HomeMy WebLinkAboutTANAINA HILLS LT 22 Municipality of Anchorage Page I of
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Permit Number: ~{49~d~o3 PID Number: OIIO~"I/Z
Nam°~o.~'~-,?'' ~'.~O0~,/~ Wastewater System: [] New ~ Upgrade
Address:
P.o. /3o~ ~/~ ABSORPTION FIELD
~cHO~,, ~ ??~0~ ~d ~DeepT)ench ~ Shallow Trench ~ Bed D Mound D Other
LEGAL DESCRIPTION sog Rating: Total Depth from original grade:
~,~ GPD/Sq. Ft.
LeE Block: Subdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe
Township: Fill added above original grade: Gravel length:
Distance betwee~ lines:
WELL: B New ~ Upgrade
~ Pt, / ~ Ft.
Classification (Private, A,B,C}: ~X) ~ ~ Total Depth: Cased TO: Total absorption area: Pipe material: F~
Driller: DateDrllle : SlsticWaterLeveb In~ller: Date installed:
Yield: C~sing Height Above Ground:
~ GPM PumpSet~;/~ Ft.I ~ Ft. TANK
SEPARATION DISTANCES ~Septic ~*/~ o Holding US.T.E.P,
From Tank Field Station Tank Sewer Lines
s.,~o~ --- LIFT STATION
Water /~ /~ /~ t~ ~
/ /¢ / ~ "Pump on" fevel at:~~evel at: High water alarm at:
Foundation
~ump Mak~ Electrical Inspections pedormed by:
Curtain .~0~ ~ DW~
Drain
Remarks: BENCH MARK
ENGINEER'S SEAL
~ & 5 ENGINEERING ..,; ~ ,
Department of Healtb~d Huma vices approval ....
Roviewod and approved b ~ ~Z.~. - Date: .
72-013 (Rev, 9/91) MOA 25
Permit No.5w940305
Page 2 of 2
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIFIONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Legal Description.NAINA HILLS SUBD,; LOT 22 PID No.: 01105112
CO1
CO2
EXISTING
1000 GAb
SEPTIC
TANK
SI~P'I'IC SYSTEM
ABANDONEO SgOH THAT IT MAY BE
CO
f' = 40'
(CO,
MT1 MT ;CO
(CO3&
C04)
TRENCH
76.?
(M'rl)
& 70.7' NO WATER FOUND
A B
GO1 g9,O 23,(
Cb2 34.5 26.(
D;V. 38.5 29.(
CO3 47.5
Cp4 t8.0 23.(
Mf['l 45.0 20~
[STING t000 GAL,.
....... SI~PTIC'
WELL
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUR~ER:SW940303
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:CROUCH ROBERT &
OWNER ADDRESS:P.O.BOX 92155
ANCHO]LAGE, AK 99509-2155
DATE ISSUED: 8/18/94
EXPIRATION DATE: 8/18/9.~
/~ /'~'~? ~/~f
PARCEL ID:01105112
LEGAL DESCRIPTION: TAi~AINA HILLS LT 22
LOT SIZE: 49866 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD 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 AiYD 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)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
RECEIVED BY:
2]aV~lOdF/ ,OCj = ,,.I,
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
July 22,
1994
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUI~IES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SiTE PLANS
ROAO DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 'L' Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
REFERENCE: Tanaina Hills Subdivision; Lot 22
Request you issue a permit to upgrade the septic system serving the
three bedroom house on the referenced property.
An adequacy test was performed on the existing system on July 02, 1994.
from this test it was concluded that the system is in a state of
failure.
Test holes were excavated and percolation tests performed in the area
of the proposed upgrade. The approximate location of the test holes
are located on the attached site plan. The monitoring tubes within the
test holes have been checked and found to be dry. Attached is the
proposed upgrade design.
We do not anticipate any adverse effects on neighboring properties by
the installation of the proposed septic system.
If you have any questions, or require additional information for your
review, please contact us.
/R~/LSU/jk
ON SITE
WASTE WATER
OISPOSAL SYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP · SUITE 204 - EAGLE RIVER, ALASKA 99577
ON-SITE WASTEWAT~ DISPOS~i SYSTEM
CONSTRUCTION PRAC'f ICES
and
M~'l'~i~I AL SPECIFICATIONS
REFERENCE: Tanaina Hills Subdivision; Lot 22
The scope of this project includes the installation of a leachfield
trench to serve the three bedroom residence located on the referenced
property and excavation of the existing septic tank to verify its
integrity. If the integrity of the existing septic tank is poor the
exlsting septic tank is to be excavated, pumped, crushed, and abandoned.
The existing trench is to be abandoned in such a manner that it may be
used in the future.
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.
Unless specifically agreed otherwise, the property owner shall be
responsible for final grading areas subsequently depressed from soil
settling.
Contractors installing wastewater disposal systems must be certified by
the Municipal Health Department for system installations. Owners
installing their own systems must also receive prior approval from the
Municipal Health Department.
SEPTIC
1o
TANK INSTALLATION:
A septic tank is to be constructed by a certified septic tank
manufacturer. Construction shall include two 4" cleanouts for pumping
access.
The septic tank shall be sufficiently bedded to prevent settling or
shifting of the tank.
3. Ail standpipes on the septic tank shall extend a minimum of 12 inches
above final grade.
Page Two
Tanaina Hills Subdivision; Lot 22
July 22, 1994
Septic tanks installed with less than 4' of cover shall be insulated.
A foundation cleanout shall be installed one to four feet from the
building foundation. In the line between the tank and the leachfield
there shall be two adjacent cleanouts (unless an effluent pumping system
exists within the septic tank). These cleanouts shall be located on
undisturbed soil not more than 10' from the tank. The first cleanout,
in line, shall be to clean toward the leachfield. The second cleanout
shall be to clean toward the septic tank.
Final grading over the septic tank shall be such that a positive slope
exists away from the septic tank.
A~SORPTION TRENC}{/DRAINFIELD INSTALLATION:
Excavate the proposed trench to the dimensions shown on the design. The
bottom of the excavation shall be withJ, n 2 inches of level. If the
sidewalls of the excavation become smeared, they must be raked or
scratched (roughed-up) before gravel (sewer rock) placement.
Once the gravel is installed, the distribution pipe is to be installed
level with the perforations faced downward. Gravel is then to be placed
over the distribution pipe to provide a minimum of 2 inches of cover
over the pipe.
A silt barrier must be installed between the final gravel layer and the
native soil backfill. Ensure the silt barrier covers the entire gravel
surface before placing backfill.
Monitor tubes shall be of four (4) inch diameter and installed
approximately in the locations shown on the design. 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.
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.
MINIMUM MATERIAL SPECIFICATIONS:
1. Any septic tank proposed for installation must be constructed by a
Municipally approved septic tank manufacturer.
