The URL can be used to link to this page

Home My WebLink AboutPENNINGTON PARK BLK 1 LT 3Pennington Pork Block Lot 3 #020-181 - 35 Municipality of Anchorage :~;,~..".,~g~.", Development Services Department Building Safety Division On-Site Water and Wastewater Pro(jram, 4700 S. Bra(jaw SL P.O. Box 196650 Anchorage, AK 99519-6650 Page vcmv.ci, anchora(je.ak, us (907} 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: 5 (,'~)0~ 0 Z_~<~7/~ PID Number: 0 '~ 0 ~ [ ~/~ 5~ D~ + Dct~ ~ WastewaterSystem: ~New ~Upgrade ~'~ ~~ ~e~ ,~Y~ ~ ~ 1~ ABSORPTION FIELD Township: LEGAL DESCRIPTION Well: [] New [] Upgrade Classification (Private, A, B, C): Total Dep~ Cased to: __ ,..<-?, r, ¢ a ~ Fb ~ Ft. Y~eld: ~l Pump Set at: Casing Height SEPARATION DISTANCES TFrom'~ Septic Absorption LiE Tank Field Station we,, 11'7' 15i' II7' o,s-Ft. To~I ~¢tion ~e~ Pi e Material: TANK [] Septic [] Holding I~S.T.E.P. BI Other: Number of Compartments: LIFT STATION Make & Model Ei~m~ ~spec OhS peffo~ed b~ a~ ~ ~ BENCH MARK ,,,~,,~ '~ ' ,.¢ ....... ¢,,- ~ ~ :-" /5 S l S ENGINEERING ~ / ~ lnspections pedormed ~' 170~4 Eagle River Loop ,oaS, No. 204 1't j~_ ~-0~ ~- --~,,~,.w..¢..~....,.,.: t~~o. --~ ~ ~ ~ ROBERT C COWAN Development Se~ices Depa~ment ARproval ~ ~. x CE-880] PERMIT NO. SW020486 PAGE 2 OF 3 Municip. cLil o~ Anchorage DEPARTIVlENT OF HE~_THAND HUNAN SERVICES ENVIRONMENTAL SERVICES DI¥1$1ON P,O. Box 196650 ~Ancho~ge, ALcsk~ 99519-6650 ~TeLephone~ 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 5, BLOCK 1, PENNINGTON PARK S/D &T NEW 1.30.0. G. ALLON HDPE S.TE P TANK \ \ \ \ \ \ P.I.D. NO. 020-181-,55 LOT IBM TRENCHES 6A \ \ \ \ \ \ \ \ \ \ \ \ l" = 40' \ LOT 4 ROBERT C. COWAN CF.. - 8801 PERMIT NO. SW020486 PAGE $ OF 3 Nlunicip. c4i-tv Olc Anc½orcee DEPARTMENT OF HEALTH AND HUMAN SER¥1CE$ EN¥1RONMENTAL SERVICES DIVISION P,g. Box 196650 ·Ancho~'age, Alaska 99519-6650·Telephone~ 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEC, AL LOT 5, BLOCK 1, PENNINGTON PARK S/D P.I.D. NO. 020--181--35 ST1 MH /- 99.5' FINAL GRADE ~z/-z INbULA/ION 96..,..., POLYETHYLENE "-- 95.7 SEPTIC TANK MT1 =103.3' iV!T1 MT2=103.3'-x~-_ ~...rFINAL GRADE M_T3 M_T4 MT3=104.4' ~ ~¢~- MT4=i 04.4' · NO WATER FOUND 94.6' B.0.H. DISTRIBUTION SYSTEM: PUMP = BLASTER 20EB05 (~$OGPM) 2 LATERALS ~ 51' LONG EACH = 15 GPM/LAT. 15 HOLES PER LAT. (5.6' O.C.) 30 HOLES TOTAL = 1.0 GPM/HOLE 3/16"¢ HOLES FACED BOWNWARD 1-1/4"¢ LATERALS 1-1/4"¢ SOLID MANIFOLD A FCO 8.5' ST1 18.0' MH 20.5' TMT 22.5' DV1 54.0' DV2 34.0' MT1 45.0' MT2 - MT3 63.5' MT4 - B C 4.5' - 23.0' - 26.5' - 28.5' - - 37.0' - 36.0' - 42.5' 65.5' 45.0' - 53.5' 81.5' 62.5' 02.0' MUNICIPALITY OF ANCHORAGE Development Sen/ices 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: Dec 17, 2002 Expiration Date: Dec 17, 2003 Permit Number: SW020486 Legal Description: PENNINGTON PARK BLK 1 LT 3 Design Engineer: 0003 S & S Engineering Owner Name: Brian & Susan Bergt Owner Address: 17335 BETTIJEAN STREET ANCHORAGE, AK 99516-5610 Parcel ID: 020-181-35 Site Address: 017335 BETTIJEAN ST Lot Size: 41699 SQ. FT. Total Bedrooms: 2 Permit Bedrooms: 2 This permit is for the construction of: [] Disposal Field [~ Septic Tank [] Holding Tank ~ Privy Private Well ~ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ), 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Parcel t.O. Mttttlclpaiity of Anchorage Development Services Depar mei BUilding sa!e{y Division on-Site Waier and Wasf[eWater Program 4700 South bragaw St. P.O. Box ~g6650 Anchorage, Ak: 995t9-6650 wwW'cl'anCb°~age'ak'us (907) 343-7904 ON-SiTE SEWER/WELL?ERMIT APPLICATION FOR A SINGLE FAMILY DWELLING r~¢O '-- I ~ I - 3~.3' Permit Number Property owner(s) Mailing address (1) Maillng address (2) Legal description (Lot, Block & Legal description (Section, ToWnship & Range) Lot Size ~ ~. ~ ~ 3 ~ THIS APPLICATION IS FOR: Day phone Zip Code Number of Bedrooms ~., Sewer Only E] Well Only [] Sewer and Well [] Water Storage [] Sewer Upgrade ~[ THIS PROPERTY CONTAINS: Hot Tub [] JacUzzi [] SWimming Pool [] Water Softening Unit [] Therapy PooJ [] I certify that the above tntormatlon is correct. I further certify that this application is being made for a Single Fatuity DweJjing and is in accordance with applicable Municipal Codes. ~Z ~r7,~'3,.,---.~ S & $ ENGiNEERiNG 17034 Eagle River Loop Road, No. 204 (signa{ure of properly owner or authorized agent) Eagle River, Alaska 99577 Date pt Paymenic I~/i6/~ "~ Date o{~ Payment: Recelp{ NUmber: 0 ~ o/i ~" (2 '~,~ Receipt Number: (Rev. 12/00) HEALTH ,NJT HORITY APF~IOVALS December 13, 2002 ROBERT C. COWAN, P.E. CIVIL ENGINEER~ (9O7) 694-2979 FAX (907) 694-121 i SEWER&WATER MAIN I~TEN~ONS MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK. 99519 SEWER&WATER INSPECTION REFERENCE: Lot 3, Block 1, Pennington Park Subdivision ENGINEERING STUDIES AND REPORIS It is requested that you issue a permit to upgrade a septic system with a 1300 gallon HDPE septic tank with lift station & pressurized trench to serve the existing: bedroom dwelling on the referenced property. W~U. INSPECTION & FLOWTEST A test hole was excavated on 12/9/02 and 'a percolation test was performed/ The approximate location of the test hole is located on the attached site plan. Ground water ~as monitored as shown on the attached soils log, and after seven days of ground;water monitoring