HomeMy WebLinkAboutFORD LT 1Ford
Lot 1
#051-281-58
· ° ' : Muni~ipality of Anchorage Page 1 of 3
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 · Anchorage. Alaska 99519-6650 · Telephone: 343-4744
On-Si. te Wastewater Disposal System and/or Well Inspection Report
Permit Number. SW000225 PiDNumber: 051-281-58
Shau~ & Lucianne 'Copelin., Wastewater System: E] New' I~I Upgrade
Address:
P.O. Box 772064 ' ABSORPTION FIELD
P~one: . I No. of Bed -
.694-2767 Four r~ -.i I-1Deep Trench ~[~3hallow'Trench r'lBed r'lMound nOther
LEGAL-DESCRIPTION so..~..~: 1:2. G.o~.F,. - 6 .'..
'1 ..... " -. ' "Ford · "· .... '
.... · ' ' ' 'rt. . .'50 "F,.
· ~ U ' r~de" - ' Grave/width: . Number of ,lnes:
WELl' . n New,...... " ..y,d pg .. .... .. . . '55 : · '~
I
· . Privab~ ·" *"'~> ' 101· r~ ~01 r,. ''* . '" 500 56.'~,.' %STM D3034' PVC'
...·Sullivan: '~ ' 5/16/0C ' 59 ~Ft Barr Excav~ti'n'~
',' . [PumpSetat: .... . [Casa~14ekjhtAbo~C.m~ ~ · ., . .
Yie~: . ..[6 GPMI ' ' · , · . FLI" 2 -" FL ':'° .
SEPARATION DISTANCES ~ ' '
· '~' - "'.:... tic ' '.~' ! '[]Holdi ' ''" ~S.T.E.P.' ~ ·
~" .". ~ r~ . s~ ~ ~u~ Anchorage 'Tank .1 , 250 · ' ' -'~ · '.'. ' ..
'i"Wet~' >100'! >'100' N~'A N'/A >25' ~,e~: Number0fC4~npa~nt=~ .''
· ' . · . - Steel ' '' ' ' Two ' · ..... ' · ".
SurfaCewater ."~ >100'.. >I00.'... '. .N/A. N/A. . .N/A"... . :':=i '." ' '-' .LIFT STATION. - "N/A" "'...I
S~e in gallons: J Mandtacture~. · : . .', '. .
"'"' LineL°t ""' >'$':..1 '~10'- 'N/A N/A N/A . . :. . ..... .......: .. :.. ,... - ..
Rema~ku. Existinq Well Was Aband~ae~l" ...... "' -'
' .k~'"Acc6~dance'. With =AD'EC.'.R'egui're-'" L0csU0~an4Desc,pti0n: . h' · .' ., . · . ....
· ·Concrete Ste~ at'Ba'ck Do'fl ' .' "::."
'ments. · Existing .'Septic.~?'a'nk ~as · ' ':":~'." .""" · .'.''. ' ..: ."" .: '. "..'' .' ' .; '."...
Pushed, 'iCfushed. and 'Abahdoned.i':.: '- . ..: .." .'>' .'-' '.'! .. .~ .- ~ ...:.
' 'I '.. , ". 100.0 '.'-'..~!
'~ '2'.'. in~ulati6h 0Ve~' Taflk'and'T~encn. '.>. '.'.'. ::..' .... :.' ' ' .£~mL-~,s~ . '.'
· .-:.~,~IE~ -- .~., "~t,
"<" Departm
ent of Health and Human Servia:esOp oval ·
'R ieWeda d p edb
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES '-
ENVIRONMENTAL SERVICES DIVISION
, ,' P.O. Box 196650 - Anchorage. AK 99519-6650.343-4744
On-Site INastewater Disposal System or,Nell Inspection Report
Page2
~'ermit Number SW000225 PID No. 051-281.58
· ..- - Lot 3~..... .. , ":"'" ...... : ." '' i~ L~t:2:'.' ' " "'
. · '.- : ' .. -Lot 1.', Ford.'Subdivi~i0h'j .' ' '- ... .
. · :, ..~' :'~ . . ..' , . .. . ,:-.'°-' .... '~ .: .' . . . . .: .-...-
· ~ ...: ~.':.:.: ~: :!~..:·~i~."~ : . :.. :...'
