HomeMy WebLinkAboutJEWEL LAKE HEIGHTS #1 LT 5A-1Onsite File
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MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
Pump Installation Log
Well Drilling Permit Number: _______________ Date of Issue: ____-____-____
Parcel Identification Number: ____-____-____
Legal Description Block Lot Property Owner Name & Address:
Pump Installation Date: _____-_____-_____
Pump Intake Depth Below Top of Well Casing: __________ feet
Pump Manufacturer’s Name: ___________________________ Pump
Model: ____________________________________
Pump Size: ____________hp
Pitless Adapter Burial Depth: _________ feet
Pitless Adapter Manufacturer’s Name: _________________________
Pitless Adapter Installer: ____________________________
Well Disinfected Upon Completion? XX Yes No
Method of Disinfection: _____________________________
Comments:
Pump Installer Name: __________________________________
Company: ___________________________________________
Mailing Address: ______________________________________
City: ___________________ State: __________Zip: _________
Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation.
Municipality of Anchorage Page 1 of 3
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: SW990321 PID Number: 011-213-53
Name: TOM WOOD
Wastewater System: ❑ New ■ Upgrade
Address:
4655 EMERALD CIR, ANCH, AK 99502
ABSORPTION FIELD
Phone:
(907) 248-0050/562-2712
No. of Bedrooms:
2
❑Deep Trench ❑Shallow Trench ■Bed ❑Mound ❑Other
LEGAL DESCRIPTION
Soil Rating:
0.7
Total Depth from original grade:
*10.06 MAX.Ft.
GPD/Sq. Ft.
Lot: Block: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe:
6A — JEWEL LAKE HEIGHTS
9.39 MAX. Ft.
0.67 Ft.
Township:
Range:
Section:
FII added above original grade:
Grovel length:
—
—
—
0 Ft.
30 Ft.
WELL: ❑ New ❑ Upgrade
Grovel width:
30.3
Number of lines:
5
Distance between lines:
5' +/—
FL
Classification (Private, A,B,C): Total De
Cased To:
Total absorption area:
Pipe material:
Ft
FL
455 SD. Ft.
ASTM D -3034/F-810
Driller. Date Drilled:
Static Water Level:
Installer.
Date installed:
G & G EQUIPMENT
10/28/99 — 11/6/99
Yield:
Pump Set At
Casing Height Above Ground:
TANK
GPM
Ft.
SEPARATION DISTANCES
■ Septic ❑ Holding ❑ S.T.E.P.
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer.
ANCHORAGE TANK
Capacity in gallons:
1000
From
Tank
Field
Station
Tank
sewer Lines
Well
100'+
100'+
—
—
25'+
Material:
STEEL
Number of compartments:
2
Surface
100'+
100'+
-
-
-
LIFT STATION
Water
LotSze
5 ' +
10'+
—
—
—
In gallons:
Manufacturer.
Line
"Pump on" level at:
•Pump offat
High water alarm at,
Foundation
5'+
10'+
—
—
—
Curtain
Pump Make el:
Electrical Inspections performed by:
Drain
NONE KNOWN
—
BENCH MARK
Remarks: THE EXISTING WELL IS CURRENTLY BEING USED
Location and Description:
AS A PRIVATE WELL. IT IS A POSSIBLITY THAT THE WELL
TOP OF CARPORT SONATUBE.
MAY BE USED AS A CLASS "C" WELL IN THE FUTURE.
Assumed Elevation:
100.00
100' WAIVER WAS OBTAINED FROM ADEC.
Ft.
* TO TOP OF SAND — 0 TO 3.3 FEET OF LEVELING SAND ADDED.
ENGINEER'S SEAL
Qo�000OO
f
0 ' jI H
• • • : •' • • ��• • • • • • .. .... ° ..�
AWWC, INC.
Inspections performed by: Dates: 1 st l o/2s/9s
2nd 11/3/99-11/6/99
3rd 11/10/99
F..�PA
00 ° ° ° . Je��Ffr y A. • Car Ss.:
�� r-79 3
Department of Health and Human Services approval
s�•°••., °.••° .,�o�
��p400
Reviewed and approved by: Date: -27-00
fess10"o
O00
72-013 (Rev. 9/91) MOA 25
PERMIT NUMBER: AS -BUILT DRAWING PARCEL ID NUMBER:
SW990321 011-213-53
NEW 1000
GALLON
SEPTIC TANK
DBL1
DBL2-
A Arno
EXISTING
2 BEDROOM
HOUSE
EMERALD CIRCLE
\\\
SOW DIVERTER (FO) -- I
o,b K I' \\ H#1 I
Co NEW DRAINFIELD
1�\ � � I
G �c EXISnNG TRENCH TO REMAIN
�IN PLACE FOR FUTURE USE
\ AS A RESERVE SfTE.
7JEWEL
1
TS. S/D
O.E.C, I
100 FOOT WAIVER
GRANTED BY ADEC I
l
FINAL GM - 983 (AVG.)
5fl / 5f2
fop OF TANK
Af INI.Ef - 94,81
....................................................f77
Puw6_/ NSW 1000 6&LON
Aff INL�f -u OF 944,2 23 5MY fA V K
100'+ FROM DRAINFIELD TO
SURFACE WATER AS STAKED BY
SYMPEC Inc. PROFESSIONAL
LAND SURVEYORS.
� SHORE LINE
W A B
I �
I n
J
LLJ
D
IN5 LA11ON
ST1
11.2
28.3
ST2
16.9
30.3
DBL1
19.0
31.2
DBL2
20.0
31.7
FD
20.9
32.1
MT1
42.2
48.8
C01
43.8
48.6
CO2
53.0
56.5
CO3
61.3
63.9
C04
67.2
69.0
MT2
69.0
70.6
C05
67.3
66.2
C06
65.4
62.1
C07
66.7
60.1
MT3
69.8
62.5
-f0F OF TANK
Af OL=f - 94.79
\wvEff OF PUNG
Af OIXLEf - 94,04
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD, SUITE 28. ANCHORAGE, AK. 99504
PHONE: (907) 337-6179/FAX: (907) 338-3246
LEGAL DESCRIPTION:
JEWEL LAKE HTS. SUBDIVISION; LOT 6A
TYPE OF WORK:
AS -BUILT OF SEPTIC SYSTEM UPGRADE
PREPARED FOR: PHONE NUMBER:
TOM WOOD (907) 248-0050/562-2712
DATE: DRAWN BY: SCALE: PAGE:
11/18/99 K.D.W. 1 = 40' 2 OF 3
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PERMIT NUMBER: /� S -BUILT DRAWING PARCEL ID NUMBER:
SW990321 ' ` 011-213-53
ORIGINAL FLL-
clmf - 95,88
ORIGINAL 6WA
91.99
►F
TOP OF L�V�LING
5AND - 81,93 (AVG.)
