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HomeMy WebLinkAboutALPINE TERRACE BLK 3 LT 1Alpine Terrace Block 3 Lot 1 #015-243-10 Municipality of Anchorage Page of Q 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 5W 970-335 Number: 015- a�3- l0 Permit Number: PID Name: Wastewater System: ❑ New ❑ Upgrade Address: p vc 995!6 v4 ABSORPTION FIELD Phone: 3V5-93,310 No. of Trooms: 7 ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mou ❑ Other LEGAL DESCRIPTION Soil Rating: Total Depth fro original grade: GPD/Sq. U. Lot: Block: Subdivisio Depth to pipe bottom from original grade: Grav epth beneath pipe ' Ft. Ft. Township: Range: Section: Fill added above original grade: Gravel length: _ Ft. Ft. WELL: �x New ❑Upgrade raveiwidth: Numberoflines: Distance between lines: Ft. Ft. Classification (Private, A,B,C): Total Depth: sed To: Total absorpti rea: Pipe material: Ft. Ft. SQ. Ft. Driller: Date Drilled: Static Water Level: Inst r: p L S Date installed: I 4 7 Yield: Pump Set at: Casing Height Above (around: TANK GPM Ft. Ft. SEPARATION DISTANCESSeptic ❑ Holding ❑ S.T.E. P. To Septic Absorption Lift Holding Public/Private M ufacturer, IWAIX. Capacity In %pops: /-VU From Tank Field Station Tank Sewer Lines /t/ -• well-, t WI I V� ^G f� dCJ Material � Number of Com�artmenis: a Surface 100'4- I004 LIFT STATION Lot r 04- r 10� Size in gallons: Manufacturer: Line Foundation 61 /O f� "Pump on" level at: p off" level at: High water alarm at: Curtain P.WJ kA/0 Pump Make el Electrical Inspections performed by: Drain �1 BENCH MARK Remarks: Location and De criptiow f'KoeA O�F_ c)ZAA-9 CLOS o- -P Fk_PIT " I Assumed Elevation: I�OFt ' 4 S & S ENGINEERING D�,@�S: 1 S '� 1 � r Inspections performed by: •. • .. .. wrr a.Ne••...+'rn. �' "'"' ....17034 .. , e ver oa o. �e 9 �p 2nd / ���� d 7 g ��. ROBERT C. COWAN /�@ Eagle River, Alaska 99577 tt� 0% CE - 8801 �r `� Department of Health and Human Services approval at=tF<-a •,' " ; ' �`� f/�^^- C Date:/I- M -Y 7- Reviewed and approved by: 72-013 (Rev. 9/91) MOA 26 pNN= NO, SW970335 PA= 2 or 2 Municipalit of Anchora e DEPARTMENT OF HEALTH AND HUNI�AN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O. Box 196650 • Anchorage, Alaska 99519-6650 • Tetephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT 120" LOT 1, BLOCK 3, ALPINE TERRACE S/D P.I.D. NO. 015-243-10 ST1 22.0 26.5 DBL1 22.5 40:o CIRCLE DRIVE DBL2 22.5 41.0 IF 22.5 41.5' EXISTING TRENCH w co a /� Ca INSTALLED FLOW DIVISA*Elt(FD) I / / � / F \ \tioejK ST1 G, ��9�� "1 MT 1T` ST2 B J DBL2� `D81.1 O NEW 1500 GAL. EXISTING CRIB SEPTIC TANK SCALE 1" = 40' ST1 ST2 /FINAL GRADE 100.0' ���, ,•.............. el� 7` >4 NEW 94.5' �r.... ..... ....«....:..... q 94.21 1500 GAL S.T. �... .,. ....... ' % ROBERT C. COWAN fl�O 1 c' CE -8801 f `� N.T.S. ,at t lA E'� A� ��OfC�J,�� 'r~► nc�sn C's 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:SW970335 DESIGN ENGINEER:S & S ENGINEERING OWNER_NAME:KURKA RALPH J & ALICE L OWNER ADDRESS:11820 CIRCLE DR ANCHORAGE, AK 99516 PARCEL ID:01524310 LEGAL DESCRIPTION: ALPINE TERRACE BLK 3 LT 1 LOT SIZE: 36200 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 9/26/97 EXPIRATION DATE: 9/26/98 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: 7wz 1. 4, '7/x, DATE: �/lI ISSUED BY: ��.� DATE: 7 S&S� �ineeRing September 24, 1997 ROBERT C. COWAN, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 SEWER & WATER MAIN EXTENSIONS REFERENCE: Lot 1, Block 3, Alpine Terrace Subdivision SEWER & WATER INSPECTION Request you expedite the issuance of a permit to upgrade the septic system serving the existing house on the referenced property. The existing 1000 gallon septic tank has collapsed and is LEA M4G EFFLUENT. The exisiting 500 gallon and 1000 ENGINEERING STUDIES AND REPORTS gallon septic tanks will be excavated, pumped, crushed, and abandoned completely and replaced with a new 