Page Three
Tanaina Hills Subdivision~ Lot 22
July 22, 1994
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 Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM FS10 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
Use of a type of pipe other than listed above must be approved by the
inspecting engineer.
Insulation shall be at least 2" thick extruded direct burial polystyrene
(Dow Chemical Company Styrofoam HI or equal).
Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Fernco, or equal).
A permeable nontoxic silt barrier (Typar 3401, Mirafi 140/N, or equal)
must be installed between the final leachfield gravel layer and the
native soil backfill.
Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel
with less than 3% passing the #200 sieve.
When sand is being used as a filter material, its gradation
specifications must conform to current M.O.A. or D.E.C. requirements.
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:
1o 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.
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.
Page Four
Tanaina Hills Subdivision; Lot 22
July 22, 1994
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 contractor's 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
contractor's activities. Final acceptance of the contractor's work rests with
the owner and the M.O.A.
S & S Engineering shall have no liability to the owner or to others for acts or
omissions of the contractor or any other persons performing work on this project
or the failure of the contractor to 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 & HUMAN SERVICES
825 "L" Street, Anchorage. Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
Al.,
LEGAL DESCRIPTION: L. oF
1
2
3
4
5
6
7
8
9
10
11
13-
14-
15-
16-
17-
18-
19-
20-
'T~/~Jf:llf-~A ~ILI~ -~/Z~ownship, Range, Section:
SLOPE
WASGROUNDWATER
ENCOUNTERED?
(ENGINEER'S SEAL)
SITE PLAN
S
IF YES, AT WHAT O
DEPTH? p
E
Depth to Water Alte~;
M0ait0rir]D? Dale:
Reading Date Gross Net Depth to Net
Time Time Water Drop
, ,,
PERCOLATION PATE / 0 {mlnute$/~nch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~ FTAND ~'~f__F~
PERFORMED BY: 17034 Ea!ill{, River Loop Road, No. 204 CERTIFY THAT THIS TEST WAS PERFORMED IN
Eagle River, Alaska 99577
ACCORDANCE WITH A[L STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
' ./ '?//) "'- Ran e, section
LEGAL DESCRiPTiON: /._..O'(' ~_~ '"7~.}LI/,~/,j/). ~I/U.j Township, g ' :
SLOPE
1
2
3-
4-
5-
9-
10-
11
WAS GROUND WATER
ENCOUNTERED?
13
14
15
16
17
2O
IF YES, AT WHAT
DEPTH?
(ENCiIN~ER'S sEAL} ,
SITE PLAN
P
E
Monitoring7 { Dale:
Gross Net Depth to Net
Reading Date Time Time Water Drop
Nfo Io,~ I~ t, I'{~. '/
;,~o ID ,' l~ ,, I ' ~
: ~ ~o " /~'¢~ /"
PERCOLATION RATE __
TEST RUN BETWEEN __
S & $ ENGINEERING
17034 Eagle Rival* Loop Road No. 204
PERFORMED B~a~;, r, ...... , I
[ -: :)N THiS DATE.
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEL NI S
72-008 (Rev. 4/85)
{mmutes/mchJ PERG HOLE DIAMETER
CERTIFY THAT THIS TEST WAS PERFORMED IN
DATE:
MUNICIPALITY OF ANCHORAGE L~'I¥1,~ON,~,i£~q),,r,L
DEPARTMENT OF HEAL'tH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street · Anctmrage, Alaska 99501 Telephone 264-4720
oN-s,TE SEWAGE D,S.OSA,. SYSTEM AND/O. WE,. ECT,O
ILQCATION !
DISTANCE TO: I Well
DISTANCE TO:
IF HOMEMADE: Inside length
Well Dwelling
Well Poundation
DISTANCE TO:
No. of lines Total length of lines
Top of tile to finish grade
Material beneath tile
PHONE [] NEW
!~/ NO. OF BEDROOI ~S
Dwelling ,/ PERMIT NO
No. of compartments
Width Liquid dept h,/¢/4
Material
PERMIT NO.
Liquid capacity in gallons
Nearest lot line PERMIT NO.
Total effective absorption area
PERMIT NO.
Length Width
Type of crib Crib diameter
Well
DISTANCE TO:
CJass Depth
DISTANCE
OTHER
PIPE MATERIALS
SOIL TEST RATINO/~/A
Crib depth
NS ALLER
Total effective absorption area
NeaCest lot line
Driller Distance to lot line
foundation Sewer Pine Septic tank
DATE
LEGAL.
F:'ERM I T I',10: '
DATE IEH!iLIED:
II*'11 Eli Ih,,.ll ][ I ....................... :
L.,, ,~. F" ~l:~z~* IL,.. ][: 'IF' "~F CJi IF::r' i.-1~ ~ 411 I~ Il £ l II '* i.. E.* ~:
DEPAIRTMIEIqT JIF:' I'II!~AI-.TH AND IE:NVIFR~alxfMIENTAL.I::':' '"::1~0 I El, 1 ....... .I. ON
8,'.,;~5 L !!)TREET, AIqCFI[IRAI;~iE, Al< 9950 1
,9.64.-.4720
..... ,IL..~,*JIIL..~ ~. IF~'EEIF:II*dl '.l~ '"iF'
Al ~ I...,ICAN I ,,
ADDRESB ~:
COItTAC"I" I:::'HONE:
DEARMOUN EXCAVA'TINI!) INC.
5,]!;44 IR I VIii{FITOIt
AIxlCHORABE, Al< 995:L6
345...- 1619
I...l::bAl.. DL..,..d.,Fs].I ,,
LCI'T
,.dJEDIVI,.d. LII~I. TAItA]:I'4A HII_.LS L.OT'-'~"~'"",,.
SFCTION: 4 'TOWIqSHIF': l,':.~l',l RANGE: 4W
zI..:!,E.)6(..~ (,:~Q. t'., F. [IR ACRIE]S )
BI...OCI .... 1'4/A
I cer'tify that:
1. I am t'ami, l:i. ar wi'Lb
For'Lb by 'l;he lqurlic:ipal:i.'Ly c:)f' Arlmhorage (MOA) arlc:l 'Lhe ~ta'l:.e cH' Alaska.
I will ins'Lall t, he ~iys'Lem iFI accordanc:e w:i.'Lh ali MOA co, des and
and :i.n c:omp].iarlce w:i.'M] the design El'itl. DP:ia C)~ th:[~l pern~i'L.
