HomeMy WebLinkAboutSTETSON LT 1t
n
Lot I
#015-163-28
oGRE
,'ER ANCHORAGE AREA BOk JGH
Department of Environmental Ouality
3330 C Street
Anchorage, Alaska ggB03
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
SEPTIC TANK:
DISTANCE I
FROM WELL I (~O 4- MANUFACTURER
INSIDE LENGTH INSIDE WIDTH
, NUMBER OF
MATERIAL ICN"~.~ COMPARTMENTS
LIQUID DEPTH '~' LIQUID CAPAClTYIO(~OGALLONS.
AIN FIELD:
DISTANCE FROM WELL.
I
NUMBER OF LINES
/
0_¢,.,.,¢ o
ABSORPTION AREA&'~"~"~i"~""'~L] I"'~O SQ. FT. LENGTH OF EACH LINE
! DEPTH OF FILTER
DEPTH: TOP OF TILE TO FINISH GRADE. ~ MATERIAL BENEATH TILEX ';~ IN. ABOVE TILE
!
% '~,~ I I TOTAL LENGTH /¢>0 ~-'~II
FOUNDATION~NEAREST LOT LINE O"~ ~' OF LINES
DISTANCE BETWEEN LINES J~J Ac TRENCH WIDTH~'L~z~ IN, TOTAL EFFECTIVE
IN.
WELL: u,'-
Typ~'~JAC~ lO' g-~ CONSTRUCTION
BUILDING (¢>(,~ (' NEAREST NEAREST ~ SEPTIC J SEEPAGE
FOUNDATION , LOT LINE
/
CESSPOOL OTHER SOURCES
APPROVED DISAPPROVED REMARKS
DISTANCES:
SEWER LINE DEPTH:
LOT SLOPE:
REMARKS:
DIAGRAM OF SYSTEM
APPROVED ~'"~
J G.A.A.B.
F'ERMIT NO.
RF'PLIC:RNT
LOCRTION
L. EGRL
?RLLRS NIC:HOL~
HIDEFIHR9 TRFIIL
2606 WEST ~2ND FIVE
27S~-7071
L± STETSON SUBD
LOT SIZE 53000 SQURRE FEE'r
'T~r'F'E OF SOIl_ RBSORBTION S"r'STEM IS: TRENCN
MRXIMUM NUMBER OF FIEDROOMS = 3:
SOIL. RR"CING (SQ F].'?BR)= :1_50
THE REQUIRED SIZE OF THE SOIL. FIBSORPTION SYSTEH IS:.
[:' [:£ F" "il-' F-I = :t. :'L L. E I'4 ~S'T H == ':-:" ':" ~ ........ '.." ....
TNE LENGTH DIMENSION IS THE LENGTH (IN FEET::, OF THE TRENCFI OR DRFIINFIELD.
'¥'HE DEPTH OF R TRENCH OR F'IT IS THE DISTFINCE FIETHEEN THE SURFFICE OF THE
GROUND FIND THE BOT'T'OM OF' ]'HE ENCFIVRTION ,::IN FEET:).
]'HERE IS NO SE]'' WIDTH FOR TRENCHES.
THE GRFIVEL DEPTH IS THE MINI'I"/UM DEPTH OF GRFI',/EL BETHEEN THE OUTFFILI... PIPE
FIND THE FIOTTOI'd OF THE EXCFIVFI].'ION (IN FEET).
'-Ir' [,-~ C, ( g~' ::, ][ ~'-,~ S F' E C: ]" :I C~ ['-,~ S Fi F: E F-: E: ~]-:.~ ~.....~ ][ F~: E:
B~-aCI<FILI_.ING OF FIN"r' SMSTEM HITHOUT FINFIL INSF'EC:TION FIND FIPPROVFIL B'¢ THIS
DEPFIR. TMENT HILL BE SIJFIJECT TO PROSECUTION.
MINIHUM DISTFINCE BETWEEN FI [,]ELL FIND RN'T' ON-SITE SEHFIGE DISPOL=:FIL S'¢S'TEM IS
:1.00 FEE]" FOR FI PRIVFITE HELL OR 2z00 FEET FOR ia F'UFII._IC HELl....
