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HomeMy WebLinkAboutEAGLES NEST BLK 2 LT 1C-1 (2)Onsite File Eav,o%lebam N,..s-t Municipality of Anchorage Page I of '7. 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: .~,)'~ "/O~,O"t PID Number: ~ ~ - ~ ~1 - N.~: ~O~f~ ~ Wastewater System: ~ New ~ Upgrade Address; ~, ~1, ~ ABSORPTION FIELD No. oi~drooms: ~ Deep Trench ~ Shallow Trench ~Bed ~Mound ~Other LEGAL DESCRIPTION SoilRating: O'~ GPD/Sq. Ft. Total Depth from~r~inal grade= Subdiv~ion: Depth to pipe boflom from original grade: Gravel depth beneat~ pipe Lo~: i C ~oc~: ~ ~, .< ~S~ 3' F~. ~ ,t. Township:~ ~ Range: ~ ~ Section: _ Fill added aboveoIoriginal~ ~. ~grade:l Ft. Gravel length: I I Number of lines: Distan~ ~t~o lin~: WELL: E~s~d~ New D Upgrade Gravelwidth: ~ '~ Ft. I ~ Ft. Pipe material: Classific~on (Private, A.B.O): Total .epth: ~o: Total absorptio~r~ ~ ~.~ Driller: ~ Drilled: Static Water Level: Installer: Date installed: I"Mm" s"' "': .,. Icasing Height A~v. GrOund:Ft. TANK SEPARATION DISTANCES ~ septic a Holding ~ S.T.E.P. To Septic Ab~rption Lift Holding =ublic/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer LIn~ ~~ ~ Number of Compa~ments: We~ iool+ iO0~~ ~ ~ ~1~ Material:~ su,.~. LIFT STATION Water IOe I~ iOOl~ ~ ~ ~ "Pump on" level at: ~ High water alarm at: Foundation I Cu~ain Drain BENCH MARK Remarks: CuT~o~ P;~cP~.<~ Location and Description: Elevation: .... I~pections pedormed by: i~ ~.gie ~;.r L.p ~o.~, No~s: 1st ; DepaAment of Heal. nd ~n Se~ices approval --, ~-' ...... <~' Reviewed and approved bY: Date:/2 -~-~ 72-013 (Rev, 9/91) MOA 25 PERMIT NO. SW970309 PAGE 2 OF 2 Municip. ali% oP Anchorac~e DEPARTMENT OF HEA~THAND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.D, Box 196650 eAnchorage, Alaska 99519-6650eTe[eohone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~CAm. LOT lC, BLOCK 2, EAGLE~NEST SUBDIVISION P.I.D. NO. 050--761--10 % WELL ALT. SITE #2 WITH USE OF A LIFT STATION GAZEBO / / / / ! · ALT. SITE #1 ST1 ST2 /99.9' ,/,,-'/FINAL NEW 1000 GAL ~ SEPTIC .0' TANK FCO -NEW 1000 GAL. SEPTIC TANK ~IEW TRENCH ~8t = ~3.~' 94.4"- · NO WATER FOUND 76.6 B.O,H SCALE 1" = 40' A B 5T1 13.0' 5.5' ST2 12.5' 11.5' DBL1 13.5' 14,5' DBL,2 14.0' 15.0' CO1 28.0' 36.0' MTi 30.0' 37.0' C02 75.0' 74.0' M?~ 74.5' 73.5' PAGE 1 OF MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUM3~N SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW970309 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:MARDEN JONATHAN D OWNER ADDRESS:8600 AUGUSTA CIRCLE ANCHORAGE, AK 99504 DATE ISSUED: 9/22/97 EXPIRATION DATE: 9/22/98 PARCEL ID:05076110 LEGAL DESCRIPTION: EAGLES NEST BLK 2 LT lC LOT SIZE: 217350 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM 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 (18A_AC72) A_ND DRINKING WATER REGULATIONS (iSAACS0). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ROBERT C. COWAN, RE. ROBERT A. SHAFER, RE. CIVIL ENGINEERS HEALTH AUTHORITY APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ONSITE W~STEWATER DISPOSAL SYSTEM DESIGN July 21, 1997 (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot lC, Block 2, Eagle Nest Subdivision Request you issue a permit to install a septic system to serve the existing one bedroom house on the referenced property( T~ e~,~,~ ~ s~,~ ). A test hole was excavated and a percolation test performed. Thc approximate location of the test hole is located on the attached site plan. The monitoring robe within the test hole has been checked and found to be dry. This property has enough area for a future septic upgrade which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage pattems by the installation of the proposed septic system. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. ~'"'~" ~ .... :, ,,, RCC/mg JUL Enclosure E.CE! V_ED 17034 NORTH EAGLE RIVER LOOP ° SUITE 204 ° EAGLE RIVER, ALASKA 99577 0.,~ 0~-- (,0w NO WELLS/SEPTICS WITHIN 100'+ Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' StreeL Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: ~'0N/v~ ~-/-/d,~ LEGAL DESCRIPTION:j''0T lC ~J.~ ~- ~.4~L,t J~/~.-~;T DATE PERF Township, Range, Section: 1 2 3 4 5 6 7 8 9- 10 11 12 13 14 15- 16 17 18 19 20 Tf-$T- N~c£ ~ J COMMENTS WAS GROUND WATER ENCOUNTERED? SLOPE IF YES, AT WHAT -- O DEPTH? P E SITE PLAN A Depth to Water After Monitoring? Gross Net Depth to Net Reading Date Time Time Water Drop - - ~ :o l /~ ~ '/~" I )O PERCOLATION RATE -- TEST RUN BETWEEN ~'~ LR4Ay ~, ~, 6--~ T' (minutes/inch) PERC HOLE DIAMETER __ __ FT AND ~ t/'2'' FT S & $ ENGINEERING CERTIFY THAT THiS TEST WAS PERFORMED IN PERFORMED BY: ...... I ACCORDANCE WI~-I~a~BIII~,~/~I~I~I~AL GUIDELINES IN EFFECT ON THiS DATE. DATE: 72-008 (Rev, 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: ~" ~/~,~L~ LEGAL DESCRIPTION: ~T DATE PERFORMED 2- f.~4~,~. ~v~YTownship, Range, Section: 1 2 3 4 5 6 7 8 9 SLOPE SITE PLAN 10 11- 12- 13- 14- 15 16 17 18 19 20- WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT O DEPTH? P E Depth · Water Alter ~/~.~./q ~ Monitoring? J)Ay Date: Gross Net Depth to Net Reading Date Time Time Water Drop ~l/~/,~,/ ~: .~o ~ $ '/,z" - .;f ' ,,cO ~ 0 ~,~ ~" / ~" ?: ~ ,~ ~ Ye" I '~+ ,, ~: ~ ~ 4 ,/~,' ~,, PERCOLATION RATE TEST RUN BETWEEN ~. O (m~nutes/inch) PERC HOLE DIAMETER 5 FT AND "~' ~ FT COMMENTS PERFORMED BY: ~,~.~ ~alt~ ~,~-¢~r ~p ~ mO. ~ I - - - CERTIFY THAT~ / THISiTEST WAS PERFORMED IN ACCORDANCE W~8~6~~AL GUIDELINES 'N EFFECT ON THIS DATE DATE: r ' 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 4- 7 8 14- 17- 18- 19- 20- COMMENTS Township, Range, Section: WAS GROUND WATER ENCOUNTERED? SLOPE SITE PLAN S IF YES, AT WHAT / OL DEPTH? p E Depth to Water After Monitoring? J)J~ ¥ Date: ~/)&/q ~ Gross Net Depth to Net Reading Date Time Time Water Drop i ~ .~-,'11 14): 3o 5 ', ~ PERCOLATION RATE ,~,,~O (minutes/inch) PERC HOLE DIAMETER ~=~ ~'i TEST RUN BETWEEN ~' FT AND ~ FT $ ~GINEEEING PERFORMED BY: _ _ . llb Eagle River L~ Road No. ~ ACCORDANCE WI~~~L GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Co. SULLIVAN WATER WELLS P.O. 6OX 6?0272, CHUQIAK, ALASKA 99567 · TELEPHONE 688.2759 LEGAL DESCRIPTION (~'~ i ~ /.~._..~6t;~' hJgS~DRA~, DOWN FT. DATE-Started Ended __L~d~ GALS, PER HR ___ C~_O PERMIT NUMBER KIND OF cASInG KIND OF FORMATION: From 0 Fi. lo- ~ Ff. ~ ff~.~'~6 From/°O~ Ft. to_e/bb Ft. From Ft. lo Ft From ,Ft. to,..__...~__Ft, From _FI. to Fl. From FI. lO ,FI From From From~ From From STl¢ O Vrom VI. ,o el From Fr. to__.Ft __ From FI. lO Fl. From__FI. to__FL From, Ft Io, FI From~Ft to _~FI.. From__FI. lo FI From .Ft. so From .Ff. lO Ft. From~Ft. to ,Fl. FI. tO Ft. .-FI. to Ft, h. to Ft FLtO . Fl Ft. Ft. to~FI. Fl. to~, Fi MISCL. INFORMATION: ZO *d 831UM HU^IqlF)$ NU ~l; 8m8 I~-m ~-6--g~--'lflf Parcel I.D. # 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 050--~Cl RECEIVED 1. GENERAL INFORMATION Complete legal description Lot lC: Block 2; Eaqle Nest Subdivision Location (site address or directions) 19513 Upper Skyline Drive Eaqle River, AK Property owner Monte Gates M~'ili6g address ''i9513 Upper Skyline Drive :""l~ending agency ~ Day phone .694-4406 Eaqle River, AK 99577 Day phone Mailing address Agent Day phone Address o Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual well xxx Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: XXX 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 5. STATEMENT OF INSPECTION BY ENGINEER As certified by m.y 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. Name of Firm Address Engineer's signature S & S ENGINEERING 17-34 E-~=!e g_;,,,r [,~p Road Ne.