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HomeMy WebLinkAboutNORTH WOODS BLK 1 LT 13No thwoods Block Lot 13 #051-731-68 Municipality of Anchorage .-'z;~":"[~.'" Development Services Department :~ ~. Bu~ng Safe~/Division On-Site Water and W~stewater Program, 4700 S. Eragaw SL P.O. Box 1966ti0 A~chorage. AK 99519-6650 Page www. cLanchorage.ak, us (907) 343-7S04 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: ~0~0 qD~ PID Number: O5/--7.~/-- ~8 ~r~ ~~ WastewaterSystem: ~New ~Upgmde J O~ 7~ ~r~ ~ ~/~-~7 ? ABSORPTION FIELD LEGAL DESCRIPTION Well: [] New [ri Upgrade · *~ ~ ~ ~s~ ~~ TANK SEPARATION DISTANCES ~sep6c D Hold~g ~ S.T.E.P. ~ Othe~ BENCH MARK Boq/o,. too ,, S & S ENGINEERING 17034 Eagle River Loop Road, No.~)4 Inspections performed by: F.4,gla Ri,er, Alad,, 995/7 Dales: Development.S_e/~s Department Approval ~.,e,.,~ie,._~/~ed and approved by:/,.-~" O~-te: P£R,~IT ~0. $W020423 PACE Mu~ni[ ip. cxl, i-'c oF DEPARTHENT OF HE~TH AND HUMAN SERVICES ENVIRONHENTAL SERVICES DIVISION · P.D. Box 196650 e_Anchop~ge, A_tcsk~ 995t9-665p · Te.l.e,ohone=. 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LECAL LOT 15, BLOCK 1, NORTHWOODS S/D P.I.D. / / / / / / / / / / / / / 051-751-68 / / ' f,OT 14 / /OBLt & OBL2- / co~ NEW / / / / / / I,OT 12 CE - 8801 NO. $W020425 PAGE 3 OF 5 Municip. Grit oF DEPARTMENT OF HE~_THAND HUHAN SERVICES ENVIRONMENTAL SERVICES DIVISION p.rl. Box 196650 ~Ancho~oge0 Alosko 995t9-6650·TeleDhone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 13, BLOCK 1, NORTHWOODS S/D P.i.D. NO. 051-731-68 FINAL S_T1 ST_~,- 101.2' GRADE/ GALLON SEPTIC TANK A B FCO 19.0' 27.0' ST1 16.5' 34.5' ST2 17.0' 43.0' DBL1 20.0' 46.0' DBL2 24.0' 44.5' C01 25.5' 4.3,5' 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 Date Issued: Oct 17, 2002 Expiration Date: Oct 17, 2003 Permit Number: SW020423 Legal Description: NORTH WOODS BLK 1 LT 13 Design Engineer: 0003 S & S Engineering Owner Name: bruce ochrasa Owner Address: P O BOX 103374 ANCHORAGE, AK 99510-3374 Parcel ID: 051-731-68 Site Address: 022730 NORTHWOODS DR Lot Size: 29590 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 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 not[fy DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: Date:/0//7/0~ Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 ON-SITE SEWEPJVVELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. O~ I - '~ ~ I -G8 Permit Number SWO ~.04 ? ~ Property owner(s) I~/~ u c.. d.. ~ c./c A/I. Mailing address (1) J3-O- De~ 1'7o37"/q Mailing address (2) /}~ c.H~,4.,,Ic..~/ ,~ Legal description (Lot, Block & Sub'd.) Lo+ Legal description (Section, Township & Range) Lot Size '~ ~0 Acre~ THIS APPLICATION IS FOR: Sewer Only ' Sewer and Well Sewer Upgrade THIS PROPERTY CONTAINS: Hot Tub Swimming Pool Therapy Pool Day phone Zip Code Number of Bedrooms [] Well Only [] [] Water Storage [] [] Jacuzzi [] [] Water Softening Unit [] I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and'~s in accordance with ap~l~a.bJ~.