the test hole was found to be dry. SITEPLANS ROADDESIGN We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. SOILTEST PERCOLATION TEST Sincerely, kCC/jhm STRUCTURAL & MECHANICAL iNSPECTIONS Enclosure oNs[TE WASTEWATER O~POSAI. S~STEM DESIGN 17034 NORTH E~GLE RIVER LOOP ~, SuffE 204 ~ EAGLE RIVER. ALASKA 99577 J.H.M. DESIGN CRITERIA: Z BDRM = 300 OPD SOILS - 0.6 GPD/SQ.FT. 300/0.6 - 500 SQ.FT. REQ'D. TRENCH CRITERIA: LOT 3, BLOCK 1 PENNINGTON PARK R.C.C. 12 13-02 1 OF 2 STRUCTURES, EASEMENTS, OR ENCROACHMENTS SHOWN ON THIS SITE PLAN ARE AS SHOWN ON AN AS-BUILT SURVEY DRAWN BY: GERALD V. RANDALL, Jr. IT IS THE RESPONSIBILTY OF THE CONTRACTOR TO VERIFY EASEMENTS, REQUIRED SEPARATION DISTANCES, AND PROPERTY LINES PRIOR TO l' DZZS 17054 EAGLE RIVER LOOP ROAD 0.5' EFFECTIVE EAGLE RIVER, ALASKA 99577 5' WIDE PHONE~ (907)694-2979 1fiD' LONG (2 ~ 50' EA ~ LATERALS ~ 48' LONG EACH = 15 GPM/LAT. g~ ~ HOLES ~R LAT. (~.40.C.) ~ 30 HOLES TOTAL = 1.0 GPM/HOLE ~ ~/16" DiA. HOLES FACED DOWNWARD ~' 1" OR 1-~/4TMDIA LATERALS 1-1/4 DIA. SOLID MANIFOLD Z <~ ALL PORTIONS OF SYSTEM WITH LESS THAN 3.5' OF COVER REQUIRE INSULATION. '\ '\ \ '\ '\ '\ \ CONTRACTOR IS REQUIRED TO OBTAIN UTILITY LOCATES PRIOR TO ANY EXCAVATION 3A ? 4 '\ \ \ ineerin~ '~*': LOT 3, BLOCK 1 PENNINGTON PARK .Ltt. I,I. R.C.C. 12-13-02 2 OF 2 DESIGN CRITERIA: SOILS = 0.6 GPD/SQ FT. aoo/o.6 = 500 SQ.FT. REq'D. TRENCH CRITERIA: 1' DEt~P STRUCTURES, EASEMENTS, OR ENCROACHMENTS SHOWN ON THIS SITE PLAN ARE AS SHOWN ON AN AS-BUILT SURVEY DRAWN BY: GERALD V. RANDALL, Jr. IT IS THE RESPONSIBILTY OF THE CONTRACTOR TO VERIFY EASBMENTS, REQ,UiRED SEPARATION DISTANCES, AND PROPERTY LINES PRIOR TO CONSTRUCTION. 17034 EAGLE RIVER LOOP ROAD 0.5' EFFECTIVE DISTRIBUTION SYSTEM: / ·TH# o~ 1" OR 1-1/4" DIA. LATERALS / 1-1/4" DI~,. SOLID MANWOLD / -rANKS (TO _ / PUMPED, CRUSHED ~ / & ABANDONED) S.T.E.P. SEPTIC TANI . Z ALL PORTIONS OF SYSTEM WITH LESS THAN 5.5' OF COVER REQUIRE INSULATION. \ \ \ \ \ \ \ \ \ \ \ 10' MIN. \ \ \ \ \ \ \ \ \ 30' \ 51' \ NEW TRENCHES 4 \ \ \ \ \ \ \ \ \ \ \ \ Performed For: Legal Description: Municipality of Anchorage Devdopment Services Department Building Safety Division On-Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK @9519-6650 w,,wA ci.a nchomae.ak.us (907) 343-7904 Soils Log - Percolation Test ~.. ~/{ ~, ~,,,/ ~ ¢.. ,'~ 6./T Date Performed: j~J.,K;, i jO~ ~ FI ~¢/'-d,~' ~,~K. Township, Range, Section: Slope Site Plan Depth ¢ ~1.~ 4- 5- 8- 9- 11- ~2- ~4- 15- ~6- 20- /¢,'T".r~ (--1'/ WAS GROUND WATER EXCOU,~T?,,E~? IF YES, AT WHAT DEPTH? Depth to Water After Monitoring? Resding Date COMMENTS Gross Time O bo 6o pERCOLATiON PATE ~ / ~ (minuteCndn) TEST RUN BETWEEN :~1 ~/.3~ FT AND __ Net Drop D, '1~" Il' PERFORMED BYi7N4 E~ River L~p Road No. 2~ ~, . - ,' . - ' ~ T~ST WAS IN ' ~ ~~T- AND k UNICIPAL GUID:LINES IN EFFECT ON THIS DATe DAT:' I ~//~ /0 ~ Municipality of Anchorage Development Services Department Building Safet~ Division On-Site Water and Wastewater Program 4700 South Bragaw SL P.O. Box 196650 A~chorage, AK g9519-6650 www.ci.anchoraee.ak.us (907) 343-79O4 Soils Log - Percolation Test ~, 6'/'~ ~ 4>`/ ~ ~. ~ 6- T Date Performed: ¢~¢,~.T¢~ /3,i~.~¢( Township, Range, Section: Slope Site Plan Depth (Feet) $-~ ~2-/ ~3-.// 14- 15- 16- 17- 18- 19- 20- WAS GP,OUND WATE:.P, ~,~COU,~TEP,ED? IF YES, AT WHAT DEPTH? o Depth to Water After n ~ p Monitoring? ~'/&/ ,. E Reading Date Gross Time o 7~ ~o 6o 6o Net Time I Depth to Water ~ ~ ,.,,. ~/~/,t" ~ 5' '/~" 30 *,~,¢'¢ ~'/~" - Net Drop -~/S" ~/s/' ~/~. ~' CONIblENTS PERCOLATION RATE TEST RUN BE*PNEEN (m~utes.'inc.h) PERC HOLE DIAMETF~R Fi' AND ~. ~/'~ FT S & S ENGINEERING I Jo. crUZ ~ CERTIFY THAT THIS YEST ~V4S ~ PERFORMED BY: ,~ ' - ' ' PERFORMED IN ~m Kwer, Alaska ~5~ HEA~TH AUTHORITY APPROVALS ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATEI~AL SPECIFICATIONS ROBERT C. COWAN, P.E. CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& ~ECHAN~C~ INSPECTIONS ON SITE WASTEWATER DISposAL SYSTEM REFERENCE: Lot 3: , Block 1, Pennington Park Subdivision December 13, 2002 GENERAL: 1. The scope of this project includes the installation of two pressurized five foot wide drainfields, and a 1300 gallon HDPE S.T.E,P. tank to serve the existing two bedroom residence located on the referenced property. 2. 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. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. 5. 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: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the sePtic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LO0~ ~ SUITE 204 ,. EAGLE RIVER, ALASKA 99577 Page 2 Lot3~_Blockl,Pennington Park S/D Decemberl3,2002 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the holes faced downward. The distribution piping is to be ofPVC (ASTM D3034 or equal). All joints are to be solvent cemented. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A sir barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt bani. er covers the entire gravel surface before placing backfill. 4. Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. 5. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page 3 Lot 3: , Block t, Pennington Park S/D December '13, 2002 MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron ASTM D3034 (PVC) ASTM F810 (HDPE) ASTM D2662 (ABS) Yes Yes Yes Yes Yes No Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native s0il backfill. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever specifications applies. Page 4 Lot 3., Block 1, Pennington Park S/D December 13, 2002 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-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 will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's 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 fa/lure of the contractor to carry 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 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES ~--- Environmental Health Division 0 :~- O -- / ~'/--- 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name J'1);~7,. ¢ ~/~o ~ DISTANCES Address ~ ~O SEPTIC ABSORPTION p~ ~. //~ ~/~ ~ ~ ~ ~ ~ ~ TANK FIELD WELL Phone(s) ' ~ Permit No, JNo. o, Be ms WELL LEGAL DESCRIPTION LOT LINE / Lot ~ Block I Subdivlsio. ~ / I ~ ~ ,~, ~ ~¢~ FOUNDATION Township, Range, Section ~//~ /~ ~ ~/O ~/~ ~ /~/~ AS-BUILT DIAGRAM (Show location of well, septic system, prope~y lines, foundation driveway, water bodies, etc.) Manufacturer Capacity in gallons Material No. of Compadments TYPE OF SYSTEM ~ Depth to pipe botto~ fro~ Total depth from original grade original gra~e -- FT F Fill adde~above orig~de / Gravel depth beneath pipe '~ravel length ~ / Gravel width FT /~/ FT ~ ~ / Total absorption area Distance between lines ~ ' FT .,.e ..er,., ~nstaller ~ -' ¢~ ~/~ Date Instated WELL~ D PRIVATE ~ OTHER (Identify) ~, ~// ~ / Instamler ~ Date Installed: I 1' ~' ~ . ce.ify that this inspe.i0n was ped0rmed according t0 all J 72_01:::'::5:epadment ApprOval i! FOOTING , - FOUNDATION BOND BEAM FRAMING INSULATION ii .' ~' SHEETROCK ilil: STRUCT. FINAL OTHER COMMENTS L MUNICIPALITYI~}OF J NCH DEPT. Oi~::HEAJ. THm ENVIRONMEN[AE qFP~( ~oo' INSPECTION REPORT MUNICIPALITY OF ANCHORAGE, BUILDING SAFETY DIVISION 3500 EAST TUDOR ROAD INSPECTIONS (907) 563-3464 INFORMATION (907) 786-821 [] ELEC. TEMP..---.k_ -~ [] PLBG. UNDGR, [] [] ELEC. SERVICE.~L~'~ PLBG. ROUGH [] [] ELEC. ROUGH .~ LI GAS TEMP. [] [] ELEC. FINAL[} [] GAS [] [] OTHER [] MECHANICAL [] [] MECH. FINAL __ [] [] FIRE FINAL [] PLBG. FINAL [] [] ZONING [] OTHER [] [] CORRECTIONS ESSENTIAL AS EXPLAINED BELOW [] DO NOT CONCEAL UNTIL REINSPECTED .~O NONCOMPLIANCE OBSERVED [] WILL REEXAMINE AT NEXT INSPECTION /// ./," INSPECTOR '~ DATE )NHEN CORRECtiONs ARE MADE, PLEASE CALL FOR INSPECTION './ED ,' // / / I ,C . DO NOT REMOVE THIS NOTICE 84-002 (Rev. 11/87) . ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET NO / OF '~ CHECKED BY SCALE / ''/~ ~'~ ~*v~ ~' '~ · ~/ DATE ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 561-5040 SHEET NO / OF C^'CUL^TED .Y t' &~-,- W DA*E_ ~//¢/~ ~ CHECKED BY DATE / SCA,E / '~ /'0 / , · ~ ~ ~ .... ~ ~.. ....... ~ ..... '. ...... ........ ..... ..~ ........................ / ~ ....... ' ....................... :'~ ' ~',~1 ~U j~: ~ ~ 6 ~:~.~2/ ...... ......................................... ~..~ dc ~...~..? ~.?~'~ ..... ~ r ..d~....~.d ···7. ~.?~. ~' .......... .......................................... ~'7~'~' PRODIICT 204-1 ~A~7 I~C.r Grotofl, Mo~ 01471. ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASI/,A 99503 (907) 561-5040 SHEET NO CALCULATED BY CHECKED BY SCALE / ~--- DATE / /, PROD~-'T ~-1 ~ Inc.. {~oto~, Ma~. 01~?1 ~Z FFO n 0 ~0 Z 0 0 r~ b. I I I I I ! ~m ! I I ZH MIl: Z~ O ~J 0 0 0 n' rr ~J Z o × PERFORMED FOR: Municipality of Anchorage 825 "L" Street, Anchorage, Alaska 99502-065~ LEGAL DESCRIPTION: ~. 3 ~ ! /~.~ ,~ -/L~.1 gr~Township, Range, Section: '.7-///~ /~:_~/--O ~- SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT - - O DEPTH? p E neplh t° Waler Alter I Monitoring? ~ ]PT Date: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Reading Date Gross Net Depth to Net Time Time Water Drop PERFORMED BY: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) PERCOLATION RATE 7 (m,nutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN / ET AND ~' ET CERTIFY THAT THIS TEST WAS PERFORMED IN ALASKA eFIUIROnme[1TAL CO[1TROL $ RUIC $, Inc. .,,~q-~'~ ~nqineerin§ ~ {~nuironmenlal $1udics SPECIFICATIONS FOR BED WASTEWATER TREATMENT SYSTEM LEGAL DESCRIPTION: LOT 3, BLOCK 1. PENNINGTON PARK SUBD. 1.0 GENERAL 1.1 The Drawings, sheets ] through 4, shall be part of this specification. 1.2 All materials and workmanship shall meet the requirements of the Municipality of Anchorage, Department of Health & Human Services (DIIHS), the conditions of the permit, and ali applicable rules and regulations currently in effect. 1.3 All excavations and depths are advisory, and are to be verified or modified in the field by the Engineer or inspecting agency. 1.4 It is 'the responsibility of the property owner or installer to adhere to approved design for the installation, to maintain the specified separation distances and to have the appropriate inspections. 1.5 It is the responsibility of the property owner or installer to report to the engineer any observed conditions which would put the system in violation of state or Municipal regulations. ]. · 6 If the installation is not inspected by an AECS engineer, AECS will not be responsible for the installed system. An engineer at AECS should be consulted prior to construction, to determine the number of inspections that will be required and to explain what these inspections will involve. 