HomeMy WebLinkAboutTHUNDERBRUSH LT 1Thund
rbru h
Lot
1
015-142
-70
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP231379
Work Type: SepticTank Upgrade
Tax Code Number: 01514270000
Site Legal Address: THUNDERBRUSH LT 1 G:2637
Site Mailing Address: 11400 BIRCH RD, Anchorage
Owner: HAN WHEE AMY
Design Engineer: GARNESS ENGINEERING GROUP LTD
This permit is for the construction of:
❑ Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy
Effective Date:
Expiration Date:
Lot Size in Sq Ft:
Total Bedrooms:
C ll j-
�0 fi S',
f.
c�
De paI-t4ntell t
11/14/2023
11 /13/2024
32756
❑ Private Well ❑ Water Storage
All construction shall be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80)
3. The wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
Received By: -� 7-j C E
Issued By: L �—
Date:
Date: I t / `1 0 Z- 3
3
Development Services Department Phone. 907-343-7904
On -Site Water & Wastewater Section -- Fax: 907-343-7997
ON -SITE SEPTIC/WELL PERMIT APPLICATION
Parcel I.D. 015-142-70
Property owner(s) MINA HAN (BUYER)
Mailing address 11400 BIRCH ROAD *ANCHORAGE, AK
Site address 11400 BIRCH ROAD *ANCHORAGE, AK
Day phone 907-252-0811
Legal description (Sub'd., Block & Lot) THUNDERBRUSH; LOT 1
Legal description (Township, Range & Section)
Lot Size Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN:
TYPE OF DWELLING:
(® all that apply)
Absorption Field
❑
Initial [ ]
Single Family (SF)
Septic Tank
ElUpgrade
(w/wo ADU)
Holding Tank
ElRenewal
❑
Duplex (D) ❑
Privy
❑
Multiple Dwellings ❑
(SF and/or D)
Private Well
❑
Water Storage
❑
THIS APPLICATION INCLUDES A WAIVER REQUEST FOR:
Distance:
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Permit/Rush Fees: 2 Z Waiver Fees:
Date of Payment: It Z Zo Z Date of Payment:
Receipt Number:
Permit No. 0 S P Z 3/ 3 ?5
Receipt Number:
Waiver No.
G.\Development Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231379, Curtis Townsend, 11/14/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231379, Curtis Townsend, 11/14/23
Municipality of Anchorage
On-site Water and Wastewater
REVIEWED FOR CODE COMPLIANCE
OSP231379, Curtis Townsend, 11/14/23
FNt? REBAR N 14 27' E27' FiVG? 3"BRASS SAP
/ crane r rvu jDj rrcn r-ncrrrn®r
THE INFORMA TION HEREON IS FOR THE USE OF LENDING INSTITUTIONS SPECIFICALL Y TO SHOANY
CONFLICTS BETWEEN EXISTING STRUCTURES AND PLA TTED L OT LINES ANDOR EASEMENTS,- AND IS
NOT TO BE USED FOR POST TIONING ADDITIONAL S TRUCTURES, IMPRO VEMENTS, OR FEN 'ELINE :
EASEMENTS OF RECORD, OTHER THAN THOSE A PPEA RING ON THE RECORD PLA T, ARE NOT SHOWN
HEREON ( UNLESS INDICA TED)
NOTE- FENCEINES THA T ILIA YAPPEAR ON THIS DRA WINO ARE NOT TO BE USED TO DETERMNE
PROPERTY L INES OR POSI TION ADDI TIONAL IMPROVEMENT,
ANY PA VING SHO WN HEREON MA Y BEAPPROXIMA TE DUE TO EXCESSI VE SNOW AND/OR ICE.
