HomeMy WebLinkAboutCALKINS LT 6Calkins
Lot 6
#050-211-15
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program, 4700 Bragaw St.
P.O. Box 196650 Anchorage, AK 99519.6650 Page 1 of 3
www.cl.anchorage.ak.us (907) 343.79N
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SW0700040 PID Number: 011.121.54
'ri
Wastewater System: [:]New ® Upgrade
ABSORPTION FIELD
105ifi Crestview Lane E.R. AK 99577
Phar: Nuft" Of Oeaoan
D Deep Trento D Shallow Trench o tied a MpxM v o"'W'.
LEGAL DESCRIPTION
Sol Rabng
ToWDWhftmoVnWWe":
cPaFr
Ft.
bloc.. La: Sub*vvw:
Depa, to pipe bonen tom OdvfW wade
Grave depth beneath pipe:
6 Calkin
Ft.
FI
Ta~ip: Range: Section'
Fa added Wove cdonal wade:
Grow Length:
Ft.
Ft.
Well: ❑ New ❑ Upgrade
GnM wdlh:
Nuttier of Imes:
0.a between ones:
Ft.
FI
Clasoenbm tPmate. A. S. Cl:
TOW Depth:
Cased b:
TOW absorpbm area:
Rpt Met&*:
Exisfo Private I
Fl.
I FI
FIs
Wier:
Date Dneed
Subs Water Leval:
InsYeer.
Date Wtalled:
FI.
JR's Pum in /Fiintstone
4/3012007
TWd:
Pufm set al:C.Lrp
Nnghl Above Graeld:
TANK
GPM
Ft.
FL
SEPARATION DISTANCES
® Septic ❑ Holding ❑ S.T.E.P. ❑ Other.
To
Septic
Absorption
Lift
Holding
ublic/Pdvate
M"acaer:
C,9 a ly
From
Tank
Field
Station
Tank
Sewerune
Anchorage Tank
1 1250 ca.
We.
104.7
100+
95
M.IeW
Steel
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2
Saf.W.ter
100+
100+
LIFT STATION
50
10+
s °
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wph wateralarmal:
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50+
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nfJl Inspeons Woffned by
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c~ Oran
New Tank only. A 1250 g septic tank was the only available tank
New
BENCH MARK
L=bm and sc
DenW m:
on short notice, so It was Installed. Existing tank abandoned per
WINDOW SILL NE=AQ'• IJ E2 `
code.
Aaauned Elevabm.
•' 100.0
r FI
Engineer's Stamp
Inspections performed by: PANNONE ENG. SVC, LLC Dates: 1' 413012007
2nd 413012007
��•.••�����
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: ��:.. �...... iqA`s+
Development Services Department Approval
�,. .,•��i
Conditional Approval Date:,,
,„ .... •... ......T,••••%
—Steven ,i
cK't•rt, •• cnnone: i
C
♦ tt
.,••• No CC E149 .•
Reviewed and approved by: Date: 12
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ISTG 1000g T2 SEPTIC TANK
SEPTIC
TANK C1 INSTALLED DCO
A
ANDONED AFTER TANK
IN PLACE C2 & CO @ START
PER CODE OF FIELD
106.9 EXISTG.FIELD
I
TO BE REUSED
1
SWINGTIES
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FC 14.0 12.0i•�
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T2 14.0 21.9
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PANNONE ING SVC, LLC
REVISED
Date
��OFAL\gs��)
P.O. BOX 102954 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
05-03-07
Scale
*.49 h1 *,
1•'40'
'•"••'•
P.I.D. NO
Stewe;Xo annone
Lot 6 Calkins SID
011-121-54
PERMIT NO.
lI/ CE 8149'
Richard Adams
ROFS ES�ON�� �
10515 Crestview Lane
Eagle River, AK 89577
RD
SW0700040
sneer
\\\\XI VZ
DRAW
1 of 2
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON-SITE WASTEWATER DISPOSAL SYSTEMS.
2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS.
3. SCOPE OF WORK: 3 -BEDROOM HOUSE, NEW SEPTIC TANK. INSTALL FOUNDATION CLEANOUT do DOUBLE CLEANOUTS
AFTER TANK.
4. GROUNDWATER IS NOT EXPECTED TO BE ENCOUNTERED DURING EXCAVATION, AS EVIDENCED BY THE SOIL TEST HOLE
INFORMATION. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 12 FEET BELOW
EXISTING GRADE, NOTIFY THE ENGINEER IMMEDIATELY.
5. INSTALL CLEANOUT AT START OF EXIST'G FIELD.
JU
0] Q
Z
ILL Q U U
F-
93.1 92.9
NEW 1250g SEPTIC TANK
TANK ELEV.
NTS
92.6
DESIGN PARAMETERS
ABBREVIATIONS
LEGEND
CU
COPPER
— W WATER LINE/
NO. BEDROOM: 3
DIP
DUCTILE IRON PIPE
WELL RADIUS
TANK SIZE: 1,000 gallon
TH
TEST HOLE
TANK REPLACEMENT ONLY
`
FC
FOUNDATION CLEAN-OUT
— SS EXIST'G SEPTIC
1,0009 SEPTIC TANK
� T
TANK CLEAN-OUT NO.
Cly
CLEAN-OUT NO.
— SS NEW SEPTIC
Mp
MONITOR TUBE NO.
DCO
DOUBLE CLEAN-OUT
0 CHAINLINK FENCE
DV
DIVERTER VALVE
PANNONE ENGINEERING SVC, LLC
(� • qS+ (� P.O. BOX 102954 ANCHORAGE, AK 99510
Gj'�p'•• •.�y �� PHONE (907) 272-8218 FAX (907) 272-8211
* 49 Lot 6 Calkins SID
Sleven R. Pa none j Richard Adams
(9��. cEs149 10515 Crestview Lane
II1►ff�FOoe'�-0naA�E`F Eagle River, AK 99577
05-02-07
Scale
NTS
P.I.D. NO
15-272-6E
PERMIT NO.
SW070040
RECORD Sheet
NOTES 2 of 2
MUNICIPALITY OF ANCHORAGE
Development Services Department
Onsite Water & Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Apr 25, 2007
Expiration Date: Apr 24, 2008
Permit Number: SW070040 Parcel ID: 050-211-15
Legal Description: CALKINS LT 6
Design Engineer: 0062 PANNONE ENGINEERING SERVI( Site Address: 010515 CREST VIEW LN
Owner Name: RICHARD ADAMS Lot Size: 20663 SO. FT.
Owner Address: 10515 CRESTVIEW LANE Total Bedrooms: 3 Permit Bedrooms: 3
EAGLE RIVER. AK 99577-8442
This permit is for the construction of:
❑ Disposal Field Q 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 DSD at least 2 hours prior to each Inspection. Provide notification by calling
(907) 343-7904 ( 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:
Date: 64 -Z ✓J 0-1F
Municipality of Anchorage
• Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
www.muni.org/onsite
(907) 343-7904
ON-SITE SEWERIWELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcell.D. tDSd -ill- i'S
Property owner(s) Richard Adams Day phone 349.1211
Mailing address'! 0515 Crest View Lane, Eagle River AK Zip Code 99577
Site address 10515 Crest View Lane Zip Code 99577
Legal description (Sub'd., Block & Lot) Calkin SID, Lot 6
Legal description (Township, Range & Section)
Lot Size 20.663 Sq. Ft. Number of Bedrooms 3
THIS APPLICATION IS FOR (® all that apply):
Absorption Field ❑
Septic Tank
Holding Tank ❑
Privy ❑
Private Well ❑
Water Storage ❑
THIS APPLICATION IS AN:
Initial
❑
Upgrade
El
Renewal
❑
certify that the above information is correct. I further certify that this application is being made for a
Single Family Dwelling and is in accordance with applicable Municipal Codes.
