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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: '--~L'J =/~loOH(,' PID Number: O~! - H8 ~ --
Name: J~ ~o~E~ ~/O Pg~a~ q~ Wastewater System: D New ~Upg~
Address:
~ ~~ ~,~ ~,~ ~o~ ~.~ ABSORPTION FIELD
Ph~r~ ~ ~ ~/~- ~ I NO. o~moms: D Deep Trench D Shallow Trench ~ D Mound ~
LEGAL DESCRIPTION So,,.~n~: ~o~ ~ TotalDepthfromoriginalgrade:
Lot: Block: Subdiv~ion: Depth to pipe bo~om from original grade: Gravel depth beneath pipe
~ F ladded aboveor in grade ~
Township: ~ IRange: JSection: O -- ~ ~)Ft. Gravellength: Ft,
Number of lines: J Dis~nce be~een lines:
WELL: E~ls~/~ew U Upgrade Gravel width: I O I Ft. ~I ~ Ft.
Driller: ~ ~Drilled: St,ticW.erLe.l: In.aller: Date~inst led:
SEPARATION DISTANCES ~ Septic ~ Holding
To Septic Absorption Lift Holding ~ubllc/Pri~te Manufa~umr: Capaci~ in gallons:
From Tank Field ~tion Tank Sewer Lin~ ~C~ ~ ~
Material: Number of Compa~men~:
Wel~ Joot~ Iool+ Io01+ -- ~1+ ~T~L
Sudace
water Io~1+ Io~+ Ioo1+ ~ ~ LIFT STATION
"Pump on" level at: "Pump off" level at: High water alarm at:
Pump Make & M~el El~rical Inspections pedoo~ ~ by:
Remarks: ~Ys~ ¢~ ~s~e~ ¢o~ BENCH MARK
Lo~tion and Description:
I Assumed Elevation:
Depadment of Health and Human ~e~ces approval '~L~ %,.
Reviewed and approved by: ~ ~ ~ Date:~-2~-~
72-013 (Rev. 9/91) MOA 25
sw99oo46 ' o5 -46 - e
LOT 2, ElLOCK
NEW 1500 GALLON / ~ ~ / ......
NEW BO~OMLES
INTERMI~E~
6901 D~R R~ SU~ 2B. ~CHO~E, ~ 995~
LO~ 2, 4, & 5, BLOCK 4, CHUGACH PARK ESTATES S/D ,
~:4/19/g9 J.L.M. 1 = 40' 2
A El
)BL1 32.6 10.3
~ElL2 33.O ~
~T1 4.3.2 53,.6
~2 42.2 58.5
~H ~-:~.o5~.9
~4T1 22.6 21.5
~ 26.3 ~
~5 ~ 5.2 ~
~"'~ ~"~: AS BUILT DRAWING ~-
SW990046 ' 051-481 - 18
~ \ ~ ~.C~/ '~'~
~1~ ~5 ~
- ~,7~ (A~)
LOTS 2, 4, & 5, BLOCK 4, CHUGACH PARK ESTATES S/D ......
.,~ ~: ,~ ,uu~:
J.L.M. I = 40' 3 OF 3
...~4/ZgtLg9~' 0~:2g 907-696-~05 ~EEN GENERAL CONT, P~GE gl
D~#t 4-1~99
I~bj~t~ L,i~ Stati~ l~aliation
~'rem~: Jan~s g.rnP~
This is t~ ~m~i~ that the inst~ll~fion of ~he septic lii~ mt~o~ at Lot 2, 4, $ Chu~l,.cls
Sttl~dlvlgiolt was ~ompt~t~l following ali applicable Mtmic~al and National
Jar~ Kra~
Ak, Electrical Lis, #107363
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 995'i9-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Mar 31, 1999
Expiration Date: Mar 30, 2000
Permit Number: SW990046
Legal Description: CHUGACH PARK ESTATES BLK 4 LT 4
Design Engineer: 0041 AK Water & Wastewater Consulta
Owner Name: Jeff Towner & Diane Chelens
Owner Address: PO BOX 670606
Chugiak. AK 99567-0606
Pamel ID: 051-481-18
Site Address:
Lot Size: 54485 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
This permit is for the construction of:
[] Disposal Field [] SepticTank [] Holding Tank [] Privy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
5. The following special provisions.
blDSF - This permit is for a bottomless Intermittant Dosing Sand Filter system.
The house on Lot 4 is served by the septic system on Lot 2 and the well on Lot 5.
A system maintenance agreement signed by the buyer shall be a part of the As-Built package.
Received By:
Issued By:
Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road Suite 2B ~ Anchorage ~ Alaska 99~04
(907) 337-6179 ~ Fax (907) 338-3246
Consulting Engineers
March 3, 1999
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Re~ Sewer Upgrade for Lots 2, 4, & 5; Block'4; Chugach Park Estates S/D
To whom it may concern: , .~ ~
The referenced lots are all owned by the saro~ e owner and have a single 3 bedroom house located
on them. The 3 bedroom house is served by a~nsite septic syste~, and a private well. The
existing septic system consists of a 1000 gallon septic tank and two trenches (one 42 feet long and
the other 24 feet). The system was installed approximately in 1980 and the documentation was
done on 7/18/87. The system was documente~based upon the assumption that the system was
installed aceordi~ to the permit that was issued (permit g 800334). Several adequacy test have
been performed, but the system will not pass an adequacy test and must be upgraded.
As can be seen from the attached pictures, site plan, topography site plan, cross-section profile,
etc., there is no area suitable for an upgrade. Due to steep slopes on both the west, east, and
south sides of the house, the only area for a upgrade is where the existing septic system lies. We
have determined two viable options for the septic upgrade for this property short of installing a
holding tank. We will address the soil conditions first and then the two options.
SOILS: On February 16, 1999, two test holes were excavated and one percolation test was
performed in the area of the proposed septic upgrade. In test hole gl (TH#I), the soils below the
organics is a GM/SM material with some cobbles/boulders to a depth of approximately 15 to 18
feet deep (bottom of test hole). The bottom of the test hole elevation is 8.3 feet deeper than the
lowest monitoring tube elevation of the existing trenches. No percolation test was performed, but
the soils were visually rated to be less than 1 minute/inch. In test hole g2 (TH#2), the soil below
the organic layer is primarily SM material to a depth of 12 feet (bottom of test hole). A
pereolation test was performed between the depth of 6.5 to 7.0 feet and the rate was 12
minute/inch. No groundwater was encountered at the time of excavation, and 15 days later the
monitoring tubes were found to be dry.