60tfOM 0r PIPS
82.6 (AV0
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504
PHONE: (907) 337-6179/FAX: (907) 338-3246
LEGAL DESCRIPTION:
JEWEL LAKE HTS. SUBDIVISION; LOT 6A
TYPE OF WORK:
AS -BUILT PROFILE OF SEPTIC SYSTEM UPGRADE G
PREPARED FOR: PHONE NUMBER:
TOM WOOD (907) 248-0050/562-2712
DRAWN BY: SCALE: PAGE:
11/18/99 1 K.D.W. I N.T.S. 1 3 OF 3
ORIGINAL 6mE
88.98
6" OFF 12MNRO
BENEATH PIPE
��.
0F.A X44
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.... ... ......
P ' rey� A. Corness.
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�f2 \ ORIGINALGRA17E - 88.98C09\
1coo1'_'
PMOM OF MAMION - 78.6for&
DEPTH - 1038
C0 \\
CO2 _
CO6 \\ 30' LONG KITORAM7
I
/
I
�z
�z \\
W
/ C01lit
C01 \
??
U�
/_0 Mfl
-
N _ _ \
MO
ORIGINAL FILL GRA17E - 95,88
FtzOM 5;I'fIC
LANK
ORIGINAL GRA17E - 91.99
���
42b'ORIGINAL
60ffOM OF EXCAVATION - 79.78
GAM
- 92,29
fOr& 17EPV - 12,21
60ffOM OF EXCAVATION 2,05
for& DEPTH - 10,19
SINAL G1RAl%� MT1 C01
I�
= 99,51 I I HH
CO2
CO3 C05
R n n n INAL
R n C07 MT3
PI
- 90,10
ORIGINAL FLL-
clmf - 95,88
ORIGINAL 6WA
91.99
►F
TOP OF L�V�LING
5AND - 81,93 (AVG.)
60tfOM 0r PIPS
82.6 (AV0
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504
PHONE: (907) 337-6179/FAX: (907) 338-3246
LEGAL DESCRIPTION:
JEWEL LAKE HTS. SUBDIVISION; LOT 6A
TYPE OF WORK:
AS -BUILT PROFILE OF SEPTIC SYSTEM UPGRADE G
PREPARED FOR: PHONE NUMBER:
TOM WOOD (907) 248-0050/562-2712
DRAWN BY: SCALE: PAGE:
11/18/99 1 K.D.W. I N.T.S. 1 3 OF 3
ORIGINAL 6mE
88.98
6" OFF 12MNRO
BENEATH PIPE
��.
0F.A X44
.' • OI
.... ... ......
P ' rey� A. Corness.
CE -7953
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MUNICIPALITY OF ANCHORAGE ti L Y� 1�CtG G
Q
Department of Health and Human Services
On -Site Services Program ����� L GrV 5 1 ;� 99 j
825 L Street, Room 502 �� J
P.O. Box 196650, Anchorage, AK 99599-6650 �I
(907) 343-4744
Permit Number: SW990321
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Sep 08, 1999
Expiration Date: Sep 07, 2000
Parcel ID: 011-213-53
Legal Description: JEWEL LAKE #1 LT 6A
Design Engineer: 0041 AK Water & Wastewater Consulta Site Address: 004655 EMERALD CIR
Owner Name: Tom Wood Lot Size: 17300 SQ. FT.
Owner Address: 4655 Emerald Circle Total Bedrooms: 2 Permit Bedrooms: 2
Anchorage , AK 99502-5120
This permit is for the construction of:
❑✓ Disposal Field [?] Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations (18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify 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.
Received By: /4 P Date:
Issued By: �ir� (� /y�J��� Date:
s
Alaska ater & Wastewater Consultants, Inc.
6901 DeBarr Road, Suite 213 — Anchorage, AK — 99504
(907) 337-6179 — Fax (907) 338-3246
Consulting Engineers
August 11, 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: Sewer Upgrade for Jewel Lake Heights Subdivision, Lot 6A
To whom it may concern:
The existing 2 bedroom house is served by a private septic system and a private well. The
existing drainfield surcharged and surfacing effluent. An upgrade is needed. The existing well
is private but has the potential to be upgraded to a class "C" well if the lot to the southeast is
developed in the future. If the well is upgraded, a waiver to the new septic system will be
needed. One test hole was excavated on the property to the northeast of the existing septic
system. Comments regarding the proposed design are summarized as follows:
1. SOILS: The test hole was excavated to a depth of 17 feet and no groundwater was
encountered. There was approximately 1 foot of organics at the top of the test hole excavation.
The soil below the organics layer was an ML material to a depth of 9 feet. At 9' the soils
transitioned to a SP material that was visually rated as less than 1 min./inch. One percolation test
was performed in the ML layer at a depth of 6.5 feet to 7.0 feet and found the rate to be 36.9
min./inch.
2. TRENCH DESIGN: It is our intent to excavate to such a depth that the bottom of the bed
lies in the sand layer. M.O.A. approved sand filter material will be added to the bottom of the
excavation for use as a leveling course.
a. Percolation Rate: <1 minutes/inch
b. Allowable Application Rate: 0.7 gallons/day/ft2 (sand filter)
c. Number of Bedrooms: 2
d. Design Flow: 300 gallons per day
e. Minimum Absorption Area: 428 ft
2
f. Maximum total depth: 11 feet
g. Effective Depth: 0.5 feet
h. Reduction Factor= N/A
i. Width: 30 feet *
j. Length: 39.5 feet
k. Effective absorption area = 446 ft
2
* The proposed septic bed is triangular in shape (see attached detail drawing, page 3 of 3).
3. SURFACE WATERS: Jewel Lake borders the east property line (see attached site plan).
The proposed septic system will be over 100 feet from the lake.
4. TOPOGRAPHY: Beginning at the east end of the house, the lot slopes downward from
southwest to northeast. The area where the proposed bed is to go slopes at approximately 10% to
20% (see attached design drawing). In short, there are no slope concerns.