I w:L].J.: adhere .to) all MOA and ~'l;.a'Le of Alasl<a r'equiremerH:s ~or 'l:.h~.~) s(~.r~ back
!BeNl~!paglD IByB'~.~ffll (~rl 'Lhi!B (DP any adjacerrL I~r' I]¢~ar'by
II= A IJ]I::"F c) lAI ION IS IIqSTAI...I...ED ]:I',1 AN AREA COVE. b,E.D BY MOA ['L.III...DIIIb M]l.)lx.,:~,
TI-IEIq (1) AN IELECTRIC',AL F'ERMIT AND ],II,~I'-I::E, I10N MUEFT BE []BTAINED;
WIL.L. NOT BE AF'F:'FI[IVED WtTHOLIT AN
I:,I...I::I,,FR1CAI.. IIxlSI::'ECTION REPORT; AND (3) THIS
ELI::[,[I~,[I..,~I.., WI.J~ El::, DONF~ ~ LtCE:Iq~d::D EI..,I:L,]I-~I[,.I.~N,
MUNICIPALITY OF ANCHORAGE
h and EnvironmenLal Prote .on
Fourth Floor West
825 L Street
Anchorage, Alaska 99501
264-4720
SEPTIC TANK:
DIS1 ANCE ~ _~_ _.~... NUMBEI7 OF ~~._
TILE DRAIFI FIELD:
DiSr/,IICE r~OMWt!LL ~? -- _FOLIPli)A]ION_z~ _NJ. ARIS1 [Gl LINE ...... OFL. INE .
~ of Lines I][SF,~NCE BE]WEEN LII'!ES ..... FRE~ICII WIOTII ~ IN, TOrAL EFFECTIVE
' q ~ ...... AREA ~(M . __ SO. Fl'. LENGrH OF EACt! L I~E
SEEPAGE PI'F:
Log Crib ___Rings Crib Size: OlAME] [{R DEPI Il ...... OISTANC['_ Fi!OM: WELL
Class: Depth: __
Well Distance To: Lot Line
Bldg: Sewer Line:
Pipe Materials:
~! of Bedrooms:
Installer:
Remarks:
Well Owner
Location
DRILLING,
DRILLING LOG
INC.
Use of Well
(address of: Township, Range, Section, if known; or distance main road
Size of casing (,~ _Depth of Hole
Statm water level--'., ft. (al~6v~,)
Screen ( ); Perforated ( ).
Describe screen or perforation, i~!/A
Well pumping test at -~ gallons per ~Sfi~)
of drawdown from static level.
//.
Date of completion
1.9 ) ~eet Cased to 1.,>.2 feet
(below) land surface. Finish of well (cheek one) open end ( :
(minute) for ii hours with
WELL LOG
Depth in feet from
ground surface Give details of formations penetrated, size of material, color and hardness
);
ft.
) .T O.
.TO_
" TO
TO_
.TO_
TO_
TO
TO
TO
TO
TO
'l 9 0
2 -- STATE
F I-L. J....I-
L. OCFrI" I Epi'.,I
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:,._ .(I.... k. I .I.N.a E 1, 1...t: .............
THE LE::I'.,IEiTH [:) I ME:NS I ON 12; THE LEN[~iTH ,:: 1 i'4 FEET ;, O1:: THE "I"I.;i:E:I"~CH OR DRi;:I:I. I',IF;' :1:1:i:1...1.).
THE: DEPTH OF FI TRENE:I'4 Of:i: PIT iS THEE biSTFINE:E: BI:.-:THE:E:N THE; E;I...II~'.FI:::ICE; OF: I'HE:
Eil-.~'.OI..ll',11.) FIN[;, "l"lqE.: BOI"T£)i"I ELF;' THE EE~.,',(::FI%,,'FI'I':[(:)i'4 (IN F:'E:E;'I'::'.
'I'HEI,~!E :t:S N(:I SET HI C, TH FOR 'rRL::I'.,IC'HES.
I"HIE diRFI',,,'EL [:,IEPTH IS "rFIE: FIII".,III',IUf,'I 1,)IEI::'TH OF GI;;;'.F:I',,,%L. Eflii:;-rl.,.IEEl'-,I THE OU'I'I::'I:::I1._L.
FIN[) -I'I-.IE E~I:3TTEiM OF;' 'THE E::,.,',CFI',/FIT 1 O1'4 ( I N FEET ).
F:I F'I::t1,:;:I<FIGli~; I::'LFIN"r f,tFl'.r' BIE iN':_:;'I'FIL. I_.IiEI::~ l:fl" THE: I::'E]Ri','IITTEE~"S OPTION '..:.:UB..]'EX:::T 'fO I'HIE
I::'OML.OI4 :[ i'.4G Cl.)NJ;:, I TI: ONS:
:'L. IEITHER I:t E:[.R'.E;.'.;i; I OR I:l. NSf:' FII::'I.:'I:,~:O',/EB, I::'LflNT I"lE¥'r' E:IE IN.'E;T1.:ILLE[).
2. R CONT I NUOIJS I"IEI I i",ITE;NFIf',ICE] RC'iREEfqtEN-I' I'.~; RE6!U I I;i:E[). I F' F:I MEI I NI"E. hlFII",ICli~;
I::IGREIEI'"IENT IE; N(:)T I':::E;PT CURRENT "/OU I'11:1"¢ BE F;?.E:1.;!tJIli!IED TO I-ElxlLF:IRGE THE SOIL.
FIBSE~RI::'"rIOi'4 :'(;'¢ETI'EI',I I:li'.,l[::v'OR '¢OU f,lf;:l'¢ BIZ SLIIELtlE1.~:T TO F;'I;~:OSE1.]X..I"I ION.
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:;LEIO F:'EET FOI:E'. FI I:::',~.~::[',,,'i:l'l'E: klE:LI._ O1:;~: 2EIEI I:::E:E:T EOF.'. I:;:1 F'UBL.:[C I.,.IIEL. L..
.L,.IEL. L 1...O1.:~r.E; i:::JI:;;fE F:,'.E(;.!UIRE:D F:iI'.,I[) MIJS'f' E:E ~,i:E'fLIt4'.NE:D ]O 'I"HE: DE:F'FIRTf, IE:I,,tT 14iTI.411'4 ::i:/Ei I:)I::I'-¢E-;
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:!~:: I 1...II",I[::,EI',::S]'I::INI:::, 'I'HFIT,~I~ 1.:d'.,I-E;ITE SEk!EI;i: SCr'E;"lE:lfl i"lFl"r' 14:E:1.;!!..IiI:i'.IL:' FEI'.,I1...EII:;~:(2iE;I"llEI",IT iE' THE:
I:;.:EE;]:I:)I!Ei"4CE~: :1,2; I:(:E~I"~:I..~:EI) "1]O :~,~...IJ[)E: r'IORE 'IHI:::Ii"4 ~
E'; I El I'.,I E;[::,: .... ~ .L7 :..~ -*..~.:~. ................ ~.. _~7.. ...........................................