SPECIFICFITIONS FIND CONSTRUCTIOIq DIFIGRFIMS FIR. E FI ',,,' FI I L FI FI L E TO INSURE PROPER
INSTFILLRT I ON.
F"E]RIP'~ I: ]t-- "..."[:-IL_ :I [:, F C~-~: C,I'-.] E: %-"EF~tF~-: FF:E'-~IP-It ][
I
FORTH B'T' THE MUNICIF'FI[_I]"¥ OF FINCI'-IORFIGE.
2: i HiLL INSTFILL :.'HE S"?'STEM IN FICCORDFINCE HITH THE CODES.
S.. I LINE.,ERSTRND THRT THE OI.4-S;IT~-.SE~ER _-q-rSTEM I'1R¢ REg. LIII.;:E ENLFiR. GEf,IEi'.4T
RESIDENCE IS RE~lODEL. ED -ro INCJt/LtDE I-,~F::E THRN ?. E:EDROOMS.
FIPPL I CFINT [;!)~L.L FI:~ L LFI:~ NN I C:HOLgI C:HOLS
................... ......
CERTIFY THFIT
I FIM FFIMILIFIR HITH THE REQUIREMENTS FOR ON-SITE SEWERS FIND HELLS FI5; SET
IF THE
March 11, 1977
R & M No. 751122
Carl Luchsinger
SRA Box 94
Anchorage, Alaska
99507
Re:
Test Hole and Soil Log Report for Sanitary System
Lot 1, Stetson Subdivision, NW¼, Sec. 24-T12N-R3W, S.M.,
Anchorage, Alaska
Dear Mr. Luchsinger:
We are submitting herewith the test boring results and our comments
regarding soil conditions encountered at the subject site. This in-
vestigation was performed in accordance with your request of March 7,
1977 and those procedures outlined in a letter dated July 15, 1975, by
Mr. Rolf Strickland of the Municipality of Anchorage, Department of
Environmental Quality.
A single test hole was put down within the subject site area for the
purpose of defining general subsurface soil conditions for the proposed
sanitary system. Excavation was accomplished with an auger t~vpe drilling
rig and the test hole was entended to a total depth of 20 feet below ground
surface. The final log prepared for the test hole has been included in
Drawing A-01.
Groundwater was not encountered in the test hole while drilling.
We appreciate being given this opportunity to he of service to you,
Should you have any questions with regard to the above, please do not
hesitate to contact us.
Very truly yours,
R & M CONSULTANTS, INC.
Vice President
J~R: amc
xc: Municipality of Anchorage
250'
LOT 1
Not to Scale
T.H. 1
3-q-77
ORGANIC MATERIAL O 5'
SILTY SAND W/SOME GRAVEL
2.5~
GRAVEL W/SOME SAND A+~
TRACE SILT (<5%) (GP)
Slightly ~ist, Brown
SANDY GRAVELW/TRACE
SILT (GP - SP)
Slightly Moist, Brown
11.0'
SA}~ W/SOME GRAVEL A~
S~IE SI~T (SM)
No Uater Table
20.0' T.D.
Test Hole locations are approximate
and have not been located by survey
methods.
This log represents subsurface soil
conditions within Lot 1, Stetson
subdivision; ~, Sec. 24-t12N-R3W,
S.Mo, Anchoraqe, Alaska
~ 3~-1~1- 7--7 ~
[SCaLE: 1" -- 3'
F.8
SANITARY SEWER TEST HOLE
GR~D: 2640
CARL LUCtiSINGER
ANCHORAGE, ALASKA P~0g. N0 751122
DWG. NO. A-Q1
MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTIO~EpT. OF HEALTH &
825 L Street - Anchorage, Alaska 99501 ENVIRONMENTAL PgOTEC~ION
ENVIRONMENTAL ENGINEERING DIVISION ~,'~1 ~-
Telephone 264-4720
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SE ..... I
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed Pleas.e allow ten (10) days for processing.