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you
for your assistance. n
Sincerely
Jeff> OAy k: ,qarnes` �1 ., M.S.
t
WEST 88TH _
LOT 1A
JEWEL LAKE HTS. S/D
LOT 2A
JEWEL LAKE HTS. S/D
LOT 3A
JEWEL LAKE HTS. S/D
LOT 4A
JEWEL LAKE HTS. S/D
LOT 37
JEWEL LAKE HTS. S/D
I / \
I
LOT 36B
�O�JS I JEWEL LAKE HTS. S/D
/JEWELLOT
LAKE3 TS. S/D
(CITY WATER)
—eSEPTIC ARS \
i
i ` VACANT
'3P LOT 7A
JEWEL LAKE HTS. S/D
LL]
w ( w 1 o f E IU `i/AC,
'S0 cCqS
I �
EMERALD CIRCLE
LOT 8A
JEWEL LAKE HTS. S/D
LOT 9A
JEWEL LAKE HTS. S/D J
!— _._. _ _ — — ___ — — —1
- PROPOSED SEPTIC SYSTEM
(SEE DESIGN, PAGE 2 OF 2)
EXISTING SEPTIC SYSTEM
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD, SUITE 2B. ANCHORAGE, AK. 99504
PHONE: (907) 337-6179/FAX: (907) 338-3246
LEGAL DESCRIPTION:
JEWEL LAKE HTS. SUBDIVISION; LOT 6A
TYPE OF WORK:
SITE PLAN FOR SEPTIC SYSTEM UPGRADE
PREPARED FOR: PHONE
NUMBER:
DR. TOM WOOD (9O7)248-0050/562-2712
DATE: DRAWN BY: SCALE: PAGE:
8/11/99 K.D.W./A.C.G. 1 = 100' 1 OF 3
—EXISTING TWO
BEDROOM HOUSE
W
Q
I
W
W
D
OF
- SOI
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Garness: �•.
—7953
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40 aprofessiof'o%
/ PROPOSED 1000 GALLON
SEPTIC TANK
/ (:SEPTIC ARE�-
I
9
TH#1
100' SURFACE WATER SETBACK
`4 I \ j
I EXISTING TRENCH TO REMAIN f
IN PLACE FOR FUTURE USE I
AS A RESERVE SITE. I
WELL
EMERALD CIRCLE
STALL DOUBLE
CLEAN -OUTS
INSTALL FLOW
DIVERTER
-PROPOSED BED
(SEE DETAIL, PAGE
3OF3)
\ E)
-EXISTING SEPTIC TANK
TO PUMPED, CRUSHED,
AND BURIED ON-SITE.
1
1
00' PRIVATE WELL
15n'
� 1 I
i
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E
/f
------7--------------- /--------
10' UTILITY EASEMENT /
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD SUITE 2B, ANCHORAGE, AK 99504
PHONE: (907) 337-6179/FAX: (907) 338-3246
LEGAL DESCRIPTION:
JEWEL LAKE HTS. SUBDIVISION; LOT 6A
TYPE OF WORK:
DESIGN DRAWING OF PROPOSED SEPTIC SYSTEM
PREPARED FOR: PHONE NUMBER:
DR. TOM WOOD (907) 248-0050/562-2712
DATE: DRAWNBY: SCALE: PAGE:
8/11/99 K.D.W./A.C.G. 1 = 30' 2 OF 3
Wj'
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SETBACK FROM
( w
10' SETBACK OF THE NORTH PROPERTY LINE
1STING TRENCH 1
La
'
REGISTERED LAND SURVEYOR PRIOR TO THE
f
W
I
i
Y
CVACAN! 1
I
Lu
I
LOT 7A
j
W
JEWEL LAKE HTS. S/D
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------7--------------- /--------
10' UTILITY EASEMENT /
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD SUITE 2B, ANCHORAGE, AK 99504
PHONE: (907) 337-6179/FAX: (907) 338-3246
LEGAL DESCRIPTION:
JEWEL LAKE HTS. SUBDIVISION; LOT 6A
TYPE OF WORK:
DESIGN DRAWING OF PROPOSED SEPTIC SYSTEM
PREPARED FOR: PHONE NUMBER:
DR. TOM WOOD (907) 248-0050/562-2712
DATE: DRAWNBY: SCALE: PAGE:
8/11/99 K.D.W./A.C.G. 1 = 30' 2 OF 3
Wj'
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NOTE: THE CONTRACTOR SHALL HAVE THE
100' SETBACK FROM SURFACE WATER, THE
10' SETBACK OF THE NORTH PROPERTY LINE
AND THE 100' WELL RADIUS FLAGGED BY A
'
REGISTERED LAND SURVEYOR PRIOR TO THE
'c weLC
PRE -CONSTRUCTION SITE VISIT WITH THE
ENGINEER.
I
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------7--------------- /--------
10' UTILITY EASEMENT /
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD SUITE 2B, ANCHORAGE, AK 99504
PHONE: (907) 337-6179/FAX: (907) 338-3246
LEGAL DESCRIPTION:
JEWEL LAKE HTS. SUBDIVISION; LOT 6A
TYPE OF WORK:
DESIGN DRAWING OF PROPOSED SEPTIC SYSTEM
PREPARED FOR: PHONE NUMBER:
DR. TOM WOOD (907) 248-0050/562-2712
DATE: DRAWNBY: SCALE: PAGE:
8/11/99 K.D.W./A.C.G. 1 = 30' 2 OF 3
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RIGINAL Gm
PROPO5PI7 5fPl1C P3 p - 30' PY 30' Py 395' WIC,
PXCAVAT� I I' PFW ( MAX, PPOM ANY POINt) ,
A1917 05' MINIMUM OF M.O,A, APPI;OVN? 5ANI7
Mt FL1 fk MA11;tzI L POk U55 A5 A COLR%, APP
cO/ ° \ 0,y' OP CI.PAN, WA51-lPf7 51 VM;12PAINPOCK.
co \ co
CO / \ CO
co/ \co
/cl
Z --
Mf
Mt Pf;OM SEPTIC LANK 30 Mf
0N6 PPWOVAt[9
H�AP7 k
MT CO CO CO CO CO CO MT
n r -I n n n n n n FINAL 6mP
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} 6" OP PMNt O
o :- n -.. 6PNPA1N PH
0.y' MINIMUM 5MP
L. \(f.ING cow5l�
ALASKA WATER AND WASTEWATER CONSULTANTS, INC.
6901 DEBARR ROAD SUITE 2B. ANCHORAGE, AK 99504
PHONE: (907) 337-6179/FAX: (907) 338-3246
LEGAL DESCRIPTION:
JEWEL LAKE HTS. SUBDIVISION; LOT 6A
TYPE OF WORK: G
DETAIL DRAWING OF PROPOSED BED
PREPARED FOR: PHONE NUMBER:
DR. TOM WOOD (907) 248-0050/562-2712
DRAWN BY -
8/11/99
Y -8/11/99 A.C.G.