2.0 SEPTIC TANK 2.1 If there is an existing septic tank it may be used if it meets the capacity requirement for the residence. The structural integrity of the tank must be verified. 2.2 The septic tank shall be a UPC-approved two--compartment tank, constructed of 12 gauge steel with bitumastic coating and set level on undisturbed soil. If the tank is buried at a depth of 4 feet or less, it must be insulated with an overlying layer of 2 inch burial type polystyrene rigid board insulation. .... '-~,t .... n.-X 1,,.--~, ,.-, & l~-,r-hnn-,r:c Al~¢l/~, 9959~ (907) 279-5553 2.3 2.4 2.5 2.6 2.7 The septic tank shall be a minimum of 5 feet from the house foundation, and a minimum of 5 feet from the absorption area. The septic tank and bed shall be a minimum of 100 feet from any private wel] or body of water, 150 feet from Class "C" wells, and 200 feet-from Class "A" or "B" wells, unless otherwise specified. Less than the required separation distance must have prior approval or waiver by DHHS or Alaska Department of Environmental Conservation (ADEC). Piping shall be fitted with a mechanical watertight calder coupling on the outlet and inlet of the septic tank. Piping shall be 4 inch solid PVC ASTM D--3034 or cast iron, sloped a minimum of 1/4 inch per ]]neat foot on the inlet side and 1/8 inch per foot on the outlet side. If the piping is buried at a depth of 4 feet or less, it must be insulated with an overlying layer of 2 inch burial type polystyrene rigid board insulation. Cleanouts shall be installed as designated and capped with air-tight rain caps (Jim Caps or equivalent), and extend a minimum of I foot above ground level. If a lift station is required it shall be a combination lift station septic tank per Anchorage Tank and We]ding, Inc. design. Specifications and design drawings are on file with the municipality and the engineer. 3.0 SEEPAGE BED 3.1 The gravel for the bed shall be 0.5 to 2.5 inch, screened rock with less than 3 percent passing the No. 200 sieve. Ail substitutes must have prior DHHS approval. 3.2 The bottom of the excavation shall be level and raked with the backhoe blade to ensure that the bottom has not been compacted during excavation. 3.3 Sand, for leveling, shall have a size distribution which meets the requirements of MOA code 15.65.077. 3.4 The distribation pipe shall be perforated 4 inch rigid PVC with a minimum crush strength of 1500 3.5 3.6 3.7 3.8 pounds and shall meet the approval of DHttS for use as drainfield pipe. Al/ pipes shall be laid level, and spaced according to the drawings. Monitor standpipes shall be placed as shown in the drawings. They shall be 4 inch rigid PVC ASTM D-3034, or cast iron. The section shown with holes may be either drilled 0.5 inch holes on 6 inch centers on opposing sides of the pipe, or a section of regular perforated sewer pipe may be clamped to the solid section with a no-hub coupling or solvent joint. The perforated section of the monitor tube shall be located in gravel only. The portion of pipe above the sewer rock shall be solid. A rubber raincap (Jim Cap or equivalent) shall be placed over the top of the pipe. Filter fabric is required. The side slope of the mound shall be slope 1 foot vertical to 3 feet horizontal. The bed shall be planted with a white clover and red fescue mix, or with Kentucky bluegrass. 4.0 INSPECTIONS This bed will require a minimum of three inspections. The first inspection will be of the open excavation, to assure that the system is installed in the proper soil strata, correct depth and meet minimum specified design parameters. 4.2 The second inspection will be after placement of gravel, monitor standpipes, and distribution pipe, to verify proper installation and position of pipes prior to backfill. 4.3 The third inspection will be after final backfill grading and seeding' to ensure 'that adequate so:il cover has been provided over the bed. 4.4 The inspection of the septic tank or lift station installation can be incorporated with any one of the above listed inspec'tions. 4.5 The lift station will require either an MOA electrical inspection or certification by a licensed electrician depending on whether the building code applies to this part of the city. 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 NAME _ ~ tPHONE I []NEW LEGAL DESCRIPTION LOCAT,ON /72 d / Ve. NO.O BEDROOMSj AbS,~i~n~a~:ea.~! Dwelling 2 7 ~ DISTANCE TO: I ~Of )'PI ~1-I- =~ Manufacturer~.z/~ ~'e L° ~' Material(-~,e)! / No. of compartments 2 Liq. capacity in gallons Inside length~ Width Liquid depth /~)~) ~) IF HOMEMADE: ~ ~,.~ DISTANCE TO: Well Dwelling PERMIT NO. ~O _ ~ Manufacturer Material Liquid capacity in gallons ~1~ m DISTANCE TO: Well ~0t /'h F°undati°n4~- ! Nearest lot line ~-~'ZO? ,.'"No. oflines ~ Length of each line,~,,_ 20~-~/' Total length of lines7 / Trenchwidth~inches Distance between lines /~ , ~ ~-. Top of tile to finish grade Material beneath tile Total effective absorp.tjon area Q ]' 84 inches ~, Length Width DepOt h PERMIT NO. <~ l- Tvpe of crib Crib diameter Crib depth Total effective absorption area DJ Well Building foundation Nearest lot line u~ DISTANCE TO: , Class Depth Driller Distance to lot line PERMIT NO. ~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS SOIL TEST RATING INSTALLER / : ::;";;:; - \ L APPROVED DATE LEGAL 72-013 (Rev. 3/78) MUNICIPALITY OF ANCHORAGE Department f Health and Environmenta' ?rotection 825 .. Street, Anchorage, AK. ~9501 264-4720 * * * HANDWRITTEN PERMIT * * * Permit 9 ~A~ WELL ANI~ ON-SITE SEWER PERMIT Applicant.