.';.. . ..... '~- :~.- ._ . , . ,.- ...,
. - -.'..:-'. · :-.....~:
~S" A B
I 9.1 30.1
S2 17.0 33.3
M1 46.0 ~ 47.2
.C5 146.2 43.5
Municlpalit~ of Anchorage *
DEPARTMENT O~ HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DMSION
P.O. Box 196650. Anchorage, AK 99519-6650. 343.4744
On-Site Wastewater Disposal System or Well Inspection Rep{~rt
Page 3
20'
~" Insulation." ' '"
92.8
· ~ Dratnfield'Roc'k' 92.75
88°8
82.0
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGIAK; ALASKA 99567 · TELEPHONE 688-2759
OWNER OF LAND J"',~/'~(d,d
ADDRESS
LEGAL·DEscRIPTION j' o"'r' . I
PERMIT NUMBER ~O0~)o~[ Date of Issue
T~x ~.BENT~F~CAT~ON HUMSER 0~! -' ~./- ~
Is well located at approved permit location? .~-~f~'es ~ No
Method of Drilling: 4~'~ary [~ cable tool
Depth of well: .~/0 [ . ;
BOREHOLEOATA
DEPTH
[~. Screened; Start
O~e~or~tions Stad
Gro~lt Type: 6~eJ ~'~ ;4
Depth: from'" '0
Pump Intake Depth:
' feet
Casing Stickup Above Ground:' ~. feet
Static Water Level (from ground level): ~'"6;~ feet
Pumping I~vel: ~eet after__hrs, pumplng · gpm
Re~ver Rate: ' · ~ opm
Me,hod of Testing: ~1 ~
Well In~ke Opening T~: ~ Open End ~ Open Hole
feet Stopped feet
.(Re'toped ~'C, feet
~eel
Pum~ Size .bp. Brand Name
Well Disinlected Upon ~plelion? ~os - 0 No
Me~od of Disinf~tionJ C~41,~" ~0
Comments:
:RECEIVED.
Municivality of Anchm:a~e
Dept. Health & Human Serwces
ATTENTION: It Is the responsibility of the property owner to submit a copy of the well log to the proper auth0rlty, mMuniclpafit',,
of Anchorage: Department of Health & Human Services and/or Department of Environmental Conservation. MatSu Boroug~_m
Department of Environmental Conservation...
ANDERSON ENGINEERING
P.O. BOX 240773
ANCHORAGE, AK 99524
522-7773 522-6779 (FAX)
MEMORANDUM
DATE:
January 5, 2001
TO: Jeff Poet
FROM: M, ike Anderson, P.E.''/V ~')'/''''~ ,
SUBJECT: Lot 1, Ford Subdivision
Septic System As-Built
The bottom of the septic syster~ recently placed on Lot 1, Ford Subdivision is only 5.5'
above the bottom of the test hole utilized for the design of the system. An older test
hole placed in August of 1975 by O & E Geotechnical and Development Company,
however, was placed to a depth of 14' with no indication of the presence of bedrock.
We are therefore confident no bedrock can be found within 6' of the bottom of the new
absorption trench.
A copy of the old test hole is included for your review. Please let me know if you have.
additional questions.
OErE
Russell Oyster
694.2774
Soils ~ Foundations
GEOTECHNICAL 8- DEVELOPMENT
Box 90, Davis St., Eagle River, Alaska 99577
694-2774 or 688-2280
CO.
Ead Ellis
688-2280
Land Development
S_OIL LOG
Performed for:
Legal Description:..
.Depth (feet)
0
Name:
Hailing Address:
/
Soil Charactertsttc~
2
Tel. No.
3
4
7
g
10'
11
12
//-/.,
Grou6d Water Encountered:
Yes
Proposed Installation: Seepage Pit..
No """ If yes, what depth
,, Drain Field ~
Comments:
Y.
Date:
V
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Jut 12, 2000
Expiration Date: Jul 12, 2001
Permit Number: SW000225
Legal Description: FORD LT 1
Design Engineer: 0014 Anderson Engineering
Owner Name: Shaun & Lucianne Copelin
Owner Address: PO Box 772064
Eagle River, AK 99577-0384
Parcel ID: 051-281-58
Site Address: 016311 FORD DR
Lot Size: 35733 SQ. FT.
Total Bedrooms: 4 Permit Bedrooms: 4
This permit is for the construction of:
[] Disposal Field [] SepticTank [] Holding Tank [] Privy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsudace 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.
July 5, 2000
ANDERSON.ENGINEERING'
, : P.O. BOX 240773 - '. .
. ' ANCHORAGE; AK 99524', ,
522-7773 522-6779 (FAX) ,
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
Anchorage, AK 99502-0650
Subject: Lot 1, Ford Subdivision ..
Septic System Design and Permit Application
· Impacts to Adjacent Pro pertie~
.Dear Onsite Services Engineer:
The existing absorption trench on Lot 1, Ford Subdivision has failed and must be
replaced as soon as possible. We are therefore applying for a permit to construct a
new septic system on the lot to serve the four bedroom house house. The attached
Site Plan and backup document~Jtion identify the location and configuration of the new
septic system and the parameters used in the design. A new well was recently placed
on the lot to provide additional room for the septic system upgrade. The old well will be
decommissioned in accordance with ADEC requirements during the. placement of the
new septic system.
The test hole placed on the lot at the Ioc~tion shown revealed well graded sand and
gravel with only a minor amount of silt. The percolation rate of the material was
determined to be right at 1 minute per inch. Some water seepage was encountered in
the test hole at the 10.5' level. No .water was noted during the ensuing monitoring
period however. We are therefore proposing to construct a 5' Wide shallow trench
system with a maximum depth of 6' below the original ground surface. The length of
the trench will be 50' with an effective depth Of4' Mounding will be required over the
trench to provide a minimum of 3' of cover to prevent freezing.
The ground surface on the lot slopes from south to north at a very slight grade. · The
new system will be constructed parallel to the slope in conformance with Municipal
requirements at the flattest area on the lot. Grading will be accomplished once the
system is completed so drainage is away from the trench and septic tank but'in the
direction of the current drainage pattern. No surface water will accumulate in the trench
area.
If the system is constructed in accordance with our design the following statements
apply:
1, The system, 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 system, if constructed as designed, will have no adverse impact on existing
L'ot 1, Ford Subdivision
July 5, 2000 . · '
Page Two
septic systems in the area or those to be constructed in the future.
Sincerely,
The system, if constructed as designed, will have no adverse impact o~ reserve
space, either surface or subsurface, on any lots located in the area.
The system, if constructed as designed, will have no adverse impact on drainage
patterns in the area. The current drainage pattern will be maintained.
. Michael E. Anderson, P.E.
Attachments
NOTE:
Lot 3 ·
No' ConfliCts W~hh We ls
on Adjacent Lots.
Lot 1, Fo, rd Subdivision
I1
50'. Long X 5' wid
X 4' Eff. Depth Tr~
· 1,250 Gal~lol
Septic.
Existing
-.Septic System
Abandon
Existin¢
Well
Four
Bedr(
Home'
Lot 2
~Existing Well
Undeveloped
Land
NOTE:
Abandon.Existin, Well in Accordance
· With.State and Municipal Regulations.
Pump, Crush and Backfill Exisiti~g
Septic Tank.. Abandon Existing
Absorption Trench in Place.
SITE PLAN
SCALE1"=30'
LOT 1, FORD SUBDIVISION
DESIGN FACTORS:
Four Bedroom Home
Perc. Rate: I MinJInch
Application Rate: 1.2 GPD/SF
SYSTEM REQUIREMENTS:
5' Wide Trench System
1,250 Gallon Septic Tank
4' Dralnfield Rock
4 Bedrooms X 150 GPD I 1.2 GPD/SF = 500 SF of Absorption Area
500 SF/5 LF (Width) X .5 (Red. Factor) = 50 LF Trench Length
Therefore: Construct a 5' Wide By 50' Long Absorption Trench As Shown
on the Site Plan with 4' of Dralnfield Rock Beneath the Lateral.
Distribution Pipe in Trench Placed at 2.0' Below Original Ground
Surface. Total Depth of Trench to Be 6.0'. Mound Over Trench to Provide
a Minimum of 3' of Cover.
'~Natural Backfill~ '
__ /~ ~ (3' Minimu~.._-~-~ ..... --
1.5' '! Geotextile Fabric
...S' ~j~',, O ~ ·
4.0 '~ Drainfield Rock -
St
NOTE:
TYPICAL WIDE TRENCH SECTION ,,-~.~..~.~.,.5,(~t,
Grade Area Over Trench ,o Drain Away. ~(~e~7:~]~%
Minimum 6' separation From Bedrock. m~~r};;~",_
Minimum 10' Separation From Lot Line. ~2.~~ -------------~)~..,~~~ %
Minimum 4' Separation From Groundwater. ~f~,~~~
Municipality of Anchorage
Department of Health & Human Services
825 L Street, Anchorage, AK 99502-0650
SOILS LOG - PERCOLATION TEST
Performed For. Chuck Ban' Construction
Legal Description: Lot 1. Ford Subdivision
SLOPE
Date Performed:
SITE PLAN
8
9
10
11
12
13
14
15
16
17
18
21
OG/OL
GW/SW
Was Groundwater
Encountered? Yes S
If Yes, What Depth? 10.5' L
Depth to Water O
After Monitoring None P
Bottom of Date: 711100 E
Hole
See Site Plan
Reading Date Gross Net DepthTo Net
Time Time Water Drop
I 6-Jun 1:30 7'
2 1:35 5 12' 5"
3 1:36 7'
4 1:41 5 12" 5"
5 1:42 7"
6 1:47 5 12' 5"
Peru. Rate: I Min./Inch Perc. Hole Diameter. 6"
Test Run Between 4 Ft. and 5 Ft.
Comments: Percolation Cavity Presoaked Prior to Testing.
Performed By: Tim Kimbmuoh. I, ' , Certify That This Test Was Performed
In Accordance W~th All State and Municipal Guidelines In Effect On This Date: 715100
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION AND MATERIAL SPECIFICATIONS
SUBJECT: LOT1, FORD SUBDIVISION
GENERAL:
The scope of this project includes the procurement and placement of a
new 1,250 gallon septic tank at the location shown on the Site Plan. It
also includes the construction of a new 50' long x 5' wide x 4' effective
depth absorption trench. Distribution pipe will be placed at 2' below
the odginal ground surface. The total depth from original ground
surface will be 6'. The existing septic tank must be pumped, crushed
and backfilled on site. The existing absorption trench must be
abandoned in place. In addition, the existing abandoned well must be
decommissioned in accordance with ADEC requirements.
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.
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.
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.
Contractors installing wastewater disposal systems must be certified
by the Municipal Department of Health and Human Services for
system installations. Owners installing their own systems must receive
prior approval from D.H.H.S. before beginning system installation.
SEPTIC TANK INSTALLATION
1. The new 1,250 gallon septic tank must be procured from an approved
source and installed at the location shown on the plans.
A septic tank is to be constructed by a certified septic tank
manufacturer. Construction shall include two 4" cleanouts for pumping
access.
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.
· Lot 1, Ford Subdivision
July 5, 2000
Page 2 of 3
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 drainfleld shall be constructed to the dimensions shown on the
design. The bottom of the trench shall be within 2" of level.
Distribution piping must be placed level with perforations down atop a
level bed of drainfleld 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.
Contractor shall verify the septic tank and drainfield are a minimum
100' away from any pdvate water wells in the area, 150' from a Class
'C" Well or 200' from any community well.
o
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 trenches to drain away.
A minimum 2' of accepting soil is required below the dreinfield rock for
a 5' wide trench. Contractor shall vedfy this condition prior to
placement of the rock. All pockets of unacceptable materials must be
removed and replaced.
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 budal polystyrene
(Dow Chemical Co. Styrofoam HI or equal).
4. Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Femco, or equal).
' ' Lot I, Ford Subdivision
July 5, 2000
Page 3 of 3
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 shall provide a copy of all field survey layout and construction
notes for use in preparing the certified as-built of the completed system.
o~e l~. iluerch, layor ~epartm¢.t ~
~ Public Works
Btfilding Safety Dsvision
P.O. Ik)x 1OC'C,50 * S700 S. Bragaw Street
Anchorage, Alaska 00519-C~50 · (907) 82t3-8301
6/25/2001 httl~://www'cl'mlch°mg¢'ak'us
Shaun P. & Lucianne Copelin
PO Box 772064
Eagle River AK 99577
Subject:
Expired On-Site Water and/or Wastewater Permit.
Permit Number: SW000081,
Parcel ID: t/051-281-55
Dear Shaun P. & Lucianne Copelin:
An On-Site Water/Wastewater Permit, number SW000081, issued by this office for a
single-family system, expired on May 01, 2001. This permit was valid for 365 calendar
days.
If this was a well permit and the well has been drilled, a well log must be sent to this
office for documentation of the installation and to close the permit.