OF THE FOL L OWING DESCRIBED PROPERTY
ANCHORAGE RECORDING DISTRICT ALASKA, AND THA T THE
VISIBLE IMPROVEMEIt!TS S1 TUA TED THEREON ARE WITHIN
THE PROPERTY L INES AND NO VISIBL E ENCROA CHMENTS
EXIST O THER THAN NO TELL
DA TED A T ANCHORAGE, ALASKA THIS 14 TH DA Y OF
SEPTEMBER , 2023
HOL T LAND SURVEYING
9309 GROVER DRIVE
ANCHORAGE,AK 99507
223-8615
/'"% MUNICIPALITY OF ANCHORAGE
DE, .,,~TMENT OF HEALTH AND HUMAN SER¥...ES
'~' '"~' Environmental Health Division
· '.'"~ ' 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name
CNA~L~ s GA~ ~ ~D!STANCES
Address ~ TO . SEPTIC ABSORPTION
il ~ ~ t~ ~ ~,FRO~ ~ ~TANK FIELD WELL
Phone(s) ] Perm,t No. .. iND. of Be~room, WELL
~E~L oEsc.,.,,o. LOT LINE
I Lot
TM ON~ ~O~ ~ FOUNDATION
m . Urlveway. water bodies, etc.)
' TANKS N
~ SEPTIC ~ HOLDING
Manulacturer Capaoty m gallons
I
Material = No. of Compa~ments
TYPE OF SYSTEM
~ TRENCH ~ BED ~ W. DRAIN ~ OTHER
~pthtop~pebottomlrom~ - ~otalOepthlromong~nalgra~e ~ ~
Fdl aeeed above original grade Gravel oepth ~neath p~pe
Gravel leng~ ~ravel w~dlh ~
Total absorptmn area ~ D~stance between hnes ,
'~umber of hnes J 50,I rat,nD j P,pe material FI:
Installer Date Installed
I I,
WELLS ~ '
~ PRIVATE ~ OTHER {Identify)
ClasslhCatlon
(A.B,C~
3oral
Depth
~1 Cased to c '~, .'..' ~; :~ ~ ~ ~,~'~
FT FT F;2'
Installe~ Date Installed, ',
REMARKS:
Inspecbons Pedo~mea
' ~ ~ ~ ~,-~", ....... ~f.~,>;.
Da e. -
....
I cedily ~at this inspe~ion was pedormed according
Municipal and Slate ~delines in e ~ ~; e~¢ '
Health DepadmentAppr~val:.. -~/- -- Date;~~
72-013 (3/85)
PERMIT NO:
DATE ISSUED:
APPLICANT:
ADDRESS:
CONTACT. PHONE:
~-tlUI~ I C T F~('aL Z TY I~ICi--i~--~AGE
DEPARTMENT ~. OF A
HEALTH AND ENVIRONMENTAL , .,OTECTION
825 L STREET, ANCHORAGE, AK 99501
264-4720
OI~--S I TE SEL~JER F'ER~ I T
86£ ~7 ENGINEERED DESIGN
09/05/86
GAUSE/SF'URKLAND
203 WEST 15TH. AVE.
ANCHORAGE, AK 99501
279-5916
LEGAL DESCRIP:
LOT SIZE:
SUBDIVISION: THUNDERBRUSH
SECTION: o~)
· ~.~- TOWNSH I F':
.75A (SQ. FT. OR ACRES)
LOT: 1 BLOCK: NA
12N RANGE: 3W
I certi;'y that:
1. 1 am £amiliar with'the requirements £or on-site sewers and wells as set
F'orth by the Municipality o~ Anchorage (MOA) and the State o( Alaska.
2. I will install the system in accordance with all MOA codes and regulations,
and in compliance with the design criteria o~ this permit.
3. I will adhere to all MOA and State o£ Alaska requirements (or the set back
\ distances £rom any existing well, wastewater disposal system or public
sewerage system on this or any adjacent or nearby lot.
IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES,
THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2)' AS-BUILTS
WILL NOT BE APPROVED WITHOUT APl ELECTRICAL INSPECTION REPORT; AND (5) THE
ELECTRICIAN.
DATE:
ELECTRICAL WORK MUST BE DONE BY/~ LICENSED
SIGNED -~, ~
DATE:
p/nE.
VeL
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street. Anchorage. Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCR,.T,ON:
1
3
5
10
11
12
13
14
15
16
17
18
19.
20
COMMENTS
31,2..-
~ ~. (~ERG~EEEI'S,$EAL)
_.'. ',,~" "- '. 4'-'~
· '"~7.:% ' ,, f,
i -. JUNE 25. t97! .'.
gATE PERFORMED:: '
SLOPE -- ~;IT"E P~L-AN' ! -
WAS GROUND WATER
ENCOUNTERED?