1 = 30' 1 3 OF 3
f A. Garness;
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ALASKA WATER & WASTEWATER CONSULTANTS, INC.
690PHONEARR (907) 337-6179 *B FAX (907) 338 9504
3246
SOIL LOG — PERCOLATION TEST
LEGAL DESCRIPTION: JEWEL LAKE HEIGHTS S/D; LOT 6A
PERFORMED FOR: DR. TOM WOOD
DATE PERFORMED: 6/14/99
DEPTH TEST HOLE � 1
(feet)
1 � I ORGANICS
2
I
DRY
11�sy
SOIL CLASSIFICATIONS
GW
8
ORG
I
3:'t:>
9
GPML
I�)
J�ffi avyffi4✓u�
1
3:30
GM
//////i
CL
4
SP
2
��
i171!/GC
!I!I;
OL
3
4:01
SW
�I_II_
MH
5
4
4:31
MIL �eff °# SP
MUM SM
_r//O�
%%��
CH
OH
5
4:32
—
6"
«�..'� eat•,,
6
1
6
5:02
SC
5-3/16"
13/16"
7
DATE
DRY
11�sy
e€lu
8
I
I
I
9
a.�f1 GO' f
J�ffi avyffi4✓u�
1
3:30
6ffi �5�gm
6"
10;-t.
�^
°oe �
SP
DEPTH TO
GROUNDWATER
DATE
DRY
11�sy
e€lu
6/21/99
6/15/99
PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING
a.�f1 GO' f
J�ffi avyffi4✓u�
1
3:30
6ffi �5�gm
6"
13
�^
°oe �
SP
2
��
30
5-1/4"
3/4"
3
4:01
—
6"
—
4
4:31
30
5-1/4"
15
5
4:32
—
6"
«�..'� eat•,,
6
5:02
30
5-3/16"
13/16"
eQ D ,, n
17
B.O.H.
18
DEPTH TO
GROUNDWATER
DATE
DRY
6/14/99
DRY
6/21/99
6/15/99
PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING
o QF �:9 pp4
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. cess c
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
6/15/99
PERC. HOLE WAS PRESOAKED 4+ HOURS PRIOR TO TESTING
1
3:30
—
6"
—
2
4:00
30
5-1/4"
3/4"
3
4:01
—
6"
—
4
4:31
30
5-1/4"
3/4"
5
4:32
—
6"
—
6
5:02
30
5-3/16"
13/16"
19 PERCOLATION RATE 36.9 (MIN./INCH) PERC. HOLE DIA. 6 (INCHES)
20 TEST RUN BETWEEN 6.5 FT7/7 . 0 FT.
COMME S: NT
PERFORMED BY ALASKA WATER & WASTEWATER I, Y. CERTIFY THA
THIS WAS ERFOR E�Q IV ACCORDANCE WITH ALL STATE 0/pUN'C� IPAL GUIDELINES IN EFFECT ON THIS
DATE.DATE:
STlIlrr� o FL�lS �"�iv,
DDIEIPU. ®iF IEITY111iGOMMENTAL CONSERVATION
DIVISION OF ENVIRONMENTAL HEALTH
DRINKING WATER and WASTEWATER PROGRAM
555 CORDOVA STREET
ANCHORAGE, AK 99501
http://www.state.ak.us/dec/home/htm
Jeffrey A. Garness
Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road, Suite 2-13
Anchorage, Alaska 99504
WALTER J. HICKEL, GOVERNOR
Telephone: (907) 269-7521
Fax: (907) 269-7650
September 3, 1999
Subject: Lot 6A, Jewel Lake Heights Subdivision, Anchorage, Alaska, ADEC Project Number
645, Separation Distance Waiver Request.
Dear Mr. Garness:
This letter is in response to your recent submittal received in this office requesting a separation distance
waiver between the existing Class C Public Water System (PWSID #218547) Source Well and the
proposed septic system upgrade both located on the above -referenced property.
I have completed my review of the submitted information, which included a cover letter, a site plan, soils
information, a well log, absorption bed design details, topographical information, and recent nitrate and
total coliform bacteria results. Based on this review, and a review of the Department's existing file for
this site, it appears that the proposed septic system upgrade on Lot 6A will not impact the above
referenced Class C well.
Therefore, in accordance with the provisions of 18 AAC 80.030, the following separation distance is
granted:
Between the existing Class C well on Lot 6A and the proposed septic tank and
absorption bed upgrade on Lot 6A from 150 feet to 105 feet.
This approval does not imply the granting of additional authorizations, nor obligate any federal, state, or
local regulatory body to grant required authorizations.
Thank you for your cooperation with this department. If you have any questions, please contact me.
Sincerely,
4.
Steven A. Pettis
Env. Eng. Asst. II
00 printed on recycled paper b y C. D.
GREA,,-,:R ANCHORAGE AREA BOR~aGH
Department of Environmental Ouality
3330 0 Street
Anchorage, Alaska 99503
,,INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
LEGALDESCR,PT,ON '
SEPTIC TANK:
DISTANCE
FROM WELL P~>/"
INSIDE LENGTH
MANUFACTURER
INSIDE WIDTH
MATERIAL ~"T¢-"' ¢-~/
LIQUID DEPTH
NUMBER OF
COMPARTMENTS
LIQUID C A PAC I T~'~4~'<~GA L LON S.
DISTANCE FROM WELL /{~)01 C--'FOUNDATION
NUMBER OF LINES / DISTANCE BETWEEN LINES
ABSORPTION AREA ("/q~
DEPTH: TOP OF TILE TO FINISH GRADE
TOTAL LENGTH
_NEAREST LOT LINE /~'¢/ / OF LINES ¢~) /~
TRENCH WIDTH ~"~"IN. TOTAL EFFECTIVE
SQ. FT. LENGTH OF EACH LINE
~:2'" ~/"' DEPTH OF FILTER
MATERIAL BENEATH TILE
7~, IN. ABOVE TILE
IN.