~p, nicipal~, ,, a "n~m££~lN(~C°des' Eagle River, Al.ski 99577 (Signature of property owner or authorized agent) Permit Fees: ,.~ Date of Payment: Receipt Number: (Rev. 12/00) Waiver Fees: Date of Payment: Receipt Number: October 15, 2002 ROBERT C. COWAN, RE. ROBERT A. SHAFER. RE. CML ENGINEERS (9o7) 6~4-~970 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 13, Block 1, Northwoods Subdivision It is requested that you issue a permit to replace, with a new 1250 gallon septic tank, the existing septic tank currently serving the existing three bedroom dwelling on the refcrenccdproperty, c~.,~?,,.,~. ~~,~ ~,~-~ co,.,.,~,~.o. We do not anticipate any adverse effects on neighboring well's, septic systems, reserve areas or drainage patterns by the installation of the proposed septic tank. The construction ofthis system will not prevent any future development on any ofthe adjacent properties. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCO .ij Enclosure 17034 NORTH EAGLE RIVER LOOP * SUITE 204 · EAGLE RIVER, ALASKA 99577 B.J.J. / / BLOCK [:-tc~o s,: R.C.C. / / / / / / 1, NORTIIWOOI)S [~'~: 10-15-02 / DOUBL CLEANOU~' / INSTALL /. CLEANOUI' / %.5' MIN.' £XISTINO SEPTIC TANK D£ pUMPED PROPOSED / 12.50 GALLON / SEPTIC TANK // '~ / -% LOT 12 , o~, ~'-':,'....- ~-.-~"..~. CONTRACTO~ tS RCOU,R~O TC~; ~i /7/~.//,$.~'~/ ,;,....:. PRIOR TO ANY EXCAVATION ."~sr~ /'~ _~ .~.~..,.'* ~?"" '~'~'~---,~, ,o,,,, ~ ~.;;;~ 7,.,' J WORK. k' LOT 14 ROBERTC. COWAN, RE. ROBERTA. $t IAFER, RE. ClV1L ENGINEERS (907) 694-2979 FAX (907) 694-12 ! 1 TEST ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 13, Block 1, Northwoods Subdivision October 15, 2002 GENERAL: The scope of this project includes the installation of a new 1250 gallon minimum septic tank to serve the existing three bedroom residence located on the referenced property. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: I. A septic tank is to be constructed by a certified septic tank manufacturer. ~,, AI~. OUtS ,' Construction shall include two ,~ ,.,~an for pumping access. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 Page 2 Lot13, Block 1, No~hwoods Subdivision OctoberlS, 2002 2. The septic tank shall be sufficiently bedded to prevent settling or shifting ofthe tank. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. ofcover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not mom than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). Page 3 Lot 13, Block t, Northwoods Subdivision October 15, 2002 INSPECTIONS: Typically there will be a minimum of two (2) inspections required during the installation, of the septic tank. These inspections will occur as follows: The first inspection must be conducted after the septic tank is set in place, but may not be backfilled until after this inspection. 