HomeMy WebLinkAboutGLENN VIEW ESTATES WEST PH 2 BLK 2 LT 9Glenn View
West Estates
#2
Block 2
Lot 9
#051-793-30
Municipality of Anchorage
� =•
�fl-> Development Services Department :;=�
1 Building Safety Division =
.
On -Site Water & Wastewater Program, 4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-8650
www.cLanchorage.ak.us (907)343-7904 Page 1 of 3
Onsite Wastewater Disposal System and/or Well Inspection Report
SW010175 PID Number. 051-793-30
Permit Number.
Name: MIKE UNDQUIST
Wastewater System: IINew • Upgrade
AddrseP.O. BOX 771151 EAGLE RIVER, AK 99577
ABSORPTION FIELD
Phone: No. of Bedrooms:
(907) 240-6459 3
O Deep Trench ■Shallow Trench 0 Bad [Wound OOther
LEGAL DESCRIPTIObdNl
Sol 0.6 cPD/so-
edo
Tad *4 (® TEST HOLE) FL
born
pm* MPU beneath
Lot: Bock: GLENN VIEW WEST EST.
9 2 PHASE 12
Dash 1e pipe bottom original Voda
1.65 — 1.85 n.
pipit
2.15 & 2.31 n.
d a
Cm* kept
Township:_Range: — Section: —
A added above inot groom
2.0 — 2.5 n.
111' (1056' & 1055') n.
WELL: 0 New ■Upgrade
Crawl Mau
5 n.
Numb% al bare:
2
Dkdaw batmen ire:
15+ R
Cloedeoalbn (P,%ob. PAC):Total°
�
n.
Ceded Ta
n.
Total absorption oma
824 so. n.
embed.*
D 3034/ F-810
Dealer. Bt1Ci Wp
pU
Cral.t
Static Water Int
e
cab k.tS
f<
wta m:
WALKER CONSTRUCTION
8/1-4/2001
Data
That
DV
Pump Set ft
n.
Cody Haight Mom Grunt
ti
TANK
SEPARATION DISTANCES
■Septic OHolding 13S.T.E.P.
0Other
To
From
SepUc
Tank
Absoorprption
FI&d
UOHog
Station
Tanldink
Pabne/Pdwte
sea« urs
ra"'IOL�r'
ANCHORAGE TANK
Capacity ti's
000
Well
100'+
100'+
—
—
25'+Ilatat�
STEEL
Hendee a . 2
Surface Water
100'+
100'+
—
—
—
LIFT STATION
Lot Line
5'+
10'+
—
—
In
Yawfaabeer.
—
so. gain:
Foundation
5'+
10'+
—
—
—
'Pup on- Mel et
Tunp off.
of
ISp, fl Sam at
Curtain Drain
KNOWN
Thep rdu •
Dermad Ivo edbti
pp/owe' ton
NONE
Remarks: 'THE LOT WAS GENERALLY FIAT IN THE AREA
BENCH
MARK
OF THE SEPTIC SYSTEM. EXCAVATOR REMOVED ALL ORGANICS
locdbn ora Dnatptba
TOP OF ELECTICAL BOX
ON THE CORNER OF
FROM THE AREA EXCEPT THE AREA AROUND THE TEST HOLE.
LOTS 7 & 8, BLOCK
2,
THE MAXIMUM DEPTH WAS BASED ON THE ELEVATION OF
Mourned Ileratlora
100.00 n.
THE ORIGINAL GRADE THAT HAD NOT BEEN DISTURBED NEXT TO THE TEST HOLE.
003elsa7 UM
6060.4 •
2/P
•• .: • et
AWWC, INC.
Inspections performed by Dates:1st 8/1/2001
o :S.-
:•, r;,
* • .� 9Q,
2nd 8/2/2001
�e�l
7m
i.
3rd 8/4/2001
•p
e A. .ss.:
000 3s •
Department of Healt d Hu a Services a prove!
•1 'r
s>, . •� 7ss3 : • „es:,
Reviewed and approved by Date. /2/7/0/
�I4e°pea fe1laPe` oer
(pmv. 12/00)
4444000
PERMIT NUMBER P1L NUMBER:
SW010175 AS-BUILT DRAWING 05051-7793-30
B
ALTERNATE SITE
1_ J
SUBDMSION
TEST HOLE 1
L 8r
D
EXISTING PAD FOR
PROPOSED HOUSE
p '1 ia
MT2 hal
CO JJ 1 7 TO BE INSTALLED PRIOR
FD .. MT4 TO COMPLETION OF HOUSE.
