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DAUGHERTY LT 1
Daugherty Lot 1 #015-461-36 .% e Municipality of Anchorage Development Services DepartmentBuilding Safety DivisionOn-Site figej�' Water and Wastewater Program, 4700 S. Bragaw St.P.O. Box 196650 Anchorage, AK 99519.6650 of 3 www.ci.anchorage.ak.us (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: SW OgDySI PID Number: a/ S- q%1 -36 Nems:t A ✓I Wh ah Wastewater System: ❑ New $[Upgrade Atltlresa: �li• I �� /a ABSORPTION FIELD Phone: / _ Number of Bedrooms: / D Deep Trends O Shallow Trench D Betl Q Mountl 11(Dthe LEGAL DESCRIPTION Soil Rating. D Total Depth from original grade: Block: LOC Subtlivisian: [��a / GPDIFtt Depth to pipe bottom from original` rexi `` Ft. f Fl. Grovel depth beneath pipe: � °s Township: Range: 8ecb n: Fill added above original grade: q,7Ft. Ft. Gravel Length: Ft. Well: ❑ New ❑Upgrade Gravel wldth I Ft Number of lines: 015M bppvean linea: 3 FC Clea on (Pnv t A, B,, ( Total Depth: caw to: S Ill 414 Ft. Total absorption area: [/�`Material: o • Pi ena V Ftt 0"Iter. Det Static Water LavN: Ft. Mel r. V i Data Installed: Y®Itl: untoSet at:Casing Grouts: GPM Ft. FL TANK SEPARATION DISTANCES ❑ Septic ❑ Holding 9 S.T.E.P. ❑ Other: To From Sep Tank Absorption Field LM Station Holding Tank ublidPrivate Sewer Line nutad or. 6-A ep.dty: O Gal. Wall' �ry t / /�t �C�1- t 25 * Malenal: �i� Number of Compartments: Surface Water ®t// ( 11�y I1�I+ G- LIFT STATION Off Lot Li IffD e t get '' / size: 5 al. anu acture;: nC TA� Found A t Fump on' level al: 'Pump Or level eC Highwateria tin. in. 0 n `�_ Pump Make/�Eledricalinspectionsperfomiedby: ST (3 Fi If ,rillCurtai5 //l Remarks: [ / fiZ_ k pope MARK I / N /7� an N Location and Description: on: Gl�/ 7IC,td� S% oT airs ( 1 N N sumetl Elevabon: neap tn/ B 100 Ft. 4y Aw "�� 17034 Eagle River Loop Road, No404 bates: 1a ) -MInspections performed by ✓a ,r,...... ' (t L „nd Mos. p N ROBERT c COWANDevelopment Services Department Approval , c�asol /0,e Reviewed and approved by: Date: cRN limb) PERMIT No. SW040451 PAGE 2 OF 3 Municipalit of Anchora e DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 s Tele hone; 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 1, DAUGHERTY S/D P.I.D. NO. 015-461-36 W 0. FCO Off' 4 z TBM r r Fa p �.J DQ I NEW0 GALLON STI N S.T..T.E TANK ST MH y H' THA I FYI-FV4 TI FLUSHING VALVES SCALE: 1" 50' 4 JI .1 NM. . .. _/L%M1s_ _____________3'_SECTION _LINE EASEMENT T ROBERT C. COWAN icy --------------�� CE 8801 r a• HUFFMAN ROAD PERMIT NO. SW040451 PAGE 3 OF 3 DEPARTMENT pHEALTH ANDhHUM-AN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 1, DAUGHERTY S/D P.I.D. NO. 015-461-36 FINAL GRADE ST1 ST2 94.0' 2" INSULATION MH 91.9' 89 1' NEW 1500 GALLON S.T.E.P. SYSTEM MT1=99.1' MTI FINAL GRADE INttl ORIGINAL GRADE FG 16UR."unw.m1RJ YF YMP MTI =95.4' BOTTOM OF SAND=93.4' DIST. LINE=95.7' GROUNDWATER AT 90.9' N.T.S. 78.9' B.O.H. 1c P AB .......... +.. FCO 31.0 39.0 G� +" ,.9 ST1 63.5 72.5 r� f '„p ST2 71.0 79.5 r MH 73.0 81 .0.�� FV1 111 .S 106.0 ROBERT C. COWAN?% FV4 1 14.5 104.5 •?', MTi 114.5 104.0 (hnXff�CF�•8801 0\����� ��Ar Inspection Report Municipality of Anchorage, Building Safety Division 4700 South Bregaw INSPECTION: VOICE S43-8300 INSPECTION: FAX (907)249-7777 Name Address Legal Subdivision Comments or Directions �i1.111Y t. Hl -1 kevin Permit 12300 GINAMI ST Phone LT 1 `1=1m;tm INFO: 363-7962 04-9630 260-1100 Inspection Date 1 111 6/20 04 PM Inspection Retro Electrical LIF! Relnspectlon N NO NONCOMPLIANCE OBSERVED Q CORRECTIONS ESSENTIAL AS EXPLAINED BELOW WILL RE-EXAMINE AT NEXT INSPECTION [J DO NOT CONCEAL UNTIL REINSPECTION COMMENTS: (for Inspector use only) 4. r Inspector oy(Ilot4 MUNICIPALITY OFANCHORAGE 11/)a/uJ Development Services Department On -Site Water 8 Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519.6650 (907) 343-7904 ONSITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial C� cc� pr'-) Date Issued: Oct 22, 2004 Expiration Date: Oct 22, 2005 Permit Number: SWO40451 Parcel ID: 015-461-36 Legal DescriptionAMUGHERTYCT-1 - Design Engineer: 0003 S & S Engineering Site Address: 012300 GINAMI ST Owner Name: LINDA DONEGAN Lot Size: 90064 SQ; FT. Owner Address: 12300 GINAMI STREET Total Bedrooms: 4 Permit Bedrooms: 4 ANCHORAGE, AK 99516 - This permit is for the construction of: ❑✓ Disposal Field ❑✓ Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal Code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations ( 18AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either. A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By. 7U12- 456� Date: ) oil Xx/0 Issued By: Date: 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 ON-SITE SEWERIWELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING 6% 5 - Parcel Parcel I.D. &-fi9f — N b/ – 3 V Permit Number SW P of erty owner(s). Mai4ing� address (1 Mailing address (2) /10/– Legal description (Lot, Block & Sub'd.) Legal description (Section, Township & Range) Lot Size g6daD4__,_Acre Sq.Ft. THIS APPLICATION IS FOR: Number of Bedrooms phone 3`{5- 6669 Code 9 1 5/6 Sewer Only ❑ Well Only ❑ Sewer and Well ❑ Water Storage ❑ Sewer Upgrade 19 THIS PROPERTY CONTAINS: Hot Tub ❑ Jacuzzi ❑ Swimming Pool ❑ Water Softening Unit ❑ Therapy Pool ❑ 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.'. �S & S ENGINEERING X/ 17034 Eagle River Loop Road No. 2% (Signature of property owner or authorized agent) Permit Fees: N60Op Waiver Fees: Date of Payment: to // 9 toy Receipt Number: S'l 7 210yZ Y (Rev. 10) Date of Payment: Receipt Number: WEALTHAWHMTV APPRWALS SeNOLWATER WN EXTF11 KM ENOINEERINGSTUDIES ANOREPORTS WELLMSPECTION AFLOWTEST SRE PUNS SOILTEST PERCOLATION TEST SmOnAmi MCNAr O& WPECTIONS ONSRE WASTEWATER DGPOSN.SYSMM OESION ROBERT C. COWAN,P.E. CML ENGINEERS (907)694.2979 October 19, 2004 FAX(907)694-i2ii MUNICIPALITY OF ANCHORAGE Development Services Department P.O. Box 196650 Anchorage, AK 99519 REFERENCE: Lot 1, Daugherty Subdivision It is requested that you issue a permit to install a septic system upgrade to serve the existing four bedroom dwelling on the referenced property. A test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation 10/5/04, water was found at 3 feet. After monitoring, ground water was found at 3.5 feet. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. If you require additional information, please contact us. Sincerely, VZeP.E. RCC/bjj Enclosure 17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RNER, ALASKA 99577 DESIGN 1Npb9 Ip 'off$ b SITE -PLAN 000p. d "' o F: O "N 0 o,M v "!J Sf 'i/ xza �i N :U zo*m"nM 7 r ZM m W oF��6 �/ oSo <M r o m O d Z_O G m � m "ted <<N D�-+ a --I FtiN Z ti C7 O m � a ti � n O 9 m y Zm n P m 1�1 �.J 2= Z O N x K y N •�' O y mcZ m im z� m� i 'V' 1Npb9 Ip 'off$ b V O 000p. d "' o F: `r o,M N�NO� Sf 'i/ xza �i N :U m IIo113 II N II Z ZM W oF��6 �/ oSo 000p o /V�S�O'7 Z_O 000c d <<N 0 --I FtiN m T1 Dyom a � n loo,'.'