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HomeMy WebLinkAboutSAND LAKE #2 BLK 2 LT 5e " � it-► 33- IAJ4 72-013 (Rev. 3/78) _'�p MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264.4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME �cfz. /Y�G77 PHONE •-/// } KNEW ❑ UPGRADE V! S / S Url�.3 MAILING ADDRESS 9rs� ,r � '�' C! r�P y LEGAL DESCRIPTION LJ LOCATION NO. OF BEDROOMS Well /e 01 Absorption area Dwelling PERMIT NO. Uy DISTANCE TO: ,✓n t 5-/ Q V F Z M< Manufacturer Material No. of compartments Y`-Pe S PSP Liq. capacity in Sallons Inside length Width Liquid depth /'9 o L--> IF HOMEMADE: DISTANCE TO: Well Dwelling PERMIT NO. J0z Z Q 2—F Manufacturer Material Liquid capacity in gallons O Well Foundation Nearest lot line PERMIT NO. w= DISTANCE TO: J U.2 No. of lines Length ofe ch line *�j Total length of lines Trench widt Distance between lines Z w inches FTop of til' to finish grade Material beneath tile Total effective absorption area / Z_inches /j Length Width Depth PERMIT NO. w 0 Q H Type of crib Crib diameter Crib depth Total effective absorption area as LU y Well Building foundation Nearest lot line DISTANCE TO: Class Depth Driller Distance to lot line PERMIT NO. -a LU 3:DISTANCE T0: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALSSJ // /x(257 SOI L TEST RATING/ S�D INSTALLER REMARKS �r e V 2 Lt Nt- /t r - 1 4.4 APPROVED DATE LEGAL o _3 --/ / S /J 2- S� o/ L/ ># z t1v 72-013 (Rev. 3/78) _'�p ��LJ P -A I ��I "'C-1 L_ I _r 0-? CH F�" F=l rA C- Ff'�����F---' . DEPARTMENT L HEALTH AND ENVIRONMENTAL ' �OTECTION ' ' 825 'L' STREET/ ANCHORAGE, HK� 99501 264~4720 ���L.- F� PA C- CH IrA 1 --r- E-- ��I .-I ���ir.1 1 7 - PERMIT NO. ( 810760 ) HPPLICHNT HULTQUIST CONSTRUCTION 7324 THNHGH CIRCLE 119 LOCHTION SEHYIEW LEGAL. L 5 B 2 SAND LAKE #2 LOT' SIZE 6750 'QUARE FEET TYPE OF .--.,OIL ABSORPTION SYSTEM IS: TRENCH MA MUM NUMBER OF BEDROOMS = ] SOIL RATING (SQ FT/BR)= 150 THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS� ����H-A= ������� �� ����FEEL_ ����FA� � THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRHINFIELD. THE DEPTH OF A TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFACE OF THE GROUND AND THE BOTTOM OF THE EXCAVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFALL PIPE FRID THE BOTTOM OF' THE EXCAVATION (IN FEET). I C: ���� �1 Ez ��ff -7-1 ���I . CR�� PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE INSTHLLHTION INSPECTIONS OF ANY WELLS HDJHCENT TO THIS PROPERTY AND THE NUMBER OF RESIDENCES THAT THE WELL WILL SERVE. ��F.?.� ����I F...'. [== _— -- BHCKFILLING OF ANY SYSTEM WITHOUT FINAL. INSPECTION AND HPPR0VHL BY THIS DEPARTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM I':: - 11210 S100 FEET FOR H PRIYHTE WELL OR 150 TO 200 FEET FROM H PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL MINIMUM DISTANCE FROM H PRIVATE WELL TO H PRIVATE SEWER LINE IS 25 FEET AND TO H COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ]0 DAYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE AVAILABLE TO INSURE PROPER INSTALLATION. 1 7- F�,E_E'f�; E> EEC--- EZ Irel EE." I—:- F..-' I CERTIFY THAT 1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET FORTH BY THE MUNICIPALITY OF ANCHORAGE. 2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES. ]� I UNDERSTAND THHT THE ON-SITE SEWER SYSTEM MHY REQUIRE ENLARGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS. SIGNED HULTQUIST CONSTRUCTION ISSUED BY~�~���~��~~~_����~~���--_~�~��DHTE ^1------__~~ V4. 0 &71 ��+~°~0~~~~^"t .MUNICIPALITY OF ANCHORAGE,-, Department Health and Environmenta_ ?rotection 825 L Street, Anchorage, AK. 99501 264-4720 # # # HANDWRITTEN PERMIT # # # WELL AND�t ON-SITE SEWER PERMIT Applicant: Mailing Address: Location: '40_� 0'/_ Phone Number: Legal Description: L -'?, 1'� Z n2�5(a Lot Size: Type of Soil Absorption System Is: Trench: (/ Drainfield: _ Seepage Bed: Holding Tank: Maximum Number of Bedrooms: Soil Rating(sq.ft/br) /S The Required Size of the Soil Absorption System Is: DEPTH L LENGTH 3'� GRAVEL DEPTH ( WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE = GALLONS # # Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. * # * TWO(2) INSPECTIONS ARE REQUIRED # # Backfilling 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 disposal system is 100 feet for a private well or 150 to 200 feet from a public well depending upon the type of public well. Minimum distance from a private well to a private sewer line is 25 feet and to a community sewer line is 75 feet. Well logs are required and must be returned to this department within 30 days of the well completion. Other requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 u 1 # # # I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3 bed o ms. Signed: /'/'/ugyp' Issued by: Appl cant Date: SWP/024(1/81) ❑ SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264.4720 SOILS LOG - PERCOLATION TEST PERFORMED FOR: N\/V�! N -1V N,Q t iSfi DATE PERFORMED: -7 IS" 1 v �k z 54%N o�-r%XF- S v 13 LEGAL DESCRIPTION: a� V} S t o 4 M�.O IGF -1 FT 117 SLOPE I SITE PLAN 1 I11= :efr{ �TOe 2 �L7 5 . 