~/~ . Location: Z ~, ~~ ~P2hone Number: X Legal Description: Type of Soil Absorption System Is: Trench: ~ Drainfield: Maximum Number of Bedrooms: Lot Size: ~/~-r-~ + _.. Seepage Bed: Holding Tank: Soil Rating(sq.ft/br) ~~ DEPTH The Required Size of the Soil Absorption System Is: LENGTH GRAVEL DEPTH . W I DTH 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 = /~){2,(~> 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 1 9 8 3 * * * 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. SigneE~.~i .... __ ~.~.~./ Issued by Applicant ~ Date: ~ ~ ~- ~_~ SWP/024 (1/81) SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST PERCOLATION TEST LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 DE %~C~V~\ DATE PERFORMED:, SLOPE SITE PLAN 10 11 12 13 14 15 16 17 18 19 2O COMMENTS PERFORMED BY: 72-008 (6/79) ENCOUNTERED? (-~ O P E IF YES, AT WHAT DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop ~'.sq /.2B , /, Z/ ' ~'H~O q" ~' ~.z.~ + I~O ~"~-~ "~ Ut'O PERCOT_ATION RATE TESTRUN BETWEEN ALASKA I1UIF OrlmE TAL COI1TI OL SEr UIC S, InC. Subdivision Supplemental Soils Information. mook I, ~Let -3 LOT ~ LOT LOT LOT TH ~ TH TH TH 1 1 1 2 2 2 3 3 3 4 4 4 5 5 5 6 6 6 7 7 7 8 8 8 9 9 9 10 10 10 11 11 11 12 12 12 13 13 13 14 14 14 15 15 15 16 16 16 17 17 17 18 18 18 19 19 19 20 ~0 20 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 1200 gJ~sl 33rd Au~nL,¢ Suit~ ~ · Anchoraq¢, Alaska 99~03 · (9o7) 276-136t 9 10 Perfo~',med i/or Floral Palmateer !>rite ?erformed 9/2/71 This Fcrm pepth -------'~"' Feet Location Sketch 1 2 3 4 5 6 7 m ~ I~1 D~rk brown silty sand (SN) Ora, and brown sandy gravel (OW) w/silty sand ravel seams Was Ground Water Encountered? f No I)pain Fi eld Dec, t?, Of 2r, let --. ', - , om Pit %"enc~ - -' 180 s~ Y~f~f~ ...... · · - . --- - -- - CO~:4E~,~T3:~~ u~-a~nage area ~s re~mredBer beoroom. ~ _ _ . _ Test Performed :3v: R.E. Carlisle Data Certified By: National Testing Services, Inc. Date: WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geolocjicol ~ Geophysical Surveys Drilling Permit No. LOCATION OF WELL ~ (Pleose complete either lo, lb or lc.) A.D.L. No. '~o~.lBorough Subdivision Lo, Block I-~.1 '/4qtrs. Section No. Township N[~ Range EO Meridion : ~ " ~ ~of~of~of ~ S[--] WI-'] Ic.J~DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS 5. OWNER OF WELL: Address: ';' ) ~'~ : Street Address ~,d Area of Well Location 2. WELL LOG Feet Below Surface 4. WELL DEPTH: (final) 5, DATE OF COMPLETION Material Type Top Bottom :/~'.: ,. : , .... , ~ 6. ~Coble tOO' ~Rolery ~ Driven ~ Dug : ? ~ ~. ~ Auger ~detted ~ Bored ~ Other: : r'~ '~; '~,,~ J ~ : ,: ? ,;:',~-, ;:. '~? ~' ~:;~ 7. USE: ~ Domestic ~ Public Supply ~ Industry ~ Te~t WeU ~ Other: 8. CASING: ~ Threaded ~.Welded diam. ;~'~ in. to .~ ft. Depth Weight : ,'lbs./ff. diam.~ in. fo ff. Depth ~tickup ft. 9. ~INI$H OF WELL: Type: Diameter: ~lot/~esh Size: Length Set between ft. and ft. Backfilling Gravel pack I0. STATIC WATER LEVEL: ~ Above or ~ Below land ~urface Date Equipment used: II. PUMPING LEVEL below land surface and YIELD -':~ ~;. ft. after ~ hrm. pumpin9..,;:;,:~?' g.p.m. ~ ft. after ~hrs' pumping g.p.m, 12.GROUTING Well Grouted: ' ~ Yes ~ No Material: ~ Neat Cement I~, PUMP: (if available) HP ' Length of Drop Pipe ft, capacity g.p.m, 14, REMARKS: 16, WATER WELL CONTRACTOR'S CERTIFICATION', 15. Water Temperature ~o ~ F ~ C This well was drilled under my jurisd{ction and this report is true to the best of my know~edge and belief; Registered Business Name Contract License Number Signed: , , ~ i : Authorized' Re'presentaHve Form O~-WWR (11/81) Copy Distribution; WHITE-State DGGS, PINK-Driller, CANARY-Customer 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. 020-181-35 GENERAL INFORMATION Complete legal description t~ot 3; Location (site address or directions) Current Property owner(s) Susan & Mailing address 17335 Lending agency Mailing address 02..0 Expiration Date: _"2 - ~ ~- O~ Block 1; Pennin~ton Park Subdivision 17335 Betti~ean St. Brian Bergt Day phone 345-5572 Bettijean St. Anchorage, AK 99516 Day phone Real Estate Agent Grog Hamilton Mailing Address 3705 Arctic Blvd. #1811 Unless otherwise requested, HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: ?, Day phone 272-3991 Anchora~;e, AK 99503 TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class __ Public Water System Well TYPE OF WASTEWATER DISPOSAL: ~ Individual On-site X_~ [] Individual Holding tank [] [] Community On-site [] [] Public Sewer [] The Municipality of Anchorage Development Services Department (DAD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional c/vii 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. = 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 Apprevai 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 flies and from my investigation and inspection, the on-sRe water suppty and/or wastewater disposal system is(are) in compliance with ail applicable Municipal and Slate codes, ordinances, and regulations in effect at the time of installation. Phone 694-2979 Loop Ste. 204 EaEle River, AK 99577 C. Cowan Date bedrooms. ~ bedrooms, with the following stipulations: Name of Firm S & S Engineering Address 17034 N. Eagle River Engineer's Printed Name Robert DSD SIGNATURE ~'""'Approved for ..