Pannone Engineering Services, LLC
(Signature of property owner or authorized agent)
Permit/Rush Fees: Waiver Fees:
Date of Payment:
Receipt Number:
(Rev. 11/05)
Date of Payment:
Receipt Number:
Pannone Engineering Services, LLC P.O. Box 102954
Consulting Engineers Anchorage, Alaska, 99510
(907) 272-8218 (907) 272-8218 Fax
April 25, 2007
Municipality of Anchorage
Development Services Department
On -Site Water & Wastewater Program
4700 S. Bragaw Street
P. O. Box 196650
Anchorage, Alaska 99519
Subject: Lot 6 Calkin S/D
Emergency Septic Tank Replacement Permit Request
Ladies and Gentlemen:
I am writing to request that a permit to install a new septic tank be issued for this property. The
system currently serves an existing three-bedroom house. The lot is currently developed and is
served by a private water system. The top of the existing septic tank has corroded through and is
a danger and health threat.
1. Tank Replacement. The original 1000 -gallon septic tank was installed in 1975. The tank
collapsed recently and is being pumpeddaily to keep the house operating This situation poses a
serious health risk and a potential dangerous situation. See the attached site plan. The existing
drain field was inspected and found tobe approximately 50% saturated and appears to be
operating adequately.
2. Surface Water: There is no surface water within 100 feet of the proposed system.
3. Topography: The average topography in the area of the proposed septic system is
approximately two to three percent to the southwest. There are no changes in.slope greater than
25% within 50 feet of this lot.
The proposed installation will not affect the future development ofthe surrounding or existing
lots. There are no wells or septic systems within 100 feet of the proposed septic tank location.
If you have any questions or concerns, please contact me at 2273522 or 272-8218.
Steven R. Pannone, P.E.
Civil Engineer
C:\Work\Letters\6 Calkin.001.doc
1
EXIST'G .
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WELL !
•
EXISTG
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WELL I
I
135.6 '
107.5,-
W
\`&STALL
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SEPTIC
_ ...• FCO
_
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GARAGE 49.4
NEW 10008
�.
i
E
ISTG 1000g SEPTIC TANK
S
PTIC TANK INSTALL DCO
OLLAPSED! AFTER TANK
ABAND
N IN PLACE & CO @ START
PER CODE OF FIELD
'U FIELD
TO 9E REUSED
104.2
1
i
15
s
A \\\
CgSI
PANNONE ENG SVC, LLC
REVISED
Date
04-25-07
�(� • "'
i �Q:•'• '•
P.O. BOX 102954 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-6211
Scale
49 TM
1'-40'
P.I.D. NO
•
Lot 6 Calkins SID
011-121-54
Steven R PaWr; /
/�
Richard Adams
PERMIT NO.
9,0•.• CE 8149 /�
04-2�°7''e`:
10515 Crestview Lane
SW070XXX
DESIGN
sheet
�I f�oROFESSt
Eagle River, AK 99577
DRAWING
t a z
SPECIAL PROVISIONS TO SPECIFICATIONS
1. ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
ON—SITE WASTEWATER DISPOSAL SYSTEMS.
2. ALL WORK SHALL BE IN ACCORDANCE WITH THE ATTACHED SPECIFICATIONS
3. SCOPE OF WORK: 3—BEDROOM HOUSE, NEW SEPTIC TANK. INSTALL FOUNDATION CLEANOUT & DOUBLE CLEANOUTS
AFTER TANK.
4. GROUNDWATER IS NOT EXPECTED TO BE ENCOUNTERED DURING EXCAVATION, AS EVIDENCED BY THE SOIL TEST HOLE
INFORMATION. IF AN APPARENT WATER TABLE IS OBSERVED IN ANY OF THE EXCAVATIONS LESS THAN 12 FEET BELOW
EXISTING GRADE, NOTIFY THE ENGINEER IMMEDIATELY.
S. INSTALL CLEANOUT AT START OF EXIST'G FIELD.
DESIGN PARAMETERS
N0. BEDROOM: 3
TANK SIZE: 1,000 gallon
TANK REPLACEMENT ONLY
SLOE.
1,0009 SEPTIC TANK
ABBREVIATIONS
CU
COPPER
DIP
DUCTILE IRON PIPE
TH
TEST HOLE
FC
FOUNDATION CLEAN-OUT
T#
TANK CLEAN—OUT NO.
C#
CLEAN-OUT NO.
MPJ
MONITOR TUBE NO.
DCO
DOUBLE CLEAN-OUT
DV
DIVERTER VALVE
LEGEND
W— WATERLINE/
WELL RADIUS
— SS — EXIST'G SEPTIC
— SS — NEW SEPTIC
PANNONE ENGINEERING SVC, LLC
(� • "' • qS �� P.O. BOX 102954 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
Lot 6 Calkins SID
Steven Panna' "/ Richard Adams
90'% C 14 AW 10515 Crestview Lane
1'��fE�f��04p5-0nk1�E�'� Eagle River, AK 99577
CHAINLINK FENCE
NTS
'ERMIT N0.
SW07xxxx
DESIGN Sheet
NOTES pat 2
SANITARY SEWER SYSTEM
Part 1 General
1.01 DESCRIPTION. Provide all labor, equipment, material, and supervision to
complete the sewage disposal system for a single family house including, but not limited to,
sewer pipe, septic tank, drain field, and all required fittings and appurtenances in
accordance with the Drawings, Specifications, and Special Provisions.
The Contractor shall be Municipality of Anchorage (MoA) certified to install on-site
wastewater disposal systems within the Municipality of Anchorage.
1.02 RESPONSIBILITY
A. Owner
1. The Owner shall contract with the Contractor to perform the work described in these
Specification and the accompanying Drawings in accordance with the attached MOA
On -Site Department Permit. There is no contractual relationship between the
Contractor and the Engineer. The Engineer shall inspect the work as required by
MOA On -Site Department, so as to document the installation. Final acceptance of
the Contractor's work rests with the Owner and the MOA On -Site Department.
2. The Owner shall notify the Engineer of any conditions that are known that will affect
the design or installation of the septic system, to include, but not limited to, locations
of drains, utilities, water wells, property comers, subsurface anomalies, or known
hazards.
B. Engineer
1. The Engineer is responsible for inspecting the installation of the septic system and
preparing Record Drawings that document the installation to the satisfaction of the
MOA On -Site Department. Inspections are performed as necessary to document the
construction of the system to the satisfaction of the MOA On-site Department. In all
cases, inspection shall be performed as necessary to establish the following:
• The original grade at the drain fields and site
• The bottom of all excavations for drain fields
• Top of sand on all sand filters
• Top of drain pipe
• Septic tank, lift station, or holding tank prior to back filling
• Placement of filter fabric and insulation
• After final grading and seeding is complete.
