HomeMy WebLinkAboutTANAINA HILLS LT 8Tanaino H il Is
Lot 8
#011-051-17
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 Well Inspection Report
Permit Number: S [M~qO/4 ~ PID Number:
~:'~ /~ L P R ~-~ ~ ~G~ Wastewater System: D New ~ Upgrade
Address:
~/~ ~T~ b~, ABSORPTION FIELD
Phone: ~ No. of B~drooms:
~ ~H~ ~DeepTrench ~ Shallow Trench ~Bed ~Mound MOther
LEGAL DESCRIPTION sog ~ati,g:
Lot: ~ Block: Subdivision: Depth to pipe bottom fr6m original grade: Gravel depth beneath pipe
Township: I Range: J Section: Fill added above original grade: Gravel length: ,
Gravel width: Number of lines: J Oislance beJweea lines:
WELL: D New D Upgrade
CIassificagon (Priv~e, A,B,C): Total Depth: Cased To: Total absorption area: Pi~e material:
Date Drilled: SlaticWater Level: Installer:
Yield: Pump Set at' ' Cssing Heigh(Above Ground:
SEPARATION DISTANCES ~s~¢io ~ Holding ~ S.T.~.P.
TO Seplic Absotptlon Lif( Holding Public/P~ivsl(Manufacturer: Capacity in ga[ions:
From Tank Fiel~ Station Tank Sewer Lin
Compadments:
s.,~ LIFT STATION
Curtain J
Drain ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ Pump Make & Model Electrical inspections performed by:
Remarks: BENCH MARK
Location and Description:
J Assumed Bevation:
Department of Health and ~uman Services approval
Reviewed and approved by: Date:
72-013 (Rev. 9/91) MOA 25
SENTEC Technical Management Systems Inc.
Monday, September 1 t, 2000
Department of Health and Human Services
Division of Environmental Services
Anchorage, Alaska 99519-6650
Ph: Fax:
2102' Cleveland Street
Anchorage Alaska 99517
Phone (907) 243~969
Fax (907) 243-9967
W.O,#: 99428
ATTN: Dan Ruth
RE: Hogge Septic Upgrade
Mr. Roth
We were finally able to track down the contractor and get a cut sheet from him on the HDPE
septic tank. Carl of Carl's excavating said you should already have a copy of the cut sheet on file
but we've included another copy(See attached). Summary of responses to Questions:
1, The PVC pipe was Sched 30 SDR3034
2. Separation of 74' private sewerline to Well indicated on sht 1of I
3. Manufacturer of Septic Tank See Attached
4. Edge of Drainfietd to lot line is 10' as labeled on the drawing.
5. Mulligan
6. Total depth is not deeper than the designed 11 feet below original grade. Fill was bermed
above original grade at places to increase frost protection,
Please call me if you have any further questions.
, $incere~~
'¢, Pu~am
RECEIVED
SEP i 1 2000
I~IUNIcIPALITY OF ANCHORAGE
ENVIRONMENTAL SERVICES D~ViSION
SENTEC Technical Management Systems Inc.
2102 Cleveland Ave.
Anchorage Alaska 99517
Phone (907) 243-9969
Fax (907) 243-9967
5/15/00
Department of Health and Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, AK 99519-6650
RE: Hogge Septic Upgrade As-Builts L 8 Tanaina Hills Subd.
Sir:
Please find the attached final "As-Built" Drawings for the septic system for the above
property.
If you have any questions, please give me a call.
Sincer ly, ///
Permit No.
Municipality of Anchorage
Department of Health and Human Services
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 ' Anchorage, AK 99519-6650 ° Tel: 343-4744
0n-SiLe WasLewaLer Disposal SysLem/Well InspecLion
Legal Description: LOT 8 TANAINA HILLS 8UBD.
Page / of ~'_
W.O. 99428
Date 5/15/00
ReporL
PID No.(bll_.os/. /'?
DATE
TBM TI
ASSUMEO
NEAR HEAO OF CUL BE-SAC 0
AS-BUILT
EXISTINO 500 GAL. TANK
EXISTING 1000 GAL TANK (Removed) ~
PVC (Ti'P)
DEEP
4" ~PERF
4 BOR- 2 STORY
MONITOR I~BE HOUSE
CALE. 1
Permit No.
0n-SiLe
MunicipaliLy of Anchorage
Department of Health and Human Services
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650' Anchorage, AK 99519-6650' Tel: 343-4744
Wastewater Disposal System/Well Inspection
Page .~.__of 5
W.O. 99428
Date 5/15/00
Legal Description: LOT 8TANAINA HILLS SUBD
Report
PID NO.Dll,.O$I
AS-BUILT ~'GEOTEXT, LE
/ / ~-3'-6" MIN. COVER
jRESTOR EXIST. GRADE AFTER CONSTRUCTION / / ~ AFTER SETTLMENT)
// / ,, 4" CLEANOUT~
/ / / 4" MONITOR TUBE
SEPTIC TANK I x u~.~ I 4 PERF. PVC
98.26
RIDGID INSULATION
FABRIC.
SEWER ROCK PER MUNICIPAL
SPECS. SEE NOTE 10
(~) TYPICAL SECTION
NTS
89.9'
(~TYPICAL END SECTION
(NT~}
Permit No.
Municipality of Anchorage
Department of Health and Human Services
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650' Anchorage, AK 99519-6650' Tel: 343-4744
On-Site Wastewater Disposal System/Well Inspection
Legal Description: LOT 8 TANAINA HILLS SUBD PID No.
Page
W.O.
Date
")
99428
6-9-99
Report
NOTES:
7
8
9
10
11
12
15
14
1
2
3
4
ALL CONSTRUCTION SHALL BE IN ACCORDANCE WITH CHAPTER 15.65. WASTEWATER DISPOSAL REGULATIONS
OF THE MUNICIPAL CODE AS CURRENTLY AMENDED.
SITE TOPOGRAPHIC SURVEY CONDUCTED ON 6/2/99. EXISTING STRUCTURES SHOWN ON SITE PLAN
ALL LOTS IN SUBDIVISION SERVED BY INDIVIDUAL WELLS
ANY DEVIATION FROM THE DESIGN MUST BE AUTHORIZED BY THE ENGINEER PRIOR TO ITS INCORPORATION
INTO THE SYSTEM.