S
IF YES, AT WHAT L
DEPTH? ~ O
P
E
Depth to Water Alter
Monitoring? Date:
Reading Date Gross Net Depth to Net
Time Time Water Drop
0,,,~. R //?.t~[. o 0 7 //~" 0
~ , 8 fl~]~ o 0 A.. ~.
PERCOLATION RATE.Z~/~__ . (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~;/'~- FT AND ~-~' FT
i
PERFORMED BY; D.t ~/CICA/ ,
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE.
?2-008 (Rev. 4/85)
CERTIFY THAT THIS TEST WAS PERFORMED IN
DATE:
REA- ER iANCHORAGE AREA BOROb 'H
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 995'03
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME
LOCAT).o,N
MAILING ADDRESS g (:3/~ /(03-"0 PHONE. ~-~ Z/~/-O ~7'~)0
LEGAL DESCRIPTION g--~5"~'I ~'H-U~t~l~2-['~l~O-.(4/~"tz4
SEPTIC TANK:
DISTANCE'
FROM wELL
INSIDE LENGTH
MANUFACTURER ~.~ t~-~_t~ MATERIAL
INSIDE WIDTH .LIQUID DEPTH
NUMBER OF
S4~..~.. / COMPARTMENTS '~-
,LIQUID CAPACITY / OC~ O GALLONS.
SEEPAGE PI"I:
tr
NUMBER !OF PITS ~ DIAMETER
LINING MATERIAL CRIB SIZE:
OR WIDTH ~, LENGTH , DEPTH
DIAMETER DEPTH DISTANCE FROM: WELL
TOTAL EFFECTIVE
ABSORPTIONIAREA (WALL AREA) ~(/~' P SQ. FT.
BUILDING i FOUNDATION ~
ADDITIONAL ABSORPTION
NEAREST LOT LINE
WELL:
TYPE
BUILDING
FOUNDATION __
CESSPOOL
APPROVED
CONSTRUCTION
NEAREST
LOT LINE
OTHER 5OURCE5
DISAPPROVED
DEPTH DISTANCE FROM:
NEAREST SEPTIC 'SEEPAGE
SEWER LINE , TANK __ , SYSTEM
REMARKS
DISTANCES:
INSTALLED BY: i ~ ~~ CO ~ ~
LOT SLOPE:
REMARKS:
Form No. LQ-031
DIAGRAM OF SYSTEM
DATE
APPROVED f~' ~I~
G,A,A,B,
,Rz,-)'/,*.6 [..z--v,,.-- ~. :2 P r:,
-/)nAo
/5- 6.]?.~.
PERMIT NO.
:r.lt/,,..,r,:.,:.; -. .. ,, .~ , -. ,...,, ..: ........ ., .: .... ./'. ,,.., ,
APPLICANT REGINALD .. v,-, ~-. .~'.:- .' BOX' "'16~0 SRA ANCHORAGE ~'4'--097'0
LOCATION
LEGAL L1 ~HUNDERBRUSH'SUBD .!, !".,,:-.,'::::LF -t'~ .... "' ' '-"
-' - LOT~'StZE:'' -: _~2756'"_~.OA~E FEET
.... ' .
TYPE OF SOIL ABSORBTION SYSTEM IS:';TRENCH"'-~';.-- ./',-....' .; ~.,.,
MAXIMUM NUMBER OF BEDROOMS = g SOIL RATING (SQ ~/BR>= 150
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
F--~EPTH= 7 L E t~l G T H =~\..,5 7 GRFi%.'EL DEF"I-H= '~:~
THE LENGTH DIMENSION IS THE LENGTH (IN FEET> OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF R TRENCH OR PIT IS :THE DISTANCE BETHEEN THE SURFACE- OF _THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET>, "
THERE IS NO SET HIDTH FOR TRENCH, ES.
THE GRAVEL DEPTH IS THE ftlNIMUrt DEPTH OF GRAVEL BETHEEN THE OUTFRLL 'PIPE
AND THE BOTTOM OF THE EXCAVATION (IN FEET>.