~ Disapproved. Conditional approval for Additional Comments By: Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements Supplemental Engineer's P, epor~ Other Original Certificate Date: (Rev. 01/02) ............. ,~ .:-....:.. .... ...~:,?.~!;~C~ge;~s .",....".:: ....'~ .. ........ '.: ' .~ '. :'::: ~.'"~(9~..~,:",.'? :'..-,"..'". ~ · ': ':..-:.-,t;.~r...~::;...~ .. . . ...... - . , . .:: .,..:,....,%...::,? · ':;. ',".: .... ,~.,.....~ . :..:'...- .,. ".: .:" ,..~';SA~,..L~'.. ..... .~].~:'.'. ':'... '...,?..' ..... ' .... -.'... ... '.:~ ..- ..'.~.' .... .' .,.' '.. '. .... ' ·. '... . .....:: .. :..?..,~... ,L;:.,~:...~,..... ;~..,....,.:. :.?..-.~.~:,., ,...;~... ,:::. ':': ~.: ...,, ~::...; ...:,:.. ::....:.,:., ..:'.......'; .. ,: :: .... '~ ....... ~l~=mNe'.: ..' ~:...,,f .~...:::. :, .-, ,: ,..: .. ' :. :,'Svs~em ~pe.. :'.Y~ ~:G~ Do "Pu Dat~jm Size in gallons / .3 0...O Manhole/Access~/N) ~"fl J- "Pump ofF' level at ~"/,. ~T n ' High watel' alarm level ' 5~ ,:~,:~w~ ,.;,,,,.,~ -i Meets alarm & circuit requ rements? Absorption'field on lot ! Public'sewer main Sewer/septic service line ~,. E-' /-./- SEPAI~A:I'ION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation J 3 Property line ' 6 (~ ' Absorption field Water'main N / /~ Water service line /o '-'/- On adjacent lotS Public'sewer manhole/c!eanout Holding tank Water.:Service JJne .... /~) 'C~ff~i~'d'r~in ~'O~rt..; t~ ~ow~' Wells on adjacent lots )c~ ~- that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date Engneer'sPrintedName ~Z~,£/,,.7' ~'. Date / ~/'~ ¥//'0 2.. Receipt. Num'be~ (Rev. 12/01) Waiver Fee S Date of Payment Receipt Number ,gNehicle storage ~'~z-~ 11-25-D2 15:~6 FROI~-CT&E ENVIRON~NTAL SRV .~tk CT&E E"~ir°nmental Services lac' T-923 P.02/03 F-49F CT&E Ref.# Client Name Project Namem Client Sample Matrix 1027976001 S & S Penn/n~ton Pa~k LL Permin~ton P~k L3~ ~ BI Dfi~g Water ?WSlD 0 Sample Remarks: Wa~erS Department Nitrate-N 1.23 o.~OO m~/L EPA 300.0 All Dates/Times are Alaska Standard Time Pr4nted Date/Time 11/25/2002 9:31 Collected Date/Time 11/21/2002 12:15 Received Date/Time I 1/2i/2002 14:20 Allowable Prep Analysis Limils D~te Dale Init {<=10'} 11/21/02 JS Microbiolog~ Laboratory Tnt~ Coli~rm 0 coi/100mL SMI8 9222B ('<=1) 11/2tt02 KAP FROM :GREG HAMILTON FAX NO. :g072720794 Nov. 2i 2~2 06:52PM Pi ENGINEERS PLANNERS SURVEYORS MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner I~e/''~r' ~' ~y ~'~,~-o,~ Mailing address 1-7~]~5'' i~¢["¢-,j¢,~,~ _C~-. a Lending agency Day phone Day phone Mailing address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: Day phone /Jr ~ ¢e5-0'7 If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEI~R As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm F/,~/',~f Address /,~/~- .~{2 ~ c/~¢ ~'~L..~ Engineer's signature DHHS SIGNATURE ~ ./~_ Approved for Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: .~~~~~~~ Date ¢/~,.~./~,~// The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev, 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: AC"'/' 3., ~ ('oC~ _f~ P¢~//]/~. ?AC, ParceI I.D. A. WELL DATA Well type J~ Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. Date completed /1' o" ~ Cased to ~'/,5" ' Date of test Static water level Well flow FROM WELL LOG Pump level ADEC water system number 0" Driller be/./V, I.A.,,,~i/-¢ Casing height '3 9" Wires properly protected (Y/N) Y MUNICIPALITY OF ANCHORAGE AT INSPECTIO~NVIRONMENTAL SERVICES DIVISION OCT 1 1 1991 g.p.m. RECEIVED g.p.m. SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main N, Public sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank Al, ,4, h(on ,e WATER SAMPLE RESULTS: Coliform 47 col / I00 ,,~.~ Date of sample: 1o /7 /~/ Nitrate I, '/ '~'/"( Other bacteria O co I / too r,,.~, Collected by: B. SEPTIC/HOLDING TANK DATA Date installed O"/~ 7 ! ,¢ .3 Tank size /~,C,42 ~,~/ Cleanouts (Y/N) )" Foundation cleanout (Y/N) High water alarm (Y/N) /V,,~. Date of pumping g/7/9/ Compartments Depression (Y/N) Alarm tested (Y/N) /~1, P,.. by RoA, /V SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot I:~0' To property line dO ' Surface water/drainage On adjacent lots ;> ¢oo' Foundation Absorption field '¢ O' Water main/service line ~oo~ 72-026 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) Y' High water alarm level 500 "Pump on" level at Manufacturer i~hckor~/~ Manhole/Access (Y/N) "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot I YO On adjacent lots D. ABSORPTION FIELD DATA Date installed ~/t ¥/9 0 Soil rating Length ~/5" Width 1 5' Total absorption area ~' Depression over field (Y/N) Results (pass/fail) r~,~.~.~ ~e¢ ~¢ro,,,Fo/~ym¢ ~'~&o,f)for Peroxide treatment (past 12 months) (Y/N) SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellon lot I¢O' On adjacent lots I Y~" ' Surface water ~ 5'0 ~'/~c4rr,, System type Gravel thickness /. 0 Cleanouts present (Y/N) Date of adequacy test If yes, give date Total depth Y io17 bedrooms Property line To building foundation ,.5"~ ' ~Cr~p, C.O, To existing or abandoned system on lot On adjacent lots ~. 3'~' Cutbank /~,,'~. Water main/service line Surface water ~. too' Driveway, parking/vehicle storage area Curtain drain No~ eG.