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Home My WebLink AboutBOREALIS LT 10Borealis Lot 10 #015-203-04 Municipality of Anchorage Page 1 of 3 Development Services Department Building Safety Department Onsite Water and Wastewater Program, 4700 S. Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.sk.us (907) 3437904 ONSITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW980137 PID Number: 015.203.04 Naar: Leonard A. Horton e Wastewater System: New ®Upgrade '" 4941 Alpha Circle Anch. AK 99516 ABSORPTION FIELD Haar: Number of Bookoams: Six 6 O OW TWO 0 WN Trerrn D Bed Moand I O Omer: LEGAL DESCRIPTION Soe Rewq: Taw Depth from on" grade: 81l .81.45 GPD/Fe Ft. Block: Lot: subdNatal: Depth r ppe Wm from agmal Pada: Gravel depth ll r m ppe: 10 Borealis 4-5 Ft. 41 FL Tawnsnp: Ranee: Becbon: FA added of ompmat grade: Grant L"th; l 1.5.4 Ft. 159 Ft. Well: ®New El Upgrade Graw avdn. 5 monw of Yre. 3 Ds ben vra. 1 10 Ft. FL cleseftabon (Penne, A & c): 70ul Depen: Goad b: TOW M>enrpeon Mea: Ppe Marr W: l Class A Ft. I Ft. 1,572 Fe ASTM D3034 PVC Dryer: Date Dred: Sum Water Lew: Y"Wler: is neullad: l Ft. Jim Tallman 6130.7120196 rya: Pump SM M: 09M Above Gd: CUMran TANK GPM Fl. fl. SEPARATION DISTANCES ® septic ❑ Holding ❑ S.T.E.P. I ❑ Other. To From Septic Tank Absorption Field Litt Station Holding Tank blkJPrivate samerune Anchorage Tank 2,000 WON >200 >200 >200 NIA >25' tee Steel b« pad math e. Three swwece water >100' >100' NIA NIA LIFT STATION W tree >5 >10, NIA WA 500 Gat. Anch. TanklOrenco Foatd.mn >5' >10, NIA WA al. 40 ti. p .L 40 In. Mata .L 44 I In. None Noted �m'p a'a`• a Alodal EbcarN frrpeamr °"amid by c"un Oran Orenco Dennis R. Chaussee Fleets":BENCH MARK Failed sorp ion I rench Was L:xcavated and Removedu In Garage Slab Depth the AFea Within 16' a! the New Constrdatien. +I 700.0 FL I Ealthe qes Stamp .:%t�.OFIA(gto 49.. (/ e� • .. Inspections performed by: A. Harala Dates: 1" 713-9198 2nd 719198 .�y. • �+ rr`".; .. Department of Health and Human Services approval r`>� MICHAEL E. g1:DER50N;�a Reviewed by: Date: - O � !r• GE-4381 �0� ��r' ! and approved . ••'•�� I ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 522-6779 (FAX) MEMORANDUM DATE: June 7, 2001 TO: Jeff Poet FROM: Mike Anderson, P.E. SUBJECT: Lot 10, Borealis Subdivision Septic System As -Built Certificate of Health Authority Approval Attached is additional test hole information to verify the lack of bedrock on Lot 10, Borealis Subdivision. The first test hole was placed by Jim Mack in 1976 during the construction of the first absorption trench. The location of the log is near the failed absorption trench, which is closer than 30' to the new trenches. The depth of the test hole was 16' and the probable elevation at the bottom was 78'. This is nearly 8', below the bottom of the new absorption trenches and verifies the separation distance of more than 6'. The second test hole was placed during our investigation of the lot in 1996. The log labeled as Test Hole No. 1 was also excavated to a depth of 16' or near elevation 78.0. This test hole was not submitted with the original design because soils encountered did not percolate as well as those in Test Hole No. 2. 1. The as -built drawings have been modified to include this test hole data and verify the lack of bedrock. Please review this information and issue the Certificate of Health Authority Approval for this lot. Thank you for your assistance with this project. PL Municipality of Anchorage Page 2 of 3 Subd. DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 - Anchorage, AK 995195650 - 343-4744 Onsite Wastewater Disposal System or Well Inspection Report Permit Number SW980137 PID No. 015-230-04 -- - PL k TH7 +Trench - 3 - - -- swing A ties B - ► Vi (2) .52 LF, 50 W, 4' E. D. SP1 I SP2 36.5 47.1 14.8 21.7 absorption, trenches I . . A F ,Ito, TiiMack' MT1 36.7 13.6 i -- — Trench- 2 - - - - • 1E F 1 MT2 31.6 21A � 2,000 gal. MH: I C D 38.6 ' MT3 27.8 - S.T.E.P. SP 2 . �G PL;. SP1. MT4 37.0 52.3 A AgR I \' MT2 \\ . MT7 //'�6 . WLKIN p �_ I V. TH3 \ Keybox Legend: _ SP standpipe MT monitortube CO clean out MH man hole Lot 1b. Borealis Subd. e,( -••' lir. /r MICHAEL E.ANDERSON *•V Plan As-Bltw s; •. CE 1331 ?