HomeMy WebLinkAboutCALL EARL BLK 1 LT 2Call Earl
Block 1
Lot 2
#015-501-19
\ Municipality of Anchorage
Development Services Department
Building Safety Division
On -Site Water and Wastewater Program, 4700 Elmore Road
P.O. Box 196650 Anchorage, AK 99507 Page of
www.d.anchorage.ak.us (907) 343.7904
ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Permit Number: SWJ090056 PID Number. 015-501-19
Robert A. Davison
Wastewater System: ❑ New 0 Upgrade
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P.O. Box 113164 Anchorage, AK 99511
ABSORPTION FIELD
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LEGAL DESCRIPTION
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To
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Municipality of Anchorage
p�FRe
Existing Septic Tank Pumped, Crushed and Backfilled.
BENCH MARK
W tw,.a DNw.bn.
Existing Absorption Trench Tied In For Future Use.
Entrance Slab at House.
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Inspections performed by: A. Harela Dates: 1" 8162009
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W2009
40
Development Services Department Approval
: 49�•��•:*
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Conditional Approval Date:
/.. 1. NN NN o • ..N
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�M1QIAEL E ANDERSON :
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CE -4381
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Reviewed by:! i2L
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and approved Date: -?
�pROFCSS1t1N+e
M,
Municipality of Anchorage
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904
Permit Number: SWO90056
EAST 289.45
Existing Tank Pumped,
Crushed. Baskriige k
ondone n Ad /
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Creek
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Three Bedroom
Home
Fosentent
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1? 25'
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LOT 2, BLOCK 1
CALL EARL SUBDIVISION
49th
AEL E. ANDERSON
No. CE -4381
10' Utility Easement
EAST 289.65
NOTE: Not a Surveyed As Built.
Locations May Not Be Exact.
O'MALLEY ROAD
PLAN AS -BUILT
SCALE 1' = 50'
Garage
Page 2 of 3
PID No.: 015-501.19
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LEGEND
C1 — Cleanout
S1 — Septic Vent
FCO — Foundation Cleanout
DV — Diverter Vat"
M1 — Monitor Tube
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Three Bedroom
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1? 25'
Creek
ka'ntananae faS°'Hent
LOT 2, BLOCK 1
CALL EARL SUBDIVISION
49th
AEL E. ANDERSON
No. CE -4381
10' Utility Easement
EAST 289.65
NOTE: Not a Surveyed As Built.
Locations May Not Be Exact.
O'MALLEY ROAD
PLAN AS -BUILT
SCALE 1' = 50'
Garage
Page 2 of 3
PID No.: 015-501.19
O
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to
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to
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in
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LEGEND
C1 — Cleanout
S1 — Septic Vent
FCO — Foundation Cleanout
DV — Diverter Vat"
M1 — Monitor Tube
Permit Number. SWO90056
Municipality of Anchorage Page 3 of 3
DEVEOPMENT SERVICES DEPARTMENT
4700 Elmore Road Anchorage, AK. 99519-6655 - 343-7904
On -Site Wastewater Disposal System or Well Inspection Report
PID No. 015-501-19
U
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PROFILE AS -BUILT -
No Scale
90.0
Municipality of Anchorage
Development Services Department
Building Safety Division
OwSke Water and Wastewater Program
4700 Elmore Road
P.O. Boa 198850 Anchorage, AK 99507
www .N. a n chora x. a k. u s
(907) 343-7904
0 A4 44
Fv
1^G1NEER' F _ �. (
4918 ��
MICHAEL E ANDERSON
s
CE -4381
Soils L tt�t�,o�issio,¢�
ww,,�� // Log -Percolation Test
Performed For. _150r.YPry�btj Date Performed:
Legal Ion: MIA, 1;ilk-t, 5W.0 Town
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IF YES. ATWHAT DEPTHVel, L
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Date
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ENCOUNTERED?
IF YES. ATWHAT DEPTHVel, L
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Net Time
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PERCOLATION KATE (mmossAnth) PERC HOLE DIAMETER
TEST RUN BETWEENLI FT ANDPT
PERFORMEDBY &I I CERTIFY THAT THIS TEST WAS
PERFOR!k` D IN ACdORa4NCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water& Wastewater Program
4700 South Bragaw Street
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Permit Number: SWO90056
Legal Description: CALL EARL BLOCK 1 LOT 2
Design Engineer: 0014 ANDERSON ENGINEERING
Owner Name: ROBERT A. DAVISON
Owner Address: P.O. BOX 113164
ANCHORAGE. A 99511 -
Date Issued: May 14, 2009
Expiration Date: May 14, 2010
Parcel ID: 015-501-19
Site Address: 5441 O'MALLEY ROAD
Lot Size: 104817 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 3
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 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.
5. The following special provisions.
A. Permit has been revised to include the drainfield.
B. SOILS TEST HOLES ARE REQUIRED PRIOR TO CONSTRUCTION TO SUBSTANTIATE THE DRAINFIELD
DESIGN FOR:
I. VERTICAL SEPARATION FROM BEDROCK AND GROUNDWATER,
ii. THE PROPOSED DESIGN PERCOLATION RATE.
PLEASE SUBMIT STAMPED AND SIGNED RESULTS WITH THE AS -BUILT INSPECTION REPORT. IF THE
RESULTS REQUIRE A DESIGN CHANGE, CONSTRUCTION OF THE SYSTEM WILL STOP PENDING ON-SITE
REVIEW AND APPROVAL.
Received
Issued
Date: 7130161
Date: o't
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 677-7766 FAX
MEMORANDUM
DATE: July 16, 2009
TO: Jay Crewdson, P.E.
FROM: Mike Anderson, P.E.
SUBJECT: Lot 2, Block 1, Call Earl
Septic System Permit No. SWO90056
The owner of the subject lot has decided to upgrade the absorption trench in addition to
replacing the septic tank. We have revised the system design to include placement of a
new trench. The design is included with this memo. We are requesting the test hole be
placed prior to construction of the new trench. We are confident no groundwater will
develop and the soils will absorb water at a rate between 15 and 30 minutes per inch.
This confidence is based on the test hole placed during construction of the original
septic system.
Please modify the septic system permit to include placement of the new absorption
trench.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 FAX
July 16, 2009
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 2, Block 1, Call Earl Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The septic tank on Lot 2, Block 1, Call Earl Subdivision is failing and must be replaced.
In addition, the owner would like to place a new absorption trench near the existing
trench. We are proposing to replace the existing tank with a new 1,000 -gallon steel
septic tank to serve the three-bedroom home on the lot. We are therefore requesting a
permit be issued for the construction of a new septic tank and absorption trench to
serve the home. The attached Site Plan and backup documentation identify the
location and configuration of the existing septic system and the location of the new tank
and absorption trench. Also identified on the plans is the existing well on the lot. The
new tank and trench will be placed more than 100' from the well on this lot and those in
the area. The existing tank on the lot will be properly disposed on the property. The
drainage patterns will be maintained after construction.
A test hole must be placed to verify the soils in the area of the new trench. The test
hole utilized to design the existing trench indicated 220 square feet per bedroom. We
have used an application rate of .6 gallons per day per square foot which is more
conservative than that used for the original design. If conditions actually found in the
field vary from those anticipated the construction will stop pending redesign. The new
design will then be submitted to the City for review and approval.
The ground surface on the lot is basically flat with a minor slope to the north. The new
septic tank will be constructed near the location of the existing tank and as parallel with
the contours of the land as possible in conformance with Municipal requirements.
If the tank and absorption trench are constructed in accordance with our design the
Lot 2, Block 1, Call Earl Subdivision
July 16, 2009
Page 2 of 2
following statements apply:
1. The tank, if constructed as designed, will have no adverse impact on the wells in
the area or those to be constructed in the future.
2. The tank, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The tank, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
4. The tank, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
Michael E. Anderson, P.E.