EIF:'F'L, I CFII",IT 1"11 I'(E Bt;?.EII.,.II",I
· ,;',: c'. i~ E'FI I E -......~. -
August 25, 1977 R&M No. 751224
Mr. Jim Rldgeway
4631 Caravelle Dr.
Anchorage, Alaska
99503
Subject: Soil Investigation for Sanitary Sewer System, Lot 21 and Lot
22, Tanaina Hills Subdivision, Anchorage, Alaska
Dear Mr. Ridgeway:
At your request of August 22, 1977, we conducted a subsurface soils
investigation on each of the subject lots at the proposed location of
the sanitary sewer system. The investigation complied with those procedures
required by the Municipality of Anchorage, Department of Health and
Envirorm]ental Protection.
This investigation, which was accomplished on August 23, 1977, consisted
of two test holes, one at each location, drilled to a depth of 20.0 feet
below the existing ground surface. The test holes were sited according
to your instructions. Their locations and soils logs are shown in
attached Drawings A-01 and A-02. Drilling was accomplished with a
rotary drill rig using continuous-flight solid-stem auger with an outside
diameter of 6 inches. Samples were taken at the depths shown on the
soils logs and the samples will be held in storage at our lab for approx-
imately six months. All material brought to the surface by the augers
was continuously monitored by an experienced engineering geologist.
The topography at the drilling site is horizontal to gently sloping. At
the time of the investigation the lots had original vegetation consisting
of poplar, birch, alder and willlow. Both testholes were located in
areas previously stripped of surface organics and now covered by a re-
growth of 5 to 10-foot high alders. The top of each test hole was
located at the existing ground surface.
The soils encountered in the test holes are shown in the test hole logs
in Drawing A-02. The symbols used in Drawing A-02 are explained in
Drawings B-01 and B-02. Each log displays specific conditions encountered
at the test location. However, subsurface conditions may vary in other
parts of the lots without any apparent surficial evidence of the change.
Groundwater was not 9_ncountered. Bedrock was not encountered. At the
tf~-~-~--~o~6I~Q~e drilled, seasonal frost was not present and permafrost
was not encountered.
A percolation test was performed within each test hole at the depths
shown in the attached Tables 1 and 2. All depths were measured from the
top of the hole. The data in the tables show average infiltratJ, on from
the depths indicated to the bottom of the hole. The measured percolation
rates were as follows: --~_~_
Subdivision Lot Test Hole No. ii'Percolation Rate ~
/
Tanaina Hills 21 1 <1.1 Minutes Per Inch )
Tanaina Hills 22 2 ~9~_5~ Minutes Per Inch/
We appreciate this opportunity to be of service to you. Please contact
us if you have any questions concerning this letter or if we can be of
additional service.
Very truly yours,
R & M CONSULTANTS, INC.
Michael Mitchell, Jr.
Senior Geologist
Jim McCaslin Brown, Ph.D.
Head, Earth Science Department
MM:JMB/rds
Attachments: Drawings A-01, A-02, B-01, B-02; Tables 1, 2.
KITLISA DRIVE
T. H. 1
Lot 21
T.H.
Lot 22
Lot 21 and Lot 22, Tanaina Hills Subdivision
Distances shown are approximate and have not been
measured by surveying methods.
LOCATION SKETCH II ..........
ANCHORAGE, ALASKA t[yOd'NO 751224
TEST HOLE NO. 1
Scale: 1"=3'
~A
SILT GRADING TO SANDy
SILT (~)
Dry, Brown
Occasional Gravel
SAND WITH TRACE SILT
SILT WITH TRACE' TO SO~
SAND (~)
Dry, Brown
SILT (ML)
Slightly [~ist, Brown
SILTY SAND (SM)
SILT (ML)
3.0I
10.0'
A
18.0'
19.0'
-20.0' T.D.
TEST HOLE NO. 2
Scale: 1"=3'
SANDY SILT (~)
Slightly ~ist, Brown
0.0I
SAND WITB TRACE SILT
(SP-S~)
Very Moist, Gray
4.5I
14.0'
INTERBEDDED SILTY SAND AND
SANDY SILT (SM &
Very Moist, Rusty Brown to Gray
20.0' T.D.
Each log depicts subsurface soils
observed within the test hole at
the location sho~wn in Drawing A-01.
See Drawings B-0gand B-02 for
explanation of symbols.
TIME
10:49
10:50
10:51
10:52
10:53
10:54
10:55
10:56
10:57
10:58
10:59
11:04
11:09
11:14
11:19
11:29
11:39
11:49
ELAPSED
TIME
0
1
2
3
4
5
6
7
8
9
10
15
20
25
30
4O
50
6O
TABLE riO. 1
PERCOLATION TEST
Jim Ridgeway
TEST HOLE riO. 1
IrlCHES
78.0
96.0
105.0
109.0
111.0
113.0
114.5
115.5
117.0
118.5
120.0
122.0
123.5
126.0
127.8
130.8
132.0
132.6
R&M No. 751224
DROP IN
INCHES
0.0
18.0
9.0
4.0
2.0
2.0
1.5
1.0
1.5
1.5
1.5
2.0
1.5
2.5
1.8
3.0
1.2
0.6
54.6 Inches Total Drop
1.1 Minutes Per Inch
TI~
11:04
11:05
11:06
11:07
11:08
11:09
11:10
11:11
11:12
11:13
11:14
11:19
11:24
11:29
11:34
11:44
11:54
12:04
ELAPSED
TIME
0
1
2
3
4
5
6
7
8
9
10
15
20
25
30
4O
5O
6O
TABLE NO. 2
PERCOLATION TEST
Jim Ridgewa¥
TEST HOLE ~o. 2
INCHES
12.0
18.6
25.2
31.8
35.4
39.0
41.4
43.8
46.8
48.6
50.4
55.2
58.2
61.2
63.6
67.2
70.8
75.0
R&M No. 751224
DROP IN
INCHES
0.0
6.6
6.6
6.6
3.6
3.6
2.4
2.4
3.0
1.8
1.8
4.8
3.0
3.0
2.4
3.6
3.6
4.2
63.0 Inches Total Drop
0.95 Minutes Per Inch
1. GENERAL INFORMATION
Complete legal description
DEPARTMENT OF HEALTH & HUMAN SERVICES_'
. On-SiteServ ces Section . ,
P.O. Box 196650 Anchorage 'Alaska 99519-6650
843-4744
CERTIFICATE OF HEALTH AUTHORITY '
APPROVAL FOR A SINGLE FAMILY DWELLING ~ ~1~ g~ ~,~ ~, ~ ~.~1,
-22;'T' ""¥ ' :~ "'
Lot a~.c~ H.~.~S Subd~vlsion
Location (site address or direct ons)
Property owner
Mailing address
Lending agency
Mailing address_
5911 Tanaina Drive
Anchoraqe, AK
Robert and Lau~e Crouch Day phone
C/0 THE REAL ESTATE STORE 8~.~ W. ~.~d A.~h.~,z~?;
Day phone ..