1500 gallon septic tank. Attached is the proposed upgrade design. WELLINSPECTION & FLOW TEST We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic tank. SITE PLANS We request you expedite the issuance of this pemit due to the unsanitary conditions. If you require additional information, please contact us. ROAD DESIGN Sincerely, SOILTEST gRober/t C. Cowan, P.E. PERCOLATION tr RCC/mg TEST Enclosure STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP - SUITE 204 - EAGLE RIVER, ALASKA 99577 I 1" = 60' I SITE -PLAN I DESIGN SCALE n� ro 0 0 V, 0 �wIq �N �o' 0 z n F- m z p��OGZ1 N Nmz` 02 9p -9m �� m� �.yif 71 D, z o yLDpT.NA o oy ca E �m a �p Drri_ o� m to r— r, 0 � W < m �� r �J0 �] O 0 � I .� o Z2 -01y y y.�..� ^� IZi1D<N Dec D L J� n ;m. = L1. z m T IN.� Lyz�Y a0 qA I np-coN MFa H �� -f" QyyIM �-�1N O Zz 0 Vl 2 N AZN v, rom m-1� Cfl a 0 c GS o Z, " z a0 m yo "r m!�C V U1 0 0/ 00 �A� ° n zDz V DX V1 P hoz WC> O 0 OAZ �n M ;o =O = 0 :d> � m o0 zz O Z 0 o N -rl \ to � -1 .9 o -ci o .?J i n � to if — T co m . ('' o0 xo� r' (.''S a $ .` �mA fa Z GREA,tR ANCHORAGE AREA BM. JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 i INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME LOCATION SEPTIC TANK: DISTANCE FROM WELL INSIDE LENGTH MAILING ADDRESS \ ( �J'' Z 26 PHONE LEGAL DESCRIPTION /O © l��f- J� �'�" _� �X4, MANUFACTURER_ INSIDE WIDTH _ MATERIAL LIQUID DEPTH NUMBER OF COMPARTMENTS LIQUID CAPACITY GALLONS. I u r r , TILE ___ /'O� Z/ x�__W)'/ 11 i i TOTAL LENGTH DISTANCE FROM WELL -FOUNDATION NEAREST LOT LINE -- OF LI ES NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH- IN. TOTAL EFFECTIVE ABSORPTION AREA SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE MATERIAL BENEATH TILE_ IN. ABOVE TILE --IN. WELL: TYPE- CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC SEEPAGE FOUNDATION LOT LINE , SEWER LINE , TANK , SYSTEM CESSPOOL , OTHER SOURCES APPROVED _ DISAPPROVED REMARKS --- DISTANCES: _ ()'3 ,�_- DIAGRAM OF SYSTEM INSTALLED BYA41: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: REMARKS: _ Form EQ -032 1i � ` "'A DATE ?J J DATE r APPROVED l_ z�_ /th-�-I. tL G.A.A.B. rf DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 2516 E TUDOR RD. . ANCHORAGE/ HK. 99507 276-2221 I -T"F-:" ��L-A �� �F= F�! I'l I J- /0_ //- PERMIT NO. ( 768]0 > �/ /�l�/\ APPLICANT RALPH KURKA SRH BOX 396L ]49-1185 LOCATION CIRCLE DRIVE LEGHL L1 B] ALPINE TERRACE LOT SIZE 43000 SQUARE FEET TYPE OF SOIL HB5ORBTION SYSTEM IS: PIT MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING (5Q FT/BR)= 85 THE REQUIRED SIZE OF THE SOIL HBSORPT STEM IS: /oQW; = . C., EE F-�`r -1 C21 ���C-3 -IF ��F:� %o'EF I �F---���= ` THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF EACH SIDE FOR H SEEPAGE PIT. THE DEPTH OF H TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION (IN FEET). FR. EZ- ��1 F;?- 1= C-N �FEE ��I f_-.; -IF ��F-< �I 2'FE= ���E-:1 ����P-0 '-c= -Y" t4 cl < ;a* > I N!E. F=p F-:- C_-_"jr 1 Ci "!-=. " FP.-* I=- ����I F -r FEE E --u BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR H PRIVATE WELL OR 200 FEET FOR H PUBLIC WELL SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. F:="IF- FZ Irl I J- ���l E�m F="(--1 F-* ��r=- �E� " �R ��t-D t-1 I�9 - J L- --"* I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS HS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 3: I UNDERSTAND THAT THE ON TE SEWER SYSTEM MAY REQUIRE ENLHRGEMENT IF THE RESIDENCE IS REMODELED 10 INOLUDE MORE THAN 4 BEDROOMS. SIGNED: APPEW: 11T WLPH KURKA �~~-�� /��_~y ���. ISSUED _ ____DHTE_______________ , ' �^ ^����] ���«��°c3^ , ��/ ��, ��~�~� ��°�����=�~�� ��~ ^ _ _�_~~�� ��� . � . -/ /- / / -' CONSULTING GEOLOGIST BOX 476-M, STAR ROUTE A • ANCHORAGE, ALASKA 99507 • PHONE 344-7071 Date 10/1 i SOILS LOG Performed for Za(�\A kM�<� Legal Description fir'\ t �_� k 13 X ocN � ?2th feet) Soil Description 