HomeMy WebLinkAboutWOODBOURNE BLK 2 LT 5 & 6Onsite File
Block 2
Lots 5&6
PID# 015-351-36
Formerly 015-351-25 and 015-351-26
Municipality of Anchorage Page of
Municipality
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: PID Number: 01s"3s12Cv -
Name:
Wastewater System: 0 New 0 Upgrade
C091UERS7010F Z>U11-Q9_P_5 1/_0 c— -
Address:
ABSORPTION FIELD
IT510 S CP-EsT L-,,4AJG
P44ope:
Aluc-HolaAc'—, lqi" 995 . 'I
No. of Bedrooms:
I , Deep Trench JK Shallow Trench 13 Bed 0 Mound 0 Other
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade:
6'-6 GPD/Sq. Ft.
61
Lot: Block: Subdivision:
Depth to pipe bottom from original grade:
Gravel depth beneath pipe
b z WZ.DECVP_1jE- SUS.
Z,-' Ft.
3-rFt.
Township:
Range:
Section:
Fill added above original grade:
Gravel length:
Ft.
90 Ft.
WELL: 21 New El Upgrade
Gravel width:
Number of lines:
I Distance between lines:
Ft.
15' Ft.
Classification (Private, A,B,C):
Total Depth:
Cased To:
Total absorption area:
lInstaller:
Pipe material: FP10
PR_1 V,47 -f
137 Ft.
i Z2- Ft.
SO. Ft.
As-Im 1736311 ;1
Driller:
Date Drilled:
Static Water Level:
Date installed:
ENT.
79 Ft.
4iCgA�
Yield:
Z/
Pump Set at:
I
I
Casing Height Above Ground:
TANK
GPM
/.?, —, Ft.
Z Ft.
SEPARATION DISTANCES
,(Septic 0 Holding 0 S.T.E.P.
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer:
Capacity in gallons:
From
Tank
Field
Station
Tank
Sewer Lines
AA)CHO;2.AGE
/060
well,
137
/,577
2_G 1+
Material:
Number of Compartments:
2-
Surfac
Watere
I 106
/00
LIFT STATION
LotSize
in gallons:
Manufacturer:
I
Line
Foundation
"Pump on" level at:off"
level at:
High water alarm at:
CurtainPump
Nam
KMO
Ma a[
Electrical Inspections performed by:
I
Drain
Remarks: 1A)Sv1_147-jo1j ovE-A
BENCH MARK
Location and Description:
TE, -n - LOP CE
Assumed Elevation:
/00-00 Ft
SEAL
S & S ENGINEERING
17034 Eagle River Loop Road, No. 204
Inspections performed by: Wigle River, Alaska 99577 Dates: 1st 6 7& -
2nd 6 -16, - qqPC-ERT
C. COWAN
Department of Health nd Hum Services apprqvalt
Reviewed and approved by: Date:
72-013 (Rev. 9/91) MOA 25
Permit No.SW940086 Page 2 of 2
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 Descriptio WOODBOURNE SUBD.;BLOCK 2, LOT 6 01535126
PID No.:
95.0
NEW
.................. - ..................... 91.'41' '12*50 CAL
S.T.
FINAL :GRADE
C
--INSULATION
.......... ............. .............
�01 0.
80.2'
(CO3&
83.7'
(C04&
MT 1) 81.7
(C06,
MT2)
78.2'
(C05&
............. ................ ............ ........... ................................ . . ................
76.7'
(MT1 ) 74.7'
(MT2:
A 68::7' NO WATER F(
100' WELL I
NEW 1250 GAL.
SEPTIC TANK
.....................
SCALE I" = 40'
72-013 A (1/93)'
TRENCHES::
COI .75.5 54.0
CO2 .82.0 - 62-.0
CO3 119.0 106.
C04 151.0 133.
C05 121.0 113,
C06 158.0 143.
MT1 144,5 128.
MT2,147.0,133.
13
.... ....... ..... .....
RCZERT C. COWAN
CP- 88101
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW940086
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:CORNERSTONE BUILDERS INC
OWNER ADDRESS:17510 SNOW CREST LANE
ANCHORAGE, AK 99516
PARCEL ID:01535126
LEGAL DESCRIPTION: WOODBOURNE BLK 2 LT 6
LOT SIZE: 107100 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
PAGE 1 OF 1
Cc - I tL)
DATE ISSUED: 4/21/94
EXPIRATION DATE: 4/21/95
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS
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:
RECEIVED B
ISSUED BY:
Y: DATE: ZZ
' l
DATE: „� c
HEALTH AUTHORITY
APPROVALS
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
CIVIL ENGINEERS
(907)694-2979
FAX 694-1211
STRUCTURAL&
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 'L' Street
SEWER & WATER
P.O. BOX 196650
MAIN EXTENSIONS
Anchorage, Alaska 99519-6650
SEWER & WATER
REFERENCE: WOODBOURNE SUBDIVISION: Lot 6; Block 2
INSPECTION
Request you issue a permit to drill a well and install a septic system
ENGINEERING STUDIES
AND REPORTS
to serve the proposed three bedroom house on the referenced property.