Agent. Allen Jones/ The Real Estate Store
Address
_Dayphone_. 561-4944
Unless otherwise requested, HAA will be held for pickup,
2. NUMBER OF BEDROOMS: -~""'
3. TYPE OF WATER SUPPLY:
NOTE:
Individual well XXX
Community well
Public water
If community well system, provide written confirmation from State ADEC attest-
~ng to the legality and status of system.
4. 'rYPE OF WASTEWATER DISPOSAL:
NOTE:
Individual on-site XXX
Holding tank
Community on-site
Public sewer
If community wastewater system, provide written confirmation 'from St~t; ADE~
attesting to the legality and status of system. ,~;
72-025 (Roy, 1/91} Front MOA
qq.5J 8
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 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 fr/Om my investigation and inspection, the on-site water
supply and/or wastewater disposal sys/te'm is in compliance with all Municipal and State codes,
ordinanc, es, and regulation~~n the date of this inspection.
~-nglneers signature,/,.;-' uate
6. DHHS SIGNATURE
"K" 'Apl~r0v;d for~':;i ~_,~'
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph $ 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 satisf~ certain federal and state roquirements. 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. .:~ ,-
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: "~/J/,~/J,R- /71/L~-$'~ ~ CT 2.2- Parcel I.D.
A. Well Data
Well type
Log present (~) yES
Total depth /qo '
Sanitary seal (~)
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed //2,¢,/q? Driller /'~-~'
Cased to /?q, 2 ' Casing height /2-//~''
Wires properly protected (~)
FROM WELL LOG
.g.p.m.
Date of test
Static water level
Well flow
level1
Pump
SEPARATION DISTANCES FROM WELL TO:
Septic/b~,M~ tank on lot
Absorption field on lot /0
Public sewer main 2~' '
Sewer service line /o '
AT INSPECTION
(,, -,3o -9L~ ~:~ ~'
I'1'1 r~
/ 2R' t""t
~,~ ~ g.p.~ -~
; On adjacent lots _ /¢(2 ' +
; On adjacent lots /O0 ' ¢'
Public sewer manhole/cleanout 2E '+-
Petroleum tank /J/,~
WATER SAMPLE RESULTS:
Coliform [g co/d ~,'e~ Nitrate_
Date of sample: . . ~' 7- ?z//
F2, K)
Collected by:
Other bacteria
B. SEPTIC/IA~BtNEI, TANK DATA
Date installed
Cleanouts (~'N)
High water alarm
Date of pumping
~/ - I~ ~ S)ff Tank size /000 ¢¢z/. _Compartments
Foundation cleanout (~N) V~ Depression (Y~)
X)o ,¢J,//q Alarm tested (Y~J~ .x.J,/,'~
(,-..go _?z./ Pumper /~ ~ HOrn6
SEPARATION DISTANCES FROM SEPTIC/~ii%~ TANK TO:
Well(s) on lot / 0 c/,
To property line _ /7'
Surface water/drainage
On adjacent lots
Absorption field
/00 / 'f"'
/00 ' +' Foundation /q'
~- ' Water main/service line
72-028 (3/93)' Front CONTINUED ON BACK PAGE
D at e i n st all~-'~'"'"'~ Manufacturer
Size in gallons ~ Manhole/Access (Y/N~:/
Vent (Y/NI ."Pa at
High water alarm level ~ ~test~ ~
Well ~ / On adjacent lots Sud~e wa~
D. ABSORPTION FIELD DATA
Date installed ~ - 2 - ? 5/
Length ~-3'" '
Total absorption area
Date of adequacy test
Water level in absorption field before test
Peroxide treatment (past 12 months)
Width
Soil rating (GPD/FF) O. ~ System type ~so~P'F/o~
· ~' Gravel thickness o°. 3' Total depth
Cleanout present (~N) y-cs Depression over field (Y~ ~rJ
Results (pass/tail) ~ / ~ for /J/~' Bedrooms
/d/,,~ After test
~O If yes, give date /J,/,~
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot
To building foundation
On adjacent lots
Sudace water
Curtain drain
On adjacent lots ¢'dO ' + Property line
/~ ' To existing or abandoned system on lot
Cutbank /J / ,~ Water main/service line
Driveway, parking/vehicle storage area ~'~-'
/O %-
E. ENGINEER'S CERTIFICATION
Engineer's Nam~
Date
HAA Fee $
Date of Payment
Receipt Number
72-026 (3/93)' Back
Waiver Fee $
Date of Payment
Receipt Number
Commercial Testir~g & Engineering Co,
Environmental Laboratory Services ~,~,~r~e',~r,~-,e,~,',~'~',~,~rar, e',e'~,
LABORATORY ANALYSIS REPORT
CT&Bgef # 9a ,,'tS gl - 1
Oiig. t S~u:aple ID LOT 22. TANATNA H1L} .$ S/D
WO l'd4 Order 82001
OlientNmn¢ S & g ENG]'~E~INO Printed Dat~ 09112/94 ~) 13',~6 lu'~.
Ordered By R. Si'lAiR Collected Date 09/07/94 (~ 15;05 1~.
Th'o.}ect Name Rcceived~te 09/07/94 ~(~ 16:30 hrs,
l'rojec~
I'WS1D
I. IA Teclm i cal Director STRPHi!,N C. EDF,
Rclett,qed By: ,
QC Allowable Ext. Anal
Paramclcr Resulls Qual Units M'etho4 Limits l)at¢ ' Da{¢ init
............................................. ~ ..... b- ...... ;5~7~-' .... ~X-~-£<i'/~5 F ...... ~ .............. ?¢7/~,7,4-- ~YaT'-
Nitl'ate-N
(IA = Unavailable
* See Speciu[ lnstnlC, tjons Above NA = Not Analyzed
** Sec Se, rap I c P,.eln ark 8 Aim v c
I ~ Um~i~ted, g~m~c(lval~:i~ thepn~ctical qmntificalioI~ limit.
ii; D == 8ecoit6u'y t[iution, (~ = ~'eater ~um
5633 BStreet, Anohorago, AK 99518'1600 -- Tel: 907) 562-2343Fax:(907)561'5301
ENVIRONMENTAL FACILITIES iN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO. UTAH, WEST VIRGINIA
MUNICIPALITY OF ANCHOI~AGE
DEPARTMENT ¢)F IIEALTII AND ENVII]ONMENTAt. PROYECTIObt
Dl¥1SIOfl el: ENVIROIXII¥1ENTAL HEALTII
CI-Fi'[ IFICATE OF INSPECTION fOR HEALTI I AUTlaORITY APPROVAL
OF ON-SErE SEWER AND WATER FACJM IY
264-4720
Application Date _~/ t,
GENERAL IN FORtVlA'H ON
(a) Legal Doscriptioa (include lot, block, subdivision, section, towaship, range)
Locatioa (address or directions)
(b) ,,~,,,~ ....... me _~ ,~, ~ ,,=;_..- ....... I'elephone: Home 13usiness
(c) Applicant is (chock one): Lending Institution~:; Owner/builder ~::; Buyer [~; Other ~ (explain);
(f) Mail the I-IAA to the following address:
TYPE OF F~ESIDEI~ ,CE
Single~Famiiy)~ MuKi.-Family
Number of Bedrooms
WATF-,r', SUPPLY
individual Well>~ Community IZ] Pabiic [:!