PHONE
/ / 0 /
TYPE OF RESIDENCE ~/ NUMBER OF BEDROOMS
[] One [] Four
/Lz~ SINGLE FAMILY [] Two [] Five
[] MULTIPLE FAMILY ~ Three [] Six
[] Other
7. WATER SUPPLY
~ INDIVI DUAL* * ATTACH WELL LOG. A well log is requ'ired for all wells 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
~ INDIVI DUAL/ON-SITE~
PUBLIC UTILITY
**If individual/on-site, give installation date
I~-system_i~over-tw~(-2}-years-old~ n-ad equa ey test-is-required
by-~his~) epar~ merits-
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
7:~-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME: TIME TIME
DATE DATE DATE
I NSPECTO R INSPECTOR I NSP ECTOR
DIRECTIONS:
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
[~'~DIVI DUAL/ON -SITE
DATE INSTALLED
[]PUBLIC UTILITY
Commction Verified
INSTALLER
[]Septic Tank or [~Holding Tank
Size: If Tank is homemade SOILS RATING
give dimensions:
TYPE OF TANK MANUFACTURER .,r~~
TOTA'ABSORPT,ONAREA MATER,AL
4. DISTANCESwELL TO: Beptic/HolOin~ tS'c)Tank Absorption/..~Area Sower Line Nearest Lot Lin~
Absorption Area to nearest Lot kine
5. COMMENTS
/'APPROVED FOR '~ BEDROOMS
CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
DATE (Title)
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
January i7, 1984
V. Jane and Dallas Nichols
11201 l~ideaway Trail
Anchorage, AK 99516
Subject: Lot 1, Stetson Subdivision
Approval for the individual sewer and water facilities cannot
be granted until the following items have been completed:
o[ The septic tank pumped with a receipt submitted to this
~ department°
~ An adequacy test needs to be perform~,d on the exlstln~
~i~0~/~ leaching area. This test,will determine if the system is
iadequate according to National Standards. A listing of
.... ~ '= enclosed. This re)ort
private f~rms performing the te~t
~needs to be submitted to this office for our review. .
o Locate and expose the cleanout to the seepage pit and/or
leaching area for our inspection. This is to insure the
minimum distance requirements are met Detween the well and
sewer system.
Please notify this Department for a reinspection when the
noted discrepancies have been corrected. If there are any
further questions, please call this office at 264-4720.
Sincerely,
..... ~ - : - /~ ..4-/?
/'J ira Roberts
Associate Environmental Specialist
JR22/ej/E1
Enclosure
CHEMICAL & GI"~LOGICAL LABORATORIES
TELEPHONE (907) 562-2343
~'" ALASKA, INC.
ANCHORAGE INDUSTRIAL CENTER
5633 B Street
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER'
I.D. NO.
WATER SYSTEM:
./'~1 C-HO
Water System Name Phone No.
Mailing Address
~io Code
City State
MO. Day Year
SAMPLE TYPE:
~._cRoutine
heck Sample (for routine sample
with lab ref. no. ) [] Treated Water
[] Special Purpose
[]~ Untreated Water
SAMPLE
NO.
, I
4
5
Time
LOCATION ,--,if' Collected
Collected
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
~l~Satisfactory
[] Unsatisfactory
[] S'amole too Ion~ in transit; samole should
3ot be over'48 hours old at examination
to ndicate redable results. Please send
new samp e.
Time Received /'
Analytical Method:
[] Fermentation Tube
~Membrane Filter
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
06-1220 (b)
Rev. 1978
BACTERIOLOGICAL WATER ANALYSIS RECORD
BGB__
Cgllforrn/lOOml
ALASKA E IidlROIlmE F1TAL COI1TROL SERUICeS, IIlC.
~nqin¢¢rin§ ~- ~nuironmentol Studies
February 2, 1984
Robbie Robinson
Department of Health and Environmental Protection
825 L Street
Anchorage, Alaska 99501
Dear Robbie:
On February 1, 1984, I performed an adequacy test for M/M
Nichols on a system located at Lot 1 Stetson Subdivision. At
that time all three standpipes were capped and standing above
ground level.
Approved:
Sincerely,
~en Turner
invironmental Scientist
1200 LUest 33rcl Aucnu¢, Suite ~ · A.choreCl~, ^lask, 99503 · {907) 276-1361
ALA.$KA I 'IidlROFImE rlTAL COFITROL SeRuICe$,
~l~gi~¢¢rinc~ 6 ~nuironmcnM $ludi¢~
InC.