CONTRACTOR TO LOCATE ALL UNDERGROUND UTILITIES, PROPERTY LINES, EXISTING WELLS, WATER WAYS,
SURFACE AND SUBSURFACE DRAINAGE FACILITIES, LAKES, PONDS, AND OTHER FACILITIES REQUIRING
SEPARATION DISTANCES FROM THE PROPOSED SEPTIC SYSTEM. NOTIFY THE ENOINEER OF ANY OBSERVED
CONFLICTS PRIOR TO CONSTRUCTION.
NOTIFY THE ENGINEER 24 HOURS PRIOR TO COMMENCING WITH CONSTRUCTION. A MINIMUM OF THREE
INSPECTIONS ARE REQUIRED. THE FIRST INSPECTION SHALL BE OF THE SUBGRADE, PRIOR TO PLACING
SAND FILETER. THE SECOND INSPECTION SHALL BE AFTER THE PLACEMENT OF GRAVEL, DISTRIBUTION
PIPING, STANDPIPES, TANK, AND OTHER COMPONENTS AS SPECIFIED. THE THIRO INSPECTION SHALL BE
AFTER THE WORK IS COMPLETED.
CONTRACTOR SHALL DELIVER TO THE ENGINEER A SET OF RED-LINEO, AS-BUILT DRAWINGS SHOWING ALL DATA
AS SPECIFIED IN SEC. 15.65.F.2, 3, 4, 5, 6 OF MUNICIPAL WASTEWATER DISPOSAL CODE WITHIN TEN DAYS OF
THE FINAL INSPECTION. INVERTS AND SWING TIE LOCATES SHALL BE TO THE NEAREST TENTH OF A FOOT. THESE
AS-BUILTS SHALL BE USED TO DOUBLE-CHECK THE ENGINEER'S INFORMATION PRIOR TO SUBMITTAL TO DHHS.
STAKE ALIGNMENT OF SYSTEM WITH MARKERS SHOWING THE PROTECTIVE DISTANCES FROM WELLS AND
OTHER BODIES OF WATER PRIOR TO BEGINNING INSTALLATION.
ALL EXCAVATION DEPTHS ARE ADVISORY. THEY ARE TO BE VERIFIED AND MAY BE MODIFIED BY THE
ENGINEER.
EXCAVATE THE ABSORPTION FIELD. BOTTOM OF EXCAVATION SHALL BE FREE OF ORGANICS AND SCARIFIED.
RECORD ELEVATIONS AT BEGINNING, MIDDLE, AND END OF BED BOTTOM. CONSTRUCTION EQUIPMENT SHALL
NOT OPERATE ON THE FLOOR OF THE EXCAVATION. ANY MATERIAL COMPACTED BY THE OPERATION OF
THE CONSTRUCTION EQUIPMENT SHALL BE REMOVED AND REPLACED WITH UNCOMPACTED MATERIAL.
PLACE THE SEWER ROCK TO THE SPECIFIED DEPTHS. DO NOT CONTAMINATE ROCK WITH NATIVE MATERIALS OR
SPOILS FROM EXCAVATION. LEVEL ROCK SURFACE TO ± 1" PRIOR TO INSTALLINO THE PERFORATED PIPE.
ALL PIPE SHALL BE PVC CONFORMING TO ASTM D3034 OR ENGINEER-APPROVED EQUAL.
GEOTEXTILE SHALL BE MIRAFI 140S OR ENGINEER-APPROVED EQUAL. LAP ALL JOINTS 2' MIN.
MATERIAL USED AS FILL SHALL BE CLEAN AND FREE OF ORGANICS, TRASH AND CONSTRUCTION DEBRIS.
SLOPE ALL FILL MATERIAL TO BRAIN AT 2% MIN. SLOPE, AND .3:1 MAX SLOPE, AND IN SUCH A MANNER THAT
PONDINO AT OR NEAR THE DRAIN FIELD DOES NOT OCCUR. THE FILL SHALL BE LEFT AT 6" HIGHER THAN
SHOWN TO ALLOW FOR SETTLEMENT. SEED SURFACE AFTER COMPLETING INSTALLATION AS PER MUNICIPAL SPECS.
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street. Anchorage. Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
DATE PERFORMEI
LEGAL DESCRIPTION~
1
2
3
4
5-
6-
7-
8-
9-
10-
11
12
13
14
15
16
17
18
19
20
COMMENTS
,L ,.~ ? ~ '~y~, ,t/.?] ].~V,.<{ /-:/Z '2. ~:Towns ~ p Range, Section:
WAS GROUND WATER
S
IF YES. AT WHAT ~,,// L
DEPTH? /..~ pO
./
E
Deplh lo Waler AReF
Monilorifl9?
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE .
TEST RUN BETWEEN .
~ ~ (mJnules/mchJ PERC HOLE DIAMETER
~ FT AND 7 FT
PERFORMED BY: ~/'~;~-/~ ~-~/"-,~¢ ~/'~/~ I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
Municipality o! Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502~0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR: f~.. A l.. ~ J'~ )~ ~'~ ~.'~' ~ ~ DATE PERFORIV
..,, , ~
LEGAL DESCRIPTION: ~L,~'T' 8 -~'A>-~ .~ i.;') J:' i2)~-L ./') Township, Range, Section: 7' /P-...,~/ ,,~ .... .b~:~' C ?)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
COMMENTS
S~
5P
SLOPE SITE PLAN
WAS G.OUND WATER /"/0 '
ENCOUNTERED?
S
L
IF YES, AT WHAT /ty///~ pO
DEPTH?
E
Deplh to Water After
Monitoring?' ~/~,Li ~ Date:
Gross Net Depth to Net
Reading Date
Time Time Water Drop
PERCOLATION RATE /-~ (minutes/tach) PERC HOLE DIAMETER __
TEST RUN BETWEEN £J ' FT AND G ) FT
PERFORMED SY: ~'~ )'~¥i*,~'' -I ) ~',Z ?e~ /~,~% I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCEWITHALLSTATEANDMUNICIPALGUIDELINESINEFFECTONTHISDATE. DATE: ./~,//+~/~, ~
72-008 (Rev. 4/85)
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jun 17, 1999
Expiration Date: Jun 16, 2000
Permit Number: SW990147
Legal Description: TANAINA HILLS LT 8
Design Engineer: 0076 SENTEC, Inc.