¢~r E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines the date of this inspection. Signature ?.,/~~- '~' 77/~..~ Engineer's Name ~1¢,o~or~ f~, hloor~ Date fo(l~ /9/ HAA Fee $ Date of Payment .ece pt Number 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number ALASKA elqUIROrlmErlTAL CONTROL SeRUICe$, Inc. ~nqincmncI ~- ~nuironrn~nlcd $ludics P. 0. Box 240668 Anchorage, AK 99524-0668 (907) 279-5553 *** FAX (907) 276-8706 October 28, 1991 Nunicipality of Anchorage Department of Health & Human Services 825 L Street, Fifth Floor Anchorage, AK 99501 ATTN: Dan Bolles RE: Lot 3, Block 1, Pennington Park Dear Dan: OCT 2 8 1951 · On October 23, 1991, I checked the differential level between tile two standpipes of the bed. The level differential was 7.5 inches. On October 24, 1991, Bob Dean opened that part of tile system. It appeared that the southwest corner had settled for several reasons. There was a section of Hancor pipe which was used to prop up the cleanout to keep it level. This had collapsed. Also, there appeared to be come settlement in that corner. I dug through the rock to examine the under soil. It was wet, but not plugged. was evidence of some sludge in the field, but it wasn't much. The owner reported to me that he had problems with the lift station basket floating. bulking of the sludge. There This was probably due to The corner was leveled -to the NS and EW pipes. Rock was used to bring tile rock fill to grade over the pipe. It was then reinsulated and backfilled. I believe that tile system should now function properly. cc: Peter Johnson LCR/sr Sincerely yours, Phi), PE, BEE CIVIL & ENVIRONMENTAL ENGINEERING · ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345-1355 October 11, 1991 ANCHORAGE, ALASKA 99516 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: The following is a report of adequacy tests conducted between October 7-9, 1991 on the water supply and wastewater disposal systems serving the residence on Lot 3, Block 1, Pennington Park S/D, located at 17335 Bettijean St. According to the driller's log, the well was completed in June of 1983 and has a total depth t~f 46 feet and a yield of 20 gpm. On October 8 the static water level stood at 14 feet below the top of the casing. Steady pumping of 726 gallons of water from the well at the maximum pump output of 6.6 gpm caused the water level inside the casing to be drawn down to a maximum of 19', and the water level recovered rapidly once the pumping was stopped. Based on this test we determined that the total yield of the well is in excess of 6.6 gpm, which is more than adequate to meet Municipal approval for any single family residence, and also exceeds the FHA criteria of being able to supply water at 3 gpm over a 4 horn' period. Water samples collected on October 7 were satisfactory, showing 0 coliform or other bacteria and 1.4 mg/1 of nitrate-N. The wastewater disposal system consists of a 1000 gallon steel septic tank installed in June of 1983 .followed by a 500 gallon Orenco lift station package installed in October of 1990 which pumps effluent into a 15' by 45' soil absorption bed which was also installed in October of 1990. Prior to the start of our test on October 7, 1991 we measured fluid depths in the bed's north cleanout to be 0 inches, in the center monitoring tube to be 6 inches, and in the south cleanout to be 6". This indicates that the bed bottom is not completely level. At no time during the course of our test did the fluid level in the bed rise to a point where it could be observed in the north cleanout pipe. To assess the absorption capability of the system we added a total of 918 gallons of water over a 2 day period through the second compartment of the septic tank. The lift station pumps approximately 176 gallons of water per dose. The first dose caused the fluid level in both the center monitor tube and in the the south cleanout to rise 1.31". After the second dose these fluid levels had increased to 2.31" and excess fluid was observed to be siphoning back into the lift station after the pumping cycle was over. This indicated that the fluid level in the bed had risen to the level of the pressure line from the lift station. Based on 3 days of observations of fluid levels in the lift station and soil absorption bed, we concluded that the surge capacity of the bed is approximately 260 gallons, and that the system is capable of absorbing 600 gallons of water per day, when the bed is filled to the level of the high point of the pressure line from the lift station. This measured absorption rate is slightly greater than the minimum Municipal criteria for approval of a three bedroom residence. Sincerely, Ted Moore, P.E. CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. ~____:.: ..... __~..--.--~- --~-:--~ ~ --~ ._.--:~ _-~--~~ 5633 B STREET ANCHORAGE. ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 ~ate Eepogt ~xlnted: OCT lO 91 t 15:00 Client $a~le ID:L~ BI P~NINGTOW P~K OUY$IDg 3 HO$~ ' Client N~ F~SID :U~ Client ~oct Collected OCT 7 91 I I~:30 h~.. ~PO S PO I NO~ ~[CgI~D ~ecetv~ ~T 7 9t ~ ~7:00 ~t. ~oq S A~lyetm Coapleted :OC! 9 9l Send Eepoxte to: ~,l,,ed ,y : ~---/~ ~..~.~ 2) Chemlab Re[ l: 915341 Lab ~1 ID: 1 ~{at[ix: WAYBR Allowable Pa~amete~ Ye{ted Re.ult Umtt. Nethod LimAte NIT~AT~-N 1.4 m~/1 EPA ~$~.2 t0 ~aple ROUTINE ~AWPLE COLLECTED BY: Y.