Note: If community well system, must have Wlitten confJ~ marion from the State Department of I:nvirenrnental Conservation
attesting to the legality and status.
SEWAGE DiSPOSAl.
Onsite~!*(i Public El Community I:] Fielding Tank
Note: tf cornmuaity well system, must have written confn'rnation fl om the State Department of Lnvirenmental Conservation
attesting to tho legality and status.
Page t of 2 ,2 o?t: m ~m
L:NGINEEF~dNG FI~M I~flOVII}IN,=~ INSPECTIONS, TESTS, FILE SEARCH, D~,, A AND INI::ORAqATION
As ce~lified by my soai affixsd bolero and as of tho validation date shown bo~ow, I vm i/y that my investigation of this Health
Autbority Approval $howR that the on-site water supply and/or wastewatol disposal system is safe, fLmctJonal ~lid adequate
[or the ael~ber o~ bedrooms and type el stractule indicated herein I fu*ther verify tha~ based on the information obtah~ed
Irom tho Municipality o/ Anchorage files and from my investigation and inspection, tho on-site water supply nnd/or
wastewater disposal system is in compliance with all MunicipaJ and ~tato codes, ordinances, and regulations in effect on
ibe date of this inspociion.
Date . 4 ................
Approved for ~.L'b ~)edmorns
Approvea ........ DL~app~ov,~u
~/\
Terms of Conditional App~ oval
CA~FI-ION
The Muncipality of /~,nchorarje Department o~ Health and l:nvironmental Protection (DI-.IEP) issues Health Authority
Approval certificates based solel)! upon the representations given in paragraph ,~ above by an independent professional
engineer registered in the State of Alaska, The DHEP does this ~s a courtesy to purchasers of homes and tbeir lending
institutions in o~de~ to satisfy certain federal and state requirements. Employees of DIdEP do not condect inspectioes or
analyze data before a cedificate is issued ] he Municipality of Anchorage is not responsible for e~ro~s or omiss*ons m the
professional engineer's work,
Page 2 of 2
MU, NICIt"ALIT¥ OF ANCHORAO,~
· D~.PT, O~ HEALTH &
~NVI~ONM~NTAL PROTEC110N
RECEIVED
A, WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
264-4720
Legal Description: .~¢~7~'
O '0%/~Z~
7~//v',,4/,'v/,,4' /-//~5
Well Classification /~::2~//'/,~.~7"~--~'~ If A, B, C, D.E.C. Approved (Y/N) J~JF
We,, Log Preeent Date comp,died Yie,d
Total Depth /~ Cased to~, ~epth o Grout ng ~ ~ ' ~
Static Water Level /~ ~' Pump Set At ~~ ~'~
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
Depression Around Wellhead
; On Adjoining Lots
TO Nearest Edge of Absorption Field on~.c~t ~/~(~)"~,~'._~; On Adjoining Lots __ /'r"~L~
To Nearest Public Sewer Line ~/~ To Nearest Public Sewer .
Cleanout/Manhole ~/~ ~ To Nearest Sewer Service Line on Lot
Water Sample Test Results %.~~
Comments ~ ~ ~
SEPTIC/~J~Et~I~Iii~6 TANK DATA
Date Installed .~//'~,~,.//.~)' Size /¢:::~¢¢:2~_¢,~'Z.: No. of ~mpadments
Standpipes (Y/N) ~ ~ Air-tight C~s (Y/N) ~ Foundation Cleanout (Y/N)
,/
Depression over Tank (Y/N) /~ ; Date Last Pumped
Pumping/Maintenance Contract on File (Y/N) ~ ; for
Holding Tank High-Water Alarm (Y/N) _ ~ Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding/~nk:
To Water-Supply Well
To Property Line _ ¢"4<'F'F
TO Water Main/Service Line ,A////
Course /4/,4
1-o Building Foundation
:to Disposal Pield _ /,
To Stream, Pond, Lake, or Major Drainage
Page 1 of 2
ABSORPTION FIELD DATA
Soils Rating in Absorpt on Strata.,..,'~' '.~',~'/Z~.z¢2/~/t// Type of System Design ~~
Date Installed¢/77~ ' Length of Field ~/~
Width of Field Depth of Field ~ ®
Gravel Bed Thickness ~¢
Square Feet of Absorption Area ~/~ ® Standpipes Present (Y/N) ~ ¢
Depression over Field (Y/N) ~ ® Date of Last Adequacy Test ~/¢~ ®
Results of Last Adequacy Test ~ ~~ ~
Separation Distance from Absorption Fi~:
To Water-Supply Well /~T%. TO Prope~y Line /O~T ~
To .i din o nd tio To
Lot ~/~ ; On Adjoining Lots IOO/~T
TO ~re~m/Pon~/Lake/or Major Drainage Cou~e ~ ~
To Driveway, Parkin9 Ares, or Vehicle 8tor~ge Area ~ ®
on
L,FT STAT,O.
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Chec(,l~ Bedroom Rating Against HAA Request **
I certify't~ I ~ave 0heckec~eri~.ed~,r conformed to all MOA and
Signed~-o ~ Date
Company ~-~J~H _~G~ MOANo.
Receipt No. \ 'O ~, \ ~-')C)
Date of Payment ~ [ [I./~ ~
Amount: $ ~:~ ~ ,'~ o
HAA guidelines in effect on the date of this inspection,
cai
Page 2 of 2
72-026 (11/84)
MUNICIPALITY OF ANCHORAGE
DIVISI(]IN OF ENVIRONMENTkL H[~LTH
DEPAF~rMENT OF HEALIH AND Elq%rfRONMENTAL PR(7~EC'£ION
APPLICATIC~N t,~)R HEAL[II{ AUTHOIAITY APPROVAL CERTIFICATE
1. C~.nez?al Infornkntion Application Date .__ 5_~.~ 4__
(a) I~gal D~sc~iption (include lot, block, subdivision, section, to~r~ship, range)
Lot ~_2~_J]~nain~a ?lls Subdivision
Location (add~ess or directions)
6911Tanaina Road
(b) Applicants Na~TM. Robert S. Crouch [[%l?iohone(206) 392-736_~8_
Applicants N~¢t~ess 490 Mt. Hood Dr. I.s__s_~?juah~ Washin~ton 98027
(C) Applicant is (ch~ 0m) ~nding I~stitution I~ ' O~r~il~r ['] ,
Buyer ~il; Orbs= [~[ (explain); ---
(d) ~ndi~j Institution National Bank of Alaska ~],epi~o~ 265-1818
Address 301 Northern ?_shts Blw~.