JANUARY 31 1984
JANE & DALT,A~S NICHOLS
11201 HIDEAWAY TRAILS
ANCHORAGE ALASKA AK 99503
sRr.LER - JANE & DALLAS NICHOLS BUYER - SAME
SUBDIVISION - STetSON BLOCK - LOT - 1
ADt~QUACY TEST FOR SEWER SYSTEM
THE TYPE OF ABSORPTION SYSTEM IS A TRENCH WITH AN AREA OF 720 SQ~T.
THE SYSTEM IS CAPABLE OF ACCEPTING 450 GALLONS OF WATER PER DAY.
THE SURGE CAPACITY OF THE SYSTEM IS 675 GALLONS.
BASED UPON THE TEST DATA THE SYSTt~4 IS ACCMPTABLE FOR A
3 BEDROOM HOME.
THE SEPTIC TAN~ WAS PUMPED ON 1/30/84 .
SEPTIC TANK ADEQUACY
THE EXISTING SEPTIC TANK VOLUME OF 1000 IS ADEQUATE FOR
'I~HIS 3 BEDROOM HOUSE.
1200 W¢sl 33rd ~tu¢nu¢, SuJi8 ~ · ~nc}~ora§¢, Aloska 99503 "(907) 276-1361
__MUNICIPALITY OF ANCHORAGE~._~
DEPARTMFN~F HEALTlt AND ENVIRONMENT/ !PROTECTION ,
825 L Street, Anchorage, Alaska 99501
279-2511, ext. 224 or 225
Date Received: _Au_~s_t 5
#1: Time 5:30 R.m. #2: Time #3: Time
Date 8-8-77 Monday Date Date
Insp Kennedy Insp Insp
'7.
R_~QUES~ FOR APPROVAL OF INDIVIDUAL SEWER AND WATER FACILITIES
Lending Institution Request: State of Alaska, Veteran's Administration
Mailing Address:
Property Owner:
Mailing Address:
Phene:
Dallas Nichols
209 Post Road
Phone: 272-0536
Legal Description: Lot 1 Stetson Subdivision
S_ngle Family Residence: ( i Number of Bedrooms: Three
Multiple Family Residence: ( ) Number of Bedrooms:
Well System:
Permit ~
Construction
Individual well (x) Community/Public System ( )
Depth of Well 102' Well Log on File
Bacterial Analysis
Sewage Disposal System:
Permit #
Septic Tank Size
Absorption Area
On-site System (x~ Public
Installed 1977 Installer
Manufacturer
Soils Rate
utility ( )
Material
Distances: Well to Septic Tank to Absorption Area
to Sewer Line Nearest Lot line Absorption Area
to Nearest Lot Line
Page T~O
Department of Health and Environmental Protection
Request for Approval of Individual Sewer and Water Facilities
Legal Description: Lot ~
Comments
Affad. avit Attached.: ( )
App oved:
Disapproved:
Letter Attached: )
Date:
Date:
Department Worksheet:
-~· ~-~MUNICIPALITY OF ANCHORAG~E~-~ ,.
:~~quest for Approval of Igd~v~dual Sewer and Water"'F'~ciZities
1. ,Proper~y Owner: ¢~ ¢ ~ ~
e
/__~'~7'7' ' '
,Name of Buyer: _~-~ '-~-*
Phone
Lending Institution:
Mailing Address:
.4.
Realtor/Agent:
Mailing Address:
Phone:
Se
,Legal Description:
Single Family Residence: ~ Number of Bedrooms: .
,Multiple Family Residence: (.) Number 6f Bedrooms:
Water Supply: , individuall Well Publ%c/Community System
If Individual Well, well d'epth
If Co~nunity System, name of system
Sewage Disposal System: On-site System k,/~) Public System (
~f On-si~e system, date o~ in~tanation:
*NOTE: A well log is requzred on ALL wells drilled since 6/75.