~. ~E. ' BIB. ~emt~ Pe:~ozmed ' See Speolel Inat~uct~o~ Above ~A-Unava~lable None Detected "~ee ~ample Ee~azk~ Above Mot Am~l~e~ EY-~e.~ T~n. GT-G~eate~ T~n '-',~1 ~~ Member of the SGS Group (societe Gen~rale de Surveillance) MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Property owner ~.,,'~-/v/~¢ Mailing Address f'. O. ~'c,,~ /! ~' (c) Lending Institution Mailing Address 15-C, d~ Telephone' (home) ~.6'&-~'d'¢"/ Business E~'~-' Telephone 86-'~ - (d) Real Estate Company and Agent N, ,~. Address Telephone (e) Mail the HAA to the following address: (or check here [], if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Number of bedrooms Single-Family [] 3. WATER SUPPLY Individual Well [] '3 Community [] Public [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. 4. SEWAGE DISPOSAL On-site ~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. NameofFirm ~(¢[~r~ '7-~cA/~ t'~4! ..~'ur~f Telephone Address / fi' ~'_~0 ~c~¢' -('~ /,¥,~ChOr',~¢¢~. ,,4.~ Date 6. DHHS APPROVAL Approved for ~' Approved '~ bed rooms by~~--~4~= .~-/~_ ate/2 Disapproved Conditional Terms of Conditional Approval The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHH$ does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 7/88) Sack Page 2 of 2 Well Classification Well Log Present (Y/N) ~/ Total Depth /-/-(o Cased to / Static Water Level 35' o~ Casing Height Above Ground MUNICIPALITY OF ANCHORAGE (MOA) Health Authority Approval (HAA) CHECKLIST- FEBRUARY 1984 343-4744 Legal Description: Date Completed h S If A, B, C, D.E.C. Approved (Y/N) kJ,~, Yielc~ ~,(o GPt't Ifl~ftS 1~-/t3/~o Depth of Grouting ~,/3r ' IZ/~,~/?~ Pump Set At ~' ~ 3 7 ' Sanitary Seal on Casing (Y/N) Y Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: To Septic/Holding Tank on Lot I 3'2 To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line ,~/oo To Nearest Sewer Service Line on Lot Depression Around Wellhead (Y/N) Iq ; On Adjoining Lots / ~ 172 ' ; On Adjoining Lots To Nearest Public Sewer Cleanout/Manhole Water Sample Collected by F~-ATTOP Water Sample Test Results Comments~ ~TEA~Y Pu~PIN ~ ~TE~ L~L IN ~H~ B. SEPTIC/HOLDING TANK DATA Date Installed G1~.7/'~3 Size Standpipes (Y/N) '/' Air,tight Caps (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contact on File (Y/N) N Holding Tank High-Water Alarm (Y/N) N ,~. No. of Compartments ~/ Foundation Cleanout (Y/N) Date Last Pumped c~Il°/cIO ;for Temporary Holding Tank Permit (Y/N) ~J./~. SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water-Supply Well I To Property Line ~. (oO ~ To Water Main/Service Line To Building Foundation To Disposal Field ,~ To Stream, Pond, Lake or Major Drainage Course '7'/o0' Comments 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed Width of Field I$ ' 15o Square Feet of Absortion Area ~, 7 5' z= Depression over Field (Y/N) Results of Last Adequacy Test N,~r, SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well J '72 To Building Foundation ~.5" ' IcR0t'l Lot ~ 2_5' ?Er~ Rs To Water Main/Service Line ~ 80 r To Stream, Pond, Lake, or Major Drainage Course '>./oo' To Driveway, Parking Area, or Vehicle Storage Area ~'//8o~ ~ Type of System Design BEb Length of Field //-5 / ! Depth of Field 0 - 1 Gravel Bed Thickness J ' Statndpipes Present (Y/N) Date of Last Adequacy Test ! To Property Line I ~ To Existing or Abandoned System on ; On Adjoining Lots I 2 2./ To Cutback (if present) N,A-~ Comments D. LIFT STATION Date Installed c~ Size in Gallons .500 "Pump On" Level at High Water Alarm Level at (,1~" Tested for N,~. Meets MOA Electrical Codes (Y/N) Comments P'~" a~ Dimensions Manhole/Access (Y/N) "Pump Off" Level at ¢$" Vent (Y/N) "// Pumping Cycles during Adequacy Test. I~£Po~eT iN F/ **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA g..u~L~f~.~ffect on the date of this inspection. Signed ?-/. :....::: t:'::> ..~ '*%:~;5 . , - Company ~:~ ..................... t; ~', ,, ;~ Engineer s Seal Date of Payment Amount: $ 72-026 (Rev. 7/88) Back Receipt No. Waiver Fee: $ Date of Payment Page 2 of 2 APPLIC' NT FILLS OUT UPPER HAl "' ONLY Property Owner F~?/~ ...~, /D~ .._. /,/' d:~ /d,,/~) ./t? ~, 4,.,,, ,/~-"* Phone Mailing Addre~ ~ ,~ / ~ ~~~~~ ~~..~. I/~ Zip ~ Buyer ~ ~- ~ ~ / .... Lending Institution ~ /~. /~- ' ~ ~x ~ "? 7 Phone Realty Co. & A~nt ~.,¢/~, ,..~ ;~-~ ' ' ~-;;n; ' - - Legal Descript~n~¢ ¢~ /2//~ ¢ /~ '~ ~' ~/~¢ Type of Resi~nce ............. ~ .... Single Family Multiple Family No. of Bedroo~ .~ ~ Other Water Supply Individual A~ACH ~LL LOG. A w~l Icg is required for all wells drilled since June 1975. Community For wells drilled prior to that date, give well depth (attach Icg if available). ~ Public Utility Sewer Disposal Individual Year IndivMual Installed: /'~ ~'.~* Public Utility When Connected to Public Utility: ~ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED. Time Time Time~'~ (~(I'/~4~'/~' Time . i Date ~ / ~ Date Date Date ~ ~-~ ~ )~.~( . ~ ~ ~- ~( ~ ~:~ Insp~tor Insp~tor Insp~tor Insp~tor / ~ Field Notes: ~ ~.~ ~ MUNICIPALI~ OF ANCHORAGE ~_ ~. c¢¢~ cL~ ,~ ~PT. OF H~ALTH ~, ~ ~ (_,O,% ~ ENVIRONM2NTAL PROTECTION ('~) APPROVED BEDROOMS *CONDITIONS OF APPROVAL ( ) DISAP~OVED ( ) CONDITIONAL APPROVAL' DATE ~-'~ ~ ~- ~ ~ O ~-~ ~ ~ ;~ Well to Tank /~ t~ Septic T~k Size ~ 72-023 (3182)