advisory
Maintenance Agreements
Supplemental Engineers Reort
Other
I ,NEN
ONSITE •'•
WATER AND
WASTEWATER
PROGRAM
By:��/� /"—/, Original Certificate Date: / G — 5 f ' 07
(Rw. 11105)
Municipality of Anchorage
Development Services Department
Bu iding Safety Division
On -Site Water & Wastewater program
4700 Bragaw Street
P.O. Box 198850
Anchorage, AK 9951968W
www.muni.org/onsits
(907)343.7904
CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST
Legal Description: ELMORE BLOCK 2. LOT 2 Parcel ID: 0 113- 171" 427
A. WELL DATA
Well type PRIVATE If A, B, or C provide PWSID# N/A Well Log (Y/N) YES
Date completed 12/19/1985 Sanitary seal (Y/N) YES
Total depth 111 R. Cased to 111 ft.
FROM WELL LOG
Date of test 12/19/1985
Static water level 86 ft.
Well production 6 —
g -p.m -
WATER SAMPLE RESULTS:
Coliform 0 colonies/100 ml. Nitrate 3.25 mg./L.
Wires properly protected (Y/N) YES
Casing height (above ground) 12+ in.
AT INSPECTION
10/26/2007
80 ft, .
5.71 g.p.m.
Other bacteria 0 colonies/100 ml.
Arsenic: 0.826 ugJL. Date of sample: 10/24,/200 Collected by: GEG Ltd.
B. 8EPTIGHOLDING TANK DATA 'NO CLEANOUT O FOUNDATION,
DOUBLE CLEANOUTS PRE–TANK.
Tank Type/Material SEPTIC/STEEL Date installed 7/17/1999
Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) `YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A
Date of pumping 4/20/2007 Pumper NORTHLAND PUMPING SERVICES
C. ABSORPTION FIELD DATA
Date installed 7/17/1999 Soil rating (9.p.d./feor(1!5� 1_2 System type SHALLOW TRENCH
Length 51.9 ft. Width 5 ft. Gravel below pipe 2.7 ft.
Total depth + 7.33 ff. Eff. absorption area 405 ft' Monitoring tube YES Depression over field NO
Date of adequacy test 10/26/2007 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test DRY in. Water added 5144 gal. New depth DRY in.
Elapsed Time: 0 min. Final fluid depth DRY in. Absorption rate >= 450+ g,p,d,
Any rejuvenation treatment (past 12 mo.) (YM & type) NONE KNOWN If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N
"Pump on" level at _In. "Pump ofr leve High water alarm level at in.
Cycles tested Meets alarm 8 circuit requirements?
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/I(ft station on lot 100'+ On adjacent lots 100'+
Absorption field on lot 100'+ On adjacent lots 100'+
Public sewer main N/A
Sewer /septic service line 25'+
Animal containment areas 50'+
Public sewer manhole/deanout N/A
Holding tank N/A
Manure/animal excrete storage areas 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 5'+
Water main N/A Water service line 10'+ Surface water 100'+
Wells on adjacent lots '96'
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main N/A
Water service line 10'+ Surface water 100'+ Driveway, parking/vehicie storage 10'+
Curtain drain NONE KNOWN Wells on adjacent lots '97'
F. COMMENTS
. WAIVER #WR040096
G. ENGINEER'S CERTIFICATIONS �!...
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in ' • • """' "' ' """' .....
