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HomeMy WebLinkAboutO'MALLEY HEIGHTS LT 4A MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP241055 Work Type: Septic Upgrade Tax Code Number: 01511243000 Site Legal Address: O'MALLEY HEIGHTS LT 4A G:2536 Site Mailing Address: 10600 PACER PL, Anchorage Owner: COJOMA JESUS X APAZA & Design Engineer: ANDERSON CONSTRUCTION & ENGINEERING This permit is for the construction of: Effective Date: Expiration Date: Lot Size in Sq Ft: Total Bedrooms: p,cnt AS, J t)epat-mient 4/23/2024 4/23/2025 26763 Q Disposal Field Z Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: No waiver required for 18' bed width. Engineer justified to the satisfaction of the department that topography and access will allow construction of this bed without tracking the bottom. Received By: 1 S U�� /y� r 0 S.D/� Issued By: Date: Date: MUNICIPALITY ANCHORAGE %1 Development Services Department Phone: 907-343-7904 On -Site Water & Wastewater Section `— Fax: 907-343-7997 ON -SITE SEPTICM/ELL PERMIT APPLICATION Parcel I.D. 015-112-43 Property owner(s) KAREN MENEDEZ Mailing address 10600 PACER PL ANCH AK Site address 10600 PACER PL Legal description (Sub'd., Block & Lot) O'MALLEY HEIGHTS Legal description (Township, Range & Section) Lot Size 26763 Sq. Ft. Number of Bedrooms 5 Day phone LT 4A APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (N all that apply) Absorption Field 0 Initial ❑ Single Family (SF) 0 (w/wo ADU) Septic Tank 0 Upgrade 171 Duplex (D) El Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: �'q 5 Waiver Fees: Date of Payment: Zy �� $�7o Z y Date of Payment: Receipt Number: Receipt Number: Permit No. )5P 2.`A 10 55 Waiver No. GADevelopment Services\Building Safety\On Site Water and Wastewater\Forms\Client Forms\Permit Application.doc April 15, 2024 Municipality of Anchorage Development Services Dept. On-Site Water & Wastewater Section Anchorage, Alaska 99519 Phone 343-7904 Re: Septic permit and bed width waiver Legal: O'MALLEY HEIGHTS LT 4A To Whom it may concern: This is a request for a septic permit on the above referenced lot. The existing leach field will remain and a new 18 x 60 bed will be added with a new tank, see the site plan. A soil log for the reserve bed was found in the MOA file by Ted Moore P.E. and was used for this design. The perc rate was 2.3 minutes per inch with no water, measured in May of 1991. The new bed has an application rate of 0.7 which is conservative (0.8 is allowed) but the width is 18 feet not the required MOA 15 feet width. This extra width will require a waiver. The wider bed can be excavated without entering the bed system with the excavator which is my justification and the soils are sandy gravels so no smearing can occur. The slopes are flat in the area of the new bed and none of the surrounding properties will be impacted by this new system. Sincerely Michael N. Anderson, P.E. 4661 Natrona Anch, Ak 99516 Ph 727-8864 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241055, Curtis Townsend, 04/23/24 SEPTIC FIELD SECTION DESIGN CRITERIA: 0.5' EFFECTIVE 5 BDRM X 150 = 750 GPD SOILS = 750/0.7 = 1071 GPD 1071 GA/18 = 59.5' 18' WIDE 60' LONG (1) BED 6.0' DEEP 18.0' -6.0 -5.5 FILTER FABRIC 0.5' SEWER ROCK ‘3,3( GRADE 1"=100' PROPERTY LINE PROPOSED HOUSE PROPOSED DRAINAGE FIELD SCALE: DJRDRAWN: DATE: OMALLEY HEIGHTS LT 4A Anchorage, Alaska KAREN MENEDEZ 4/10/2024 -P A C E R P L - EXISTING WELL & INSULATION SPACED @ 60" -18.5 (TH#3 BY TED MOORE ) -5.5 SP/SM GM -1.0 PT DRY MAY 1991 Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241055, Curtis Townsend, 04/23/24 1"=50' EXISTING HOUSE EXISTING BED SCALE: DJRDRAWN: DATE: OMALLEY HEIGHTS LT 4A Anchorage, Alaska KAREN MENEDEZ 4/10/2024 D R I V E W A Y WELL CO/MT CO/MT FLA T N O S L O P E WELL WELL TH#3 BY TED MOORE VALVE W/ DCO BEFORE AND AFTER NEW 1500 GALLON TANK, MAINTAIN 10' TANK TO HOUSE AND 5' FROM TANK TO FIELD WELL MT EACH CORNER TYP W/ CO ON EA. RUN. Municipality of Anchorage On-site Water and Wastewater REVIEWED FOR CODE COMPLIANCE OSP241055, Curtis Townsend, 04/23/24 ANCHORAGE RECORDING DISTRICT, ALASKA AS -BUILT OF: O'MALLEY HEIGHTS SUBDIVISION LOT 4A PLAT 82-288 SURVEYCERTIFICATE: 1, John L. Schuller, Have conducted a physical survey of this property as shown on this drawing and that the improvements situated hereon are within the property lines and no enchroachments exist other than noted. Under no circumstance shout( any information on this drawing be used for construction of fences, structures, improvements, or for establishing boundary lines. EXCLUSION NOTES: It is the owners responsibility to determine the existence of any easements, covenants, or restrictions which do not appear on the recorded subdivision plat. WORK ORDER NUMBER: DAM SCAM E-MAIL APRIL 4, 2024. 1 =30 schullerokOgmail.com 24­020 DRAYM BY. CHECKED BY. MD NUMBER: BOOK AGE: JLS SW2536 240124 33' 30' 1" 30, C6 Li 0 LLJ < 0 0 °� I 00 of 0 LLJ a 0 0 < V) CL 3 01 33 S (IR AW OF 't L A r� N, �1v AW 4 A07N, 0 A*, � 1:� 4 of Z_ 00 elgTH ?A -J N L. SCHULLER.