""' C04 NEW 1000 CALLON
— — -- SEPTIC TANK /
CO3
THfl1
NEW DRAINFIELDS '
NEW
A
I
7
A
8
A
B
ST1
163.10
176.41
CO2
95.05
119.27
ST2
157.03
173.04
MT2
99.30
119.26
DBL1
153.87
170.49
CO3
166.09
188.64
081.2
152.41
169.44
MT3
163.83
185.47
FD
140.48
162.61
C04
111.46
152.55
C01
144.09
157.98
MT4
115.94
157.31
MT1
142.21
153.91
/
''DRAWN
DATE
9/18/2001
ooR`Jppp
0 Q
I t
_'�T
BY:q
•`.•••••.ik4c.
p
�
WATKR & ATKR
C.J.G.
�s�ALASKA
`�,:,
INC.
6901 OEHARR ROAD. SUITE 29 • ANCHORAGE. AX99504CONSULTANTS,PHONE (907),1376179' FAX (907)336-5246
IN= 40'
may;*,;4�
%
� �"
PREPARED FOR: PHONE NUMBER:
MIKE LINDQUIST (907) 240-6459
PAGE NUMBER
2 OF 3
'/O ..ff
1 i�Go ss:�
LEGAL DESCRIPTION:
GLENN VIEW WEST ESTATES S/D PHASE #2; LOT 9. BLOCK 2
Di
Q'e,
440QO
.
'•
C: 953 •'
., Y...., ••' t.6``00
TYPE OF WORK:
AS-BUILT DRAWING OF NEW SEPTIC SYSTEM
�o fsaa1 ace
p000ci°
PERMIT NUMBER:
SW010175
AS -BUILT DRAWING
PARCEL ID NUMBER
051-793-30
TOP OF TANK A
INLET - 98.87
INVERT OF BUNG
AT INLET i• 98.10
FINAL GRADE AA
100.75-101.07
TOP OF TANK AT
OUTLET - 98.85
111.
%///////////////// %/
INSW1TION PER
EXCAVATOR
INVERT OF BUNG AT
OUTLET - 97.88
NORTH
F61AL. GRADE -
100.71-100.98
SOUTH
ORIGINAL GRADE
98.58
O TEST HOLE
FILTER FABRIC
ORIGINAL GRADE
98.56
O TEST 1401E
FINAL GRADE
7-
101.08-101.16
FILTER FABRIC
2.31
INVERT OF PIPE
98.91
2.15
1—.5.-1
BOTTOM OF
TRENCH -
94.60
10'
••••i
i••••
•••••
•••••
•t••i*• ••
i••••«
••••••t
i
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
/ sfir c
2:307.01,
�p rpSPC ow".
$'l —0/ s':OOp.•M.
3�v INsPEcrioN
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT B —2 -0/ yD:00 4.w.
Initial
Date Issued: Jun 07, 2001
Expiration Date: Jun 07, 2002
Permit Number: SW010175 Parcel ID: 051-793-30
Legal Description: GLENN VIEW ESTATES WEST PH 2 BLK 2 LT 9 ,
Design Engineer: 0041 AK Water & Wastewater Consultant Site Address:
Owner Name: MIKE LINDQUIST Lot Size: 40848 SQ. FT.
Owner Address: NI -IN PAULA SUE CIRCLE Total Bedrooms: 3 Permit Bedrooms: 3
CHUGIAK . AK 99567 -
This permit is for the construction of:
Q Disposal Field Q✓ Septic Tank O Holding Tank ❑ Privy n Private Well ❑ Water Storage
All construction must be In accordance with:
1. The attached approved design.
2. All requirements specified In Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska
Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ).