• Alpha Cir. Municipality of Anchorage Page 3 of 3 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 -Anchorage, AK 99519-0650 -343-4744 On -Site Wastewater Disposal System or Well Inspection Report Permit Number SW980137 PID No. 015-230-04 I 10. Borealis Subd. house ` t` I I ! + ' +line 110 • : T : nC , 77 ---+-- 3 I L.. —l,geotex •T. � b ic! h 1'• septic-; .._ � I rocY, (Typ) II _-_F. _ I • •• �ouse� I .! nom:- , ;I � _... .. .. :._..4'.`_3034=1?VC—�=---.�- 94:03 I ! SCN . 1401 ! -'-- -- -—�� --- '-- '- --- PVC _�- .T r e n'c ! I �,..� �Fi L�qAlt. 7 - • 3 4 91 H j� �• �� goo- - - - : aP� N .. ................. ! MICNA'=L •E.ANDFRSG�y `t _ { + E .� Elevation As Bit t ' •_ ` ,-A3 1u - ;�� t •ao " "`':• GREATER 10:11DRAGL ARCA M .;N Department of I'uviroruncnlal Oua11ty ' 3330 "C" Street Anchorage, Alaska 99503 tiU11.S LOU • 1'l�il ())lA,1'lON'I'I:S'l' Perfunvd for_.�NtiL �• �1L Legal Uexriptiun:_ Q�- ip_,12 IgG/C SlJ�. This fonu reports: Sous lop — Perco Depth Feet 7 2r 2 l N/P_� L.4c,Pre� 3 4 5- b 7 PPI`c. TESD z-- 8 -,, {� 9- 'i 13 - 14 - �6I D >/_,, r� Has ground water encountered? No If yes. at wiiat depth? !)ate Pcrfut,lk�d_/Q�j� Mon Reading Date Gross Time Net- Time Depth to Water .I Net Drop is M�� _ -z ...� - Reading Date Gross Time Net- Time Depth to Water .I Net Drop _ -z ...� - - _ -__ -•-_----___ __...._ IZL.-..___ ..r __ - _- 5-v _---- rercolat)on rate__ unnute. Y• -Proposedhistallatlun: �eepagc Pit Urain Field Depth of Inlet Deptlito boCtom uF pit or trench C01,91l'N/T/S: 1.90 .. c/�1�F _fL!Q%}1Nf36et.%rQG4_R�1 Perfo liv I>y:_, Municipality of Anchorage Department of Health & Human Servi 825 L Street, Anchorage, AK 99502-0 SOILS LOG - PERCOLATION TES Performed For: Lennie Horton Legal Description: Lot 10. Borealis Subdivision SLOPE 1 � OG/OL 4 SM North South Was Groundwater 9 Encountered? No If Yes, What Depth? 10 Bottom of Depth to Water Hole After Monitoring None 11 Date: 8122/00 1 1 1 1 16[_1 Bottom of Hole 17 1 To Perc. Rate: Min./Inch Perc. Hole Diameter: 21H Test Run Between Ft. and Ft. Comments: No Perc. Test in this Material. Soils Thought to be too Tight. Performed By: Alan Harala. I, Michael E. Anderson Certify That This Test Was Performed In Accordance With All State and Municipal Guidelines In Effect On This Date: 617101 1 �T o (,) hon, i T >71./i -Y .C.a.AJ Ce - -- OIJ Sep�-I.c s ys -s- t-oc.o-re& t T_ ..1-1 T.. `._lo, TK is . 1, oa tC. W_A5 1--r 'A C pa:n aF I CA -1"e _ .o j...Tj TN e-sS .402 ...�es i De,u"T 0g Ll J-96110 Md.4 CvPY MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES iI P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 IA la a1 R PAGE 1 OF 1 I clL cr 7-41- 1Si 3:00 A o? .7: /" Y ✓. PAD aa l dusk ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW980137 DATE ISSUED: 5/29/98 DESIGN ENGINEER:ANDERSON ENGINEERING EXPIRATION DATE: 5/2 OWNER NAME:HORTON LEONARD A SR 6 EILEEN P OWNER ADDRESS:4941 ALPHA CIR ANCHORAGE, ALASKA 99516 PARCEL ID:01520304 LEGAL DESCRIPTION: BOREALIS IT 10 LOT SIZE: 17407 (SQ. FT.) NUMBER OF BEDROOMS: 6 THIS PERMIT: 6 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM 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 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: Pm l)-ct1 ' 19 RECEIVED BY: wF,�u DATE: 4 1Z -If J ISSUED BY: `I'L DATE: S -Z 7- 78 i Municipality of Anchorage Department of Health and Human Services 825 "L" Street Rick Mystrom, Mayor P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 Leonard A Horton Sr. Eileen P Horton 11222 Sagehill Houston. Texas 77089 4632 Subject: Lot 10 Borealis Subdivision Permit #SW960215, PID #015-203-04 The subject permit, issued July 23, 1996 by this office for a single family well and/or on-site wastewater system, has expired as of July 23, 1997. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as -built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. Si rely, IMSa'o Ja es Cross, P.E. Pr gram Manager On-site Services enc: Copy of Permit cc: Anderson Engineering 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 NUMBER:SW960215 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:HORTON LEONARD A SR & OWNER ADDRESS:4941 ALPHA CIR ANCHORAGE, ALASKA 99516 PARCEL ID:01520304 LEGAL DESCRIPTION: BOREALIS LT 10 LOT SIZE: 17407 (SQ. FT.) NUMBER OF BEDROOMS: 6 THIS PERMIT: 6 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1 2 3 4. 