3/77
ADHW- LAB - 2W
DATE
STATE OF ALASKA
[r-~ARTMENT OF HEALTH AND
DIVISION 'OF PUBLIC HEALTH
BACTERIOLOGICAL WATER. ANALYSIS
OPFICE
PUBLIC I~ SEMI-PUBLIC [~
NAME
ADDRESS
OF SOURCE
SAMPLE COLLECTED BY
£
DATE COLLECTED
Sample Collected From
[] Olher (List
.... TIME COLLECTED ' '
[~ Kitchen Tap [] Bathroom TaD
WeJ [~ DuD ~ Driven [] Drilled [] Bored
SOURCE: [] Spring [] Clslern D Olher
Dug WeJ or Cislern Conslruction:
When?
Ii an "UnsotisJactory" or "Questionable" slalus is ]ndlcaled abave
you should lake immediate action as recommended belo~
I. Noilly consumers wafer is noRuled, Boil or chemically
Ireat this waler os outlined in Ihe enclosed leaRet
"Drink II Pure."
2. Increase chlorination suJJicienlly lo meet recommended residual slandards.
Determine source of contamination and take adJon necessary 1o maintain
a safe water supply at all times.
cblorinalian' and olher mechanical eauiamenf. Make cerlain il is
functioning properly.
If ariel; cl{eckJng equipment a disinJe~ling residual is not oblained, please
wire Ibis eFJice for emergency asslstance or advisory servicem-
5, This is a surface water souFce and subjecl to pollution by man and animals.
An approved waler supply source should be developea.
6, Improve your [] spring [] dug well [] driven well
E] drilled well [] cislern.
7. Relocale your well To a safe Iocalion n relationship to your sewage
disposal system. [] see enclosure
8. Sample too long m lransit; sample should not be over 48 bouts old at
examination Io indicate reliable resulls, please send new sample
[] Bottle Broken in fransib please sena new sample.
9. Contact your nearest [] Local Health Department or [] Alaska
Division of Public Heallh, sanitation oJJice Ior bulletins, consuJlalJon and
assislance.
READ INSTRUCTIONS
REVERSE SIDE
BEFORE
COLLECTING SAMPLE
I BACTERIOLOGICAL WATER ANALYSIS RECORD ~' (-~ }
~' / 'i / ~,r~ ~; '/
AGAR.
48 hrs. .GramLs stain
(Most probable No. per JOOcc.)
This analysis indicales Coliform Organisms lo be:
Signalure
Records in Ibis office indlcale this WATER SUPPLY to be of:
SaiJsJaclory [] Questionable [] Unsalisfactory Sanitary Stalus.
Analysis shows Ibis Water SAMPLE to De:
Salisfaclory [] Questionable ~ Unsatisfactory.
SANITARIAN'S REMARKS
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage. AK 99519-6650
www.ci.anchorage,ak, us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D.
1. GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Current Property owner(s)
Mailing address
Lending agency
LOT I
Day phone
Mailing address
Real Estate Agent.
Mailing Address
Un/ess otherwise requested, HAA wi//be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY: ·
Individual Well
Individual Water Storage
Community Class __ Well
Public Water System
TYPE OF WASTEWATER DISPOSAL:
Individual On-site ~
Individual Holding tank []
Community On-site []
Public Sewer []
The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upcn the representations given in paragraph 4 by an independent professional civil
engineer registered in the Stata of Alaska. Certificates cf Health Authority Approval are required fcr the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homecwners. Certificates of Health Authodt,/Approval are
valid fcr 90 days from the date cf issue for properties served by a pdvate or Class C we!l and may be reissued with
new water sample results. (Ce~ficates may be reissued for a pedod of up to one year with valid water samples.)
Certificates are valid for one year for properties served by Class A or R we!Is or a public water system. The
Munic!pality of Anchcrage is not responsible for errors or omissicns in the professional engineers work.
4. 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 prccedurcs outlined in the Health Authority Approval Guidelines for this application, shows that the on-
site water supply and/or wastewater disposal system is(arc) safe, functional and adequate for the number of
bedrcorns and type of structure indicated herein. I further redly that based on the information obtained from the
Municipality of Anchorage flies and from my investigation and inspe~on, the on-site water supply and/or
wastewater disposal system is(arc) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
NameofFirm -I ,.~/~/~,-~ ~o~,~_~,,~c~ '~.~--
Address ~-;L~5 ~,~/' ~ ~ IO~
Engineers Printed Name
DSD SIGNATURE
Approved for ,~
Disapproved.
Conditional approval for
Date
: -.: . .~.-,--~,~T~,P . ~, ..