~.04 Eagle River, Alaska 99577 // Phone '~ ci ~ - ;)''¢/'7 ~ Date ~'/1 5/~J ~ 6. DH~S SIGNATURE Approved for ~~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments By: 7,-~-''''- C' ~(~t~ Date '~' ID"/'d/~ 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 (Rev. 1/91) Back MOA ~21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICERS' 825L Street, Roo~nvirOnmental Services Division 502 · Anchorage, Alaska 99501 Legal Description: A. WELL DATA Well type Health Authority Approval Checklist {~.o¢~ '2.~ E.~,G~,~ ~JC--~'r' Parcel I.D.: Log present J~N) Total depth Sanitary seal (Y/N) Date of test Static water level If A, B, or C, attach ADEC letter. ADEC water system number Date completed t o/'1 ~' Cased to ~_~ i ,~ a Casing height (above ground) Wires properly protected (~N) Well production FROM WELL LOG AT INSPECTION' WATER SAMPLE RESULTS: Coliform O Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed ~ - 3.~ -,~t'l Tank size Foundation cleanout (~N) Date of Pumping Nitrate J ' '~' Other bacteria Collected by: S & S ENGINEERING 17034 Eagle River Loop Read, No. 204 Eagle River, Alaska 99577 J0oo Depression (Y,~) Pumper Number of Compartments ~ O High water alarm (Y~) C. ABSORPTION FIELD DATA Date installed Length /o_~' Width ~...~1. Effective absorption area "7-~(~ ~ Date of adequacy test f, Je u,3 oj. ;;[~t - ~"1 Soil rating (Ocr fF/bdrm) 0. & System type Gravel thickness below pipe (e Total depth Monitoring Tube present (~/N) ¥'e£ Depression over field (Y/~ ~J o Results (Pass/Fail) For '~ bedrooms Fluid depth in absorption field before test (in.); ~ Immediately after ~ gal. water added (in.): Fluid depth -"" (ins) Minutes later: ' Absorption rate = .g.p.d. Peroxide treatment (past 12 months) (Y/N) If yes, give date 72-026 (Rev. 3/96)* LIFT STATION Date installed Manhole/Access (Y/N) High water a. larm level at* Size in gallons ~ "Pump on" level at* ~" level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Ioo Absorption field on lot Public sewer main l-J//~, Sewer/septic service line · ~ ~ I-I' ! On adjacent lots Ioo ~' I On adjacent lots ! oo Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation $~..~ Property line lo I-F Absorption field Water main/service line Io~1- Surface water/drainage Joel{- Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line I o~-I' Building foundation I Zo~'~ Water main/service line t Surface water /O o i .y Driveway, parking/vehicle storage area 1 ..~ Curtain drain tJo~l c. J/-N o~ Wells on adjacent lots Io'o I .{,. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections andreview of Municipal re~ ~j~.~.~j;~ystems ~,,,,,~..~ · .... ..~.~. in conformance with MOA ~ guideJines in effect on this date. ~ ~ ~ '..~ Signature ,~~ ~~., ~ ~~ . .~ .... ~ Engineer's Name ~6~ ~,~, ~-~ ~ ~ ~ ,c~E~ ~ ~o~ .~~ HAA Fee $ ~/'~ ' Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number are 72-026 (Rev. 3/96)* MUNICIPALITY OF ANCHORAGE MEMORANDUM WATER WELL ADVISORY HEALTH AUTHORITY APPROVAL NO. During a recent Health Authority Approval on-site inspection and test of tt~e potable water supply well on Lot Block ~ of ~.O~!~ ~Y Subdivision, the well's productivity was determined to be 0,~ gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a ~ bedroom residence is 0,SIZ gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concerned are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval.