HomeMy WebLinkAboutHILLSIDE VIEW LT 4Hillside View
Lot 4
#015-242-37
Municipality of Anchorage[(;;
Au'Page6120283
On -Site Water and Wastewater Section • (907) 343-7904
ON-SITE WASTEWATER INSPECTION REPORT
Permit Number: OSP191372 PID Number: 015-242-37
Dwelling: 9 Single Family (SF) ❑ with ADU ❑ Duplex (D) ❑ Two Single Family Project: ❑ New ® Upgrade
Name
Ted Chenier
ABSORPTION FIELD
X Deep Trench ❑ Wide Trench ❑ Bed ❑ Mound
Site Address
7540 Alatna Avenue *Anchorage, AK
❑ Other
Phone
Number of Bedrooms
Soil Rating
Total depth from original grade
907-561-0768
5
1.2 GPD/SF
*11.79 Ft.
LEGAL DESCRIPTION
Depth to pipe invert from original grade
SEE DWG. Ft.
Gravel depth beneath pipe
6.02 Ft.
Subdivision Block Lot
Hillside View; Lot 4
Fill added above original grade
SEE DWG. Ft.
Gravel length
15 Ft.
Township Range Section
N/A
Gravel width
2.5 Ft.
Beds: Number of Lines
-
Distance between lines
- Ft.
SEPARATION DISTANCES
ToSeptic
Absorption
Lift Station
Holding
Sewer
Total absorption area
Number of trenches
Dist. between trenches
From
Tank
Field
Tank
Line
180+ Ft2
-
- Ft.
Well
1001+
100'+251+
TANK ® Septic ElS.T.E.P. 171Holding [IOther
Manufacturer
GREER TANK
Capacity
1500 Gal.
Surface Water
100, +
1001+
Material
HDPE
Number of compartments
2
Lot Line
5'+
10'+
NA
Foundation
10'+
10'+
LIFT STATION
Manufacturer
Capacity
Gal.
Remarks OLD TANK DECOMMISSIONED PER UPC PER
CONTRACTOR "SEE LETTER IN MOA RECORDS
Alarm location
Electrical installed by
PIPE MATERIAL House to tank D3034 Tank to D3034
drainfield
Installer
A+ HOME SERVICES
Drainfield D3034 CO/MTD3034
Inspector GEG AND TIM ECKLUND
BENCH MARK (Assumed elevation) 100.00 ft
Inspection1�1 7/30/2020 7/31/2020
Location and description
ates: 2�d
TOP OF GARAGE SLAB
3`d 7/31 /20ii 411i 7/31/206
ON-SITE WATER AND WASTEWATER SECTION APPROVAL
Engineer's Stamp
�o6o0O /
Conditional Approval: Date
o....:..... o
...........
�.... �:�....... o
0�0 f A. Gayness:
Septic System
Approved Date a /,?oo
p�O
CE
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, .
�Q lPa � Eo
Note: this approval does not include well permit requirements.
as Eccea���0o00010
(Rev 05/02/18)
PERMIT NUMBER:
OSP191372
A I B
DBL1
16.7
31.0
DBL2
17.3
31.2
MH1
18.8
31.8
ST1
23.2
34.4
DBL3
24.7
35.0
DBL4
25.7
35.6
MT1
55.7
54.9
C01
59.0
58.6
CO2
64.3
61.4
MT2
77.5
69.7
CO3
77.5
69.9
C04
33.9
39.7
RECOR D D RAW I N G PARCEL ID
015 242-37 NUMBER.
I �
0 ALPINE TERRACE;
m BLOCK 3, LOT
m
\ m
I
ALATNA AVENUE
NEW IBEDROOM
DRAINFIELD EXTENSION
OICKS; LOT 1
APPROXIMATE LOCATION
OF EXISITNG DRAINFIELD
DICKS; LOT 2
N
SCALE:
1"=40'
®®'®®®M tk m fj 4
IS IS E N (GINE LTA,t
9 o ..... c ............. .........
ENGINEERING SALES - CONSULTING =� 7
3701E. TUDOR ROAD, SUITE 101 -ANCHORAGE, AK 99507• PHONE(907)0375179• FAX(907)3383246. MSSITE: gmeszengn ng com ,,,,,,,,,,, „,,,•„ ,�
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
0 J1e Garnss c 4mr
TED CHENIER 907-561-0768 2 OF 3
1�C'
E3
LEGAL DESCRIPTION: DRAWN BY: �� Z
HILLSIDE VIEW; LOT 4 D.J.G.40-
TYPE
TYPE OF WORK: DATE: LICENS E®44)9%F gS®���®®®�
�._ SEPTIC TANK AND DRAINFIELD RECORD DRAWING 8/13/2020 #AECC884
.•
100' VJE?'ADIUS
''�
'_ _
HILLSIDE VIEW; LOT4�
!-, _ :. ' • • r. •!' •: a MT 03
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\
... • •., DRIVEWAY � s
02
T 01
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w
. Ti`
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DBL384 In
w
TING NEW 1500 GALLON
EXISHOUSE
:"'„ GREER TANK
BL182
NEW IBEDROOM
DRAINFIELD EXTENSION
OICKS; LOT 1
APPROXIMATE LOCATION
OF EXISITNG DRAINFIELD
DICKS; LOT 2
N
SCALE:
1"=40'
®®'®®®M tk m fj 4
IS IS E N (GINE LTA,t
9 o ..... c ............. .........
ENGINEERING SALES - CONSULTING =� 7
3701E. TUDOR ROAD, SUITE 101 -ANCHORAGE, AK 99507• PHONE(907)0375179• FAX(907)3383246. MSSITE: gmeszengn ng com ,,,,,,,,,,, „,,,•„ ,�
PREPARED FOR: PHONE NUMBER: PAGE NUMBER:
0 J1e Garnss c 4mr
TED CHENIER 907-561-0768 2 OF 3
1�C'
E3
LEGAL DESCRIPTION: DRAWN BY: �� Z
HILLSIDE VIEW; LOT 4 D.J.G.40-
TYPE
TYPE OF WORK: DATE: LICENS E®44)9%F gS®���®®®�
�._ SEPTIC TANK AND DRAINFIELD RECORD DRAWING 8/13/2020 #AECC884
RECORD DRAWING f N G OSP 191'372 PARCEL ID NUMBER:
015-242-37
TOP OF MH = 101.44
FINAL GRADE = 101.0-101.2
MH ST
TOP OF TANK AT INTLET = 94.97 n10'BURIAL
OF TANK AT OUTLET = 94.95
NEW
INVERT OF BUNG AT INLET = 94.39 H. DINVERT OF BUNG AT OUTLET = 94.11
SEPT
FO
Mr co
ORIGINAL GRADE AT FINAL GRADE = 99.8-99.9
HIGHEST POINT = 99.05
FILTER FABRIC
00
00
INVERT OF PIPE = 93.28
°o
00
0
6.02 FEET
0
g BOTTOM OF TRENCH = 87.26
OF
Ap
o E Ar \ ®®#
;�� ��++ �7+ y r �> 40
l� Si 1� L R INS y
�.....::.... 49�� .... = s
- 0 m
3701 E. TUDOR ROAD, SUITE 101 'ANCHORAGE, AK 99507 -PHONE (907) 3376179 -FAX (907) 338-3246' WEBSITE: v ..gamessengineering.mm .... i• ....... .....................