,:,. -
bedrooms.
·
bedrooms, with the following stipulations:
Additional Comments
Attachments:
HAA Checklist
Septic System Adviso~
Well Flow Advisory
X
Maintenance Agreements
Supplemental Engineer's Report
Other
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 South Bmgaw SL
P.O. Box 196650 Anchorage, AK 99519-6650
www. ci.anchorage, ak. us
(907) 343-7g04
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: LOT' I ST'ET'C.~c:~ I~1
A. WEU. DATA
Well type '~_ IfA, B, or C provide PWSIO # ~"~/~,
Date completed~F)l''~ If77 Sanitmy seal (Y/N) y
Total depth 1~..~ ft. Cased to ~O+ ft.
O ~z4A .~,~.~L l~ROM WELL LOG
Date of test
Static wa~er level ft.
Well production g.p.m.
WATER SAMPLE RESULTS:
Coliform ~ c~lonie~'lO0 mi. Nitrate
A~enic: __ m./I. Date of sample:
e. SEPTIC/HOLDING TANK DATA
Parcel ID:
Well Log (Y/N) ~/
wires properly protected (Y/N)
Casing height (above ground)
AT INSPECTION
fL
g.p.m.
Other bacteria ~ colonies/100 mi.
Collected by: ~
Tank Type/Material
Tank size Ioo<~ gal. Number of Compmlmente
Foundation cdeanout (Y/N) ¥~ Depression over tank (Y/N)
Date of pumping ~'~a,~.l ~2q. ~"t. Pumper ~(¢
C. ABSORPTION FIELD DATA
Date installed 1~/~-~/7"/ Soilrating (g.p.d./ft~orlt2/bdrm)
Length _/~, o fl. Width ~ fL
Total depth I I fL Eft. absorption ama.7_z~ft2 Monitoring tube .
Fluid depth in absorption fleid before test /-'/ in. Water added
Elapsed Time: ~ min. Final fluid depth 4 in.
Any rejuvenation treatment (pest 12 mo.) (YIN & type)
Data ~talled ~
Cleanoute (Y/N)
High water alarm (Y/N)
System type
Gravel below pipe ~4~ fL
7 Depression over field
For ~ bedrooms
New depth ~ in.
gal.
Absorption rate >=
If yes, give date 4,/
D. UFT STATION
Date installed /
'PumPDatum on" le~//
E. SEPARATION DISTANCES
Size in gallons
'Pump off'~
Cycles teZted
Manhole/Access (Y/N)
/
High water ala~,~vel at
Meets alarm & circuit requirements?
in.
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot i ~O ~
Absorption field on lot I ~-'/
Pubfic sewer main t"///A~
Sewer/septic se~Jce line I e.O ~"
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Holding tank
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation
Water main
Wells on adjacent lots
Property line /~'~
Water sewice line
Absorption field
. Surface water
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line ~ ~ Building foundation
Water Service line ~ Surface water I~[
Curtain drain J'~/O Wells on adjacent lots
Water main
Driveway, pmtdng/vehlcie st~mgs
F. COMMENTS
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections end
review of Municipal records that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name "~"o/~ b ~ ~
HAA Fee $
Date of Payment
Receipt Number
Waiver Fee $
Data of Payment
Receipt Number
(Rev. 12~01)
Municipality of Anchorage
George P. Wuerch, Mayor
Building Sa_fcty DixSsion
P.O. Box 1OC~kS0 · 4700 S. Bmgaw Street
Anchorage, Alaslm 99519-6650 * (907) I~I3-8301
htt p://www.ct.anchoragc.ak.us
Public Works
6/25/2002
Tobben Spurkland, PE
523 West 8* Avenue #102
Anchomge, Alaska 99501
Subject:
Waiver Request for Stetson Subdivision Lot 1
Waiver Request #WR020028
Parcel ID #015-163-28
Health Authority Approval Number WR020267
Dear Mr. Spurkland:
Your request for a waiver of the required 100 feet horizontal separation from the
absorption field to private well has been approved. The approved separation distance is
75.0 feet. Thig waiver is valid for the separation to the water well located on Gato Del Sol
Subdivision Lot 2. This waiver is also valid for the subject lots absorption field to lot
line of 5 feet.
This waiver approval applies to the existing absorption field to private well separation
only. Any future upgrade to the on-site wastewater disposal system will require all
separation distances be met or another approval from this department.
If there are any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
Daniel J. Roth
Civil Engineer
On-Site Water & Wastewater Program
M-nicipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Waslewatcr Program
4700 Bragaw SWeet
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchorage.ak.us
(907) 343-7904
Waiver Review Worksheet
WRY: WR020028 PID~. 0t6-t63-28
HA#: HA020257 Permit#:
Date Received: 6120/02
Legal Description: Stetson Lot 1
Engir~er. Tobben Sourklsnd PE
Applicant: Ron Morris
LOT Z g.,~,l'o PJL Sot
Waiver Requested: 75 feet from the well on T~.2.~: ~2;;' Cc:'.'.:,-. ?A ,~w,~ ew,~..~!-_~..~,-..;; to the dr~lnfleld
on Stetson Lot 1
Criteria: Geology Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Waiver Is Granted:
List Conditions or Reasons for above: -,~'~'~'
Date:
Rec~: 21581 Amount: $1.000.00 Date Paid:
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T.SPURKLAND P.E.
203 W. 15th. AVE. SUITE 203
ANCltORAGE, ALASKA 99501
(907) 279-3916
Fax (907)-276-6013
Municipality of Anchorage
Development Services Department
On Site Water and Wastewater Program
4700 South Bragaw St.
Anchorage, Alaska 99519
June20,2002
Subject: Waiver Request
Lot I Stetson S/D
Gentlemen;
We are applying for a waiver of the separation distance required between the septic system on this lot and the well
located on the parcel to the north, Lot 2, Gato-Del-Sol. The trench monitor are located approximately 80 feet from the
outside of the well casing. We request a waiver to 75 feet for the drain field.
During field inspection it was also discovered that the a section of the drain field is less than the required I 0 fc~ from the
property line.
The submitted siteplan, shows the approximate location of the stand pipes of the septic system and the location of the
well in question.
As can be seen, the drain field is to close to a 30 feet dedicated road easement. The north part ofthe road easement was
vacated some years ago, and there are no justification for the remaining easement. The present ofthe dralnfield will not
cause any inconvenience to any body.
There are no well logs on record for both the well on this site and the well to the north. I Iowever, well logs are available
for the surrounding properties. Copies of these are attached.
The well was installed prior to 1965 and septic system in 1977. A field measurement on June 6, 2002 showed
approximately 80 feet separation.
Copies of well logs from Lots 1,2,3,and 4 ofLongview S/d and Lots 3 and 4 World Top Acres can be used to evaluate
the contamination potential. Longview Acres is up gradient from subject well and World Top Acres is down gradient.
The World Top Acres wells were artesian at the time of drilling, while the Longview Acres well had a static water level
at 40 and 80 feet. The Longview Acres well are in bed rock while the World Top Acres are in sand and gravel.
The justifications for granting this waiver are:
Water sample taken June 6, 2002 shows a concentration of Nitrates of 3.54 mg/l and no bacteria of any
kind in subject well. The well on Lot I Stetson showed Nitrates of 3.02 mg/I and no bacteria.
2. Thc well logs show several impervious layers between thc surface and the intakes of the wells.
2. The topography will prevent over land flow from the septic system standpipes towards the well.
T.SPURKLAND P.E.
203 W. 15th. AVE. SUITE 203
ANCHORAGE, ALASKA 99501
(907) 279-3916
Fax (907)-276-6013
Municipality of Anchorage
Development Services Department
On Site Water and Wastewater Program
4700 South Bragaw St.
Anchorage, Alaska 99519
June 20,2002
Subject: Waiver Request
Lot I Stetson S/D
Genllemen;
We arc applying for a waiver of the separation distance required between the septic system on this lot and the well
located on the parcel to the noah, SWI/4, SWI/4. NEI/4, NWl/4, Section 24, Ti2N R3W. The trench munitor are
located approximately 80 feet from the outside of the well casing. We request a waiver to 75 feet for the drain field.
During field inspection it was also discovered that the a section ofthe drain field is less than the required I 0 feet from the
propen'y line.