(e) Real Estate CO. & Agent The Real Estate Co. Gret__a_R~o~ers
Address 823 W. 53rd Ave.
®
3.
Individual hla, 11
561-4944
Other (describe)
Note.~ If co~unity ~11 system, must ha~ w~itl~n ~nfi~,~.tion f~,~ the State
~pa~3nt of Ehvironm~ntal Conjuration attesting to t~ legality ~d status,
Is ~'le %~11 adequate fo~ the ~'%u~~ of ~c~ s~cified in this }~ (~...~
Is the wastewate~ dis~sal system adequate fc~ the n~u~r of l~dr~ .(Y~)
[Pacye 1 of 2]
2-15-84
5. E_n_~i~_ Firm Providin..q_In~sp~.,c~ti__qns~, ~..sts, Data and Information
I cert.t.~y that I have checked, verified, o~ conformed to all ~DA [~AA ~.lldel].re..= in
effect: on the (late of this inspection,
Si~r~d _~ ',2./~/: .... ~',vk?: ~ ,.. Date · ': ' -
(ENGINEER SEAL)
Naire of Firm
Adck'ess
Sigr~d by
Date
6. DHE? A__~)rova 1~
App~ ore d fo
~ ].e[J []0~~ 2 i
Conditional
'l'ne Municipality of Anchor. age Depa~tm~nt of Health and Envirommntal l>£otectior, does
not guarantee the continued satisfactory performancm of the water supply and/o~ the
wastewate~ disposal system. This approval indicates that~ as of. the validation dat.a
shc~r~ above, based on the data and information furnished b/ an engir~eer registered in
the State of Alaska, the ~-lter supply and wastewater disposal system is safe and fun.c~
tional for the rzmtbe)z of ~.~drooms and ty£~a of structure indicated.
( DttEP SEAL)
7. Mai]. the HAA to the following adck. ess:
KB2/d5/s
[Page 2 of 2]
2-15-84
A®
MUNICIPAH17 OI; ANCHORAG;.-~O
D~P'r, OF H~ALTH & ~ ~,
MAY J 1984
CHeCkLIST -
REC[IV I D,'
LEGAL: Lot 22, T~in8 HJ11s Subd.
Well Classification I nd i v i d ua 1
Well Log P~esent (Y/lq) ¥
Total ]Depth 190'
Static Water I~vel 135'
Casing ~eight Above Ground
Electrical Wiring in Conduit (Y/N) Y
Sepamation Distances f~om Well:
To Septic/Holding Tar~ on Lot 80'~
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewe~ Line N/A
Cleanout/Manhole
Water Sample Collected By
Water Sample Test Results
C~nts
If A, B, or C, D.E.C. Approved(Y/N)
Date Completed
Cased to 189.23'
Pump Set At
12" +
1/25/78 Yield_5 gpm
Depth of G~outing__unknown
unknown
Sanitary Seal on Casing (Y/N) Y
Dep=ession Around Wellhead (Y/N) N
; On Adjoining Lots 100' +
125' ; On Adjoining Lots 100'
To Nearest Public Sewe~
To Nearest Sewer Service Line on Lot
D. Maney ; Date 5/7/84
Satisfactor. z for Tota~ Coliform
Performed well yield test 5-10-84 showinq_~d of 5 qpm __
N/A
B. SE]?TIC/HOLDING TANK DATA
Date Installed 9-77 Size 1000 No. of Ccmpa~tments 2
Standpipes (Y/N) N,.-~---Ai=-tight ~aDs (~_/N_~) ~ Foundation Cleanout (Y/N) Y
Depression over Tank (Y/N) N Date Last Pumped 5/9/84
Pumping/Maintenance Contract on File (Y/N) --- ; fo~ --
Holding Tank Hig~-Water Ala~m~(Y/N) -- TenLoora~y Holding Tank Permit (Y/N) --
Separation Distances f~om Septic/Holding Tank:
To Water-Supply ~)11 80'
To ~ter Main/SerVice Line
Course None Noted
10' +
To Building Foundation 42'
To Disposal Field 47'
To Stream, Pond, Lake, o~ Major Drainage
Cor~rents Standpipe broken off at ground surface
[Page 1 of 2] 2~15~84
Ce
ABSORPTION FIELD DATA
Soils Pating in Absorption Strata
Date Installed 9-77
Width of Field 4'
Square Feet of Absorption A~ea 310
Depression over Field (Y/N) N
Results of Last Adequacy Test --
85
Type of System D~sign Irencb
Length of Field 31'
Depth of Field 9'
Gravel Bed Thickness 5'
Standpipes P~esent (Y/N) ¥
Date of Last Adequacy Test none noted
Separation Distanc~ f~OmAbso~ption Field:
To Weter-Supply Well 125' To P~operty Line 10' +
To Building Foundation 89' To Existing Or Abandoned System
Lot None ; On Adjoining Lots 100' +
To Water Main/Service Line 10' + To Cutbank(if p~esent)
To Stream/Pond/Lake/c~ Major D~ainage Co~se None Noted
To D~iveway, Parking A~ea, o~ Vehicle Storage A~ea
Comments Pumped~00 ua]. water into dra]nfie]d, which w~'c0mp]ete]y absorbed in one
hour and five minutes.
D. LIFT STATION N/A
Date Installed
Size in Gallons
"Pump On" Level at
High Water Ala~mLevel at
Tested for
Electrical Codes(Y/N)
Dimensions
Manhole/Access (Y/N)
"Pt~ Off" Level at
Vent (Y/N)
Pumping Cycles du~ing Adequacy Test.
Meets MOA
Cc~ents
** Check Permitted Bedroom Rating Against HAA Request
I certify that I have checked, verified, o~ con'fo~ed to all MOA HAA Guidelines in effect
on the date o~ ~his inspection.
KB1/d5/s
[Page 2 of 2]
DEPT. OF ENVI~@NMENTAkL CONSERV/%TION
SOUTHCENTRAL REGIONAL OFFICE
437 "E" STREET, SUITE 200
ANCHORAGE, ALASKA 99501
BILL SHEFFIELD, GOVERNOR
Telephone: (907}
Address:
274-2533
July 12, 1984
MUNICIPALITY OF ANCHORAGE]
DEFT. OF HEALTH &
ENVIROHMENTAL PRO [ECTION
Arctic Engineers
1506 W. 36th Avenue
Anchorage, Alaska 99501
Dear Sir:
JUl ']
R [! C t:l V D.
Subject: Private Well Radius Waiver to 80 Feet (8521-WA-003)
Lot 22, Tanaina Hills Subdivision
The Department has evaluated the subject waiver request an~' cannot approve
the waiver. The mandated 100 feet separation was in effect at that time
and is for use in good soils with properly constructed water systems a~d
wells and it was not demonstrated that the required separation was
clearly not necessary for this property.