Attachments
V -A '. F A`,;?SCV
LOT 1 TRACT A TRACT B
LOUDERMILK
SUBDIVISION GLEASON SUBDIVISION
�i
LOT 1, CALL EARL
SUBDIVISION LM LOT 30
28B 28A E
VACANT
LOT 2 '\
28C %
28D
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2r �
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O'MALLEY ROAD
,gyp. •...._............ •
AREA MAP
_ _
♦•� jMGMEI L AMOERl91 i"
SCALE 1' = 100' �c,' No. Ct � a"
EAST 289.45
ona x 4'
rr
co
Verify Location
Radius Prior
m.
ON
Creek---I_
faSe`hent
LOT 2, BLOCK 1 '-
CALL EARL SUBDIVISION
1
NOTE:
Septic Tank Replacement Only
Under This Permit.
49th
E. ANDERSON
CE -4381
Easement
O'MALLEY ROAD
SITE PLAN
SCALE 1' = 50'
f asement
Vplve
8 Effective
0
0
N
w
M
to
to
M
N
O
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I1111x42me i
CO — Cleanout
SV — Septic Vent
FCO — Foundation Cleanout
OV — Diverter Valve
MT — Monitor Tube
LOT 2, BLOCK 1, CALL EARL SUBDIVISION
DESIGN FACTORS: SYSTEM REQUIREMENTS:
Three Bedroom Home Deep Trench System
Perc. Rate: 15-30 Min./Inch 1,000 Gallon Septic Tank
Application Rate: .6 GPD/SF 8' Drainfield Rock
3 Bedrooms X 150 GPD/.6 GPD/SF (Application Rate) = 750 SF Absorption Area
750 SF/16 SF/LF = 46.88 LF Trench Length
THEREFORE: Construct a 50' Long x 3' Wide x 8' Effective Depth Absorption Trenches at the
Location Shown. Flow Line Elevation in Trench to be 4' Below Original Ground Surface. Total Depth
to be 12' Below Existing Ground. Provide 4' Cover Over Septic Tank and 3' Cover Over Absorption
Trench. Maintain 100' Separation from Wells in the Area. Place Diverter Valve and Tie In Existing
Absorption Trench for Future Use.
®,
3'
Drainfield Rock
TYPICAL DEEP TRENCH SECTION ,....•OF
..��,�
(NO SCALE) �.�p'(................ ..
NOTE: Grade Area Over Trench to Drain Away. : a;'
Minimum 6' Separation From Bedrock. ; .. aero L
Minimum 4' Separation From Groundwater.
Minimum 100' Separation From Wells in the Area. ""'""' E.MMR"" *, *74
MiGM�EL E. ANOER90N •:�
Minimum 100' Separation From Surface Water or Streams. No. CE. l
Natural
Backfill
3'6"
Geotextile
Fabric
6R
0
4" Perforated
PVC (Holes Down)
®,
3'
Drainfield Rock
TYPICAL DEEP TRENCH SECTION ,....•OF
..��,�
(NO SCALE) �.�p'(................ ..
NOTE: Grade Area Over Trench to Drain Away. : a;'
Minimum 6' Separation From Bedrock. ; .. aero L
Minimum 4' Separation From Groundwater.
Minimum 100' Separation From Wells in the Area. ""'""' E.MMR"" *, *74
MiGM�EL E. ANOER90N •:�
Minimum 100' Separation From Surface Water or Streams. No. CE. l
n.
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 2641720
SOILS LOG - PERCOLATION TEST
L7 /SOILS LOG '
L�1 PERCOLATION
TEST
PERFORMED FOR: - � V \Se DATE PERFORMED:_JS �� o
LEGAL
4
5
e
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMM
ENTS IV.,4-60 P-70 n'i./a
SLOPE
--I_
SITE
mom
IMENIMMIN-F no
Reading
Date
Grose
Time
Net
Time
Depth to
Water
Net
Drop
11
o
i�G
y
ttadd
PERCOLATION RATE_ t (minutes/inch) zOK�
20AND FT 7-6
.�oscsZ
TEST RUN BETWEENFT
PERFORMED9Y:_. Lee_ aer-r CERTIFIED
72-008 16/791
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 2, BLOCK 1 CALL EARL SUBDIVISION
GENERAL:
The scope of this project includes the pumping, crushing and backfilling of
the existing septic tank on the property and the procurement and placement
of a new 1,000 -gallon septic tank at the location shown on the Site Plan.
Work also includes the verification of the integrity of the foundation cleanout,
placement of two new post tank cleanouts, a diverter valve and construction
of a new 50' long x 3' wide x 8' effective depth absorption trench at the
location shown. The total depth of the trench will be 12' with the distribution
line at 4' below the surface. The new septic tank and absorption trench
must be placed 100' from all private wells and any surface water in the area
and 10' from the water service line from the well. A minimum of 4' of cover is
required over the septic tank.
2. Construction shall be in accordance with the approved site plan, design
drawings, Municipal Permit with any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal Regulations.
3. The Contractor shall be responsible for obtaining all underground utility
locates and for the layout of the septic system and verification of the location
of all lot lines. The Contractor must also verify the location of wells in the
area and assure that the separation distances are met.
4. Unless specifically agreed otherwise, the contractor shall be responsible for
final grading areas subsequently depressed from soil settling. Property
owner shall be responsible for revegetation of affected areas unless
specifically agreed otherwise.
5. Contractors installing wastewater disposal systems must be certified by the
Municipal Development Services Department Building Safety Division On -Site
Water and Wastewater Program for system installations. Owners installing
their own systems must receive prior approval from the On -Site Water and
Wastewater Program before beginning system installation.
SEPTIC TANK INSTALLATION
A new 1,000 -gallon septic tank must be procured from an approved source
and installed at the location shown.
2. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
Lot 2, Block 1, Call Earl Subdivision
July 16, 2009
Page 2 of 3
3. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
4. All standpipes on the septic tank shall extend a minimum of 12 inches above
final grade.
5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial
insulation.
6. A foundation cleanout shall be installed one to four feet from the building
foundation. Two cleanouts are required between the tank and the drainfield.
7. Final grading over the tank shall be such that a positive slope exists away
from the septic tank.
DRAINFIELD CONSTRUCTION:
1. The drainfield shall be constructed to the dimensions shown on the design.
The bottom of the trench shall be within 2" of level.
2. Distribution piping must be placed level with perforations down atop a level
bed of drainfield rock. Rock should then be placed over the pipe to provide a
minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the drainfield rock
and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations shown on
the design. The portion below the distribution line must be perforated.
5. Contractor shall verify the septic tank and drainfield are a minimum 100' away
from any private water wells in the area, 150' from a Class "C" Well or 200'
from any community well.
6. Direct bury insulation must be placed over the distribution system if less than
3' of backfill depth is available. Finish grade over the trench must be
mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trench to drain away.
8. A minimum 2' of accepting soil is required below the drainfield rock for a 5'
wide trench. All pockets of unacceptable materials must be removed and
replaced.
Lot 2, Block 1, Call Earl Subdivision
July 16, 2009
Page 3 of 3
MATERIAL SPECIFICATIONS:
1. Septic tanks must be constructed by a municipally approved septic tank
manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and
solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662
or A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow
Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Fernco, or equal).
5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed
between the final drain rock layer and the native soil layer.
6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the
#200 sieve.
INSPECTIONS:
Municipal Ordinance requires a minimum of two inspections. These inspections
must be conducted under the supervision of a professional engineer registered
in the State of Alaska. The first inspection must be conducted after the
excavation of trenches, beds or pits and before the installation of any gravel. A
septic tank may be set in place, but may not be backfilled.
The second inspection must be conducted after the placement of the geotextile
fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No
backfill should be in place at the time of inspection.
Contractor or owner shall provide a copy of all field survey layout and
construction notes for use in preparing the certified as -built of the completed
system.
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water d Wastewater Program
4700 South Bragaw Street
P.O. Box 196650. Anchorage, AK 99519-6650
(907) 343-7904
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: May 14, 2009
Expiration Date: May 14, 2010
Permit Number: SW090056 Parcel ID: 015-501-19
Legal Description: CALL EARL BLOCK 1 LOT 2
Design Engineer: 0014 ANDERSON ENGINEERING Site Address: 5441 O'MALLEY ROAD
Owner Name: ROBERT A. DAVISON Lot Size: 104817 SQ. FT.
Owner Address: P.O. BOX 113164 Total Bedrooms: 3 Permit Bedrooms: 3
ANCHORAGE. A 99511 -
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 %
Issued By
Date: 6/1`7 Ol
Date:��
Municipality of Anchorage
—� Development Services Department
Building Safety Division
On -Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650
Anchorage, Alaska 99519650
www.muni.org/onsite
(907) 343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 015-501-19
Property owner(s) Robert A. Davison Day phone 346-3769
Mailing address P.O. Box 113164 Anchorage, AK Zip Code 99511
Site address 5441 O'Malley Road Anchorage, AK Zip Code 99516
Legal description (Sub'd., Block & Lot) Lot 2, Block 1, Call Earl Subdivision
Legal description (Township, Range & Section)
Lot Size 104,917 Sq. Ft. Number of Bedrooms Three (3)
THIS APPLICATION IS FOR (® all that apply): THIS APPLICATION IS AN:
Absorption Field ❑ Initial ❑
Septic Tank El Upgrade El
Holding Tank ❑ Renewal ❑
Privy ❑
Private Well ❑
Water Storage ❑
I 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.
El
(Signature of property owner or authorized agent)
Permit/Rush Fees: San Waiver Fees:
Date of Payment: ✓� �� ��_
Receipt Number. 000,6 yG
(Rev. 11/05)
Date of Payment:
Receipt Number.
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 FAX
May 9, 2009
Municipality of Anchorage
Development Services Department
On -Site Water and Wastewater Program
4700 South Bragaw Street
Anchorage, AK 99519-6650
Subject: Lot 2, Block 1, Call Earl Subdivision
Septic System Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The septic tank on Lot 2, Block 1, Call Earl Subdivision is failing and must be replaced.
We are proposing to replace the tank with a new 1,000 -gallon steel septic tank to serve
the three-bedroom home on the lot. We are therefore requesting a permit be issued
for the construction of a new septic tank to serve the home. The attached Site Plan
and backup documentation identify the location and configuration of the existing septic
system and the location of the new tank. Also identified on the plans is the existing well
on the lot. The new tank will be placed more than 100' from the well on this lot and
those in the area. The existing tank on the lot will be properly disposed on the property.
The drainage patterns will be maintained after construction.
The ground surface on the lot is basically flat with a minor slope to the north. The new
septic tank will be constructed near the location of the existing tank and as parallel with
the slope of the land as possible in conformance with Municipal requirements.
If the tank is constructed in accordance with our design the following statements apply:
The tank, if constructed as designed, will have no adverse impact on the wells in
the area or those to be constructed in the future.
2. The tank, if constructed as designed, will have no adverse impact on existing
septic systems in the area or those to be constructed in the future.
3. The tank, if constructed as designed, will have no adverse impact on reserve
space, either surface or subsurface, on any lots located in the area.
Lot 2, Block 1, Call Earl Subdivision
May 9, 2009
Page 2 of 2
4. The tank, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
Sincerely,
Michael E. Anderson, P.E.
Attachments
VC -.At- C. •\CERCCV
LOT 1 TRACT A TRACT B
LOUDERMILK
SUBDIVISION GLEASON SUBDIVISION
LOT 1, CALL EARL
SUBDIVISION LM LOT 30
28B 28A `"
VACANT
LOT 2'
28C /
J 28D
U
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O'MALLEY ROAD
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AREA MAP1�..
......... _.. . ML c. _... , l
MOUEL E N!➢ERSM i �
SCALE V = 100' �i �' NoCE�=
EAST 289.45
Existing 87' Long x 4'
E. stings Depth a sorption
Trench to Remain in Service.
tate End ymC Cleonouts
\ Raise to Above Surface.
�O.
Pump, Crush and Abandon
PP co (a Existing Tank In Place.
.F Place New 1,000 Callon
Septic Tank, Foundation
Cleanout & 2 Post Tank
Cleanouta.
N f
V)
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`\ Home
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LOT 2, BLOCK 1 fseme°t
CALL EARL SUBDIVISION
---------------------------------------------------------------
10' Utility Easement
NOTE. EAST 289.65
LEGEND
Septic Tank Replacement Only cIeaenout
Under This Permit. SV — Septic vent
FCO — Foundation Cleanout
4.6
all,e:'.Awl, •. O'MALLEY ROAD
l.......... i�.1 C I• — —
:......I ..� — — — —
0..... i1
•
0 j MIC HAEL•E,•ANOERSON : SITE PLAN
'. No. CE-4381 �� :
•��•,;,, �.'•• SCALE 1' = 50'
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT 2, BLOCK 1 CALL EARL SUBDIVISION
GENERAL:
The scope of this project includes the pumping, crushing and backfilling of
the existing septic tank on the property and the procurement and placement
of a new 1,000 -gallon septic tank at the location shown on the Site Plan.
Work also includes the verification of the integrity of the foundation cleanout
and placement of two new post tank cleanouts. The new delivery line must
then be tied into the existing absorption trench line. The new septic tank
must be placed 100' from all private wells and any surface water in the area
and 10' from the water service line from the well. A minimum of 4' of cover is
required over the septic tank.
2. Construction shall be in accordance with the approved site plan, design
drawings, Municipal Permit with any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal Regulations.
3. The Contractor shall be responsible for obtaining all underground utility
locates and for the layout of the septic system and verification of the location
of all lot lines. The Contractor must also verify the location of wells in the
area and assure that the separation distances are met.
4. Unless specifically agreed otherwise, the contractor shall be responsible for
final grading areas subsequently depressed from soil settling. Property
owner shall be responsible for revegetation of affected areas unless
specifically agreed otherwise.
5. Contractors installing wastewater disposal systems must be certified by the
Municipal Development Services Department Building Safety Division On -Site
Water and Wastewater Program for system installations. Owners installing
their own systems must receive prior approval from the On -Site Water and
Wastewater Program before beginning system installation.
SEPTIC TANK INSTALLATION
A new 1,000 -gallon septic tank must be procured from an approved source
and installed at the location shown.
2. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shall include two 4" cleanouts for pumping access.
Lot 2, Block 1, Call Earl Subdivision
May 9, 2009
Page 2 of 3
3. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
4. All standpipes on the septic tank shall extend a minimum of 12 inches above
final grade.
5. Tanks installed without 4' of cover shall have a minimum of 2" of direct burial
insulation.
6. A foundation cleanout shall be installed one to four feet from the building
foundation. Two cleanouts are required between the tank and the drainfield.
7. Final grading over the tank shall be such that a positive slope exists away
from the septic tank.
DRAINFIELD CONSTRUCTION: - EXISTING ABSORPTION TRENCH TO REMAIN IN
SERVICE
1. The drainfield shall be constructed to the dimensions shown on the design.
The bottom of the trench shall be within 2" of level.
2. Distribution piping must be placed level with perforations down atop a level
bed of drainfield rock. Rock should then be placed over the pipe to provide a
minimum of 2" of cover.
3. A silt barrier or geotextile fabric must be placed between the drainfield rock
and the natural soil backfill.
4. Monitor tubes must be 4" in diameter and installed at the locations shown on
the design. The portion below ground must be perforated.
5. Contractor shall verify the septic tank and drainfield are a minimum 100' away
from any private water wells in the area, 150' from a Class "C" Well or 200'
from any community well.
6. Direct bury insulation must be placed over the distribution system if less than
3' of backfill depth is available. Finish grade over the trench must be
mounded to prevent settlement or depressions.
7. Grade area surrounding the absorption trench to drain away.
8. A minimum 2' of accepting soil is required below the drainfield rock for a 5'
wide trench. All pockets of unacceptable materials must be removed and
replaced.
Lot 2, Block 1, Cali Earl Subdivision
May 9, 2009
Page 3 of 3
MATERIAL SPECIFICATIONS:
1. Septic tanks must be constructed by a municipally approved septic tank
manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Cast Iron (perforated and solid), ASTM D3034 or P.V.C. (perforated and
solid), ASTM F810 or H.D.P.E. (perforated, but not solid) and ASTM D2662
or A.B.S. (perforated and solid).
3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow
Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Fernco, or equal).
5. A permeable geotextile fabric (Typar, Mirafi or equal) must be installed
between the final drain rock layer and the native soil layer.
6. All drain rock shall be .5" to 2.5" in diameter with less than 3% passing the
#200 sieve.
INSPECTIONS:
Municipal Ordinance requires a minimum of two inspections. These inspections
must be conducted under the supervision of a professional engineer registered
in the State of Alaska. The first inspection must be conducted after the
excavation of trenches, beds or pits and before the installation of any gravel. A
septic tank may be set in place, but may not be backfilled.
The second inspection must be conducted after the placement of the geotextile
fabric, gravel, distribution piping, standpipes, cleanouts and insulation. No
backfill should be in place at the time of inspection.
Contractor or owner shall provide a copy of all field survey layout and
construction notes for use in preparing the certified as -built of the completed
system.
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
NAME � HONE
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MAILING ADORES`�
c\N
LEGAL DESC@I PTI IN /L5
NO. OF ED�QOMS
(Dwellin i p( J
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Well Absorption are
DISTANCE TO:®(�✓ _%
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PERMPO.����
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rn
Liq, c�t�y n gallons Inside length
IF HOMEMADE: g
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Width
Liquid depth
G Y
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DISTANCE TO:
Well
Dwelling
PERMIT NO.
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Manufacturer
Material
Liquid capacity in gallons
D
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W
!� Foundatio a
DISTANCE TO: Well to,
Nearest lot
T
PERMIT PERMIT NO
lels
J LL z
Z W
No. of line Length o e h a
Total length Trench wi
Distance belwepn lines
~ Q H
rl
Top of tile to finish grade
Material beneath tile inches
Total eff ti ab orption area
{wlaos
w
Length
Width
Depth
PERMIT NO.
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Type of crib
Crib diameter
Crib depth
Total effective absorption area
ur
DISTANCE TO:
Well
Building foundation
Nearest lot line
J
J
Class
Depth
Driller
Distance to lot line
PERMIT NO,
W
DISTANCE TO:
Building foundation
Sewer line
Septic tank
Absorption area(s)
OTHER
PIPE MATE�L$
SOIL TEST RA((T.•IFF//�`NG
N
INSTALLER
REMARKS
v
APP VED DATE^LEGAL
72-01 Rev_ 3/7M
DEPARTMENT HEALTH AND ENVIRONMENTAL' -,OTEC"rIOPd if%t25:� a L
88'25 ''L _;TREET: ANCHORAGE: RK. 9955,_
64-4720
' ClI ' I "rte ':_E=I-.6E:F~' UF:3F
""9'F=3E-•E= F='E_'FZr-1 I -
PERM?i' NO, 8108-730,!�,Jsol &. DATE OF ISSUE 8108:
WARNING - CLUE TO C:HANGI?00 RE1-UIREMENTS THIS PRINTOUT r°9h'r' NOT BE: AN
COPY OF THE ORIGIONAL PERMIT S- 8l T#�ur
APPLICANT EARL W. DAVIS SRA BOX l717, ANCH. _99507 34q-, -,:rlA
LOCATION MILE 2.5 Ot MALLEY ROAD - -
LEGAL T12N R2W SECT.15 LOT 29 LOT SIZE 217800 SQUARE FEET
TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH
MIRX'IM UM NUMBER OF BEDROOMS� OIL EATING (SQ FT.�'BR)= 2,:^',
THE REQUIRED SIZE OF THE SOIL AB.,CtF`F`. �+.-'=Y'STEf`t IS: c
- -1 L_ E= VA 0_a --"_er.er...0j R fi=i V E ' E E=,.F= F' -r 9
THE LENGTH DIMENSION IS THE !_ENGTH ::IN FEET: OF THE TRENCH OR DRAINFIELD.
THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE
GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET).
THERE IS NO SET WIDTH FOR TRENCHES,.
THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL, PIPE
AND THE BOTTOM OF THE E:,CAVATION (IN FEET).
-8-' L4 0--1 < ;2 `• .I IR F� K= a 0.._.0 I F2' E7E-a ----
BACKFILLING
---
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THI
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MIt'diMt-M DISTANCE BETWEEN A WELL AND ANY Cit -4 -SITE SEWAGE DISPOSAL -SYSTEM IS
100 FEET FOR A PRIVATE WELL: OR
150 TO 200 FEET FOR A PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC: WELL.
MINIMUM DISTANCE FROM A PRIVATE WELL. TO A PRI'M'ATE SEWER LINE IS 25 FEET AND
TO A COMMUNITY SEWER LINE IS. 5 FEET.
WELL LOGS. ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTIIENT WITHIN 30 DAYS
OF THE WELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY - SPECIFIC:ATIONS AND f:iJt',i.=TRUC:TION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION
F= Fr rl :E -9-- FE eF=^ I F E7E7 3 I-'>FEI EEB-lE?'E=F:'
I CERTIFY THAT
1: I AM FAMILIAR WITH THE REQUIREMENT= FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
<' I UNDERSTAND THAT TH CiN-SITE SEWER SYS'T'EIM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE � ,nE EL D r iNCl�UDE MORE THAN BEDROOMS.
SIGNED:-- G dt� �------- - -------
APPL ICAN7, Ew RL W, Dfi% IS
ISSUED E:4'_ llail�f !11,�.`�7�te�st a--- __•__MATE_ �sy_ _L �I
INSPECTIi_N HISTORY - SEWE€? 1 is SE W 2 tom+
WELL !NSP 0 WELL LOG DATE s_ DRILLER
' /0'%,*0 SOILS LOG
MUNICIPALITY OF ANCHORAGE
.• .,v�l DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Y' PERCOLATION
I�Pouch 6650, Anchorage, Alaska 99502 276-2221 TEST
SOILS LOG — PERCOLATION TEST pnc $ fo7y
PERFORMED FOR: aRRL pq.V IS DATE PERFORMED: //-/`I 11'�O-
LEGAL DESCRIPTION: LM Lo �9 I ScL /ti 'r 12 N R S N 5 M,4Ljas�A
,FIDEPTH OR6RNhc h.n RTS2hgL SLOPE SITE PLAN
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PERCOLATION RATE
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AReP Woo08O �/ Zl� t sY>' a To /4 ••
* ® Reading Date Gross Net Depth to Net
® Time Time Water Drop
`i' II/So�g 4:Ss 1.70'
/D:oS /O MIN 1. SL 0.12
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COMMENTS 5EE R. EV.B RS
( mutes/inch) O•
.3 /0 MIN g.33 MINT,
J FT AND /_T /•1 INC INCM
A"D 17 GPET�
PERFORMED BY: D. PD Pf+AM CERTIFIED BY:
72-008 (7/76)
DATE: 1)41 I $I{
COMMENTS 5EE R. EV.B RS
( mutes/inch) O•
.3 /0 MIN g.33 MINT,
J FT AND /_T /•1 INC INCM
A"D 17 GPET�
PERFORMED BY: D. PD Pf+AM CERTIFIED BY:
72-008 (7/76)
DATE: 1)41 I $I{
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LJ SOILS LOG
MUNICIPALITY OF ANCHORAGE
• DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION
825 L. Street, Anchorage, Alaska 99501 264-4720 TEST
SOILS LOG - PERCOLATION TEST
PERFORMED FOR: L fAf L D f A U \ 1J (DATE PERFORMED: 2— �� o
LEGAL DESCRIPTION: T t_ IV ,, ]S l,o _C,C C._- -
F—DEPT—H-1 SLOPE SITE PLAN
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
ENTS /( ,,A YP
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ENCOUNTERED? _ 00 L
0
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IF YES, AT WHAT E
DEPTH?