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0o' L'i/;ey /�`. Ga esS :• � a
TED CHENIER 907-561-0768 3 OF 3®�%,`•� �' ;' CE, -7953 _®
AV
PROJECTILEGAL DESCRIPTION: DRAWN BY:
HILLSIDE VIEW; LOT 4 D.J.G.� m
tegQ ppp�,,•�!•:•,P�,
TYPE OF WORK: DATE: LICENSE ��®���®S� per,
SEPTIC SYSTEM PROFILE RECORD DRAWING 8/10/2020 #AECC884
Lot 3
ALATNA AVENUE
0
m
O
co
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C'7
0
0
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S 89055'00" E 164,84
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Lot 2, Addenda Subdivision 1
��.OFAW
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low
�. 49th
�:.,.. l
10 i • Elizabeth L, Walatka .`,8 ow
�s�� • , 4�1 00
8036 - LS . • •I
low
®ph'OFESSIONAI- �.�4'
EASEMENTS OF RECORD, OTHER THAN 8e ®'� %XXN:"-
THOSE SHOWN ON THE RECORDED
PLAT ARE NOT SHOWN HEREON. 6-2 i - ZQ Z6
UNLESS OTHERWISE NOTED FBI 9-3 , pg 21-22
Lot 1, Dick's
Subdivision
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Lot 2, Dick's
Subdivision
M. i,I
SCALE: V= 50'
RECERTIFIED 8-19-20 L G �i�.J
AS -BUILT NO CORNERS SET THIS DATE
I hereby certify that I have performed a Mortgagee's inspection
in accordance with ASPLS Standards of the following
described property: LOT 4,
HILLSIDE VIEW SUBIVISION
Anchorage Recording Precinct, Alaska, and that the
improvements situated thereon are within the property lines
and do not overlap or encroach on the property lying
adjacent thereto, that no improvements on the property lying
adjacent thereto encroach on the premises in question and
that there are no roadways, transmission lines or other
visible easements on said property except as indicated
hereon.
Dated at Anchorage, Alaska
this 7th day of May 2019.
MB 1 907-248-1666
FRED WALATKA & ASSOCIATES, L.L.C.
Engineers and Surveyors
This drawing is a representation of conditions found at the time the mortgage location survey was performed. This document does not constitute a boundary survey
and is subject to any inaccuracles that a subsequent boundary survey may disclose. The information contained on this drawing shall not be used to establish any
fence. structure or other improvements. This drawing shall only be used for a single property transaction. Use of this drawing by the original client or by others at a
later date without the consent of Elizabeth L. Walatka Is a violation of f=ederal Copyright law. Unless gross negligence is discovered, the liability extent of the
preparer Is limited to the amount of fees collected for services In preparation of this product.
MUNICIPALITY OF ANCHORAGE
On -Site Water & Wastewater Program
PO Box 196650 4700 Elmore Road
Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997
http://www.muni.org/onsite
On -Site Wastewater Disposal System Permit
Permit Number: OSP191372
Work Type: Septic Upgrade
Tax Code Number: 01524237000
Site Legal Address: HILLSIDE VIEW LT 4 G:2740
Site Mailing Address: 7540 ALATNA AVE, Anchorage
Owner: CHENIER THEO M JR & PAMELA K
Design Engineer: GARNESS ENGINEERING GROUP LTD
This permit is for the construction of:
Effective Date
Expiration Date
�ll�etlY
a c
c�
y
1?e partmLilt
Lot Size in Sq Ft:
Total Bedrooms:
9/6/2019
9/5/2020
49381
Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage
All construction shall 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 wastewater code requires inspections during the installation. The engineer shall notify the Development
Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
shall be either:
a. Opened and Closed on the same day, or
b. Covered, sealed, and heated to prevent freezing
0/6P C o 73Z See Helfer '�ronm eA 1 n e'er r^CA, Ackl es
Received By: ' _ Date
0
Issued By: Date
4
MUNICIPALITY OF ANCHORAGE
•,ire
Community Development Department _ Phone: 907-343-7904
Development Services —' Fax: 907- 343-7997
On-Site Water & Wastewater Program
Mayor Dan Sullivan
On-Site Sewer/Well Permit Application
For A Single Family Dwelling
Parcel I.D. 015-242-37
Property owner(s) TED CHENIER Day phone 907-561-0768
Mailing address 7540 ALATNA AVE 'ANCHORAGE.AK 99516
Site address 7540 ALATNA AVE ANCHORAGE,AK 99516
Legal description (Sub'd, Block & Lot) HILLSIDE VIEW: LOT4
Legal description (Township, Section & Range)
Lot Size Sq.Ft. Number of Bedrooms 5
APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING:
(®all that apply) Initial ❑ Single Family (SF)
Absorption Field ®
Upgrade (w/wo ADU)
Septic Tank ® Duplex (D) ❑
Renewal
Holding Tank ❑ Multiple Dwellings ❑
Privy ❑ (SF and/or D)
Private Well ❑
Water Storage n
THIS APPLICATION INCLUDES A VARIANCE/WAIVER REQUEST FOR:
N/A Distance: -
I certify that the above information is correct. I further certify that this is in accordance with
applicable Municipal codes.
GARNESS ENGINEERING GROUP. Ltd.
(Signature of property owner or authorized agent)
Permit/Rush Fees: #2-i $ 7 0 Waiver Fees:
Date of Payment: /Zkf r 6)/6/1 q Date of Payment:
Receipt Number: 5-Y5 & 0C17 Z.11G Receipt Number:
Permit No. O5p 11Waiver No.
(Rev.01/11)
r_ c)
GAR.N SS ENGINEERING GROUP9 Ltd
ENGINEERING SALES - CONSULTING
August 5, 2020
Municipality of Anchorage
Development Service Department
On -Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
During the installation at Hillside View; Lot 4 it was noted that the contractor had "over -
excavated" for a total depth below original grade of 11.79 feet. Per the design drawing, the
maximum depth was 10 feet. Per our discussions with you on 7/31/20 the maximum depth on
the design to be 11.79 was allowed based upon the following justifications:
There is a 1979 testhole by "RJP" which shows a total depth of 19 feet with no
groundwater, bedrock, or impermeable soils encountered (no 7 -day GWM)
There is a 1986 testhole by Toben Spurkland, PE in the MOA records which shows a
testhole to a maximum depth of 16 feet with no groundwater noted on 9/29/1986 (7 -
day).
Given that 9/29 is two days from seasonal high of October, we felt as though it was
reasonable to allow a variance of 5 feet separation to groundwater down to 4.21 feet
In addition, a 16' dirt plug was not provided. The drainfield was installed end to end with a 5 -foot
dirt plug but could have been installed end-to-end as an extension of the "older" drainfield.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact us at 337-6179. Thank you for your
3701 East Tudor Road, Suite 101 * Anchorage, Alaska 99507-1259
Phone: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.garnessengineering.com
Ape
GARNESS ENGINEERING GROUP, Ltd
ENGINEERING SALES CONSULTING
September 4, 2019
Municipality of Anchorage
Development Service Department
On-Site Water & Wastewater Program
4700 Elmore Road
Anchorage, AK 99507
Ref: Proposed Septic System Upgrade for Hillside View: Lot 4
To whom it may concern:
The existing 5-bedroom home is served by a private well and septic system. Per MOA records,
the septic system was installed in 1979 and consists of a steel septic tank and deep trench type
drainfield. Per MOA memorandum, a septic tank that is 30+ years old, must be physically
exposed for inspection and/or replaced. Based upon this fact, it was our recommendation the
septic tank be replaced. We are proposing to decommission the existing 1250-gallon steel
septic tank per UPC and install a new 1500-gallon HDPE Greer Tank septic tank rated for 10'
burial. Additionally, we would like the septic system to be approved for 5 bedrooms. Per MOA
records, the COSA application by Toben Spurkland, P.E. in 1986 states that the drainfield is
sufficient for 5 bedrooms. However, per conversations with the MOA, they will not accept this
and are requiring that the drainfield be extended for an additional bedroom. We are proposing to
install a "spillover" trench, that will be connected to the existing trench off the north end.
Comments regarding the design are as follows:
1. SOILS: See attached 1986 testhole by Toben Spurkland, P.E. which shows, soil
classification, percolation test and groundwater monitoring.
2. DRAINFIELD DESIGN: See attached design drawing for drainfield specifications.
3. SURFACE WATERS: There are no surface water concerns.
4. TOPOGRAPHY: There are no topography concerns.
We are unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact us at 337-6179. Thank you for your
assistance.
inc rely,
( -
Jeffr .arn- '.E., M.S.