- WeLI G y c C oo`"o RADIO$ P m 1�1 �.J O �4 Z- 04.4 V O �g "' 0�wo o,M Sf 'i/ xza �i ZM > w oF��6 �/ oSo o /V�S�O'7 Z_O <<N 0 =O m m m T1 Dyom a N x loo,'.'- WeLI G y c C oo`"o RADIO$ GINAMISTREET N � s 5e! ; § k K t | g E § t Performed For: Legal Descdptim: `9 TT 3' -rwwvice W -." Tjbck m; ►u - i'eob" FA y 9MA?'S Municipality of Anchorage Development Services Department Building Safety DNbion Onsite Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196550 Anchorage, AK 99519.5550 www.munLoWorafte (907) 343-7904 Solis Log - Percolation Test 0 Depth (Feet) 0 c i ML Stt-r wl &A4asL Date WAS GROUND WATER `'',� t ENCOUNTERED? 5( IF YES, AT WHAT DEPTH? i Depth to Water After 1lonaoring? t02I 5 Date: -1.6 oe PERFORMED BY: S PERFORMED IN AT, .p > ROBERT C. COWAN ``mac cE - 8801 Date Perlomhed: i Reading Date Gross Time Net Time Depth to Water Net Drop 1 1 30 ,17; b0 PERCOLATION RATE FERC FWLE DIAMETER b•, TEST RUN BETWEEN 2—�FT AND _FT Jr— ...�__.. �.....w Eagle River, Alaska 99577 ZZ YKIAU Fwc.l-I. 101-�o 16,Out, -V0 CERTIFY THAT THIS TEST AS EFFECT ON THIS DATE. DATE: I Z 0 1� w.. �S y�,kperD� R- I t t 1 To -3 _ g o I J " " 1 ROBERT C. COWAN, P.E. GIYIr?ER1ifG CMLENGINEERS (907) 6942979 FAX(907)694-1211 INTERMITTANT DOSING SAND FILTER SPECIFICATIONS Lot 1, Daugherty Subdivision October 19, 2004 APPROVALS GENERAL STATEMENT OF WORK SPA"&WATER The work and plans covered by these specifications consist 'of furnishing all labor, ,AA,Na,Es,o,m materials, tools, transportation, and equipment necessary to complete an Intermittent Dosing Sand Filter system as described herein and on the attached drawings. SEWERSWATER All work under this project shall comply with current Municipality of Anchorage (MOA) M6PECTION Regulations. The scope of this project includes the installation of a 1500 gallon septic tank with anti- floatation weights, and installation of a new I.D.S.F. septic system to serve the existing. IAWREPMS four bedroom residence located on the referenced property. proposed SITE INVESTIGATION aPLowTEsr The Contractor must carefully examine the project documents, have full knowledge thereof, have investigated the site, and be satisfied with the conditions affecting the work. Conditions include, but are not limited to those bearing upon transportation, disposal, anP M handling and storage of materials, availability of labor, water, electric power, roads, and uncertainties of weather, physical conditions at the site including all underground utilities, the conformation and condition of the ground, the character of equipment and facilities ROAGOEsm needed preliminary to and during prosecution of the work. The Contractor must be satisfied with the character, quality and quantity of surface and subsurface materials or obstacles to be encountered. Any failure by the Contractor to become acquainted with the available information will not relieve him/her from responsibility of performing the work as stated in SO&MT these specifications and drawings. Location of utilities will be the contractor's responsibility. PERCOLMON TEST STRUCTURAL& keCKMAC& MSPECTIONS , CNSM WASTEWATER . GSPOSNSYMM DESIGN 17034 NORTH EAGLE RNER LOOP + SIRfE 204 • EAGLE RNER, ALASKA 99577 Page 2 Lot 1, Daugherty Subdivislon October 19, 2004 SEPTIC TANK / LIFT' STATION / AIR COMPRESSOR A. General The work under this section consists of the performance of all operations pertaining to finishing and installing the septic tank/lift station, air compressor and piping to the sand filter. B. Materials 1. Tank a. Septic tank shall be a two compartment tank of at least the minimum size indicated on the drawings and MOA approved. b. First compartment shall have a separate 4" pump -out riser. The second compartment shall have a separate 4" pump -out riser. 2. Manhole Riser or Lift Station Tank a. An additional second compartment manhole riser shall be capable of being equipped with the following: 1. A junction (Nema 4x) box or equal, bonded or attached to the pump basin. 2. UL listed electrical cord grips, installed in the J -box. -OR- b. An additional tank (M.O.A. approved) may be provided for the effluent pumping assembly and the items in (a.) above. 3. Effluent Pumping Assembly, Controls, Alarm & Piping a. Effluent pumping assembly shall be of approved materials, including the following: 1. A 110 volt or equal U.L. Listed effluent pump. 2. High-density PVC cylinder housing the pump, with level controls and screen, serving as a baffle to prevent the screen from clogging. Page 3 Lot 1, Daugherty Subdivision October 19, 2004 3. All piping shall be PVC or other non -corroding material. b. Pump controls and alarm system shall be an approved system with the following options consisting of. 1. Event counter 2. Elapsed time meter 3. Program timer 4. 10 wattheater 5. Remote alarm panel option with a minimum of 80 DB sound pressure at 24", operating temperature 30AC to 65AC, continuous sound to be located in the home. 6. Oil -tight visual alarm with push -to -silence feature. Automatic audio -alarm reset. 7. 15 amp motor rated toggle switch, double pole, double throw with three positions; manual (man), automatic (auto) and center (off) (H.O.A.). 8. Nema 4x-mted, fiberglass, or equal, enclosure with hinged cover. 9. All controls to be installed as per manufacturer's recommendations. 10. Control panel to be installed on outside wall of home within sight of septic tank/lift station. c. Piping from the septic tank to the sand filter is to be 1 1/4" PVC schedule 40 solvent weld piping properly bedded as described in Materials Specifications and sloped to drain back to the lift station. Insulation board 2" thick and T wide centered over pipe is to be placed where soil cover is less than 4' depth over pipe. d. The airline from the house to the filter is to be HDPE arctic insulated pipe 3/4"-2" SDR - 11. The compressor will have a gauge (0-10 psi) and be extended into the living area or garage for easy monitoring by home occupants. 4. Air Compressor Page 4 Lot 1, Daugherty Subdivlalon October 19, 2004 a. Air compressor shall be a Txom As LINEAR SERIES model number 5060-A or 507OV-A or M.O.A. approved equal. CONSTRUCTION SEQUENCE In order to insure proper installation, the system is recommended to be installed in the following order: I. Sewer line from house to tank 11. Septic tank/lift station in. Sand filter IV. Leachfield bed (if required) V. Final grading CONSTRUCTION 1. Construction Instruments Contractor shall provide instruments such as transits, or levels, for establishing proper elevations and levelness of pipe or materials. 