3, The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-7904 (24 hours ). ( Not required for a Water Supply Permit only ).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather
must be either: A. Open and closed on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received By:
Issued By:
Date: CC/0f
Date: 6 - 7-0/
Municipality of Anchorage
Development Services Department
Building Safety Div'eon
Onsite Water & Wastewater Program
4700 South Bragaw St
P.O. Box 196650 Anchorage, AK 99519-6650
www.clanchorage.ak.us
(907)343-7904
ON-SITE SEWER/WELL PERMIT APPLICATION
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 05/ -7 9 3- 3 0
Property owner(s) MIKE LINDQUIST
Mailing address (1) P.O. BOX 771151 • EAGLE RIVER. AK
Mailing address (2) NNi PAULA SUE CIRCLE
Permit Number SWO/0175
Day phone
240-6459
Zip Code
Ph 2
Legal description (Lot. Block & Sub'd.) GLENN VIEW ESTATES WESTASUBDIVISION•
Legal description (Section, Township & Range) N/A
99577
LOT 9. BLOCK 2.
848
Lot Size 40. Acres/Sq.Ft. Number of Bedrooms 3
THIS APPLICATION IS FOR:
Sewer Only lit Well Only
Sewer and Well 0 Water Storage
Sewer Upgrade 0
THIS PROPERTY CONTAINS:
Hot Tub 0 Jacuzzi 0
Swimming Pool 0 Water Softening Unit 0
Therapy Pool 0
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.
ALASKA WATER & WASTEWATER CONSULTANTS, INC.
Permit Fees. i 3 Po _ mo
Waiver Fees.
Date of Payment 6/3olo/ Date of Payment
Receipt Number. .&o88 Receipt Number
ALASKA WATER Fr WASTEWATER
May 23, 2001
CONSULTANTS, INC.
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On -Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Septic Design for Lot 9, Block 2, Glenn View Estates West Subdivision
To whom it may concern:
The proposed 3 bedroom house will be served by a public water system and a private septic
system. Test holes were excavated on the property. The proposed septic system will be designed
around the 30 foot radius of test hole #1. We are proposing that a 1000 gallon septic tank and a
dual five foot wide drainfields be installed. Comments regarding the proposed design are
summarized as follows:
1. SOILS: See the attached logs which shows the soil classifications, groundwater monitoring,
and the percolation test results. It is our opinion that due to the overall appearance of the soils, an
application rate of 0.6 gallons/day/ft2 should be used.
2. TRENCII DESIGN:
a. Percolation Rate: 20 minutes/inch
b. Allowable Application Rate: 0.6 gallons/day/ft2
c. Number of Bedrooms: 3
d. Design Flow: 450 gallons per day
e. Minimum Absorption Area: 750 ft2
f. Total Depth: 8 feet (max.)
g. Effective Depth: 3 feet
h. Width: 5 feet
i. Reduction Factor: 0.58
i. Minimum Length: 90 feet total length (2 @ 45 feet long each)
j Effective absorption area = 776 ft2
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed
upgrade.
6901 Debarr Road, Suite 2B * Anchorage, AK 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com
4. TOPOGRAPHY: As can be seen on the attached design drawing, the average topography of
this property is a 1 to 5 percent running from approximately north to south; in short, there are no
slope concerns. The trench is to be installed parallel to slope contours.
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.
Sincerely,
Je rey ess, P. ., M.S.
Preside t 1
NOTE: Attached is a site plan drawing, a design drawing, 2 soils logs, and a 7 page
construction specification letter which are all part of the design package for this septic system.
6901 Debarr Road, Suite 2B * Anchorage, AK 99504
Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: akwwc.com
________ROSS VOYLES AVENUE
6
PROPOSED
3 BEDROOM
r HOUSE
LOT 14, BLOCK 2;
GLENN VIEW ESTATES WEST
SUBDMSION TEST 140LE—
DONE BY KND ENGINEERING
POEDNWEYSM
(SEE NEW SEPTIC
OF
LOT 15, BLOCK 2;
GLENN VIEW ESTATES WEST
ALTERNATE SITE /
t /1
\\` TH/1
er
LOT 8. BLOCK 2;
GLENN VIEW ESTATES WEST
44'
4
LOT
LOT 16, BLOCK 2;
GLENN NEW ESTATES WEST
ti au
DATE:
5/23/2001
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
6901 CREAM ROAD. SUITE 26 • ANCHORAGE. AS 99504 • PHONE (907)337-0179 • FAX (907)335-3246
DRAWN BY:
J.L.M.