Two test holes were excavated and percolation tests were performed.
The approximate location of the test holes are shown on the attached
WELL INSPECTION
site plan. The test holes were checked for ground water on 3/11/94 and
& FLOW TEST
were 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
SITE PLANS
effects on neighboring properties by the installation of the proposed
septic system.
If you have any questions, or require additional information for your
ROAD DESIGN
review, please contact us.
y,
SOIL TEST
4in
t A. Shafer, P.E.
PERCOLATIONTEST
SU/ jk
STRUCTURAL&
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
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Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERC LATION TEST
PERFORMED FOR:PPJ ST Gt7� S d1��114 4DATE
ll��// S
LEGAL DESCRIPTION: M)90 ,W E%{�, WownshiP Range, Section:
SLOPE
101 WAS GROUND WATER �V
ENCOUNTERED? V
S
11 L
IF YES, AT WHAT O
DEPTH?
12
13.U,N, E
Depth to Water Aft C
13 Monitoring? Date:
14
15
16
17
18
19
20 1.
PERCOLATION RATE (minutes/inch) PERC HOLE DIAMETER
_ TEST RUN BETWEEN �dS FT D FT
Cow r;_.RSTaesc.
€S-czt i sale Eimer Loop Road No. 204�
SITE PLAN
Reading Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
3 Iv'�1
to
`10
COMMENTS
Alaska
PERFORMED BY:
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUI
72-008 (Rev. 4/85)
CERTIFY THAT THIS TEST WAS PERFORMED IN
ON THIS DATE. DATE:
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG — PERC LATION TEST
e
PERFORMED FOR:CME,--,Tbr,�E- tum_ ACKK ^ U DATE PERFOR
S Townshi e, Section:
LEGAL DESCRIPTION: �� O(.lt'115�' 1a� L.QI' ® i f�2� P. Range,
DEPTH
(-FEET) of 6,gf,4hC�5
2 C»'Vl – S(4 -T y Spy 614Vb L
3
t S/ Ty S /4'Q'D
I.
. � LFrtSFs
5 � ,
t
7
i
8 Mt))S7
9 l `
10
11
13-
14-
15-
16-
17
314151617
81920 18-
19-
20
COMMENTS
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Depth to Water Afterh
Monitoring? —
SLOPE
S
L
O
P
E
Date:
SITE PLAN
.y r.
PERCOLATION RATE A%f (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN _,�AND 9L FT n
PERFORMED BY: 17034 Eagle River Lmp Road No. 2
04
CERTIFY THAT THIS TEST WAS PERFORMED IN
E�,gie River, Alaska a
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELI S FF CT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
Depth
...
.y r.
PERCOLATION RATE A%f (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN _,�AND 9L FT n
PERFORMED BY: 17034 Eagle River Lmp Road No. 2
04
CERTIFY THAT THIS TEST WAS PERFORMED IN
E�,gie River, Alaska a
ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELI S FF CT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
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. # U t S - 3 5- 1 - 3 (- HAA # , ii`\i t t 1•�
1. GENERAL INFORMATION
Complete legal description Lot 6; Stock 2; Woodbou,Lne Subdiviaion
Location (site address or directions) 11951 Woodbourne. C.irceee.
Anchokage, AK
Property owner Dania 9 Linda Tnue.6de22 Dav nhnna 344-2008 W Linda
Mailing address 11951 Woodboutme Ci4cte Ancho,%acge AK 99516
Lending agency
Day phone
Mailing address
Agent Ctyde. Mo6e.4/A.2a6ka A66ociate.d Reatty Day phone 344-2008
Address 725 Chl.i6ten6on Anchorage, AK 99501
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3 \'
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.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site XXX
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 (Rev. 1/91) From MOA #21
4,00-L
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. # -S 3 S I a �' HAA # SEP 53&
1. GENERAL INFORMATION
Complete legal description Lot 6; Btock `2; Woodboui.ne 'Subd-i.vizion
0
Location (site address or directions) 11951 Woodbourne C.in..i'e
Anchorage, AK
Property owner CORNERSTONE BUILDERS Day phone 345-6338
Mailing address 17510 Snowcae6t Lane Anchorage, AK 99516
Lending agency
Mailing address
Agent
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3
3. TYPE OF WATER SUPPLY:
Individual well XXX
Community well
Public water
Day phone
Day phone
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
NOTE:
Individual on-site
Holding tank
Community on-site
Public'sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72-M (Rev.1/91) Front MOA #21
Municipality OfAnchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: Parcel|.D.
A. Well Data
Well type�/�B.orC.atbsohAOE��tbs�AD��wote�ayntannnunnbar
�
y
Log present ^�/N) Date completed Oh|ier
Toba|dapth –Cased to Casing height
Sanitary seal 6N YEs Wires properly protected ON) YES
FROM WELL LOG AT INSPECTION 41
Date of test (~
Static water level 75
Well flow 9 -p.m. M.