Owner Name: Ralph Hogge
Owner Address: 7100 KITLISA DRIVE
ANCHORAGE , AK 99502-1825
Parcel ID: 011-051-17
Site Address: 007100 KITLISA DR
Lot Size: 48266 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
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.
Date:
SENTEC Technical Management Systems Inc.
7801 E. 36th Ave. Suite A
Anchorage Alaska 99504
Phone (907) 333 6881
Fax (907) 333 1085
June 9,1999
Department of Health and Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, AK 99519-6650
RE: Hogge Septic Upgrade Approval L 8 Tanaina Hills Subd.
Sir:
Please find the attached application an upgraded drain-field system for the above
property.
DESIGN NARRATIVE
The original well and septic system were installed on this lot in 1981. The owners
report that the existing field is not absorbing the sewage of the family. The proposed
upgrade field will be located near the existing field and tie into the existing tank outlet
with a field switching valve that will allow the existing field to be used after a rest period.
No additions or improvements are planed for the house. Lots in this subdivision are
one acre plus in size. Adjacent septic systems are greater than 200 ft from the
proposed field. The proposed improvements will have no negative affects on
surrounding wells or septic systems. There will be no affect to drainage in the area, all
water bodies and streams are greater than 200 fi away. There is adequate space on
the lot to allow for an alternate drain field.
If you have any questions, please give me a call.
Sincerely,
Permit No.
MunicipaliLy of Anchorage
Department of Health and Human Services
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650' Anchorage, Al< 99519-6650' Tel: 343-4744
0n-SiLe WasLewa[er Disposal SysLem/Well Inspection
Legal Description: LOT 8 TANAINA HILLS SUBD. PID No.
Page of
W.O. 99428
Date 6-9-99
Report
EXISTING
DRAINFIELD
]BM
ASSUMED
. NEAR HEAD OF CUL-DE-SAC 0
EXISTING 1000 GAL
:4 BDR- 2 STORY
MONITOR ~JBE HOUSE
DRAIN FIELD
4 BDR=> IOOOSF
XSO'LONO=1280SF
4" PERF
CALE: 1" : 20' ~
Permit
On-Site
Legol
Municipality of Anchorage
Department of Health and Human Services
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 ° Anchorage, AK 99519-6650 ° Tel: 343-4744
Wastewater Disposal System/Well Inspection
Description: LOT 8TANAINA HILLS 8UBD PID No.
PageotLof
W.O. 99428
Date 6/9/99
Report
EXISTING
10OO gol
SEPTIC TANK
RESTOR EXIST. GRADE AFTER CONSTRUCTION
EXISTING
500 gal
SEPTIC TANK
8.5'
TILE FABRIC. SEE NOTE 1.3
3' 6" MIN. COVER (5' 0" MIN.
AFTER SETTLMENT) SEE NOTE 15
4" MONITOR TUBE
4" PERF. PVC
INVERT = 101.00'
SEWER ROCK PER MUNICIPAL
SPECS. SEE NOTE 10
TRENCH BOTTOM 93.00'
(~ TYPICAL SECTION
HOR: 1" = 10'
VERT: 1" = 5'
Pe'rmit No.
On-Site
Municipality of Anchorage
Department of Health and Human Services
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650' Anchorage, AK 99519-6650 ° Tel: 343-4744
Wastewater Disposal System/Well Inspection
Legal Description:
Page ~ of
W,O. 99428
Dale 6-9-99
LOT 8 TANAINA HILLS SUBD
Report
PID No.
NOTES:
7
8
9
10
11
12
15
ALL CONSTRUCTION SHALL BE IN ACCORDANCE WITH CHAPTER 15.65. WASTEWATER DISPOSAL REGULATIONS
OF THE MUNICIPAL CODE AS CURRENTLY AMENDED.
SITE TOPOGRAPHIC SURVEY CONDUCTED ON 6/2/99. EXISTING STRUCTURES SHOWN ON SITE PLAN
ALL LOTS IN SUBDIVISION SERVED BY INDIVIDUAL WELLS
ANY DEVIATION FROM THE DESIGN MUST BE AUTHORIZED BY THE ENGINEER PRIOR TO ITS INCORPORATION
INTO THE SYSTEM.
CONTRACTOR TO LOCATE ALL UNDERGROUND UTILITIES, PROPERTY LINES, EXISTING WELLS, WATER WAYS,
SURFACE AND SUBSURFACE DRAINAGE FACILITIES, LAKES, PONDS, AND OTHER FACILITIES REQUIRING
SEPARATION DISTANCES FROM THE PROPOSED SEPTIC SYSTEM. NOTIFY THE ENGINEER OF ANY OBSERVED
CONFLICTS PRIOR TO CONSTRUCTION.
NOTIFY THE ENGINEER 24 HOURS PRIOR TO COMMENCING WITH CONSTRUCTION. A MINIMUM OF THREE
INSPECTIONS ARE REQUIRED. THE FIRST INSPECTION SHALL BE OF THE SUBCRADE, PRIOR TO PLACING
SAND FILETER. THE SECOND INSPECTION SHALL BE AFTER THE PLACEMENT OF GRAVEL, DISTRIBUTION
PIPING, STANDPIPES, TANK, AND OTHER COMPONENTS AS SPECIFIED. THE THIRD INSPECTION SHALL BE
AFTER THE WORK IS COMPLETED.
CONTRACTOR SHALL DELIVER TO THE ENGINEER A SET OF RED-LINED, AS-BUILT DRAWINGS SHOWING ALL DATA
AS SPECIFIED IN SEC. 15.65.F.2, 3, 4, 5, 6 OF MUNICIPAL WASTEWATER DISPOSAL CODE WITHIN TEN DAYS OF
THE FINAL INSPECTION. INVERTS AND SWING TIE LOCATES SHALL BE TO THE NEAREST TENTH OF A FOOT. THESE
AS-BUILTS SHALL BE USED TO DOUBLE-CHECK THE ENGINEER'S INFORMATION PRIOR TO SUBMITTAL TO DHHS.