If this permit was for a wastewater disposal system, an original as-built inspection report
must be sent to this office for review, approval and documentation. This as-built
inspection report must be signed by the licensed Professional Engineer who inspected the
installation of the system. As-built inspection repons are required to be submitted within
30 days of the completion of the system.
If no system was installed under this permit, and you are still planning to install a well or
wastewater disposal system, a new permit must be obtained from this office. When
applying for a new permit, the fees are: $320.00 for a wastewater permit and $120.00 for
a well permit.
If you have any questions, please call this office at 343-7904.
Sincerely,
James Cross, PE
Manager
On-Site Water and Wastewater Program
Municipali , of Anchorage
Btuldmg S,'tfc ~' Division
P.O. Box 196C~50 * 4700 S. Bragaw Street
Anchorage, Alaska 99519-6650 * (907) 843-8301
httl~://www.cl.anchoragc.ak.us
Public Works
June25,2001
Faye Vandenverken
PO Box 773492
Eagle River, AK 99577
Dear Ms. Vander~verken:
I am sending you the copies ofthe permit package as you requested. Please note that
though the legal address states Ford Lot 3, the site plan enclosed is for Ford Lot 1. As I
explained on the phone we issue permits using the municipal tax system database
CAM& so when Lot 3 was entered, your name was automatically inserted into the
permit.
If you have further questions, please call this office at 343-7904.
Sincerely,
Sonnet L Fleener
Permit Clerk
On-Site Water and Wastewater Program
Enc: Copy of permit package.
Public Works
Faye Vanderwerken
PO Box 773492
Eagle River AK 99577
Subject:
Permit Number: SW000081
Parcel ID: 0551-281-57
Dear Faye Vanderwerken:
Expired On-Site Water and/or Wastewater Permit.
An On-Site Water/Wastewater Permit, number Fa3'c Van&:-c.'z, rken, issued by this office
for a single-family system, expired on May 1, 2001. This permit was valid for 365
calendar days.
If this was a well permit and the well has been drilled, a well log must be sent to this
office for documentation of the installation and to close the permit.
If this permit was for a wastewater disposal system, an original as-built inspection report
must be sent to this office for review, approval and documentation. This as-built
inspection report must be signed by the licensed Professional Engineer who inspected the
installation of the system. As-built inspection reports are required to be submitted within
30 days of the completion ofthe system.
If no system was installed under this permit, and you are still planning to install a well or
wastewater disposal system, a new permit must be obtained from this office. When
applying for a new permit, the fees are: $320.00 for a wastewater permit and $120.00 for
a well permit.
If you have any questions, please call this office at 343-7904.
Sincerely,
{Letters sent 6/7/01 without copies being made, second printing for file copies}
James Cross, PE
Manager
On-Site Water and Wastewater Program
eno: Copy ofpermit
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Sen/ices
On-Site Sen/ices Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WATER SUPPLY PERMIT
Initial
Date Issued: May 01, 2000
Expiration Date: May 01. 2001
Permit Number: SW000081 Parcel ID: 051-281-~
Legal Description: FORD LT y (
Design Engineer: 0014 Anderson Engineering Site Address: 016327 FORD DR
Owner Name: Fcyc Vc,~,~,-.~c~:,c.-. ~.~'p,~.,L~.4J~,,A,~.~. Lot Size: 17250 SQ. FT.
;2{3
Owner Address: PO Box 77 .... Total Bedrooms: 3 Permit Bedrooms: 4
Eagle River. AK 99577-
This permit is for the construction of:
[] Disposal Field [] SepticTank [] Holding Tank [] Privy
[] Private Well [] Water Storage
All construction must be in accordance with:
1. The attached approved design.
2. Ail requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered. sealed, and heated to prevent freezing.
Issued By: ~
Date:~
Date: .,~'"-- ~ "~)
ANDERSON ENGINEERING-
" '"" 22.7773,
' P~,O. BOX 240773'
ANCHORAGE; AK 99,524 ~ 522-677t
~pfil 25, 2000
Municipality of Anchorage
Department of Health and Human Services
825 "L" Street
Anchorage, AK 99502-0650
Subject: Lot~, Fo.rd Subdivision
' Well Design and Permit Application
Impacts to Adjacent Properties
Dear Onsite Services Engineer:
The existing Well on Lotj~,, Ford Subdiws~on is producing water with unacceptable levels
of fecal coliform and is dangerous to the health of the residents of the house on the
property. 'We are therefore proposing to abandon the well and place a new .we at the
location shown on the attached Site Plan. The plan shows both the ex~sting and
proposed wells and the existing septic system.. The 100' protective radius for the new
well is also shown.