2. The inspecting Engineer has no direct authority over the Contractor's activities or
construction/safety practices. Should the Engineer identify conditions which dictate a
design change, the Engineer will recommend that the work be stopped and/or the
design modified. If a design modification is necessary, the Engineer shall notify the
property Owner or his/her representative. The inspecting Engineer does not have
the authority to direct the Contractor to modify the system design in such a way that
it would be in violation of Alaska State or MOA regulations.
Page 1 of 8 4/25/2007
C. Contractor
1. Pre -construction lay -out: The Contractor is responsible for locating all buried utilities,
casements, property lines, surface water setbacks, well radii, and water service lines
which may been crouching upon the proposed septic system. The Contractor shall
ensure that all setbacks are clearly marked and flagged by a registered land
surveyor, or other appropriate means prior to construction. Pannone Engineering
Services, LLC, (PES) Field Inspectors/Engineers will not be responsible for
establishing or confirming any of the aforementioned setbacks.
2. Discrepancy Between design Drawings and Specifications: Construction shall be in
accordance with the approved site plan, design Drawings, and any Special
Conditions noted on the MOA On -Site Department Sewer Permit. The Contractor is
responsible to notify the Engineer of any discrepancies noted on the design plans or
Drawings prior to starting work.
1.03 REFERENCES.
A. American Society of Testing and Materials (ASTM)
1. ASTM D2241 - Standard Specification for PVC Pressure Rated Pipe
2. ASTM D638 - Test Method for Tensile Properties of Plastic
3. ASTM D696 - Test Method for Coefficient of Linear Thermal Expansion of Plastics
4. ASTM D792 - Test Methods for Density and Specific Gravity (Relative Density) of
Plastics by Displacement
5. ASTM D1505 = Test Method for Density of Plastics by the Density -Gradient
Technique
6. ASTM D1621 - Test Method for Compressive Properties of Rigid Cellular Plastics
7. ASTM D1622 -Test Method for Apparent Density of Rigid Cellular Plastics
8. ASTM D1785 - Specification for Poly (Vinyl Chloride) (PVC) Plastic Pipe, Schedules
40, 80, and 120
9. ASTM D2240 - Test Method for Rubber PropertyCDurometer Hardness
10.ASTM D2842 - Test Method for Water Absorption of Rigid Cellular Plastics
11.ASTM D2856 - Test Method for Open -Cell Content of Rigid Cellular Plastics by the
Air Pycnometer
12.ASTM D3034 — Specification for Type PSM (PVC) Sewer Pipe and Fittings
13.ASTM D3350 - Specification for Polyethylene Plastics Pipe and Fittings Material
14.ASTM F789 — Specification for Type PS46 PVC Plastic Gravity Flow Sewer Pipe.
B. Municipality of Anchorage, On -Site Water & Wastewater Department (MOA Onsite)
1. Anchorage Municipal Code (AMC)15.65 Wastewater Disposal
2. "On -Site" Wastewater Installers Manual.
3. Municipality of Anchorage Standard Specification (MASS)
4. Standard Specification for Component Parts and Materials Used in Construction of
On -Site Wastewater Disposal Systems, Dated January 1991.
C: International Conference of Building Officials (ICBG) 2003 Uniform Plumbing Code as
amended by the Municipality of Anchorage and adopted November 1, 2005.
Page 2 of 8 4/25/2007
1.04 SUBMITTALS. The Contractor shall submit their MOA Onsite Certified Installer
certificate and number'along with the date of class and expiration date prior to installation
of system.
After the complete system is installed, the Contractor shall submit unqualified as -built -
Drawings and certificates on MOA Onsite approved forms to the Engineer for approval to
Operate. The Contractor shall record survey notes and submit these with the As-builts. All
field joint locations shall be noted on the as -built Drawings.
1.05 SOILS REPORT. Pannone Engineering Services, LLC, conducted a soils
investigation. The investigation can be found attached to the Drawings.
Part 2 MATERIALS
2.01 PIPE BEDDING. Bedding shall conform to Class C Bedding as specified under
MASS Division 20, Section 20.11.
2.02 GRAVITY SEWER PIPE. Pipes shall conform to the material schedule
specified by Reference B-4 above and shall at a minimum be:
a. Solid pipe: Schedule 3034 PVC plastic
b. Perforated: F810 HDPE or 3034 PVC Plastic
2.03 SEPTIC TANK. The Septic tank shall be a cylindrical welded steel tank,
constructed with No. 12 U.S. gauge (0.109 inch thick) material, with an operating capacity
of that specified on the Drawings. The tank shall be a two-compartment design constructed
in accordance with AMC15.65 and the Uniform Plumbing Code, and fabricated to the
approximate dimensions as shown on Drawings. Tanks of alternate dimensions but equal
capacity may be approved at the discretion of the Engineer. The septic tank shall be
manufactured by Anchorage Tank and Welding or approved equal.
The tank shall have a minimum of two access clean -outs, one over the inlet and one over
the outlet.
The inlet pipe opening shall be Schedule 40 steel in the location shown on Drawings. The
inlet shall be baffled as shown or as approved by the Engineer. The inlet baffle shall
penetrate six (6) inches below the liquid level in the tank.
Lifting lugs shall be attached to the top of the tank for ease in handling.
All steel structural members shall be jointed by electric arc welding with fillets of adequate
section for the joints involved. Welds shall be continuous inside and out, ensuring a
watertight tank. Pipe passing through tank walls shall be welded on both sides for a
watertight fitting.
After welding, all inside and outside surfaces of the tank shall be sandblasted to remove
rust, weld flux, oil, and other foreign material. Weld splatter and surface roughness shall be
Page 3 of 8 4/25/2007
removed by grinding. Immediately after cleaning, all metal surfaces shall be protected from
corrosion by using Hi -Build Cold Tar Pitch, #46-465, or approved equal; the exterior shall
be treated with one coat and the interior shall be treated with two coats. Coating
applications shall follow the manufacturer recommended procedures.
2.04 SOIL ABSORPTION SYSTEM. All material used in the soil absorption system
shall be approved for their intended use by MOA Onsite and shall be in conformance with
the above references.
Gravel to be used in the soil absorption system shall conform to AMC 15.65.010
Definitions, Gravel.
Pipes used for monitor tubes shall be 3034 PVC with the portion protruding into the drain
field either slotted or perforated the full effective depth as specified on the Drawings.
Clean-out caps shall be rubber "Jim Caps," or approved equal, securable with adjustable
metal bands. Friction fit caps will not be accepted.
Filter Fabric shall be Mirafi woven or felted fabric, or approved equal.
2.05 RIGID INSULATION. Rigid insulation shall be rigid board extruded or expanded
polystyrene material meeting the following criteria:
• Density: 2 PCF minimum
• Compressive Strength: 35 psi minimum at 5% yield per ASTM D1621
• Water Absorption: 0.25% by volume, maximum per ASTM C272
• Thermal Conductivity: 0.23 BTU-in/°F-ft2-Hr, per ASTM C177
2.06 FILTER MATERIAL. Filter Material shall conform to that specified in AMC
15.65.060 Subsurface Disposal Fields, Paragraph D Filter Material.
PART 3 CONSTRUCTION
3.01 GENERAL. All construction shall be installed as specified in the most current
edition of the MoA Onsite Regulations (AMC 15.65), the most current edition of the MOA
Onsite Installer's Manual, Specifications, and Special Provisions.