2. Pipe Laying All pipe shall be laid with material free of large or sharp rocks and organic matter. Each section of pipe shall be handled carefully and placed accurately. The spigot end shall be fully inserted pointing in the direction of flow and glued in place to make a water tight seal. Each section of pipe shall be properly supported to insure true alignment and an invert which is smooth and free from roughness or irregularity. At all times, when work is not in progress, open ends of pipe and fittings shall be closed so that no undesirable substance will enter the end of the pipe or fittings. 3. Bedding of Pipe for Sewer Lines Page 6 Lot 1, Daugherty Subdivision October 19, 2004 The pipe should be bedded with materials free of large or sharp rocks and organic matter, compacted. Native materials may be used as back fill material above the pipe, provided it is free of large rocks and organic matter. All lift stations shall be installed in accordance with the manufacturer's; recommendations and standards. Electrical installation is to be in accordance with the National Electric Code (latest adopted edition) by a licensed electrical contractor, with M.O.A. inspection where required. If MOA inspection is not required, a licensed electrician is to provide a letter to the Engineer stating that the system meets or exceeds all applicable codes. 4. Excavation Excavate to proper depth to allow gravity flow, install tank level, tolerance 0.05 foot, on undisturbed or compacted classified sand fill material. Create a level sand surface over the tank and add 2 burial foam +35 PSI directly over tank. Mound unclassified soil over tank with a minimum of 2 feet of cover and anti -flotation weights that may be required in areas of shallow ground water. 5. Connections All connections to be as per MOA requirements, PVC 3034 piping with Caulder or equivalent couplings for inlet riser pipes. All tank connections are to be completely water tight. Page 6 Lot 1, Daugherty Subdivision October 19, 2004 SAND FILTER The work under this section consists of the performance of all operations pertaining to furnishing and installing the sand filter. A. Materials 1. Sand Filter a. Liner (if required - not required for bottomless sand filter) - OSI Model LI or equivalent. 30 mil PVC cut and fabricated to provide water tight enclosure of filter sand volume. Seams to be permanent as per Manufacturer's recommendations. All connections, such as boot flanges, through sand filter to be permanently bonded to the liner. b. The Contractor shall provide a washed sand to meet ASTM C-33 ;Concrete Sand Specifications with the additional requirement that all but 1% of the materials passing the #100 sieve be removed. All aand shall be approved for use by the Municipality of Anchorage (M.O.A.). If the sample does not meet specifications, all sand will be removed and replaced. c. The Contractor shall be responsible for providing pea gravel that shall be a washed material containing no fines (0% passing the 4100 sieve) and a maximum size of 1/4" diameter. d. The Contractor shall provide the manifold assembly. The manifold assembly shall be of approved materials with orifice shields and flushing assembly. All drilled holes to be cleaned of burrs and pipes flushed, prior to assembly. Flushing valve to include riser to finish grade. Lateral distribution piping is to be laid level (@ t 0.05'). e. Sidewalls and top of the filter box to be insulated with 2" direct burial polystyrene insulation. f. The Contractor shall be responsible for providing filter fabric. g. Air coil in sand filter to be geoflow WF16-4-24 150 LF placed b" above bottom of sand. Page 7 Lot 1, Daugherty Subdivision October tg, 2004 Construction of Sand Filter The sand filter construction is to follow procedures as outlined below, as applicable to this design. Pea gravel and filter sand are to be hand leveled to proper depth (tolerance within 0.05 feet) in filter, taking care not to allow mud or fine soil material into the filter or gravel layer. This would include any soil material picked up by excavation machinery buckets while loading specified material. The Contractor should estimate filter material volumes such that allowance is made for wastage of material in contact with the ground at site. The area over the sand filter to be finish graded with a minimum of 2 feet of cover and to prevent ponding of surface water run off. Side slopes shall not exceed 3:1 The Engineer will reject any sand or pea gravel that does not meet specifications or is contaminated in transit or while handling. If such material is placed in the filter, all soil material may be required to be removed and replaced with new material CONTRACTOR/INSTALLER Municipality of Anchorage Page ,� of 7Z__ DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Permit Number: -!.g5,W61 Io&0i PID Number: Naw.;? (�N Wastewater System: ❑New Upgrade Address: .� ��„ AAS ABSORPTION FIELD Phone: No. of Bedr oms: Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: D. Total Depth from original grad PD/S . Ft. Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe r 1 4–f Ft. Ft. Township:Range: Section:./ �ina Fill added above oril grad t ( Gravel length : �..�t� t I- Tt %� VT Ci Ft. .ic/- Ft. WELL ❑New El Upgrade Gravel tlepth: Wtt 11 I Number lines: Distance between lines: Ft. / Ft. Classi tion (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipematerial: & Ft. Ft. Ft. Q. Ft. Y'"J,s"1. _D Driller: Date Drilled: Static Water Level: In alter:Date installed:) ^ �P- Ft. 1 I – Y Yield:Pump Set at: Casing Height Above Ground: TANK GPM Ft. Ft. SEPARATION DISTANCES •I7�Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufact(ure,r/ ST� Capacity in gall S: `` _2_A51n From Tank Field Station Tank Sewer Lines JCi /—f 1.� Well I�51 I�l _ — �1 Material: Number of Compartments: Surface 1604 ICD14- , — _,_, LIFT STATION Water LotI t I D (+ Size in gallons: Manufacturer: Line (l Foundation t f i i ..� `' "Pump on" level at: "Pump level at: High water alarm at: Curtain Pump Make & Motlel ctrical Inspections performed by: Drain i.t ►.S� Iti.l BENCH MARK Remarks: ' location and Description: Assumed Elevation: M IN ki,GV4, EER9,SEAL' �E ff 1s Inspections performed by�—t$tes: 2nd -�� I • �`� RO J. PER, RE wI : i,,"S=�P~'."r ent and Human Servic oval ZS Dateppr 2 RevDwed ed bye andnappro 72-013 (1/91) MOA 25 Permit No. ee�vaclloaaI Page of Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: 1 PID No.: _—G01 / Klf GJ i_P;WUA0S_1 )C4 -fi'fJ�fyi \ G03 �" � 4� ►t9si+ S i � TNS •fir® 72-013 A (2/91) MOA 25 � GOA f�44 Mn h'}f2 M13 t�,e (�° I'LL° gft5 �4% 104= �6 / Klf GJ i_P;WUA0S_1 )C4 -fi'fJ�fyi \ G03 �" � 4� ►t9si+ S i � TNS •fir® 72-013 A (2/91) MOA 25 PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE �IF'YYI DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW910301 DESIGN ENGINEER:S & S ENGINEERS OWNER NAME:DAUGHERTY RONALD D & OWNER ADDRESS:12300 GINAMI ST ANCHORAGE, AK 99516 PARCEL ID:01546136 LEGAL DESCRIPTION: DAUGHERTY LT 1 T12N, R3W, SEC 24, SM LOT SIZE: 90064 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: DATE ISSUED: 9/23/91 EXPIRATION DATE: 9/23/92 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED B ISSUED BY: Y: W` DATE: DATE: ��s it. HEALTH AUTHORITY APPROVALS September 17, 1991 Municipality of Anchorage SEWER &WATER DEPARTMENT OF HEALTH AND HUMAN SERVICES MAIN EXTENSION$ 825 L Street Anchorage, Alaska 99501 SEWER &WATER REFERENCE: Daugherty Subdivision Lot 1 INSPECTION g Y ROBERT SHAFER, P.E. ROGER SHAFER, P.E. CIVIL ENGINEERS (907) 694-2979 FAX 694.1211 MUNICIPALITY OF ANCHORAGE ENVIRONMENTAL SERVICES DIVISION SEP 19 1991 RECEIVED Request you issue a permit to upgrade the septic system serving the referenced property. ANDRE RINGORIS STUDIES An adequacy test was performed on the existing system and the AND REPORTS q Y P g Y absorption capacity of the system was found to be less than adequate. WELL INSPECTION A test hole was excavated and a percolation test performed in & FLOW TEST the area of the proposed upgrade. Attached is the proposed upgrade design. The lots in this area are relatively large with sufficient SITE PLANS room for future well and septic upgrades. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic upgrade. If you have any questions or require additional information ROAD DESIGN for your review, please contact us. Sincerely, SOILTEST-} ROGER J. SVAFE�. PERCOLATION TEST RJS/lsu STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 si LEGAL pP DRAWN L S. vilw Su��►v►s►o�► _-.- nrt� uaVN�iav W. GF T. N• volt I 1 y M -r .�XISfINGi . 260`-t To We4,VS I.[sr 1 bJ-►i -�%1 SHT. .� 1 ufrgfl RuVrH PIN Izocv 1": r ° :1..���@ e � pp�p J.3►iAFEfl, P.E14, ° OW Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG - PERCOLATION TEST PERFORMED FOR: UYiL�KL?1�l V1/.I►G�.IL..� q� DAT LEGAL DESCRIPTION. J 1 Township, Range, Section: DFEEPETTH SLOPE ( I 1 ) � ✓ fIL_I�I�If IIL_JII 2 eo 6 3 4 d6 6 5 'ae> or 6 t 7 J 9- 10- 12- 10 12 p` �t 13 14 vJ' 15- 16- 17- 18- 19- 20 5 1617181920 COMMENTS Z4 m u WASGROUND WATER ENCOUNTERED? S IF YES, AT WHAT L O DEPTH? P E Depth to Water Ager Monitoring? —I Date: SITE ^ PERCOLATION RATE (minutewinch) PERC HOLE DIAMETER --62!— TEST RUN BETWEEN FT AND �5 FT J a J GLV pYGGR���V PERFORMED BY: pp����II�� RR77 ee'' C`�� qqoqp� 7R7i _ ACCORDANCE WIT&%A VX%ANb'hbNICiPAL GUIDELINES IN 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST ,WAS PERFORMED IN THIS DATE. DATE: �—J.!! — / / NAME Cie GREk,rR ANCHORAGE AREA BOR,JGH Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 '1 n i J 14(n I _ �) (D INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM LING ADDRESS° — LOCATIONcik m 11 ' LEGAL DESCRIPTION SEPTIC TANK: 1 PHONE DISTANCE / �i,� _ NUMBER OF FROM WELL, ®o MANUFACTURER b o MATERIAL C�%%��e�'2' COMPARTMENTS o� INSIDE LENGTH INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /�ALLONS. TOTAL LENGTH�� DISTANCE FROM WELLFOUNDATION i NEAREST LOT LINE ;?D o - OF LINES NUMBER OF LINES/— DISTANCE 81ETWEEN LINES _.— —TRENCH WIDTH IN. TOTAL EFFECTIVE ABSORPTION AREA (O0 SQ. FT. LENGTH OF EACH LINE DEPTH OF FILTER / DEPTH: TOP OF TILE TO FINISH GRADE -44 —, MATERIAL BENEATH TILE_'Z�_+FN. ABOVE TILE _!!�Z IN. WELL: JJff TYPE - 1 e / "`�' CONSTRUCTION 1 �� DEPTH DISTANCE FROM: BUILDING NEAREST NEAREST SEPTIC ''��nnf SEEPAGE ,,r�y� FOUNDATION LOT LINE , SEWER LINE �Q TANK, SYSTEM V CESSPOOL OTHER SOURCES &I�A APPROVED -'e- DISAPPROVED REMARKS DISTANCES: A. -BL -- INSTALLED . -B INSTALLLED BY: . ® �t q Lk C - SEWER LINE DEPTH: �� PIPE MATERIAL: `/� A& r LOT SLOPE: REMARKS: SSS" Form EQ -032 DIAGRAM OF SYSTEM DATE69-SO^'�% APPROVED G.A.A.B. C X -yaL _ � 0 G C9 DATE69-SO^'�% APPROVED G.A.A.B. C Well Log For _.... ......... Locational,' r Date completed <....4r.r....._., .,-. '..-,.............................................. Depth of well...... J ;.: t ..... x `r., f`. Size of casing.—,,. aJ' - Distance to water ...:.., , ! .�`:............. . Distance to water chile pumping..... ......... .............. at rate of..... '.4'....:.........................gallons per hour, Formation ! from to 1 r r. > Driller DELTA DRILLING COMPANY SRA 90v 394 8 ANCWCRAGE, ALn SKA 99507 g;3dc4rn. -a9-1 7 110A ehiLe-la p ) APPLICANT RONALD Difill, HERTY P 0 BOX 4.-118 LOCATION GIPdAMI. LEGAL S1/2 SWI/4 SWI/4 SEI/4 S24 T12 UiLx.�. LOT SIZE 217800 SQUARE FEET TYPE OF SOIL. AB_ORBTIONd SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = •a SOIL RATING <:_Q FT/ R)l 165 THE REQUIRED SIZE OF THE: _OIL AE ORPTIONd SYSTEM IS: F :" F� d✓ F N = II_ Al F_ F= fA CA T F A -110 C3 d =.". FA " 6 = d__ d : " d-" d d -d THE LENGTH DIMENdSI.ON IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINdFI:ELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION 0Nd FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH Imo; THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL FIFE: AND THE: BOTTOM OF THE EXCAVATION 0Nd FEET). F; -_'d= uG-a II_ 0 E F= EE d_> On Eo F Y- 1E i::: TI- FFl d°•.d d __ _. I — EF �. .lL -L:" C-3 K F:9 d_. L.- Cu g Lod p < a_ _" 3: F F— EE u:7-. -T 1 CoB d__: HF:=d= Fed=f:. LJ 1: Fes:'FEEIF-- BACKFILLING °BACKFILL_II' G OF ANY SYSTEM WITHOUT FINAL_ INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE UTSPOSAL. SYSTEM IS 100 FEEL- FOR A PRIVATE= WELL OR 200 FEET FOR A PUBLIi: WEL_I� SPECIFICATIONS S ANBD CONSTRUCTION D.T.AGRFIMS ARE AVAILABLE TO—INSURE PROPER INSTALLATION. F-= FE' F -" F-' F :F - "ti° F -R F__. ]I= F " F- ED F 2 CDOAK °-e-` En F=F Fm' F== IF-., e -F F -'I I ": _> F__F F-. I CERTIFY THAT 1: I AM FAMILIAR WITH THE FEQUIREMENdTS FOR ON-SITE =EWERS ANaC? WELLS AS .SET FORTH BY THE MUNICIPALITY OF ANCHORAGE, I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 1: I UNDERSTAND D THAT THE ON-SITE SEWER SYSTEM MAY REI;UIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INdCLUDE MORE THAN 4 BEDROOMS. SIGNED: -----.._..... ------------------ .. -- APPLIC:ANdT RONALD DOUGHERTY ISSUED BY ............ fo-L9g n_ a. 8 d _. 1E -T',' (3 E= Fl lAC � N :_eI�"#=lC:i d:E GE:PARTMENdT OF HEALTH AND ENVIRONMENTAL PROTECTION B?` 'L" STREET, ANCHORAGE, AK. 99501 279-251:1 TE T d_ 'n F= hl E_ Fr~" d=° d= Fes' Irl 1'-F PERMIT NO. 773_38 ) g;3dc4rn. -a9-1 7 110A ehiLe-la p ) APPLICANT RONALD Difill, HERTY P 0 BOX 4.-118 LOCATION GIPdAMI. LEGAL S1/2 SWI/4 SWI/4 SEI/4 S24 T12 UiLx.�. LOT SIZE 217800 SQUARE FEET TYPE OF SOIL. AB_ORBTIONd SYSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = •a SOIL RATING <:_Q FT/ R)l 165 THE REQUIRED SIZE OF THE: _OIL AE ORPTIONd SYSTEM IS: F :" F� d✓ F N = II_ Al F_ F= fA CA T F A -110 C3 d =.". FA " 6 = d__ d : " d-" d d -d THE LENGTH DIMENdSI.ON IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINdFI:ELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION 0Nd FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH Imo; THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL FIFE: AND THE: BOTTOM OF THE EXCAVATION 0Nd FEET). F; -_'d= uG-a II_ 0 E F= EE d_> On Eo F Y- 1E i::: TI- FFl d°•.d d __ _. I — EF �. .lL -L:" C-3 K F:9 d_. L.- Cu g Lod p < a_ _" 3: F F— EE u:7-. -T 1 CoB d__: HF:=d= Fed=f:. LJ 1: Fes:'FEEIF-- BACKFILLING °BACKFILL_II' G OF ANY SYSTEM WITHOUT FINAL_ INSPECTION AND APPROVAL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN A WELL AND ANY ON-SITE SEWAGE UTSPOSAL. SYSTEM IS 100 FEEL- FOR A PRIVATE= WELL OR 200 FEET FOR A PUBLIi: WEL_I� SPECIFICATIONS S ANBD CONSTRUCTION D.T.AGRFIMS ARE AVAILABLE TO—INSURE PROPER INSTALLATION. F-= FE' F -" F-' F :F - "ti° F -R F__. ]I= F " F- ED F 2 CDOAK °-e-` En F=F Fm' F== IF-., e -F F -'I I ": _> F__F F-. I CERTIFY THAT 1: I AM FAMILIAR WITH THE FEQUIREMENdTS FOR ON-SITE =EWERS ANaC? WELLS AS .SET FORTH BY THE MUNICIPALITY OF ANCHORAGE, I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. 1: I UNDERSTAND D THAT THE ON-SITE SEWER SYSTEM MAY REI;UIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INdCLUDE MORE THAN 4 BEDROOMS. SIGNED: -----.._..... ------------------ .. -- APPLIC:ANdT RONALD DOUGHERTY ISSUED BY ............ NAME OF APPLICANT INSTALLATION LOCATION LEGAL DESCRIPTION GREATER ANCHORAGE AREA BOROUGH DEPARTMENT OF ENVIRONMENTAL QUALITY 3330"C"STREET ANCHORAGE, ALASKA 99503 TELEPHONE 274-4561 SEWAGE DISPOSAL SYSTEM — APPLICATION AND PERMIT INSTALLATION OF: SEPTIC TANK �.U2vr7% TYPE AND SIZE OF FACILITY TO BE SERVED MAILING ADDRESS PERMIT NO.27 PHONE DRAIN FIELD , OTHER FINANCED THROUGH TO BE INSTALLED BY SOIL TEST RESULTS tal� NOTE: THIS PERMIT IS NOT VALID WITHOUT SOIL TEST COMPLETION DATE ANTICIPATED FINAL INSPECTION: Z4 HOUR NOTICE REQUIRED. BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION BY THE DEPARTMENT OF ENVIRONMENTAL QUALITY AUTHORITY WILL BE SUBJECT TO PROSECUTION. SEPTIC TANK SIZE ���[� TYPE LG'iDh�I%JSEEI6AGE AREA SIZE MINIMUM DISTANCES, REQUIREMENT'S FOUNDATION TO SEPTIC TANK S / 7,¢eueti i FOUNDATION TO SEEPAGE PIT S � ,DRAIN FIELD �. SEPTIC TANK TO SEEPAGE PIT WTTL,(LnG �T SEPTIC TANKpG�.QLT' / /DRAIN FIELD TO NEAREST LOT LINE. Al WELL TO SEPTIC TANK Al0 DRAiM�P1ELD_ ALSO CONSIDER AREA WELLS. WATER MAIN TO SEPTIC TANK A / SEEPAGE PIT , DRAIN FIELD SEPTIC TANK, v� SGEPRG'E-PIT , DRAIN FIELD Zo'c__, TO RIVER, LAKE, STREAM. CAST IRON INTO AND OUT OF SEPTIC TANK AND INTO CRIB CROSSING GAP OF EXCAVATION 5 FEET INTO UNDISTURBED SOIL, 4 INCH DIAMETER CAST IRON SIPHON PIPES ON SEPTIC TANK AND SEEPAGE PIT FITTED WITH AIRTIGHT REMOVABLE CAPS. /f/� GRAVEL 8/4:4FILL f) // �((�/^�fr� L�7'kvq CONFORM TO BOROUGH REGULATIONS REGARDING INSTALLATION. OR LICENSED DESIGNER �e,v` /,- DIAGRAM OF SYSTEM 1 CERTIFY THAT 1 AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE DESCRIBED SYSTEM IS IN ACCORDANCE WITH SAID CODE. DATE `' 12 �Vy /_a APPLICANT'S SIGNATURE FORM NO. EO -016 O R&M CONSULTANTS, INC. 249 EAST 51 ST. AVE. FGH> • AN .... AGE, AK. 99502 - P.H. 907 279' 04H3 ^ TLX. 090'25380 July 6, 1976 R & M No, 656266 Serendipity Unlimited Mr. Patrick Wright P.O. Box 4386 Anchorage, Alaska RE: Test Hole and Soil Log Report for Sanitary System R3W, Section 24, S' , SW's, SW,, SE's Dear Mr. Wright: We are submitting herewith the test boring results and our comments regarding soil conditions encountered at the subject site. This invest- igation was performed in accordance with your request of June 8, 1976 and those procedures outlined in a letter dated July 15, 1975, by Mr. Rolf Strickland of the Municipality of Anchorage, Department of Environmental Quality. A single test hole was put down within the building site for the purpose of defining general subsurface soil conditions for the proposed sanitary system. Excavation was accomplished with an auger type drilling rig and the test hole was extended to a total depth of 17.0 feet below ground surface. The final log prepated for the test hole has been included in Drawing A-1. Ground water was not encountered in the cest hole while drilling. We appreciate being given this opportunity to be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact us. Very truly yours, R. &; JM CONSULTANTS, INC. % 'James W. Rooney Vice President JZ4R/DM/pe xc: Municipality of Anchorage 'ANCHORAGE FAIR8ANKS JUNEAU ':KO: DiMLeg of Test Hole Pa`.GRAD= , INC. - l-_- 7/:��^ ..e....-. �.ew..... ...�.... .....,..�.. _ria: ,,Iric'h i`. R& -A CONSULTANTS T.H. l or NN N ORGANIC MATERIAL N N N 2' jY-'a dd. D�o SILTY SAND W/ SOME _ GO3 GRAVEL 69 Sultana Rd. - SANDY SILT W/ TRACE - GRAVEL D' T.H. 1 .d 7y 15 -40' SILT W/ SOME SAND o<.b. 16• GRAVEL W/ SOME SAND 17'T.D. No Water While Drilling Upper Huffman Rd.. ':KO: DiMLeg of Test Hole Pa`.GRAD= , INC. - l-_- 7/:��^ ..e....-. �.ew..... ...�.... .....,..�.. _ria: ,,Iric'h i`. R& -A CONSULTANTS PERCOLATION TEST PATRICK WRIGHT R & M NO. 656260 _ ELAPSED. DROP TIME TIME INCHES 4:25 0 0 4:26 1 2.0 4:27 1 2.0 4:28 1 2.0 4:29 1. 1.0 4:30 1 1.0 4:31 1 - 1.0 4:32 1 1.0 4:33 1 _ 110 4:34 1 0.5 4:35 1 0.0 4:40 - 5 1.5 4.45 5 0 4:50 5. 1 0 5 1.0 5.05- 10 2.0 , 5:15 10 1i0 5:25 —= 10 1,0 60 Minutes 21,0^ Total Drop IJ.Iz%vlk R&M CONSULTANTS, INC. 249 EAST $'197. AVE. - BOX 6067 ANCHORAGE, AK. 09502 - A.N. 907.279.0463 - TL%. CUO-20360 July 6, 1976 R & M No, 656260 Serendipity Unlimited Mr. Patrick Wright P.O. Box 4386 Anchorage, Alaska C,3 RE: Test Hole and Soil Log Report for Sanitary System R3W, Section 24, S' , SW's, SW4, SE14 _ Dear Mr. Wright: We are submitting herewith the test boring results and our comments regarding soil conditions encountered at the subject site. This invest- igation was performed in accordance with your request of June 8, 1976 and those procedures outlined in a letter dated July 15, 1975, by Mr. Rolf Strickland of the Municipality of Anchorage, Department of Environmental Quality. A single test hole was put down within the building site for the purpose of defining general subsurface soil conditions for the proposed sanitary system. Excavation was accomplished with an auger type drilling rig and the test hole was extended to a total depth of 17.0 feet below ground surface. The final log prepated for the test hole has been included in Drawing A-1. Ground water was not encountered in the test hole while drilling. We appreciate being given this opportunity to be of service to you. Should you have any questions with regard to the above, please do not hesitate to contact us. Very truly yours, R &/ M CONSULTANTS, INC. '`James W. Rooney...- Vice President JWR/DM/pe xc: Municipality of Anchorage lNi: if0A4G�=A1619AN K9 .JUN=?. L3 T.H. 1 o' NN N N ORGANIC MATERIAL N N 2' .p dp SILTY SAND W/ SOME GRAVEL 6 1 Sultana. Rd. SANDY SILT W/ TRACE '. - GRAVEL - T.H. 1 '. D :.. 15 n 40' ro �'', --- :% •:'0 SILT W/ SOME SAND 16' o GRAVEL W/ SOME SAND 17'T.D. No Water While Drilling Upper Huffman Rd. DWN:C. F.B. Log of Test Hole GRiD1 CKD DWK RSM CONSIJLTANTST INC.. ,,..............,.. Patrick Wright +-_ 7/6/76 .