The majodty of the Protective 'radius for the new well is contained on the lot and will not
affect the existing developed lots' to ·the nodh. .The property to the .' south . is
undeveloped, but contains sufficient land .area for' both a new and reserve septic
· system outside the-protective radius. Adjacent properties 'will not be adversely
· impacted by the placement of th,e new well.
The existing well wi1 'be abandoned in accordance with regulations ~stablished by the
Municipality and ADEC.: We hereby request a permit be issued to construct the new
well at the location shown.
Sincerely, .
Michael E. Anderson, P.E.
Attachments
Lot 3
Lot 1,
Ford Subdivision
/Existing
· -~eP~iC System
Abandon
Existin¢
Well
FOUr
Bedroo~
Home'
· ~ndevgioped
Lot ..'2
Land
Proposed
. W~ll Location
NOTE:
-Abandon.Existing well. in Accordance
With. State and Municipal Regulations.
SITE PLAN
SCALE 1" = 30'
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. 051-281-58
1. GENERAL INFORMATION
~. Complete legal description Ford Lot
LOcation (site address or directions)
Cun'ent Prop'erty owner(s) Sheun &
Mailing address
16311
Lucianne
HAA # E~)
Expiration Date:
Ford Drive= Chugiak; AK 99567
Co.nelin Day phone
'Lending agency
Mailing address
' Rbal Estate Agent
Mailing Address
3.. TYpE OF WATER SUPPLY:
IndMdual Well
Individual Water Storage
Community Class
Public Water System
Day phone
Mike Mcgwairl. -' Dayphone 764-3120
POB 772313 Eagle River= AK 99~;77 '-
Unless otherwise requested, HAA will be held by DSD for pickup.
NUMBER OF BEDROOMS: . 4
Well
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 upon the representations given in paragraph 4 by an independent profesSional
civil engineer registered in the State of Alaska, Certificates of Health Authority Approval are required for 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 homeowners, Certificates of Health
Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well
and may be reissued with new water sample results, (Certificates may be reissued for a period of up to one
year with valid water samples,) Certificates are valid for one year for properties served by Class A or B wells or
a public water system, The Municipality of Anchorage is not responsible for errors or omissions in the
professional engineer's work,
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 Health Authority Approval Guidelines .for this
application, shows that the on-site water supply and/or wastewater disposal system is(are) safe, functional
and adequate for the number of bedrooms and type of structure indicated herein. I further verify that
based on the information obtained from the Municipality of Anchorage files and from my investigation and
inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all
applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm KND ENGINEERING= Inc.
Address 20441 Ptarmigan Blvd.= Eagle
.Engineer's Printed Name Kenneth M. Duffus
River, AK 99577
Phone (907) 696-6111
Date' 5/28/04
Engineer's Comments:
This investigation was completed in compliance with
ADEC and MOA regulations. The assessment of the
condition of the well and septic applies only to the
conditions as of the day tested. The flow and absorption
rates may change due to subsurface conditions that
may not be observed from the Surface, changes in
land use, local soil characteristics, groundwater levels
that may fluctuate during the year and the water usage
of the family being served by the system. The operational
life of all well and septic systems are subject to these
various and dynamic characteristics and are outside the
control of the evaluator of the well and septic system.
Therefore, KND can not give any estimate of how long a
system will function satisfactory for current or future
occupants or can'KND guarantee that no unseen
encroachments, deficiencies or discrepancies exist.
DSD SIGNATURE
Approved for ~7~
Disapproved.
Conditional approval for
'
WA ERAND :
bedrooms.
. .
bedrooms, with the following st~pulab~)j~)~j) j)~:
By:
Attachments:
. HAA Checklist
Septic System Advisory
Well Flow Advisory
X
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Certificate Date: -~" ~-' ~)/7z'
Legal. Description:
A. WELL'DATA
Date ;(~' teSt
Stat-i(~~ , .~
.water level
Well production
WATER SAMPLE RESULTS:
Colif0~m
Municipality of Anchorage
Development Services Department .!
Building Safety Division
On-Site Water & Wastewater Program -.