2. The final inspection is to occur upon final grading ofthe property. The inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pm-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There xvill be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owners representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to cany out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR / INSTALLER NAME ,~_~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT PHONE [] NEW J~ UPGRADE LEGAL DESCRIPTION 4'4/ LO°AT,ON ~ ~ DISTANCE TO: ~ ~ Material ~ ~ capacity in gallons Inside length W dth Liq. IF HOMEMADE ~ ~ I Manufacturer Q Well/~ · __ Foundation i ~ i ~ I DISTANCE TO: ("0~[~~ , .~.7 ~ lNo. ofnnes I ILengthofe~ch~i~e/ ~ Totallengt. orll~l ~ ~ Top of tile to finish grade ~,(~-i ~ Material beneath tile w I Length ' Width Depth ~ ~ I Type of crib Crib diameter Crib depth ~ Well Building foundation ~ DISTANCE TO; ~ IClass Depth Driller ~ I DISTANCE TO: Building foundbtion Sewer line I NO. OF BEDROOMS PERMIT NO. Material Nearest lot line,~,~.l'~-l,~l Trench widt h.~. ,,~') inches inches No. of compartments Liquid depth PERMIT NO. Liquid capacity in gallons Distance between lines ~ effective absorption area PERMIT NO. Total effective absorption area Nearest lot line Distance to lot line Septic tank PERMIT NO. Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS 7~-o~3 m~. LEGAL L 15, DEPRF,.TMENT ~' Ow HERLTH A['.tD EN"/I RF~NMEi'-.tTAL 'PC. OTE ]:T I iN · ..'.J L -,TREET., RNEHOF'.RGE. FP..'; ~'=~.=;A:i. 26,4-4728 TIE SE~-.-~Ei:;;: F'EF..: !'"1 I: T PERMIT NO: [:'RTE I -',-,LEE. 8402L::5 UPGRRDE 8F'F'L I CRNT ': RDDREISS: CA[.,tTFtCT PHONE RODERICK HOFFMRN SR~ BOX ±4t~ CHUGIAK, RK 99567 562-25i4 LEGAL [:,EISCRIP: LFiT _, I-.-E: _,LIB[. I, I .=, I UN: [',IORTHI400[;,S SECTION: ~ &::. 4 TOWNSHIP F ' 2959¢~ (SQ. FT. dE RCREIS) LOT: :l.-'-': BLOCK RRNGE: ±W I CERTIFY THRT: ±. I AM FAMILIAR WITH THE REQUIREMENTIS FOR ON-SITE SEWERIS'AND WELLS Als ISET FORTH 89 THE MUNICIPALITY OF ANCHORRGE (MOR) AND THE STATE OF ALAISKA. 2. I WILL INISTRLL THE ISgisTEM IN ACCORDANCE WITH RLL MOA CODES AND REGULATIONS, AND IN COMPLIRNCE WITH THE DEISIGN CRITERIA OF THIS PERMIT. 2, I WILL ADHERE TO ALL MOB AND ISTRTE OF ALRSKR REQUIREMENTS FOR THE SET BACK DIISTANCES FROM RN9 EXISTING WELL, WASTEWATER DIISPOSAL SgSTEM OR PUBLIC SEWERRGE SgisTEM ON tHIS OR RN9 RDJACENT OR NERRBY LOT. IF Ft LIFT ISTFtTION IS INSTBLLE[.', tN AN RF:EFI COVERE[:, B'¢ MOB BUILDING CODES. THEN ,:.'::L) Al'.,l ELEITF'IFRL_ F'ERMIT R[',ID !N-";,PECTIOI'.,I MI_liST BE OBTF-IINE[:,.~ ,.'.2) H_,-B-C '1_1I LT=,'- WILL [..IOT BE RPPRO',,,'ED I.,.IITHOUT PIN ELECTRICFIL INISF"ECTIOI'.,I REPORT.~ AN[:' (_--.':) THE ELECTRICPIL WEIRI< MUST BE DONE B'¢ A LICE[.,IISED ELEf':TRICIF;N. ISIG[-,IED -~.., ,.-.. ~4p__..\'x k-x ~'"~ ,.~)% \'k~'~'~ [:,RTE: RPPLICRNT: RODERICK HOFFMAN ~ ISSUED ~ . ' 825 ~,~Street, Anchorage, AK. ~,_301 ,- ._~ ~ 264-4720 * * * HANDWRITTEN PERMIT ~ * * Permit ~ f~ o ~ WELL AND/OR ON-SITE SEWER PERMIT Location: Phone Number: ~ - ~/ Legal Description: ~- /~ ~ ~ ~/~~/~ Lot Size: Type of Soil Absorption System Is: T~c~chh~ Drainfield: Seepage Bed: Holding Tank: of Bedrooms: ~ ~'-% Soil Rating(sq.ft/br) Maximum Number The Required Size of the Soil Absorption System Is:' DEPTH /~' ~ ' LENGTH ~ ~.o / GRAVEL DEPTH ~'~ / WIDTH The length dimension is the length(in feet) of the trench or drainfield. 