WELL: .~ . ~ /
TYPE ~.~) ~/~ CONSTRUCTION
BUILDING NEAREST
FOUNDATION LOT LINE_
CESSPOOL OTHER SOURCES
APPROVED- - DISAPPROVED
DEPTH DISTANCE FROM:
NEAREST SEPTIC SEEPAGE
SEWER LINE , TANK SYSTEM
DISTANCES:
INSTALLED BY:
SEWER LINE DEPTH:
PIPE MATERIAL: q-"-~' ' ~
LOT SLOPE:
REMARKS: //~' ~ ~'' /
Form EQ-032
RF'F'L I CF:Ibl]" [:::E~'4 H I NC:HE:¥
L. OC:F:FT ]: ON E:MEI:E:FtL D
L~I~i:I:3FIL [..e; ..:t'EHE:I_ LI:9I<E HE I GH'/":i::; ::_;I..tE~:D LOT S l ZE
T'T'F:'L:E OF' SCi 1' L [gE::iJ;OIRL:Ft"Z O1",1 ~;'T".~TE:M I S: 'T'F:ENC:H
MFf,:.:',iMLIM hlL.IHE:[::JD: [.'ti'-:' E:D':E:,Fi'.OOI'"tS = 4. '.:.:.';Oil.. DiI::I'T]:NG (L:.;Q F T ,.." E: D'. .':, =: J..:'LO
'T'HE: F.':Iii:QU I D:EE:, S 12. E OF THE :F.!;O t L FIBSOI;:'.PTI ON ':];'t'STEM I :[5:
C:, ~:: Y:" '"'Ii-' IF-Ii ..... i.
FEET
THE t_Eh,IGTFI C, i I"'IEiqS I I.EIN ]: E; THE: I...ENC~T'H ,:.' I N FE::ET ) OF' 'THE TK:[.:'hlC:ft I.EIF.: E:,F::F:I .'t1 hll::' I EL.E:,.
THE [::,IEF:"I"H O1::' FI 'Tt~'.':E:I'.,ICFI CIE'. PIT I:~; THE E:,I~;'T'I~f.,IC:E B[£]"HEEN THE-_'
CiD:OUN[:, F]I'-,I[::' THE BOTTOM OF THE EF::C~VB"t" ]: ON (IN FEET).
"t'HL::D:E I'Z; h40 SET I.qlDTH FOE.'.
THE: GD'.FIVEI_ [:,EF'TH IS THE MINIMUM DEF'TH OF:' (]l~i:l:l'v'EL E;ET[,.IEI~I'-~ TH[C OLH"FFaLI_ F'!F'E
laND THE: li~:OTTOM OF' THE E;:-:',C[aVF~TI ON ,:: I [",1 F[:_'ET :.',.
E:F:iCF'.'F't LL i HG OF' F:tt"~tr' '_E;"r'STEM H I 'THOIJT F I Nt::IL I N:~;F'ECT I Oi",! FIND I:tF'F'i;:.'IgVFIL. B'~" TH I S
I)E:.:PFtDt"FME:NT ,~'.1 t LL., [i:E :iSL.IE_:L.:t'ECT TO F'IE:OSECUT t Otq.
Mi i"4IMUH [::'IS'TFINCE E:E'TI,.t[EE".'N I::I HEI_I_ FINE:' F'lt",i"d OI",!-:E:ITE ':?',EHFtGE D I':_:;F'OL:'i;F:IL ':7,"r"STEM
:1. OO FEET F'OI:;~: FI I:::'I~:I',,,'FFI"E HEL. L OD: 200 F:EET FOF: FI PLIBL..IC HEL. L.
HELL. LOG:i.:; l'at::~:E F.:[.::L.-..ILIID'.E[:, FIND MUST BE: D:ETUD'.NED TO THE ['.:,[".'.".i:::'F:ID:T'I"IENT I.qlTHIN :Z.::O E:'FI't'S
OF THE HEL. I_ COHPLIZT]:ON.
'.:J;PEC I F'I CFtT' I ON:L:, FIND C:OI"4':'STF..'UCT I O1",1 E:' l I'-tGD:FII"'I'.:5 FIF. tE: FI',,,'f:t I L. FIE;LE "FO I t",I'.'"SUF.:EE
I N:g"FF~LL.F:IT I OF,I.
i CERTIF:"," "FHR'T
i: I laM F'F]MII_II::ID: I.,.II]"H THE RE:.'I..Z.!LIIREMENT':'::; DOD: ON-..S:ITE SE:HEI;-.'E; F:II",IE:, P.tEEL..L..'.:~; I::lS :!~;E:T
F:OD:T'H D"r' THE I'dUNICI F'FIL. I'TY OF' F~NC:HOD:SGE.
2: I HILL. INfE;'FlaL. L T'HE '..::;'T'STE:P1 IN FIL-:COD'.E:'I::INC:E: HITH THE COC'IE:E;.
:~:: I L.IN[:,IL:'i~i:5i;T~N[.':' THFIT THE': ON'-'Z;ITE f~i;EHED. ::-";¥E;TEH P'I[%' D'.E[[.:!UIF'.EE E:NLFaF~:GE:ME:NT IF' THE:
RE:=, i L I:1 ,I ..E ]: '.'5 F::E:MODELF::[:' "1'O I NCLI_IE:,EE i"IOIE:E 'I'HI:~N ~.t E',E[:,I;.':OOI"'I5:.
I S~;U~E:, E: t'_~..~.,~.C..~..,:.~-~~ ................ :H ~ ~ ...............................................
'"~,~'.....,:_. :' ', ~ ~ ""5"~;
g()ll,~ 1,()('. - I'I~I~()I,A't'I(JN 'FI':ST
.Performed For ...... ~.J~._Hia~ho~ ............... ~ .............. Date Perfon;led Z/1=/76
Legal DescripLion: _~Ot ~ ~ewel Lalce H=,}~h+~· Amcho~~' ~a .....
This form reports: Soils log. ~ Percolation kest
l)eptil
Feet
]- -I'lL (27p) ......... - ..... [' -
3 -YL (279) 1.5 - S'.'! (ilO)
4 -~,~L (27.5)
6 - m? (po.)
8 - m,z (po)
s - s:,; (z~.o)
lO - sw (zzo)
11 -sw (ILO)
12 -st,t (ilo)
13 -sv,, (ilO)
.14 -sw (iiq)
Flat
Was ground waLor encountered?
~0
If yes., at wllat depLh?
Reading Date Gross Time Net Time Depti~ to Water Net Drop
................... t(.pUI ~o b(,cLoln of pit or
COi,,[,,FS.
I';Q (I.1(1 (6/7q) Richard A. Drahn, P.S'. Richard
WELL OWNER
LOCATION ~.0~
WATER WELL LOG
FOSS DRILLING
1336 Ingra Street
Anchorage, Alaska 99501
NOV 0 $ lg?6
RECEIVED
SIZE OP CA~ING~",,DEPTH OP HOLE/~L~. CASED TO ~)~ FT.
FEET OF DRAWDOWN.