conformance with MOA COSA guidelines in effect on this
date. is A. Gcmess.�
Engineer's Printed Name JEFFREY A. GARNESS s 79
Date (� ISO/off CPA— ._ d`"c
COSA Fee S tZZo.Oo "f 175 •yo ICU 514
Date of Payment I O 1 3 c 1 6%
Receipt Number A
(Rev. 11/05)
Waiver Fee $
Date of Payment
Receipt Number
'Mimicipalilty 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.cl.anchorage.ak.us
(907)343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 018 — I"? f —07 HAA . _ CA Ot o3 j
Expiration Date:
1. GENERAL INFORMATION
Complete legal description Let 2, 8I4•c k -2, ,Elmore S ij3
Location (site address or directions) ir600 De r*Zec,a f?,
Current Property owner(s. Cct rr.1 Ao(u ns Day phone o`o) SS1s - 037
Mailing address
Lending agency
Mailing address
2Y79 ?em chi >' &d Rod Nom_ &f JC"', /}tlun%x�,9 to�od^
k - Day phone
Ag yp 273
Real Estate ent 130& SrI'*o i' cl vv Da hone 2 y0
Mailing Address if 7_'y/ °t3"S>R, fi++Gtio� A -k 99s'a�
Unless otherwise requested, HAA will be held by DSD forpickup. pjewj en I/ /3ogS&M6n@Z73_73Se
2. NUMBER OF BEDROOMS: 3 wr'cn /f,+,4 CCrAAeerk reoary JG- pick_V
3. TYPE OF WATER SUPPLY: '
TYPE OF WASTEWATER DISPOSAL:
Individual Well
Individual On-site
Individual Water Storage
❑
Individual Holding tank
❑
Community Class Well
❑
Community On-site
❑
Public Water System
❑
Public Sewer
❑
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given In paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with
new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.)
Certificates are valid for one year for properties served by Class A or B wells or a public water system. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-
site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the
Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation. See ea m m sn,b a n cbar kh6 l- sb «f
Name of Firm Fl«//¢� 71cAnrcac/ Phone 34's - I34 -s`
Address IHS30 ��o 5,��lnc���apgei J -1c 9'9S -4r
Engineer's Printed Name %;ieockx-e F. PsaO-c Date Nov 7- 2aaZ
eeeeI:49LN
eeeeeeee,
-�elKsei���•7ieiiue
5. DSD SIGNATURE . nNODORE F. MOORE
_ Approved for bedrooms. ' 4 Cti 3589
•. r .
Disapproved:
Conditional approval for bedrooms, with the following stipulations:
Attachments:
HAA Checklist X Maintenance Agreements
Septic System Advisory Supplemental Engineer's Report
Well Flow Advisory Other
By: /I Or �����p, �w - Original Certificate Date: 1,911L 6—ceg
(Rev. 01112)
Municipality of Anchoragee
• "` Development Services Department M}}
Building Safety Division -Y °
On -Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907)343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: !.c l 2, 13(00 E(Warr S /.b Parcel ID: O 0E' - 1-71 -O7
A. WELL DATA
Well type P- t If A, B, or C provide PWSID # = Well Log (Y/N) Y
Date completed �Y/2-2/89' " Sanitary seal (Y/N) Y Wires properly protected (Y/N)
Total depth 11 l . ft. Cased to J 1 1 ft. Casing height (above ground) 2 in.
FROM WELL LOG AT INSPECTION
Date of test- y /20 /85" le; / z&/ay
Static water level ft. B 7 ft.
Well production d g.p.m. H• 9 + g.p.m.
WATER SAMPLE RESULTS:
Coliform U colonies/100 ml. Nitrate 0.87 mg./I. Other bacteria U colonies/100 mL
Arsenic: mg./I. - Date of sample: lo/ll-,916Y Collected by: F lot ,tk+r iecb Svc
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Sc„!u / / Date installed -7 / 17 /99
Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) _r_ Depression over tank (Y/N) N High water alarm (Y/N) A/, A.
Date of pumping 11 / 19 / DY Pumper A -711-
C. ABSORPTION FIELD DATA See Ce.n.n eqb
Date installed 7 /! 7 / 99 Soil rating (g.p.d./ft2 or ftZ/bdrm) 1_2.5rgr-d-'i System type S-%ac+f —,de dremfm e/{
Length S-1-9 - ft. Width S ft. Gravel below pipe '2,-7 ft.
Total depth 7m / ft. Eff. absorption area yRr ft' Monitoring tube Y Depression over field JU
atogr "/Ay
Date of adequacy test _ID / Z8/oy Results (Pass/Fail) Parr For ? bedrooms
Fluid depth in absorption field before test O in. Water added1233 gal. New depth7, y in.