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
IT
10
/ 617
if
010
1
� j lo
PERCOLATION RATEZ1 (minutes/inch)
(�n 5 'ZoX� %
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TEST RUN BETWEEN � FT AND Z FT xtz
PERFORMEDBY: L2C 4� po�'ef I CERTIFIED
72-008 (6/79)
•
I ! ,
ti
• Municipality of Anchorage
�j SEP ( I
`t On-Site Water and Wastewater Program a r < , n
c: 1M
(907) 343-7904Is. ,• ^ 2'�'
Certificate of On-Site Systems A Pproval °` s
Parcel I.D. 015-501-19 Expiration Date: 1 2-2-/ -( 7
1. GENERAL INFORMATION
Complete legal description Call Earl Block 1 Lot 2
Location (site address) 5441 O'Malley Road
Current Property owner(s) Robert Davison Day phone
Mailing address PO Box 113164 Anchorage, AK 99511
Real Estate Agent Day phone
2. TYPE OF DWELLING:
D Single Family (w/wo ADU)
El Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 4
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well Individual 0
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received be .' 4 I ' I ', i ._
• Date:
COSA to be release• to the engineer,unless otherwise requested byte ngineer.
COSA Fee $ i Waiver Fee $
Date of Payment Q1/�l17�' Date of Payment
Receipt Number ,76Q?6 Receipt Number
COSA# QSCJ?-1(129 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.
In conducting an adequacy test, I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test,
and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil
condition,ground water levels that may fluctuate during the year,and the water usage of the family being served by the system.These conditions
are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLC Phone (907) 272-8218
Address P.O. Box 100217, Anchorage Ak. 99510
Engineer's Printed Name Steven R Pannone Date 9/13/2017
°F4 4 k
*
TMv FA
.
' 1
6. DSD SIGNATURE r " �f 4
System #1 Approved for 3 bedrooms �1.euen 13. Pannone
System #2 Approved for bedrooms # 4�, CE-8149• ��
Disapproved 'kW, OFESS.00
Conditional approval for bedrooms, with the following stipulations:
.`0,ikklu tirrtr
OF AA, .
'0
•
ON-SITE
WATER AND rn
WASTEWATER•
z=
PROGRAM
•0.o J•,
—_r J
Original Certificate Date: ( -2- I �( (
The Municipality of Anchorage 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
COSA blue sheet r •
If more than 1 septic system is on the lot:
COSA Checklist# 1 of ,
Structure served by this system 1
Certificate of On-Site Systems Approval Checklist
Legal Description: Call Earl Block 1 Lot 2 Parcel ID 015-501-19
A. WELL DATA
Well type Private If A, B, or C provide PWSID# Well Log (YIN) N
Date completed UNK Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth UNK ft Cased to UNK ft. Casing height (above ground) 12+ in.
FROM WELL LOG AT INSPECTION
Date of test UNK 8/25/2017
Static water level UNK ft. 229 ft.
Well production UNK gpm 4.0 g p m
WATER SAMPLE RESULTS'
Coliform NEG colonies/100 mL Nitrate N� mg/L
Arsenic ND ug/L Date of sample: 8/18/2017 Collected by: PES
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Steel Date installed 8/6/2009
Tank size 1 000 gal Number of Compartments 2 Cleanouts (YIN) Y
Foundation cleanout (YIN) Y Depression over tank (Y/N) N High water alarm (Y/N) N/A
Date of pumping 8/30/2017 Pumper A+ Home Services
C. ABSORPTION FIELD DATA
Date installed
8/6-8/2009 Soil rating (g.p.d /ft2 or ft2/bdrm) 0.6 GPD/SF System type Deep Trench
Length 50 ft. Width 4 ft. Gravel below pipe 7'5 ft
i otal depth 14-15 ft. Eff. absorption area 750 ft2 Monitoring tube Y Depression over field N
Date of adequacy test 8/25/2017 Results (Pass/Fail) PASS For 3 bedrooms
Fluid depth in absorption field before test in. Water added 462 gal. New depth in.
Elapsed Time: IU.0 min. Final fluid depth in Absorption rate >= 450+ g p d.
N
Any rejuvenation treatment (past 12 mo.) (Y/N & type) If yes. give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (Y/N)
"Pump on" level at in. "Pump off' level at in. High water alarm level at in.
Datum Cycles tested Meets alarm& circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100+ On adjacent lots 100+
Absorption field on lot 100+ On adjacent lots 100+
Public sewer main 75+ Public sewer manhole/cleanout 100+
Sewer/septic service line 25+ Holding tank 100+
Animal containment areas 50+ Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5+ Absorption field 5+
Water main 10+ Water service line 10+ Surface water 100+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10+ Water main 10+
Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
G. ENGINEER'S CERTIFICATION ��~~F
Rk,
't�OF A�gs>rh
ale
I certify that / have determined through field inspections and G .• • 77
review of Municipal records that the above systems are in * Tii yor
conformance with MOA COSA guidelines in effect on this date. 9'
Engineer's Printed Name Steven Pannone •• ,-- ,O,
1.even R.'Pannone .
CE-8149
Date 9/13/2017 ��{�q�;��,,, •���
IkU P40FE5SI �..s
COSA canary sheet_2-6-15.doc
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measured from line of .
ordinary high water V 'er Plat No 85-87 Note 2
o. Lots 1$2 shall share common
';` acess points on the South
4-1 boundary to O'Malley Road.
10'T&E Easement(misc Book42,P-31)
EAST 289.65
0
o In
to
O'MALLEY ROAD
q `�`", AS-BUILT NO CORNERS SET THIS DATE
4 Or � ' I hereby certify that I have performed a Mortgagee's inspection
itio"C q(• . 5 'ji afthe CALLiIEARLdSUBDIVISIONproperty: LOT 2, BLOCK 1.
P
air
0 • 49th /N .-7
ir Anchorage Recording Precinct,Alaska,and that the
gio* •* .0 improvements situated thereon are within the property lines
)�� �' oiland do not overlap or encroach on the property lying
/�/]•�—•• /s/ .� / adjacent thereto,that na improvements on the property lying
r% .Fred WaI otka , / adjacent thereto encroach on the premises in question and
t! �% • S' / that there are no roadways,transmission lines or other
srF•• 3255 — S ••,�� visible easements on said property except as indicated
*�to + • • • • . o s hereon.
SCALE: 1"= 60' I orrss!owl- Dated at Anchorage,Alaska
EASEMENTS OF RECORD,OTHER THAN 114%V‘'‘. this 11tH clay of September ,2017.
THOSE SHOWN ON THE RECORDED FRED WALATKA&ASSOCIATES
PLAT ARE NOT SHOWN HEREON. FB 17-5, pg 71 BE 907-248-1666 Engineers and Surveyors
1
r
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES
DIVISION OF ENVIRONMENTAL SERVICES
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
2644744
Application Date
GENERAL INFORMATION (MUST BE COMPLETED PRIOR TO SUBMITTAL)
(a) Legal Description (include lot, block,rst6division,, section, township, range)
r&tl Ear L. o+ Q, B /
Location (address or directions) ~'
A
(b) Property Owner
Mailing Address
(c)
(d)
5- Telephone: Home
Lending Institution
Mailing Address 3'
Real Estate Company and Agent
Address
Telephone
Telephone
Business S(pQ A414-
(e) Mail the HAA to the following address: or: Check here CJ, if hold for pick up.
List contact person and day phonenumber below.
C&L1 Stea-2414 4491 p�cpl�ul�
nR ale(– ISS9 — l a.t •
2. TYPE OF RESIDENCE
Single -Family.
Number of Bedrooms -rhre e
- cc
/f(f,fCl.}VAA�
3. WATER SUPPLY
Individual Well K Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite Public ❑ Community ❑ Holding Tank ❑
Note: 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 (Rev 8/88) Front
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this igspectfon.
Name of Firm LE��I AfJtrdC cLC 9 Telephone a-4(. 1170
Addre
Date
6. DHHeAPPROVAL2
Approved for L bedrooms by ��'"`�^ Date /2
Approved A Disapproved
Terms of Conditional Approval
0>
�' 1/Ilil11�
Conditional
CAUTION
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
order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data
before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional
engineer's work.
Page 2 of 2 1 74-026 (Rev. 8/86) Back
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY 1984
264-4720
Legal Description. CALL
A ( F Vf ' LA4, a.