STAKE ALIGNMENT OF SYSTEM WITH MARKERS SHOWING THE PROTECTIVE DISTANCES FROM WELLS AND
OTHER BODIES OF WATER PRIOR TO BEGINNING INSTALLATION.
ALL EXCAVATION DEPTHS ARE ADVISORY. THEY ARE TO BE VERIFIED AND MAY BE MODIFIED BY THE
ENGINEER.
EXCAVATE THE ABSORPTION FIELD. BOTTOM OF EXCAVATION SHALL BE FREE OF ORGANICS AND SCARIFIED.
RECORD ELEVATIONS AT BEGINNING, MIDDLE, AND END OF BED BOTTOM. CONSTRUCTION EQUIPMENT SHALL
NOT OPERATE ON THE FLOOR OF THE EXCAVATION. ANY MATERIAL COMPACTED BY THE OPERATION OF
THE CONSTRUCTION EQUIPMENT SHALL BE REMOVED AND REPLACED WITH UNCOMPACTED MATERIAL.
PLACE THE SEWER BOCK TO THE SPECIFIED DEPTHS. DO NOT CONTAMINATE ROCK WITH NATIVE MATERIALS OR
SPOILS FROM EXCAVATION. LEVEL ROCK SURFACE TO -+ 1" PRIOR TO INSTALLING THE PERFORATED PIPE.
ALL PIPE SHALL BE PVC CONFORMING TO ASTM D3034 OR ENGINEER-APPROVED EQUAL.
GEOTEXTILE SHALL BE MIRAFI 140S OR ENGINEER APPROVED EQUAL. LAP ALL JOINTS 2' MIN.
MATERIAL USED AS FILL SHALL BE CLEAN AND FREE OF ORGANICS, TRASH AND CONSTRUCTION DEBRIS.
SLOPE ALL FILL MATERIAL TO DRAIN AT 2% MIN. SLOPE, AND 3:1 MAX SLOPE, AND IN SUCH A MANNER THAT
PONDING AT OR NEAR THE DRAIN FIELD DOES NOT OCCUR, THE FILL SHALL BE LEFT AT 6" HIGHER THAN
SHOWN TO ALLOW FOR SETTLEMENT. SEED SURFACE AFTER COMPLETING INSTALLATION AS PER MUNICIPAL SPECS.
PERFORMED FOR;
LEGAL DESCRIPTION:
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" St re et. Anchorage. Alaska 99502~0650 I ~.'~J:~/'~''"'"
SOILS LOG ~ PERCOLATION TEST J~~~
DATE PERFORME
~'/Z/~Township, Range, Section:
SLOPE SITE PLAN
WASGROUNDWATER
ENCOUNTERED?
Oeplh Io Water Al~er . ,~)
Moniloring? Dale: ~,/~ /~
Gross Net Depth to Net
Reading Date Time Time Water Drop
~ :3~,~ ~/~ ,. ~_-~ ~V~"
~ :~. ~ ,. <Vv- 97fq ~'
PERCOLATION RATE ~'- 0 (minutes/tach) PERC HOLE DIAMETER __
TEST RUN BE'[WEEN ~ ~ ~
FT AND '~ FT
PERFORMED BY: ~"/~-'/~ f'P/"4-'~/~/'~/"~ I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES tN EFFECT ON THiS DATE. DATE: b ,/ ~f/c) c~
72~08 (Rev. 4/85)
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR: /~A L?~ H~ ~-lv~
LEGAL DESCRIPTION: ~'~' ~ ~'2~A'~/ '~ I'() /%
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
DATE P ER FORM-E~~'~'''
Township, Range, Section: ~/~
DEPTH
(PEET)
SLOPE S)TE PLAN
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Onplh (o Walor After
Monitoring? . 7-/~Ll ~
Gross Net Depth to Net
Reading Date Time Time Water Drop
)- :5-: -10:o~ ', ~ ~- ~
PERCOLATION RATE /~ (mmuteshnch) PERC HOLE DIAMETER __
TEST RUN BETWEEN £/ ' FT AND ~'J FT
PERFORMED BY: ~' /~ '~ 4t~ ~,/'~ ~'~ I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORO^NCEW,THA LBTATBANOMU.,C,PALGU'DEL'NES'NE ECTONTH'SDATE- OAT :
72~)08 (Rev. 4185)
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~r.e DISTANCES
Address
~',0, ~)~ /0/02--0 ~ ~ ~/0 TANK FIELB WELL
Phone(s} Permg NO.
Township, Range, Section
AS-BUiLT DIAGRAM (Show Iocahon OI well, septic system, properly hnes, ~ound~lion,
SEPTIC ~ HOLDING
TYPE OF SYSTEM
~TRENCH ~ BED ~ W. DRAIN ~ OTHER
original grade FT /~ ET
Fill added above original grade Gr~veJ depJb beneath pipe
Inspections Performed y:
HealthDepadmenlApproval:~~' /¢' ~Date:l¢--
72-013 (3/85)
[' (;:,j) c'i f !:~.;?j:;! [_ ;i c;; '[:..iill :: ( !:!. ) ( LI ,, (
· : I. : . { iqi'l() ~ ~ .,,,1::
Id: il;i )l:,'.DIi Z I i'
~ i::) I' '? II D y [ I'i 62 ?!iii i ii. (: :i [;i c:'~ :i :i..¢ .y c) f' [}1 ~ c Ii c;) i' ,:'~. c]i:, (l'l() Fi ) :,.ri i:J t I i ;, }J'[..:'.i [ ~:::, (:) ~, (:i]l :', S~ l.:: ~2[ ~
-¥-
\
'1
0
NOTE:
This As-built shall not be Used
any purposa other than financing
r~quirements. Under no circumstances
s[tUllld auy data Ral'80~ h9 usad for
uonstructinn or for estahllslflng
boundary or fence lines.
Municipality of Anchorage
DEPARTMENI' OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION: Z~ 7'""'~"'
Township, Range, Section:
1
2
3
4
5
6
7
8
9-
10-
11
13-
14-
15-
16-
17-
18-
19-
20-
"T~P 6o//-
SLOPE
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT O
DEPTH? p
E
Moflllorlno? Date:
SITE PLAN
~,0
Gross Net Depth to Net
Reading Date Time Time Water Drop
~. ~ l~~ /~<¢ ( I,.~-1,¢¢ .0~
PERCOLATION RATE ~5%',
TEST RUN BETWEEN
COMMENTS ~ol~ ~ ~ /~'~ ~-YO
CERTIFY THAT THIS TEST WAS PERFORMED iN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
ALASKA ENVIRONMENTAL
CONTROL SERVICEr INC.
1200 West 33rd Avenue, ouite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
f
SHEET NO OF
CALCULATED BY- /~' /~J?/~'/ DATE
CHECKED BY DATE
/.' ~o
SCALE
.4
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
N A M ~ P ~'N--E
[] UPGRADE
MAI LING ADDRESS
LEGAL DESCRIPTION
LOCATIQN ~ NO, OF BEDROOMS
...., , 3
Well ~ - l Absorption area Dwelling ~/ ~ PERMITNO.
~ DISTANCE TO: _J ~0/ ~I ~'
~< ~Z Manufacturer ~ Ma~ N°' °rc°~Xpar tments7
~N Liq capacty ~ ga o s Insidelength Width ~ --
/~¢0 F HOMEMADE: ~ Liquid depth
Dwelling
PERMIT NO.
~ Manufacturer ~ U.terial kiq~id capaciW in ~al~ons
,u~ DISTANCE'FO: ~rl I/, ~d
~ Z Ne. of lines / Length of each~ /line Total lengthens/of lines Trench width~2 inche~ Di%tancebetweenli~)s/~/v/iT~ '
Length Width ~th PERMIT NO.
m Well Building foun ~ --~
OTHER ...... -
PIPE MATERIALS
APPROVED / / DATE LEGAL
72-013 (Rev. 3/78)
F'EI:;!HZT NO.
[:,EF'FIf~'.THENT ,. HEFILTH FINE:, ENV ]: ROi'..II'dEI'.~TFII .... OTEC:T Z Ed'.,I _(~ /
"'~' '" L '"...,-f F..EE f., Fii'.g_-:}-ICff;::FI(.'iE., F:IK. '.~:,'S, EiEP:L '
....... ,:.. .. F3' Cl
,....~:,~. q., ,:.:..
B,,.]E<L. It .... IFq P",,~I[:,C_} P-,-~'-"--'."~ X '-fl'"[2~£ "2L~ EZ ~..-IIEC F,". If:Z:" E"E' E~Z~'"1% "T"
,' ,~',tt37:L6 ', ~ ',
24 ']: - ,q~:q: k37' /
I_CIT SIZE 522:55 SQUFIRE FEE"P---
FIPPL Z CP/IqT
LOCRT :[ ON
.EGFIL.
J'EFF' FIIqDDOCK F', O.
KITLISR DR
LOT 8 TFII'.,IFINFI HILL.'.-.-: SUE:
YF'E OF S;OZL FIE=SOF..'I--'T]:ON S'T'S'f'EM IS: 'I-RENC:FI
R::':: ]Z MUH NUHBEF". OF' BEZDROCIMS =: 3: S, CIIL RWFINE ,.'.F.';Q FT,.'"E,'FL'.',= J.(55
HE REQUZF:ED '-SIZE OF THE 5OTL IqB"_qCIRP'rZON 5"r'STEH lS;
THE L. ENG'I"H [:,IMENL:;ION IS; "rile L. ENG'rH ,::]:1',1 FEET) OF TFIE ]"t';:ENC:F.I i]iR DRFIIhlFZELD.
THE DEPTH OF FI TRENC:H O[~'. PIT IS THE [:'ISTFINCE E:ET[,.IEEN THE SURFFIC:E OF THE
GROUND FINE> THE BOTTOH OF' THE EXE:FIVFfTION (IN FEET>.
THERE IE; NO SET HIE>TH FOR TRENCHES.
THE GR~qVE:L [>EPTH Z5; THE MII"IZf'IUH DEPTH OF GRFI'v'EL. BETP.IEEN THE OUTFFqLL F'IF'E:
FIND THE: BO'TTC~FI OF THE E',:'~CFI',,,'FITZON ,::IN FEET).
PEF;'.I'"II'T RF'F'LZC:FINT HRE: THE RE'~,PON'Z:;IBILI'F'T' TO :[I'..IFOF4rH THIS I::,EF:'FIRTi"IENT DUR)ii'qG "FHE
]:NS'TFtLLFFI'ION ](NSF'ECT:[ONS OF FIN',? HELLS FID.]'FICENT 'FO THI:5 PROF'ERT'¢ ~I",ID THE
I",IUNBER OF' RESZDENC:ES THFIT THE HELL HILL SER',,,'E.
BRCI<FZ LLZNG OF FIN'T' 5h.'STEH 14I"FHOIJT FZNtlE.. INLE, F'EC'f']:ON RND RPF'ROVRL B'T' TFll 51;
DEF'FII'Et"FHIS. NT HILL E:E SUBd'ECT 'TO PROSECUTION.
H;[NIP'IUM DIE;I'FINCE BETHEEN FI HELL RND
IE~(~ F'E',ET FOR FI PRI'v'FITE HELL OR ~SE~ 'f'O 2E~(~ F'EET FROM Fl PUBLIC HELL DEPEF,IDINC4
UPON UFHE "r'¢F'E OF PUE:LIC: HELL.
P1ZNZMLIM DZSTRNCE FROH FI P[;:Z',,,'RTE HELL TO R PRIVFITE 'E;EklER LZP,IE Z:5 25 FEET FIND
TO Ft I30t'tHI.JIqZT'.r' SE%.IE:R LINE IS; 7~5 FEET.
HELL I_OGS RFi:E F;'.EiC¢_K[F~:E[:, F:FN[) MUST E:E RETURNED 'FO THE DEPFff;~Tf,IENT HITHIN ]:O [:,F~¥5;
OF THE HELL COHPLE:TION.
OTHER RE:QUZRE:HENTS MFI'r' FIF'F'L"r'. _,FE.....[I
FI'v'FIZL. FIE:LE TO INSURE PROPER ZNSTFILLRTZON.