5. PAGE 1 OF 1 PERMITI DATE ISSUED: 7/23/96 EXPIRATION DATE: 7/23/97 THE ATTACHED APPROVED DESIGN. 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). 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 PER 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 THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: '' jt4j� E ISSUED BY: DATE IIT) DATE:.7,2-13- ,2-1-�� July 10, 1996 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 10, Borealis Subdivision Septic System Design Impacts to Adjacent Properties Dear On Site Services Engineer: The septic system absorption trench on the subject lot has failed with effluent surfacing in some areas. It is urgent, therefore, that the system be upgraded as soon as possible. Very little room is available on the lot for the new system so all possible areas have been explored. The attached site plan indicates the location of the new absorption trenches along with the new S.T.E.P. tank. The lot is served by a community water system so separation distances are not a concern. The house now has six bedrooms which will require a 2,000 gallon S.T.E.P. tank and a total length of 158 linear feet of absorption trench. These trenches will be placed in both the front and back of the house because of the shortage of available space. The surface of the lot slopes from south to north at varying grades. If the new system is constructed as designed the following statements can be made: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. The subdivision is currently served by a community water system. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact an reserved space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, /J r Michael E. Anderson, P.E. M,chuJ E Arid- ' ii Y Attachments 4�L ��IIEfJ��f LOT 10 BOREALIS SUBDIVISION AREA SEPTIC SYSTEM PLAN SCALE 1" = 30' NOTE: SUBDIVISION IS SERVED BY A COMMUNITY WATER SYSTEM. S _ _ LoT 12� _ Lor � Lor II r SITE PLAN SCALE 1" = 20' �I ME p .tee G/o BS .- I . SHM NM I . CALCWTM BY / DATE A. . CHECKM NY DATE acs L= te r' a i i • � � —f � � I _ I I I�i I 1 i _._..... ;_. tr < �.,y� � •�..bt -E- �, �� – . LOT 10, BOREALIS SUBDIVISION DESIGN FACTORS: Six Bedroom Home Perc. Rate: 12 MinJlnch (TH 3) 33 Min./Inch (TH 2) Application Rate: .8 GPD/SF (TH 3) .45 GPD/SF (TH 2) SYSTEM REQUIR Shallow Trench System 2,000 Gallon S.T.E.P. Tank 4' Gravel Beneath Lateral Pressure Distribution System 6 Bedrooms X 150 GPD = 900 Gallons Per Day 440 GPD/.8 GPD per SF = 550 SF / 5 LF (Width) X .5 (Red. Factor) _ 55 LF of Trench Centered Around Testhole No. 3 460 GPD/.45 GPD per SF = 1,022 SF / 5 LF (Width) X .5 (Red. Factor)= 103 LF of Trench Centered Around Testhole No. 2 1 Therefore: Construct a Shallow Trench System with a 2,000 Gallon S.T.E.P. Tank and Pressure Distribution Piping. 55 LF of Trench to be Centered Around Testhole No. 3 and Two 52 LF Trenches Centered Around Testhole No. 2. 1 41001 - ��PJL i. S!Oto _i (NO SCALE) NOTE: Bottom of Trench to be 4' Above Groundwater. Grade Area Over Trench to Drain Away. Fa3rs�c. DQJ►laF/� RoaL Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 `L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: 4_Snn P/ //or'/a Depth to Water LEGAL DESCRIPTION: b 4 4, /o 00-eAL/, --7 e DEPTH (FEET)%/DG ENCOUNTERED? 1 . e• G./3 • 7S 11 0 2- /3 % 3- 3o`5 /, 0 IF YES, AT WHAT 12 v', 04- DEPTH? —`�— 13 j• 5 ql «AMer�� S2 SM �Erl lid N Maetu l aIc �/ 6 gm w 8 ° 9 c ; SLOPE DATE PER Section: 10 Net Time Depth to Water WAS GROUND WATER ND 3 /.:%oq e ENCOUNTERED? /3%Z . e• G./3 • 7S 11 0 /3 % • /, 0 IF YES, AT WHAT 12 v', - .2T DEPTH? —`�— 13 j• ql «AMer�� S2 lid N Maetu l aIc �/ 14 ° � s 15- 16- 17- 18- 19- 201 516171819 20 %%f � r PERCOLATION RATE 33 (mmutesnnch) PERC HOLE DIAMETER 8 TEST RUN BETWEEN/ S FTAND G FT 1 L Ti fi$ S.s�C.•I `�. moi— A I -:'(ENGINEER-STEAL) •Vi i • 9 �e ••iO M;• iM•1 .H .. « r� w•j w T`•MkAc.l E Atr!