„,,.,......,.,..... Anchorage; Alaska ��A-01 SCALE= n.t.s. DWG_:40: PERCOLATION TEST PATRICK WRIGHT R & M NO. 656260 ELAPSED DROP TIME TIME INCHES 4:25 0 p 4:26 1 2.0 4:27 1 2.0 4:28 1 2.0 4:29 1 1.0 4:30 1 1.0 4:31 1 1.0 4:32 1 1.0 4:33 1 1.0 4:34 1 0.5 ; 4:35 1 0.0 4:40 5 1.5 .4:45 5 2.0 4:50 5 1.0 4:55 5 1.0 5:05 10 2.0 5:15 10 1.0' 5:25 10 1.0 60 Minutes 21,0" Total Drop SOILS LOG v. 0 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION Pouch 6650, Anchorage, Alaska 99502 276-=! TEST SOILS LOG - PERCOLATION TEST Lbr) r)— r'F:)RNIED FOR: Le__ --DATE PER FORMED; "Al DESCRIPTION. Z_ '5 S Z'� L /4 7 SLOPE SITE PLAN � t d e- 3 170 <p �l S� I,-- <' � Gr&_'Cl L Reading Care Grosv Netj Depth to Net Time TUTle water Drop ---------- P ER CD LAT ION RATE TEST RUN BETVVEEN L R r ),', M E: C BY: CERT; F I ED 8 Y; FT AND (minutes/mchi FT WAS GROUND WATER r ENCOUINITERED? 0 p A rt--, v- 4F YES, E DEPTH? Reading Care Grosv Netj Depth to Net Time TUTle water Drop ---------- P ER CD LAT ION RATE TEST RUN BETVVEEN L R r ),', M E: C BY: CERT; F I ED 8 Y; FT AND (minutes/mchi FT �1 tk56 l r E. C,,,,�F„i Municipality of Anchorage Development Services Department - Building Safety Division On -Site Water and Wastewater Program -g r ` 4700 South BraSt. P. x 196650 Anchorage, AK 9951951 9650 www.ci.anchorage.ak.us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parceil.D. 015-461-36 HAA# 0r/oQIq Expiration Date: Z / t I to 5 1. GENERAL INFORMATION Complete legal description Lot 1: Daugherty Suhdivinin" Location {site address or directions) 12300 Ginami St_ Anchnragn. AIC_995t6 Current Property owner(s) Linda Donegan Day phone 243-3166 Mailing address same Lending agency Mailing address Real Estate Agent Mailing Address Day phone Rey Hixon Dayphone 273-7749 Prudential Vista 4241 'B' St. Anchorage, Art 99503 Unless otherwise requested, HAA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 4 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well Individual On-site XQ Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System ❑ 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. 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 *anlror�j wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and typucture indicated herein. I further verify that based on the information obtained from the Municipality ,o�fe files and from my investigation and inspection, the on water supply and/or wastewater di 0.. I system is(are) in compliance with all applicable Municipal and.State codes, ordinances, and regulations in effect at the time of installation. ° Name of`0irm S & S Engineering Phone' 694-2979 Address 17034 N. Eagle River Loop Ste. 204 Eagle River, AK 99577 Engineer's Printed Name Robert C. Cowan Date 4t ��QLb OF AtzQi., 5. DSD SI NATURE Approved for J/ W bedrooms. Disapproved. ROBERT C. COWAN CE -8801 Conditional approval for bedrooms, with the following stipulations: Attachments: HAA Checklist X Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other By: Original Certificate Date: Ii I Municipality of Anchorage' Development Services Department Building Safety Division On -Site Water & Wastewater Program e 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cl.anchorage.ak.us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: J -O / 1 UAu cF%Ca:'`/ S %,0 Parcel ID: 0 t,i —'t6/ A. WELL DATA Well type /'R� uti rte If A. 8, or C provide PWSID # Well Log 69N) yE Jr Date completed 6 3/W Sanitary seal a/N) y4 J Wires properly protected QN) Y4-Jr Total depth t SO ft. Cased to '90 t ft. Casing height (above ground) ! a f in. FROM WELL LOG AT INSPECTION Date of test G 1J/77 q/!6/sK Static water level 2L 7 Well production 3,5- g:p.m: a. of g.p.m. WATER SAMPLE RESULTS: Coliform 0 colonies/100 ml. Nitrate $. S( mg./I. Other bacteria colonies/100 mi. Arsenic: mg./I.Date of sample:9�r6/o N Collected by: S&SENGINEERING ragle, River Loop R ad No. 204 B. SEPTIC/HOLDING TANK DATA Eagle River, Alaska 99577 TankType/Material SdFTrc(s.tE,P,)/5T£EG Date installed tf �/� �a } Tank size 7 SaO gal. Number of Compartments a Cleanouts (9N) yf- J Foundation cleanout &/N) YEI Depression over tank (Y/JO No High water alarm (!VN) Y4� Jr Date of pumping N(4 N4 -w < Pumper C. ABSORPTION FIELD DATA Date installed it Ay/o y Soil rating (g.p.d./ftZ orft2/bdrm) 1=0 System type Length 30 ft. Width 1 2 ft. - Gravel below pipe 0- a S ft. Total depth ft. Eff. absorption area 34 0 ftZ Monitoring tube YSJ Depression over field ^' o Date of adequacy test PIA /VCw Results (Pass/Fail) For bedrooms Fluid depth in absorption field before test _ in Water added gal. New depth in. Elapsed Time: min. Fi uid depth in. Absorption rate >_ g.p,d. Any rejuvenation treatm past 12 mo.) (Y/N & type) If yes, give date Date installed II / I t /D Y Size in gallons I S-00 Manhole/Access(9N) "Pump on" level at N as in. "Pump off' level at 3 in. Datum iS 0T'ron 'k 7ANIr Cycles tested 7 E. SEPARATION DISTANCES VE J High water alarm level at "l y in. Meets alarm & circuit requirements? %-fJ SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot ) I N On adjacent lots i Absorption field on lot / a a On adjacent lots 100 f Public sewer main N 1A Public sewer manhole/cleanout _ Sewer /septic service line a } Holding tank SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation L4 S , Property line 1a-7 , Absorption field t , Water main N AA Water service line /0 Surface water /oo f Wells on adjacent lots /OO �y— SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property fine g ti Building foundation C 0 Water main J14 Water Service line )D Surface water iy O + Driveway, parking/vehicle storage / O0 f Curtain drain ru4^'E 'KMOwt✓ Wells on adjacent lots l 00 4 F. COMMENTS G. ENGINEER'S CERTIFICATION 1 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. �� ROBERT C. COWAN. CE -8301 Engineer's Printed Name lel),64A CO wA"' �t�� Date _ to / 1' /0 HAA Fee $ Y 3 O + l -7 S— CR-rN Waiver Fee $ Date of Payment 11 V/0 y Date of Payment Receipt Number O 60 $ �'! Receipt Number (Rev. 12/01) Municipality of Anchorage o Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchomge.akus (907)343-7904 WATER WELL NITRATE ADVISORY FOR HEALTH AUTHORITY APPROVAL #HA040619 Legal Description: Daugherty S/D Lot 1 PID # 015-461-36 The well for this property meets existing State and Municipal Codes. There are nitrates present. It is suggested that periodic testing be performed to insure the wells continued suitability. Current nitrate concentration is 8.51 mg/l. EPA maximum concentration is 10.0 mg/l. This advisory must be attached to all copies of the subdivision Health Authority Approval Certificate. If there are any further questions regarding this advisory, or would like more information on nitrates please call the On -Site Services Program at 343-7904 0-24-04; 4:3/PM; ;907 6616301 0 2/ 3 SGS Raf.