F-:Em;!U I AEC, SEPT I C TRr~K S I ZE: 10m3m,-3 GRLLmDrqS
BACKFILLING OF ANY SYSTEM HITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT HILL BE SUBJECT TO PROSECUTIO~'' r; . :-
MINIMUM DISTANCE BETHEEN A NELL RND~ ANY ON-SITE',:~EHRGE DISPOSRL'"~YSTEM IS J
· 0~ FEET FOR R PRIVATE HELL OR 2~EET~FOR~.R PUBL ' '" I C HELL.~ ....
HELL LOGS ARE REQUIRED RND HUST.BE~RETURNED TO 'THE 'DEPRRTHENT NITHIN ~ DRYS
OF THE HELL COHPLETION. ~.' . ............................
SPECIFICATIONS AND CONS~LIC~-ION"DIRGRRMS ,ARE AVAILABLE TO INSURE PROPER
I NSTRLLRT I ON. ~: ~"' '"
F'ERr-IIT "..~RLIE~ F~DR OraL. '~ERR FRCmrl I SSI_IL
I CERTIFY THAT
l: I AM FAMILIAR HITH THE REQUIREMENTS FOR ON-SITE SEHERS AND NELLS AS SET
'FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I HILL INSTALL THE SYSTEM IN ACCORDANCE HITH THE CODES.
~: I UNDERSTAND THAT THE ON-SITE SEHER SYSTEM MAY REQUIRE ENLARGEMENT IF .THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ~ BEDROOMS.
A"choratle, A I aslca 9g'.,U3 ~
,(~.;tl'lioM I,(~; .. I'I~IIOI,A'I'If~N 'I'I';:{T
.Pc~'~° rmcd for
uescr~pc]on: Lo~ 1 S~ 1/4 g~z'), ~ _ . ...... J)ate Perfonmzd ,. ~ z
b:is" --- '
form reports: S~Fs-~j--~--,~,z..=~._~.2~= 22, T12~,. =z,.. =~, --~-~~
Percolation te~Y'--~ ......... -
z.7 - z,:' (~9)
Was ground water encountered? ..U.m. ......... 'If yes, at what depth?
Reading Date Gross Time___.___ __j~.~'e~t _T.i__me i.)eptl) tO Writer Net Drop
.............................. 2
........ LL]" .--:_' .................... ' ........ / ....... ~ , ........ , .... -'" '."
· . . utc _ .2Z m~nutea · - ........................ 'J ........~ ........
· ' " · I rdlll ! 1Cid . ·
Parcel I.D. #
1. GENERAL INFORMATION (Must be completed prior to sUbmittal)
(a) Legal Description (include Iht, block, subdivisiOn, section, township, range)
LoT!
'; ': : ;'MUNICIPALITY OFA~IcHORAGE: ' : ~
~' Department of Health & Human Services
' DIVISlON OF ENVIRONMENTAL SERVICES :
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Location (address or directions)
(b) Property owner
(c)
Mailing Address
Lending Institution
It H o-c=,
~.
Telephone: (home) ._~usiness
Telephone
Mailing Address
(d)
Real Estate Company and Agent
Address
(e)
Telephone ~-T&, - ~_-~"~'~ !
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'l~ 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 , ; ~ Public[] ' Community[] ' Holding Tank[]
Note: I~/ 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 o~ 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..
Address
Date
Engineer's Seal
6. DHHS APPROVAL
_Approved for ,.. -,:~ edrooms by
Approved ~ Disapproved
Terms of Conditional ,~,pproval
Conditional
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 DHHS does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees oi DHHS do nOt conduCt inspeCtions
or anal~:ze data'before a'certifiCate is issued. Th:e Municipality of Anchorage is not reSponsible fOr errors or omissions
in the professional engineer's work. ' '
72-025 (Rev. 7/88) 8acl( Page 2, ,of 2
,...: ,:: [..*--~__~.~ ..... .Health Authority Approval (HAA)
, .MAR ]989' -
A.'WELL DATA
Total Depth ~/$~ Oasedto)/~ Depth of Grouting .
Static Water Level. I ~
Casin~ .eight ~bo~ ~[o~n0 ...
filectrical Widng~in Conduit {Y/~) ~
SEPARATION DISTANCES FROM WELE: ',",~;
To Septic/~ Tank.on Lot - I ~,"..