119
Pump�ve1 �� �� `v
SEPARATION DISTANCES FROM WELL TO:
`
Septic/holding tank on lot ' .hJ«djocent|otn
AbaorpUonfield on lot On adjacent lots
Public sewer main Public sewer manh e/o
Sewer service line Petroleum tank &)A
WATER SAMPLE RESULTS:
Coliform Nitrate bacteria
Date of sample: I C) Collected by: S�s ENC111\j&EikiN6--
B. SEPTIC/HOLDING TANK DATA
Date installed - (. 116 [7 L-1 Tank size I 1� r-.10 Compartments 1),
Cleanouts; (DN) Foundation cleanout &N) YjF�-, —Depression (YON N6
High water alarm (Y/N) Alarm tested (Y/N) �Q/4
IA–
SEPARATION DISTANCES FROM GETANK TO: '~
Well(s)lot ' Onadjacent lots Foundation 4'
'
Top,opadyUnm f�� rnain/man�ceUne
`-L
Surface
72-026 Front CONTINUED QNBACK PAGE
10i07i94 16:11 ME ENJIRDNMENTRL LRB SERVICES -� 9076941211 N11 BOB D02
Commercial Testing & Engineering Co.
Environmental laboratory Services err srt�;va�r�.�toiis®r��swr►,rrs'�®.o�s�e►�ars.�r.+a>•onai
swce �Od
LABORATORY ANALYSIS REPORT
CT&L Ref #
94,5075-1
ClientS:unplelD
TABLK2WOODBOUR R
Matrix
WATER
C1ietltNamc
S & S ENCiTNEERIN(.)
Ord=d By
R. SHAFER
PLo1 ect Nanrc
@,,11:15 hrs,
Project#
lyw8lf)
UA
Sample Remarks: ROITrTNE SA.MPLF COLLLC FET> RY: J, W.
WORK Order
82698
Printed Date.
10/07/94
(rii 14:32 hm
CollaotcdDOe
10/04/94
(i�10,45 hm
Receiv cd Date
10/04/94
@,,11:15 hrs,
Technirol Director STEPHEN C. J.' WV
Releauud 13l -M-
QC Allowable Ex(. Anal
Parameter Resulw Qual Units Method Limilo Da.tc Date lr>it
---------------
--------------�-------T-2-1----------�-----------------------�----------------_-_--
Nitrate -N ? mglL EEPA PA 353.2/300.0 l0 I t)IU4/94 MCL -
x See Special lnstnx.tions Above UA= TJnava€fable
'* SeeSw-apleKemarksAbove NA=NDIUalyud
t) = tJno tected, RepMed valor is 0e pmli cal quantiliaatin n I imit. Uftt- Less 'l1wi
D=S«wndary di€otion. GT=OreaterDw
5633 6 Street, Anchorage, AK 99551 a-1600 — Tel. (907) 562-2343 Fax: (907) 661-5301
.
_ —..... —._ ... ......._....___.. �...
ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURCES
DIVISION OF WATER
WATER WELL RECORD
LOCATION OF WELL
BOROUGH
SUBDIVISION
I r (11 ,
LOTBLOCK
. I
SECTION GTRS
j,
SECTION
TOWNSHIP
❑ N
RANGE
❑ E
MERIDIAN
a
p
❑s
❑w
LOCATION/SKETCH:
WELL OWNER:
' f1
DEPTHS MEASURED FROM:[A.casing top ❑ground surface
WELL DEPTH: DATE OF COMPLETION
Depth of hole: J 1 _ft
Depth of casing:, ft � l � J l Q1_1
BOREHOLE DATA: Depth
Material Type and Color From I'D
ZX�WAT
DEPTH TO STATIC R LEVEL:
—ft below top of casing ❑ ground surface
01
5
Date:
S
q j
METHOD OF DRILLING: N air rotary ❑ cable tool
❑ other
USE OF WELL: L f domestic ❑ irrigation ❑ monitor
❑ public supply ❑ other
CASING STICK- .. f
UPt. Diam:_,0 :n. to / eft
Casing type: in. to /Z4t_
WELL INTAKE OPENING TYPE: ❑ open end ❑ screened
❑ perforated ",0 open hole
00
f
Depths of openings: to ft
j
SCREEN TYPE: Diam: in.
Slot/Mesh Size: Length: ft
GRAVEL PACK TYPE:
--
Voiurne used: Depth to to;,:
GROUT TYPE: Volume:
Depth: from ft to ft
DEVELOPMENT METHOD:
Duration:
1 1996
Mu►ticr a ,
f-oralJrn Mealth & Human Se
PUMPING LEVEL AND YIELD:
JIS ft after �. hrs pumping ___..,/-9Pm
ices
PUMP INTAKE DEPTH: It Horsepower:
WELL DISINFECTED UPON COMPLETION?'\[] YES ❑ NO
CONTRACTOR INFORMA, ION: REMARKS:
1?
Registere Business Name
Signature of Authorized Respreseyftative Date
PLEASE MAIL WHITE COPY OF LOGJO:
DNR/DIVISION OF WATER
PO BOX 772116
EAGLE RIVER AK 99577-2116