President
3701 East Tudor Road, Suite 101 *Anchorage,Alaska 99507-1259
Phone: (907)337-6179*Fax: (907)338-3246*Website: www.garnessengineering.com
i 1
(CNk) ,
ALPINE TERRACE; `.
BLOCK 2,LOT 1 -. , I /#
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ALPINE TERRACE; 1 ALPINE TERRACE; "---
—
BLOCK 2,LOT 6 40. 0
XBLOCK 3,LOT 4
ALPINE TERRACE;
M BLOCK 3,LOT 5
....;:,.1 J.„
ALATNA AVENUE f/ °�� i ��
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GARNESS ENGINEERING GROUP, Ltd - �-
ENGINEERING,,SALES.CONSULTING •
•
3701 E.TUDOR ROAD,SUITE 101•ANCHORAGE.AK 99507'PH019E(907)337-6179'FAX(907)338.3246•WEBSITE:www.gamessenptrroehg.eom ••
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: •1�`• • , ey •. @SS
TED CHENIER 907-561-0768 1 OF 2 ••ait.. CE 79f3 •'• �
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PROJECT/LEGAL DESCRIPTION: DRAWN BY: •. �
1
HILLSIDE VIEW; LOT 4 D.J.G. •.,�••••.•e,••• ••'•P �`,�
PRoF
TYPE OF WORK: DATE: •11 ESS x`44
LICENSE SEPTIC SYSTEM DESIGN UPGRADE 9/3/2019 #AECC884 1 �� J
I • NOTE:THE CONTRACTOR \
SHALL HAVE THE NORTH&
J EXTENSION DESIGN CRITERIA: _ EAST LOT LINES,AND ALL WELL
NUMBER OF BEDROOMS:1 RADII FLAGGED BY A c o PROPOSED DRAINFIELD
GALLONS PER DAY(GPD):150 GPD REGISTERED LAND SURVEYOR
PERCOLATION RATE/S:2.5 MIN/INCH PRIOR TO CONSTRUCTION.
PROPOSED APPLICATION RATE:'1.2 I I M
MINIMUM DRAINFIELD SO.FT.:125 FT' RESERVE SITE
-...,....T 1 �uIT
DRAINFIELD EXTENSION DESIGN: /
MAXIMUM DEPTH:10 FEET / Li 16'+
WIDTH:2.5 FEET / / APPROXIMATE TESTHOLE LOCATION PER
11 /15 FEET / 1986 SOIL LOG BY TOBEN SPURKLAND,P.E.
M.O.A.APPROVED SAND FILTER:N/A D
I
EFFECTIVE:6 FEET o i
/
REDUCTION FACTOR:N/A - / I APPROXIMATE LOCATION OF EXISTING
ACTUAL SQ.FT.:180 FT'
DRAINFIELD PER MOA RECORDS; REPLACE
/ SUMP WITH CLEANOUT AND MT;SOLID PIPE
I /... TO BE USED FROM END OF EXISTING
RESERVE SITE DESIGN CRITERIA: DECK / I I DRAINFIELD TO PROPOSED DRAINFIELD
NUMBER OF BEDROOMS:5
V 445
GALLONS PER DAY(GPD):750 GPD
PERCOLATION RATE/S:2.5 MIN/INCH 4, 5+TO ` I DICKS;LOT 1
PROPOSED APPLICATION RATE:'6.0 DECK POST
MINIMUM DRAINFIELD SO.FT.:125 FT'
'CAT III ADVANCED TREATMENT EXISTING 5 I PROPOSE 1500 GALLON HDPE GREER TANK RATED FOR
RESERVE SITE DRAINFIELD DESIGN: BEDROOM HOUSE 10'BURIA ;INSTALL DOUBLE CLEANOUTS BEFORE AND
ii. AFTER TR NCH.CONTRACTOR TO CONFIRM BEGINNING
MAXIMUM DEPTH:10 FEET .,. -c' '�Ii
WIDTH:2.5 FEET ./j�j���'II OF DRAT FIELD AND INSTALL CO AND MT TO CONFIRM
LENGTH:10 FEET 411°\Vj.%j4j- SEP RATION DISTANCE TO PROPOSED TANK
M.O.A.APPROVED SAND FILTER:N/A
EFFECTIVE:8 FEET DECK vole
REDUCTION FACTOR:N/A •,jj�
ACTUAL SQ.FT.:160 FT'
GEG,Ltd.HAS AN 8 PAGE SPECIFICATION LETTER DICKS;LOT 2
THAT PERTAINS TO THIS DESIGN.BY PROCEEDING
I-
THAT
WITH THIS INSTALLATION,THE W
ENGINEER,WELL DRILLER,CONTRACTOR AND 15'RECORDED EASEMENT PER W
PROPERTY OWNER AGREE THAT THEY HAVE MOA ONSITE DEPARTMENT Q
READ THESE SPECIFICATIONS AND AGREE TO W
ACCEPT THE TERMS AND CONDITIONS OUTLINED. >-
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GARNESS ENGINEERING GROUP, Lt - *: ,\ %.* t
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ENGINEERING,SALES'CONSULTING , - - 0 0
3701 E.TUDOR ROAD,SUITE 101'ANCHORAGE,AK 99507•PHONE(907)337-6179•FAX(907)33&3246•WEBSITE:www garnessengineeringcorn •• 'I •• ,
PREPARED FOR: PHONE NUMBER: PAGE NUMBER: 0 J- 17-'M @SS .W is
TED CHENIER 907-561-0768 2 OF 2 �j��'• 7'53 ,.. •
PROJECT/LEGAL DESCRIPTION: DRAWN BY: • l,-• •••c�•5 f�••',,• 4,
HILLSIDE VIEW; LOT 4 D.J.G. •• 0 •' •`,.sP�, •
TYPE OF WORK: DATE: LICENSE4tIII i "`,�44•
DESIGN OF SEPTIC TANK UPGRADE 9/5/2019 #AECC884 i
8482N
ALATNA AVENUE
O O
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S 89°55'00"E 164.84
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10'Utility Easement
———— S 89°59.50"W 165.00 I
Lot 2,Addenda Subdivision I
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1t
�I ASBU�T NO CORIJERS SET THIS DATE
JJ ��%"`\1 I hereby certify that t have performed a rtor�gapoe•=hsoectio�
F, OF A( 1 1 a the blowing described proprty.I of 4.
•s.• t Flitida View Subdivision
%? '•ir'I
C'). 49t+ 9 'I A„d,c age Recording District ansa,and mat the
Itproventrtb busted thereon re Main the property Ines
• .:i'4.'1�G='�
and as not overlap«enc encroach on a»propr+y Moo
IE.s'.. L Wdatka.Q.. se aadjacent thereto.ba�echmme�po cm premises the ION
end
¶j u . that then re no eo t,tntwnteelon berm
� o vharem
ise*eaaentrns on said property except as Waded
EASEMENTS OF RECORD,OTHER THAN I� `%w. b ace' Ills 7S1 -dRY a acne.
THOSE SHOWN ON THE RECORDED
PLAT ARE NOT SHOWN HEREON S-9-I.1q 1 FRED WALATWA d ASSOCIATES,LLC.
UNLESS OTHERWISE NOTED. FB193.pg 21-22 MB 967-246.7688 Engineers and Surveyors
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
NAM E /~)j~ j~.(~.~ ,,"~ C~ PHONE
MAI LIN ~-ADD~rESS -
LEGAL DESCRIPTION
E~]UPGRADE
DISTANCE TO:
Manufacturer
Liq,
DISTANCE TO:
iF HOMEMADE:
Well
Manufacturer
DISTANCE TO: Well
No. oflines / Length of 2c_~line
Top of tile to finish grade (..~ f_~.~ /
Length
Type of crib
DISTANCE TO:
Class
DISTANCE TO:
Width
Crib diameter
Well
Depth
Building foundation
NO, OF BEDRO-OM$~,~
IAbsorption area Dwelling PERMIT NO.
No, of compartments
I nside length W dth Liquid depth
Dwelling PERMIT NO.
Material Liquid capacity in gallons
Foundation Nearest lot li~o ¢ PERM,,~ ~O~) / ~ ¢
Total lengt~ines Trench width Distance betwee~z~f
Material ben~ tile ~ ~ incheSinches Total effe~ien
Depth [ PERMIT N~
Crib depth
Building foundation
Driller
Sewer line
Total effective absorption area
Nearest lot line
Distance to lot line
PERMIT NO.
Absorpt on area(s)
Septic tank
OTHER
P I P E M AT E R I A LS~//i~.,~/~/'/(_.'
SOIL TEST RATING
/j -o
INSTALLER
REMARKS
I _7'o
APPROV E,p ~ /' /') DATE LEGAL
MUNICIPALITY OF ANCHORAGE
MEMORANDUM
Date June 8, 19719
To:
From:
Re:
Les
See attached for the following reasons.
The tank is good for a four(4) bedroom single
family dwelling, the trench is not.
The engineer has performed an adequacy test
and says that the trench will perform for a
four(4) bedroom single family dwelling.
The want the inspection to read that it is
approved for a four(4) bedroom single family
dwelling for their loan(which will be coming
~~Signed
. : =": .... ' ' - ' I S ..... ' .......
'1""¢I':'E O1'::' :!::; ] ]: I... ~ [ ......... RI., 1 .[ .. t I '":'i;"r'EE?HEM ' [ F. EN ..H
, ,. .... ; ... .-
l l*'?,Irl ft t,I.IH[,[:.L r]F: E~EDROOMS
THE F;'::E6!UZRE[:, SIZE '"iF THE SOIL.
lC:' EEE F"'"'F' ~-fl ......::~... ~Y~; L...E:~",~ C]~'T' ~-ff== :Z~::E~= .::fi fi'"'=, fi'-'~ "," I:::~ ........ E::" E~Efl::::::"'"~"" }'""B ............ : .....
THE L. Et,I.3 [ H [::' Z MENS Z O1`'4 I S THE I....ENGq"Fi, (I N FEET) OF THE q"RIE1`',ICFI OR DRI.::I ! 1`'4F I El...[:'.
'I"I'"IE E:'EPTH OF Ft TRENCH L D F:'IT I:5 THE E:'ZSTFINCE E:ETI.,.IEE1`',I ]'q'"IE ~;UI:~:FI.::ICE O1:::' THE
':iF'F. NJ' RND THE E:OTTOH OF THE E"':FIVF:T~:N '::IN FEET::'.
THERE ZS NO SET t.,.tI[::'TH FOR TRENCHES.
THE GRI.::IVEL. I.)EPTH 1:5 THE M Z 1`'41 MLIM [:'EPTH OF GRFt',/EL. BEq"I.,IEEN THE OUTFFfl....t.... F:' I F:'E
FIN[:' THE E:OTq"oM OF' THE E::':;]I::fVFtTI ]1`',l ':: ZN FEET"
I, E.F.t t I RPPL I C:I,:INT I."IFIE; TI,,,II,E I, .E: ,F u1`,L':, ] E, I L q -r q"o I I',IF'ORM "t]..'11 S [:,I,i:.I::'F~RTME:I",tT I.)1...11:;: :i. NG q"HE
]' M'::;TF:II [..l::fT' I ON :1; I'.,I':'~;PECT I Ot'.,1:i:5 OF l,::IN"r' FIIEL. I...:i~; I:::IC, J'I::tCE1`',!q" TI,ii q"H I la; I: I _ F [ I l P':t1`',l[:, T'l."lli.:::
N JI"It']~:EI;? ]i':' RE'.:.:.;I' E:,ENCE:E; 'THt:::Iq" T!'ql'~: I.,.IEI....L FI I L L SER',/E.
:'r.:::l[::]'l FI'[TH("...T Ft1`',IFIL. INSPECT):()1`'4 1'":11",I[:, HFI: 1,.4 ,HL 'T'HI:::]
[?,I,:IC:KF' I I,...L ,~ 1`',1(~ OF' l.:lf',l~'r' '-' "- ..... - .......... , "' E,'"r' . .
E:'EI'::'F:ff;:':q'ME1`,IT FI :[ I._L. E:E fSI...IELJ'ECT TO PF' ]2: E]'":I Iq" 'i. E 1`',1
M I1`',IIP'IUH D'tZSTRNCE BETFIEEN R WELL I':IND l:::llq"r' OI",I'"'SITI'.:: SEI.di'::I(%':: [:'I'E;POSI':IL. Sh"STEM !:!.~;
:t00 FEET FOR IR F'RIVFITI,E f.,.IELI'....; OR ·
:1.50 TO ;?.00 FEET FROM FI F'I.JBI,,..IC FtE:LL.. DEPEND Z1`',tG IJt::'I,)N THE TYPE OF PI,.II']i',L.I(] l.,.tl,i::l....l, ....
F!EI..,.L I,..,OC4S FIRE REQI,..IIRE:D FIN[':' Mt..I~..BE F.'.ETIJI,~:NE[':' q"o TI'"tE DEt::'FIRT'MEI",IT I.,.l!q"HI1`'4
O1'::' '['I'"IE WI'ELI'.: COt'"IPLI,ETI O1`',1.
O'T'HER REL::!U I REMENT'S i'"11::1'¥' FIPI,:'L"r'. SI::'E:C I I::' I CRT I
FIVF:I ]: LFIBI,...E TO INSURE PROI,::'ER I I'.,ISTF:IL:L.F:IT 1 O1'.4.
I CER,T t F"? TI'qRT'
:k: I RM FRI"IlL, i;I::II:;:': t.4ITH THE REQI.JIRE:MENT'S F:'OR O1`-,I-':'i.:;ITE SEWER':; FIN[:, I,I.EI...I,..S Fl:iii;
F:OI,:?.TI,4 !E¢'¢ THE MUN I C I I,:'1:::11,... I 'I"'T~ OF RNCFIORI:::IGE.
;.2: I t.;:fI I,...i,.. 11'.,tSTFtL. I,... "FHI,F. ::,"r':STI'EM 11',I I:::ICCOR[:'I.::tNCE: 1.41 TH TI'"IE CO[:'E:E;.
:i!:: l' UNDER:STRND THf:FI,' T'I'"IE ON-:!;:;ITE SEt.qER ':5"r':?T, TEH MFI"r' REI]:!UIRE:' ENL. FIR(]iEi:ME1`',IT Il::' THE
I",[:ESIDENCE I:E; F..'EMODELE[:' TO I I",tC:LUI}E MOI:~tE: THRN 4
'r.E 5; JE[:, E, r.
CONSTRUCTION TEST LAB
"One Test is worth a Thousand Opinions"
2204 Cleveland Anchorage, Alaska 99503 277-0231
Performed for ~f~%-~'//
Legal Description: Lot ~ -Block
This Fomn reports: SOILS TEST ~'2~
Date Performed
SU bd iv i s i 0 nd//~& IZr/U
PERCOLATION TEST
Depth
Feet
Soil Characteristics
Was Ground Water Encountered
If YES, What depth?
Date Gross Ti:ne t Net TLme 1 Depth to H20 Net Drainage
Reading
Percolation Rate
Proposed Installation:
Depth of Inlet
CO:~IENT S: /~-' .~¥j~;' ~W~ y/~]'/~
Test Performed by
Minute
SEEPAGE PIT DP~AIN FIELD
Depth to Bottom of Pit or Trench
Dat
Date
t
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
1'8
19
20
COMMENTS
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
Township, Range. Section:
SLOPE
WAS GROUND WATER
ENCOUNTERED?
II
S
L
IF YES, AT WHAT ~
DEPTH? pO
E
Depth to Water Altej/~ ...
Monitoring? ~ Date:
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN
(minutes/inch) PERC HOLE DIAMETER
PERFORMED BY: --.L.,', t"~,.,.~.N ~. I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
Use of We]lDonl, _ .
l~ocation (address of: Iowas}up, l{an,ge, Section, if known; or dislance main road
Lot 4 Block t tti.1]s:[d)! View Subd., Anchora~e .....
S ',' of cas/nil 6" Depth of Hole 200' ie-t "~
...... (.a.~ed ~o 43; 9 feet
Siatic water level O t't. (above) (below) land surface. Finish of well kc wok one) open end ( )
creen ( ); Perforated ( )
Describe screen or t ,flotation
WclI pumping test at C gallons i;~r (hour) (mkmte) for heur:4 v ith fl.
of drawdown from :~ ~tic level.
6/2/79
Da~e of compJetion
2 TO 28 _
28 .TO . 33
_33 TO. }_8. _
38 TO 200
fPO ..........
I)eplh in feet from
~,~round surface Give details of formad(ms penetrated, size of malerial, color aod hardness
0 TO ~ _ Casing stickup ........
Si.~ ¢~gr~vel
~aker gravei 15-~ gpm ....
L_TO
TO
_TO___
.TO.
(a _.
WeN Owner
Lok: d~ Block
.~ N/A
Date of completi(m
0 T ( )
2 TO ] 6
3 5 ~ro
TO
TO
TO
~ TO
TO
TO
TO
Sandy gravel
Si]_l:y hard pan
Sand}/ grave]
G~ay bedrock: no ~,'~t e'x'
end ( X );
2 1 TO 32
,
T()
,]'( )
TO
TO
'R)
_ 'J'O
1 ' C[/3TO,MER
Parcel I.D. O15-242-37
1, GENERAL INFORMATION
Complete legal description HILLSIDE VE'W S~D LOT 74'
Location (site address or directions) - 7540 ALANTA AVENUE
Munici pality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewate~' Program
4700 South Bragaw St,
. _ P~O, Box'196650Anchomge AK9951,9-6650
· www.ci.enchorage.ak.es
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAHILY DWEI_'LING
'Expiration Date',' / O
TIM SCHWANKE
7540 ALANTA AVENU~
PEGGY FRENCH
Day phone 344-2644
Current Property owner(s)
Mailing address
Lending a~enc~ -' "'
Mailing address
Real Estate Agent
Day phone 276-~761
Mailing address
Un/ess otherwise requested, HAA will be held by DSD for p/ckup,
2, NUMBEROF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
TYPE OF WASTEWATER DISPOSAl..:
Individual On-site
Individual Holding tank
Communlty 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 5 by an Independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer
cf 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 g0 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 less than 30 days old. (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 Municlpality of Anchorage Is not responsible for errors er omissions In the
professional engineer's work.
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $1000.00 at, or prior
, to closing for the engineering sarvfces provided. ,
4. STATEMENT OF INSPECTION BY ENGINEER
As cerb'fTed by my seal affixed I~ereto and as of the validation date shown below, I veri~Y that my
Invesb'gafion, based on procedures outlined In the Health AuthoriO/ Approval Guidelines for this application, '
show~ that the on-site water supply and/or wastewater disposal system is(are) safe, fun~'onal and adequate
for the number of bedrooms and ~ of st/z~cture indicated herein. I further veri~y that based on the
information obtained from the Municipality of Anchorage files and from rny Investigation and Insp~cti°n, 'the
on-site water supp~/ and/or wastewater disposal system Is(are) in compliance with all applicable Municipal
and State codes, ordinances, and regulations In effect at the Eme of installation.
Name of Firm ALASKA WATER &: WASTEWATER CONSULTANTS, INC.
Address 6901'D~BARR ROAD. SUITE 2B * ANCHORAGE. AK 99504
Engineer's Prfntad Name
JEFFREY A. GARNESS, P.E.
Phone 337-6179,
Data
Engineers Comments:.
In conducting thls eva/ua#on, AWWC, Inc. attempted to provlde a thorough, , :
ccnsdentious engineering ennuis of the system In accordance with ADEC and MOA
DSD Guldetines & R~julattons. The reported results described the performance of ~e
system under the cond~ons encountered at the time of the tcat, and separation
distances measured to readi¥ identifiable features. The operational life of at/we/Is and
septic systems depend on the Iocal so~Ts condition, groundwater levels that may ·
l~uct~ats during the year, and the water u~age of the farni~, being sen/ed by the system.
These conditions are ou~lde the control of tho evatuater of the system. ,Satisfactory test
results do not guarantee future performance of the system, n~r do they guarantee that
there are no hidden dofecte or encrcachmonte. AM/WC, Inc. can therefore not pn~fde
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The contsnt of this report is for
the sole benefit of the owner llsted above. Any reliance upon or use of this repor~ by any
other person or pany ls not authorized, nor wfll lt confer any legal fight whatsoever.
5. DSD SIGNATURE
Approved for '~ bedrooms.
Disapproved.
Conditional approval ~r __ bedrooms, with ~e fllowlng stipulations:
Note: The well on this property meets State and Municipal code.There are nitrates
present. It is'suggested that periodic testin~ be performed to insure the wells
continued suitability. Current nitrate concentration is 7.24 m~/1. EPA max~u~
concentration is 10.0ms/1. More INFO is available from On-Site Pro,ram, at 3~-7904
Attachments:
HAA Checldist
Septic System Advisory
Well Flow Advlsoi'y
Manitenance Agreements
Supplemental Engineer's Reort
Other
Original Certificate Date:
7- I I-o/
Municipality of Anchorage
Development Services Department
eu~n; safety o~am.
Or. Site Water & Wastawmr Program
4700 ~ emgaw 8L
P~. Box 196650 A~, AK 99519-6650
WELL DATA
Well t~pe P~VA*~
Date completed
Total depth 200
HEALTH AUTHORITY APPROVAL CHECKLIST
HILLSIDE VIEW S/D LOT 4 Pamel ID:
ifA, B, or C provide PWSID# N/A
6/27/79 Sallltery ~ual (Y/N) YES
ft. Caseqto 43+' It.
FROM WELL LOG
6/2?/?9
0 lt.
18 - 2o gop.m.
015-242-37
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Col~oml 0 colonies/100 mi.
Date of ~ample: 6/28/Ol
B. SEPTIC/NOt. DING TANK DATA
Well Log (Y/N).
W~s proper~ pmtec~ (Y/N)
coslng be~ght (~ ground)
AT INSPECTION
24' It.
6.2 g.p.m.
Nitrate 7.24. reg./J_ Ol]lerbacted8 0
Collected by:. AWWC, INC.
2
Tank Type/Material STEEL
Tankalze 1250 gal. NumberofCompeltments
Foundstinncteanout(Y/N) YES Copresslonovertank(Y/N) NO
Date of pumping 6/27/2001 Pumper OlD laC00NALD'~
C. ABSORPTION FIELD DATA
D~te In~
Lenglh 33
6oll rating ~ ~Fodzm) 15o
Wldth 3 I[
Y
coloales/lO0 nd.
Toteldapth 12.3 It. Eff. ebsoq~lonama ,528 Ita Monltoringtube YES
Date of adequacy test 6/28/01 Results (Pass/Fall) PASS
Fluid depth In absorption field before test DRY In. Water added 935 gal.
Elep~ed Time: 10 min. Final fiuld depth DRY In.
Any rquveuaUon treatment (past 12 mo.) (Y/N & type)
System t~m TRENCH
Gravel below pipe 8 lt.
Depmsalon over field NO
For 4 bedrooms
Newdapth 29 in.
Absorption rate >=. 600+ .g.pzL
NONE KNOWN If y~, give date --
12' in.
Date In~teUed 5/17/79
Cleanoute (Y/N) 'YES
High water alerm (Y/N) N/A
D. UFT STATION
O,::te In.~lli~l $1;~ in ~llon; ~
Pump on' kw~l at In. "Pump n. High water ~=m level at in.