The first option is to rebuild the existing trenches by removing all contaminated material and
~ new drainfields on uncontaminated soils. We propose to excavate down to a maximum
depth of 6 above the test hole elevation and install the new drainfields. The existing septic system
was documented to have 9 feet separation distance between the distribution lines which appears
to he true according to field measurements. We are unable to obtain the 10 foot separation
distance between the sidewalls of the proposed trenches. Most likely the separation distance will
only be 5 or 6 feet. We request that your department advise us on how to address this issue. The
design criteria are as follows:
TRENCH DESIGN
a. Percolation Rate: 12 minutes/inch
b. Allowable Application Rate: 0.8 gallons/day/it2
c. Number of Bedrooms: 3
d. Design Flow: 450 gallons per day _
e. Minimum Absorption Area: 563 ff2
f. Effective Depth: 4 feet
h. Width: 3 feet
i. Reduction Factor: N/A
j. Minimum Length: 80 feet total len,~h (two ~t 40 feet long each)
k. Effective absorption area = 640 it~ (>563 1~ OK)
1. Maximum depth = 6 feet above the bottom test hole #1
OPTI _BI_
The second option is to replace the existing trenches with a 10' x 36' bottomless intermittent sand
filter (ISF). We propose to excavate and remove all contaminated material and place the bottom
of the ISF on uncontaminated material. The design criteria are as follows:
TRENCH DESIGN: Bottomless Intermittent Sand Filter (ISF)
a. Percolation Rate: 12 minutes/inch
b. Allowable Application Rate for ISF: 2 gallons/day/ti2
c. Number of Bedrooms: 3
d. Design Flow: 450 gallons per day
e. Minimum Absorption Area: 225 ft2
f. Effective Depth below pressure pipes: 3 inches
g. Width: 10 feet
h. Length: 36 feet.
i. Effective absorption area = 360 fi2 (>225 tt2 OK)
j. Air Supply: Thomas Industries, Model 5070, "Anchorage Tank".
k. Air Supply Line: "Wasteflow' emltterline, 1/2 inch I.D, "Anchorage Tank".
1. Sand Material: M.O.A. Approved sand filter
m. Pea Gravel: 100% passing 3/8" sieve, less than 20% passing the 1/4" sieve, and
less than 1% passing the #8 sieve.
We are proposing to excavate down to a maximum depth of 4 feet above the bottom of test hole,
place a minimum of 6 inches of sand, install the air supply line, and cover it with 1.5 feet of sand.
On top of the sand, we will place 6 inches of 3/8 inch pea gravel, with the pressure literals
midway in the liyer. We will use a conventional lffi station (Anchorage Tank), equipped with a
programmable timer so that flow can he intermittently dosed to the ISF.
MATERIALS AND CONSTRUCTION PRACTICES: The materials used, and the
construction practices will comply with DHHS' "Intermittent Sand Filter Design, Installation &
Maintenance Manual". The contractor should read this document prior to construction. Copies
are available at the Municipal Onsite Services office (Sth floor, 9th & L St.).
OT ER CONCE S
SURFACE WATERS: There are no surface waters withih 100 feet of the proposed septic
system.
TOPOGRAPHY: As can he seen on the attached topography site plan and the photographs, the
average slope, on the west/northwest side of the driveway, is approximately 50 percent. We
request that your department issue a 35 separation distance waiver to a slope that is greater than
25 percent. Elevations shots have been taken and it is our conclusion that at a 25 percem slope
from the top of the proposed distribution line elevation will not daylight 35 feet away. The
existing drainfield bas been in place for approximately 20 years, and there hss been no problems
with daylighting. In short, there appears to he minimal risk associated with the proposed
encroachment.
SEPTIC SYSTEM IN UTILITY EASEMENT: As can he seen on the attached site plan and
designs, the existing and proposed septic system is in the utility easement. Letters of
non-objection are in the process of being obtained. We do not foresee any objection from the
utility companies due to the fact the easement will most h2kely not he used in the future except for
the individual service to the existing house on the referenced properties.
CONCLUSION: It is our recommendation that 3 to 4 feet of material over the existing trenches
he excavated and pliced on the west/northwest side of the driveway. A portion of the driveway
will most likely need to he relocated further to the west/northwest.
I am open to any suggestions from your department, which would he an improvement to the
proposed design. I am unaware of any adverse impacts this installation would have on adjacem
wells or septic systems. If you have any questions, please contact me at 337-6179. Thank you
for yo urly,aSsist ance.~. /~
LOT 6, BLOCK 3, / SEE ATFACHED DESIGN OPTIONS
C.U~CH ~K ES~. / / (OPTION ~1 AND OPTION
//
/~/ 'x.,~// ~. /
z ~x ,~ CHU~H
PHONE (90~ ~7-6170/r~: (9o~ ~-~
~ ~C~N: d
CHUOACH PARK ESTATES S/D: LOTS 2, 4, · 5; BLOCK 4; .
~E OF ~:
SITE P~N FOR SEPTIC UPGRADE ~fffF~ ~. G~rness. '"~
~-,~o ,~:~1.[...~ .....
JEFF TOWNER · DIANE CHIELENS (~O4) EXT.
....
OPTION #1
LOT 2, BLOCK 4,
CHUGACH PARK EST.
SEE A'Fi'ACHED CROSS-
S~ PRORLE.~~
PROPOSED 1000 GN.I. ON SEF~C
WATEE
/
/
/
\
/
\ /
\ /
\
\
\
TANK
BE ABANDONED cnMP~Y
INSTN. L
INSTALL FL01
LOT 5, BLOCK 4,
CHUGACH PARK EST.
/
/
/ /
/
DRAINRELDS TO BE INST.~lrn
IN THE S~,tE ~RB AS THE EXiS~NG
~ESCHES. EXCAVATE ALL CONTAMIN~IED
I~D~!N. TO A I~MUM DEFTH OF 6 FEk-T
ABOVE THE BOTIOU OF TEST HOLE 1~1.
EXCAVA'I~ ~ TRENCHES 40 ~'1' LONG
S(EpABAllSO ~-~1 TOTAL LENGTH)
ON Btrl~iN '11tE
OF THE TRENCHES. ADD 4 FEET OF CLEAN,
W/~I-IED ~ ~,AINROCK.
NOTES:
1. A I~ANDATORY SiTE ~sn' IS REQUIRED WITH THE E~IGINEER AND THE CON~R,~'TOR
PRIOR TO CONSI~UCIION.
2. THE CONIEACTOR SHALL RELO VERIFY ALL SEPARATION DISTANCES V/ILL BE MET
PRIOR TO CONS~tUC~IQN.
3. THE EXISTING SEPTIC TANK IS pARqlALLY UNDER THE FRONT PORCH. ANY DAMAGE
CR CONSmUC'noN T~T iS NEC;~SABY TO RE POACH SHOO. BE C~NG~=~;n AND
INCLUDED INTO THE C~'";BIDS B .