F" EE; t~;: D1 X 'T' E :>:." F" X F'~: EEF£ ~% E:" E C: E I'"1 E: [~:.:' F: 7::'~: ::'~ ...... ::tL :',~-~' :;£~ :1.
I CEF:TIF5~ I'HFIT
J.: I Fff'l FI'3HILIFIF..' HITH THE REL".!UIREHEN'FS FOR'
F'ORTH B"r' THE i'"ILII",IIC:IF:'Fd..IT'¢ Ii. IF FINC:HOF,'FIGE.
;2.': :[ HZLL ZNSTFILL. THE S'T".:STEP'I Zh,I [~CCOF;tE:,FINE:E H:[TH THE C:ObES.
3:: :[ UN[)ERSTFIND THFIT THE ON-SITE SEI.,E'"F.~'. S"r'$TEh'I P'IFI'¢ REgCJ]:RE ENLF~Fd3Ei"IENT IF'
RE:'T,]:DENCE IS; REHODEL. ED TO INCLUDE i"IORE THFfi",! 2: BEDROOHE;.
............... ......
ON-.*S];TE SEHERS RJ',,ID HEL. L.S FI'.-.-., SET
THE
V4. 0
Alaska Tes lab
4040 "B" Street Anchorage, Alaska 99503 Phone (907) 278-1551 ( Telecopier (907) 272-5742
Gittins Construction Company
1011 East Tudor Road
Anchorage, Alaska 99507
Attention: Tom Gittins
July 9, 1981
W.O. #A19925
Grid #2123
%°00%.
Subject: Percolation Test, Lot 8, Tanana Hills Subdivision
[)ear Tom:
This letter transmits the results of a percolation test con-
ducted on the above referenced lot. The test was conducted
according to procedures outlined in the "Manual of Septic Tank
Practice", U.S. Department of Health, Education & Welfare,
Public Health Service. The test was conducted in a backhoe
test pit dug at the location shown on Figure 1.
Soils encountered are illustrated on the log shown on Fi'gure
2. Below the one foot of topsoil the soils consist of brown
silty sand to five feet depth. The sand becomes gravelly at
five feet. Silt was encountered at 13 feet depth. The perco-
lation rate in the silty gravelly sand was 10 minutes per
inch. This percolation rate is applicable for soils from one
foot to 13 feet depth. Below this depth the sclls should be
considered impermeable. For an absorption trench less than 13
feet in depth we recommend that the absorption area be 165
square feet per bedroom. This recommendation is based on the
criteria outlined in the Public Health Service manual refer-
enced above.
We trust this information is sufficient for your present
needs. If you ]]ave any questions, please contact us.
,
~ ~)a" James R. einlev,.ir. ;" ,~ .'
3RF/mg
Attachments
Sincerely yours,
ALASKA TESTLAB
James R. Finley, Jr.,
GeotechnicalF~ng~neer'
/,I
2,4
15
12
?'?d I
BORING
ELEVATION:
LOGGED GY__D.
~'_pTH
I 13'
KEY
UNCONFINED COMPRESSIVE STRENGTH (PENETROMETER)(TGF)
pp:
TV-- SHEA~,~ S FP, ENGTH (TORVANE)(TSF)
MA: MECHANICAL ANALYSIS
LL= LIQUID LIMIT (%}
Pi -' PLASTIC INDEX
[]- GRAIt) GAMPt. E
~ll- SPT SAMPLE
,, - ~.5" I O SPOON SAMPLE ~
~40:1~ WEIGHT, :~O" cALL ATL
[~- SHELBY lUBE- PUSHED
~'""~ "'""""~ LOG OF' BORING E,*,,.~ :~
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
CERTiFiCATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4744
Application Dat;'
GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or direCtiqns)
(b) Propedy O~ner , Telephone: Home
Mailing Address v '
(c} Lending Institution - :' Telephone
Mailing Address
Business
(d) Real Estate' Company and Agent'
Address
Telephone '"~'~: ¢~' ¢'"~
(e) Mail the HAA to the lollowina address: or: Check here [], if hold for pick up.
List contact person and day phone number below.
TYPE OF RESIDENCE
Si n gle-Family~..~
./'
Number of Bedrooms
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
OnsiteXl~L. 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 fRev 8/861 Fronl
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e;Ignbep8 pup iBuo!lounJ 'BIBs s! LUBjS,~S IeSOdg!p JBlgMBjgBM Jo/puB/~lddns JB:JBM
t41198H S!q110 UO!jBB!jSBAU!/~UJ Ieql ~J!JB^ I 'MOleq UMOqS 81Bp UO!IBp!IeA 8ql JO Se pug O;IOJeLJ pBx!J,tB JgBg/~LU ~q pe!J!pBo sv
NOIJ.¥1NIJO:INI aNY ~¥a 'Nou~as ~'114 '$J.$=I.L '$NOIJ. O;=IclSNI ~)NlalAO~ld INI:II:I
.g
~.~'4\~'0~ ,. ,..rCt~C~I"blPALITY OF ANCHORAGE (MOA)
0~/~ '¢'- ~rI¢~.LTH AUTHORITY APPROVAL (HAA)
. ~¢'II~KLIST - FEBRUARY 1984
~, {~ ~,\ 284-4744
Legal Description: ZoT" ~'
WELL DATA
Well Classificatioe
Well Log Present (Y/~.