- 0 000 , . LS-10408 A 1831 Talkeetna Street Anchorage, Alaska 99508 OfeSSjon,3� AW (907) 227-1455 office (907) 274--4992 fax Municipality of Anchorage Page / 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 Wel~ Inspection Report Perrnit Number: .~' v'V ~//0/' ~- PID Number: Numa: Wastewater System: ,~New [] Upgrade Address: ld6oo F/?c~ F~.,~-cE,4~c 4~,YD-~ ABSORPTION FIELD ~ No,~ Bedrooms: Phone: ~ y ~ _ ~ ~ ~ [ ~ Deep Trench ~ Shallow Trench ~Bed D Mound ~ Other Total Depth from original grade: LEGAL DESCRIPTION SoilRating: ¢./ 7 GPD/Sq, Ft. ~ /~0 Lot: ~ ~ Block:~, ~ ~ ~.Subdiv~i°n'~' ~[ ~ ~ Depth to pipe.~_~bottom Iromjl original grsds: Ft. Gravel deptho~_~beneathl/pipe Ft~  Fill added ~bove original grade: Gravel length: Township:[ ~- ~ Range: ~ b~ SectiOn:/~-- ~.- ~ "~V~¢- ~¢-d Ft. ~--,~- / FL Number of lines: Distance between lines: WELL: ~ New ~ Upgrade Gravelwidth:¢¢ Ft. .¢ 6i~Ot( Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: ~ ~ Ft. Ft. /i/00 SQ. Ft. t~ ~ ~¢~ [~ Driller: Date Drilled: StaticWater Level: Installer: Date installed: Yield; Pump Sei at: Casing Height Above Ground: TAN K GPM Ft. Ft. DISTANCES ~s~.tic ~ ,o~in¢ ~ SEPARATION TO Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Slation Tank SewerLines ~/~ ~ ~- ~[~i1~ /( ,~--~ 0 ~ ~ ,. -- Materiah Number of Compartments: su~c~ ~ LIFT STATION Water ~ ~ ~ LOt ~ . Size in gallons:t Manufacturer: Foundation ~ ~ ,~ ~ ~ ~ "Pump on" level at: "Pump off" level at: High water alarm at: i Curtain ~ .~- ~ ~- ~ Pump Make & Model Electrical Inspections performed by: Drain Remarks: BENCH MARK Location and Description: Assumed Elevation: [oO~O0 Inspections performed by: Dates: 1st 7-2/~/ - ~ ~ % Marvin E. Browueh ~ ~ % CE 5936 Department of Health and Human Services approval -t;'ea:" ........ Reviewed and approved by: Date: 72-013 (Rev 9/91) MOA 95 Permit No. .¢ W' ~/! ©1 2~ .~ Page Municipality of Anchorage 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 LegalDescription: 5¢c. t,F/ -r / 2_, /t,// ¢,.3 ¢~', 5/'1 PIDNo.: O/&-//¢'/.~ _ / / / / / / t / / / J Permit No. 5~/ ~ll o! ~,5~ Page ,_.R of ,~, Municipality of Anchorage 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 LegalDescription: 5F-c. 15'/ T-/8,f/¢ I~w~ ,~,,,vl PIDNo.:_OIS'-I/ag.~, £~ CV, ~ I t,Vv. -- | r_.cu, ~ 3.5" (~ ROU,q b gO' 72-013 A (1/93) TECH.NICAL,..SER IC:ES CIVIL & ENVIRONMENT/d, ENGLNEERING · ENERGY CONSERVATION & ANALYSIS TI{EODORE F. MOORE, P.E. May 27, 1991 PH: (907) 345.1355 14530 ECHO ST. ANCHORAGE, ALASKA 99516 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dear Sirs: The purpose of this letter is to provide the required design narrative to accompany our permit application to upgrade the wastewater disposal system serving Lot 4A O'Malley Heights S/D to a 5 bedroom rating. Soils logs, a site plan, design drawings and specifications are enclosed for your review. Since tlie existing seepage pit is failing, the proposed project is for a totally new septic system. Test hole #2 is representative of the conditions in the proposed soil absorption bed. Since the measured percolation rate in the designated absorption stratum is faster than 1 minute per h~ch, a 2' thick sand filter is incorporated in the design and the bed area is based on 0.7 gpd/sq, ft. per code. For this 5 bedroom residence the required area is (5 x 150)/0.7 = 1072 squm'e feet, which is accomplished with an 18' x 60' soil absorption bed. Due to constraints imposed by the available space, this is a better configuration than would be achieved with a 15' wide bed. The replacement site is designated on the site plan and the size is based on tlie measured perc rate of 2.3 minutes per inch in test hole #3, which translates into a required area of (5 x 150)/0.8 = 938 square feet. This can be achieved by a bed having a width of 22 feet, and an average length of 43 feet configured as shown on the site plan. Tlie topography in the proposed soil absorption bed site is a shallow depression, which will be largely filled by construction of the proposed bed. Special care will be taken to ensure that there will be no depression remaining over the bed, and that surface ch'ainage can make it's way around the end of the bed. The site plan shows the location of all known wells and septic systems within 200 feet of the proposed project. The proposed project will have no impact on existing or future water and wastewater systems on adjoining lots, or on reserved space/surface and subsurface. By filling a small depression, there should be an improvement of surface drainage patterns on the subject lot. Sincerely, Ted Moore, P.E. Flattop Technical Services 14530 Echo Street, Anchorage, AK 99516 Phone (907) 345-1355 Lot 4A O'Malley Heights S/D 10600 Pacer Place Wastewater disposal system installation Specifications 1.0 General: '1.1 The scope of the project includes abandonment of an existing septic tank and seepage pit and installation of a new 1500 gallon septic tank followed by an 18' x 60' soil absorption bed incorporating a sand filter. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations from these drawings may he allowed or required by the engineer conducting the inspections. All construction procedures and material specifications shall conform with Municipal and State requirements. 