~ Cy~se tested Meets el~rm & dmult requirements?
SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Se~c tenk/11ff ~tatlon on lot 100'+
Absorption field on lot. 100'+
Public sewer main N/A
8ewer Isept~o service line 25'+
On adjacent lots 100'+
On adj,:'cent lots 100'+
Public sewer mm~hole/deanout
Holding tank N/A
Bulidlng foundallon 5'+ Property line 5%
Water main N/A Water service line 10'+
Wells on adjacent Iote 1 oo'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Bulidlng foonda~on I 0'+
Surface water 10o'+
Wells on adjacent lots, 100'+
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Absorption field.
Surface water, lOO'+
Property line 10'+
Water service line 10'+
Curteln drain NONE KNOWN
F. COMMENI~
Water main N/A
Driveway, parldng/VeNcle storage 3'+
Waiver Fee $
Date of Payment
Receipt Number
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH &HUMAN SERVICES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Complete legal description
Location (site address or directions) 75~0 AcL,w~.
Property owner
Mailing address
Lending agency
Mailing address
Agent
Ad dress
Day phone
Day phone
Day phone
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
Unless otherwise requested, HAA will be held for pickup.
//
NOTE:
,/
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
NOTE:
Individual on~site
Holding tank
'Community on-site
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-025 (Rev 1/91) Front MOA #21
STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation of this Health Authority Approval application shows that the on-site water supply
and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I further verify that based on the information obtained from
the Municipality of Anchorage files and from my investigation and inspection, the on-site water
supply and/or wastewater disposal system is in compliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
NameofFirm I~.~'1 ~¢~-[-~-~ 7.~Y~, Phone ~'~/~
Address ~ ~ ~ ~ /~ ~ ~ ~
Encnoer's signature ~ate
DHHS SIGNATURE
Disapproved.
Conditional approval for
bedrooms
with the following stipulations:
By:
Additional Comments Note: The well £or th±s property meets e×istinc, f
State and Municipal Codes. There are nitrates present. It is
suggem~_ed ~_h~La p~riodlc ~es~ng be performed to ~nsDre the wells
continued suitability. Nitrate concentration is 6.39 mg/1. EPA
maxi~mmm co~c-entratien is 10.0. mg/1.
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.
72K)25 (Rev. 1/91) Back MOA#21
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
A. Well Data [~_..g
Well type '~
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Parcel I.D. O/~T_ jA ~Z2_ _
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed ~//~7/7'~ Driller I~-- I,/..'/
Cased to /"/~. ~ Casing height
Wires properly protected (Y/N)
AT INSPECTION
~. (~ ~NVIRONMENTAL SERV iCES DIVISION
RECEIVED
FROM WELL LOG
Date of test ~'/,~7/~
Static water level
Well flow /
Pump level1
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer service line
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS:
Coliform
Date of sample:
Nitrate
~. ~ ~ Other bacteria
Collected by: '~.~
B. SEPTIC/HOLDING TANK DATA
Date installed
Cleanouts (Y/N) ~'/
High water alarm (Y/N)
Date of pumping
Tank size I ~-. ~'cg Compartments
Foundation cleanout (Y/N) t"l Depression (Y/N)
/~- Alarm tested (Y/N) ~'~/'/-~
Pumper J~5I
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot
To property line
Surface water/drainage
On adjacent lots
Absorption field
Foundation
Water main/service line
72-026 (3/93)* Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
Meets MOA electrical codes (Y/N)
"Pump on" level at
Manufacturer
Manhole/Access (Y/N)
"Pump off" L~vel at
.Cycles tested
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot
On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed ~ ?/~'~
Length E, ..~ Width
Total absorption area ,~ ~,
Date of adequacy test Ill I -] ~q
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y/N)
Soil rating (GPD/Ft2) /
Gravel thickness
Cleanout present (Y/N) ~/~
Results (pass/fail)
System type 7/c4-~ c~/
(~ Total depth / .-..~
Depression over field (Y/N)
for /?/
After test / y
If yes, give date
Bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot [ ~
To building foundation
On adjacent lots ~
Sudace water ~
Curtain drain fi'//C~
On adjacent lots '~ //..,<~ Property line ,.~
To existing or abandoned system on lot
Cutbank ~k] ~ ~ ~. Water main/service line ,,~ /
Driveway, parking/vehicle storage area
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Engineer's Name
Date I' [ ?-...-ff l ~...~
HAA Fee $ ',-~
Date of Payment
Receipt Number
Waiver Fee $
Date of Payment
Receipt Number
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 ~¢)¢-~
GENERAL INFORMATION
(a)
(b)
(c)
Legal. Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
Applicant Name (~'~, /~/[,.../~I~//_1 Telephone: Home vq~,~'~'~7~'''' Business
Applicant Address 7 ~,~2.'ZCL"~¢)I/"'~/_..,
Applicant is (check one): Lending Institution []; OwnerJt~:~r~]~; Buyer []; Other [] (explain);
(d) Lending Institution ~O vi ~ Telephone
Address
(e) Real Estate Company and Agent
Address
Telephone
(f) Mail the HAA to the following address:
2. TYPE OF RESIDENCE
Single-Family~ MuI~ily~ ~ ~her
Number of Bedrooms ~
3. WATER SUPPLY
IndiVidual Well ~ Community
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.
72-025 (11/84)
Page I of 2
EN'GINEERING 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 th~'s Healtl~
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, ana, regulations in effect on
the date of this inspection. _
Name of 'Firm ~"~-. ~ _~_~_ _.~~ Telephone
Address
Date
f
Engineer's Seal
DHEP APPROVAL
Approved for .~_~ (.~_~ bedrooms by
Approved ~ --
Disapproved
Terms of Conditional Approval
Conditional
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.
MU.,C,PA',TY OF A.C.O.AG£ (MOA)
~;;ILITY OF ANr~^.HEALT" AUTHORITY APPROVAL ("AA)
"~rAL PROTE~i~ 264-4720
0~T O~ ~a, Description: ~"~
w , RECEIVED
Well Classification /~ If A, B, C, D.E.C. Approved (Y/N)
Well Log Present (Y/N) ~f Date Completed ~/??/,/O~ Yield
F/~,f ~w
Total Depth ~[i~/ Cased to ~ Depth of Grouting
Static Water Leve~ - Pump Set At /
; On Adjoining Lots
To Nearest Edge of Absorption Field on Lot / I ; On Adjoining Lots
To Nearest Pubtic Sewer Line ~ To Nearest Public Sewer
Cleanout/Manhole /~ ~//~ To Nearest Sewer Service Line on Lot
Water Sample Collected by. ~ /~I~,Y~;~ ;Date
Water Sample Test Resu ts
Comments ~ ~ ~/~ ~ ~ ,
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
Sanitary Seal on Casing (Y/N) ~
Depression Around Wellhead (Y/N) /~
> 10¢_J
t
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes(Y/N) y
Depression over Tank (Y/N) /'~
Pumping/Maintenance Contract on File (Y/N) ///4
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well //,~_~0.
To Property Line
To Water Main/Service Line ~.,/
Course
Comments
Size ,1~,_~ NO. of Compartments
Air-tight Caps (Y/N) y Foundation Cleanout (Y/N)
Date Last Pumped
Temporary Holding Tank Permit (Y/N) .~/~
/
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed u~"/7~
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test
Separation Distance from Absorption Field:
II ;'
To Water-Supply Well
To Building Foundation
Lot .A/,14
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
Type of System Design
Length of Field
Depth of Field t:~'/
Gravel Bed Thickness ~/
Standpipes Present (Y/N)
Date of Last Adequacy Test?/,'~'~/~-~/
To Property Line c.'22~/
To Existing or Abandoned System on
; On Adjoining Lots .,~''~l~/
To Cutbank (if present)
TO Driveway, Parking Area, or Vehicle Storage Area
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
Page 2 of 2
72-026 (11/84)
** Check Permitted Bedroom Rating Against HAA Request **
I certify that l have checked, _vedfied..or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed ~"~' "' -" /' ~-~--~/5~'~'~'''v~-'''~ Date ~J;~/~O/,,-~' ~
Company MOA No.