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). ~ * REQUIRED SEPTIC(HOLDING) TANK SIZE = Q/~-~ GALLONS * * 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 will serve. ~ * * TWO(2) INSPECTIONS ARE REQUIRED ~ * * Backfilling of any system without final inspection and approval by this department will be subject to prosecution. 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 this department within 30 days of the well completion° Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31~ 1 9 * * 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 will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bedrooms. ~ ~x 'R~,J MIJNICIPALITY OF ANCHORAGE ,-~.~: DEPAR'FMENT OF HEALTH & ENVIRONMENTAl. PROTECT ON ENVIRONMENTAl. ENGINEERING DIVISION 825 1. Street - Anchorage, Alaska 99501 Telephone 2~4-4720 ON-SITE SEWAGE DiSPOSAl_ SYSTEM AND/OR WELL iNSPECTION REPORT MAILING A~ES LEGAL DESCRIPTION ~O. OF B~D~OOM~ LOCATION ~' ¢~ ' Mater~a~~ No. of~mpartments ~ ~ Manufacturer ~ Liq. cap city in ~lons Inside length Wi~ Liquid depth Well Dwelling PERMIT NO. ~ Foundation ,~. - Near~st~t~ , PERMIT ,O~ ----~ ,o.o, lines¢;/O~M Longthofe~""~o~ ~' Total length ofl.~s¢ Tronchwidt~inches k~ Top of tile to finish gra~ , Material beneath tile Total effec r~ion area Length Width Depth PERMIT NO. ~ k Type of c~ eter Cdb~ tel effective absorption ~( ~' Building foundation ~estlo~ ~ ~ ~ISTANCE TO: Well __ ~aj~ ~. Depth Driller ~ Distance to lot line PER~ITNO. ~ Building foundation Sewer line Septic tank Absorption area(s) ~ DISTANCE TO: OTHER PIPE MATERIALS ~OIL T~T ~Tl~ INSTA~ REMARKS /~,~°¢ ~ ~ /O~ ~>~_ ~'~' ,', ~,,; / APPROVED f) DATE LEGAL 77-013 (sm /78) PERMIT NO. RPF'L I C P, hlT LOC:FiT 1 ON LEGRL [:,EPRRTMENT (:, ¢,-!ERL]"P RND Ei'.t',,,'IF.'CNMEi'.CI"RL YTECTION '=""'~ "L.'" L:;TF.:EET., Fll'.IF:HOF-.:FtGE., RK. 0 ~ ,4 _, ,¢ ' .-:'..-., ..~ FF.:RNK E:ETHFIRD F E fEF..:, _-:F?E'EK L:1_3: B'I NORTblHOOE) SUE: LOT SIZE 2'_--¢5'30 SC.R_IRRE FEE]' T'¢F'E OF' SOIL RE:SFIRP]`'II]d",I =,~..,TEI'I IS: TF. EN..H MR::-(IMUM NUME:ER 3F BEDROOMS SOIL RRTING ,::SQ FT,-."E:R)= '-"~ THF F.:ELT.!I_IF.'EF, SIZE OF THE SOIL HE,-_.,_RFTION S'¢STEI'd IS: THE LENG'I'H DIMENSION IS THE LENGTH (IN FEET:.', OF THE TRENCFI OR DRRINFIELD. THE DEPTH OF Ft TRENCH OR PIT IS THE DISTFINCE E,'ETHEEN THE SURFRCE OF TNE GROLIND RND THE BOTTOM OF TNE E::.:',CFI',,,'RTION (IN FEET). THERE IS NO SET ~,.IIDTH FOR TRENCHES. 'THE GRFI',,,'EL. DEPTH IS THE MINIMUM DEPTH OF GRF¢,.,'EL BETHEEN THE OUTFRL. L F'IF'E FIND THE BOTTOM OF THE EXCR',,,'FITION (IN FEET.'.',. F'E'F.:MIT RF'PLIC:RI'.,IT HI=IS THE RESPONSIE:ILIT'¢ TO INFORM TNIS [:,EF'FIF.:TMEN. T DURING THE tN'-qTPqL..LR'I"I~ZIN II'.,I_-,FE_.FII]NS OF FII'4'T' 1.4ELLS FID.TRCENT TI] THIS F'ROPEF.:T'¢ FIND TNE NIJME:FF.: OF RESIE:,ENCES TNFiT THE HELL 14ILL '--F'~",'F TI ~..l~ ~-~ ,:" ~-'.' ':, Z ~'-.