4-. ANY PORTION OF THE DRNk-~/AY THAT E~CRO~CH,i~_DON TH;' EXISTING OR pROPOSED
FORT[ON OF THE SEPTIC SYSTEM SHALL BE RD.OC~ .
5. ALL SE~E~ JOIl~r;~ 1HAT ABE ~/F~IIN 10 FEET OF TH;' WATER UNE SHJkU- BE ENC~SEZ
IN CONCEStE.
ALASff [ FATER AMI) CON T ,
6901 D~R R~ ~ 2B, ~E, ~ 9g~
P~NE (907) 5~7-6179~: (90~ 5~2~
~ ~C~ON: ·
CHUGACH PARK ESTATES S/D; LOTS 2, 4, · 5; BLOCK 4,
DESIGN OF SEPTIC SYSTEM UPGRAOE
PR~ ~: ~E NUMAR:
JEFF TOWNER · DIANE CHIELENS (504) 656-~400 E~. 50
~5/3/g9 I~N~:J'L'M' I 1 = 40' ~20F6
LOT 4, BLOCK 4-,
CHUGACH PARK EST.
AREA IS TO BE RM.E~ WITH SAND FILTER MATERIAL,
2. THE EXCAVATION OF THE SE3~TIC TANK WILL MOST EKEL'~
CAUSE DAMAGE TO THE: FRONT PORCH. ANY DAMAGE AND
CONSTRUC33ON NEEDS SHALL BE COOEDINA'f~ BY THE
CON~RACTOR ~ 'rile HOMEOWNI~.
/
~--PROPOSm MATERIAL TO BE
\PLACED HERE TO RELOCATE / m J -
\ omv~-w^Y ARb AO~ uoBE ,---a..Ev^'noN ./ CO -T [
\COVE~ FOE THE PEOPCISEZ~ \ = 94.16 ~~
~ ~%'~'%X~~' t ABOVE ALL UNES I I I
iL_ j ,~
/p.op~,%,T~cA..°EX,~ ',~cH LEX,s.< ~.c. EX,~ s,~,: ,AR"
PR~E~ ELEVATION OF
BOTTOM OF ~1' HOLE ~1
NOTE:
ALL CONTAMINATED SEWER ROCK AND SOILS FROM £LEVA~ON = 76.79
THE EXISTING TRENCHES ARE TO BE REMOVED AND
BURIED ON-SiTE IN A SUITABLE AREA. THE NEW
DP~iNFIELDS ARE TO BE INSTALLED IN THE SAME
LOCATION OF THE EXISTING TRENCH. THE; NEW
TRENCHES SHALL BE PLACED IN UNCONTAMINATED
SOILS /~ID CLEAN, WASHED SEWER DRNNROCK
SHALL BE USEB.
PHONE: (907) 3~7-6179~FAN: (907) 338-3245
CHUGACH PARK ESTATES S/D; LOTS 2, 4, & 5; BLOCK 4; ~-.~.: ...... I./. ..............
CROSS-SECTION PROFILE A-A / PROFILE OF SEPTIC SYSTEM /~ ~ ........
PR~ARE~ FOR: M"IONE NUNBER: r/O~ ", ~ :L* 7953 ..'
636-~OD so ~rl.".....' ....... -"~o~'
JEFF TOWNER & DIANE CHIELENS (304) EXT. ~ ·
CA%/3/~ I J.L.M. N.T.S. 3 OF 6
LOT 2, BLOCK 4,
j CHUGACH P~K E~.
~O~ 12~ ~ ~ / ~ ....................
~S~ ~ I~~ /~
~O RL~ m BE INkeD IN ~ ~ ~ ~ ~ ~ CHU~H PARK ~T.
~E ~E ~ OF ~E ~ ~ / ~//~ -~/Y
~R ~ ~U~.
IN ~.
~ ~ON: '
DESIGN OF SEPTIC SYSTEM UPGRADE
3~ mR: PHONE NUM~:
~-~~.~'-.. ........... .-':~
JEFF TOWNER · DIANE CHIELENS (304) E~. 30
~2/2/g9 I~w"~: IS~ I~' ~ 0~6 ~~'~ --
= ,o,
OPTIONttL' °
~ IS TO ~ R~ ~ ~D RL~ ~R~ I
2. ~E ~VA~ ~ ~E SE~C T~K M~ MO~ UK~Y
~ON N~
~ W~ ~E
3. ~ UN~ ~T
PO~H
REU~ 3 ~i ~ 4 ~l ~OP ~ ~RC~
0~ St~ OF DRaY7 /
/
~P~ HERE ~ ~ /
~R FOR ~E PRIED ~ = 0~16 T H
~C T~K
-- - I , ' '
~ { ~~ ~ I ,~UQUiO~IN
~p~ ~ ~N / ~MP~Y
U~ ~A~ '
NOTE: ~ OF
ALL CO~I~TED S~ER R~K AND SOI~ ~OM
~E ~I~ING ~ENCH~ ARE TO BE REMOVED ~D
BURIED ON-SI~ IN A SU~AB~ ~. ~E PROPOSED
BOSOM.S ~D RLTER S~L BE P~C~ IN THE
~E L~ATION ~ THE ~ISTtNG TRENCH. THE N~
I.S.F. S~ BE P~CED IN UNCONTAMI~TED SOI~
AND CLX, W~HED S~ER D~NROCK S~LL BE
USED.
6~1 ~ R~ SU~ 28. ~O~E, ~ 9g~
PH~ (~7) 337--6179~ (90~
CHUGACH PARK ESTATES S/D; LOTS 2, 4. · 51 BLOCK
~E ~ ~: ,
CROSS-SECTION PROFI~ A-A / PROFI~ OF ISF UPGRADE ~.~.V.~.~.~.~...:....j
=R~ ~: ~ONE NUU~: "..~. C E -7953 ...."
JEFF TOWNER · DIANE CHIELENS (304) ~. .,,,;. ......... .
~3/5/99 I~:J.L.M. I~ N.T.S. I
,,WASfFrP..OW" ~ PI~P ' ~ P~ll~i 1~5~ ~ C~NcO
LII/4"~~ ~'~~~ ~
~,(~ I/~ ~5)
P~N VIEW
~OPTION ~]
10' ~ ~, ~.~
~'~~ PROFILE VIEW
CHUGACH PARK ESTATES S/D; LOTS 2, 4, · 5; BLOCK 4~ .... : ........ : ....
BO~OMLESS SAND FILTER (ISF) DETAIL
JEFF TOWNER · DIANE CHIELENS (~04) EXT. '~ ~.~.. ...........
J.L.M. N.T.S. 6 OF ~ ~~ores,
,rzs ,,,Am., co sour. r ,
m somL LOG - PERCO~TION TEST J
PERFORMED FOR: J~F TOWNER · DI~E CHI~ENSc..~ j~. ~.;.,.~.