1" = 100'
PREPARED FOR
PHONE NUMBER:
MIKE LINDQUIST 240-6459/762-1605
PAGE NUMBER:
1 OF 2
LEGAL. DESCRIPTION:
GLENN VIEW ESTATES WEST SUBDIVISION; LOT 9, BLOCK 2,
TYPE OF WORK:
SITE PLAN FOR PROPOSED SEPTIC SYSTEM
' 4 etm.P , • tlily ..-.741y
el
j v.
' • Je F ,. Camess,
�',f
4II 0 ' • t •
11 953 .`1>
‘1/4‘1.4=0;6-.
r--
1. — —
SUBDMSION TEST HOLE ,- DI I
DONE BY KND ENGINEERING
INSTALL FLOW
SPUTTER (FS)
PROPOSED NEW DRAINFIELDS.
EXCAVATE A TRENCH THAT I5 8 FEET
DEEP MAXIMUM AND 5 FEET WIDE BY
45 FEET LONG EACH (90 FEET TOTAL
LENGTH) ADD 3 FEET OF CLEAN.
WASHED SEWER DRAINROCK. INSTALL
TRENCHES PARALLEL TO SLOPE
CONTOURS.
PROPOSED
WATER LINE
FC0
PROPOSED 1000 N /
SEPTIC TANK
INSTALL DOUBLE \ '
CLEANOLTTS (DBL)
KEY BOX
(APPROX. LOCATION)
ea
ALASKA WATER & WASTEWATER
CONSULTANTS, INC.
6901 DEBARK ROAD. SUITE 29 • ANCHORAGE. AX 99504 • PHONE (907)337-0179 • FAX (907)536-3266
5/23/2001
DRAWN BY:
C.J.G.
" = 40'
PREPARED FOR: PHONE NUMBER:
MIKE LINDQUIST 240-6459
PAGE NUMBER
2 OF 2
LEGAL DESCRIPTION:
GLENN VIEW ESTATES WEST SUBDIVISION; LOT 9, BLOCK 2,
TYPE OF WORK:
DESIGN OF PROPOSED NEW SEPTIC SYSTEM
\
N
ceFQ4od-
0
0
ft.
if, NI
;,J fr' Camess•
Q�aJ 953 SFO
ite:. •••........•• F,o�
��00000l
ALASKA WATER & WASTEWATER
CONSULTANTS. INC.
6901 DE&RR ROAM, SURE 28 • ANCIcWfE M. 99504 • P101E, (907)331-6179 • FM (907)336-3248 • N'EBSIIE: Sinc.com
ISOIL LOG - PERCOLATION TESTI
LEGAL DESCRIPTION: GLENN VIEW ESTATES WEST SUBDMSION; LOT 9. BLOCK 2
PERFORMED FOR: MIKE LINDQUIST
(feet, ORGANICS
M .
2-
3-
4
5-
6-
7
8-
-
9-
9-
10-
10-
11-
11-
12-
12-
13-
13-
14
14
•
B.O.H.
15-
5-
16-
16-
17
17
18-
8-
19-
19-
20
20
COMMENTS:
GM/SM/ML
TEST HOLE #1
SOIL CLASSIFICATIONS
131191
°. 0°Y E
nii
GW
GP
GM
GC
SW
SP
SM
SC
DATE: 4/16/2001
ORG
ML
CL
OL
MH
CH
OH
DEPTH TO
GROUNDWATER
DATE
DRY
4/16/2001
DRY
4/25/2001
SITE LO
PROPOSED
3 BEDROOM
'HOUSE
=SUBDIVISION '"PROPOSED
TESTHOLE DONE SEPTIC
BY KND ENGINEERING SYSTEM
DATE
READING
CLOCK
TIME
NET TIME
(MINUTES)
WATER LEVEL
READING
NET DROP
(INCHES)
4/18/2001
1
4:35
6'
-
2
5:05
30
4 1/2'
1 1/2'
3
5:05
6'
-
-
4
5:35
30
4 1/2'
1 1/2'
5
5:35
6'
-
-
6
. 6:05
30
4 1/2'
1 1/2'
PERCOLATION RATE
20 (MIN./INCH) PERC. HOLE DIA.
TEST RUN BETWEEN 3.0 FT. AND 3.5
PERC—HOLE WAS PRE—SOAKED FOR 4+ HOURS
FT.