The Contractor shall restore all disturbed property, including drainage swales, which were
disturbed due to construction activities for this item to preconstruction condition or better.
The Contractor is required to maintain the required horizontal and vertical separation
distance required by the code. Specifically:
• Solid pipes transporting wastewater from the house to the septic tank, and from the
septic tank to the drain field shall have a minimum of 36 inches of vertical separation
between any storm drain or footing drain. If 36 inches of separation cannot be
Page 4 of 8 4/25/2007
maintained, install a minimum four -inch (4 -inch) thick insulation buffer between the
septic system and the storm drain or footing drain.
Solid pipes transporting wastewater from the house to the septic tank, and from the
septic tank to the drain field shall have a minimum of 11 feet horizontal and 18
inches vertical separation between water service lines and mains. Sanitary sewer
pipes shall be centered over the crossing and no joint shall be closer than at least
half the standard pipe length to the waterline crossing.
Septic Tanks and Drain Fields shall be placed no closer than:
• 100 feet to any private well, unless previously approved by the MoA;
• 11 feet horizontally measured to any water main, water service, storm sewer, street
light, transformer pad, electrical/telephone/cable box;
• 10 feet horizontally measured to any side lot line
• 50 feet up -gradient or 20 feet down -gradient of any footing drain or curtain drain.
• Those separation distances required under AMC 15.65
The Contractor shall relocate any item installed with less than minimum measured
distances prior to final inspection and at no cost to the Owner.
3.02 LOCATIONS AND GRADES. The Contractor shall verify and record the
horizontal and vertical locations of all utilities encountered in the field and record any
changes on the Contractor Record Drawings.
The Contractor shall hire or employ a Registered Land Surveyor to stake the location of the
septic tank, drain fields, property lines, well, 100' well radius, ten -foot property line
setbacks, or any other required feature. Failure to properly stake these locations shall be at
the risk of the Contractor and the Contractor shall be responsible if the required distances
are not met.
The septic tank shall be placed at the locations and elevations as shown on the Drawings.
The tank shall be set level to a tolerance of plus or minus 0.05 feet from end to end.
The drain field shall be placed in the location shown on the Drawing, with minor
adjustments allowed to minimize excavation and accommodate the existing terrain. The
drain field piping shall remain level over the length of the drain field. The drain field shall be
constructed entirely within 30 feet of the test holes shown on the Drawings. Contact the
Engineer immediately if the drain field cannot be installed in the location shown on the
Drawings.
3.03 EXCAVATION.
Sewer services pipes shall be bedded. Bedding and trench backfill shall be compacted to
95% of maximum density.
Material that is placed while frozen or during freezing conditions shall be removed and
replaced during periods when the material is thawed so proper compaction can be
achieved.
Page 5 of 8 4/25/2007
3.04 SEPTIC TANK. The septic tank shall be placed on undisturbed soil on a level
grade at a depth as indicated on Drawings. Backfill around the tank with sewer gravel fill to
at least the spring line of the tank. Fill above the spring -line of the tank shall be installed in
12 -inch lifts compacted to 95% maximum density. Any damage to the protective coating
during installation shall be repaired as recommended by the manufacturer.
The tank inlet shall be set at the elevation shown on the Drawings. Care shall be taken
during installation to ensure the proper elevation drop between the inlet and the outlet.
Install flexible "Fumco" rubber fittings, or approved equal, at connection from tank to inlet
and outlet pipes as indicated on the Drawings. The Contractor shall take caution to prevent
the tank from floating once it is set in place. The Contractor shall reset the tank to the
proper grade if it floats, at no additional cost to the Owner.
3.05 PIPES. Pipes shall be joined to one another, to the polyethylene fittings,
cleanouts, and tanks in accordance with these Specifications and the manufacturers
recommendations.
A. Plastic Pipe to Cast Iron. The existing cast iron sewer line from the house shall be
connected to the new septic tank using 4" 3034 PVC Pipe. Connect the two pipes
with a Fumco "No -hub" coupling, or approved equal, consisting of a rubber gasket
and adjustable metal bands.
B. Sewer Distribution Lines. Sewer distribution piping shall be joined using two-part
PVC cement. The first part shall prime and clean the PVC pipe. The second part
shall join the two pipes. Each section shall be able to withstand a working pressure
of 25 psi.
All piping shall be placed as shown on the Drawings and placed as straight as practical.
In case of conflict between stationing of pipe or fittings, use dimensioned locations relative
to the centerline and property line, the dimensioned locations shall govern. Dimensions and
length called -out and indicated on the drawings shall govern over the scaled distances.
Reliance on scaled distances and length shall not be allowed and is done so at the risk of
the scaler.
3.06 SOIL ABSORPTION SYSTEM. The drain field shall be constructed as shown
on the Drawings and in accordance with all applicable regulations described in AMC 15.65
Wastewater Disposal.
The drain field area shall be excavated to the elevation and dimensions as shown on the
Drawings. Remove all organics and silt. After excavation, the open hole shall be protected
from surface runoff to prevent the entrance of silt and debris. Under no circumstances shall
the use of heavy equipment be permitted on the drain field surface. All smeared or
compacted surfaces shall be raked to a depth of one (1) inch, and loose material removed,
before any of the drain rock is placed.
The bottom of the trench shall be level to within 0.2 feet, end to end.
Page 6 of 8 4/25/2007
The gravel and distribution piping shall be installed as shown on the Drawings. Perforated
PVC pipes shall be laid in the drain field so that the holes are placed down in the gravel.
The drain field shall then be backfilled with gravel to a depth of a half -foot above PVC
distribution piping invert. Filter fabric and insulation shall be placed over the bedding as
required by the Drawings. Backfill above the filter fabric with material excavated from the
excavation to the elevation shown. The material shall be mounded over the drain field as
shown on the Drawings. Backfill of drain field shall not be compacted.
All slopes and surfaces shall be top -soiled and seeded with a minimum of six inches of
topsoil and MOA Schedule A Seeding.
3.07 Demolition of Existing Septic System. This section is to be used only if required on
the Drawings. The existing septic tank adjacent to the existing drain field shall be
demolished in accordance with Appendix K of the Uniform Plumbing Code and AMC 15.65.
The existing septic tank shall not be demolished until the new septic tank is connected to
the existing residence and is ready for operation, or if temporary provisions are made and
approved by the Engineer.
The septic tank shall be exposed and all piping removed and disconnected. All liquid shall
be removed by an MOA ONSITE Certified Sanitary Pumper and disposed of in a certified
septage disposal area. The top of the septic tank shall be removed. The entire inside shall
be coated with lime to stop the biological action. The septic tank shall be crushed in place
or removed and disposed of in a certified landfill. The ensuing hole shall be filled with
unclassified backfill and compacted to the required density. The area shall be covered with
topsoil and shall be seeded per MASS Division 75.
The existing drain field shall be abandoned in place. If the drain field is a crib type system,
the crib shall be collapsed and filled with structural material. The entire are shall be top -
soiled and seeded in accordance with Mass Division 75.