~ft
DATE PERFORMED: 2/16/99 )~'~ ~L795~ ..."~
mI ~ GP ~ ML
~ GM~ Cl
~--~ GC OL CHU~H
~-- ~ SP CH
SM OH ~l~NO
s~c
7-- DEPTH TO DATE
9 -- COBBLES/DOUSERS D~ 3/3/9g
11 -- ] DATE ~ING CLOCK NET TIME WATER ~VEL NET DR~
TIME (MINUTES) RE,lNG (INCHES)
16 -- I, ~ ~ ~0
la-- B.O.H. --
19-- ~TION ~TE ~ (HIN./INCH)~ PERC. H~ DI~ 8" (I~HES)
20- . TEST R~ B~E~ -
CO..BUTS. BOSOM OF TE" HOLE E~ATION IS 8.3~ ~~OM OF ~E LOW" MON~ORINO
PERFOMEB ~ A~S~ ~ATER & WA~ATER I, (~r~__~ , CE~I~ THAT
THIS WAS PERFOrMeD ~N ACCORDANCE WI~ ALL S~ ~qD~MUNIClPA~ GUIDELINES IN EFFECT ON THIS
OA~. DA~: ~ / ~ ? ? I-
I
DEPTH TO DATE
GROUNDWATER
DRY 2/16/99
DRY 3/3/99
7320 ~' CHES'll~ HTS. CIRCI~ * ANCHOR/~E, N(. 9950~
P~NE (907) ~7-6179 * F~ (90~
l SOIL LOG - PERCO~TION TESTI
LEGAL DESCRI~ION: CHURCH P~K ~ATES S/D; LOT 2, ~, · 5, BLOCK 4, ) ~ ........
DATE PERFORMED: 2/16/99
ITEST HOLE ~2J
~Hr
feed ORGANICS
GM CL
CHU~ P~K
~ SW HH
SP CH
SM OH ~Ne
S~C '
p SC
(
DEPTH TO DATE , .=
GRO~DWATEB
D~ 2/16/99
i D~ 3/3/99 //
10 // /
11 DATE RE.lNG CLOCK NET TIHE WATER ~VEL NET DROP
TIHE (HINUTES) RE.lNG (INCHES)
B.O.H. --
12 2/16/9~ - 4:15 p,m. - BEGAN
13 2/16/99 1 8:30 p.m. - 6" _
2 9:00 p.m. 50 MiN. 2 1/2" 3 1/2"
14 5 9:01 p.m. - _ 6" _
4 9:31 p.m. 30 MIN, 3 1/2" 2 1/2"
15 5 9:32 p,m. - 6" _
16 6 10:32 p.m. 50 MIN. 5 1/2" 2 1/2"
17
18
1 , ~RC~TION ~ 12 (HIN./INCH) PERC. H~ DIA. 6" (I~HES)
20~
TEST RUN BE~EEN 6.5 ~. ~B~~.
I~ THAT
THIS W~ PERFOR~E~ IN ACCORD~CE W~ ALL STA~NIClPAE GUIDELINES IN EFFE~ ON THIS
DEPTH TO DATE
GROUNDWATER
D~Y 2/1B/99
D~ 3/3/99
ALAS1L~ WATER, AND WASTEWATE~ CONSULTANTS, INC.
6901 D£~,RR ROAD SUITE 28, ANCHORAGE, AN 99504
LEGAL DESCRIPllON:
CHUGACH PARK ESTATES S/D: LOTS 2~ 4, & 5; BLOCK
1YP£ OF WORK:
SITE PLAN ,FOR SEPTIC UPGRADE
PR~ANE]) FOR:
JEFF TOWNER & DIANE CHIELENS
DRA~N BY:
J.L.M.
PHONE NUMI~R:
(,.t04) 656-1400 EXT. 50
SCALE: PAGE:
t = 100' 1 OF 5
ENSTAR Natural Gas Company
401 E. International Airport Rd.
P O Box 190288
Anchorage, Alaska 99519-0288
Engineering Dept. Fax (907) 563-4085
March 16, 1999
Anchorage Water & Wastewater
Mr. Jeffrey Garness, P.E., M.S.
6901Debarr Road. Suite 2B
Anchorage, Alaska. 99504
Dear Mr. Garness: :
ENSTAR Natural Gas Company has no objection to a wastewater disposal system that will
encroach into the 20 foot utility easements on Lots 2, 4, & 5 BlOck 4 Of Chugach Park Estates
Subdivision and shown on the attached asbuilt survey2 There is a gas line in this area. Please call
The Locate Call Center before you dig. Hand digging is required within 2 feet of any gas line.
If you have any questions please call me at 264-3743.
Right of Way Agent
MTN OSP EN~
F8×:907-761-2646
Nar 30 'g9 14:35 P. 02
By this doc~ent Matanu~k~ T~lephon~ Association, I~e;~(~~es that i~ ~ no obj~cdo~ to the
~c~t~e~K of a water line ~d was~water dbpo~h~'~in.,~.,, tho pl~ I0' Ufi~ Easement
U~O~
LOtS 2,4, & 5, Block ~ Chugaeh P~k Estam,~¢y¢;~~ i'5 North, ~nge I W,st, S~¢tioa 15, S.M. . ~g;: .?-
PI¢Rs~ be advised thru MTA ~ ~e i~mxce of fils docum~t doe8 not forfeit ~y of its dCts to th~ use
of the ~ea cited. ~n th~ ~er~ae of ~ase rlghts MTA M1L ~f deeded, up.Mo, m~nt~n, ~p~r, ~d/or ~place
b~ed or aerial teleco~aafio~ f?~il~fies ~thin ~e ~em~nt. ~y r~a~s ~hat n~.y be ~eq~d m ~e
enoroachment as a r~t ofu~i~y eo~mt~ion ~ll b~ ~e by the proper~ own~ of~cord. T~s 8oomnent
do¢~ not an~ori~ the pl~ement of any ad~donal ~mroacl~ents wi~ ~ easement m'~.
T~j,,s do.em'nent is. in ~9 war, an a~,reealent to vacate any portion of the utility easemem and ~hould. no~ be
fnteroreted as such.
Issued for Matanuska Telcphone A~sociat/on, lac. this 30th day of Mm:ch, I999 by,
~ ~ d/~,,J Real Estate & Properties Sup~w~sor
TNIS IS TO CF.~TIFY, tiaa on this 30lb day of Mm'ch, 1999, before me the undersigned, a Notaxy Public in and
for the S,ate of Alask~ duly commissioned and sworn as such, permnally apl)em'ed Becky Glenn knomt m
me and to mo lmown to be the individual nm~ed in and who executed the :~bragoing immunent and
acknowledged to me tlmt he signed and sealed the sante as a voluntary act dud deed for the uses and pms0~ses
therein mentioned.