To Nearest Edge of Absorption Field on Lot ..... ]~ ~ ; On Adjoining Lots
To Nearest'Public Sewer Line ~/~ To Nearest Public S~wer Cleanout/Manhole
Pump Set At
:Sanitary Seal on Casing'{Y)N)".
Depression Around. Wellhead (Y/N).
To Nearest'Sewer Service Line on Lot -i~//A ' - '
Water Sample Collected by -. ,.-¢,~..S ;Date ~.'~l~. ~':~ '
Water Sample Test Results ' '.' .~."~' ~.o///,~" . ' Oi ~,/..//t4,4 .~//~
Comments ~" ;
b. SEPTIC/I'I~I~i;~:RG TANK DATA .... ' ....
Date Installed "I~rT~.--- :Size I~ No. of Compartments .... "~
Standpipes (Y/N) T'~'O ' Air-tight Caps'(Y/N) 7 F°undati°rz'Ctean°ut?¢/~
e,,~o/~' "'
Depression oVer Tank (Y/N) ~ ..... Date Last pUmP
Pumping/Maintenance Contact on File (Y/N) ~/t~ ; for ~.
-.' '' '' ,i. ; ~..I ".' ::" -. ;::: 'J . ' ' ;~.' ~ ' "
Holding Tank High-Water Alarm (Y/N) ~ TemporarY ,Holding Tan? Permit (y/N)
;"~:,'.,.~j,:. ,. o'.:. :.~-~ .
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
'TO Buildin~F0undatioh t./~
· To .Water-Supply Well ] "~C) ~' .... ~ '
To Water Main/Service Line _'~ ! O
To Stream, Pond, Lake or Major Drainage Course
Comments ..... "'
72-026 (Rev. 7/88) Front Page 1.0_f 2-
Soils Rating in Absorption Strata ir'~'l ~, ~ ::': ';: ~': TYPe*of System:Design
Date Installed "I:'gt'~' ~ ~~':--';Length 0f~i~'
· ~,LWidth.of:Field~ i:-c ~ ~ ....... ', Depth of Field ~
.::,, ;~.'. </,, '~,",: ','/ ~: J: 3 ~Gravel Bed Thickness ~"
Square Feet of Abs°rti;~ A~ea ~ ~'~ ~ Statndpipes Pre';h{' (~
.1. pepre~sion 9var F~eld (Y/N), ~__. ~e~f~ AdequacYTe;t' ~/Io 18~ ' '
Resultsof Last Adequacy Test ' ' ~ , ~
SEPARAtiON ~ISTANCE ~ROM ABSORPT;ON FI~C&~ ,
.... To Water-Supply Well ...... ~:~ / ~:~ '~ "" ':~ TO" Properly ':~: ~;';~ Line '~
' To Building Foundation ........ ~ ~: ' :: -* TdE~isting or Abandoned SY~te~ on
Lot- ~' ''' ~
.... r;~.... ::~:: :'~,~..,: "OnAdjo~mngLotsl,; ,,~:~:~. .... ~ , . ... .'
To Water ~in/Service ;Line !.: ' "P/c-c:': ~: :.
To Stream, Pond, Lake, or Major Drainage Course
_..To riveWay;' _Pa. rking Area,!or!Vehic!e,.St0,rage Area
Comments
To Cutl~ack (if Present);'
D. LIFT STATION
""'
..... Date Installed
· Size in Gallons- ' ~.-'.'5'o-c> '::: :;
....... :!Pump On"-Level at
... High.Water. Alarm Level at ri' ~ '
Tested for /
Meets MOA Electrical Codes (Y/N)
Comments · · .'..
Dimensions ' ,5'°'¢~
Manhole/Access (Y/N)'
"Pump Off" Level at ~ ~ ' ',:
Vent (Y/N) ~/
Pumping Cycles during Adequacy Test.
Check Permitted B~droom Rating Against HA~ ReqUest*,* ....
I certify that l have checked, verified, or conformed to all MOA a'n~' HAA ~l~idelines in'~fiect ~' :' ';' :~ '"':~'
on the'd~te 5f this
inspection:
Company I
Date ~~ '~ ~ ~ ~ Q ~. :~T~ ~..~ ~r,.' Engineer%Seal
-~ . ~-~ ~1 ~, ' '. ~% .. ' .... [;.'/J, .