DATE COMPLETED/~./~ ~./_~/~ PUMP TO BE SET AT~
~0
tO
tO
tO
,to ,
tO ,
tO' ,
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.D.# Of')! / ¢ / ~ .~--3 HAA# O~-Od,--~)~'~O~
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
owner ~'¢~1,,/~.~, Telephone: (home)
(b)
Property
(J
Mailing Address tJ~ ~ ¢ ~r.~-~/,4,¢¢'~ (~ ~
(c)~ending Institution ~ ~-- ~ ~'~¢~
Telephone
Mailing Address ~ ~
__Business 7~ ~--3/~//
(d) Real Estate Company and Agent
Address
Telephone
(e)
Mail the HAA to the following address: (or check hereJ~if hold for pick up.)
List contact person and day phone number below:
2. TYPE OF RESIDENCE
Single-Family'l~ Number of bedrooms
3. WATER SUPPLY
Individual Well ~;~ Community [] Public []
Note~ If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On~site,[~ Public [] Community [] Holding Tank []
Note: If!community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality and status.
72-025 (Rev. 7/88) Page 1 of 2
')tJOM s,Jeeu!6ua leUO!SSeloJd
9UO!SS!LIJO JO SJOJJa JO~ elq!suodseJ ],au s! e6eJoqouv to XHled!o!u nlAI eq.L 'penss! s! e],eo!~RJeo e eJoceq e)`ep aZXleUe Jo
suop, oadsu! lonpuoo )`au ap SHHC] to sea/~Old LU=I 's~ueuJeJ!nbaJ a)`e)`s pue leJepe~
8u!puel J!eLl)` pue SeLUOLI ~O sJaseLloJnd o], ,~se~Jnoo e se SILl), seep 9HHC] eLl.t.
Jaeu!6ue leuo!ssajoJd )`uepuedapu! ue/,q eAoqe B qdeJl~eJed u! UeA!6 sUO!le)`ueseJdeJ eq~, uodn XlUO peseq
leAoJddv/q!Joq)`nv q)`leaH senss! (SHHC]) seo!A]es UeLUnH pue q],leeH ,~o )`UeLU~,Jede(3 e6eJOLIOUV,[o Xl!led!a!unlAl eMJ.
le^oJddV leUO!l!puoo J,o swJe.L
leUO!],!puoc) pa^o~ddes!C] ~ paAo~ddV
~.~'~ ~ ~~7 Xq SLUOOJpeq ~- J°' peA°Jddv
lVAOI:Idd¥ SHHQ '9
leas s,Jeeu!l~u:E]
sseJpp¥
'uoRoedsul s!q~ to elep e 8 !P~
pue ted!o!unR lie ~1!~ eoUe!ld~Oo u! s! ~elsXs leSOds!p Jele~else~ ~o/pue Xlddns Jele~ el!s-ua emi 'uo!loedsu!
pue uoRea!iseAu! ~ ~oJl pue Sel!t eaeJo~ouv lo Xl!led!o!unR eq~ ~oJl peu!elqo uoRe~Jolu! e~l ua peseq
~e~l XlpeA JaMPnl I 'u!aJeq pele~!pu! e]nlonJls 1o edXl pue s~ooJpeq to Jeq~nu e~l Jot elenbape pueleUOROunt
'ales s! ~elsXs leSOds!p ~eleAalse~ ~o/pue Xi.ddns Jele~ e~!s-uo emi ~eM1 s~oqs leAo]ddv Xlpoqlnv MlleeH
s! q~ to UO!lea!~SeAU! ~ ~eq~ ~t!JeA I 'Moleq UMOqS olep uoReP!leA eq~ 1o se pue o~eJaq pex!tte leas X~ Xq pe!tRJeO ~V
MUNICIPALITY OF ANCHORAGE
MUNICIPALITY OF ANCHORAGE (MOA) ,f,~,~ENVIRONMENrAL SERWC, liS
Health Authority Approval (HAA)
CHECKUST- FEB.UA.¥ 4984 1 1988
343-4744
Legal Description: ~T GA, ~ ~ D
A. WELL DATA
Well Classification P--, f--~ ¢'
Well Log Present (Y/N)_~__Date Completed 1~/2-?/'7
Total Depth ~/~,~ Cased to /-1/~ L% Depth of Grouting
Static Water Level b (~
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot I ~
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
To Nearest Sewer Service Line on Lot
Water Sample Collected by "~"~ --~
Water Sample Test Results (~¢ ~-
Comments L~',z.~J~ / / ~L,'~ ¢4~/--Cf
tf A, B, C, D.E.C. Approved (Y/N)
Yield / O~...~
Pump Set At ~
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer Cleanout/Manhole
h+
B. SEPTIC/;-~J~ TANK DATA
Date Installed 10//7~ Size /j~,~O No. of Compartments ~ ~O
~U~pes (Y/N) ~ ~ Air-tight Caps (Y/N) y F ~L(Y~)~
Last Pum;;~'~~'~ ~/~/~..~::~:.~~
Pumping/Maintenance Contact on File (Y/N) ~/~ ;for
Holding Tank High-Water Alarm (Y/N) ~/~ Temporary Holding Tank Permit
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water-Supply Well / 0-~
To Property Line i ~ ./b
To Water Main/Service Line .~ /~
To Stream, Pond, Lake or Major Drainage Course
To Building Foundation
To Disposal Field
Comments
IO
72-026 (Rev. 7/88) Front Page 1 of 2
ABSORPTION FIELD DATA
Soils Rating in Absorptio. n Strata
Date Installed (~) ~ '~'- j ~]
Width of Field -~, cO I~
·
TyPe of System Design
Length of Field /2/0
Depth of Field -~ 'Z~'
Gravel Bed Thickness
Square Feet of Absortion Area t7/ L//O ~.~o' Statndpipes Present (Y/N) T/.I~'~
Depression over Field (Y/N) ~'~ ._...Date of Last Adequacy Test
Results of Last Adequacy Test "~- ~/.--~.-~ 7z-" ~'- /'7/ ,'- ,~.~¢-
SEPARATION DISTANCE FROM ABSORPTION FIELD:
/~'~) TO Property Line /,~
~ '~- To Existing or Abandoned System on
; On Adjoining Lots ~'~
~/O To Cutback (if prese~nt) ~/.~I)~-
To Stream, Pond, Lake, or Major Drainage Course ! I O
To Driveway, Parking Area, or Vehicle Storage Area ~..~>O ~'
To Water-Supply Well
To Building Foundation
To Water Main/Service Line
Comments
LIFT STATION H ~) ~'~ ~'-
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test,
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this
Company ~~ ~ ?~ ~ ' "" ":' '" '
Date - ~/;~!~ 4 Eng,neer'sSeal
MOA No.