IN WiTNESS WHEREOF, I have h*reunto set my hand &md offi¢ial ~eaI the day
Notary PaNic m and for
-~..
GRANTORS ADD'SS: O~N~ES..~D~SS: ,
Please Return ~o:
. i Malanuska Telepholm Association, Inc.
· Real E~tate and Propel'de$ Section
P. O, Box 3550
Palme~, Alaska 99645'
600 Telephone Avenue · Anchorage, Alaska · 99503-6091 · 907 564-1000
March 10, 1999
Jeffrey A. Garness
Alaska Water & Wastewater Consultants,
6901 DeBarr Road, Suite 2B
Anchorage, AK. 99504
ATU Telecommunications has no objection to the encroachment of the
existing septic system drain field into a platted easement located on
Lot 15, Block 5, Talus West Subdivision #1, as depicted on the as-
built drawing submitted.
Acceptance and use of this letter of non-objection by yourself, your
heirs, your assigns, or your successors, will constitute agreement to
the following stipulations:
ATU will be held harmless, now and forever, for any
damages or injury to any person or property as a result of
this encroachment.
Any ATU facility damaged or destroyed as a result of this
encroachment will be repaired at no cost to ATU.
3. Any costs incurred by ATU for special construction
necessitated by this encroachment will be borne by the
property owner.
4. Ail applicable safety code regulations will be observed
and maintained.
This letter of non-objection will in no way preclude ATU
from full use and enjoyment of its rights within any
portion of its right-of-way.
Sincerely,
eering
DATE:
G$\ml \ g: mswd\ cot\ nonob\ * * * .doc
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 "L' Street, Anchorage, Alaska 99502, Telephone 264-4720
· - ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
N.me 'DISTANCES
C ~-r~L ~ m~l/~ ~/Z.,~y'~ Tfl SEPTIC ABSORPTION
FROM~ TANK FIELD WELL
Phone(~)~ ~ --~/~ ~,~Permd NO. "' ind. of Bedrooms~ WELL
orlgma, grade ~ FT / ~ + FT
~ ~ ~ FT ~ FT ~
NumUer gl ,mas SO,I rat,nM Pipe mater,al J
FT Cased to
170~ Ea~le RiY~ L~ ~d ~. ~m / c~ify thai this in~ection was pe~ormed accoraing m all
I
Health Depadment Approval:Date: ~
72-013 (3/85)
PERMIT NO.
MLINICIP..~LITY OF ANCHORAGE ~ / ~ ~ ~
DEPARTMENT tERLTH 8ND ENVIRONMENTRLITECTION
825 ~E" STREET., ANCHORAGE, AK. ~
2~4-4720
~ELL AND Ot~--5 I TE 5E~ER PERM I T
APPLICANT CARL STRNBERR¥
LOCATION PETERS CREEK
LEGAL
SR 7t4~ CHUGIRK
LOT SIZE
~B8-~010
40000 SQUARE FEET
TYPE OF SOIL RBSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS
SOIL RATING (SD FT?BR>= 175
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS:
DEPTH---- 8 LE~GTI-{= ~6 GRAVEL DEPTH= 4
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF 8 TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFRCE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN T~E OUTFRLL PIPE
AND THE BOTTOM OF THE EXCRVRTION (IN FEET).
REQL! I RED SEPT I C TANK $ I ZE= ieee GALLONS
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY WELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THRT THE WELL WILL SERVE.
T~qO (2.) I t~$PECTIO~$ ARE RE(~IJ IRED
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN R WELL RND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR R PRIVATE WELL OR i50 TO 200 FEET FROM 8 PUBLIC WELL DEPENDING
UPON THE TYPE OF PUBLIC WELL.
MINIMUM DISTANCE FROM 8 PRIVATE WELL TO R PRIVATE SEWER LINE IS 25 FEET AND
TO 8 COMMUNITY SEWER LINE IS 75 FEET.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DRYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS RRE
AVAILABLE TO INSURE PROPER INSTALLATION.
PERM I T EXP I RES DECEr4BER __~:L. igS~q
I CERTIFY THAT
l: I 8M FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLRRGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOMS.
SIGNED: __.
APPLICANT ~RRY , /
V4. 0
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
Ruseell Oyster
694-2774
Performed for:
LegalDescription: ~'~-//" z.~.j ~/C)~_..k ,Z/3
Depth (feet) $oll Characterisllcs
Earl Ellis
SOI~.~G 688-2280
Name' -/Z~//~T/c/'~dm'/L/ "-~/V'c=,%-7'-~. Tel. No. ~-- ~l
Mailing Address: ~ 7 / ~?~ O~l'~) ~C 7
9
10
11 ,
PLOT PLAN
12
13
14
15__
16__
PERC. TEST
~Y~"~ ~o ~,~.
/B' /'~'/~'/f/~'-
~ ~ * Earl P. Ellis
..<%~%~
Ground Water Encountered: Yes No ~ If yes, what depth
Proposed Installation: Seepage Pit Drain Field
Comments:
Performed by: Date:
jLtiq 4 I979
SULLIVAN WATER WEL $C E IV [ D
P. O. BOX 272, CHUGIAK, ALASKA 99567 · TELEPHONE 688-2759
OWNER OF LAND :" ~.~ ,'~
ADDRESS
LEGAL DESCRIPTION - :: '~ ~. i', ".-': ~ ..z .~L C
DATE - Started :.; ' , :'. :/? .' Ended
PERMIT NUMBER 7 .~ ; tr. ~ '
DEPTH OF WELL 'i~[ ~: ::/'
STATIC LEVEL OF WATER FT.
DRAW DOWN FT.
GALS. PER HR
KIND O~ CASING
KIND OF FORMATION:
· ,: , ~ c~.- 5".'2
From /,~ Ft. to ,]~ Ft. t ..... ...... · From Ft. to Ft.
From , Ft. to ; Ft. ~J~-"./ ~q'~; From Ft. to Ft.
From / ~' Ft. to'" ~' Ft. 5/:.-,,O From '. ' ¢' Ft. to 7'?i Ft.
From ' '' Ft. to ~ '. Ft. ;i,7,. :'--'c' ,, /~ ,~' ~ c From ~,, / -' Ft. to J, ,'?' Ft,
From : Ft. to ~- 7' Ft. -:;2,~]' ' " ' '
- - ,- .~* ~ ";'*' :- :- From Ft. to Ft.
From r :-2 Ft. to / ,Ft. ,%~';~' ;" (.c,,,'~,~ L From e,~ ,3 Ft. to ( '/
From / ,",~" Ft. to;" .... ' Ft. :~"'~" ~ .'~A~'~;''~ ~ From Ft. to
From / ~:b Fi. to ,,',% .Ft ,:'~'/~'z; ; .~ %m ~,.,7/~ From~Ft. to~.Ft.