...... ., . ,),~ , ,, .... . . . ~ ' ' :
MOANo. __
,~, ~.' ~"~'. JUNE 2S. ~971 .'./~
............. 7 ,~ _ · ~...(~...,~.., ,' , - ..,.~, . : . · . ' .
Rece,pt No.
Receipt No.
Date of Payment ~/~/ Waiver Fee: $
72~26 (Rev. 7/88) Back P~ge 2'°f 2 .
203 W. 15th AVE "C" SUITE 203
ANCHORAGE. ALASKA 99501
TELEPHONE: (907) 279-3916
LEGAL:
LOCATION:
OWNER:
RESIDENCE:
WELL:
SEPTIC SYSTEM ADEQUACY TEST
Lot 1, Thunderbrush
11400 Birch Road
Charles Gause
Single Family, Three'Bedrooms
On Site
SEPTIC SYSTEM:
DATE OF LAST PUMPING:
FROM MUNICIPAL RECORDS: 3-Bedroom System
TANK: Greer Steel, 1000 gal, 2 Comp.
ABSORPTION SYSTEM: Pressurized Bed
ABSORPTION AREA:..- 1408 sq. ft.
SOIL RATING: 312 sq. ft. per bedroom
INSTALLATION DATE: November 1986
March 9, 1989. Marx
DATE OF TEST:
March 10, 1989
TEST PROCEDURE: System was inspected and measured. Tank was
found with 5 feet of cover, monitor tubes to bed had 3 and 8
inches of liquid. System had been pumped on Feb. 24, and the bed
had dried out by March 3. Approximately 700 gallons of clean
water were added to the absorption field while the water levels
in the monitoring tubes were monitored. The water level rose one
inch per 360 gallOns. The absorption was monitored for 2.5
hours. The water level dropped .25 inches during this period,
indicating that approximately 60 gallons were absorbed. This is
the same as 575 gallons per 24 hours.
TEST RESULT: This system meets the code requirements of
the Health and Social Services Department of the Municipality of
Anchorage.
NOTE The operational life of all septic systems depends on the
local soil conditions, groundwater levels that may fluctuate
during the year, and the water usage of the family being served
by the system. These conditions are outside the control of the
evaluator of this septic system. We can therefore not give any
estimate of how long this system will function satisfactory for
current or future occupants. This system is designed for a water
usage of not more than 450 gallons per day. A higher water usage
will cause the the system to overload and a period of no use
will be required to restore the system.
17034 Eagle River Loop Road
Eagle River, Alaska 99577
~---~7 _ DATE OF TEST:
'~"~:::'~"¥-
DRILLER:
ROBERT A. SHAFER
PROJECT: '[:~~~ ' "~::::::'O~
LOCATION OF WELL (Legal Description):
WELL DEPTH: ~,~'~"'~'-- ~ FT. CASING: __
DATE DRILLING COMPLETED:
STATIC WATER LEVEL (Top of Casing): ~. "7-~--"°1
CIVIL ENGINEER
694-2979
SCREEN;
CLOCK ELAPSED TIME SINCE DEPTH TO DRAWDOWNI PUMPING
TIME PUMPING STARTED/
STOPPED, MIN. WATER, FT. RECOVERY RATE, GPM REMARKS
I
%
25
30
35
40
45
50
10
15
20
25
30
~ 35
\
Comments: ~)~..~ ~.~j~.~ ,~ ~ )~ ~ ~0~
-- ~, ~ ~. Flow is not Guaranteed
Subsequent Variations
Can Occur.
;-' ,,' : i *' ' . ' ', iMUN CIP/~Llff 07 ANCHORAG
,' - : ~ : r MUNICIPALITY OF ANCHORAGE '! .... I .... '~' '*^ ; O '
~"~'-. ~ DEPARTMENT OF HEALTH & ENVIRONMENTAL~
' ~-I] ~[ ~ ' 825 L Street- Anchorage, Alaska 99501 ; .............. ~' .... ~. .... ~'Y"
fl ~ ~
~ ~' ,' , ~' '.~ I ' ~ .:~
~~ ~ ~ ,' Telephone264~720 . .'~ r'~t": ~. ~ ; '~.