The existing piping that remains shall be disconnected from the septic tank and abandoned
in place. All clean -outs or other indications of the piping at the surface shall be removed.
PART 4 BASIS OF PAYMENT
4.01 METHOD OF MEASUREMENT. Sanitary Sewer System is a lump sum item and will
not be measured directly for payment but shall include all work necessary to install an
operational system as detailed in the Drawings and Specifications. All component items
necessary to complete operational systems will be considered subsidiary to this item and
will not be measured separately for payment. Excavation and backfill for this item will be
considered subsidiary. This item will be considered complete when the system is
demonstrated to be operational.
Dewatering operations as required will be considered subsidiary to Sanitary Sewer System.
Submittals required as described in this Section will not be measured for payment but will
Page 7 of 8 4/25/2007
be considered subsidiary to Sanitary Sewer System.
5.01 BASIS OF PAYMENT. Sanitary Sewer System will be paid for at the contract lump
sum price.
Utility location and coordination required to complete this item will be considered subsidiary
to this item and will not be paid for separately.
Payment will be made under:
Pay Item Pay Unit
Sanitary Sewer System Lump Sum
Page 8 of 8 4/25/2007
- n T
D
GREh.ER ANCHORAGE AREA BOR.,JGH
Department of Environmental Quality
flo u� F_ Anchorage, Alaska 99503
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME _Y �NCCu �� N!7/� MAILING ADDRESS �'3�� E p 8r i+/�C PHONE 71 4-9'"
LOCATION-C'��Sfd(GaI O,P(i� f� LEGAL DESCRIPTION�Q Tfi Cita-Lk�s SI,(J
SEPTIC TANK:
DISTANCE NUMBER OF
FROM WELL / MANUFACTURER SL(,Jt/Se MATERIAL ��^.fS7
COMPARTMENTS
INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY_o0d GALLONS.
TILE DRAIN FIELD:
�0 4 TOTAL LENGTH
DISTANCE FROM WELL FOUNDATION ZS NEAREST LOT LINEA% OF LINES —52
NUMBER OF LINES �j/DISTANCE BETWEEN LINES TRENCH WIDTH IN. TOTAL EFFECTIVE
ABSORPTION AREA 3SQ. FT. LENGTH OF EACH LINE ( 3 3
L/ DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE _1' MATERIAL BENEATH TILE v IN. ABOVE TILE` IN.
WELL: Nor Z') &r or
TYPE CONSTRUCTION DEPTH DISTANCE FROM:
BUILDING NEAREST NEAREST SEPTIC SEEPAGE
FOUNDATION , LOT LINE , SEWER LINE , TANK , SYSTEM _
CESSPOOL , OTHER SOURCES
APPROVED DISAPPROVED
DISTANCES:
INSTALLED BY
SEWER LINE DEPTH:
PIPE MATERIAL:01-45 / X-460-`
(Ai 17 -If Pee F 17/19
LOT SLOPE:
REMARKS:
Form EQ -032
_(REMARKS
DIAGRAM OF SYSTEM
Cao, lee) ,a
SVA ' 3a.
-,o
FRG Air
/3y •�1�t�-S �x�. I�
rVIc0
DATE //� APPROVED
G.A.A.B.
Traifirb Bolfing twag
by.
A & L DRILLING COMPANY
BOX 97, EAGLE RIVER, ALASKA 99577 •. TELEPHONE 6942588
OWNER OF LAND R I SG H _ L3/jTES JO/nVj 'yEl✓T^ D&II OF WELL 3 3 C
a
ADDRESS
STATIC LEVEL OF WATER FT. 9 4
LEGAL DESCRIPTION—ZQT C Ay< DRAW DOWN FT. aS,
U�YF7&arfed 313 O '76 Ended / r-76 GALS. PER HR 300
S
PERMIT NUMBER
KIND OF FORMATION:
KIND OF CASING j= O 0
FromFt. to--a--Ft. 1911 QDt�✓ From Ft. to Ft.
From Ft. to /s) Ft. (/9//O �" CRfiyC� From Ft. to Ft.
FromFt. to SF Ft. C.[T r 4e,1'064 t~ ,(3_UAV-c SFrom Ft. to Ft.
From/'_ Ft. to 40 Ft. SANG
From -60 --Ft. to _6F Ft. S<IN'67 4QJal e�
From-6y—Ft. to LO) PFt. HR
From lag Ft.to_jS_Ft. S' lgevDICQ/9✓cL
From Ft. to Ft
From Ft. to Ft
Front Ft. to Ft.
From Ft. to - Ft.
From �Ft. to 117Ft. `Lfl / C'IroqUCL From Ft. to Ft.
From /97 Ft. to a3 8 FL Dn VQ 44;V41fe I &0412F4 -{From Ft. to Ft.
From23FFt. to TS_ Ft. 7 /61 f r SANr7
From 2571- Ft. to 12 a Ft. 9'
JO I �QR uE L
From�Ft. to R9D171. '4/?A_ 04c-'4Qz5<T
F 2TO Ft t Ft �j'Lo't ""1-4-
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft. to
Ft.
From
Ft to
Ft
rom o
From '25 From `�rL From Ft. to Ft.
From /6 Ft. to 3�Ft. SgND From Ft. to Ft.
From -31 Ft. to C1gY4ellUtC %'8oy4�'P-rFrom Ft. to Ft.
FromFt. to 337 Ft. -f4'0-"O "4"t" * ""'Firom Ft. to Ft
MISCL. INFORMATION:
fi/R 4 H/U
DRILLER'S NAME
GREe�lcR ANCHORAGE AREA 1301'�UGH
DEPARTMENT OF ENVIRONMENTAL QUALITY PERMIT NO.
3330 "C•' STREET ANCHORAGE, ALASKA 99303 • POA/F/aYJe/J
EtHONE 274.4381 -
��77 •'Lit{ -'L !.-'"�C// L N
SEWAGE DISPOSJA�L S ST — APPLICATION ANDD PERMIT 7 e �
NAME OF APPLICANT Z• 1!J �7+7-CfS MAILING ADDRESS
INSTALLATION LOCATION �3J__A1l s J U Ll e-4- L 6, -
LEGAL DESCRIPTION
INSTALLATION OF: SEPTIC TANK 1/� pSEEPAGE PIT— DRAIN FIELD O�ER
TYPE AND SIZE OF FACILITY TO BE SERVED L1 /[ ♦ 1 / N Cy /k- �fJ Jas / �L/ A -r 71,
FINANCED THROUGH TO BE INSTALLED //BY
���♦f �� ♦�S�♦ ` �" rt `Z
SOIL TEST RESULTS /���'«�" S T� //• ��� �lu4 IEdTE, THIS PERMIT IS NOT VALID WITHOUT SOIL TEST
COMPLETION DATE ANTICIPATED
FINAL INSPECTION: 24 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE
DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. -
SEPTIC TANK SIZE l'•'" D "/ YPE
SEEPAGE AREA
MINIMUM DISTANCES. REQUIREMENTS
I
FOUNDATION TO SEPTIC TANK -
1♦.E.Z /
FOUNDATION TO SEEPAGE PIT DRAIN T"IR9 L ,
SEPTIC TANK TO SEEPAGE PIT WALL
SEPTIC TANK SEEPAGE PIT DRAIN F—M
TO NEAREST LOT LINE.