•reon :.,s�. i MEN Net Time Depth to Water NUNN 3 /.:%oq /3%Z /L G./3 • 7S /3%L/e /3 % / /, 0 7S 3'A; - .2T lid Reading Data Gross Time Net Time Depth to Water Net Drop 3 /.:%oq /3%Z /L G./3 • 7S /3%L/e /3 % / /, 0 7S 3'A; - .2T lid gm w COMMENTS PERFORMED BY: •�� 1 yy4"'4/'d1 !LCERTfFY THAT T7�IS T ST WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE �/r0�1✓ 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH a HUMAN SERVICES 825 •L• Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST .j9nS Atida*I E : r PERFORMED FOR: Z—ICA^y ?orl DATEPERFORMED LEGAL DESCRIPTION: LIC>, Township, Range, Section: DEPTH SLOPE SITE PLAN (FEET) ��/J� �'j� 1 L I II I 1 24 1 0` 3 j' �M 4 20-3a� 5 6 71 4gXr o 13 14 15 16 17 18 191 I 1-713 kill No De* to Warr Aller NwAirin0? A/M aW =mmm JA•• W t 10 I �.-lvl WAS GROUND WATER ENCOUNTERED? 11 j IF YES, AT WHAT 12 fo /N DEPTH? ��r��s■cra�s 13 14 15 16 17 18 191 I 1-713 kill No De* to Warr Aller NwAirin0? A/M aW =mmm �.-lvl ��r��s■cra�s /Y .r PERCOLATION RATE Immutevincn) PERC HOLE DIAMETER I _L TEST '01 BE. WEEN�� FT AND $ FT COMMENTS 'cc rry ry it rs��•C /i -i I PERFORMED B ' 1 FY THAT TIs EST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE -- 72-008 (Rft. ATE72-008(Rev. day) i BV IlEA DATE 7lO N CLIENT SHEET ' OF CHKO. BY DESCRIPTION LOT- ID 909XALdS SUR• _ JOB NO. 54prlL 7AmL l4avto 14--vCL 951 N1c;Hcsr (�Tc24t, C4.w.4-rim /07 -Tt, -,p,ar INE L -4e -TN /Gn• Tiu3"SP0R-r' LNC DjAmcrM 1.5 L.srtOUIL O/urIC.0 lb)A'VlLrM . l $75 n 02+F-IrsS PcR- �arETtAt- 30 T, i� 01Z,,rlG¢ 5PI4UN4 sl. LAxrtlU L- i Qo = lz. d 'v'77 , 975/8 6PMl02ri� t .97yc8 GPMInUVIC.0 x 30 ovirl"I's z.9.3. GP M Z- .oco4as (t9.3) I' v%GD. TDFi//Z 951, t 171 4 - do ,•, tp osz o5 HNF-5 .•.. 21 E Ar AWI.E EN 15 110178) I GREi..,R ANCHORAGE AREA BOR - .,.JH i�pEr� Department of Environmental Quality • t�liA!. 3330 C Street Anchorage, Alaska 99503 INSP CTIO _ REPORT ON-SITE SEWAGE DIS OSAL SYSTEM I 3� �o e-sL o'i/ -c yiG NAME _ MAILING ADDRESS y�/ PHONE LOCATION �� LEGAL DESCRIPTIO N D �� 7/ I SEPTIC TANK: /J DISTANCE I �%. P y� FROM WELL ! ANUFACTURER MATERIAL COMPARTMENTS I INSIDE LENGTH / INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY_�Ga LLONS. TILE DRAIN FIELD: / I / Jim d �S TOTAL LENGTHS G DISTANCE FROM WELL FOUNDATION NEAREST LOT LINE OF LINES NUMBER OF LINES DISTANCE BETWEEN LINES TRENCH WIDTH_ IN. TOTAL EFFECTIVE ABSORPTION AREA—,r7/ / SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER I nCDTH. TDP DF TILE TO FINISH GRADE MATERIAL BENEATH TILE .�j. WELL: TYPE�0 CONSTRUCTION BUILDING FOUNDATION CESSPOOL n000nvCn DISTANCES: NEAREST LOT LINE OTHER SOURCES DISAPPROVED INSTALLED BY: SEWER LINE DEPTH: PIPE MATERIAL: LOT SLOPE: REMARKS: Farm EQ -032 NEAREST SEWER LINE REMARKS 10 DATE! ABOVE TILE IN. i I DEPTH DISTANCE FROM: I SEPTIC SEEPAGE TANK . SYSTEM DIAGRAM OF SYSTEM I i6 I )ol E/Iv 1).0 q G.A.A.B. tlUt4I C 1`9 t- I TY OF t=fLVCF_�%RF=irE M DEPARTMENT' HEALTH AND ENVIRONMENTAL .,.OTECTION Q_ •��o 2516 E. TUDOR, RD., ANCHORAGE, AK. 99507 J x,95 i 276-2221 • � ` 1 Ot.J—S I TE SEWER F•ERt•Y I T �3 PERMIT NO. C 7CS47 ) APPLICANT SANDOR CONSTRUCTION 3424 THOMPSON 344-0416 LOCATION ALPHA C ti LEGAL L10 BOREALIS SUED LOT SIZE 17402 SQUARE FEET TYPE OF SOIL ABSORBTIOFJ SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 SOIL RATING CSO FT/BR)= 90 7 THE REQUIRED SIZE OF THE SOIL ABSOP.PTI _ " EM IS: GEF'TH= 22 LEhJGTH=��? iGRAk?E__L �EjF?TH=''' THE LENGTH DIMEFISION IS THE LENGTH CIFJ FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACEIOF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IFJ FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MIFJIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE AND THE BOTTOM OF THE EXCAVATION CIFJ FEET). F'FFCF.:F=iGE F'L_ntJT REiGU I RED ------ ---------- --� EITHER. A CLASS I OR II NSF APPROVED PLANT MAY BE INSTALLED. R CONTINUOUS MAINTENANCE AGREEMENT IS REQUIRED. IF A MAINTENANCE AGREEMENT IS NOT KEPT CURRENT YOU MAY BE REQUIRED TO ENLARGE THE SOIL ABSORPTION SYSTEM AND/OR YOU MAY BE SUBJECT TO PROSECUTION. IF R CLASS I SYSTEM IS USED THE LENGTH IS 211p FEET. IF A CLASS II SYSTEM IS USED THE LENGTH IS 44.0 FEET. TLJO C 2] I "SF•EiCT I OFJS RRE Fea DU I F:EL7 BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MIFJIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS 100 FEET FOR R PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL. I SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO IFJSURE PROPER INSTALLATION. F>ERtl I T NA Fq L_ I E> FOR OhdE keEF=iR F'ROt•7 ISSUE 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 THE CODES. 