1.3 All separation distances shall be in conformance with Municipal requirements, unless specifically waived. 1.4 The contractor shall be responsible to obtaiu any necessary utility locates, and to work around any buried utilities. 2.0 Septic Tank: 2.1 The existing leaking 1000 gallon concrete septic tank is to be properly abandoned by pumping, removing, crashing if possible, and burying the remains in the old seepage pit. The seepage pit is to be pumped and then completely filled with clean soil around the remains of the old septic tank. 2.2 The new 1500 gallon septic tank shall be Municipally approved with a minimum of two compartments, and shall be set level on undisturbed soil. Each compartment shall be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buried less than 4 feet, it shal/be insulated with 2 inches of approved burial type, rigid insulation. 2.3 All pipe connections to the tank shall be equipped with waterpr6of mechanical couplings. The waste line from the residence to the septic tank shall have a minimum slope of 1/4'" per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A cleanout shall be installed within 5 feet of the building foundation, and a double cleanout shall be installed within 5 feet downstream of the septic tank. 3.0 Soil absorption system: 3.1 The soil absorption system shall be constructed by excavating the sm'ficial soils from the entire 18' x 60' bed area to a depth of approximately 6 feet in the vicinity of test hole #2 to expose a coarse gravelly sand stratum. The bottom of the excavation shall be level, however the native gravelly sand may be graded as necessary to achieve this level surface. A minimum of 2 feet of pit run filter sand shall be placed on the top of the bed bottom to achieve another level sm~face approximately 4 feet below the original ground surface. Sand for leveling or serving as filter material shall comply with Municipal specifications. 3.2 A total of 12 h~ches of approved sewer gravel shall be placed on top of the filter sand layer. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.3 The 4" diameter perforated and non-perforated distribution pipes shall be buried level in the sewer gravel in the configuration shown on the design drawings such that the inverts of the distribution pipes are no less than 6 inches higher than the bottom of the sewer gravel. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending througli the sewer gravel shall be perforated. 3.5 Approved filter fabric shall be placed over the entire top surface of the sewer l~ravel before backfill with unclassified soil. The cover material shall be mounded an average of 3 feet higher than the original ground. The top sm~face of the cover material shall be sloped down towards the south from the edge of the existing driveway at approximately 5% across the top of the bed, with a 3:1 fill slope beyond the edge of the bed. The resultant low point south of the bed shall be graded to drain around the east end of the bed. 4.0 Inspections: 4.1 A total of 5 engineering inspections will be required during the course of the project: (1) initial stakeout with the contractor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it is level and at the fight elevation, and conforms with the soil test information, (3) after the sand filter material has been placed, (4) after the sewer gravel is in place and the disu'ibution pipes have been laid and connected up to the septic tank, but prior to placement of insulation or filter fabric, and (5) ffter final backfill and grading is complete. The septic tank requires one inspection after it is set level and the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently far in advance to ensure the availability of the engineer. ~'~: II ,c_ ~ _l_J' oF BEb ~ F I~-rER . SECTION Flattop Technical Services 14530 Echo Street Anchorage, Alaska 99518 LOT kA dMALLE'/ SOIL ABSOP-,?TION BED PLAN ¢ CRoss ~7 OS I DR, W~A'f Tom Fink, Mayor J unicipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Ataska 99519-~650 343-4744 July 30, ].992 John F. & Dorothy S. Sahfeld 10600 Shelburne Road Anchorage, Alaska 99516 Subject: Lot 4A O'Malley Heights Subdivision Permit ~SW910125, PID ~015-112-43 The subject permit, issued June 3, 1991 by this office for a single family well and/or on-site wastewater system, has expired as of June 3, 1992. A new permit must be obtained from this office for a well and/or on--site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $200.00 for an on-site wastewater permit; $75.00 for a well permit and $275.00 for a combined on-site wastewater and well permit. If you have any que?