From; ~, ~ Ft. to :) ,'/ Ft. &?-,i 0<: ,~, ~/~&,t, :- From Ft. to Ft.
From Ft. to Ft, g.) ~,., . ,- .. ,- -~ From ~ Ft. to Ft.
From ;%' [ Ft. to >'t:~ Ft. "~ v ~ '"~ From Ft. to~Ft.
From ;-~'"' Ft. to .~;~ ,: Ft. / ,~ :~, ;,3<c~ e--~' From Ft. to~Ft,
From Ft. to.~Ft. ~.~' z ~'~'< ~ ~ = From Ft. to Ft.
From '~ ~-/. Ft. to -' Ft. /~,'~ '~zt~ '~" From Ft. to Ft,
From qk/,, Ft. to 'q fi ! Ft. -:- ./~.- 'e c..~ t~,4~. ' From~ Ft. to Ft.
From~ Ft. to.~Ft. / "' C~.'' ~ Fromm. Ft. to Ft.
From 'fO~
Ft. to ,~ 90 Ft. ,' :,'-'ZT,~ '~. ~. ~ From Ft. to Ft.
Ft. ~ :',:Y4 , '~
Ft.
MISCL. INFORMATION:
DRILLER'S NAME -~:" '~ '~ ,~-~L.~--
C'E F:' F! F: T'i"!l; ~ N T OI
FIF:'F'L Z C:I::I[",I 1-
L.EIC:F:I"f !
L"F. 5 E',I':::. 4 C:HUGFICI--! F'FfRK EST.
' · I[::l.'.tl_J Iii ~ Fl]':::
L. OT :5:fZE
hi :[ i'.,I i Hl..Ihi [:, t E;TFINC:E E:E T!.,.IEEN Fi I.d. EL I. I~N[:,' F:tN'¢ O1'.,!-.-:~71 TIE 25EI4F~GE'
J..Ii:~3 FEET F()F: I::1 F:'F~'.f',/RTE 14ELL..~ CIR
:I.!513 FO 2()12'~I F:E:I~'2[ I::'F;:EIH I:::[ F'UBL]'C: I,IE[L. [::,E!F'E!q[:,:~NG LIF'Oi'.,! THE I"'¢F'E OF:' F'LIE',[_ZC P.IF.[LL..
i,.iELL LOG~5 RF:'.E F~:E%!LtIFeEE:, FII'..fE:, H[E::;T E',E: RETLIF;'.NE[:, TCI THE: [:,EF:'F:IF;:THE:!'.,FF
OF: 'H~.il:! h!EL.L COHF'LET :[
)'r'P!EI:;: F?.E:~%¢J 1' F?.L:;HEhlTS i"IFI'T' FIF'F'L'¥'. ~SF:'E:C Z F' :( CF!T ~ ON'.':~: F:flqD COH!iFI'F'.UCT3: ON D :[ I:::K:iRF!H'_:~; FIRE
:I',,,'FI:[I..FiE:LE 'l'Ct ]TN::i;U,~:E' PF;:OF'E:F;:
]: CEF:F]:F:"¢ 'THFFF
FIF'F'L Ii C:RNT C:f::IF[L.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
Parcel I.D, #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
051 -481 -18 HAA #
1. GENERAL INFORMATION
Complete legal description
Lof 2~4 & 5 Block
Chugach Park Estates
Location(siteaddress ordirections) Ig~U ~'Sullins Drive
Chugiak~ AK
Prope~yowner Jeff Towner & Diane.Chielens Dayphone
Mailing address C/O Prudential Vista Real Estate Eaqle River,
Lending agency Day phone
Mailing address '
Agent Eva Loken/ Prudential Vista Dayphone
Address
AK
689-6476
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 3
TYPE OF WATER SUPPLY:
Individual well XX
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
xX
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev. 1/91) Front MOA #21
5. STATEMENT OF INSPECTION BY 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 from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm
--Address
ALASKA WATER & WASTEWATER
~4;;}NSULT~IT~ ~ ~ ,~
6901 DEBARR ROAD, SUITE 25
Phone
Engineer's signature
Date
ANCHORAGE, ALASKA 99504
DHHS SIGNATURE
Approved for
Disapproved.
bedrooms.
Conditional approval for
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 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not
conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not
responsible for errors or omissions in the professional engineer's work.
Municipality of Anchorage ,'~ E (,.
DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division APR ~-
825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 3,~T~'~¥ of ^NC~O~E
ENVIRONMENTAL.SERVICES DI¥1SlQN
Health Authority Approval Checklist
Legal Description:
A. WELL DATA
Well type
Log present ~N) ~-~
Total depth ~~ol
Sanitary seal (~N) "~-.~
Parcel I.D.:
IfA, B, or C, attach ADEC letter. ADEC water sYstem number
Date completed ~/~/-/'~
Cased to ;Z ~'/4 ~_~ n Casing height (above ground)
Wires properly protected (~N)
Date of test
Static water level
FROM WELL LOG
AT INSPECTION
~oq J
Well production 0. ~' g.p.m.
WATER SAMPLE RESULTS:
Coliform O Nitrate
Date of sample: L'}/Iq/~ ~
B. SEPTIC/I=IOL;~ TANK DATA
Date instal,ed
Foundation cleanout
Date of Pumping J',).e~ Pumper
O. I ~5~ - O. tel g.p.m.
Tank size 15'eO Number of Compartments 7_.. Cleanouts
"~-~ Depression (Y/~ ~o High water alarm I~/N)
C. ABSORPTION FIELD DATA
Date installed
Length ~(... I Width
Soil rating or ......m) 'Z,O
0 1 Gravel thickness below pipe
Effective absorption area
Date of adequacy test
~a'r~,','r~'; (I .c..~)
System type ~,.o F,~."r~r~. '~ _/
~). ~./t Total depth
Monitoring Tube present (~'N) '~=~ Depression over field (YX~}
Results (Pass/Fai0 -- -- For ~ bedrooms
Fluid depth in absorption field before test (in.); ~ Immediately after ~ gal. water added (in.):
Fluid depth (ins) Minutes later: Absorption rate = .g.p.d.
Peroxide treatment (past 12 months) (Y/N)
If yes, give date
72-026 (Rev. 3/96)*
D. LIFT STATION
Date installed
Manhole/Access (~/N) '~e <-
High water alarm level at*
Cycles tested I'~ [~J
*Datum
Size in gallons I.:_,_,_,_,_,_,_,_,~o
"Pump on" level at* '"l~r~ "Pump off" level at*
E. SEPARATION DISTANCES
Absorption field on lot
Public sewer main
Sewer/septic service line
SEPARATION DISTANCES FROM WELLON LOT TO:
Septic/he~ tank on lot !
'2...~ ~ +
On adjacent lots I oo t-t'-
On adjacent lots I 0o
Public sewer manhole/cleanout
Lift station
lOot-t-.