3: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS. APP?NT SR7JDV� �OFJ51RUC�OFJ--------- �~' •:.G �. !^ f tiN ISSUED BY__� ------ IL __ 36 /G ' GREATER ANCHONAct. ARBA M;11 Department of Environmental Quality ' 3330 "C" Street e; Anchorage, Alaska 99503 Performed for �9N c-. �Ow -7; _ slate Perfomk-d /O�j� Legal Uescriptiun:_�Qr ioR fsG/C -_I This form reports: Soils log — Percolation test — Uepth �— Feet 2 - 4- e 3- si�.v.T•L�s�s.Lfs 5- 6 7POrc. TesT z oxo_ II- 9- 13 - 1 a - /6 ' Be 1�a v� %•. ,41.E-2c� Szope Was ground water encountered? /f/v _� If yes, at what depth? Rcadin9 Uatc .Gross Timc tlet•Time —Dc--pt—;I—to Water flet Urop — - ---- -- --- - _ n -- ------ — -- —rsss -- --- ---' - -- -A---A-- �riri�`iiil Was ground water encountered? /f/v _� If yes, at what depth? Rcadin9 Uatc .Gross Timc tlet•Time —Dc--pt—;I—to Water flet Urop — - ---- -- --- - _ n -- ------ — -- —rsss -- --- ---' - -- -A---A-- Percolation rate minute. •ProposedinstallaCioiit Seepage Pit Drain Field Depth of Inlet Depth to Lottoo of pit or trench COMIGITS: _.1.9.0 _.,s"c � FTZL'L+lN. e6e _ 9�4-- R. l�/B ,�%, Purformed 1;y:_. M_...�IRL.�__..�. Corti fieri lsy: ,(yL_[��q� ;iale:_,lD ?.I_`e 6044 411A� CU �MOCNUAf," �c1 l'� CIVIL—STRUCTURAL • rLECTRICAL MECHANIe7L LANO TECTONICS INCORPORATED ENGINEERS & SURVEYORS SEPTIC SYSTEM ADEQUACY TEST DATE October 31, 1980 CLIENT: Name Wayne Coggins c/o Don Brendgard Address Century 21 - Shennum 209 West Dimond Blvd. Anchorage, AK 99502 S- 107 Telephone 349-2758 LEGAL DESCRIPTION: Lot 10, Borealis Subdivision, 4941 Alpha Circle SURVEYING SEPTIC TANK: LEACH PIT: DRAIN FIELD: Material Type Probably concrete Size 1500 gal. X Number Bedrooms 4 Required Tank Size 1500 gal. Surcharge Test 500 gal. water; 0.80 (150 x No. bedrooms) min. Rate of percolation 2,000 gal./day Sludge condition in.tank: Not serious, but pumping recommended. Remarks: 500 gal. dissipated completely in 2 hours and 45 minutes. Fall in head nearly constant.0 System is functional and adequate. 349- 2526 P.O. S0X 4-2265 ANCHORAGE. ALASKA 29509 (9071 __ _ _ .5 n 5. LEGAL DESCRIPTION /n� &R DANE RECEIVED INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECT f MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE OF H-ALTfI 6' DEPARTMENT OF HEALTH ENVIRONMENTAL PROTECTIOSIEPT. 'r OTECTION ; 825 L Street • Anchorage, Alaska 99501 ENVIRONMENTAL 1 • ENVIRONMENTAL SANITATION DIVISION Telephone 284.4720 nn CC�[[ `jI F [j� REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEVI>r6.KA1CI�KI I DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERT _ ^ Orr n/l.4 QOGGINS G oR 3'174?rA NC— j`O _ IO-°� l -�6 MAIL GADO SS i YEAR ON-SITE SYSTEM WAS INSTALLED. PROPERTY RESIDENT (lf gifferent from above) PHONE r 2. BUYER GFa r.4 MAILING ADDRESS s RR / scfb A ANe.�I`,� 3. LENG INSTITUTION DI PHONE M -�*C. MAILING ADDRESS E I ' 0. RE\AL70R/AGENT ./� -,�{7t Ktl941 PHONE 3yf%r� 3/ ` 1Q JA n c s✓9� d! vNu.� MAIrG ADDRZ. I /sESS ^L O Vn Iw ta"o 5. LEGAL DESCRIPTION /n� &R I /'f /O AL► u/3 STREET OCATION LPAA C,Rc L6' — y9�1/ i i LPWA CIRCLLor I 6. TYPE OF RESIDENCE NUMBER OF,BEDROOMS Q SINGLE FAMILY O Five ❑r 0 Other Two I [❑ 13 MULTIPLE FAMILY ❑ Three Six 7. WATER SUPPLY - 'ATTACH LOG. A tog is for drilled ❑ INDIVIDUAL' WELL well required all wells X COMMUNITY since June 1975. For wells drilled prior to that date, give well ❑ PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM _ IO-°� l -�6 IAi INDIVIDUAL/ON-SITE" YEAR ON-SITE SYSTEM WAS INSTALLED. ❑ PUBLICUTILITY NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REOUEST BEFORE PROCESSING CAN BE INITIATE0. 