6' (INCHES)
PERFORMED BY ALASKA WATER & WASTEWATER I. JEFFREY A. CARNESS, CERTIFY THAT THIS W ERFORMED
IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDEUNES IN EFFECT ON THIS DATE: S�T 0/
KN]) ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
1l12 {.:. L'. _• I
Performed for:
Project
Depth
8-
9-
10-
11-
12-
13-
14-
15-
16-
17-
18-
19-
SOILS PERCOLATION TEST
0 � : Kan ft f// kV
4 Q• : CE 7116 t1� ��'s
de 89%!\oma o0 :aom
Arctic Devco Turner Construction Date Performed: 4/20/99
Lot 9, Block 2, Glenn View Estates West TEST HOLE # 99-2/9
Org — soft, black, root gnat
SM — loose reddish bm
fight root mat
Loose & soft on top
Redish brn to grey bm
SM/GM — Med dense,
W/ gravel & silt, dry
• iti4 Silt increasing on bottom
w/density.
B.O.H.
Keep system in top 4'
HOLE PRESOAKED
20- PRIOR TO TESTING
SEE ATTACHED SITE PLAN
FOR HOLE LOCATION
Was Ground water encountered? NO
Depth to water after monitoring? DRY
What depth? N/A
Date? 05/15/99
Reading
Date
Gross
Time
Net
Time
Depth to
Water
Net
Drop
1
4/22/99
12:46
-
8"
-
2
1:16
30 min
7"
1"
3
1:16
-
7"
-
4
1:46
30 min
6"
1"
5
2:16
-
6"
-
6
2:46
30 min
51/16"
15/16"
7
8
9
10
11
12
•
Water
Added
Percolation Rate v.0 (min/In) Pere Hole Diameter 6"
Test Run Between 3.5 feet and 4.5 feet
I, Kenneth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines in
effect on this date.
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.ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. 051-793-30
1. GENERAL INFORMATION
Complete legal description
HAA# ,2 t7F,4D
Expiration Date: c1 ZZI °.7
GLENN VIEW ESTATES WEST SUBDIVISION; LOT 9, BLOCK 2
Location (site address or directions)
PAULA SUE CIRCLE • CHUGIAK, AK
Current Property owner(s) ARLENE W/t4&M CONTRACTORS Day phone 688-1236
Mailing address
Lending agency
Mailing address
Real Estate Agent
Mailing address
P.O. BOX 670495 • CHUGIAK, AK 99567
Day phone
Day phone
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Individual Well
Individual Water Storage
Community Class Well
Public Water System
3
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
Community On-site
Public Sewer0
•
❑
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 samples. (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.
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $ 0 — at, or prior
to closing for the engineering services provided.
4. STATEMENT OF INSPECTION BY ENGINEER
As certified by my seal affixed hereto and as of the validation date shown below, I verify that my
investigation, based on 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. 1 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 ALASKA WATER & WASTEWATER CONSULTANTS. INC.
Phone 337-6179
Address 6901 DEBARR ROAD, SUITE 28 * ANCHORAGE. AK 99504
Engineer's Printed Name JEFFREY A. GARNESS, P.E. Date 7//14.
Engineer's Comments:
In conducting this evaluation, AKWWC, Inc. attempted to provide a thorough,
conscientious engineering analysis of the system in accordance with ADEC and MOA
DSD Guidelines 8 Regulations. The reported results described 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 focal soils condition, 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 the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. AKW WC, Inc. can therefore not provide
any warranty or future estimate of how long the system will continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the ownerlisted above. Any reliance upon or use of this report by any
other person or party is not authorized, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
iltk
.:-yOoo
D
.! A. nes. 0
—7953 �cq�F.`Qp
‘Q7.Profe19fo°°o
‘'‘‘000�CI.