44- --6- --8- --8- -2 -2-6-8 20- 1, 'Le to (;A+ Total Depth �4 feet in CW Was groundwater encountered What depth �? Depth to bedrock 2 4 How determined U P-� we -(k ? - Respectfully submitted, Gary F. Player Consulting Geologist O -k L) i 1 (\,C(- -CA, (s o-,( p 4- , S(r- . (' � , 1,4 L'-14 � - Z' k5 . GREA -R ANCHORAGE AREA BOR IGH ►c��� Department of Environment Quality u-tl 3500 Tudor Road Anchorage, Alaska 99507 {� INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM J NAME IU1S�r�pF+�C', orAwo MAILING ADDRESS '�X yr CSS PHONEo779_���1 LOCATION S`� ' T IIS'�L`LEGAL DESCRIPTION SEPTIC TANK: DISTANCE FROM WELL '�SQ JeU MANUFACTURE K/ MATERIAL tL-919- 4� -Slt-"l, INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH TILE DRAIN FIELD: NUMBER OF COMPARTMENTS LIQUID CAPACITYjQ©OGALLONS. DISTANCE FROM WELL �C)KI 611 /55/�- UNDATION �l NEAREST LOT LINE O k )' OFTLIN LAL INES NUMBER OF LINES 1 DISTANCE BETWEEN LINES TRENCH WIDTH70IN. TOTAL EFFECTIVE r `q / ABSORPTION AREA VV � SQ. FT. LENGTH OF EACH LINE �( 1 DEPTH OF FILTER / to DEPTH: TOP OF TILE TO FINISH GRADE "� MATERIAL BENEATH TILE C* IN. ABOVE TILE IN. WELL:r TYPEA )h4 'I Q — CONSTRUCTION DEPTH DISTANCE FROM: BUILDING NEAREST , NEAREST FOUNDATION , LOT LINE/, SEWER LINE CESSPOOL OTHER SOURCES APPROVED DISAPPROVED REMARKS DISTANCES INSTALLED BY: e i RO SEWER LINE DEPTH: L PIPE MATERIAL:I 6Q)b�p [is LOT SLOPE:`' S� REMARKS: 1'jja_11�i1�C Form PW027 rdA-� i il SEPTIC����/ SEEPAGE / _ TANK .`_ SYSTEM /(20 ,fir DIAGRAM OF SYSTEM 2. �c�e S;►��,Jc DATE //,— —7Z APPROVED G.A.A.B. N A/ GREATER ANCHORAGE AREA BOROUGH CDEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6.650 1 ' ANCHORAGE. ALASKA 99502 I TCI. L:rr+orie 279-86 136 PERMIT NO. SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT y--Ze5-7 z�79-73393, NAME OF APPLICANT \1 0 INSTALLATION LOCATION LEGAL DESCRIPTION INSTALLATION OF: SEPTIC TANK K) TYPE AND SIZE OF FACILITY TO BE SERVED MAILING ADDRF-SS/Nf V SEEPAGE PIT Ell DRAIN FIELD Z/ OTHER TOOJ BE INSTALLED BY SOIL TEST RESULTS S Z leo^y"1 NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST Cc;,, el, C- ? // w 11 f 1, COMPLETION DATE ANTICIPATED / /?� e✓ i r PFRMTT VAI M ONE YFAR FINAL INSPECTION, 24 HOUR NOTICE'REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE TYPE StPP1 Or rt -re-teSEEPAGE AREA SIZE TYPE MINIMUM DISTANCES, REQUIREMENTS 5 ft. FOUNDATION TO SEPTIC TANK FOUNDATION TO SEEPAGE PIT 20 fte , DRAIN FIELD 10 ft, SEPTIC TANK TO SEEPAGE PIT WALL 15 ft • SEPTIC TANK 5 ft, , SEEPAGE PIT N FIELD —10—ft-Ala— TO 10ft.TO NEAREST LOT LINE. i WELL TO SEPTIC TANK O SEEPAGE PIT - DRAIN FIELD 1Z 66*2 ALSO CONSIDER AREA WATER MAIN TO SEPTIC TANK 10 ft.- . SEEPAGE PIT 10 ft - DRAIN FIELD 10 ft. • SEPTIC TANK, 25 ft*, SEEPAGE PIT 100 ft* , DRAIN FIELD �SL��-•. T RIVER LAKE STREAM DIAGRAM OF SYSTEM 4" CAST IRON SIPHON SEPTIC PIPC WITH AIRTIGHT CRIB 1AYi:� / CAPS \\t -'A -:,;.L LAST II!1 Level—k CAST IRON INTO UNDISTURBED SOIL ?fINIIIUII MINIMUM %RAVEL PAfgKiIIA AROUND CRJB, C I required whenever line crosses (CRIB 41 KININUN ABOVE- NATER: under driveway. TABLE) 1. O Nil;l40ft V!EI.1. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF IRI_11.11jM1L EXCAVATION 3 FEET INTO UNDISTURBED SOIL, 1n PIT- 100' I,P SLVER LINE- 10' 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. 10 TANK- RD" ' TO ['if- 120' GRAVEL BACKFILL nn' -Na' tnsT IRONsc sENEr, L Ft:[ CONFORM TO BOROUGH REG ATIONS REGARDING INSTALLATION. PNPI IC TO 700 ' L IT- Til PIT - 200' I' /-: ONLY !1,,T I!1411 SEWER !. 1 1 f. 1f14'-r11i SOIIPC L' OF. HEALTH AUTHORITY °'! r'!"!If't1011 OR LICENSED DESIGNER I CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER DESCRIBED YSTEM IS IN ACCORDANCE WITH SAID CODE. ;Z12Z APPLICANT'S SIGNATURE 4 IIICH SENER LII.E. CONS'INIZ AREA WELLS. SEEPACE Pit F.%CAVATIOII BASED ON SOIL TEST. HOUSE HELL --) • Grade: E' -per ICO', or 1/4' p r font except 10' precrading tank & tha. should I not exceed 7%. 