$ions, Si~erely,~ ~ please call 'this office at 343-4744. enc: Copy of Permit 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 NUMBER:SW910125 DESIGN ENGINEER:FLATTOP TECHNICAL SERVICES OWNER NAME:SAHLFELD JOHN F & DOROTHY S OWNER ADDRE~6--~ SHELBURNE RD ANCHORAGE, AK 99516 DATE ISSUED: 6/03/91 EXPIRATION DATE: 6/03/92 PARCEL ID:01511243 LEGAL DESCRIPTION: 0 MALLEY HEIGHTS LT 4A SEC. 15, T12N, R3W, SM LOT SIZE: 26763 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 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 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: DATE: DATE: ClVfl~ & ENVIRONMENTAL ENGINEERING * ENERGY CONSERVATION & ANALYSIS THEODORE F. MOORE, P.E. PH: (907) 345-1355 May 31, 1991 14530 ECHO ST. ANCHORAGE, ALASKA 99516 Dan Bolles M.O.A. DHHS P.O. Box 19-6650 Anchorage,AK 99519 Dear Mr. Bolles: This letter responds to the concerns you expressed regm'ding our permit application to upgrade the wastewater disposal system on lot 4A of O'Malley Heights S/D. (1) The "driveway" overlying the proposed replacement site is really no more than a wide spot where vehicles can be parked adjacent to a secondary driveway access to the house. This can easily be eliminated at the time the replacement site is needed, m~d additional parking area could be created over the then abandoned primary soil.absorption bed, if needed. (2) According to the owner of the property, and as verified by our site inspection, the house is a single family dwelling only. There is only one kitchen, which is located in the upstairs portion of the building, and an interior stairway provides for unimpeded access throughout the house. The garage is accessed only by going through the lower floor of the house. I trust this information will resolve your concerns. cc: John Sahlfeld Sincerely, Ted Moore, P.E. ~ & ~V~O~ ~~ · ~¥ ~0~$~¥~0~ & ~¥S~ TItEODORE F. MOORE, P.E. May 27, 1991 14530 ECHO ST. PH: (907) 345-1355 ANCHORAGE, ALASKA 99516 M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dem' Sirs: The pm'pose of this letter is to provide the required design narrative to accompany our permit application to upgrade the wastewater disposal system sel, ing Lot 4A O'Malley Heights S/D to a 5 bedi'oom rating. Soils logs, a site plan, design di'awings and specifications m'e enclosed for your review. Since the existing seepage pit ~s failing, the proposed project is for a totally new septic system. Test hole #2 is representative of the conditions in the proposed soil absorption bed. Since the measured percolation rate in the designated absorption stratum is faster than 1 nfinute per inch, a 2' tlfick sand filter is incorporated in the design and the bed area is based on 0.7 gpd/sq, ft. per code. For this 5 bedi'oom residence the required area is (5 x 150)/0.7 = 1072 square feet, which is accomplished with an 18' x 60' soil absorption bed. Due to constraints imposed by tile available space, this is a better configm'ation than would be achieved with a 15' wide bed. The replacement site is designated on the site plan aud the size is based on the measured perc rate of 2.3 minutes per inch in test hole #3, which translates into a requh'ed area of (5 x 150)/0.8 --= 938 square feet. This can be achieved by a bed having a width of 22 feet, and an average length of 43 feet configm'ed as shown on the site plan. The topography in the proposed soil absorption bed site is a shallow depression, which will be largely filled by construction of the proposed bed. Special cm'e will be taken to ensure that there will be no depression remaining over the bed, and that surface di~ainage can make it's way m'ound the end of the bed. The site plan shows tile location of all known wells and septic systems within 200 feet of the proposed project. The proposed project will have no impact on existing or future water and wastewater systems on adjoining lots, or on rese~wed space/surface and subsurface. By filling a small depression, there should be an improvement of surface drainage patterns on the subject lot. Sincerely, Ted Moore, P.E. o ~o o r~ fi% ~)F~PT H OF £~¢cAvATto M ~qECTION A-A sc~L~: Flattop Technical Services 14530 Echo Street Anchorage, Alaskct 99516 LOT q,A O'MALLE",/ 14E~4HT% SOIL ABSOR?T~ON BED PLAN ¢ CRoss ssc-r~oN ScAL~' A~ Uo~r~b Dh/t4 ~y: ~ Flattop Technical Services 14530 Echo Street, Anchorage, AK 99516 Phone (907) 345~1355 Lot 4A O'Malley Heights S/D 10600 Pacer Place Wastewater disposal system installation Specifications 1.0 General: 1.1 The scope of the project includes abandonment of an existing septic tank and seepage pit and installation of a new 1500 gallon septic tank followed by au 18' x 60' soil absorption bed incmporating a sand filter. 1.2 Construction shall be as depicted on the approved site plan and design drawings. Minor deviations fi'om these drawings may be allowed or requked by the engineer conducting the inspections. All construction procedm'es and material specifications shall conform with Municipal and State requirements. 1.3 All sepm'ation distances shall be in confonnm~ce with Municipal requkements, unless specifically waived. 1.4 The contractor shall be responsible to obtain any necessary utility locates, and to work m'ound any buried utilities. 2.0 Septic Tank: 2,1 The existing leaking 1000 gallon concrete septic tank is to be properly abandoned by pumping, removing, crushing if possible, and burying the remains in the old seepage pit. The seepage pit is to be pumped and then completely filled with clean soil m'ound the remains of the old septic tank. 2.2 The new 1500 gallon septic tank shall be Municipally approved with a minimum of two compartments, and shall be set level on undisturbed soil. Each compm'tment shah be equipped with a watertight manhole cover and a 4" cleanout. If the tank is buffed less than 4 feet, it shall be insulated with 2 inches of approved burial type, rigid insulation. 