Approved for l bedrooms.
oit
Disapproved. �`P\\�YI0F4 �0 �l
Conditional approval for bedrooms, with the Mowing stipulatio . • ,•' • '• y0
ON-SITE !roc?...: 'PU,TG;AND : m:
WASTEWATER
�brwl�l
oa. ENTSc^nC250)��
•
Attachments:
HAA Checklist
Septic System Advisory
Well Flow Advisory
///L�(
By: fr°' / t
'I U
(Row. 12/01)
Manitenance Agreements
Supplemental Engineer's Reort
Other
JIM
-7/7 z/c>
Original Certificate Date:
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.d.anchorage.ak.us
(907) 343-7904
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: GLENN VIEW ESTATES WEST LOT 9. BLOCK 2 Parcel ID: 051-793-30
A. WELL DATA
Well type If A, B, or C provide PWSID# _ Well Log (WN)
Date completed Sanitary seal 1 i. - s properly protected (Y/N) -
Cased to ft Casing height (above ground) - In.
AT INSPECTION
PUBLIC WATER SYSTEM
Date of test
FROM WELL LOG
Static water level / ft
Well production
WATER SAMPLE RESULTS:
Coliform colonies/100 ml. Nitrate mg./L.
A :.'. Date of sample:
gpm
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material STEEL
ft.
gpm
Collected by:
Date installed 8/1-4/2001
Tank size 1000 gal. Number of Compartments 2 Cleanouts (Y/N) YES
Foundation cleanout (Y/N) YES Depression over tank (Y/N) NO High water alarm (YM) N/A
Date of pumping NEW Pumper -
C. ABSORPTION FIELD DATA
Date installed 8/1-4/2001 Soil rating
Length 111 (TOTAL) ft. Width 5 ft. Gravel below pipe 2.15/2.31 ft.
Total depth •6.1-6.6 ft Eff. absorption area 824 ft2 Monitoring tube YES Depression over field NO
/:13.1?I all TIMEX T
fttbdnn) 0_6 System type
5 -WIDE
Date of adequacy test NEW Results (Pass/Fail)
For 3 bedrooms
Fluid depth in absorption field before test = in Water added =gal New depth =in.
Elapsed Time: = min. Final fluid depth = in Absorption rate >_ - g.p.d.
Any rejuvenation treatment (past 12 mo.) (WN & type)
N/A If yes, give date -
D. UFT STATION
Date installed Size in gallons Manhole/A
"Pump on" level at in "Pump off" _• n. High water alar level at in
Cydes tested Meets alarm & circuit requirements?
Datu
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lift station on lot On adjacent lots
PUBLIC WATER SYSTEM
Absorption field on lot On ad a
Public sewer main
Public sewer manhole/deanout
c service line Holding tank
SEPARATION DISTANCES FROM SEPTICIHOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+ Absorption field 51+
Water main 101+ Water service line 101+ Surface water 1001+
Wells on adjacent Tots 200'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundation 10'+ Water main 101+
Water service line 101+
Curtain drain NONE KNOWN
F. COMMENTS
G. ENGINEER'S CERTIFICATION
Surface water 100'+ Driveway, parldngfvehide storage {._
Wells on adjacent lots 200'+
1 certify that 1 have determined through field inspections and
review of Municipal records that the above systems are in
conformance with MOA MAA guidelines in effect on this date.
Engineer's Printed Nelms/
JEFFREY A. GARNESS
Date j70�
HAA Fee $
Date of Payment rib 0 /02- Date of Payment
Receipt Number 2.2127 Receipt Number
(Rev. 12/01)
Waiver Fee S
FROM : COUNTRY REALTY
PHONE NO. : 9076881238 Jul. 09 2002 12:39PM P1
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I hereby certify that I have surveyed the fouoWing eleoliid.'e
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Anchorage Recording Precinct. 'Alaska, sad that the•laipioai�, A.
menta sitnatedthe+eon an within thinmperty 1bi s and doiio¢S' ..:
overlap or encroach on the property ly+ng.dj�ant thereios
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no tmproveenb On pmpeetytyvg a4jaant 3$n* anao�lt.�.ic'4
on the :premises' ises in qunaon andel .that there ars.no tofi.,�d.d�,ii�jweir. r.,
transmission lines -or othervtsbkmb
le eaenowiwid pro etty2: w'
aapt as indicated hereon..
Dated at Eagle River. Alaska '•
tie 1.1 . day of •DaC . •...20pl'..:'§; .:
ROSERTC:JOHNSON f ;a;d.t
SCALE: 'Registered Land Srmeyorl`fo. t 5�'Y
r - r}0' Box 71-0456, Eagle Riv'er.Waska:99R7._..,