~ _-:. F E _- T Z C~ ~"-.~ :5 [-.3 F: E IR E ~;." L...i I FR E D, BRCKFIL_TNG OF RN'.t S'T'STEM HITHCIUT F!NRL INSF'EE:TII]N FIND FIPPR. O'v'RL E:'-? THIS DEPFIRTMENT HILL BE: SUE:._fEC:T TO PF:'-'SEZLT ION MINIMUM DISTFINCE BE]`'HEEN FI HELL RND F¢.~¥ ON-SITE SEHRGE DISPOSRL S'¢STEM IS !00 FEET FOR Fi PRIVRTE HELL OR !50 TO 200 FEE]'' FROM R PUBLIC NELL DEPENDING UPON THE T?PE OF PIJBLIC HELL. MiNIMLIM DISTFINCE FROM R PRI',,,'RTE HELL TO Fi PRIVFITE 'E, EHER LINE IS 25 FEET RND TO Fl COMMUNI]`"¢ SEI4ER LINE IS 75 FEET. OTHER REQUIREMENTS 1"1R'¢ RPPLh.'. SPECIFICFITIONS FIN[:, CONSTRUCTION [:,IRGRFIMS FIRE R'v'RILRBLE TO INSURE F'ROPER INSTFiLLRTIOI'.,I. I CERTIFY THFtT 1: I BM FRMILIRR HITH THE REQUIREMENTL-7, FOR ON-SITE SEI.4ERS F!ND WELLS RS SET FORTH Bh" THE MLINICIPI-][_IT'¢ OF FiNCNORRGE. 2: I 1.4ILL INSTFtLL THE S'~.'STEM IN FtCE:ORDFINCE WITH THE CODES. -'.':: I UNDERSTFtND TFIFIT ]`'HE ON-SITE SEHER S'¢STEM MFI'¢ REQUIRE ENLFtRGEMENT IF' THE ~RE THRN 2.: BEDROOMS. ,. L,~,~.;IUNICIPALITY OF ANCHORAGE ',~.~' ' /~ DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION . PERCOLATION TEST Pou~:h 6-B50, Ancllorage, Alaska 99502 27~2~ SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: .... ~ SITE P~N ~. ~ 1 2 3 4 5 6 7 8 9 SLOPE 10 11 12 ' 13- 14- 15- 16- 17- 18- 19- 20- COMMENTS WAS GROUND WATER .. ENCOUNTERED)' :'::~:i' : 71,' "iFyEs, ATWHAT:: DEPTH)' ' " ' Gro~ Net Depth to ' Net Reading Date Time Time Water Drop I;IO ,, /.0 30 PERCO LATIOh,' .RATE TEST RUN BETW2EN PERFORMED By: ~~L~~~ CERTIFIED BY; 5 - ET AND ~' ~ F? . . MUbriCIPALITY OF ANCHORAGE DIVISION OF ENVIR~ HEALTH DEPARTMENT OF HF2kL~Td AND ENVIRONMENTAL PROTECTION APPLICATION FOR HEALTH AIJTHORITY APPROVAL CERTIFICATE 1. General Information Application Date _~__~o /~)fj~__~__ I (a) Legal Des[~.,,iption (include.lot, block, s~ubdivision~ section~ tcwnship~ range) (b) (c) Location (addm~ss or directions) Applicant is (check orm~) Lendin~ Institution ~ ~ (~r/builde~ ~; Buyer ~; Other ~--~ (explain); (d) Lending Institution Te le p hor~ Adck-ess Address Te lephor~. 2. ~ of R~sidenc~ Single-Family ~<-~ Mm,1 t i-Family N~r of ~dr~m ~_ 3. ~te= Su~_ Individual ~ll Note: If ~mmnit~ ~,~11 system, mst ham ~it~n ~nfimtion fr'~ the State ~pa~nt of ~viron~ntal Con~rvation attesting to t~ legality ~d status. Is ~e %~11 ade~a~ fo~ the n,~r of ~ s~cified in this ~ ~) 4. ~g~sal Is t~ was~water dis~sal syster~ adequate f~ the [Pa~e 1 of 2] 2-15-84 5. ~nginee~in~..~ Firm P~ovidin~ctions, Tests, Data and Inforn~tion I certify that I have d~ecked~ ve~ified~ or conformed to all MOA HAA GuideliDes JO effect on the date of this inspection° Signed ~~~1~ Date <.3 Signed by ( ENGINEER SEAL) 6. DHEP Approval Approved for -~ bedrooms Approved ~ Disappztoved ~ Terms of Conditional Approval Conditional Date The Municipality of Anchorage Depamtment of Health and Environmental Protection dces not ~uarantee the c~ntinued satisfactory ~erformance of the water supply and/o~ the wastewater disposal system° This approval indicates that, as of the validation date shc~7 above~ based on the data and information furnished bi; an, engineer registered in the State of Alaska, the %.