2.3 All pipe connections to the tank shall be equipped with wate~pr6of mechanical couplings. Tlie waste line from the residence to the septic tank shall have a minimum slope of 1/4'" per foot, and the waste line between the tank and the soil absorption system shall have a minimum slope of 1/8" per foot. A cleanout shall be installed within 5 feet of the building foundation, and a double cleanout shall be installed within 5 feet downstream of the septic tank. 3.0 Soil absorption system: 3.1 The soil absmption system shall be constructed by excavating the smiicial soils from the entire 18' x 60' bed area to a depth of approximately 6 feet in the vicinity of test hole #2 to expose a com'se gravelly sand stratum. The bottom of the excavation shall be level, however the native gravelly sand may be graded as necessary to achieve this level surface. A minimum of 2 feet of pit run filter sand shall be placed on the top of the bed bottom to achieve another level sta'face approximately 4 feet below the original ground surface. Sand for leveling or serving as filter material shall comply with Municipal specifications. 3.2 A total of 12 inches of approved sewer gravel shall be placed on top of the filter smad layer. Sewer gravel shall be 0.5" - 2.5" screened gravel, with less than 3% passing the #200 sieve. 3.3 The 4" diameter perforated and non-perforated distribution pipes shall be buried level in the sewer gravel in the configuration shown on the design drawings such that the inverts of the distribution pipes are no less than 6 inches higher than the bottom of the sewer gravel. 3.4 Monitor tubes and cleanout pipes shall be of 4" diameter and installed in the locations shown on the design drawings. The portion of the monitor tube extending through the sewer gravel shall be perforated. 3.5 Approved filter fabric shall be placed over the enth'e top surface of the sewer gravel before backfill with unclassified soil. The cover material shall be mounded an average of 3 feet higher than the original ground. The top surface of the cover material shall be sloped down towm'ds the south fi'om the edge of the existing driveway at approximately 5% across the top of the bed, with a 3:1 fill slope beyond the edge of the bed. The resultant low point south of the bed shall be graded to drain around the east end of the bed. 4.0 Inspections: 4.1 A total of 5 engineering inspections will be required during the course of the project: (1)initial stakeout with the conu'actor to establish the location of the system and to discuss the plans, specifications and construction procedures, (2) after the native material has been excavated to expose the infiltrative surface to ensure that it is level and at the right elevation,.,and conforms with the soil test information, (3) after the sand filter material has been placed, (4) after the sewer gravel is in place and the distribution pipes have been laid and connected up to the septic tank, but prior to placement of insulation or filter fabric, and (5) after final backfill and grading is complete. The septic tank mquh'es one inspection after it is set level m~d the piping connected, but prior to backfill. This inspection may be incorporated with any of the above inspections. 4.2 The installer shall coordinate the timing of the inspections with the engineer sufficiently fa' in advance to ensure the availability of the engineer. PE"PORMEO PeR= dO,IN LEGAL DESCRIPTION: 1 2 3 4 5 6 P~Rc 7 5k/ 'TE~T 8 g 10 11 12 13 14 15 16 17 18 19, 20- COMMENTS Flcdf'o? Tecta. ri:leal Servlces 14830 Ec:b,o Stz'eet Municipality el Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST ¥/t O'I'tALL¢¥ SM/ML SILT"~ UI:=-NSELV C,_. OHPACTE'b WAS GROUND WATER FINE SANb ENCOUNTERED? LIGI-tT CoLoREb IF YES, ATWHAT Township, Range, Section: ~£C I~ SLOPE T ~2 N, SITE PLAN l'{°~) 5[:' [ / ,),// '~.r,'x .sf %)'r.~l, #2 Tdl~1 DEPTH7 ~./~, Deplh tO Waler Allsr 1~/ l~. g,L. Monitoring? DR~ Dale: S/13/~t I Reading Date Gross Time N2o 2~3~:3' ~3 2',37:3 N=O 2;33:0 Net Depth to Net Ti,ne ~,,1~ Water Drop ___ 2"/ 3,/8 __ PERCOLATION RATE I .~ (n,,nums/mch) PERC HOLE DIAMETER '7 ~"L" TEST RUN BETWEEN ~ o FT AND '7.. 5' _ FT .... CLIIIIty 'INA1 ]HIS ]ES'I WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS D/,,;! DATE: ,5'-'/ ~-- ~/'¢/~_ 72-008 (Rev. 4/85) Pla[top Techn~caI Services 14530 Echo Street Anchorage, .Alar.;ka 9951fi Municipality ol Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOII..S LOG -- PERCOLATION TEST T. tt. PERFORMED POR: d0~ LEGAL DESCRIPTION: PT 1 2 3 4 GM 5 6 7 8 9 10 ~,~, 12 13~ 14 15 16 : 17 18 19 20 COMMENT8. ~-/I ~',[ tce~/__~t_o/¢ O'M/iLL£V NT5 BEbDi$Iq ~/INb"/ LottM 'T~'AN S~TIoN lNG TO 1AL SP/6p ¢OARCJE ¢I~AV£LLV SANb Township, Range, Section: ~;EC I~.~ T 12 SLOPE SITE PLAN WASGROUNDWATER ENCOUNTERED? IF YES, AT WHAT DEPT~ ~,/~, o ~'6" ~.6,L, Depth to Water AIler 5'/l$/~' / Monitoring? _ ~ Data: Gross Time ;s..; =9 :_30 30:30 g',~l ',oo Net -- Depth to Time Ct.A ,N") Water 22 -- 2'-/ ~,~ .2/ PERCOLATION RATE O.