Elapsed Time: 3 min. Final fluid depth S49 in. Absorption rate >= "19'O g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) M&Ae kn& wn If yes, give date N• A.
D. LIFT STATION V. A
Date installed Size in gallons
"Pump on" level at —in. "Pump off' level at _in.
Datum Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Manhole/Access (YIN)
High water alarm level at
Meets alarm & circuit requirements?
See co, .nM en/r-
in.
Septic tank/lift station on lot - . -� r'
` :4 , 7 two'
On adjacent lots
> le p r
Absorption field on lot ' -r� -°
>Jc O#
On adjacent lots
'> /ccs'
Public sewer main N•.4.
Sewer /septic service line 7 23"
Public sewer manhole/cleanout N•;f.
Holding tank V. A.
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: See ca. m en Ar `
Building foundation 8' Property line O' Absorption field 8 '
Water main Y. A. Water service line S ro' Surface water too'
Wells on adjacent lots tot • S fro.» c. o.
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: See as +. m en&
Property line 30, Building foundation SZ' Water main N• A.
Water Service line '> to' Surface water > t&c*l Driveway, parking/vehicle storage �=- SG '
Curtain drain Nane Seer+ Wells on adjacent lots 100. F*m,,,, c: O
F. COMMENTS The enq;nse- oL,frseer, /'go se�rh'c syr/-er rnr1&//ahao 'n 199
CerhFereL f V*e bo fir. of Me drrdrin Reel K 2.f l;.ef pie/ow ord�na/
ffrGade egAa( thef N ,l~af o // tmal-a^aa/ war p/arrcf ovrr 4Ae t 1.4rrt
G ENGINEER'S CERTIFICATION
I certify that t have determined through field inspections and rw ,««•••••�
review of Municipal records that the above systems are in a +" . • " ,
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name %ri eo dory F /'-raoa�"••'�«" •••••�
�p�vrrs' ••++'sYc7in• as
Date No-tm ber 2 1, 2001/ e, „4koocR r. s1a
1. 'V OWMnV
HAA Fee $ Y ?O ti Waiver Fee
Date of Payment tI / zY /o'Y Date of Payment
Receipt Number Lo O� 4m Receipt Number
(Rev. 12/01)
%YmtneA, COnf't/: Ort %'�[ p�al'Y o,Ffhir G�r/e�uatY �t,/f- at �%" vte fArafr"e
Vo, pe wov e,4xer---e er^4 ro X.in eAe /y 30' S6 of lAe d* -,n ,Cell r�a,4S
u�aFer arF 7 %etF yo(aw p.iomnd l•ewl. 7*e_ y tr �.,1=acvn f, � ce e ,� this
d Ser✓o oo it Nn len own.
,4t/ Styr armhoa a/<rirrne v we -e n+earc. arc/ ra S/er�s�a�.v Nr,.y a roQ Arv.
%h a Kn Clew`--ou n / cvn ��rf/ eir'airvn O / Slr kym -oml6, en /y ;j Nn✓ ,7 oeu ✓n ,
hln ow ceFeoe err -l7a;rh` se4a ,ey hor 4-een refu«�i'"r d - war/ he Cet .M,ffrd w4tn temA,
DEARMOUN ROAD_______
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1 lO' UTILITY EASEMENT
N 89°42'30"E 208.991
LOT 1 S
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...5. ...........� .
SHANE A. HOLT
LS -6914 e4
O+ + G
AS-BUILTSURVEY
SCALE: 1• • 4P
I HEREBY CERTIFY THAT I HAVE PERFORMED
MORTGAGEES INSPECTION OF THE FOLLOWING
DESCRIBED PROPERTY.
LOT 2. BLOCK 2. ELMORE SUB.