A. WELL DATA
Well Classification Alit U ah— If A, B, C, D.E.C. Approved (Y/N) --
Well Log Present (Y/N) LL Date Completed LIARA. w Yield5,_donrri
W s
Total Depth _2142l_ Cased to 40+ Depth of Grouting
Static Water Level Pump Set At
Casing Height Above Ground A U4 Sanitary Seat on Casing (Y/N)
Electrical Wiring in Conduit (Y/N) Y Depression Around Wellhead (Y/N) u('
Separation Distances from Well:
To, Septic/Holding Tank on Lot I nA ; On Adjoining Lots 18-A f
To Nearest Edge of Absorption Field on Lot t2(i—; On Adjoining Lots t ef++
To `Nearest Public Sewer Line 114F4 To Nearest Public Sewer
Cleanout/ManholeTo Nearest Sewer Service Line on Lot tlAe
Water Sample Collected by Date I!k.4&t
Water Sample Test Results
Comments mcgr4iPt cAlicrP 0a CA 9-11 _66
J
B. SEPTIC/HOLDING TANK DATA
Date Installed Size lawn No. of Compartments -Tuno
Standpipes (Y/N) Air-tight Caps (Y/N) Y Foundation Cleanout (Y/N)
Depression over Tank (Y/N) hi Date Last Pumped
Pumping/Maintenance Contract on File (Y/N) ij ; for
Holding Tank High-Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well 109 To BwldingFoundation ZS
To Property Line 4A To Disposal Field lS
To Water Main/Service Line
11:1 To Stream, Pond, Lake, or Major Drainage
1
Course.`,��n 611 C,(z
Comments
r MUNICIPALITY O
DEPT OF HEALTH &
ENVIRONMENTAL PROTECTION
vj(j �j
Page. 1 of 2 4; �. S uL�. IQ "n'�
RECEIVED
72-026(17/84)
.z
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata 220
Type of System Design �ccL
Date Installed g ZT �S�—o"& 8103
Length of Field
Width of Field k+ rr
Depth of Field
Gravel Bed Thickness 4
Square Feet of AbsorptionArea (2(08
Standpipes Present (Y/N) y
` Depression over Field (Y/N)
Date of Last Adequacy Test S-ll'EJ
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water -Supply Well
To Property Line,
To Building Foundation
To Existing or Abandoned System on
Lot
; On Adjoining Lots 1-50 i–
To Water Main/Service Line
To Cutbank (if present)
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle' Storage Area
t? O
Comments
D. _LIFT STATION
Date Installed
Dimensions
Size in Gallons
Manhole/Access (Y/N)
"Pump On" Level at
"Pump O " vel at
High Water Alarm Level at
Vent (Y/N) '
Tested for
Pumping Cycles during Adequacy Test. Meets MOA
Electrical Codes (Y/N) '
Comments
"Check Permitted' Bedroom Rating Against HAA Request**
IcertifythatIhave ch ced,y nfied,orconformedtoallMOAandHAAguidelinesineffectonthedateofthisinspection.
SignedDate
/. – $-at,
Company a MOA No.
ST 86=' lC�
Receipt No. Z Cc/ OL / Z
-.i�f� 4F a..� Q�Ej
.
A
Date of Payment �y
�Q....
•
=Gia;r••••.9�6
�S-.
�' 49L '• ®% Engineer's Seal
Amount: $ 47
•« ........ a.•.. ,.:.
Page P of 2
'r ••. LNap
E 5130 r'�c�
72-026 (11/84)
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 `�- 1-71 kS'
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
T 12 td Ram Sic. 15 !._o -I- 29 — _ baIL, JeA Ls!- Swo 1 c. -o e4g=�
Location (address or directions) i) Su%c� o 15(�
�1 t7'Mo_10m K,ym)
(b) Applicant Name-F-AP.L %A-0 iS Telephone: Home 34G 336 7 Business 5422 2-414
Applicant Address t+ S -
(c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ❑ ; Buyer ❑ ; Other a (explain);
-Re't ' 11
(d) Lending Institution "tn o.� Telephone Vos - 17-85'3
Addresses
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address:
()jam (A4 ca -11 34.1, II'?O mQ !jL& I559
2. TYPE OF RESIDENCE
Single -Family Multi -Family ❑ Other
Number of Bedrooms 4ree
3. WATER SUPPLY
Individual Well Xl Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite Public ❑ Community ❑ Holding Tank ❑
Note: 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 0ia4)
.:.... .........
Y rSg
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
FiRm.
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 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 n r� '; { } S,Scl0-4e< Telephone 34�e 1190
Address I(A-6 1
Date __-_I_S-es
6. DHEP APPROVAL
i
Approved for �Ycg `� bedrooms by � Date
Approved \ Disapproved Conditional
Terms of Conditional Approval
CAUTION
0
1 f�eormsc�e;,e ao '
1 � r
(0'r'�yOFt uS10r'P a
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 (11184)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata'2n�«/�rrA
Type of System Design
Date Installed A-97-61 IOA-13
Length of Field 87
Width of Field a%
Depth of Field 1�
4-4
Gravel Bed Thickness
Square Feet of Absorption Area WOO
Standpipes Present(Y/N) y
Depression over Field (Y/N)
Date of Last Adequacy Test
Results of Last Adequacy Test
Separation Distance from Absorption Field:
To Water -Supply Well 12%
To Property Line I`I
To Building Foundation —IS'
To Existing or Abandoned System on
Lot —
; On Adjoining Lots rea+
To Water Main/Service Line t4 4�,
To Cutbank (if present) I l A
To Stream/Pond/Lake/or Major Drainage Course
Zoe)
To Driveway, Parking Area or Vehicle Storage Area
17D
Comments
D. LIFT STATION
Dais FA, [led
Dimensions
'o
Size in Gallons
Manhole/Access (Y/N)
"Pump On" Level at
Pump Off" Lev
High Water Alarm Level at
Vent (Y/N)
Tested for
ng Cycles during Adequacy Test. Meets MOA i
i
Electrical Codes (Y/N)
Commen
I
** Check Permitted Bedroom Rating Against HAA Request**
I certify that I have ctpckeci, ven ied, orcon ed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed k Date
Company £ MOA No.
s-'9hs�
OF A/-
Receipt No.
rt
Date of Payment
�,` p.r•...•� tr
ypj �• •'•yra�
* % k ®� Engineer's Seal
Amount: $
✓ e497"
Page 2 of 2.
4`,F�aROFESSIaNAa®
72-026(11/84)
ma
May 15, 1985
Re: Lot 2, Block i
Call Earl Subdivision
Earl Davis
5441 O'Malley Road
Anchorage, Alaska 99516
Dear Mr. Davis
At your request, I performed an Adequacy Test on your existing septic
system for the three bedroom residence at the above referenced
location. According to Greater Anchorage Area Boroughts Inspection
for installation of On -Site Seward Disposal system at this location
(August 27, 1981 permit #810833) your system consists of a 1000 -gallon
steel tank and 87 lineal feet of trench.
Upon arriving at the property on Saturday May 11, 1985, 1 observed the
septic system and recorded the separation distances. The static water
levels were measured and recorded. Water was then introduced to the
field at approximately 4 gallons per minute. The water levels were
periodically measured and recorded with respect to time during the
filling and subsequent absorbing period. The absorbtion rate was
extrapolated according to Dr. Leroy Reid's paper "In Situ Testing of
On -Site Sewer Systems, "September, 1982. This system accepted
approximately 460 gallons for the 24 hour period and should be
approved as meeting Municipality of Anchorage' requirements for a three
bedroom residence.