72010 (Rev. 6/79) THIS SIDE FOR OFFICIAL USE ONLY 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON-SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER OATEINSTALLED t 6— _Connection INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL �o 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS W APPROVED FOR BEDROOMS ❑ CONDITIONAL APPROVAL Iletter must accompany certificate) ❑ DISAPPROVED _1 DATE BV 0 72 010 (Rev. 6/79) Municipality of Anchorage Development Services Department / Building Safety Division On -Site Water & Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage. AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. & g L�2Q3- L7 y 1. GENERAL INFORMATION J, COSA# 0(p b-Tq- I Expiration Date: R - -2-1 1_� ` Complete legal description BOREALIS S/D: LOT 10 522L2252 Current Property owner(s) Location (site address) • 4941 ALPHA CIRCLE • ANCHORAGE. AK 99516 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 6 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site 0 522L2252 Current Property owner(s) RICH VANDORT Day phone Mailing address P.O. BOX 222244 * ANCHORAGE. AK 99522 Public Sewer Lending agency Day phone Mailing address 727L9379 Real Estate Agent ROD STONE w/DYNAMIC PROPERTIES Day phone Mailing address 3111 "C" STREET • ANCHORAGE. AK 99503 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 6 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class "A" Well Community On-site ❑ Public Water System ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Onsite Systems Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions In the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure Indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Finn GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 • ANCHORAGE, AK 99507 Engineers Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, UD. attempted to provide a thorough, conscientious engineering analysis of tho system in accordance with ADEC and MOA DSD Guidelines 8 Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily Identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the solo benefit of the owner listed above. Any reliance upon or use of this report by any other person or party Is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE f/ Approved for CD bedrooms. Disapproved. Phone 337-6179 Date 8 A,V/0L Conditional approval for bedrooms, with the flowing stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory Arsenic Advisory Maintenance Agreements Supplemental Engineer's Reort Other OFfgiyr�y,�% �c WA7ERR : m= PROGRAM By: O�- /ir 00e Original Certificate Date: IR. 11MI Municipality of Anchorage Development Services Department Sulkting Safety Olvislon On-Ske Water & Wastewater Program 4700 Bregew Street P.O. Bax 198850 Anchorage, AK 99519.6850 www.muni.orglonsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: BOREALIS S/D: LOT 10 Parcel A. WELL DATA Well type CLASS A• Date completed _ Total depth Date of test Static water level Well production If A, B, or C provide PWSID# 211708 Well Log (YM I Sanitary seal (YIN) Tres DmPedY Pmtected (YIN) sed to ft. Casing height (above ground) in. FROM WELL LOG AT INSPECTION ft. g.p.m. ft. g.p.m. WATER SAMPLE RESULTS: Coliform aoloniesl100 mi. Nitrate mgJL.1113112 111111111ar'', —co les/10 0 ml. Arsenic: ate of sample: Collected by: I B. SEPTIC/HOLDING TANK DATA Tank Type/Materlal S.T.E.P./STEEL Date installed 6/30 i ✓1998 Tank size 2000 gal. Number of Compartments 2 Cleanouts (YIN) IYES Foundation deanout (YIN) YES Depression over tank (Y/N) NO High water alarm (YIN) ! YES Date of pumping 5/17/2006 Pumper A+ HOME SERVICES I C. ABSORPTION FIELD DATA PaELOW EXISTING•" souTH/NOErrH Date installed 7/9/1995 Soil rating .p.d ftlbdrm) 0_8 System type s' WIDF TRFNCH Length 159 ft. Width 5 A. Gravel below pipe i 4 ft. Total depth '1o.7s .911. Eff. absorption area 1572 ft' Monitoring tube YES Depression over field NO Date of adequacy test 8/11/2006 Results (Pass/Fall) PASS For 0bedrooms 29/ 4*730 Fluid depth in absorption field before test OSS I^'38.5/ Water added 170 gal. New depth4s 5 in. Elapsed Time: 160 min. Final fluid depth 9_5 In. Absorption rate a= 900+ g.p.d. Any rejuvenation treatment (past 12 mo.) (YM & type) NONE KNOWN If yes, give date "ADDED 730 GALLONS TO THE SOUTH TRENCH. ADDED ANOTHER 17o GALLONS TO THE NORTH TRENCH. LQ0 LEVEL REMMNED THE SAME. i *"ONLY TESTED TRENCHES ON NORM SWE of HOUSE. D. LIFT STATION Date installed 6/30/1998 Strain gallons 250+ Manhole/Acoess (Y/N) YES "Pump on" level at 40 in. "Pump ofP krvel at 40 in. High water alar level at 44 in. Datum BOTTOM OF TANK Cycles tested 3 Meets alar & circuit requirements? YES E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankAift station on lot Absorption field on lot Public sewer main Sewer /septic service COMMUNITY WELL On adjacent lots On adjacent sewer