THE INFORMATION HEREON 0 FOR THE USE OF LENDING INSTRUTIONS SPECIFICALLY TO SHOW ANY CONFLICTS BETWEEN ANCHORAGE RECORDING DISTRICT. ALASKA AND THAT
EXISTING STRUCTURES AND PLATTED LOT LINES OR EASEMENTS AND IS NOT TO BE USED FOR POSITIONING ADDITIONAL THE IMPROVEMENTS SITUATED THEREON ARE WITHIN THE
STRUCTURES OR FENCELINES. PROPERTY LINES AND NO VISIBLE ENCROACHMENTS EXIST
OTHER THAN NOTED.
EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON.
DATED ATANCHORAOE. ALASKA THIS 2"H--
NOTE:
6TH_NOTE: ANY FENCEUNES SHOWN ARE LOCATED APPROAMATELY AND ARE NOT TO BE USED TO DETERMINE PROPERTY LINES DAY OF—NOVEMBER 2W0_
qt LOCATE STRUCTURES. HOLT LAND SURVEYING
TEL. 34541513
\\ P.O. Bar 196860 • Anchorage, Alaska 99519.6650 • Telephone (907) 343-8301 • Fax (907) 343-8200
4700 Bragaw Street • Anchorage, Alaska 99507
Mayor Mark Begich w w.muni.org
Building Safety Division
12/16/2004
Flattop Technical Services
14530 Echo Street
Anchorage, Alaska 99516
Subject: Waiver Request for Elmore Subdivision, Block 2, Lot 2
Waiver Request #WR040096
Parcel ID #018-171-07
HAA# HAO40631
Dear Mr. Moore:
Your request for a waiver of the
absorption field and septic tank on-]
Elmore Subdivision, Block, 2, Lot
distance from the septic tank to th
distance from the absorption -field to
This waiver approv
only. Any future l
separation distances
100 feet horizontal separation from the
division, Block 2, Lot 2 to private well on
ren approved. The approved separation
well: is 96 feet. The approved separation
iwell is 97 feet.
If there are any further concerns or questions regardin
at 343-7904.
Sincerely,
Julie Makela, P.E.
Civil Engineer
On -Site Water & Wastewater Program
I septic tank separation
system will require all
waiver, please call our office
Community, Security,, Prosperity
a
Elmore, Block 2, Lot 2 (Parcel ID: 018-171-07)
Waiver for 96 feet from existing septic tank and 97 feet from absorption field on Elmore, Block 2,
Lot 2 to private water well on Elmore, Block 2, Lot 3A
Issued December 16, 2004
General
1. Total coliform or other bacteria was not detected for the water sample collected from the well on Lot 3A.
2. The nitrate sample taken from the well on Lot 3A Is 1.68 mg/L.
3. The nitrate sample taken from the well on Lot 2 is 0.87 mg/L.
4. Waivers exist for the septic system to the well on Lot 3A.
5. The well on Lot 3S is upgradient of the septic system on Lot 2.
Absorption Field (Block 2. Lot 21
The septic system on Lot 2 was installed in 1999. The absorption field is 51.9 feet in length, with an effective
absorption area of 405 square feet, and a total depth of 7.1 feet from final grade.
Well (Block 2. Lot 3A1
The well on Lot 3A was completed prior to 1976. The total depth of the well is estimated to be greater than 90 feet
according to a 1994 HAA. The static water level in 1994 was 90 feet. The well Is estimated to be cased to a depth
of at least 90 feet. A waiver (WR940052) is currently in place for the separation distance between the septic
system and well on Lot 3A.