Sincerely,
Tony. l Barter
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 April 5, 1985
1. GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, tow hip, range) II
T12N R3W Section 15 Lot 29pip
Lo ,— y e4�c- �1fiz�
Location (address or directions)
Mile 2.5 O'Malley Road
(b) Applicant Name Earl Davis Telephone: Home 346-3367 Business 562-2414
Applicant Address 5441 O'Malley Road Anchorage Alaska 99516
(c) Applicant is (check one): Lending Institution ❑ ; Owner/builder ❑ ; Buyer ❑ ; Other ®x (explain);
Refinancing
(d) Lending Institution National Bank of Alaska Telephone 265-2858
Address Pouch 7-025 Anchorage 99510
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address:
2. TYPE OF RESIDENCE
Single -Family CRX Multi -Family ❑ Other
Number of Bedrooms three (3 )
3. WATER SUPPLY
Individual Well:Ec Community ❑ Public ❑
Note: If community well system, must have written confirmation from the State Department of Environmental Conservation
attesting to the legality and status.
4. SEWAGE DISPOSAL
Onsite ax 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 (11184)
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health
Authority Approval shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate
for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained
from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or
wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm
Address
Date
6. DHEP APPROV//jL
Approved for L
Telephone
Engineer's Seal
Date April 23, 1985
Approved Disapp�vedConditional xx for three (3) bedroom
'if mo ies are scrowed for the upgrade of the on—site
r Terms of Conditional Approval p
sewer system t6 be completed by July 1, 1985
Note: original engineer's report is on file with our Department.
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 (11/84)
._... -
8WRONMENTAL PROTECTION
MUNICIPALITY OF ANCHORAGE (MOA) APR 5
HEALTH AUTHORITY APPROVAL (HAA) r
CHECKLIST - FEBRUARY 1984 RECEIVED
Legal Description:
A. WELL DATA T12N R3W SEC. 15 Lot 29 _
Well Classification private If A, B, or C, D.E.C. Approved(Y/N)-------
Well Log Present (Y/N) N Date CoTpieted unknown Yield 5.49pm -
Total Depth 262 ft. Cased to 40+11 De h of Grouting ------
Static Water Level Pump Set At btm.
Casing Height Above Ground 14 in. Sanitary Seal on Casing (Y/N) Y
Electrical Wiring in Conduit (Y/N) Y Depression Around Wellhead (Y/N) N
Separation Distances from Well:
To septic/Holding Tank on Lot 100+ ft. On Adjoining Lots 100+ ft.
To Nearest Edge of Absorption Field on Lot 100+ ft ; On Adjoining Lots 100+ ft.
To Nearest Public Sewer Line N/A To Nearest Public Sew-mr
Cleancut/Manhole N/A To Nearest Sewer Service Line on Lot N/A
Water Sample Collected By TDB Date April ] 1985'
Water Sample Test Results Satisfactory
Comments
B. SEPTIC/HOLDING TANK DATA
Date Installed 8/27/81 size 1000 gal No. of Compartments two
Standpipes (Y/N) -N** Air-tight Caps (Y/N) ** Foundation Cleanout (Y/N) Y
Depression over Tank (Y/N) N Date Last Pined 5/23/84 ck #1964
Pumping/Maintenance Contract o1 File (Y/N) N ; for ------
Holding Tank High-Water Alarm (Y/N) -----Temporary Holding Tank Permit (Y/N) n
SeparationDistances fram'Septic/Holding `Tank:
To Water-Supply Well 100+ ft. To Building Foundation 67 ft. *#
To Property Line 15+11- To Disposal Field 16 ft.**
To-Water Main/Service Line N/A To Stream, Pond, Lake, or Major Drainage
Course N/A.
Commnts ** The owner tried unsuccessfully to uncover standpipes
in the snow and ice. Distances were taken from inspection report
dated 8/27/81.(Permit #81083 eceipt QLnCp
Date Paid:
Amount': ES an
[Page 1 of 2) 2-15-84
C. ABSORPTION FIELD'DATA
Soils Rating in Absorption Strata 220sf/bdrm Type', of System Design trench
Date InstalledLength of Field 87 ft.**
Width Of Field ` 36 in. * Depth of Field 11 ft.**
Gravel Bed Thickness 4 ft. **
Square Feet of Absorption Area 660 sf Standpipes Present (Y/N) N**
Depression over Field (Y/N) N Date of Last Acbquacy Test 8/27/81
Results of Last Adequacy Test
Separation Distance frau Absorption Field:
To Water -Supply Well 100 + ft. To Property Line 15+ ft.
To Building Foundation 83 ft' To Existing or Abandoned System on
Lot 60 ft.- On Adjoining Lots 100+ ft.
To Water Main/Service Line N/A To Cutbank(if present) N/A
To Stream/Pond/Lake/or Major Drainage Course N/A
To Driveway, Parking Area, or Vehicle Storage Area 100+ ft.
Comments ** See comments on the front.
D.LIFT"STATION
Date Insta _ Dimensions
Size An Gallons _ Manhole/Access (Y/N)
"Pump On"' Level at "Pump Off°at
High Water Alarm Level at Vent (Y/N)
Tested for ing Cycles ing Adequacy Test. Meets MDA:
Electrical Codes(Y/N
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that 2 have checked, verified, or gonformed to all MOA HAA Guidelines in effect
on the date of this inspection.
Signe 1 J4 —JNdDate r,��%�"�ti
�; 0%
Carpany Barr and Associates MOA No. t85-228 p r •'���
m *t
p•.J004 Ad, ••N 11��•
KBI/d5/s
Tony D. 8 • �tykr�`
4*CE 5790
[Page 2 of 21
�•••««••• V�.!
1\�j�►
2-15-84
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONMENTAL HEALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTH AUTHORITY APPROVAL CERTIFICATE
1. General Information Application Date _ April 59 1985
(a) Legal Description (include lot, block, subdivision, section, township, range)
T122d 831.1 SE015 Lot 29
Location (address or directions)
Mile 2.5 OONa.11ey Road
(b) Applicants Name Earl Davis Telephone — Home346-33iusiness562-2414
Applicants Address 5441 O'Malley -Anchorage, Alaska 99516
(c) Applicant is (check one) Lending Institution = ; Owner/builder ;
Buyer E__1 ; Other XY (explain); F.efina.ncing
(d) Lending Institution National Bank of AlaskaTelephone 265-2858
Address Pouch 7-025
(e) Real Estate Co. & Agent
Address
Telephone
(f) Mail the HAA to the following address:
',,!ill pick-up by calling 562-2414
2. Type of Residence
Single—Family <lt Multi—Family
Number of Bedrooms Ti'hree
3. Water Supply
Individual Well M Community =
Other (describe)
Public =
Note: If community well system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
4. Sewage Disposal
Onsite = Public F__1 Community Q 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]
W
5. Engineering Firm Providing Inspections Tests File Search Data and Information
As certified by my seal affixed hereto and as of the validation date shown below, I
verify that my investigation of this Health Authority Approval shows that the on-site
water supply 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 orr-site water supply
system is in compliance with all Municipal and State codes, ordinances, and regula-
tions in effect on the date of this inspection.
Name of Firm Barter and Associates Telephone 346-1170
Address 10461 Hampton Dr. 'Anchorage, Alasks 995
Date _ April 4. 198 A%C
*.
(ENGINEER SEAL)
6. DHEP Approval /II / /f
Approved for=e bedrooms _By LL GFq
Approved / Disapproved ! `�- Conditional
/i
Terms of Conditional
CAUTION
jp%...........
.
Q
D. Barter • <V�
CE 5130w��
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS 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 REQUIRE-
MENTS. 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.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 2] 7-19-84
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® I Fwv. 82,\55 CVP klcl�. I. feemo V111EAISI0R15 ftm PLAT cr
MIBDIVISIOFL Of $W 66C, Lar Z6(YY
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/v. - (; •., .-a� 3.DIM¢NSICt1S OMt¢Ta.L 2EcoP-.D'(�:[tal
m 4" 5{MJD 'Aft, •�:: - . =� '•"9 Oa Fg-* 41 uozocoeveD R Kr Di CALL
P
545v, PAjED /l/e5.