/J
WELL TO SEPTIC TANK /el J n SEEPAGE PIT /O'-"
DRAIN FIELD - �(" (� ALSO CONSIDER AREA WELLS.
WATER MAIN TO SEPTIC TANK SEEPAGE PIT
DRAIN FIELD
SEPTIC TANK, 14/� / , SEEPAGE PIT /D�" •DRAIN FIELD
TO RIVER. LAKE. STREAM.
CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF
EXCAVATION S FEET INTO UNDISTURBED SOIL.
4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE
PIT
FITTED WITH AIRTIGHT REMOVABLE CAPS.
� r/ ZX5 S
GRAVEL BACKFILL //JJ//nn'//
CONFORM TO BOROUGH
/R ULATIONS REGARDING INSTI�CUTrION.
/
G.A A.S.
OR
LICENSED DESIGNER
<U"l 7srl/ /h d'
61ZE lzTYPE
DIAGRAM OF SYSTEM[
1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.08 AND THAT THE ABOVE
DESCRIBED SY TEEM IS IN ACCORDANCE WITH SAID CODE.
DATC ` � APPLICANT'S SIGNATURE
FORM NO. EO01
♦ . MINEEM
■MEMO
MMOM
■MEMiiIMMINMEEMMEMOO
E MOEE
MOEM ■■EMO
MMME
MEN ME
momOEE
MEN M�CM
■
ME
iMM
FEMME ■�iMMEai■
MOEOMEUMMMO
ME
MEOMMMMEMEOME
MORE
EM
MMM MEMO.
MEMIN
?
EEMEE
MEN
MEnMMMEOMOMMOOiO
1 CERTIFY THAT I AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28.08 AND THAT THE ABOVE
DESCRIBED SY TEEM IS IN ACCORDANCE WITH SAID CODE.
DATC ` � APPLICANT'S SIGNATURE
FORM NO. EO01
0 & E GE01 CHNI CAL & DEVELL. 'MENT CO.
Box 90, Davis St., Eagle River, Alaska 99577
_ 694-2774 or M-2290
Earl 011s
Russell Oyster SD 688.2280
6942774 Land Development
Soils @ Foundations
Performed for: Name' V/A1C,EN7— 15gT,ES Tel. No. Z -
Performed
Mailing Address: .2300 E ��TN /�Ncs/n,2RCrE, �K. 9yl�o
Legal Description: -407- G'Ac%K/'/S
Depth (feet) Soil Characteristics
0
1 /Vl%. — --�5/4-7— 7',n Spic.
3
y P — /GiNE SANOV
5 VEWSELc% Ge,vSvc.DN7-'0!-F0
6
7
n
9 6P— /l'Eo. To 41141 14a/0Y
10 61za tlEc. , L nos.E� Y
11 Go.vlu41 D471E6
12
13
G P— SAS/o s� �2Ac�EL ti �o5/s[-Es,
14 T,C,4GE nF Sc.7— A'•f �CA2!>�2 /'
15 /�ocK QGD�¢f/N�r J • .COolE[.✓ GO.Vf.
16
Ground Water Encountered: Yes No If yes# what depth
Proposed Installation: Seepage Pit Drain Field
Comments:
.2 '7j dT B.Q.
g`" d I%3, l2.
/s c Q6.r2.
qb5 B�
• Municipality of Anchorage v R
On -Site Water and Wastewater Program _
(907)343-7904
Certificate of On -Site Systems Approval
Parcel I.D. 050-211-15
1. GENERAL INFORMATION
Complete legal description Calkins, Lot 6
Expiration Date: 3 _ & — 1 3
Location (site address) 10515 Crest View Lane
Current Property owner(s) Richard & Valerie Adams Day phone
Mailing address 10515 Crest View Lane
Real Estate Agent Day phone
2. TYPE OF DWELLING:
I] Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY:
TYPE OF WASTEWATER DISPOSAL:
Individual Well
E
Individual
0
Individual Water Storage
❑
Holding Tank
❑
Community Class Well
❑
Community
❑
Public Water System
❑
Public Sewer
❑
Waiver/Variance request
Received by: ,;Z/l I - rr'_ I Date:
COSA to be release to tt;Zgineeef. unless othe _ requested by the engineer.
COSA Fee $ Waiver Fee $
Date of Payment Date of Payment
Receipt Number Q 1VJReceipt Number
COSA# Qse Waiver#
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation,
based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes,
ordinances, and regulations in effect at the time of installation.
Name of Firm Pannone Engineering Services
Address P.O. Box 100217, Anchorage, AK 99510
Engineer's Printed Name Steven R. Pannone
6. DSD SIGNATURE
System #1 Approved for 2 bedrooms
System #2 Approved for _ bedrooms
Disapproved
Phone 272-8218
Date /--,7 L%6
Conditional approval for bedrooms, with the following stipulations:
By: ZZ 63Original Certificate Date: 12-6—/-2,
Them icipaM of a Development Services Division (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory_ Other
COSAbWSheet S I- c
If more than 7 septic system is on the lot:
COSA Checklist # _of _
Structure served by this system
Certificate of On -Site Systems Approval Checklist
Legal Description: Calkins U6 Parcel ID: 050-211-15
A. WELL DATA
Well type Private If A, B, or C provide PWSID #
Date completed 4/1/76 Sanitary seal (Y/N) Y
Total depth 337 ft. Cased to 337 ft.
FROM WELL LOG
Date of test 4/1/76
Static water level 294
Well production
5
ft.
9 -
p.m -
WATER SAMPLE RESULTS:
Coliform Neg colonies/100 mL Nitrate Neg mg/L
Arsenic ND ug/L Date of sample: 11/7/12
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Steel
Tank size 1250 gal. Number of Compartments 2
Foundation cleanout (Y/N) Y
Date of pumping 11/13/12
Well Log (Y/N) Y
Wires properly protected (Y/N) Y
Casing height (above ground) 26 in.
AT INSPECTION
11/9/12
291 ft.
0.3
9 -
p.m -
Collected by: PES
Depression over tank (Y/N) N
Pumper SR's Pumping
Date installed 4/30/07
Cleanouts (YIN) Y
High water alarm (Y/N) NA
C. ABSORPTION FIELD DATA
Date installed 3/3176 Soil rating (g.p.d./ft2 or ft2/bdrm) 85 Sf/bd System type Trench
Length 33 ft. Width 3 ft. Gravel below pipe 6 ft.
Total depth 10.4 ft. Eff. absorption area 396 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 11 /13/12 Results (Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test 0 in. Water added 450 gal. New depth 60 in.
Elapsed Time: 1440 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) N If yes, give date
D. LIFT STATION
Date installed
"Pump on" level at
Datum
Size in gallons _
in. "Pump off' level at
E. SEPARATION DISTANCES
WELL ON LOT TO:
Cycles tested
Septic tank/lift station on lot 100+
Absorption field on lot 100+
Public sewer main 75+
Sewer/septic service line 25+
Animal containment areas 100+
Manhole/Access (Y/N) _
in. High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots 100+
On adjacent lots 100+
Public sewer manhole/cleanout 100+
Holding tank 100+
Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5+
Water main 10+ Water service line 10+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10+
Water Service line 10+ Surface water 100+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA COSA guidelines in effect on this date.