manhole/cleanout Holding tank Ani nment areas Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 5'+ Property line 5'+ Absorption field 5'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Wells on adjacent lots 200'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 10'+ Building foundation •10'+ Water main 10'+ Water service line *9'+/— Surface water 100'+ Driveway, parkingNehide storage "0' Curtain drain NONE Wells on adjacent lots 200'+ F. COMMENTS • PER 1998 ANDERSON INSPECTION REPORT. *' PORTION OF DRAINFIELD G. ENGINEER'S CERTIFICATION I ceRNy that I have determined through Reld inspections and review of Munidpal records that the above systems are in "' conformance with MOA COSH guidelines in effect on this date. Engineer's Primed Name JEFFREY A WNESS a' Date s f I Jan ��•d P, COSA Fee & T W r Waiver Fee $ Date of Payment T) 12" Date of Payment Receipt Number 9519[% Receipt Number (aw.1 trot) m Dec "AwFBLO/NO BRAWL tIII (� DRIWWAY�'000�1�0�� B o .��pi Q : SHANE A. HOLT a �000�0 4 5 E39'58'35 'F- 1 04.73' V ALPHA CIRCLE ----------------- EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON,"JLESS NOTE: ANY FENCE] NEs SHOWN ARE LOCATED APPROnMATELV AND ARE NOT TO UE USED TO pEfERL11NC pROPERTI DR LOLLTR LmI rte Oce L£G£NO: 9 6£W£R VCNT gSCALE: 1-201 (NO CORNERS SET THIS DATE) 6CALC: 1'�2Q I 10. ANCNC9AOE, ALASKA T IM 29TH NAV 2001 - 75 Yv.0 003,'�BsO..A SI l 0 AOI KILIT• [A6lMA'MT _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ^ � I I' 1 . I ( LIR B'IAfYD.( B I B ( I 4 RYAIRWA I Y I < N B 'y ( A 01 n I/i BTDRY I i FRAME BWLDINB I •' W ARCTIC Dec "AwFBLO/NO BRAWL tIII (� DRIWWAY�'000�1�0�� B o .��pi Q : SHANE A. HOLT a �000�0 4 5 E39'58'35 'F- 1 04.73' V ALPHA CIRCLE ----------------- EASEMENTS OF RECORD. OTHER THAN THOSE SHOWN ON THE RECORDED PLAT, ARE NOT SHOWN HEREON,"JLESS NOTE: ANY FENCE] NEs SHOWN ARE LOCATED APPROnMATELV AND ARE NOT TO UE USED TO pEfERL11NC pROPERTI DR LOLLTR LmI rte Oce L£G£NO: 9 6£W£R VCNT gSCALE: 1-201 (NO CORNERS SET THIS DATE) 6CALC: 1'�2Q I 10. ANCNC9AOE, ALASKA T IM 29TH NAV 2001 - 75 Yv.0 003,'�BsO..A SI l 0 Q Aug -24. 2006 6:25AMd of - Garness Engineering Group, Ltd. I No -4871 P;• I 1 IceVTLT'/ r'"CNSWr — — — — — — — — — — — — — — — - — — — — — — — — — — — — — — — — — — — w I • I• Llfr (rATB� B ) 1 I 1 4 ArA)P WA 1 7 � • 1 � N n ' i Iiairowt• 1 3 AAN. BUILBINB w • ARCY70 I • Dr I BrLT' LML r /1FANQ BVA.O/NA I (r�� 1 Aic,I i E�� O� NVCUAY 1 Qip� und�C cJ�owtL in 1 Gs� Tro r ;C6 ' BMKL I .� ORIKMA► •CO�QO� I ,1 . s..........., .5!- - • yA� SHANE A. HOLT Z LS -6014 .....S. I; c 04. --- ALPHA CIRCLE _—. _. _.—. _. 4AL0cMrOIflCco4D.07ItA rINN 1NOSG BNCIMII ON TI£ R =MMFAT.MENOT SHKMM NEAEON."&ESS MOTE! ANTItNC111ff6 tHOM ARE LOCATIM AFFROAMATaYAND AM NOT TO BE USED f0 OETENL" ►ROPERn OR LOCATE riRI/LTu R +' o V 0 LCGCNDt IS acwc i SLWY(L(NO ENs SET THIS d1TG)CCALM 1'-2f IM BOU&IS UA. TNro ;STN ' Mumcipality of°YAne o ge '' Departl,ient of Health`s" n Sellvlces i Division of 1 Ori -Site Services. ,. - ,. •..;:' .. F.O Box •196650 Anohaage. jp www ci arx forage ,. (907) 34 7 CERTIFICATE OF HEALTH AUTHO I�14Pj?RO , } r FORA :SINGLE FAWILYrD1jVE LING 2O3 ,t Parcell.D, 015-W-04 lion Date: O — 1. GENERAL INFORMATIOW._';;4 Complete legal descnphon , Lot 10 Borealis Subdivision, Location (site address or,directrons) 4941 AI ha Circle Current Property owner(s) Leonard A: 8 Eileen P., Horton t , Day, phone 5227773 Mailing address: 4941 Alpha Circle' Anchors a AK 99516-- Lending agency,Day phdn _ Mailing address` Real Estate Agent Day phone Mailing Address Unless otherwise requested, HAA will be held by DHHS for pickup HAA picked up by 2. NUMBER OF BEDROOMS: Six 6 TYPE OF WASTEWATER DISPOSAL. 3. TYPE OF WATER SUPPLY: � ` . Individual Well ❑ lndnndual On-site " i ❑ Individual Water Storage ❑ Individual Holding tank i ❑ Community Class Well E]Community.On-site i ❑ i Public Water System ❑ Public Sewer C The Municipality of Anchorage Department of Health and Human Services (DHHS) Issues Certificates of Health' Authority Approval (HAA) based only upon the representations given in paragraph 5 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) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. 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 less than 30 days old. 