~' -- (mmutes/inch) PERC HOLE DiAMETER Net Drop PERFORMEDB¥: ,~'/¢4~t~¢~__~O// .~0'c -- ' -'¢'"f"'-~ ~ (JkI'IIIY'IHA1 'I HIS 'f ES'I WAS PERFORMEO IN ACCORDANCEWITHALLSfATEANDMLiNiCiPALGUiDELiNESiNEFFECTONTNiSDAfE. DATE: _..~4-~.~--~/'9/ 72-008 (Rev. 4/85) Flattop Technical Services 14530 Echo Street ,~-choraqe, Alaska 99516 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST T.I-f. ~ 3 "ERFO.MED EOR: dOI41q LEGAL DESCRIPTION: LOT LILA O' Mt~ZL£V 1 2 3 4 5 6 7 8 SP/sM REDDISH ~lcT't SA N b'-/ LoAb'~ DR't. ~AN'.t COBBLES ANb 8OuL DEP.~, 9 10 ~o~,~E COBRLE~ 11 12 13 14 15 '~LI~HTL"{ CLEANER h~b Loose. R 16 lZ 18.- 19 -- 20 ,eTC.. Mr Al/ % ~%THEODOR[ ~, MOORE.. DATE PERFORMED: ~/~] Township, Range, Section: SEC I~C., 'T 12 N, tT,~k./ SLOPE SITE PLAN WASGROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p E Depth l0 Waler Afler Monitoring? . Reading Date Gross Net Depth to Net Time Time Water Drop I2"FRE¢oA k ~'/2 o~_ II:lz:oo 27y't ..START ti', 2~ Zo 2~ 3/8 +~2© I1~ 2q :Do 2~ ,.. ~2 il: 3q;oo ~ 21 Vq l ~H3o il: 3~', 3o 23 S/~ ~3 II; 39:30 E 2~ ?~ 2 3~, *H~O IF, qo :oo 23 S/~ PERCOLATION RATE (minulos/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~.~' FTAND ~, ~' _FT COMMENTS ,fl,,[¢_._ CEllllr Y 'IHA1 1 HIS 1 ESI WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THiS DATE. DATE: . 72-008 (Rev. 4/85) GR-"TER ANCHORAGE AREA BOROU";t D,~.~RTMENT OF ENVIRONMENTAL QUALI~ , 3500 TUDOR ROAD ANCHORAGE!, ALASKA 99507 279-8686 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME -/z. J:~, 'S,'??/j/-/ LOCATION ~f~?~-.,c//,~: OL? SEPTIC TANK: MAILING ADDRESS LEGAL D E S C R I P TI O N _/~-' ?'_~-'"/ DISTANCE FROM WELL_. LIQUID CAPACITY _GALLONS. MATERIAL INSIDE LENGTH NUMBER OF /~%.~.)//~.~ '., ;~/~_ C OM P A R TM E N T S / LIQUID INSIDE WIDTH DEPTH ~ SEEPAGE SYSTEM: SEEPAGE PIT: NUMBER OF PITS / LINING MATERIAL /~.~/~(-'~ ~'~/-)1('~ NEAREST LOT LINE "~('J ~ O~JTSIDE DIAMETER ..... OR WIDTH /"~ DISIANCE FROM WELl TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA) , LENGTH_ /-~z , DEPTH (~ BUILDING FOUNDATION ,2~ ~' ~ ("? SQ. FT. TILE DRAIN FIELD: DISTANCE FROM WELL NUMBER OF LINES___ ABSORPTION AREA.__ DEPTH: TOP OF TILE~E~'F'INISH GRADE , FOUNDATION_ , NEAREST LOT LINE DISTANCE BETWEEN LINES_ _. ~- -~' TRENCH WIDTH SQ.~ FT'. LENGTH OF EACH LINE DEPTH OF FILTER MATERIAL BENEATH TILE TOTAL LENGIH OF LINES __ IN. TOTAL EFFECTIVE IN. ABOVE TILE WELL: TYPE LOT LINE ,:, 7 I~£///~;/) , DEPTH ') ) c)' DISTANCE FROM . ' WATER ..... , BUILDING FOUNDATION. _~) ~',"~__SAMPLE_ ., NEAREST NEAREST , SEPTIC , SEEPAGE ~ ~ OTHER ,.'L;r: , SEWER LtNE~/6~() _,TANK /().0 , SYSTEM~_ /L/J(;" , CESSPOOL /' r'X.: , SOURCES DISTANCES: /z~/' '1~ ~1~. GREA,ER ANCHORAGE AREA BORuUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3500 TUDOR ROAD POUCH 6-650 ANCHORAGE. ALASKA 99502 TELEPHONE 279-8686 SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT NAME OF APPLICANT /\ ' INSTALLATION LOCATION INSTALLATION OF: SEPTIC TANK TYPE AND SIZE OF FACILITY TO BE SERVED COMPLETION DATE ANT'CIPATED - ,// PHONE SEEPAGE Pit , DRAIN FIELD , OTHER TO B~ INSTALLED BY "' / ~/'-~ NOTE= THIS PERMIT IS NOT VALID WITHOUT SOIL TES? FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. ,LING OF ANY SYSTEM WITHOUT FINAL INSPEC, TION BY THE HEALTH DEPARTMENT AUTHORITY WILL BE SUBJECT TO ~SEC*UTION, MINIMUM DISTANCES, REQUIREMENTS FOUNDATION TO SEEPAGE PIT ~ ~ , DRAIN FIELD SEPTIC TANK TO SEEPAGE PIT WALL /'~¢ / TO NEAREST LOT LINE. WELL TO SEPTIC TANK ~-'~ DRAIN FIELD WATER MAIN TO SEPTIC TANK DRAIN FIELD SEPTIC TANK, . SEEPAGE PIT TO RIVER, LAKE, STREAM. SEEPAGE PIT ALSO CONSIDER AREA WELLS. SEEPAGE PIT DRAIN FIELD CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIE~ CROSSING GAP OF EXCAVATION 5 FEET INTO UND[STURSED SOIL. 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLe CAPS. GRAVEL BACKFILL CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. DIAGRAM OF SYSTEM DESCRIBED SYSTEM IS IN, ACCORDANCE WITH SAID CODE. MunicipalityofAnchorage REQUESTFOR¥OUCHER CHECK Health & Human Services FROM: (DEPARTMENT) TO: MUNICIPAL CONTROLLER DATE: September 26, 1995 .37488 THIS SECTION FOR ACCOUNTS PAYABLE USE ONLY 109§ VOUCHER NO. PAYMENT DT. I V VENDOR NO. REFERENCE NO. INVOICE DATE ' INVOICE NO. ;CHECK NO, cHEcK DATE PREP APPR 1. REQUEST THAT A MUNICIPALITY OF ANCHORAGE CHECK BE ISSUED TO: Name John Sahtfeld 14721 NW Orchad Dale Road Address Forest Grove, Oregon 97116 2. THIS PAYMENT IS FOR THE FOLLOWING (SUBSTANTIATION ATTACHED): Lot 4A O'Malley Heights Subdivision He&lth Authority Approval was applied for~ however, the p~operty did not sale and this office did not perform any review of the HAA. Request that a refund be made to the above applicant. The address is a new address for the applicant. 