Engineer's Printed Name Steven R Pannone
Date /Zll a?)
COSA brown sheet -1 0-10-1 2.doc
Absorption field 5+
Surface water 100+
Water main 10+
Driveway, parking/vehicle storage 110+
in.
Municipality of Anchorage OE s ,
Development Services Department `-I.
Building Safety Division E,
On -Site Water and Wastewater Program
4700 Elmore Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
Water Well Advisory
Certificate of On -Site Systems Approval (COSA) # 121547
During a recent COSA on-site inspection and test of the potable water
supply well on Block , Lot 6 of Calkins subdivision, the well's
productivity was determined to be 0.3 gallons per minute. The minimum
well productivity required by this Department (AMC 15.55) for a 3 -bedroom
residence is 0.31 gallons per minute. Although the subject well currently
exceeds this minimum requirement, all parties concerned are advised that the
production capacity of the well may fluctuate. Restriction of non-critical
water uses such as washing cars and watering lawns and gardens may be
required.
This advisory must be attached to all copies of the subject Certificate of On -
Site Systems Approval.
k!�
e
) 25'. Z -'O �
R�w
Uze34-110%
I hereby certify that I have surveyed the following
desmibed property, a'SdHi'ns
Anchorage Recording Precinct, Alaska, and that —the
AMPmvements situated thereon. are Within the property
lines and do not overlap r encroach on the property
lying adjacent thereto, aOt no - vemeotts, im prap-
erty lying adi =roc
oa u the premises ra
=ono=d %7attI;h=WTeor roadways, transmission.
r visible easements on add property except
visi
as indicated hereon.
Dated at Eagle River, Alaska
th�n��.day of 0-4
ROBERT C. JOHNSON
SCALE: Registered Land Phone Surveyor No. 88Q LS
'3c5A Rox456 6 4-2 MRiver Alaska
2
Wang
Na
ar
R�w
Uze34-110%
I hereby certify that I have surveyed the following
desmibed property, a'SdHi'ns
Anchorage Recording Precinct, Alaska, and that —the
AMPmvements situated thereon. are Within the property
lines and do not overlap r encroach on the property
lying adjacent thereto, aOt no - vemeotts, im prap-
erty lying adi =roc
oa u the premises ra
=ono=d %7attI;h=WTeor roadways, transmission.
r visible easements on add property except
visi
as indicated hereon.
Dated at Eagle River, Alaska
th�n��.day of 0-4
ROBERT C. JOHNSON
SCALE: Registered Land Phone Surveyor No. 88Q LS
'3c5A Rox456 6 4-2 MRiver Alaska
2
�1c5
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 1. D. # 0 5 D - ;2- /1 - /-5-
1.
s
1. GENERAL INFORMATION
51
9
HAA# 0C)C) >f6-�
Complete legal description
Location (site address or directions) /478"/5- G¢5sr l%6ct% L >E
Property owner J��� �"��E� Day phone-zy%-zs�i
Mailing address
Lending agency Day phone
Mailing address
Agent Day phone
Address
Unless otherwise requested, HAA will be held for pickup
NUMBER OF BEDROOMS: -;:?
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE: If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025(R.v V91) From MOA#21
5. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Name of Firm Phone(�5�7% An7�
Address 99Go 45 -
Engineer's
-
Engineer's signature
6. DHHS SIGNATURE
Approved for 3
Disapproved.
Conditional approval for
Additional Comments
L2
Date _ 9. 113 . &0
. -•.'.,ii�f a�v��„�4�luu��d�G� Vii;.
.? CE -aria
bedrooms.
bedrooms, with the following stipulations:
Date- 9 - 2 6 - O 0
The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority
Approval Certificates based only upon the representations given in paragraph 5 above by an independent
professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes
and their lending institutions in orderto 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.
72-025(Rev. 1/911 Beck MOA921
RECEIVED
Municipality of Anchorage SEP 2 12000
!� DEPARTMENT OF HEALTH & HUMAN SERVICES
Environmental Services Division
825 L Street, Room 502 • Anchorage, Alaska 99501 ANCHMGE
Health Authority Approval Checklist
Legal Description: ����� e%OG�',� �"'��y�s�H'J Parcel I.D.: O rO - %Z I
A. WELL DATA
Well type If A, B, or C, attach ADEC letter. ADEC water system number
Log present (Y/N) y Date completed yZ/74
Total depth j3G �� Cased to �� fFi Casing height (above ground) Z
Sanitary seal (Y/N) Wires properly protected (Y/N) i
FROM WELL LOG AT INSPECTION
Date of test
Static water level Z 9`�� z q2 Sof
Well production �GP 9•p•m• �' 2 9 -p -m-
WATER SAMPLE RESULTS:
Coliform Nitrate D . S Other bacteria C7
Date of sample: l/Z/Oo Collected by:
B. SEPTIC/HOLDING TANK DATA
Date installed '� Tank size Number of Compartments Cleanouts (Y/N) Y
Foundation cleanout (Y/N) P- Kft '( Depression (Y/N) A) High water alarm (Y/N) �lA
Date of Pumping 01 - 13 • r o Pumper 5 �
C. ABSORPTION FIELD DATA
Date installed �3�7G Soil rating (g.p.d./ft2 or ft2/bdrm) 4P9 System type����
Length idth Gravel thickness below pipe Total depth 2
2 �f
Effective absorption area Monitoring Tube present (Y/N)Y_ Depression over field (YM)
Date of adequacy test 9� 2�e Results (Pass/Fail) For bedrooms
Fluid depth in absorption field before test (in.); 2�5 Immediately after SoSgal. water added (in.): `' ��
.�
Fluid depth 3 z (ins) Minutes later: 4'1a Absorption rate = > ys
4 p.d.
Peroxide treatment (past 12 months) (Y/N)
72-026 (Rev. 3/96)'
A) If yes, give date
D. LIFT STATION
Date installed -
-Manhole/Access (Y/N) --
High water alarm level at*
Cycles tested _
E. SEPARATION DISTANCES
Size in gallons
"Pump on" level at*
*Datum
SEPARATION DISTANCES FROM WELL ON LO'r TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
X-4
/69 / -'-/
"Pump off" level at*
On adjacent lots uJ�.J�e o,J ,.f-«15-
On adjacent lots
uJi'�/ r^/✓Gi�� �G sY1T��
Public sewer manhole/cleanout _ !q
Sewer /septic service line 2S�« Lift station
SEPARATIOI/� DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation 9 Property line Absorption field_
Water main/service line _ A� Surface water/drainage Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Property line id ��� Building foundation 30 Water main/service line z �y
Surface water y11f;z • Driveway, parking/vehicle storage area 1ra �
i(Ja w.JG �C�cJa uJ.r'
Curtain drain ra 'x sr Wells on adjacent lots
F. ENGINEER'S CERTIFICATION
i certify that I have determined thru field inspections and review of Municipal
in conformancg with MOA HA guide 'nes in effect on this date.