# Client Name Proled Name/# Client Sample ID Matrix Sample Remarks: 1046104001 S & S Engineering Lot 1 Daugherty SO Lot 1 Daugherty SID Drinking Water All Dates/Times are Alaska Standard Time Printed Date/Time 09/24/2004 13:48 Collected Date/Time 09/16/2004 11:50 Received Date/Time 09/16/2004 17:50 Technical Director StepVo C. Ede Paramder Results PQL Units Method ContainwlD Allowable Prep u Dm[nit Maters Department Ni"WN 8.51 0.100 M91L BPA 300.0 B (r-10) 09/17/04 31B Microbiology Laboratory Total Coliform 0 coV100mL SM20 9222B A (<=1) 09/16/04 DKC NOV-18-2004 1108 S&S ENGINEERING O nJMe Z e .New 1 LOT I Tic, 2.07 Ae. 0 }� .3= SECT/av uME �'SiY17 •" 7 907 694 1211 P. 01/01 r,- 1M Ih y'i1 INj CX C r Moss, -� :.... At 65* 55'00"W _'..UPPER . HUS DEFER TO NOTE NO.1 _QN 7r14E PLAT OF A=*RD. WI tat:.. Stock ••••:.: •'6 nu9her y Subdi vision (76107) ... .............. LUMMOR Anchorage Recordle9 District, Alaska fM @le• W •r wd t of "a" W "Im�/�M11 . H��ilsi ossa. an not shorn. A•rsa wfaw . � 1rQT tSURVE7 CERTIFlCATpNEi 4Y`_Y"` _�"p'•e�o► t w�q wetly gest t hors g~g M. pW%M men• w r.ern.i Q Bren ar Ah=nlawn 0app.d eoewmenr i`s`'►�op base , MA not ns bwe"Ua drw" swam w .iron 1s• /rop. C Iron tip• rebor recavnd. •rye•aMetboola•fMOKw4d•w••oelarMltiO=ls•dfk•1 O t:Y�''Vuob tockroaovend o• boeons w�. on FWD Fcweh VMW •r",1 w Is• M•� � t� ■ mbar at this •w•y M an„m d "I mm in N 01"•a", stilly w••. r •new visna ma"P.•r• on wls rNWY "Sept w Maww hm•n. . Date • - prepared by. R. L, BUTTON "le / i L^� �Ps?wtP d &6 Swvryx ; 0 p 09-24-04 �soriz�-epee a�vrrt,�,n�w. aaorro�sa Ref. F D. No. Property of: - 274/ 04 -C,roB —� ] v '- TOTAL P.01 ADVANCED WASTEWATER TREATMENT SYSTEM MAINTENANCE AND REPAIR AGREEMENT MEMORANDUM OF UNDERSTANDING BETWEEN MUNICIPALITY OF ANCHORAGE AND . L THIS MEMORANDUM OF UNDERSTANDING made and entered into as of this day of lk)pv r k, m ✓ of 20py, by and between KEA^- Lcznr L herein the "OWNER," and the Municipality of Anchorage, herein the "MUNICIPALITY." In consideration of the mutual covenants contained herein, the parties to this Memorandum of Understanding agree as follows: 1. ADVANCED WASTEWATER TREATMENT SYSTEMS. Municipality grants permission to Owner to utilize and operate an Advanced Wastewater Treatment System (AWWTS), described as _T, 12 5 - 1' located at 12300 (�' r t1 a..rn -Y , Anchorage, Alaska. VA UCH ERTy /m -r 1 2. Definitions. A. Alteration. Any change to the design or function of an AWWTS that includes the installation or removal of any parts, components or pieces not included in the original construction permit and design. Prior to performing any alterations to an AWWTS the owner must obtain a Wastewater Disposal System Construction Permit from the Municipality pursuant to Anchorage Municipal Code (hereinafter, "AMC") 15.65. B. Certificate of On -Site Systems Approval. An approval by the Municipality of existing water and wastewater disposal systems given at the time of property sale and title transfer in accordance with AMC 15.65. These approvals certify that the systems are adequate for the homes that they support and meet the codes that were in place at the time of system construction. C. Damage. Any man-made or natural change in a system that would inhibit the system from performing as designed. D. Maintenance and Repair. The scheduled and as needed replacement of existing parts, components and pieces of an AWWTS that were included in the original design which would allow the AWWTS to continue to perform as designed. E. Permit (Construction) An On -Site Wastewater Disposal System Construction Permit as defined by AMC 15.65. F. Permit (Operating) An Advanced Wastewater Treatment System Operating Permit. An annual permit, issued by the Municipality, that allows the Owner to operate an AWWTS, upon meeting all the requirements of this agreement, the conditions of Operating Permit, the requirements of the On -Site Wastewater System Construction Permit and all relevant provisions of AMC 15.65 3. Fee. Owner shall pay to Municipality an annual fee of ($ © .00), payable on or before the issuance of the operating permit and annually thereafter. The annual fee is due on or before the anniversary date of the approval by the Municipality of installed system. 4. Term. The term of this Memorandum of Understanding shall be for the life of the AWWTS. The term begins on the date of approval by the Municipality of the installed system and shall continue while the AWWTS system is in use or operational or until the property is sold or title is transferred by owner and a new certificate of On -Site approval is issued to the new owner or transferee of the property. 5. Alterations. Installation and Removal of Additional Equipment. Owner agrees not to make any alterations, removal of parts or additions to the AWWTS without a Construction Permit from the Municipality. 6. Maintenance and Repairs. A. Throughout the term of this Memorandum of Understanding, the Owner shall maintain AWWTS in good repair. In addition, it shall be the responsibility of the Owner during the term of this Memorandum of Understanding, and any extensions or renewals thereof, at the owner's sole expense, to pay for any and all: (1) repair(s), (2) maintenance, (3) adjustment(s), (4) replacement costs, and (5) inspection costs. Further, Owner agrees to comply will all applicable ordinance, laws, regulations, rules and orders for the AWWTS. B. Owner agrees to provide the Municipality a written schedule of routine maintenance and repairs which have been performed on the system pursuant to the terms and conditions contained in the Owner's AWWTS Operating Permit. This schedule shall be submitted to the Municipality annually upon the renewal of the permit. The schedule of maintenance and repair contained in the Owner's AWWTS Operating Permit is: X FAR Ll.%.-, C. Owner acknowledges that the fine schedule for failing to maintain and repair an AWWTS are codified in AMC 14.60. D. Owner agrees that only maintenance, repair personnel certified by the , Municipality will inspect and make any necessary maintenance, repairs or permitted alterations to the system. E. Owner agrees to grant the Municipality reasonable access to test and inspect the AWWTS upon 24 hours written notice. F. Owner agrees that any sale or transfer of title of the property will not occur without a new Certificate of On -Site Systems Approval. G. Owner agrees that the relevant provisions of the standard specification guidebook for AWWTS is the governing professional guidelines for the construction, maintenance and repair of the Owner's AWWTS. 7. Nonwaiver. The failure of either party at any time to enforce a provision of this Memorandum of Understanding shall in no way constitute a waiver of the provisions, nor in any way effect the validity of the Memorandum of Understanding or any part hereof, or the right of such party thereafter to enforce each and every provision hereof. 