72-026 (Rev. 7/88) Back
Receipt No
Waiver Fee: $
Date of Payment
Page 2 of 2
.1.
.~' MUNICIPALITY OF ANCHORAGE "-~"
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
GENERAL INFORMATION
(a)
Legal Description (include lot, block, s~bdivi.sion, section, township, range),
rJ
Location (address or directions~. . ·
(b) Applicant Name /'~J ~L~,~./~_.v~ Telephone: Home ..~1'~ 40 .Business
Applicant Address .~, ~--,~'- ~-.,,~,~/, ¢,~2~/J ('~ ~--,.~. ~.~
(c) Applicant is (check one): Lending Institution,~ Owner/builder []; Buyer []; Other [] (explain);
(d)
Lending Institution '~r'A'-~l~tc-:C~t~r'lr¢-~ ~ Telephone
Address
(e) Real Estate Company and Agent
Address
Telephone
(f)
Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family~ Multi-Family
Number of Bedrooms
Other
WATER SUPPLY
Individual Well~. Community [] Public []
Note: If commUnity well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
SEWAGE DISPOSAL
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 (11/84)
ENGINEERING FIRM PROVIDh.~';GJlNSPECTIONS, TESTS, FILE SEARCH, D~,A AND INFORMATION ~..
A§ certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate'
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection. ,
AddressName of Firm ~'~/ ~'~u/O/~ ~/, ~J.~ A./~..~ ,,~-~---.--~'l ~. ~ ~-"f"t~'r~/"~'~'/'f~'~-"~,~z/L''' c''/''Teleph°ne ,,~,,,.,~ .~z~ ~.~e.'~' ..~ r-- ~.~/'O ,~c' ~ 7,--~.~
Engineer's Seal
Approved ,X~ Disapproved ' Conditional
Terms of Conditional Approval
CAUTION
The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representations given in paragraph 5 above by an independen..t professional
engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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.
!~;~¢e 2 of 2
MUNICIPALITY OF ANCHORAGE (MO~i
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
264-4720
Legal Description:
MUNICIPALITY OF ANCHORAGE
DEPT, OF HEALTH &
ENVIRONMENTAL PROTECTION
2 1 1986
WELL DATA
Well Classification ~3'f,~----~J If A, B, C, D.E.C. Approved (Y/N)
WellLog Present(Y/N) ~ ~)~ Date Completed ~')/Z~/7 ~ Yield
Total Depth Cased t.
Static Water Level
Casing Height Above Ground--3~_~.~.......r_,~/
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot ' '~' --
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
Comments
Depth of Grouting ,/[,/,¢¢t./~
Pump Set At ~-~ 2~¢ '¢
Sanitary Seal on Casing (Y/N) ~'¢',~4~.
Depression Around Wellhead (Y/N) NO
; On Adjoining Lots
; On Adjoining Lots
/~/'~/~" To Nearest Public Sewer
/4,,/¢ f¢,~ To Nearest Sewer Service Line on Lot
~,],~ ~/~4~¢,-,/ ;Date / / ~-7/,~
B. SEPTIC/HOLDING TANK DATA
Date Installed /~/'¢~'/7~:~ Size ~;~"'~'~ No. of Compartments
Standpipes (Y/N) ~-_~-~ Air-tight Caps (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High~Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well /~5"t
To Property Line ~
To Water Main/Service Line
Course I~''~::> £ +
Foundation Cleanout (y/N)
Date Last Pumped
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field / ~
To Stream, Pond, Lake, or Major Drainage
Comments
Page 1 of 2
72-026(1~/84)
ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption 'Field:
To Water-Supply Well ~ '~./~ /
To Building Foundation' ~__.,i:~)
Lot
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
l
I ~ 0/:~,,~ Type of System Design
Length of Field 4
Depth of Field
Gravel Bed Thickness
4~:~ ~ ~;~ ~ Standpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots ~'?~ /
To Cutbank (if present)
Comments
D. LIFT STATION
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
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, v.erifLed, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Sign/~,.,~~ate ~
Company'S% ,~',,~,'~4 , MOA NO~,~-'-
Receipt No. ?~'-77'~
Date of Payment
Amount: $
Page 2 of 2
72-026 (11/84)
~ MUNICIPALITY OF ANCHORAGF
DEPARTMENT C? HEALTH AND ENVIRONMSNTA~ROTECT!ON
Street, -Anchorage, Alaska' 99501
279-2511, ext. 224, 225
Date Received: April 11 , 1977
Inspector ~u ~O~ .......
2nd Inspection:
Time
Date
Inspector
REQUEST FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
Lending Institution Request: Alaska Bank of commerce
Mailing Address:
2. Property Owner:
Pouch 7-012 99510
Ken M~ Hinchey
Russellyn S. Carruth
Phone: 279-5641/350
Phone: 279-2411-her
Mailing Address; 325 East Manor 99501
274-8691-him
3o
Single ~amily Residenc., (x) Number o. Bedroomst
Multiple Family Residence: ( ) Number of Bedrooms:
5. Well Data: Type. ,Indiv~ual Depth 404'
Construction ~~~ BacterialAnalysis
6. Sewage Disposal System: On-site system
Permit ~ 76525 Installed 1976
Septic Tank Size
7. Distances: Well to Septic Tank /~ /
to Sewer Lines ~c~ Nearest Lot Line
Absorption Area to Nearest Lot Line
Well Log-Filed
(x) Public Utility
Installer
Manufacturer
Soils Rate //~ ~Mafierial ,
'ho Absorption Area ./,/(~ '
APR
MUNICIPALITY OF ANOHORA~E ~C
DEPARTMENT OF ENVIRONMENTAL QUALI~~-
~3n "¢'~e~, Anchora~&, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER and WATER FACILITIES
1. Type of Inspection: CMRO VA FHA
2. Property Owner: Russellyn S. Carruth and Ken M. Hinchey
(her)
Mailing Address: 325 East Manor, Anchorage, 01 DayPhone (he)
n/a same as above
3. Name of Buyer:
CONV
279-2411
274-8691
Mailing Address:
4. Name of Lending Institution:
Pouch
Mailing Address:
5. Name of Realtor or Agent:
Mailing Address:
ALASKA BANK OF COMMERCE
7012, Anchorage, 99510
none
Day Phone
Phone 279-5641 x 350
Phone
6, Legal Description:
Lot 6, Jewel Lake Heights
NHN Emerald Circle, Anchorage
Location:.