4700 SOuth Bragaw St. :
~' P.O. Box 196650 Anchorage, AK 99519-6650
.:. : ~: · www.c~.ancnoraae.a~(.us .
· : (907) 343-7904~ '--'-
HEALTH AUTHORITY APPROVAL'CHECKL:IST
FORD LOT 1 Parcel ID:", 05'1-281'-$8
Well..yp 'iPrivate If A, B, or C provide PWSID # W(~!l. L~g (Y/N) y
Date:completed 5/16/004" Sanitary seal (Y/N) Y '
.wires prop~H~, ~rotected (Y/N).Y
Casing height-(above ground) .~ '
Total Cl"el~fl~' . lOl ft. '' Cased to 1101 ft.
FROM WELL' LOG · AT INSPECTION
0 colonies/100 mI.Nitrate 0t0~-~ mg./LOther bacteria 0 col°hies/100 mi.
Arsenic: i NA mg./I. Date of sample: 5/Z7/04' Collected by: :KND ~Engineering
SEPTIC/HOLDING TANK DATA ' ,-
Tank .Type/Material SEPTIC/STEEl.. Date installed 7/3 1/00 Tank ~ize 1 ?50 gal.
Nurnb~i-i 0f Compartments ~, Cleanouts (Y/N) X
Fouh~t'ic~n"!cleanout (Y/N) Y DepreSSion Over tank (Y/N) N: High iwater alarm~ (Y/N) N
Date ofpump~ng:~ ' - Pumper JR'
.,:. ~.1.~ .
ABSORP,TION FIELD DATA
Date;installed ?/31/00 Soil rating (g.p.d./ft~;or ft~/bdrm) 117 System:type TRENCH
Lengt~ :.$0' "ft. Width ..,5 ft. Gravel below i~ipe 4 ft.
Total:d~Pih !6 ft. Eft. absorption area 500 ft~ Monitoring tubeY Depression
overifield
N
Date '6f adequacy test $1~.1104 " 'Results (Pass/Fail) PASS Fo:fl.4 bedrooms
Fluid depth absorption field before test :'/-/,'2.~ in'. Water added '7~/'~ :gal.;i New 'depth /-~--~ in.
Elap'?;'sed ! 'd ......
Ti~e: ~ min. Final fluid ept'h /~o7-<' in. 'Absorption rate ~,= 600 g.p.d.
·
Any ri~juvenation treatment (past 12 mo.) (YiN & type) If ~,es, give date ..
· ' '!'
!
D. LIFT STATION
Date installed
· "Pump on" level at.~
~ Datum
E.
Size in gali0ns
in,.. "Pump off" level at
Cycles tested.' :
SEPARATION DISTANCES ' ,, ,-. ,, '
SEPARATION DISTANCES FROM WELL ON LOT TO:
SePtic tank/lift'station on lot 100;+
Absorption field on lot 100'+
Public sewer main 75'+
Sewer/septic service line 25'+
in.
Manhole/Access (Y/N).
in. High water alarm level at
Meets alarm & circuit requirements?
On adjacen[iots I 0 0'+
On adjac,ent lots 1 0 0' +
Public sewer manhole/cleanout
Holding tank 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+
Water main 10'+
Wells on adjacent lots 100'+~
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
100'+
Property line 5 ' + Absorption field 5 ' +
Water service line 1 0' + Surface water 1 00'+
Property line 10'+
Water Service line 10'+
Curtain drain 50'+
BUilding foundation 1 O' + . Water main
10'+
Surface water 1 0 0 ' + Driveway, parking/vehicle s!orage 1 0 ' +
Wells on adjacent lots 1 0 0'+
F. COMMENTS-
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections and
review of Municipal records that the above systems are in
Conformance with MOA HAA guidelines in effect on this date:
Engineer's Printed Name Kenneth M. Duffus
"Date 5/28/04
HAA Fee $430.00
Date .of payment
Receipt Number
(Rev. 12/01)
Waiver Fee $ ·
.D.a!e of Payment
Receipt Number
86/82/2884 88:83 9876968111
Se~nple Rcm~ks:
KND INVESTMENTS
PAGE 82
Prlnt~ Da~ ~3~ 14:1
~eiv~ ~t~lme 0~7~ 12~0
T~bnl~ Dlre~o~ ~ep~ Zee
To~! Coif'otto
Re=ubs
0.100
............ '- ~ ~,,~ "~'
mA/L ~-.PA
0.~27/04 DKC