Receipt No. d'f~O I O0 ~---'~-""
Date
of
Payment
Amount: $ ~ ~ ~*: 4*TH :: ''~ %~ Engineer's Seal
CONSULTING ENGINEER
203 W. 15th AVE "C" SUITE 203
ANCHORAGE, ALASKA 99501
TELEPHONE: (907) 279-39t6
RESIDENTIAL WELL INSPECTION
LEGAL:
LOCATION:
LOT 4, HILLSIDE VIEW
7540 ALATNA
OWNER:
TYPE OF WELL:
WELL LOG AVAILABLE:
INSTALLATION REQUIREMENTS
EUGENE MCGILL
SINGLE FAMILY
YES
MET: NO. PERFORATED AT 33 FEET.
VARIANCE OBTAINED ON JULY 23, 1979
15-20 GALLONS PER MINUTE
7.5 GALLONS PER MINUTE
SEPTEMBER 8, 1986
WELL YIELD FROM WELL LOG:
PUMP YIELD:
DATE OF INSPECTION:
TEST PROCEDURE:
GALLONS PER MINUTE
ACOUSTIC PROBE. THE
WELL WAS PUMPED AT A CONSTANT RATE OF 7.5
WHILE THE DRAWDOWN WAS MONITORED WITH AN
WELL WAS STABILIZED AFTER 10 MINUTES OF
PUMPING. STATIC WATER LEVEL WAS FOUND AT 33 FEET. WATER LEVEL
DROPPED TO 38 FEET AND REMAINED THERE FOR 60 MINUTES OF PUMPING.
TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON
SEPTEMBER 9, 1986. TEST WAS NEGATIVE.
TEST RESULT:
THIS WELL MEETS THE REQUIREMENTS OF THE
MUNICIPALITY OF ANCHORAGE.
The Municipal requirement for well flow is 150 gallons of water
per bedroom per 24 hours.This well surpasses this requirement.
The assessment of the condition of this well applies only to the
conditions as of this date. The flow rate of the well may change
due to subsurface conditions that may not be observed from the
surface, and changes in land use and other factors that may
impact the conditions of the aquifer feeding the well.
CONSULTING ENGINEER
203 W. 15th AVE "C" SUITE 203
ANCHORAGE, ALASKA 99501
TELEPHONE: (907) 279-3916
SEPTIC SYSTEM ADEQUACY TEST
LEGAL:
LOCATION:
OWNER:
RESIDENCE:
WELL:
SEPTIC SYSTEM:
LOT 4, HILLSIDE VIEW
7540 ALATNA
EUGENE MCGILL ~...~..~.~'. ...... ~ .~'2'~.
PRIVATE, ON SITE
FRO~ ~UNICIP~h RECORDS
T~NK: GREER STEEB ~O COMP. 1250 ~AB.
ABSORPTION SYSTE~: TRENCH
ABSORPTION ~REA: 528 SQ. ~T.
SOIB R~TING: 150
INSTALLATION DATE: ~Y 1979
DATE OF PUMPING: SEPTEMBER 4, 1986. ISAACS PUMPING
DATE OF TEST:
SEPTEMBER 8, 1986
TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND
WITH FOUR FEET OF COVER AND WITH 41 INCHES OF
WATER. SUMP WAS 12 FEET DEEP AND WITH 17 INCHES OF LIQUID. GROUND
BETWEEN TANK AND SUMP WAS LEVEL.
WATER WAS ADDED TO THE TRENCH AT A RATE OF 7.5 GALLONS PER MINUTE
WHILE THE WATER LEVELS OF TANK AND SUMP WERE MONITORED. A TOTAL
OF 525 GALLONS WERE ADDED. THIS CAUSED THE LIQUID LEVEL IN THE
SUMP TO RISE 10.25 INCHES, WHILE THE LEVEL IN THE TANK REMAINED
CONSTANT. THE INFILTRATION RATE WAS MONITORED FOR 30 MINUTES.
THE LIQUID LEVEL IN THE SUMP DROPPED 4.25 INCHES.
TOTAL GRAVEL DEPTH IN TRENCH IS 8 FEET. THE OPERATING LIQUID
DEPTH WAS FOUND TO BE 30 INCHES.
TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF
THE MUNICIPALITY OF ANCHORAGE. AT PRESENT RATE OF USAGE THIS
SYSTEM WILL BE OPERATING SATISFACTORY FOR 20 MORE YEARS.
The operational life of all septic systems depends on the local
soil conditions, groundwater 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 septic system. We can therefore not give any estimate of
how long the system will continue to meet the operational requi-
rements of the Municipality and State.
~viL:~',hC~P~ L.~ ~V OF /-~I'dC~L)}~AGE DEPT. OF HZALTH &
~,~ DEPARTL':FNT OF..,-,~ ..... ~ ~b ~qVU~,3Hk,~EN(AL PROTECTION. ~ ENVIRONMENTAL P~;QFECTION
" ' ,,' 'c~ '~ ' ~: , ,~ ,:~':': uq DIVISION
PEOUEST FOR APPROVAL OF ~NDIVIDUAL WATER AND SEWFR FACILFFIES
Di(~ECYtONS: (Mmplete a~l parts on paS{ 1. Incomplete i'e~ues~s will not be plocessf, d. Please show ten (10) days for processing.
~. r, no~mvo?:¢.;c¢~ ~e~ 280-6252
C. ~m - Work 264~7567 ~ ~ 344-9858
................. ~__:~ .. ~... _~ ~%e~( ........................................... ~ ...........................
MA~LINGADDR~SS
.............. ~ Z39~ Anchorage, Alaska 99507
~am~ Mutual Savings Bank AT~: Debbie Johnson
/
MAiLJNG &DD'~ESS
................... .............................................
I,~A; LI H:3 ADDRhSS
~/A
L4, Hillside View Subdivision ('(~ .... n ~.. t~ Lq ~
~..Lt~.__.~.~ ....... ~ ..........
i STPEET LOCATIGN
N~ Atlatna Avenue, ~chorage, ~ 99507
3. T~/~ OF: RAS,OENCE~'T NUMBER OF BEDROOMo
[~.] One E] Four [~ Other
Ii'[1 Two [~ Five
~ []] MULTIPLE FAMILY ~ Three ILl Six
~ INDiViL)i. JAL~* * ATTACH WEI~L. LOG. A well log is required ~o~ all wells drilled
[~ COMMUNI'FY since June I975. Fora' Wells drilled prior to that date, gi'/e weli
E~) ~ .... l_ ~,U) ~,. F daoth(attachlmtlfa'aU~l e)
8, ~FiV, tAGE DIE. P(3SAL
~ INDiVIDLIAL/ON-S!TE ~ nc, v~(~ua/,:*'n.sit~., g~vu installation ..............
If sVstem is over m,,o (2) years old an adequacy ~es[ i~ required
[21 FUBLIC UT!i_iTY i:W this Department.
NOl-i?: Tll)~ AIR'~¢n''- ~'' FEE MUS"7 ACCOP¢i?ANY EACt4 REQUEST BEFORE PF1OCESSING CARl BE IrdiTlA'~
72-0i0(3/78)
12/13/7g ~ .