Type of Facility to be inspected: well No, Bdrms. ~ ,
Water Supply
Type of Supply: Public Utility Individual zY"N'
If Individual, depth of well _
Sewage Dispo~l System
Type of System:
If Individual, number of dwellings presently served
/-IO H
Public Utility
If Individual, date of installation /(~)/9
Individual (on-site)
EO-037 (1174)
,Page. Two k~ ~'
~ ' Department of Health and EnvirOnmental Protection
~ Request for, Approval of Individual Sewer and Water Facilities
Legal Description: Lot 6 Jewel Lake Heights Subdivision
Comments:
Affadavit Attached: (')
Approved: ~ Date:
Disapproved: / Date:
Letter Attached: ( )
Department Worksheet:
F'ERMIT I'.,10. ,' ,. c:,... ,:: q. ',
l:q F:'l::' L :[ C Fl N 'T'
I_ O C FI '1' ]: t ] N
LE ~I-.,1_.
I<EN H ] I,t-.HE r
E:.'M E F::I::IL. [:' CR
L..!~.; ..:rEktEL. LRKE FITS
=4:; [- ST F::M ;2Ed.
L. OT E;IZE
:'L::I.;;L.q.]: '.:.~;QURF::E FEET
T'T'PE: OF: SEitL RE:SOREFI:'ZL]N .:, _-:., l: El'l IE;: TREi'.,Ii]:H
:i:.;OIL. l:r<Fl'l"II",lG ':'&.iQ F'T,}'E:IE:)=
THE f;;:EE:¢...I :l: REI} :iii; 12'E OF "f'HE SO l L I:IE:SOF,.".F']' I ell'-4 .:, 1-; ] I:.11 I E;:
'TtqE LEI'-,IE-FFH I}:[MEI'.4:E;iOI'.,I IS THE: L. ENGTH (I
THE DEF:"T'FI IZIF FI TI~?.E:NCH OR PIT IS Tl:'tE
GRC~UI'.,t[) l::~F,l[:, THE Eu:]TTI]IM OF TFIE E:,-<CFI',,,'F:tTI
'I'HER['Z IS NO SET 14IDTH I:::I]F.: ]'RENC:H[:ZE;.
THE: .~[,,[' , [:1._ [:,El::']"l:'t IS THE MINIMUM
Ffl'.,![:, THE BO'T'TOH I])F THE E:,'<CI=I'v'FIT I ON ,:;
'::, OF THE 'I'REI'.dI_.:H OR [:,RF:I ]: P.,tF' I EI._D.
:E 8ETI4EE:I'.,I THE :~.]IJI:~'.I::'FICE OF THE
F'EET ::,.
BFIC:I:::]:ZlL.L..ING OF' FtN"r' S't':E;TE]"'I HI'THOU: II._ INSPECTION FIND F:IPF:'RCCv'FIL E:"r' Tl:'ilS
[:,EPFff;;:THENT kI:I:LL. BE :E;LIE:JECT TO PR( f:ON.
H 1 N ]. HIJH [;' :[ ::, I"F:INCE E',E]~t.'.IEE. N FI I.,.IEL'L~ Fti" Cli",l-&S :[ TE SE.:.b. IFIGE E. I £:;F O...;F:IL. 2; ~ 2.;TE:M ):
t.OO i:::EET F'OI;.: FI I l:~:I,,,FIl~'['E HELL.(~-:'EIF:: ~'OO FEE] F Zl:;.: H F E ...
r"tF THF kIEL[ COi"IF'LE]" II..:.'!~!. '~ ,,
SF'E ..... Z :[ F' :[ (.":FIT Z ON:E; HN" ..... ) i..:I][<[¢~TF.':UC'[ ~[ OIq E:'];ti IZlGRIZIME; FIRE t::1 ',' FI I LFIE:L.E "FO INSURE .......... F F-:CiF: ER
Z N £:;'l:',::11._ I._ I:::IT I O N. ~ //i ,,,, .
T F:F'I~'T I F ?' 'T'HF:I'F "'/'""'--~'
F"ECF.:tI~-.'f,,:E -l:t .... "..-" Jf:::~! {}..._ % I[]:,~.x.F'En E~:.;// CZ~It"-,~E~... --¢ EECF..III¢4.. IF='F..:CulP't :E ::::.::::.L.fiE:
:L: I Fli',t I::FII',I)JLTF:IR t.4ITH THE REQLI):REMENTS FOR ON-'.E;:[TE E;E!-qERS FIND HELL'_'-:i; FIE; :i::';IET
FORTH E?'r' 'T'HE HUNICIPFILIT'¥' [:Il::' F'INCHORFIGE.
2: :[ 14IL. L .T.I",tSTI::ILL THE:. '.:ii"r':E;TEM IN FICCOR[.':'FiNCE WITH THE CODES.
]:: Z i. JNDEI~:S'I"I::II",ID THFI]' THE ON-SITE SEI4EER :.:.?'r'STEEM I'qFI'T' RE(;]iJIRE EI",IL.F'tRC'iEd"IENT IF THE
RES ): DENCE: :[ '.E; REHO[:'E:LE[:' 'T'O INCLUDE MORE TI:'iFIN 4 E~EDF.'.OE~M'-:5.
(,kEf~TLR ANCIIUId\(.;L /',F, Lt\
l]epartment of [mvironment. al
3330 "~" Street
Anchorage, Alaska 99b03
N()II,S I,O(; - I~I';I{OI,ATION TEST
Pe rfc rmed fo r_ ...... I,¢_~ .__!~e~_..?j ._
Legal Description:
This fornl reports:
_
Lot 5. Jewel Lake Hei_g!~?&~_kmcho%~_=~]~
Soil'~~ .................. lo9 X P~rcolation ~est
Dep th
Feet
1 - m.: (225)
2 - oy (225)
4 - s',,;
5 - e','! (85)
6 - S;',' (100)
7 - sw (].oo)
8- s;.: (~oo)
9 - sw (mo)
1o - s,:: (~oo)
II - S','l (10o)
12 - S;'! (100)
13 - S:',~ (100)
14 - S~',~ (lO0)
Was ground water encountered? ~lo
Flat
If yes, at what depth?
Reading
Date Gross Time
Drain Field
-Proposed i ns tal 1 a~T~-n-i- ' Seepage Pi t
l)epU~ of Inlet ................ · Dept~F6'~~Y-I)it or trench
COMMENTS: ...........................................................................................
EQ-040 (6/74)