REQUEST FOR APPROVAL OF INDIVIDUAL WATER ~ND S~~CI[~
da~s for pr~cessing.~:
DIRECTIONS: complete all pa~s on page 1. Incomplete reques~ will not be processed. Ple~s
1. PROPERTY OWNER ~ ;, · ~, ]~,; ~ [ PHONE :~'
: HUCKEY, [Reginald ~d"Linda '~. ~ ~:!~'. 3'44-0970
MAILING ADDRESS , "' ~' ' :' i
SRA ~ox~[650, ~c~ra~e, A~as~a 99507 ' ;~.. :.
PROPERTY RESIDENT (If different from abo~)
2. BUYER , '- ~ l
'~ ~RUC~,~ Thomas .E~. ~' ;. ~; 279'661
' 500 Wes~ Internati6nal Airport' Road. : ,
Security National~Ba~k- ~Ac~{e t~~. _. ~!:~ ~; ~I 276-6~80
2525 C Street, AnChorage, Alaska 99503 t, . ~ ~; :,
4. REALTOR/AGENT ~ ~',, ' ,I :1~'.
Larry Eaton '~" :' I :~. ~ 2 8-
MAILING ADDRESS ~ ;' ' J~j ~ ~.
SRA Box~ i651 // 5300 C Street
STREET LOCATION
4/10 mile South of:~ O~'Malle'y on West side o
L'ot 1, ThunderbruBh 'Sub
Birch Rolad
6. TYPE OF RESIDENCE {-i" " NUMBER OF
One
1[X SINGLE FAMILY I'I
' [] Two
[] MULTIPLE FAMILY ~ :I ~ Three
* ATTACH WELL LOG. A ~
since June 1975. For wells
depth (attach log if availab!
7. WATER SUPPLY
INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY
**If individual/on-site, give !r
'If system is over two (2) ~
by this Department.
8. SEWAGE DISPOSAL SYSTEM ~ INDIVI DUAL/ON'SI'lIE~:*
[] PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST, ACCOMPANY EACH REQUEST BEF~
72q310{3/78)
BEDROOMS
Fou
'Ii[] Five
!:[] Six
[] Other,
ell Idg is r, equireiJ for all wells drilled
drillb~l prior to that date, give well
e.l',...'1 ~ t ~
ars oki an adequacy test is required
;)REPROCESSING CAN BE II~ITIATED.
THIS SIDE FOR OFFICIAL USE ONL~
~ ',~ I INSPECTION APPOINTMENTS
TIME ;[ I~!!'~,, I i: ' '~ ; !!, · ~ TIME ,~ TIMEi
DATE [~; ~ ~. 'r , : : DATE I DATE
INSPECTOR I [~ ,11! ' . i I. INSPECTOR
INSPECTOR
I'
1. TY E OF RESIDENCE!
[] : SINGLE FAMILY.
[] MULTIPLE FAMILY
2. WATE SUPPLY
[] INDI~/~DUAL
[] COMMUNITY :
[] PUBLIC UTILITY
Connection Verified
3. SEWAGE. DI~;~OSAL SYSTEM
[] IN DIVi DU~,'E/ON -SITE~
[]PUBLIC O'i'i'L~IT~Y
Connecti0=n:v~rified
~Sept~ ~{~k ~ ~Holding Tank
Size: ~P ~;! ifTankis'homem~d
gave dlmensl~qS~ ~ ~
TOTAL ABSORPTION AREA
", ~
4, DISTANCES ;~
: ~ t ~ELLTO:
Absorption Area to nearest Lot Line
DATE RECEIVED
DIRECTIONS: !~.
NUMBEd OF,BEDROOMS
[] THREE
[] 'ONE
[] Two
[] FOUR
"
i[] FIVE
s,x
'l
[] .!'OTHER
DATE DRILLED.,
DATE INSTALLED
INSTALLER
I.
J MATERIAL:,i
Septic/Holding
SOILS RATING
Tank .IAbsorption Area J l'!jJSewerlLine ....
Nearest Lot Line
I
DATE
BEDROOMS
LEGAL DESCRIPTION
72-010 (Rev.