SEPARATION DISTANCES FROM SEPTIC,~TANK ON LOTTO:
Foundation ~ L~OI:E- Property line ! ol + Absorption field. ~,oI ~
water main/service line I C~lJr Surface water/drainage Io~)1~ Wells on adjacent lots ~oo I .j_
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
I
Property line. '~'~ Jo I.{.. Building foundation ~'% ~
Surface water I~o~ 4-
Water main/service line Jo
Driveway, parking/vehicle storage area
,,j Wells on adjacent lots I ooI
inspections and review of Municipal re/c~~'~rns are
Curtain drain
ENGINEER S CERTIFICATION ]/
I certify that l/~4rmi~/:f,
Signatu rd~_~_.~//vW~-~\
Engineer's Nald
Date
HAA Fee $_
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
AI.AgKA WATER & WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD, SUITE 2B * ANCHORAGE, ALASKA 99504 * PHONE: 557-6179 FAX: 338-3246
EELL FLOW TEST DATA,,
LEGAL DESCRIPTION= L.o~ z , '-t ~. ,~ 5 .~ ~.~..o~ ~' , (.~uc,~c~ xO~-V-
STREET ADDRESS: IR ur~'? ~u.~--~
CLIENT: bsr~' ~'~e~- ~eo C~A[ f_tl~-~J PHONE NUMBER:
NUMBER OF BEDROOMS ]-~ F.H.A. - FOUR HOUR FLOW TEST:
I
TEST DATE START t0 q ~ TEST DATE END I b
WELL DE~H (PER WE~ LOG): ~1
CASING DEPTH (PER WE~ LOG): ~"_ +
CASING HEIGHT (ABOVE GROUNO): ~t+ ~
DEPRESSION AROUND WE~: YES /~
w,. s ,. co.ou,T: .o
WATER SAMP~S TAKEN: YES / ~ IF YES, DATE: ~
METER TOTAL FLOWRATE WATER L~EL
TIME READING FLOW (G.P.M.) CBELOW TOP OF CASING) DRAWDOWN
q.~T zl~8o ~ STATIC = ~o
WE~ PRODUCTION M~SURED ~ O. I~ -- O. t~
COMMENTS: K~~Y T~ ~ ~o~ ~ ~.C
Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road, Suite 2B ~ Anchorage N Alaska 99504
(907) 337-6179 -Fax (907) 338-3246
Consulting Engineers
April 20, 1999
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Waiver Request and Lot Line Concerns for
Chugach Park Estates S/D, Lots 2, 4, & 5; Block 4,
To whom it may- concern:
As can be seen on the As-built drawing of the septic system, the new bottomless intermittent sand
filter system lies on both Lots 2 and 4. As stated before, Lots 2, 4, & 5, are all owned by the same
owner and will be always be considered as one parcel. It is our opinion that with the issuance of
the permit, that your department will not require a lot line waiver for this type of encroachment. If
our opinion is incorrect, please notify us and we will apply for a lot line waiver.
We will also like to request that a 8 foot waiver fi:om the new bottomless intermittent sand filter
to the foundation be isstted by your department. In order to remove all contaminated soils fi:om
the existing septic system, the new ISF system was installed 8 foot from the foundation. The
elevation oflSF system is lower than the footings of the structure and the soils are very porous. It
is our opinion that there is a very limited risk with the granting of this waiver.
During construction, it appeared that the separation distance between the sewer service line
coming out of the house to the water service line was less than 10 feet (estin~ated 5 feet). This
encroachment has existed for 20+ years with no sign of any contamination (see attached recent
water samples results). It is our opinion that there is limited concern with this encroachment.
If you have any que~
assistance. //
Pre,id nt
Ions, please contact me at 337-6179, or 244-9612.
Thank you for your
04/02/99 FRi 12:16 FAX 6896499
FRO~I : ~LASKA ~qTER & MASTEk~TE~
VISTA REAL ESTATE ER
PROPERTY OWNER AGREEMENT
FOR TFr~. MAIN~i.m,~ANCE OF AN
ON-SITE WASTEWATER DISPOSAL
S¥STEI~
The proper~ owner~ agrse to tl~ ~Llowh~g:
Submit to the Mu~f~jpal~ry of ~chorage, on au annu~/b~is, an h~pe¢~on and
operation statemem from a reg/$~ered professional eng/ueer. Th~ k~pecfien and .
operation statement shall verify that thc engLueer ha~ La,paced aH e~flucnt and air
pmnps, timers, an~ ala.rm~, and that any deficiencies/rove bccu zcp~ed and ~ rtac
sysr~n b fuacdoning as d~sig~ed.
6h'iated-~ame) (Prm~-Nam¢)
personally kuo~ to me
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
i ,-~-~
264-4744
Application Date (..~- P-~ ,~' -~L/~'"' "~
GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
(b) Property Owner .~z.~,--.¢. ,.'Lt/c~,5,WG Telephone: Home
(c) Lending Institution ~~,~
Mailing Address ~ ~ '
(d) Real Estate Company and Agent
Telephone ~ - 2PZ I
(e) Mail the HAA to the followina address: or: Check here ~old for pick
List contact person and day phone number below.
Busi n ess ~7t-/¢' - A'.E,.~
17034 Ea~le Rivet- [,~. g~.~,~ N~. 204
Eagle River, Alaska 9<)572'
TYPE OF RESIDENCE
Single-Family []
Number of Bedrooms
WATER SUPPLY
Individual Well {~/~ommunity [] Public []
Note: Jf comm unity well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE .~.~'S A L
Onsite ~ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
' attesting to the legality and status.