NO. 2240 5
Robert M. SchweRxer
•,,
gin: �•ressinrc>��^'p
la
ALASKA I)EltnPMEXT (,MULTANTS, SSC. P -ftIL.-r 61sJ�EV"
....•.< $u•vevosPianne.v LD Z &-Cry'PO 811.,\318) CALL Y.L. $USDIV151ca
'ncno•eye,.1K90,S�Ginowa� \495M318% MaHo¢ACTlF"AIhSYA
I of I
,�% ivaboaal
VTV BankofWaslta
Mortgage Loan Department: Pouch 7-025 • Anchorage, Alaske 99510-7025 • (907) 211-2051
April 4, 1985
To Whom It May Concern:
Estimates have been received (3) for replacement of the septic system
for Mr. Earl Davis's property. We will place funds in escrow to cover
the possibility of replacing the system if needed in the Spring.
Mr. Davis will need to have health authority approval of the septic system
before the escrow funds can be released.
Kathleen Vogan U
Mortgage Loan Originator
OFFICES STATEWIDE
- =:
..DAT"RECEIVED
Ld 'a9 /5-
23 u7 S Al
INSPECTION APPOINTMENTS
TIME ':;"
TIME
TIME
DATE
❑ One ❑ Four ❑ Other
DATE
DATE
❑ MULTIPLE FAMILY
[a ' Three ❑ Six
7. WATER SUPPLY P
$i INDIVIDUAL` 07/o a
*ATTACH WELL LOG. A well log is required for all wells drilled
.INSPECTOR
-
INSPECTOR
INSPECT
& SEWAGE DISPOSAL SYSTEM
:MUNICIPALITY. tF
N .INDIVIDUAL/ON-SITE**
MUNICIPALITY OF ANCHORAGE DEPT. OF I'",'LTH &
`
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTI@NVIRONMEyT .L—OTECTION -
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
825.L Street - Anchorage, Alaska 99501
�
APR 1980
1 �
ENVIRONMENTAL SANITATION DIVISION
Telephone 2644720
RECEIVED
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FXCILITIN
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTY OWNER
V,s77
PHONE
MAILING ADDRESS.
-SA f- R7',s Q
/7/ Ao A-74 -c / ,6;r 2760 7
PROPERTY RESIDENT (If differet from above) -
PHONE
2. BUYER
PHONE
E,4e1,,
333_
MAI LING ADDRESS
7-A4! E
a/ JO r4 e 414?e)CA,
_
c7
3. LENDINGINSTITUTION
PHONE
MAILING ADDRESS
-
4. REALTOR/AGENT
PHONE
MAILING ADDRESS
5. LEGAL DESCRIPTION
Ld 'a9 /5-
23 u7 S Al
STREET LOCATION
Qtp-p7R/i@eQt4
6. TYPE OF RESIDENCE
NUMBER OFBEDROOMS
2k SINGLE FAMILY
❑ One ❑ Four ❑ Other
❑ Two ❑ .Five
❑ MULTIPLE FAMILY
[a ' Three ❑ Six
7. WATER SUPPLY P
$i INDIVIDUAL` 07/o a
*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.)
& SEWAGE DISPOSAL SYSTEM
�dn
N .INDIVIDUAL/ON-SITE**
�QC g YEAR ONSITE 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
❑ SINGLEFAMILY
❑ MULTIPLE FAMILY
NUMBER OF BEDROOMS
❑ ONE ❑ .THREE ❑ FIVE
❑ TWO ❑ FOUR ❑ SIX
❑ OTHER -
2. WATER SUPPLY
❑ INDIVIDUAL
❑ COMMUNITY
❑ PUBLIC UTILITY
Connection Verified -`LOG.
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
RECEIVED' ..
3. SEWAGE DISPOSAL SYSTEM
❑INDIVIDUAL/ON -SITE
❑PUBLIC UTILITY
Connection Verified
PERMIT NUMBER
DATE INSTALLED .. ..
INSTALLER
❑Septic Tank or Cl Holding Tank
Size: If Tank is homemade
give dimensions:
SOILS RATING
TYPE OF TANK ` -
MANUFACTURERS - - - -
-TOTAL ABSORPTION AREA --
MATERIAL -
.....
4. DISTANCES
WELL TO:
Septic/Holding Tank
Absorption. Area.
Sewer Line
Nearest Lot Line..
Absorption Area to nearest Lot Line -
- - - - - -
'...... _.
5. COMMENTSdjJ
.. ... _...
....
- "❑ APPROVED FOR BEDROOMS
ED CONDITIONAL APPROVAL (letter must accompany certificate)
E� DISAPPROVED
DATEJr' �^
BY
lAunicipality
of
r
825 "L" STREET
ANCHORAGE, ALASKA 99501
(907).264-4111
GEORGE M. SULLIVAN,
MAYOR
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
April 28, 1980
Richard V./Lois Pastro
Star Route A Box 1717
Anchorage, Alaska 99507
Subject: T12N R.3W Section 15 Lot 29
Approval for your individual sewer and water facilities
can not be granted until the following items have been
completed:
(1) The water analysis report be delivered -to this
office from Chem Lab, 5633 B Street, for our
review.
(2) The separation requirement between a individual well
and an on-site sewer system is 100 feet. The separation
between your well and sewer system is 72 feet. The
sewer system will need to be relocated 100 feet from
your well and the creek that runs through the property,
(3) A 1,000 gallon septic tank will need to be installed.
(4) A soils analysis needs to be done on the property for
the new leaching area. A listing of engineers performing
the test is enclosed.
(5) Prior to any construction, a permit needs to be obtained
from this department.
If there are any further questions, please call this office
at 264-4720.
Sincerely,,
Robert C. Pratt, R.S.
Associate Specialist
RCP/ljw
xn
ME
I
MUNICIPALITY OF ANCHORAGE
�.r DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
Environmental Health Division
CASE REVIEW WORKSHEET
CASE NUMBER:.
S-7945
DATE RECEIVED:
December 3, 1984
COMMENTS. DUE BY:
December 21, 1984
SUBDIVISION OR PROJECT TITLE:
11'f �"
.
Lots 1, 2 Block 1 Call Earl Subdivision
Q�
( lf PUBLIC WATER AVAILABLE ( .PUBLIC SEWER AVAILABLE
(I ) COMMUNITY: WATER AVAILABLE
COMMENTS:
/933
-e Cemtif��UC�s 4 w deo C9t^
le
6 s t7G
.,-
Alt
71-014 (Re ..5/83)"
0
ALASKA DEVELOPMENT
CONSULTANTS, INC,,
5313 Arctic Blvd., Suite &
P. 0. Box 4-3187
ANCHORAGE, ALASKA 99502
(907) 561.1044
9
TO
WE ARE SENDING YOU 'Attached ❑ Under separate cover via_
❑ Shop drawings ❑ Prints
❑ Copy of letter ❑ Change order
❑ Plans
DATE
Z-1
JOB
ATTENTION
FE:
J
L=p
3
following items:
❑ Samples ❑ Specifications
COPIES
DATE
NO.
DESCRIPTION
L=p
3
8 --n -61
Z
o®a r
THESE ARE TRANSMITTED as checked below:
❑ For approval ❑ Approved as submitted
❑Foy your use El Approved as noted
As requested ❑ Returned for corrections
❑ For review and comment ❑
REMARKS
COPY
❑ Resubmit copies for approval
❑ Submitcopies for distribution
❑ Return corrected prints
❑ FOR BIDS DUE 19 ❑ PRINTS RETURNED AFTER LOAN TO US
PMCRt0-2 �IM, c , 0fts 01471. if enclosures are not as noted, kindly notify ua at once.
April ¢, 1985
To: Municipality of Anchorage
825 L Street
Anchorage, Alaska 99501
Reference: T12Di R316111 Sec. 15 Lot 29
Dear Sirs,
Mr. Davis, the owner of the above referenced property, has
tried unsuccessfully to uncover stanpipes for his septic system.
He has tried shoveling and spraying hot water to no avail.
In lieu of his attempts, the bank has agreed to withhold
funds in escrow sufficient for a total upgrade, should it become
necessary. Therefore, he is requesting a conditional approval for
the well only,so that the bank may continue processing the paper
work K refinancing. :)T e banks concurrence is attached.`
Thank you for your consideration in this important matter.
TDB/kb
Sincerely
114W &
TonyYD. Barter
Barter & Associates