~te~_~ supply and wastewater disposal system is safe and func~ tional for the number of b~dt, c~vs and t~. of structure indicated. (DHEP SEAL) 7. Mmil the HAA to the followin~ address". KB2/d5/s [Page 2 of 2] 2-15-84 ao WELL DATA Well Classification ~/3~ON[~b/ _ Well Log P~esent (Y/N) Total Depth Cased to Static Water Level Casing Height Above Ground Elec~ical Wiring in Conduit (Y/N) Separation Distances f~om Well: To Septic/Holding Tank on Lot To Neal~st Edge of Absorption Field on Lot %-3 Nearest Public Se~r Line C leanout/Manhole Water Sample Collected By Wate~ Sample Test Besults Mu c PAL'[ oF (MOA) HEALTH Ai?I~ORITY APPROVAL (PLA_A) C C LIST - 19S4 MAY 4 1984 Legal Description: ~D~./~_r% . _ If A, B, o~ C, D.E.C. Approved(Y/N) Date Completed Yield Depth of G~outing Pump Set At MUNICIPALITY OF ANCHORAGE DEPT. OF HEALTH ,9, ENVIRONMENTAL PROTECTION Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewe~ Service Line on Lot ; Date B. SEPTIC/HOLDING TANK DATA Date Installed ~= Jlo~J Size /~ No. of Cc~i~a~ta~ts ~ Standpipes (Y/N) ~,_~ ..Air-tight Caps ~/N) ~5 Foundation Cleanout (Y~ ~pression o~ Ta~ (Y~) k~ ~te ~st' P~C ~/~ Holding Ta~ High-Wate~ ~a~ (Y~) ~/~ . ~r~ Holdi~ Tank Petit (Y~) Sep~ation Distan~s ~ ~ptic~olding Tank: To Water-Supply ~11 ~' To ~ilding Foundation ~' TO ~o~rty Li~ + LO~ To Dis~sal Field ~' To ~ter Main/~vi~ Lir~ JO' TO Stream, Pond, Lake, c~ Major Drainage Course [Page 1 of 2] 2~15-84 C. ABSORPTI(~q FIELD [1ATA ~ De Soils Rating in Absorption Strata Date Installed ~/~-~{ Width of Field ~IQ' I~ ~ ~ Type of System Desi0n '~:~-~eh X Length of Field ~' Depth of Field ~' Gravel Bed Thickness Square Feet of Absorption A~ea ~ Sta~dp~~-~ Depression over Field (Y/N) I~0 Date ,of~~dequacy~~Test Results of Last Adequacy Test ~~~0~ ~f¢,0~%_ _ ' Separation Distance f~om Absorption Field: To To Building Foundation ~/~)' To Existing or Abandoned System cn Lot ~1~ ; On Adjoining Lots ~[{~. To Wate~ Main/Service Line.. '10' TO Cutbank(iftpresont) TO Stream/Pond/Lake/o~ Majo~ Drainage Ccurse '1- I©0~ TO D~iveway, Pa~king Area, o~ Vehicle Storage Area Con,rents ~:v pe¢ ~©~ .~.~o~(,~.0~~ size in Gallans "Pump On" Level at High Water Alarm Level at Tested fo~ Electrical Codes(Y/N) C~n~nts Dimensions ~anhole/Accsss (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles ~ving Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA ~equest ** I certify that I have checked, verified, o~ conformed to all MOA HAA Guidelines in effect on the date of this inspection. Signed KB1/d5/s Date MOA No. [Page 2 of 2] 2-15-84 ALASKA eh'dlRO me[1TAL CONTROL SeRO['CeS, Inc. APRIL 24 1984 RODERICK HOFFMAN SR 3 BOX 1413 CHUGACH AK 99567 SELLER - RODERICK HOFFMAN