Signature
Engineer's Name _y 41111-1-
Date
1111f
Date _q '�' 0,
HAA Fee $ , � D/� 0�
Date of Payment 2-1 W
Receipt Number Z i ay
72-026 (Rev. 3/96)*
Waiver Fee $
iao 11, ,Z
Date of Payment
Receipt Number
are
CT&E Environmental Services Inc.
CT&E Ref.#
1005526001
Client Name
Douglas Kenley P.E.
Project Name/#
L6 s Sub 64-1�'a?.5
Client Sample ID
L6 Yk4kdm Sub 6-I&APS
Matrix
Drinking Water
Ordered By
PWSID
0
Sample Remarks:
Client PO#
Printed Date/Time
Collected Date/Time
Received Date/Time
Technical Director
Released By
09/18/2000 15:33
09/12/2000 20:15
09/13/2000 16:40
Stephen C. Ede
Allowable Prep Analysis
Parameter Results PQL Units Method Limits Date Date Init
Waters Department
Nitrate -N 0.500 U 0.500 mg/L EPA 300.0 10 max 09/13/00 SCL
Microbiology Laboratory
Total Coliform 0 col/100mL SM18 9222B 09/13/00 KAP
Douglas T. Kenley Civil Engineer State of Alaska C.E. 8176
Legal Description
Address
Applicant
Date of Test
Inspector
Work Order
System Data
Well depth
Stafic water level
WELL FLOW TEST
Y36 /3 "
z9z.9/
Casing above ground ,2 q inJ.
TIME
System
Meter
reading
Diff.
Cum.
Volume
TEST DATA
Flow Static
Rate Water
Level
Difference Comments
t vs
zse
—
—
z92 Y
—
f9-
J2yoB
4/$/
�/
3aG s-
/3 m
%v
JA 52-
a i
/y8
3. 9
1i9cr
3
,V7
1ZGR%
53
aLJ
y.t
�i�
2
rs7
3L702
7s'
98
/. °/
.427°
9 a' Srbro�v �T'G.Q
Al
x%
°
32723
Z/
X-
-*Q0-4
27-0
'0
27
-ate
j1de
zc
.92y�
obi
(o
j2BP2
X09
.�'O
:L.�
/ �•
2 2
24
1a 97
2
?�
�?lao9
Gyp'
3•F
Jzm2
B'
7
0
749-2-
i
-74
L 4,
'
J, 6--
System Passed ✓ System Failed
Comments Z/,wZ L 7661d" AJ
i x Fm.e .4.v i4�J6.rA66
I
I
�., MIA Amov J
ll 6p,71.
I d7 -A. Li•-is_I'
0L,14 .
MUNICIPALITY OF ANCHORAGEppp111aaa gDEP�T. OF HEALTH 8
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTE�T� _ ,1-W NTAL KOTECTIQN
825 L Strest - Andtoraas, Alrka 99001 f� jY 1
�(L�
ENVIRONMENTAL ENGINEERING DIVISI(�Dkl'o
Telephone 284.4720 t6 lu , L_las E E
IL I S ��
REQUEST FOR APPROVAL OF INDIVIDUAL WaTE&�ID SEWAA
��R�
DIRECTIONS: Complete all pans on palls 1. Incatnpleb requests will not M processed. Please allow ten'ROI days for p
1. PROPERTY OWNER
PHONE
Clyde J. Temple
694-3235
MAILING ADDRESS
Star Route 1 Box 160 99577
PROPERTY RESIDENT (If different from above)
PHONE
2. BUYER
PHONE
MAILING ADDRESS
LENDING INSTITUTION
PHONE
MAILING ADDRESS
♦ REALTOIUAGENT
PHONE
Simone Thompson % Area Realtors
694-9555
MAI LING ADDRESS
Post Office Box 249 99577
S. LEGAL DESCRIPTION
Lot 6 Calkins Subdivision
STREET LOCATION
Crest View Lane 99577
S. TYPE OF RESIDENCE
NUMBER
SINGLE FAMILY
1:1One ❑ Four ❑ Other
90C Two ❑ Five
❑ MULTIPLE FAMILY
❑ Three ❑ Six
7. WATER SUPPLY
but plu ed roratnre—e-TTT-b—earoom
IC INDIVIDUAL'
*ATTACH WELL LOG. A well log is required for all wells drilled
❑ COMMUNITY
since June 1975. For wells drilled prior to that date, give well
❑ PUBLIC UTILITY
depth (attach log if available.) 320'
S. SEWAGE DISPOSAL SYSTEM
TSX INDIVIDUAL/ON-SITE"
"If individual/on-site, give installation date 1976
If system is over two (2) years old an adequacy test is required
❑ PUBLIC UTILITY
by this Department.
NOTE: THE INSPEC71ON FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3178)
IILiID L, a �Lc Jid - LLA.1
r
PLOfS
fTHIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
1. TYPE OF RESIDENCE
❑ SINGLE FAMILY
❑ MULTIPLE FAMILY
❑ ONE
❑ TWO
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLICUTILITY
Connection Verified
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON -SITE
E] PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATEINSTALLEC
INSTALL
❑Septic Tank or ❑ Holding Tank
Size: If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK
MANUFACTURER
TOTAL ABSORPTION AREA
MATERIAL
4. DISTANCES
WELL TO:.... _
Sept .. Tani.,
5. COMMENTS
NUMBER OF BEDROOMS
❑ THREES' ❑"'FIVC '❑ t'bTF1ER
❑ FOUR ❑ SIX
-, S�Q ur1 PcP£a co
G£ i rtPcr.tPti 7� AL_rmPLt`,L>
APPROVED FOR 37 BEDROOMS
❑ CONDITIONAL APPROVAL (letter must accompany certificate)
❑ DISAPPROVED
72-010 1Rev. 3178)
a' Municipality of Anchor e
�• +►•� tt�� MUNICIPALITY OF ANCHORAGE
Environmental Protection DEPT. OF HEALTH s
825 L Street ENVIRONMENTAL P90TECTION
Anchorage, Alaska. 99501
- — OCT 16 1978
REQUEST FOR APPROVAL'OF
INDIVIDUAL SEWER E HATER FACILITT.N'LECEIV_ED
1. Type of Inspection:.-CMRO- VA FHA CONY X%_ :.
2. Property Owner: Clyde J. Temple
Nailing Address: Star Rt. 1, Box 160, Day Phone 694-3235
Eagle River,'AK 99577
3. Name of Buyer:
Nailing Address: Day Phone
4. ➢cane of Lending Institution:
Nailing Address: Phone [
5. Name of Realtor or Agent: .'AREA,. Tnr. RPaT tnrs % J�.maxJ lilomOsQ✓�
Nailing Address: P. O. Box 249.'Eaale Ritlfii4ne 694-9555
6:. Legal
Description: _Calkins
Lot 6
Location:
Crest View Lane
Eagle River, AK
99577
7. .Type
of Facility to be
M&
inspected:. Home No. Bd'•�s. 2 �y(
S Water
Supply
i�/«s•,btd� �� a' .'3R
Type
of Supply: '•.Public
Utility
Individual x "
• If
Individual, *number
of dvielli'ngs.
presently .served one
If
Individual, depth
of well 320
9'. Sewage Disposal - System
Type -of System: . Public Utility Individual (on-site) x
_..I.f.Indfvidual, date of installation Summer 1976