Page 1 of 2 72 025 (Rev $/861 Front
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WELL DATA
O~'~'I~I~I~I~/~ITY OF ANCHORAGE (MOA)
$~,.i~[-sT~f~IJ¢I~IORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
264-4744
Legal Description: L=,
Well Classification
Well Log Present.N)
Total Depth
Static Water Level
Casing Height Above Ground
Electrical Wiring in Condui~/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
Cased to 2 ~/
~"~' ~' If A, B, C, D.E.C. Approved (Y/N)
Date Completed ~' ' -5~- '~ ~ Yield
Depth of Grouting
Pump Set At C-f,/¢_~
Sanitary Seal on Casing ~N)
Depression Around Wellhead (Y/~
/d~'¢ "4' ; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot /~d)/~ ; On Adjoining Lots
To Nearest Public Sewer Line "'~/,A To Nearest Public Sewer
Cleanout/Manhole /~f/~3, To Nearest Sewer Service Line on Lot
Water Sample Collected by _~.~4--~ /~-/~'L~/..~',~-~'C_~/,J'L~ ;Date
Water Sample Test Results ~/~7-r%.C~c-~:t'~p' /¢~'~'~ /t--[zz'CC4-J'~-$
Comments ~ ~*/~--F~o~z ~e.,co~,-~g-~ ~~~'- ~':'¢-
B. SEPTIC/HOLDING TANK DATA
Date Installed zO?pp_.¢~ /,~:> Size
Standpipes(~N) Air-tight Caps ~N)
Depression over Tank (Y(~)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well
To Property Line
No. of Compartments r>
Foundation Cleanout (Y/~
Date Lest Pumped -z¢ ~' -/o- ~
/'-F/:t- ;for '"//4
Temporary Holding Tank Permit (Y/N)
To Building Foundation ~ ¢
To Disposal Field -~'
To Water Main/Service Line
Course
Comments
To Stream, Pond, Lake, or Major Drainage
Page 1 of 2
72 026 (Rev 8/861 Front
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/~)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
~ ~
Standpipes Present ~/N)
Date of Last Adequacy Test
To Water-Supply Well
To Building Foundation
Lot '~'/
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments -/~ ~ ~-'-~ ~-/'/']")~ C/--/~'"~
To Property Line /¢/-/
To Existing or Abandoned System on
; On Adjoining Lots .?C~ /-/
To Cutbank (if present)
D. LIFT STATION
Date Installed
Size in Gallons ~N,.///~'/
"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
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified, or conformed to ally OA and HAA guidelines in effect on the date of this inspect on.
~ ~& S ENGINEERING
Com~ RIv~, Alaska 995~ MOA No.
Receipt No. ~ --o ~
Date of Payment ~ ¢ ~O- ~ ~
Amount: $ ~ oo
Page 2 of 2
72 026 (Rev 8/86) Back
APPLIC IT FILLS OUT UPPER HAl. 3NLY
Prbperty Owner - .~ '~ <:*[ Phone
Buyer
Address Zip Code
Lending Institution Phone
Address Zip Code
RealtyCo.&A~nt (~>.~ ~x, '~ / "'
Address . ~./_ ( ~.
Legal Description /~t'"]' ~f ~ ,',t., ~,,~4 ~: --~'"~,~}~i-. ~f~ /:~::~-Lc :~
Type of Resi~nce
~Single Family
O Multiple Family No. of Bedroo~
~ Other
Ware[ Supply
~lndividual A~ACH WELL LOG. A w~l log Is required for all wells drilled since June 1975.
~ Community For wells drilled prior to that date, give well depth (attach log if available).
~ Public Utility
Sewer Disposal "'::, /;
~lndividual Year Indiv~ual Installed: :?"?
~ Public ~tlity When Connected to Public Utili~:
~ Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH RE~EST BEFORE ~OCESSING CAN BE INITIATED.
Time L_t_~/*~,
Time Time Time
Date D.te °ate r'-~ Date V
Inspector c~ Inspector Inspector InspeCtorX /~ ~
FleldNotes: /~/~ /~.~ ~ ~_~ ~/~.~ ~f~7,~__ ~~ ~~UNICIPALITY OF ANCHOEAO,DFPT OI: ~'E.^I.T't &
RECEI _E
( ~PPflOVED BEDROOMS *CONDITIONS OF APPROVAL
( ~.~DISAPPROVED
( .~ CONDITIONAL APPROVAL* _ . .~'~· ,~
DATE ti-- ~ ~- ~'~ '""---- ~ /'~
Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received
Well to Tank Septic Tank Size
72.023 (3182)
ALASKA erlUiROrlml rlTAL COFITROL SeRUIgeS, II1C.
~nclineerinq 8 ~nuironmentel Studies
12/02/82
CARL STANDBERRY
P.O. BOX 135
CHUGIAK AK 99567
SELLER - CARL STANDBERRY
SUBDIVISION-CHUGIAK PARK ESTATES
BUYER-
BLOCK-4 LOT-4
ADEQUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A UNKNOWN WITH AN UNKNOWN AREA.
THE SYSTEM IS CAPABLE OF ACCEPTING 370 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 195 GALLONS.
BASED UPON THE TEST DATA THE SYSTEM IS ACCEPTABLE FOR A
2 BEDROOM HOME.
SEPTIC TANK ADEQUACY
DUE TO THE STEEP HILLS LEADING TO THE PROPERTY THE SEPTIC TANK
WAS NOT PUMP. THIS WILL HAVE TO BE DONE IN THE SPRING.
1220 LUest 25th Auenue · Anchoraqe, Alaska 99503 · (907) 276-1361
October 14, 19B2
Car]. and Brenda Stanberry
P.O. Box 135
Chugiak, AK 99567
Subject: Lots ~, ~! · Block
Dear Mr. and ~rs. Stanberry:
~ugac~ Park Estates
A file research from this Department's records indicates your
sewer installation was not inspected and approved by this
Department. ~]erefore, before this Department. may approve
your request the following will be completed:
Exposed electrical. ~.;ires to the well head are in violation
of the ~unicipality of Anchorage codes and y~ust be encased
in conduit.
%~qe water analysis report needs to be submitted to this
office from the Chem Lab, 5633 B Street, .for our review.
The s~ptic tank pu~ped with a receipt submitte~'~, to this
department. The total nu]aber of gallons pun]ped needs to be
on the receipt and verified by a reqJ. stered ~ngineer as to
the actual nuraber of gallons pumped. This is to verify the
size of the septic tank.
" }~xpose the septic tank manhole to verify its existence.
A four (4) inch cast iron cleanout needs to be installed to
the septic tank and/or leaching area.
An adequacy test needs to be performed on the existing
leaching area. This test will determine if the system is
adequate accordinq to National Standards. A listing of
private firms perfor,ning the test is enclosed. ~is report
needs to be submitted to this office for our review.
If you have any questions, please contact me at 264-4720.
Sincerely,
]~nc losure
Robert C. Pratt
Associate Environmental Specialist
Mark Begich
Mayor
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 Elmore Roud
P.O. Box 196650
Anchoroge, AK 99507
(907) 343-7904
Pump Installation Log
Well Drilling Permit Number: SW
Date of Issue:
Parcel Identification Number:
Legal Description
Property Owner Name & Address:
Pump Installation Date: ~-/O --
Pump Intake Depth Below Top of Well Casing:~"~t~ feet
Pump Manufacturer's Name:'~)
Pump Model: ~ ~'~
Pump Size !
Pitless Adapter Burial Depth: t~ 0 feet
Pitless Adapter Manufacturer's Name:
Pitless Adapter Installer: ~
Well Disinfected Upon Completion?~Yes [] No
Method of Disinfection: ~/'L
Comments:
Pump Installer Name:
ANCHORAGE WELL & PUMP SERV.
330 EAST 76TM AVENUE
ANCHORAGE, AK 99518
PHONE: 907-243-0740 -
AWPS.COM
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.