BUYER - SR 3 BOX 1413 SUBDIVISION - NORTHWOODS BLOCK - 1 LOT - 13 ADEQUACY TEST FOR SEWER SYSTEM THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 544 SQFT. THE SYSTEM IS CAPABLE OF ACCEPTING 165 GALLONS OF WATER PER DAY. THE SURGE CAPACITY OF THE SYSTEM IS 675 GALLONS. BASED UPON THE TEST DATA THE SYSTEM IS NOT ACCEPTABLE FOR A HOME OF 3 BEDROOMS. SEPTIC TANK ADEQUACY THE EXISTING SEPTIC TANK VOLUME 0;1000 ~S THIS 3 BEDROOM HOUSE. ADEQUATE FOR 1200 LUcst 33r(I Auenue, Suite [~ · Anchoraqe, Alasb~ 99503 · (907) 276-1361 DEPT. OF ENVIRONMENTAL CONSERVATION BILL SHEFFIELD, GOVERNOR ~lephone:~O~ 274-2533 Address! 437 E Street Suite 200 Anchorage, AK 99501 April 27, 1984 PWS I.D. #213001 To Whom It May Concern: According to records on file in this office the Northwoods Subdivision Water System is in compliance with the State Drinking Water Regulations. Sincerely, F. Hayden EnVironmental FJ Id Officer JFH/msm cc: Alaska Environmental Control Services Date Date Date Inspector Inspector Inspector Comments Conditional Approval Date Sewer Installed Soils Rating Permit No. Well To Absorption Area Well to Tank Septic Tank Size Holding Tank Size Well Log Received APPLICANT FILLS OUT LOWER HALF ONLY Property Owner Mailing Address l[ethard Construction, Inc. SRA Box 1698-K, Anchorage, AK 99507 IPhone 345-1615 Buyer Roderick }[offman 4790 Business Park -(:~lvd., Suite 1, Dldg. Address D, Anch. AK tending lnstitution First Alaska ~¢ortgage and Escrow Address ~usiness Park Blvd. Realty Co. & Agent RE/~{AX Properties, Inc. Address 2702 Gambell St., suite 101, Anchorage, AK 9950.~ Phone Phone 276-2761 Legal Description Lot 13, D].ock t, North'woods Street Location NI<.,l',~' North ~.~'oods Drive Type,of Residence ~] Single Family [] Multiple Family No. of Bedrooms 23 [] Other Water Supply [] Individual ~ Community [] Public Utility ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available.) Sewage Disposal E] Individual [] Public Utility [] Holdin¢ Tank 1981 Year Individual Installed: When Connected to Public Utility:. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. ALASKA [1UIROI]mfllTAL COIhTROL $ RUIC S, I[1C. ~nc~ince~inc~ ~- (~nuJ~onmentel MUNICIPALI~ OF ANCHORAGE D~T C'F HEAi_T',J ~ ENVIRf 4 J,MZN rAL January 29~ _~ Mr. Les Bucholz Department of Health and Environmental Protection Pouch 6-650 Anchorage, Alaska 99502 Attn: Les Bucholz FEB 4 1982 RECEIVED Dear Les: On the 29th day of January 1982, Alaska Environmental Control Services Inc. inspected the on-site sewage system for 5 homes located at Northwoods Subdivision...Lot 10 Block 3 Lot 25 Block 3 Lot 13 Block 1 Lot 16 Block 4 Lot 12 Block 1 In my inspection I found a cap missing, and final grade, needed for Lot 12 Block 1. All construction of the sewage systems, except for Lot 12 meets Municipality of Anchorage code. All had dry sump pipes. If you have any qu .ease contact me. Sincerely; C. Reid Jr., PhD, PE ident 1220 ~Uest 25~h J~uenue · J~nchora% Alaska 99503 · [907) 276-1361