6' per 100 on flat terrains. CAST IPM1, ;i SEPTIC PIPE 5' TANK I r.TO ON'- —,(4 INCH nISN' ul) ) CAST IRON SIPHON PIPE S 0 1 L .� SEEPAGE PTT `.J CRIB 1•i< _ GRAVEL OACKFILL u 20 -=MINIMUM NEA PEST LOT LINE ORAGE AREA BOROUGH ORDINANCE NO. 28.88 AND THAT THE ABOVE at j 400 GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY Case # 3330 "C" Street ANCHORAGE, ALASKA 99503 Performed For ��� /q�v►a3.1 Dated Performed Legal Description: LotI Block 3 Subdivision /P 7. re-o,-� This Form Reports Soils Log )4 Percolation Test - Soil Test Must Be Logged To 4' Below Proposed Seepage System - Depth Feet Soil Characteristics 1 --- 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14— Was Ground Water Encountered? #7a If Yes, At What Depth? O,o F Reading Date Gross Time Net Time Depth to H2O Net Drop) Percolation Rate Minute Proposed Installation: Seepage Pit Drain Field Depth of Inlet Depth to Bottom of Pit or TrencF- COMMENTS:�v% �' ` e/ra.` �/� de i�ll, --- Test Performed BY—Date Certified BY: — Date: Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program ` 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907)343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. 01S' - 2'f 3- if HAA n J�fiq�,P 0 5, % Expiration Date: 1. GENERAL INFORMATION Complete legal description f_o FB, C /o c tr 3, A lloi ne Te rrG ce -C lb Location (site address or directions) (16-01 Crrc fe Di -i. e Current Propertyowner(s) Jae � CI^oey aurrd4frkr Day phone 34fS-7f69 Mailing address 11460, l,rrly pei e 14ACbo.-0go / &c 99So7 Lending agency u, k . Day phone Mailing address Real Estate Agent 91«c k CuAi k - Cr. {*,a Ours& ,f Day phone 6•!Y - /B a3 Mailing Address 3 ZU f `C" S�.I/ i4t eA 1`4rl fey A& 99503 Unless otherwise requested, NAA will be held by DSD forpicku . fleove cert/ !?va/ir�r ar ocvnir 2. NUMBER OF BEDROOMS: 3 ar pick­V9whln /0+ 4 rtao'y J j9" 3. TYPE OF WATER SUPPLY:' TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site Q 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 we!ls or a public water system. The Municipality of Anchorage is not responsible for errors or emissions 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. fua,vir• /'.9u erf Qh :rCAro( Name of Firm F(crAV&,p 7-ec6n,cc:/ Phone Address /yS36f Ec/,o 5l.� .44cAo,-en_�e 99.sj6- Engineer's Printed Name ?X vaceorr F r"lcao-e 5. DSD SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Date 10 / /g i iao Z w bedrooms, with the following stipulations: \ti or a;y4,;, ON-SITE • �di `Z: WATERAND ; r': 't1ASTE1PjATGR PROGRAM J��J.c�,Ocw ,�.� C,\\\"\N l��///JJJIJJ))- X Maintenance Agreements Supplemental Engineer's Report Other By:� 5 t� / Original Certificate Date: /O —25- C 2 (Re, 01/CZ Municipality of Anchorage • Development Services Department Building Safety Division Onsite Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: l-af B,, ClocL 3, k1l,We 7-eer'ue-e S/p Parcel ID: 0 I - Zy3 -// A. WELL DATA Well type N4 If A, B, cr C provide PWSID R N• A. Well Log (Y/N) 1V Date completed 19 6S Sanitary seal (YIN) Y Wires property protected (Y/N) Y Total depth _t eft. Cased to y 3 ft. Casing height (above ground) 23 in. FROM WELL LOG AT INSPECTION Date of test 9 /3O / ZOO Z Static water level ft 31< fL Well production 9•P•m• G. 2 t 9•P•1n- WATER SAMPLE RESULTS: Coliform O colonies/100 ml. Nitrate `1.75 mg.q. Other bacteria O colonies/100 ml. Arsenic: tj-4, mg.11. Date ofsemple:2/3o/02 Collectedby: Ft4l'kw TKti Cc -c_ B. SEPTIClHOLDINGTANKDATA !1• FrvA 1906 udefaaey Aerf a!o/.k s4eee Tank Type/Material Sep b C. / Con c,-e)Y I' Date insta!led 19,5S7 y- Tank size f 2 s0 gal. 1` Number of Compartments 3 1` Cleanouts (Y/N) Y Foundation cleanout (Y/N) N Depression over tank (YIN) N High water alar (YIN) N• �• Date of pumping S/ 7-3 / 0 Z Pumper Jac. /e Roo fe'- C. ABSORPTION FIELD DATA Date installed 19 667 Mx Soil rating (g.p.d./ftZ or ft2/bdr) = System type Cc.ncry/r rrnqy r< ceepGev¢ /77/ Length Un k ft. Width (.