1. TYPE OF RESIDENCE
'"~ SINGi.[/ r:AMI [.Y
Iii MULTIPLE FAMII.Y
2. WATEFI SUPPLY
'~ INDIVIDUAL
ITZ: COMMUNITY
I¥.1 PUBLIC UTILITY
NUMgEF~ OF BEDROOIViS
ONE "'R~_) THREE [] FIVE [] OTHER
TWO ~] FOUR [~ SIX
P E[-~ MI'I' NUMBER
DEPTH OF WELL
DATE DRILLED
LOG HEOEIVED
Connection Verified
3. SEWAGE DISPOSAl. SYSTEM
'E~}h,~D,, DUAL,.)N -~
[~']PUBLIC UTILITY
Ccnnection Verified
~.]Scutic Tank o1' ~J itoMing T,mk
Size: ...L~ ..... I!' Tank is homemade
give dimensions:
TYPE OF TANK MANUEACTURER
TOTAl. ABSORPTION AREA MATERIAL
PI:RMIT NUMBER
DATE INS'I'ALI. ED
INSI'ALLER
4. DISTANCES
L~/' APPROVED F:C)P, _-__'~ ......... BEDIROOMS
CONDITIONAL AI;PROV/\L (letter must accompany certificate)
DISAPPROVED
................................................. 7i?-('~':~i;;~ ................ ~¢¢'*'i
mmclpa t:W
Anct: .orage
825 "L" STREET --
ANCH .)RA,<tE, ALASKA 99501
(90'/) 264-4111
GEORGE M. SULLIVAN!,
MAYOR
DEI:~ARTMEN[OI IJ[:A! TH A:'~D [r4¥'IRONMENTAI. PROTEC¥1ON
July 23, 1979
Eugene Mc Gill
Star Route A Box 396M
Anchorage, Alaska 99507
Subject: Lot 4 Block 1 Hillside View Subdivision
This department has.reviewed~ youu. data regarding well depth
waiver to thirty(30)'~ feet an:d fiKds the following:
(1) The State of Alaska has a minimum well depth requirement
of thirty(30) feet.
(2) A significant effort has been made finding alternative
wells.
(3) Bacterial sampling is suggested.
(4) Neighboring systems and area density are 1¼ acres or
greater.
Based upon the information submitted, this department will
allow the proposed well depth of thirty(30) feet with the
condition bacterial sampling be submitted at your cost
quarterly.
In the event the well shows contamination in the future, an
alternative water supply will be necessary at the cost of the
homeowner.
If there are any further questions, please contact this office
at 264-4720.
Sincerely,
Les N., Buchholz, R.S.
Senior Environmental Specialist
LNB/ljw
TION
MATERIALS TESTING · QUALITY CONTROL
SOILS ENGINEERING
2204 Cleveland Ave. / P.O. Box 10-1126 / Anchorage, AK 99510 / 277-0231
710 3rd Ave. / P.O. Box 60547 / Fairbanks, AK 99706 / 452-1267 · 456-5155
June 7, ] 979
Eugene McGill
SRA Box 396 M
AnchOrage, Alaska 99507
Re: Lot 4 Hillside View Subdivision
Adequacy Test
Dear Eugene:
The septic system located on the referenced project tested
as follows:
]000 gallons of water in 4 hours.
If you have any questions concerning this test, please
contact our office.
Very truly yours,
CONSTRUCTION TEST LAB
Managing Engineer .~~.~~
July 17, 1979
Mr. Robert A. Hall
Director of Municipal ~ealth
c/o Mr. Les Buchholz
Senior Environmental Specialist
Dept. of Health & Environmental Protection
825 L Street
Anchorage, Alaska
Dear Sir:
We are presently building a new single family home
for our own use on Lot 4, Block 1, Hillside View
Subdivision in Anchorage. The home is framed,
roofed and wired and the heating system and other
subsystems have been installed and approved.
During these activities M/W Drillers have drilled
three separate wells on the property to provide
domestic water. (Copies of the logs of the wells are
attached.) None of the wells produced usable water
at over 40 feet of depth, even though two of the
wells penetrated bedrock at a considerable depth.
M/W Drillers have indicated that all reasonable
efforts have been exhausted. Further drilling into
the bedrock would create a serious financial hardship
with little chance of more than small amounts of
water being found.
They have suggested that a variance might be considered
based on the above and on the State Department of
Environmental Conservation~actions 18AAC 80.900
indicating surface water to be that above 30 feet and
ground water below 30 feet.
I have included copies of logs of the three wells. It
can be seen that 15 to 20 gallons per minute was obtained
in well #1 at 28 to 33 feet below the top of the casing.
The ground was excavated to provide a flat place for the drill.
When the grade is restored to normal, water will then
exist at approximately 34 feet below grade. M/W Drillers
states that the water is good quality and would produce
more than sufficient amounts if the casing were perferated
at 33 feet (34 feet below finish grade).
Therefore, we respectfully request a variance of seven feet
to allow perforation of the casing at 34 feet below the
original and finish grade. We feel that contamination from
neighboring septic systems is unlikely as:
The nearest system downhill is over 110 feet away.
Our own system is approximately 115 feet away.
Because of the lay of the land, the well perforation
will be approximately 30 vertical feet below the
bottom of the system pit. During excavation layers
of clay were found in every digging site to inhibit
downward seepage.
The nearest septic systems of neighbors uphill is
about 200 feet from well #1 and about 110 feet
from well #2.
Further, we would be willing to submit to periodic water tests
at our own expense to assure that the water does not become
contaminated from septic systems.
I respectfully ask your concurrence.
Eugene F. McGill
SRA Box 396M
Anchorage, Alaska 99507
344-9858 (home)
264-7567 (work)
Attachments:
(1) Logs of Wells #1, ~2, and #3
(2) Plat of the subdivision showing location of
wells, house and drain field.
ESTABLISHED /16 COR
N REC. POSITION FROM
FND CORNERS ON THE
SOUTH ROUNDARY OF
ALPINE TERRACE
SUSDIVISION
/256 COR
5
S 89° 55'E
?~ $89°55'E B RS° 55' E~
SO,O0
74.9
5
~ ATLATNA AVENUE
~o -- S89°55'00'E MEASD~S$9°58'E REC.) 659~$MEAS'D
~: ~5.o~ .~ '~ , ~/, m~'s
/EASEMENT
~9-~ : LEGEND
NOTES
~ - HUFFMAN ROAD
25 E4 THIS is 20
ROAD
2¸5
V~CINITY MAP
CERTIFICATE OF OWNERSHIP 8~ DEDICATION
NOTARY ACKNOWLEDGEMENT
NOTARY FOR ALASKA Mir COMMISSION EXPIRES
PLAT APPROVAL
PLAT APPROVED BY THE MUNICIPAL ~={,~TTINS AUTHORITY THIS
DAY OF ,19__.
ACCEPTANCE OF DEDtCAT]O~
THE MUNIC{PAL~TY OF ANCHORAGE HERESY ACCEPTS FOR PUBLIC PURPOSES
THE REAL PROPERTY DEDICATED ONTHYS PLAT, iNCLUDING GUT NOT LIMITED
TO, THE EASEMENTS~ RIGHT OF WAIF= ~J-EYS, ROADWAYS, THOROUGHFARES AND
PARKS SHOWN HEREON. DATED AT JU~CHORAGE,ALASK~
THIS DAY OF ~19.
SURVEYOR'S CERTIFICATE
I, E~RL R. BARNARD, PROFESSIONAL LAND SURVEYOR, DO HERESY CERTIFY
THAT THE ~LAT OF HILLSIDE VIE~ SUBDIVISION
IS A TRUE AND CORRECT REPRESENTATIC~tOF LANDS ACTUALLY SURVEYED
AND THAT ALL THE DISTANCES AND ~F-~RINSS ARE SHOWN CORRECTLY AND
THAT ALL PERMANENT EXTERIOR GOt~R~OL MONUMENTS, ALL OTHER
MONUMENTS ~ND LOT CORNERS HA~ ~EEN SET AND STAKED, OR IF
FINAL COMPLETION IS ASSURED BY '~U~OI~GION AGREEMENT, THEY WILL
SE SET AS SPECIFIED N SAID SU~ION AGREEMEN~
PLAT OF
HILLSIDE VIEW SUBDIVISION
N I/2, NW 1/4, S'~ I/4, SW I/4, SEC. 24,
TI2N, RSW, S.M., ALASKA
BARNARD ENGINEERING