3. DISPOSITION OF CHECK: (1) ~XMAILTO PAYEE (2} [] MAILTOPAYEEW/ATTACHMENT (3) [] NOTIFY PAYEETO PICK UP IN TRi~SURY Name: Phone No.: 4. ACCOUNTS TO BE CHARGED: AUTHORIZED USE ONLY (6) [] NOTIFY DEPARTMENT EMPLOYEE WHEN CHECK IS READY IN FINANCE Org. NO.: - Phone NO.: DESCRIPTION ENTER ALL POSITIONS OF ACCOUNTING DISTRIBUTION Cost Cir, WA/WO AMOUNT 300 3O0 5. TOTAL AMOUNT OF CHECK 6. SIGNATURES ~:fk_L_l_Ct%.._~ Employee 7. INSTRUCTIONS 343-4744 Phone No. Approving Authority a. To be used only when payment cannot be made by purchase order, travel expense report, travel authorization or petty cash. b. Must be approved by department head unless approval authority is delegated in accordance with Policy and Procedure 24-7. c. Retain carbon copy for your file. 40-001 (Rev. 2-/91) MOA #15 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # (~\z~_ \ \,=~_ L\.~ HAA ff 1. GENERAL INFORMATION Complete legal description ~ 4A O'HALr>:¥ ,HE'TGh~S Location (site address or directlons) 10600 PACER Property owner Mailing address Lending agency Mailing address Agent ,u ,¢~J ~ Address '--'~ DOROTI {Y S AHLFELD 10600 P~CJER PL, ~xlCHOlr~%GE / t951 6 __Day phone 346-3871 [::)ay phone ¢7~- '-/~.'5 o )hone /3~ -- Unless otherwise reques:d, HAA, held for pi 2. NUMBER OF BEDROO/MS: ,~_ 3. TYPE OF WATER SUI:/PLY: ("~ Indivi~al/ well _~_? Com?hunity well _ Puyic water NOTE If comthunity well system, provide~writtell confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site x Holding tank Community on-site Public sewer NOTE: 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 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 inves!i~gation 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 ~ Phone 34,1-1335 Address 800 E. D'Z,~~ORAGE, AE 99515 Engineer's signature~ Date ~'-' /,,7. ,,~.~ DHHS sIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments By: Date 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 eng!neer 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. ?2~Y2$(Re~. 1/91) ~ack MOA ~k21 C. LIFT STATION Date installed .... '~-..... Size in gallons Vent (Y/N) High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on Ioi On adjacent lots Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested D. ABSORPTION FIELD DATA Date installed 5/91 ~ LenCh 60' ~L~ Total absorption area _ Dale of adequacy lest Water level in absorption field before lest Peroxide treatment (past 12 months) (Y/N) Soil rating (GPD/Ft2) . o.~/ System type BED Width 18' (~ Gravel thickness 1 ' ~ Total depth 75" / c~ ~ O (~ Cleanout present (Y/N) YES (~ Depression over field (Y/N) _ NO 5-10-95 Resulls (pass/fail) PASS for 5 Bedrooms o.,-/' Atler,est NO If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot 120' ~ To building foundation On adjacent lots 45' Sudace water N/A Cudain drain. N/A On adjacent Iols 120 '+ © Property line 15' ~ To existing or abandoned system on lot 30 ' ~ Cutbank N/A Water main/service line N/A Driveway, parking/vehicle storage area 7' ® E, ENGINEER'S CERTIFICATION I ce/tify th_~lL~ave checked, verified, or conformed to all MOA and HAA guidelines Enginee¢~ame ~ L~/~- Date -~' /~- ~5 Date of Payment ,.~'- - /~" ~ .~ ...... 'inspection. Waiver Fee $ Date of Payment Receipt Number 72-026 f3,;93)' Back Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~ 4A O'MALLEY HEIGHTS Parcel I.D. A. Well Data Well type RS. Log present (Y/N) NO If A, B, or C, attach ADEC letter. ADEC water system number Date completed ?~:. 1972 (~ Driller Total depth 228' Cased to 40'+TM Sanitary seal (Y/N) YES (~ FROM WELL LOG Date of test Static water level N/A Well flow N/A Pump level1 N/A SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot 1 20 Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform 0 Date of sample: 5-1 0-95 B. SEPTIC/HOLDING TANK DATA Date installed 5/91(~ Cleanouts (y/N) YES (~ High water alarm (Y/N) No Date of pumping 8-23-94 /' Pumper // SEPARATION DISTANCES FROM SEPtiC/HOLDING TANK TO: Wires properly protected (Y/N) AT INSPECTION 5-?Iz95,© ~. 'On a0iacent lots 120'+ (D : On adjacent lots 1 20+ (~ Public sewer manho/lle/Cle/anout N/A Petroleum tan~k, N/~ ~e 2.83 ~ Other bacteria ' ~cted by DUSTIN/IGH Tank size / 1500 GA~. / Cor~padmer]tf~.__2 _ Foundationcl/~nout (Y/N) i_z'~S ~,on (Y/N) · / Alarm tested (Y/N) · Well(s) on lot 112' (~ On adjacent lots 110' To property line 4,5' Absorption field 30 Sudace water/drainage 1 DHI ~'%-~?U~D ~ 2~ :3-5 72-026 (3z93)' Fret2 MUNIE P.~CORDS Casing height Y~S g.p.m. No ~> NORTHLAND PUMPING Foundation 8 ' + Water main/service line CONTINUED ON BACK PAGE 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 GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) _L. '/ o' 4AL[. _d Location (address or directions) (b) Applicant NameC¢-~i(. ~¢~.¢' __ Telephone: Home 2¥(2 ~ Ck// Business Applicant Address _ (c) Applicant is (check one): Lending Institution []; Owner/builder []; Buyer [_--]; Other [] (explain); (d) Lending Institution Address (e) Real Estate Company and Agent Address __ Telephone Telephone (f) Mail the HAA to the following address: TYPE OF RESIDENCE Single-Family/~ Multi-Family Number of Bedrooms Other WATER SUPPLY Weli,~ Community ~ Public [] Indiv[d, ual Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL Onsite~ Public[] Community[] Holding Tank[] Note: It 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 5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this I-{ealth 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 insl~ectio~n. Name of Firm Address Date -~----.¢-4~,f.