(n k R Gravel below pipe "n 1- ft. Total depth 10.2 fL Eff. absorption area Nn h ft= Monitoring tube Y Depression over field /✓ muv 913a/oZ Date of adequacy test 9 /?0 /0 Z Results (Pass/Fail) Past For '34- bedrooms Fluid depth in absorption field before test _&Lv' in. Water added -732 gal. New depth 67, 1 in. Elapsed Time:?00 min. Final fluid depth Y9_S in. Absorption rate >= 77 YSG g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) Na -)e know^ If yes, give date >t/• A. jF ie f rrom 1963 4d uet cX I-e/f• eepo e -A jF is is Ka ccxle r1falre,nenf aA 1'-111+e of rnj/a//c,/7Unr hppi0 ..ver/ Sy 1-104 Severed Iv"ne, S,nce lnsfa/Iorhr ,n. D. LIFT STATION N• -4 Date installed Size in gallons Manho!e/Access (Y/N) 'Pump on" level at in. 'Pump off" Level atlln. High water alarm level at in. Datum Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: y.w>• Septic tank/lift station on lot �— 8 7 ' On adjacent lots � /Z S Absorption field on lot —� 106 On adjacent lots /00 ( See s l% lo/an' Public sewer main N• A. Public sewer mannole/c!eanout /a - A. Sewer /septic service line > 2S' Ho!ding tank A/. A. SEPARATION DISTANCES FROM SEPTICIHOLDING TANK. ON LOT TO: Building foundation 39 Property line 6 C"' Absorption field ^ 'Zo ' Water main N• A• Water service lineSurface. water > /ac, • Wells on adjacent lots ICS" SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line , 30' Building foundation =6"r' Water main P. A. Water Service line '> to ' Surface water 7 «' Uveway, parking/vehicle sicrge = /Z I Curtain drain Novy Soon Wells on adjacent lots ^ 91, ( wa vve r rrpm o crftr.che-C, F. COMMENTS **v* le Grvundwufe� Ao^#/r,--icy %c5C /nt�rw//tom! IU/la/OL 7%i l9' 6e1� Gni/ 4.e�e •/ Nu wort.- in rnon./on iuSC, lO/l6/oZ G. ENGINEER'S CERTIFICATION I certify that t have determined through field inspections and r review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. jrciCr"'–=n Engineers Printed Name ?k eo 4&,-a r. Date Gr 6 6 e r` 18 20o Z HAA Fee S 3 7S `` Waiver Fee $ Date of Payment eo / /8 / o Z Date of Payment Receipt Number % 1:3 fi Receipt Number (Rev. 12101) 12/3/2003 Municipality of Anchorage 1Vlark Begich, Mayor Building Safety Division P.O. Box 196650 e 4700 Braga -w Street Anchorage, Alaska 99519-6650 • (907) 343-8301. Fax (907) 343-8200 littl)://-xx,NN,Nv.iiitiiii.org Theodore F. Moore, PE Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99516 Subject: Waiver Request for Alpine Terrace Subdivision Block 3 Lot 1 Waiver Request #VvR030084 Parcel ID #015-243-10 Dear Mr. Moore: ae� � c r c E � Your request for a waiver of the required 100 feet horizontal separation from the absorption field to private well has been approved. The approved separation distance is 93.0 feet. This separation distance exists between the water well on the subject property to the seepage pit on the adjoining lot described as Alpine Terrace Subdivision Block 3 Lot 8 This waiver approval applies to the existing absorption field to private well 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. Roth Civil Engineer On -Site Water & Wastewater Program 5 FD 11 9/26/2003 Municipa,]W of Anchorage Mark Begich, Mayor Building Safety Division P.O. Box 196650 • 4700 Bragaw Street Anchorage, Alaska 99519-6650 • (907) 343-8301• Fax (907) 343-8200 http://NVWW.muni.org Ted Moore, P.E. Flattop Technical Services 14530 Echo Street Anchorage, AK 99516 Subject: Waiver Request for Alpine Terrace Block 3 Lot 1 Waiver Request #WR030084 Parcel ID #015-243-10 Dear Ted Moore: 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. Roth Civil Engineer On -Site Water & Wastewater Program Municipality of Anchorage George P. Wuerch, Magor Building Safety Division P.O. Bos 196650 • 4700 S. Braga.