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. Qirv. 16991 - 5. STATEMENT OF INSPECTION BY ENGINEER As 6Wied .by my seal affixed hereto and as of the vatidatwn dale shown below, I verify that my investigation based on procedures outlined it the Heakh`Authority,Approval'Guidelines for .this'Health Authonty,Approval applicationshows that the on-site water supply;andlor wastewater disposal system is safe, functional and -ad uate for the number of bedrooms and eq type of `structure, indicated herein.'l 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 corripliance with all applicable`Municipal and State codes, ordinances; and regulations in effect of Lot of installation Name of Firm __ Anderson Engineering ' Phone 522.7773 Address : P.0. Box 240773 I Anchorage.'AK 99524 Engineer's Printed Name - Michael E Anderson: RE Date 5!29/01 OF .4(S4Qa AoEraG)NEER's *c,' MeQ ............. ' ..MIC``HAEI E. ANDERSON . Cl 6. DHHS SIGNATURE �P� s� CE 430t Approved for �_ bedrooms `C�4p�Pt�LSL��'04q Disapproved Conditional approval for bedrooms, with the following stipulations: �. WATER AND : rn Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other VWVAtilLVV ER PROGRAM By: �1/�-. / �. Original Certificate Date: h -7' o/ Expiration Date: iP ' %- Dom- Reissue Date: (Ftw.10M) Municipality of Anchorage • -• Development Services Department Bunding Safety Division On -Site Water & Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519.6650 www.a.anohorage.ak.us (907) 3437904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lot 10,Borsans SuDdivision Parcel A. WELL DATA Wen type sss A If A B, or c provide PWSID #211708 Date campletad _ Sam seal (YIN) — Total depth ft. Cased to ft. FROM WELL LOG Date of lest Static water level ft. Well production 9•p•m. WATER SAMPLE RESULTS: Coliform cotodes1100 no. Nitrate m9•ft- Date of sample: B. SEPTIC/HOLDING TANK DATA Tank TypelMateriai STEP Tank size 2.000 gat. Number of Compartments 3 Foundation cleanout (YIN) Y Depression over tank (YIN) N Dated pumping 3129x1001 Pumper OW IllaaDonald s c. ABSORPTION FIELD DATA Well Log (YIN) Wires properly protected (YIN) Casing height (above ground) I in. AT INSPECTION ft. 9.p.m. Ot her bacteria colon,ies1100 mi. Date installed ti130H998 Cleanouts (YIN) r High water alarm (YIN) Y Data installed 719M998 Soil rating (g.p.dJfF or ft'Ibdrm) A 4 OOPD Length 159 ft. Width 5 ft. Total depth 6111 ft. Elfabsorption area 7X2XftMonitoring tube Y Date of adequacy tact 5119f1001 Results (PasslFaB) Pan System two S Wide Trench Gravel below pipe 4 1 ft• I Depression over field N_ I For ft bedrooms Fluid depth in absorption field before test 0.5.5 in. Water added8L7_ I got• New deptiow* in. Elapsed Time: 13�20 min. Final fluid depth1;!� in. Absorption rate >=.78tF 100 g.p.d. Any rejuvenation treatment (past 12 mo.) (YIN d type) N if yes, give date WA I D. UFT STATION Date installed ti =90 Size in gallons 250 Manhole/Access (YIN) Y 'Pump on' level at 40 in. 'Pump dr level at 40 in. High water alarm level at 44 in. Datum Bottom of Tank Cycles tested 10 Meets alarm 8 circuli requirements? Y E SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankilift station on lot Absorption field on lot Public sewer main Sewer /septic service line On adjacent lots On adjacent lots Public sewer manhole/dearrout Holding tank SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO: Bu0ding foundation >s Property Una .>9 Absorption field >5- Water 5Water main Wk i!0 t At%64 Water service line >10 Surface water >tar Wells on adjacent lots >2ar SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line >10' Budding foundation >10 Water main >10 Water Service line >to' Surface water _>tar DrIveway,parkinghshicieamrage 2. Curtain drain None Noted Wells on adjacent lots >20(r F. COMMENTS G. ENGINEER'S CERTIFICATION I cedffy that I have determbvd through and &,pectins and review of Munklpal records that the above systems are in cmdormama with MOA HAA guidelines in effect on this date. Engineers Printed Name Michael E An 11, RE Date 5_!2912001 HAA Fee $ 300 1 Date of Paymerd boo `1 (� ' 01 Receipt Number — tr)I - 1 (Rev. 12/00) Waiver Fee $ Date of Payment Receipt Number %1k 491H f �f. CE -4381 ,44kl1r.�rCSS10N�� '