The submiRed slteplan, shows the approximate location of the stand pipes of the septic system and the location of the
well in question.
As can be seen, the drain field is to close to a 30 feet dedicated road easement. The north part ofthe road easement was
vacated some years ago, and there are no justification for the remaining easement. The present of the drainfield will not
cause any inconvenience to any body.
There are no well logs on record for both the well on this site and the well to the north, tlowever, well logs are available
for the surrounding properties. Copies of these are attached.
The well was installed prior to 1965 and septic system in 1977. A field measurement on June 6, 2002 showed
approxlmately gO feet separation.
Copies of well logs bom Lots 1,2,3,and 4 of Longview SM and Lots 3 and 4 World Top Acres can be used to evaluate
the contamination potential. Longview Acres is up gradient from subject well and World Top Acres is down gradient.
The World Top Acres wells were artesian at the time ofdrilling, while the Longview Acres well had a static water level
at 40 and 80 feet. The Longview Acres well are in bed rock while the World Top Acres are in sand and gravel.
The justificatinns for granting this waiver are:
Water sample taken June 6, 2002 shows a concentration of Nitrates of 3.54 mg/I and no bacteria of any
kind in subject well. The well on LOt 1 Stetson showed Niwates of 3.02 mgq and no bacteria.
2. The well logs show several impervious layers between the surface and the intakes of the wells.
Yours
The topography will prevent over land flow from the septic system standpipes towards the well.
300 4OO
TO, BEN SPURKLAND P.E.
205 W 15TM. AVENUE
ANCH. AK. 99501
PERMIT #
II
STETSON I, OT 1
$E¢. 24. T12N
RON ~ORRIS
P1D #
SEPTIC SYSTEM WAIVER
DATE: JUNE 20, 2002
SHEET: I/1 GRID: 25¥0
,d~K CT&E Environmental ,Services, I~c.
C'T&£ Ret.# 1021371002
Client .Name Tobb'.n Sp~kland P.E.
ProJect Name,*# N/A
Chent Simple ID Hid~way ~r~l
Ma:d~ Dr~ Watcr
O~ered By
PWS[D 0
Sam. pi= Remarks:
Hie'ate-N
All Dalei,'l'lmes are Alaska Standarg Time
Printcd Date,,'Time 06118,2002 12:~!
Collected Date/'llme 06112,~002 18:09
Rc~tbed DatdTIme 0~'13,'2002 $;25
Llmiu Dale ~le bdt
3.$4 0.200 mg/L £PA 300.0 (<10) ~6/13~02 ,~DT
~.lcrobiolog~ L&boratory
Coliform
CO7100~L SMI$ 92Z2B
(<1) 06/13:02
SBH
CT&E Environmental Services inc. ;,..,.:--.-:..-
. Laborat.qry Division
Drinking Water Analysis Report for Total Coliform Bacteria
READ INSTR~O~ ON ~E~E SIDE BEFORE COL~ING 5AMP~ 200 W. Po~er Drive
MUST BE COMPLETED BY WATER SUPPLIER
PUBLIC WATER SYSTEM ID~~ ~ ~
%~ PRIVAT~ WATER SYSTEM
AND
SAMPLE DATE:
SAMPLE TYPE:
ouflne
'- Repeat Sample
(refer to tab no.
Anchorage, AK 99518-1605
TO BE COMPL~I ~u BY ~~61-5301
~al~ Sh~ t~s Wa~r SAMPLE ~
'lime Re=elved:.
Anatysll Began;
over 30 .ho~rs Old, Resull3 may I~e urrella~te.
Analytical
Lab Ref No.
Re,alt* A~aly~
ANC FEK JUN ,. ~
Fax
Time:
Date:
Client notified of unsatisfactory results:
Date: T~me: --
Treated Water
I~Un~'eate d Water
· '.~ Special Purpose
Time C~lbcted
Lotc~.tlofl CoIll creel ~_m: , COlllGted: ~ ~fl~):
BAGTE~OLOGI~AL WATER AN~
YSlS RECORD
MMO-MUG Re~ul= Total Colifomt
Memt~'ane Filter: Direct Coun~ ~
Verification: LTB BOB
E. CoII
COLIFORM Oa -~.e' bc~e-qt