• Street Anchoragfc, Maska 99519-6650 • (907) 343.8301 htt�r /htlt�t.ci.anritorasTc,zi is nc 343-7907 November 4, 2002 Ralph J. & Alice L. Kurka Property Owner 11800 Circle Drive Anchorage, Alaska 909507 Re: Wastewater Disposal System Encroachment to Water Well Alpine Terrace Subdivision Block 3 Lot 1, PID 015-243-10 Dear Mr. & Mrs.Kurka: Department of Public Works A private sector engineer recently performed an evaluation of the wastewater system and water well on Alpine Terrace Subdivision Block 3 Lot 8. It was discovered during this evaluation that the wastewater absorption crib serving the home on this property is being encroached on by the water well serving the home on Alpine Terrace Subdivision Block 3 Lot 1. According to our records you are the owner of Lot 1. The separation distance is 93 feet as shown on the enclosed plan view drawing by the engineer. The required separation distance is a minimum of 100 feet for a private well to a wastewater system. This is a violation of the Municipality of Anchorage On -Site Wastewater Disposal Ordinance, Chapter 15.65. The wastewater absorption crib on lot 8 was constructed sometime during the year of 1965 when the house was constructed and the water well on lot 1 was constructed sometime in late 1972 or early 1973. Because the wastewater absorption crib on lot 8 was in place at the time the water well on lot 1 was const-ructed, makes the responsibility of resolving this encroachment matter the property owner of lot 1. Be advised that Alpine Terrace Subdivision Block 3 Lot 1 is not eligible for Health Authority Approval from this office at this time. The result will be the inability of the owner to transfer title of the property at the time of sale until the separation encroachment matter is resolved. If you have questions of the above, please contact me at 343-7907. Sincerely, Daniel J. Roth Civil Engineer On -Site Water & Wastewater Program O©(,_ as 7/-2:5-/o 3 i1'C�'I`t�-C4Z200 WAI✓FR ){EQLcEsr Fom AL!°/NE TERIPALE 3-aop1//s/OA/ 84vck 3 tors WAIVER xeowrsr Atw4vcK wxo200g/ bv4/vER Rgjupsr FAR {v147 -,FR WELL ON DICCR 3 "Tt To AefoR)oT/oA/ CRIB ON LOT g 8L vek 7 (SuMerLOr) -AVSORPr/ON Me - THE A+nsORPrmAl oeto /N 4uirmoo✓ /t cowsr/evcrew /N A Gw So „„x T14#r Tigiwf�rlaws /A.-Iry A ML ,S to r Sa/L BLrNE.4rA� Ir TH/ J 000 Aive POMNriAt EtFIuENr LEAKla4 Lv/LL OF 7"MeAreV Poor LI n) =- IN rNE 6t-,, SaIL Bur Fox ruer I,v rNE NL so& 8EA/6071.4 AAA . ri4is rRla S/ivcE �96s: TKE �/�rfR wEu / Hlrt 6EE�v /iv Petr duEsriom G,r}f co,vfrRtecrtV .IAv /972. (—,, -lv[LL PIMA - T Ne WELL Iry Q tABSr/e/v WAS CO3v-r7M uC TEP /N 197,Z- TIIE#fF /.T NO WS&L LO[► Av/4/LA®LE FOR rHE L✓Eu /iv QuF_Srtvov HOWEVER AovAtEROuf wF,LL Lo6S LjoSr /Ai Tor /M.KFd/ATE Suq/QOu,vp.,A4. i geh RLL IwF_LL LObf //VD/LATE AA/ APE41u47-E /¢QuIFE/'Z .r ,%O TO 6o Ftf; BEIOW 6,RVa ,,p I.FVEL. ALL u.ELL L06.S /NO/eJ4r6 COA✓T/^✓0u1 L,� TZ"o f OF'HI4RPPAr/ 'VP, '£Llti' G)e*v6L LI9YERS %TlA1er ' BFTWEtA1 61Zo64&00 SUl?FALE THT AQu/FE✓L !qT fQ PrET. wttrER S�MI°LES Fel THE WILL /,v RNESr/vAo H14S tic Dig-rrFelf J N/i AA776f ARE f.39••y�! p rle,nM � $A-CM91 S►}I►t►°LES tvERE PWF-V Iu P✓o OtYLtR Id.ELLT /N ME 1mxEPIA7'F AREA THAT Hnp 61PEp7ER Scr4,epT1O,1S Molt' M.4 RF-4KIREP IOD FEET' A,vp OA/F of ME 6vFLLT IS uP61?MVA,7- FROAA TME SEEPAGE PIr /.v quFsPov Avo T/-s/s PSRrickcAL WELL- ffAS A/►TQArES EL.EVi4TED i;l06/ l'7� Q r/-fWN r/It TkMc7- WELL i S 28tATHIS /AV/CxreS THF N/T/PI�TF_ L EVEL.i Ar/Efl/Q TO Bb ARE/ k'/VC&VO ARE ftO/Z£ OF A f4e*k61Z0atip I FVeL THshv OK16/4rr7N 45 A XT'sSuLT'"0F7741-T F_/vCMDigCIyhF,rr- THIr S'EP"A770v NAS EwSrAo FOR OVER 30 YEARr k-ITiy NO ^PI'/4rtE j- At2v4)emr Nimer-7;5- I S. of A, A R. C. S. A w. G. for S. C. R. POWT �. LV?rTE►2 rR9LE N SOIL SoleBT/o�v NNN w w W W W /2.31 coo 3.3 _r. aea PERME#01L I Ty, RIV03 /. 9 wl¢TE►e P9,-E (.0 4)91EA T rkE SEPT/C Clel$ !J ON THE 00"f- AlfRvx►M»r,� l./YpKawc.