Sincerely,
Environmental Engineer
BEE/msm
cc: Robbie Robinson (MOA)
MEMORANDUM
DATE: December 4, 1984
TO:
FROM:
SUBJECT:
Brenda Gaffney, Risk Management
Susan Oswalt~aa~z~].an id~,U:
LOt 22 Tana]_na Hills Subdiv]_sion
Keith Bandt, Environmental
Engineering Manager
Chronology
On August 29, 1977, Mike Brown obtained a permit to install an
on-site sewer and well. The permit states that a minimum 100 feet
of separation is required between a well and sewer system. On
September 27, 1977 a final inspection showed the well to be 84 feet
(or 85 feet) from the septic tank.
In March of 1978, Michael Brown requested and obtained a Health
Authority Approval for the subject property. We also have a well
log, which shows that additional development was made to the existing
well(from 163.5' 190') in January of 1978.
Again in March, 1982, a Health Authority Approval was signed by this
Department.
Upon application for a Health Authority Certificate in 1984, this
Department instructed the applicant to apply to the State Department
of Environmental Conservation(ADEC) for a waiver on the tank-well
distance. This waiver request was denled by ADEC. The tank was
moved on August 24, 1984 and is now ].00 feet or more from the well.
S umm a r ~
In this case, the Municipality acted J.n good faith when we allowed
the tank to be installed short of 100 feet as required by State
law. This action was taken because we believed that the State had
given us the authority to grant waivers. The State now says we may
not write waivers and all previous waivers are void until ADEC
itself grants them. Therefore, we could not honor the original
approval.
Re comme nd a tie n
It is my recommendation that the claim be denied.
91 OlO (4/76)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEC'FI~JNICiPAU.ry
825 L Street - Anchorage, Alaska 99501 OF ANCHORAGE
DEPT~ OF HEALTH &
ENVIRONMENTAl PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720
FEB 2 7 1981
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWF-J3 FACILITIES
DIRECTIONS: Complete a: i~arts on page 1. Incomplete requests will not be processed. Please allow [en [10) days for processing,
1. PROPERTY OWNER
MAILING ADDRESS
PROPERTY ~ESIDENT (If dlffereht from above)~-
__ p r~ ~x 6433. An~horagm. ~s~ 99502
~ 'e. - ~a R~lty~ InC.
PHONE
277-7671
PHONE
243-R090
PHONE
Unknown
IPHONE
276--6300
PHONE
~6-4501
5.--'"~EGAL DESCRIPTION
Lot 22, Tanaina Hills Subdivision
STREET LOCATION
6911 Tanaina Driv% Anchoraqe, Alaska 99502
6. TYPE OF RESIDENCE
I~] SINGLE FAMILY
[] MULTIPLE FAMILY
NUMBER OF BEDROOMS
[] One [~] Four
~ Two [] Five
[] Three [] Six
[] Other
7, WATER SUPPLY
[] INDIVI DUAL' * ATTACH WELL LOG. A well log Is reauired for all wells drilled
[] COMMUNITY since June 1975. For wells drilled prior .to~th/~t date, giv~w~l
[] PUBLIC UTI LITY depth (attach log if available, L~.'.'.') ~-~_,,.~
8, SEWAGE DISPOSAL SYSTEM
~] INDIV DUAL/ON-SITE" ~*lf individua/on-site, give installation date 1978 .
If system ~s over two (2) years old an aeeuuacv ~es~ is required
[] PUBLIC UTILITY
by this Department.
NOTE: THE INSPECTI ON FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
1, TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2, WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTI LITY
Connection Verified LOG RECEIVED ~/~'1 P ~
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
E~3 INDIVIDUAL/ON -SITE DATE INSTALLED
E3PUBLIC UTILITY ~'_ ~ '~
Connection Verified INSTALLER
[]Septic)Tank or E~Uolding Tank '"-~~
Size:_ / CO If Tank is homemade SOILS RATING
give dimensions:
TOTAL ABSORPTION AREA MATERIAL
Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
4. D,STANCESwELL TO: I
Absorption Area to nearest Lot Line
5. COMMENTS
~APPROVED FOR ~'~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE BY (Title)
LEGAL DESCRIPTION
72-010 (Rev, 3/78)
Time
Date
Insp
MUN'ICIPALITY'OF ANCHORAGE
DEPARTME~, OF HEALTH AND ENVIRONMENT PROTECTION
825 L Street, Anchorage, Alaska 99501
264-4720
Date Received: March 3~ 1978
9:30 a.m. ~2: Time #3: Time
3-8-78 Wednesday Date Da~e
Pratt Insp Insp
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
1. Lending Institution Request: First National Bank of Ketchikan
Mailing Address: 811 East 36%h Avenue 99503 Phone: 276-6911
2. Property Owner: Michael Brown
Mailing Address: 1529 Sunrise Drive
Phone: 274'2302
3. Legal Description: Lot 22 Tanaina Hills Subdivision
4: Single Family Residence: ( ~ Number of Bedreoms: Two
Multiple Family Residence: ( ) Number of Bedrooms:
Well System:
Permit #
Construction
Individual Well ~ Community/Public System ( )
Depth of Well 189' Well Log on Fiie~
Bacterial Analysis
no
Sewage Disposal System: On-site System
Permit It Installed 1977
Septic Tank Size _/~O Manufacturer
Absorption Area ~%O Soils Rate ~'
7. Distances: Well[ to Septic Tank
to Sewer Line
Public Utility ( )
Material !~.~-
tO Absorption Area /~' ~
Nearest Lot line Absorption Area
to Nearest Lot Line
Page Two
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: ]Lot 22 Tanaina Hills Subdivision
Comments:
Affadavit Attached: /~)
Approved: (~:~_. _~//
Disapproved:
Letter Attached: ( )
Date:
Department Worksheet:
~=~-- MUNICIPALITY OF ANCHORAGE Proteption
//'-9~ I Department of Health and Environmental
~([/~,~.~!.// 825 L Street, Anchorage, Alaska 99501
~equest for Approval of Individual Sewer and Wa~ 'Facilities
1. Property Owner: ~
Mailing Addross:~~~~~~_ $~ ~
Mailing Address: ~~~~__
Mailing Address:
Phone:
4. Realtor/Agent:
Mailing Address: ~' Phone:
Street Location:
Single Family Residence: ~) Number of Bedrooms:
Multiple Family Residence: ( ) Number of Bedrooms:
Water Supply:. *Individual Well ~) Public/Co]~]unity System
If Individual Well, well depth ~l~
If Community System, name of system
8. Sewage Disposal System: *~)n-site System ~ Public System
If On-site System, date of installation:
*NOTE: A well log is required on ALL wells drilled since 6/75.
** If on-site sewer system is over two(2) years old, an adequacy
test is required by this department.
A fee of $25.00 must accompany each request before processing
can be initiated.
3/77