ADEC Criteria Points
Water Table 7,0
Static water level in well on Lot 3A on 8/3/94 90 feet
Total depth of absorption field on Lot 2 -7 feet
82.9 feet
1/45 = x/42.9 x = 0.95 + 8.0
Soil Sorption 3.4
Soil descriptions from wail log for Elmore, Block 2, Lot 1 (Well log for Lot 3A unavailable; well log for Lot 2 unreadable)
Silty, sandy gravel 7.1 - 34 feet
Gravelly day 34 - 74 feet
Clay & Gravel 78 - 85 feet
Silty sand 74 - 90 feet
(26.9/82.9 x 0) + (40/82.9 x 6.0) + (18/82.9 x 2.5)
Permeability 2.0
Soil descriptions from well log for Elmore, Block 2, Lot 1 (Weil log for Lot 3A unavailable; well log for Lot 2 unreadable)
Silty, sandy gravel 7.1 - 34 feet
Gravelly clay 34 - 74 feet
Clay & Gravel 78 - 85 feet
Silty sand 74 - 90 feet
(28.9/82.9 x 1.0) + (40/82.9 x 3.0) + (16182.9 x 1.5)
Water Table Gradient 4.5
Ground surface slopes slightly away from the well
+5% slope
Horizontal Separation 2.9
97 feet between absorption field on Lot 2 and well on Lot 3A
1/25=x/22 x=0.9+2
Total Points 19.8
As per ADEC waiver guidelines a point value of 19.8 is almost sure to be free of any form of contamination from
household sewage.
Municipality of Anchorage
Development Services Department
• Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AIC 99519-6650
www.ci.anchorage.akus
(907)343-7904
Waiver Review Worksheet
WRM WR040096 PIDt#:018-171-07 HAM HAD40631 Permit#:
Date Received: 1217/2004 (tvmslti( aS0A, %a. ck8�+l,%,5 f3C6-04A Iavl9loc�)
Legal Description: Elmore Subdivision, Block 2. Lot 2
Engineer. Flattoo Technical Services
14530 Echo Street
Anchorace, Alaska 99516
Applicant: Ms. Carol Adams
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Waiver Requested: 96 feet from septic tank on Lot 2 to well on Lot 3A: and 97 feet from absorption field
on Lot 2 to well on Lot 3A
Criteria: Geology Points:
A. Water Table 7. C�5
B. Soil Sorption -2s_ L
C. Permeability c2 -C)
D. Water Table Gradient y. 5
E. Horizontal Separation �% 9
Total: 19, f
Waiver Is Granted: _ Waiver Is not Granted.,
List Conditions or Reasons for above:
Date:
Red#; 61480 Amount: $1.150.00 Date Paid: 1211&004
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TAU SFR
CML & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION 3 ANALYSE
THEODORE F. MOORE, P.E. 14530 ECHO ST.
PH: (907) 345-1355 December 6, 2004 ANCHORAGE, ALASKA 99516
M.O. A. DSD
Attn: Julie Makela, P. E.
P.O. Box 19-6650
Anchorage, AK 99519-6650
Dear Ms. Makela :
In response to your "pink slip" dated 12/1/04 regarding our application for a HAA certificate for
Lot 2, Block 2, Elmore S/D, we are hereby requesting issuance of a waiver allowing the septic tank on
this lot to be approved in its present location approximately 99 feet from the well on Lot 3A, Block 2,
and also allowing the drainfield on this lot to be approved in its present location possibly as close as 97
feet from the same well. A site plan and copies of relevant documents from your files including driller's
logs from several nearby wells are enclosed. We collected water samples from the well on Lot 3A,
Block 2, Elmore S/D on December 3, 2004, and will provide a copy of the test results to your office as
soon as we receive them from the laboratory.
The existing private well on Lot 3A, Block 2, Elmore S/D was probably drilled in the late 1960's
and no driller's log is available. In August of 1994 the static water level in this well was measured at 90
feet below the top of the casing and the yield was measured to be 5 gpm with a maximum drawdown to
94 feet. Driller's logs for 4 nearby wells (Lots 1, 2, 15, and 16) are enclosed. The depths of these wells
range from 107 feet to 142 feet, and the reported yields range from 6 to 12 gpm. The closest well to the
well in question is the well on Lot 2, Block 2, so we have used the data from that well in our analysis.