�c (,Kl+o�evT CovTnaic #f TI<E wFLL IA, QwCST/oN. AT14A,w.E CAvS&Ifl"r1vE[r 0'/0 2.9 I+ORIZpNMl .51COV/ POW 93 y = 3(X'• 72+2 2.7 �s Ig Gl�/�A,G T'argL IS S CONr-LVSION (,�ppAlr r^ CnM & ENVIRONMENTAL ENGINEERING • ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. Pit: (907) 345.1355 October 18, 2002 M.O.A. DSD P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: 14530 ECHO ST. ANCHORAGE, AIASKA 99516 By means of this letter we are requesting a waiver of the normally required 100 -foot separation distance down to 93 feet between the soil absorption system on Lot 8, Block 3, Alpine Terrace and the private well on Lot 1, Block 3. The waiver is needed in order to allow issuance of the enclosed HAA application for Lot 8, Block 3. A site plan, water sample test results,, and copies of nearby well logs are also enclosed for your reference. Because the well on Lot 1 was drilled subsequent to installation of the seepage pit on Lot 8, I understand that MOA will not hold the current owner of Lot 8 liable for its waiver processing fee. I was unable to find an as -built inspection report for the wastewater disposal system serving Lot 8, however according to documents prepared with earlier HAA applications the system was installed in 1965 and consists of a 1250 -gallon concrete septic tank which discharges into a concrete ring seepage pit. The bottom of the pit is 10.2 feet below ground level. During the course of the adequacy test described below, I measured the distance from the seepage pit standpipe to the well on Lot 1 to be approximately 101 feet. Assuming the pipe is centered on a typical 15' by 15' pit excavation, the actual distance between the closest part of the soil absorption system and the well would by approximately 93 feet, so this is the distance being requested by this waiver. To assess the adequacy of the septic system on Lot 8, on September 30 I added 732 gallons of water to it through the second cleanout of the septic tank while monitoring fluid levels in the septic tank and soil absorption trench standpipes before, during and after the flow of water was stopped. The initial fluid depth in the seepage pit was 46 inches and the maximum depth achieved was 67.1 inches. After the flow of water was stopped the fluid level receded at more than an adequate rate for a 4 -bedroom residence. Although this septic system had previously been approved for 4 bedrooms, current DSD policy is to limit HAA's for undocumented systems to 3 bedrooms, so the owners have reconfigured the residence accordingly. To resolve DSD concerns as to the potential for groundwater encroachment on the soil absorption system we arranged to have a perforated monitor tube installed on 10/10/02 to a depth of 19 feet below ground level at the location shown on the site plan. This monitor tube extends more than 8 feet below the bottom of the seepage pit and was dry at the time of installation and remained dry when checked on 10/18/02. I was also unable to find a driller's log for the well on Lot 1; however logs for several nearby wells are enclosed. According to documents available on the DSD website, the well on Lot 1, Block 3 was drilled possibly in very late 1972 or, more probably, early 1973. This was approximately 7 years after the seepage pit on Lot 8 was constructed. According to a 1973 HAA certificate for Lot 1 the well had a total depth of 40 feet, which is slightly less than the depth of other nearby wells. This may also be because the ground surface is somewhat lower at this well site. To assess identifiable contamination of the well on Lot 1 from the seepage pit on Lot 8, on October 10, 2002 I collected water samples from the residence on Lot 1. The lab test results for these samples were satisfactory, showing 0 coliform bacteria per 100 ml., 1 colony of other bacteria per 100 ml., and 5.39 mg/l of nitrate -N. This nitrate level appears to be typical for wells in that area, as witnessed by a comparable 4.75 mg/l recently measured for the well on Lot 8, Block 3, and 5.28 mg/l measured in 1996 for the well on Lot 7, Block 3. Considering the age of the systems, the water sample test results certainly lend support to a finding that the well on Lot 1 is not being contaminated by the seepage pit on lot 8. I hope that the foregoing information is sufficient for you to issue the requested waiver and HAA certificate. Please give me a call if you have any questions. Sincerely, Ted Moore, P.E. I :LOT 1 1 1 1 1 1 LOT 1 ` , 1 1 �WELL� LOT6,BLOCK4 1 1 I 1 � 1 ' 1 1 1 1 1 1 BLOCK 3 I -- DRIVE WELL 1 � I , I I I 1 CIRCLE DRIVE,, ; -=115% -------- SEEPAGE PIT 01/1 01/4.. 93' 15% GROUNDWATER M.T.. LOT 5 BLOCK 4 LOT\ SEPTIC BLOCK 3 TANK DRIVE INST. 10/1010219' B.G.L. \` M.T. DRY 10/18/02 R 100' R 100' WELL V ; 1 � 1 � ` 1 1 ^ 1 . •11 , 1 _ �1 --- `''. •1 1 LOT 3 11 ,,OF A(4 �'�t 4911-1 �Q� .......::'...' THEODORE F. MOORE: is • CE • 3589. -0 ",.I* ........ C. I HOUSE 1 444 LOT 7 BLOCK 3 -� ------ -- ISF— wore: 100 FF LOT LOTS 1 & 8, BLOCK 3, ALPINE TERRACE SID WELL AND SEPTIC SYSTEM SITE PLAN FLATTOP TECHNICAL SERVICES 1 INCH = 50 FEET 14330 ECI10 STREET DRAWN BY TFM ANCHORAGE, ALASKA 99516 OCTOBER, 2002 NOTE: THIS IS NOT A SURVEYED PLAT. ALL LOCATIONS SHOWN ARE APPROXIMATE. a OCT -28-2002 1657 It c CIRC E ji1i1VC ti N e� • SB'00' C I�O•�o , S aF rALQ ^, /J7* C.O. Lor 8 - BL,ocK 3 Lot 2 i Lir 3 SEPtK rAMik C.o.Y • f� r Ncr.rF� . 1. R£wltz DIM£NS1--4z 'T/.Ict11 PROM PLAY OF ALPINC YER;tAC6 Sr.� ,P!:&4 { ANC"gAAr . GRIo NA VAO. Z•aok3:MENt3 Sntwu 1.R'1 iAr£IS F'aOM VC64 i ANC?i= APa_ Palo K0. 274.1. * r'.TF is SJRvLvt o.tb-8S. No7F] 4ocahens of s'e/fi� Sytft� torlp"ntttt and well 01040ol 0/1 t*it a�iaw�^�J lY jec!lYoo� lo32b/o2 Scale of cc./+r LCGEND • iNO. -5/60 REBAR. 0 RuORD DIMINSIou.S FROM 9:AT P+1,4 �`O f w DLI Lot' I 3 2 Sroar w� • MAC Mousc �a 'aQ On Cer+e. 61+t. �, _� 1rGY"Drt10N � Lot 2 i Lir 3 SEPtK rAMik C.o.Y • f� r Ncr.rF� . 1. R£wltz DIM£NS1--4z 'T/.Ict11 PROM PLAY OF ALPINC YER;tAC6 Sr.� ,P!:&4 { ANC"gAAr . GRIo NA VAO. Z•aok3:MENt3 Sntwu 1.R'1 iAr£IS F'aOM VC64 i ANC?i= APa_ Palo K0. 274.1. * r'.TF is SJRvLvt o.tb-8S. No7F] 4ocahens of s'e/fi� Sytft� torlp"ntttt and well 01040ol 0/1 t*it a�iaw�^�J lY jec!lYoo� lo32b/o2 Scale of cc./+r LCGEND • iNO. -5/60 REBAR. 0 RuORD DIMINSIou.S FROM 9:AT P+1,4 P.02 TOTPL P.02 DRwN' !:cs Amu uEl'FIUP11ES7 I,OSSUli111s. �CL. A%. u1-" SJ;tvt j se P-4ipc'c3- ��y Col<7�r �y tq.+n r s+•...r� s...w. LGA o B BLOC-- 3 :sRID'Z7.c C' f� sa.sa.Qi VIS.Q]f ALPINE 5JDD.DATE' pRND:Es IZi SC-LE:153'w C.ii.4£�RA,aCE Jk%-A=KA. Dwa:I cc I P.02 TOTPL P.02 GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 Date Received Time of Inspectionq 12 Date of Inspection REQUEST FOR APPROVAL OF INDIVIDUAL SEWER S WATER FACILITIES FOR 1. Anproval Requested By: 1rhi7 7�'�lG�rrJ Address 4wx 14 _'2 2. Prooerty Owner: 3. Legal Description: Z—Of 4. Location: C— of J'I %�S�`�� 5. Type of Facility to be Inspected: Number of Bedrooms: 3 6. Well Data: (r A. Ty/f-✓ , �I �-` B. Type �r , C. Construction c� .0 D. 7. Sewage Disnosal System: A. Installed ^G�- l B• Phone: �y ?y Phone: I �i ff'� ry Depth V Bacterial Analysis Installer C. -Septic Tank: 1. Size 062 2. Manufacturer D. Seepage Pit: 1.-i!ze--"—' 2. Material S�/l E. Disposal Field: Total. Length of Lines B. Distances: A. Well To: Septic Tanks d Absorption Area Z Sewer Lines Nearest Lot Line Other Contamination f B. Foundation to Septic Tank , <,?� Absorption Area 3 C. Absorption Area to Nearest Lot Line /I Request for Approval of ividual Sewer & Water Faciliti Page Two 9. Comments: Anrrov pproved Dated Approval Valid for One Year From Date Signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subiec:t sewer and water facilities located at: Signed Date