Total Depth ~'/~-5'
Static Water Level
"~t///¢'"~ If A, B, C, D.E.C. Approved (Y/N)
¢f'~'//J~/c"d"J Yield
Date Completed
Cased to ~'/~'D'~" Depth of Grouting
Pump Set At
Sanitary Seal on Casing(~)
Depression Around Wellhead (Y~
Casing Height Above Ground
Electrical Wiring in Conduit~_~N)
Separation Distances from Well:
To Septic/Holding Tank on Lot _
/Ooc' ; On Adjoining Lots /~::t~ ¢--
/dr) ,/-
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
TO Nearest Edge of Absorption Field on Lo~'~_ ~ / ; On Adjoining Lots
,,t~ To Nearest Public Sewer
Comments (~
To Nearest Sewer Service Line on Lot
//~-'7,/ ; Date
SEPTIC/HOLDING TANK DATA
Date Installed /o ~:~-/-~?;¢_ Size ¢'"~ro No. of Compartments
StandpipesL~) 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:Pi'operty Line /0
· ~r0 Water Main/Serr~ice Line
/
Foundation Cleanout (~)
Date Lest 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 fRev 8/861 Fronl
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata 02~',~' /~"t ~f/~/¢£,//~ ~-'/'¢ Type of System Design
Date Installed ~,,4'/~
Width of Field ¢,~¢"~ ,,~
Square Feet of Absorption Area
Depression over Field (YI~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
Length of Field ~ ~ /
Depth of Field ¢~J~ /¢ /
~ravel Bed Thickness
Standpipes Presen~N)
Date of Last Adequacy Test
To Property Line ./¢'/'~
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 ~--~-.~'- ~ ~/'~/~,~
To Existing or Abandoned System on
·
; On Adjoining Lots ~
To Cutbank (if present)
D. LIFT STATION
~ '.~/)Z Dimensions
Date
Size in Gallons ~ Manhole/Access (Y/N)
"Pump On" Level at "Pump Off" Level at
High Water Alarm Level at ~ Vent (Y/N)
Tested for ~ycles during Adequacy Test. Meets MOA
Electrical Codes (Y/N) ~
Comments ~~~
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I h~ch.ed.,ked, ~'erified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Date
Company ./~-~-,~ MOA No.
Date of Payment /o/~ ~/>'/
Amount: $ .~ ~ ,) ~
Page 2 of 2
72-026fRay 8/SB/B~ck
Anchorage
P.O. BO~ 96650
ANCHORAGE, ALASKA 99519-6650
(907) 343-4200
TON Y KNO WL ES,
MA YOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
November 3, 1987
Alan C. Wien, Engineering Technician
Alaska Environmental Control Services,
1200 West 33rd Avenue, Suite B
Anchorage, Alaska 55503
Inc.
Subject: Amended Waiver for Lot 8 Tanaina Hills Subdivision
Waiver Number WR87-052A
Dear Mr. Wien:
This letter is to amend the waiver issued by Mr. Steve Morris
for well to septic tank to also include the trench. This
separation is waived to 98 feet.
The well had adequate points to meet the Alaska Department of
Environmental Conservation waiver analysis procedure for the
septic tank and the leach field. At the time when the trench
caved in at the end resulting in the two foot encroachment of
the distance to the well, %he intent~ of the wastewater
ordinance was being observed.
This waiver applies to the existing drainfield and tank
separations to the well. Any future upgrade of either will
require separation distances be met or another waiver approval
from this department.
Sincerely,
Daniel J. Roth
Civil Engineer
On-Site Services
cc: Gus Andress, P.E.
Manager, On-Site Services/Water Quality Programs
ALASKA elIUIROFImI FITAL COFITROL SERUIC S, II]C.
~n§ineeri~§ ~, ~nuironmenM $1udics
October 22, 1987
Municipality of Anchorage
Departlaent of Health & Human Services
825 L Street
Anchorage, AK, 99501
Attn: Mr. Dan Roth
Re: Lot 8, Taualna Hills Subdivision
On 10/21/87, the upgrade of the trench was completed for this lot. The trench
was excavated to tile 100 foot radius from tile well, Prior to placement of tile
sewer rock, the trench experienced a number of massive cave-ins on the west wail
which widened the trench and slightly elongated the south west corner of the end
of the trench. This made the closest point of the trench 98 feet from khe well.
Refer to the attached diagram. With a 12 foot deep trench and tile possibility
of more cave-ins, it was impractical to try abandoning this small area by
packing loose soil into it. The trench was completed with sewer rock filling
this area. We request ~hat you waive the 100 foo~ setback requirement to 98
feet. Recently, a waiver was granted for tile well to the existing septic tank.
Please refer to it for your evaluation of this waiver request.
If you have any questions, please feel free to call.
Sincerely,
Alan C. Wien
Engineering Technician
Approved by:
1200 LUgs1 33rd Auenu¢. Suile 6,J~n¢~oro§e, Alosko 99503,,(907) 55L5040
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
(ENGINEER'S SEAL)
LEGAL DESCRIPTION: Z.OT" ~¢' '--7--/~/,J/~>.J.~ ?'/tZ/.~< Township, Range, Section:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
s
IF YES, AT WHAT ~)
DEPTH? p
E
Depth to Waler After
Monitoring? Oake:
Gross Net Depth to Net
Reading Date Time Time Water Drop
'"'--~ .~._
PERCOLATION RATE __
(mmutes/inch} PERC HOLE DIAMETER
TEST RUN BETWEEN FT AND FT
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ,1~ ~/~ ~ ~
72-008 (Rev. 4/85)
ALASKA ENVIRON, .,~NTAL
CONTROL SERVICES, INC.
].200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
SHEETNO. OF
CHECKEO ~Y DATE
SCALF /
ZaO0 !~ 3:}RI) AVL SfS
/~N.t;liOll~Gl:i. IiX. 99503
Not Aaatvzed LT.'las; Than, L;;P%'ootoc 2'hah
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 /:¢~" :t- '/ // /~/' ;~'
GENERAL INFORMATION
(a)
Legal Description (include lot1 block, subdivision, section, township, range)
Location (address or.directions)
Business
(c) A~plicant'is (check one): Lending Institution []; Owner/builder.~; Buyer []; Other [] (explain);
(d) Lending Institution//' ///~'-r~]/C~' Telephone
Address " ' ~' ' //// : //-~ /~¢~ :'~.2~_ //.~. ,
Address
Telephone
(f) Mail the HAA to/~.-~)~:the'f°ll°wing~'~'7--'~'/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 Environ mental Conservation
attesting to the legality and status.
4. 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)
5
ENGINEERING FIRM PROVIDINL..,,ISPECTIONS, TESTS, FILE SEARCH, DA', .AND INFORMATION
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 shows that the on-site water supply and/or wsstewater 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 /~-"(- ~' ~ ~- Telephone ~'~ /-~"2~ y ~
Address /~C' /~/ 2~f~ ~ ~/~,~j.~ //~ ~¢~
DHEP APPROVAL
Approved 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 independent 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.