According to the driller's log for the lot serving Lot 2, Block 2, this well was completed in
December of 1985 and has a total depth of 111 feet and a static water level of 86 feet. On October 28,
2004 I conducted a yield test of this well and measured a static water level of 87 feet below the top of
the casing. Steady pumping of 1233 gallons of water from the well at the average pump output of 4.9
gpm caused a maximum drawdown to 88 feet.
According to the MOA approved engineer's as -built inspection report the present wastewater
disposal system serving the residence on Lot 2, Block 2, Elmore S/D was installed in July of 1999 and
consists of a 1000 -gallon septic tank which discharges effluent into a 51.9 -foot long by 5 -foot wide soil
absorption drainfield containing 2.7 feet of gravel beneath the horizontal distribution pipe. The site
drawing that is part of this as -built report indicates that the system components are 100 feet from the
well on Lot 3A. However recent measurements made by Flattop Technical Services and further refined
by your office indicate that the cleanout pipe for the first compartment of the septic tank is 101.1 feet
from the well casing, which indicates that the underground portion of the septic tank probably
approaches 99 feet from the well. These same measurements also indicate that the cleanout pipe at the
east end of the drainfield is 99.5 feet from the well on Lot 3A. Since the distance between the two
cleanout pipes at the ends of the drainfield is less than the reported drainfield length of 51.9 feet, we
have assumed that the drainfield is centered on the pipes as shown on the enclose site plan. Using this
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rationale, it appears that a portion of the drainfield on Lot 2 may be as close as 97 feet from the well on
Lot 3A. Thus we are requesting the waiver be issued for a 97 -foot separation distance.
The following is a breakdown of how waiver analysis points could be assigned using ADEC's
1985 "Separation Distance Waiver Guidelines for SCRO".
Category
Points
Distance to water table (90' — 3' = 87') 6.1
Soil Sorption (mostly clay and sand) 4.5
Permeability (mostly soil with perc rate of >50 min/in.) 3
Water table gradient (+5% from well to drainfield) 4.5
Horizontal separation (971 2.9
Total 21.0
Using this point assignment it appears that the requested waiver can be safely issued without
concern as to the potential contamination of the Lot 3A well attributable to the proximity of the septic
system on Lot 2. It should be noted that a previous waiver has already been issued allowing the well on
Lot 3A to be 74 feet from the septic tank and 98 feet from the leach field on the same lot. The fact that
the Lot 2 septic system is down -gradient from the Lot 3A well makes it impossible for surfacing effluent
from a failing septic system to flow towards the well.
The 2nd concern you brought up regarding the distance from the foundation cleanout to the
foundation has now been addressed by the installation of another cleanout located downstream of the
first and oriented upstream, thereby allowing the entire line between the house and the tank to be readily
cleaned as needed.
Please give me a call if you have any questions on this submittal. The closing date for the sale of
this property is scheduled for December 15, so we would appreciate your timely processing of this
waiver request. The HAA application was submitted on November 24, 2004.
Sincerely,
Ted Moore, P.E.
Cc: Carol Adams, c/o Bob Stanton, Prudential Vista.
By FAX 562-5485
DEARMOUN ROAD
— -- — ----- — -- —(:� -- — -- —--------- ---
----------
LOT
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LOT 1
I LOT 2, BLOCK 2 �.
ELMORE SID
LOT 3A
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LOT 2, BLOCK 2, ELMORE SID
WAIVER APPLICATION
SITE PLAN
FLATTOP TECHNICAL SERVICES 1 INCH = 50 FEET
14530 ECHO STREET DRAWN BY TFM
ANCHORAGE, ALASKA 99516 DECEMBER, 2004
NOTE: THIS IS NOT A SURVEYED PLAT.
Municipality of Anchorage
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ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
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AS -BUILT SYSTEM DETAILS/SITE PLAN
ELMORE S/D , LOT 2 , BLOCK 2
M O WELL
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Permit SW990167
PID#018-171-07
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SCALE, HTS
END ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER. AK 99577-8736
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(907)698-6111/8AZ (907)898-8111
WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological a Geophysical Surreys
*filling ►onnN Na.