8. Amendment. A. This Memorandum of Understanding shall only be amended, modified or changed by a writing, executed by authorized representatives of the parties, with the same formality of this Memorandum of Understanding was executed and such writing shall be attached to this Memorandum of Understanding as an amendment. B. For the purposes of any amendment modification or change to the terms and conditions of this contract, the only authorized representatives of the parties are: Owner: Anchorage: Purchasing Officer C. Any attempt to amend, modify, or change this contract by either an unauthorized representative or unauthorized means shall be void. 9. Jurisdiction: Choice of Law. Any civil action arising from this Memorandum of Understanding shall be brought in the Superior Court for the Third Judicial District of the State of Alaska at Anchorage. The laws of the State of Alaska shall govern the rights and obligations of the parties under this Memorandum of Understanding. 10. Severability. Any provisions of this Memorandum of Understanding decreed invalid by a court of competent jurisdiction shall not invalidate the remaining provisions of the Memorandum of Understanding. OWNER: / MUNICIPALITY: By: G . By: 4�_ — Title: Date: 6 O Date:y STATE k ALASKA ) ) ss. THIRD JUDICIAL DISTRICT ) r, The foregoing instrument wasac owledge efore nr this (& day of � 20Df,by Sae boor: f� '�i� LCaco of ,,, _ , on behalf of the Municipality of Anchorage. 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 Parcel I.D. # 01.546136 1. GENERAL INFORMATION Complete legal description HAA# IIOCIIC) k Lot 1; Daugherty Subdivision; Location (site address or directions) 12300 G.inanii Street Property owner Dan 9 Ba ttU DaAghty Day phone Mailing address Sa2en(, Oregon Lending agency Mailing add Day phone Agent Geargo P x inA PERKINS REA Ty Day phone SQ4-359 Address Eag& R.i,ve&, A2a4ka 99577 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: —4 3. TYPE OF WATER SUPPLY: Individual well XX Community well Public water 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: Individual on-site �Y Holding tank Community on-site — Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rey, 1/91) Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify +.hat 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. Name of Firm Phone Address 17034 Eagle River Loop Road No. 204 Eagle River, AlaSka Engineer's signature Date O lam' r7 Y Y M i+r T H P P (i ��?x.: •. PPP �4'rr QIll PROFESS 6. DHHS SIGNATURE Approved for bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments 0 Date - Z 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. 72-025 (Ray. 1/91) Back MOA k21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description b'6(U-P-VS t) 1 Parcel I.D. n124 A. WELL DATA Well type If A, B, or C, attach ADEC letter. //A --DEC water system number Log presen(Y N) Date completed w` Driller_'F�h/<��akIAA, 11 Total depth 1 � 01 Cased to r) —Casing height 12 + Sanitary seal &,N) ` Wires properly protected&N) l�/N) Date of test Static water level Well flow Pump level FROM WELL LOG g.p.m. u�l�jot�l�l . AT INSPECTION UNICIP�QI.Idp' OF ANCHORAGE l I ' ln�i'A1€IJli'At. SERVICES DIVISION NOV 1 2 1991 Z p.m. RECEIVED SEPARATION DISTANCES FROM WELL TO:�����b r 2QQr-I Septic/holding tank on lot I 0'�; ; On adjacent lots Absorption field on lot �� r ; On adjacent lots dG t Public sewer main Public sewer manhole/cleanout I Sewer service line 2 7 -I-- Petroleum tank t (21,� 16-9,1 QIA I til WATER SAMPLE RESULTS: B Coliform /CL Nitrate �. Z lMQ l P Other bacteria C Date of sample: Collected by: S l%L11; t aLg 17 t ( r B. SEPTIC/HOLDING TANK DATA Date installed `� Tank size I 1-r• LA 1 • Compartments Cleanouts (Y N) _1 Foundation cleanou (Y N)`/_ Depression (YO ,_ High water alarm (Y/N) ► Alarm tested'(Y/N) Date of pumping 1tp - to- Pumper �Aokii -j�t�� SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: r Well (a) on lot On adjacent lots %YD6 t •+ Foundation 0 !'I To property Line I b 1 } Absorption field r 4"' Water main/service line `� t Surface water/drainage 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed - Size in gallons Manufacturer -Manhole/Access (Y/N) Vent MN) "Pump on" level at High water alarm level Cycles Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots D. ABSORPTION FIELD DATA "Pump off" level at Surface water Date installed It-&- q I Soil rating 0- Li GJ �hst stem type �,iJ. �rSy Length t 3g " Width Gravel thickness r� Total depth Total absorption area Cleanouts present Y/_) Depression over field (Y& Int Date of adequacy test I IG � r� I Results (pass/fail) k S//yS � j for `� bedrooms Peroxide treatment (past 12 months) (Yo If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot t2�1 On adjacent lots SOO(4 Property line 10/ -I - To building foundation j ( 4' To existing or abandoned system on lot 1014 On adjacent lots 5J10 ( 4- Cutbank Water main/service line in (+ Surface water i on Driveway, parking/vehicle storage area loo / , Curtain drain NOMI Ili l0 . \ E. ENGINEER'S CERTIFICATION 1 certify that 1 have checked, verified, or conformed to all MOA and HAA guidelines in eff=qLcL%1!kb8&1gf this inspection. OF Acq S & S ENGINEERING Signature 17034 Eagle River Loop Road A[* X4 ®yti ' 49T—H Eagle River, Alaska 9957/ ® . ° .° ... ..... / ,r Engineer's Name. �� �"� � / 9•�� HOG J.8` 6�it �� �e°W d� Date �/'ROFESSIQNP�+�� HAA Fee $ % 10 Waiver Fee: $ Date of Payment // /-2 - 9 Date of Payment Receipt Number Receipt Number 92-M (Rev. 3/91) Back MOA 21 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 FAX: (907) 561-5301 Client Sample ID:L1 DAUGHERTY S/D PNSID :UA Collected NOV 1 91 # 15:15 hts. Received NOV 1 91 # 16:00 bra. Preserved with :kS REQUIRED ANALYSIS REPORT BY SAMPLE for i10REorder# 39894 Data Report Printed: NOV 6 91 # 09:33 Client Name :S & S ENGINEERING Client Acct :SNSENGP BPO # PO # NONE RECEIVED Req # Ordered By :R. SHAFER Analysis Completed :NOV 4 91 Send Reports to: Laboratory Super oorr/ SSS N C/' ED 1)S & S ENGINEERING Released By : / G� 2) .................................................................................................................................... Cheml.ab Ref #: 915901 Lab Smpl ID: 3 Matrix: NATER Parameter Tested NITRATE -N Sample ROUTINE SAMPLE COLLECTED BY: R.D.J. Remarks: Allowable Result Unite Method Limits --------------------------------------------------- 3.2 mg/l EPA 353.2 10 1 Teets Performed " See Special Instructions Above UA -Unavailable ND- None Detected See Sample Remarks Above NA- Not Analyzed LT -Lees Than, GT -Greater Than 16: SE38 Member of the SGS Group (Societe Generale de Surveillance) October 2, 1978 Ronald D./Eli.zasieth L. Daugherty Past Office Box 4-110 Anchorage, Alaska 59549 Subjects T12d R3W Section 24 Sh, SWC SA SE Before we may process your loan approval request, you will need to seal the well casing sea that it is air tight ane saUbnit a well lace to this department. If there are any questions, Please contact this office at 2614-4720. Sincerely*, Robert. C. Pratt, R.S. Associate Specialist RCP/ljw cc; Security National Bank 2525 C Street Suite 502 99503