Page 2 of 2
72-025 (~ 1184)
WELL DATA
MUNICIP,~LITY OF ANCHORAGE (MO~./
.. o R,TY APPROVAL <HAA,
ON . .~Lst ~HECKLIST- FEBRUARY 1984
~o~~ 264-4720
~_ t) ~ ~'~ Legal Description:
I-I/gL
Well Classification f)/" i'i//a.
Well Log Present (Y,~'))
Total Depth ~ Cased to
Static Water Level /
Casing Height Above Ground ~'
Electrical Wiring in Conduit~//N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
If A, B, C, D.E.C. Approved (Y/N)
Date Completed /'V/,,~ Yield '"~/~' ~/'~'~'~
Depth of Grouting
Pump Set At
Sanitary Seal on Casing(~,~N)
Depression Around Wellhead (Y/~
~ -? / ; On Adjoining Lots /
~/¢¢ /'¢- ; On Adjoining Lots /
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
/Of?/-~' To Nearest Public Sewer
/ O¢/''h' To Nearest Sewer Service Line on Lot ~' 0¢ /'/-
fi, ~C'G/ ;Date L.~(~ ~ 'F~ ~/
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes Y~N) Air-tight Caps~N)
Depression over Tank (Y/~
Pumping/Maintenance Contract on File (y/~C,'[/v//~
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 .../1,/o,4¢¢
Course ./'v'O ~
Size / 00~ No. of Compartments
Foundation Cleanout/~4)
Date Last Pumped "7 '-
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(11t84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
5"¢0
Square Feet of Absorption Area
Depression over Field (Y/~.)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation
Lot ./U/ c* ~
Type of System Design 7/~
Length of Field /~-
Depth of Field
Gravel Bed Thickness
Standpipes Present ~/N)
Date of Last Adequacy Test
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots /~/~'
To Cutbank (if present)
Comments
D. LIFT STATION
Date Installed ~ Dimensions
~ize in Gal, lens -'~'~-~. Manhole/Access (Y/N)
'Pump On' Level at ~~ "Pum~
High Water Alarm Level at ~. / Vent (Y/N)
Tested for
Electrical Codes (Y/N)
Comments
during Adequacy
Test. Meets MOA
** 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 inspection.
Signed ..~"~~r.~,~ Date ~>'"//",/¢ ~- '
Receipt NO. ~
Date of Payment
Amount: $ ~/~
Page 2 of 2
72-028 (11/84)
fi&unicipalaLy
Anchorage
P.O. BE 196650
ANCHORAGE, ALASKA 99519-6650
(907) 264-4111
TONY KNOWLES.
MA YOR
DEPARTMENT OF HEALTH & HUMAN SERVICES
September 9, 1987
Leroy C. Reid Jr., PhD, P.E.
Alaska Environmental Control Services
1200 West 33rd Avenue, Suite B
Anchorage, Alaska 99503
Subject: Lot 8 Tanaina Hills Subdivision
Waiver Request WR87-052
Dear Dr. Reid:
Your request for a waiver of the 100 foot separation required
between the septic tank and well on the subject lot has been
granted. This distance has been waived to 97 feet. This
waiver is based on your assessment that a health hazard will
not be created as a result of this waiver.
This waiver is valid for the existing septic tank only.
Upgrades and enlargements of the septic system are not covered
under this waiver.
Sincerely,
Stephen S. Morris
Civil Engineer
On-site Services
cc Gus Andress, P.E.
Manager, On-site and Water Quality Sections
.R
ALASKA (~IIUIROrlITIINTAL £OrlTROL
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1200 LUcsl 33rd Aucnu¢. Suil¢ [~, Anchoroq¢. Alosko 90503 *(907) 501-50/10
~ CHEMICAL :&__ G_EOLOGICA~ LABORATORIES OF ALASKA, INC~
/ ,/~'X 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE~
~",,~,'o~,~,~)~,E['"'~. FEDERAL TAX ID # 92-0040440
~I fR,'~tUqi }tl)(O,lO) ~¢I I0
o~TE RECE~V'ED - '
INSPECTION APPOINTMENTS
DATE DATE DATE
INSPECTOR I NSPECTO R I NSPECTOR~
M~NICI~A[IIY OF A~CHORAG~
MUNICIPALITY OF ANCRORAGE DEPT. OE REALTH &
) DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTEC[~ONMENTAL
825 L Street - Anchorage, Alaska 99~01
ENVIRONMENTAL SANITATION DIVISION NOV ~ 0 ~981
Telephone 264-4720
DIRECTION~: Complete aH parts on page 1, Incomplet~ requests will not ~e processed, Please allow ten (10) days for processing,
1, PROPERTY OWNER PHONE
MAILING ADDRESS
PROPERTY RESIDENT (If different from above) PHONE
2, BUYER PHONE
MAILING ADDRESS
~ LENDI, N INSTITUTION ~HON
MAILING ADDRESS
4. REALTOR/AGeNT PRONE
MAILING ADDRESS
L :ESDR,PT N .
STREET LOCATION
6, TYPE OF RESIDENCE NUMBER OF~BEDROOMS
[] One [] Four
~'~ SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY ~ Three [] Six
[] Other
7, WATER SUPPLY
~ INDIVIDUAL* *ATTACH WELL LOG. Awell log is required for ellweils drilled
[] COMMUNITY since June 1975. For wells drilled prior to that date, give well
[] PUBLIC UTI LITY depth (attach log if available.)
8. SEWAGE DISPOSAL SYSTEM
~ INDIVIDUAL/ON-SITE** /qc::~/ YEAR ON-SITE SYSTEM WAS INSTALLED.
[] PUBLIC UTILITY
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010 ( Rev. 6/79)
THIS SIDE FOR OFFICIAL USE ONLY
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2. WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTILITY
Connection Verified LOG RECEIVED
3, SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[]INDIVIDUAL/ON -SITE DATE INSTALLED
E~] PUBLIC UTILITY
Connection Verified INSTALLER
[]Sept.~c~ [] Holding Tank
Size: /¢,,,'LL./"--' If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER
4, DISTANCESwELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5, COMMENTS
EJ~"~APPROVED FOR ~ BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE BY
72-010 (Rev. 6/79)