LOCATION OF WELL tries►e complete either Is. Ib or la.1 A.O.L. No.
la. Ilwough
Anch
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I Lot
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le. Otsum Also OUECTION FROM ROAD INTLnLECT10Ns
Street Address use Aram of Well Location
B. OWNEtI OF WELL:
Brian ililson
Address` 655 We 22nd. St.
Anchorage, AK 99503
L. WELL LOO Fool Below
Settee*
Materiel Type Too Bottom
4. WELL DEPTH:(find)
1117 ft
L. DATE OF COMPLETION
10� ?A Al;
I'll 04 i a .
L. Ubbble tool *Rotary 00rlaen Olive
OAsoar Oaelt.d [3 Serve OOther I
Brown
$eavint, sand & Fravel 99 106
T.vsE:Qoomostle OPobllc Leooly Oladeatrr
O IrrleoNeo O ReUergo O Commands,
O Teat Wel O Omar:
ro d.w A (. 1n7
L. CASOIaf O Tkre fed O Welded
/169. b M. so 1 j ft. Depth Walsh/ 17 les./fl.
dtea. M. N ft. Depth sllckv0 It.
•
R. FINILN OF WELLS
Type: olamelarr
Llel/Meeh Lteel _ Leagth:
Lal betNM ft. god fl.
Lackfllllae *ravel peak
10. STATIC WATER LLVELt. Q5 ft. 1 •M
OAbere' gr 0 Salem bM sufano Dole
LgelPWaef aced: Bailer
Oe
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II.POMPINa LEVEL below load surface one YIELD
M it. after 4tears. Poa:Has IQ_*.P.M..
IL after Are. pumping—I.P.M.
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I9.6111OUT1Na Well $tested: O we 0 Ne
Material: O Meet Caveat O Other:
Is. PUMPS III available) No
Leaem of Ores pipe ft, soodally O.P.M.
O Se►w. 134s, O Centrlfleal O other
Id.REMARNS:
16. WATER WELL CONTRACTOR'S CERTIFICATIONS
IS. 1p6tet TagaNlw _• OF 13 C
This 9611 No drilled Nader My Iwfted:clloe god this record N Mee to the best of or knowledge and belief
Sommerville Well Uri111nf. A13788
Roa,slarN Business Nang Contract Lives" Member
Ad,r.s:: 111140 Polar Drive.An havire A. Agg16
Elgned i/ "Y 1 • � •.. Date: / - .341 - 9.'1
1rlMrlaea Rgraaesletles ,
two OE -Www In/gl) Choy Metrication: WHITE -Stale DgOS, PINK -Outlet. OANARY-Ceste9ar
Fax:%? -248-0042 Aug 6 '97 11:43 P.02
MOW DRILLING, Inc.
P.O. !Or 1107Ta • IQ= Ob Seward NgnwtT
(90T) 019.1376
At;CWRAGE, ALASKA 99511
DAIU MO too
Well Owner JON AH -YOU AND JUDITH MACK Use of well 5nMr&TTV
"tion (address of: Towtuhlp, 8016. Section, ft known; or distance mein tugs
LOT i, T r.6—Ar 9 t. MoRF't fRAyAtiT T a rtFaRN�T1N
Ett.^MnPIGr. AT.Acra
Sete of eaa:ng 6" Mepth of Hole j3 Beet Cued eo T 39 _ a6 r
eat
Static water levet 78.810 et (blow) (and surface. rinieh of well (check one) open end ( X );
Screen ( ); Perforated ( t . ),
Ducal screen or perforation .N/A
Well pumping teat at 12_.ca$�itr
of drawdown from static ' 1. ,
Date of complet 2 JULY 1 -2:
(minute) for t `ours wlc►+ 100! et.
Witt too
Depth to leer !rota ; _ ,•...
—2 To 210
36 Te 76
—1 Te 1110
»e To_173
N
133 T0.338,
138go
Te
To
1'10
Tn
formations
sire of material, color and hardness
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SILTS BROWNe GRAVELLY `rte
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