~ ~-~., ,~ ~'"~ Engineer's Seal Approved for ¢/_Z'J_4~'~__.~-, bedrooms by Date Approved 7~ Disapprove~f Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection ([)HEP) issues Health Authority Approval certificates based solely upon tile representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institut'ons in order to sabsf car act ons or ..... ' ' Y rain federal and state requirements. Employees of DHEP do not conduct insp ' ~;ieY~oanata~en~llneee1'°re e certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the ,7.~a~L,:~,~?.~:. - - ; fJ er's work MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST- FEBRUARY 1984 264-4720 Legal Description: 14:T & WELL DATA Well Classification '[~ J]~ Well Log Present (Y/N) _~d~__ Total Depth ¢¢[..~.~. 'K"i'- Cased to Static Water Level ¢~, Casing Height Above Ground Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge ct Absorption Field on Lot _ To Nearest Public Sewer Line Cleanout/Manhole If A, B, C, D.E.C. ApProved (Y/N) Date Completed "'~',~¢~_ I ~ '7~,. Yield ~ /'¢'~ Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ~ Water Sample Collected by '-~"' --¢~ .__; Date Water Sample Test Results Comments ~ ~--~ ; On Adjoining Lots 'l I'-~¢ ; On Adjoining Lots ,~, / ~1-4[~, To Nearest Public Sewer To Nearest Sewer Service Line on Lot .~ ~ ~.) B. SEPTIC/HOLDING TANK DATA Bate Installed Standpipes (Y/N) _ Depression over Tank (Y/N) Size /~-~ No. of Compartments ~'~ Air-tight Caps (Y/N) y Foundation Cleanout (Y/N) -[~( Date Last Pumped 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 ~ ~;,~ ~ To Water Main/Service Line Course Temporary Holding Tank Permit (Y/N) ~/'~ To Building Foundation "7 To Disposal Field ,,'~ ~ To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata /,~ ~ Date Installed 3 tJ ~ ',,/ / ¢ 7 ~ Width of Field /(~ Square Feet of Absorption Area ~t/,,~. 672 Depression over Field (Y/N) Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well //~;~ To Building Foundation Lot Type of System Design Length of Field Depth of Field Gravel Bed Thickness Standpipes Present (Y/N) Date of Last Adequacy Test To Property Line ~ O To Existing or Abandoned System on ; On Adjoining Lots ~' '~:~ O To Water Main/Service Line ~ '/~ To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments To Cutbank (if present) 1',4 otq NoN -/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 ** Check Permitted Bedroom Rating Against HAA Request ** IsiC~ rntief~ that I~~,,~-~ ~ .,~°r conf~rat?d to ~ac~.d ,.~ A/9~i~.~ es in effect on the date of this inspection. ~~ MOA No. Company Receipt No. Date of Payment Amount: $ L~ ,00 ~'~C~;'" %; ;;' E~i~ ~ Seal Page 2 of 2 ~.~ 72-026 (11184) 2.03 W. 15ih AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 RESIDENTIAL WELL INSPECTION LEGAL: LOT 4, O'MALLEY HEIGHTS LOCATION: 10600 PACER OWNER: CECIL ROGER TYPE OF WELL: SINGLE FAMILY WELL LOG AVAILABLE: NO INSTALLATION REQUIREMENTS MET: YES WELL YIELD FROM WELL LOG: NOT KNOWN PUMP YIELD: 5.5 GALLONS DRAWDOWN DATE OF INSPECTION: SEPTEMBER 20, ].985 PER HOUR WITH 5 FOOT TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 5.5 GALLONS PER MINUTE WHILE THE DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE. THE STATIC WATER LEVEL WAS FOUND 207 FEET BELOW TOP OF CASING. AT A PUMPING RATE OF 5.5. GPM THE WATERLEVEL STABILIZED AT 212 FEET AFTER 5 MINUTES OF PUMPING. THE WELL WAS PUMPED FOR 2.5 HOURS. 5 MINUTES AFTER PUMPING STUPPED WATER LEVEL WAS BACK TO 207 FEET. TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON SEPTEMBER 17, 1985. TEST WAS NEGATIVE. TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The Municipal requirement for well flow is 150 gallons of water per bedroom per 24 hours. This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flow rate of the well may change due to subsurface condi%ions that may not be observed from the surface, and changes in land use and other factors that may impact the conditions of the aquifer feeding the well. z~03 W. 15th AVE 'C" SUITE 203 ANCHORAGE, ALASKA 99501 TFLEPHONE: (907) 279-3916 SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOT 4, O'MALLEY HEIGHTS LOCATION: 10600 PACER OWNER: CECIL ROGER RESIDENCE: SINGLE FAMLIY, THREE BEDROOMS WATER SYSTEM: ON SITE WELL SEPTIC SYSTEM: FROM MUNICIPAL RECORDS: TANK: ESPINOZA CONCRETE ONE COMP. 1000 GAL. ABSORPTION SYSTEM: LOG CRIB ABSORPTION AREA: 420 SQ. FT. SOIL RATING: 128 INSTALLATION DATE: JULY i972 DATE OF PUMPING: SEPTEMBER 18,1985,ANCHORAGE CESSPOOL DATE OF TEST: SEPTEMBER 20, ].985 WATER WAS ADDED TO THE CRIB AT A CONSTANT RATE OF 5.5 GALLONS PER MINUTE. THE WATER LEVEL IN THE CRIB WAS MONITORED. A TOTAL OF 770 GALLONS WERE ADDED. THE WATER DEPTH IN THE CRIB WAS 28 INCHES AT THE BEGINNING OF THE TEST.AFTER ADDING 770 GALLONS THE WATER DEPTH WAS 48 INCHES. 17 HOURS AFTER THE TEST WATER DEPTH WAS 36 INCHES. 450 GALLONS HAD BEEN ABSORBED DURING THIS PLRIOD. THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE: FOR A THREE BEDROOM HOUSE. The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and 'the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how long the system will continue to meet the operational requi- rements of the Municipality and State.