6 7 8 9 •. i5kwo Csw> %SOSr/ So Sr/ t% WAS GROUND WATER t S ENCOUNTERED? O P IF YES, AT WHAT E DEPTH? 17 �yc" i 0 +n Apt t31r+ 7 S� 18 'rkq' �o,e •, v+mea+ai. w• .. 19 .. .�� 's Ralph B. Rkel 4, c� 20 yn •. NO. 1995 a} F \� v Vq S`�1Ja.,a or v+oakk 4k. ROF[SS�u COMMENTS Reading Date Gross Time Net Time Depth to Water Net Drop 0 11:46 30 30 1l ST 40 10 it �2iOS L-) Su to 91I 3II IZ�lS �oC� !o ii�,t Z. PERCOLATION RATE 4.4 (minutes/inch) TEST RUN BETWEEN CID FT AND =_ FT PERFORMED BY: COI.,TQgC't1fj& VNG1(.eF—ISS CERTIFIEDBY: ZPLP}1 Z04ChLJNc -DATE: ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION PUBLIC WATER SYSTEM APPROVAL TO CONSTRUCT Plans for the construction of� J 0I'D L'lJe— L' ', 1A r' f ) 1 V i ojj L to c Lot( I 7-h pr (� �j 0/-,, —Z � �� public water system located in _` t I r- ti 6A R y`7LI kr1 , Alaska, submitted in accordance with 18 AAC 80.100 by r) /f)� } (1 1(� L( l.- S / have been reviewed and are approved. ❑ conditionally approved (see attached conditions). f`/ ) /" 1^ .�2,<.,/✓_��G'e�� .�,y1 (.J IY'C)ri SV TITLE DATE If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review -land approval before construction. APPROVED CHANGE ORDERS Change (contract order no. Approved by Date or descriptive reference) The "APPROVAL TO OPERATE" section must be completed before any water is made available to the public. APPROVAL TO OPERATE The construction of the public water system was completed on (date). The system is hereby granted interim approval to operate for 90 days following the completion date. TITLE DATE As -built plans submitted during the interim approval period, or an inspection by the Department has confirmed the system was constructed according to the approved plans. The system is hereby granted final approval to operate. TITLE DATE i ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION PUBLIC WATER SYSTEM APPROVAL TO CONSTRUCT Plans for the construction of� J 0I'D L'lJe— L' ', 1A r' f ) 1 V i ojj L to c Lot( I 7-h pr (� �j 0/-,, —Z � �� public water system located in _` t I r- ti 6A R y`7LI kr1 , Alaska, submitted in accordance with 18 AAC 80.100 by r) /f)� } (1 1(� L( l.- S / have been reviewed and are approved. ❑ conditionally approved (see attached conditions). f`/ ) /" 1^ .�2,<.,/✓_��G'e�� .�,y1 (.J IY'C)ri SV TITLE DATE If construction has not started within two years of the approval date, this certificate is void and new plans and specifications must be submitted for review -land approval before construction. APPROVED CHANGE ORDERS Change (contract order no. Approved by Date or descriptive reference) The "APPROVAL TO OPERATE" section must be completed before any water is made available to the public. APPROVAL TO OPERATE The construction of the public water system was completed on (date). The system is hereby granted interim approval to operate for 90 days following the completion date. TITLE DATE As -built plans submitted during the interim approval period, or an inspection by the Department has confirmed the system was constructed according to the approved plans. The system is hereby granted final approval to operate. TITLE DATE Wafer Source Engineering Report Water System for Lots 1 thru 6 Block 2 Sand Lake Subd., (all lots single family dwellings) wA G OF J ,F:?f Ralph B. Jokcla, NO. 1995-E ✓ Well #1 located on lot 6 to serve lot 5 and lot 6. {•Jell is 6" steel casing 408 lcet deep with a static water level of 112 feet. 'fest pumped at 20 GPM. Well #2 is located on. lot 3 and is proposed to serve lot 1,2,3, & 4. Well is 6" steel casing 410 feet deep with a static water level of: 118 feet. Test pumped at 30 GPM. Wells shall be installed with a pitless adapter at a minimum depth of 10 feet. An approved water tight sanitary seal shall be installed on the well. The top of the well casing shall extend a minimum of 12" above ground with drainage sloped away from the well for a minimum of 10'. Due to the depth of the well and soils conditions, the well casing should not require grouting. Also due to the conditions noted above, it is proposed that the protective radius for this well be reduced from 150' to 100' required to on-site sewer systems. Water Distribution Proposed distribution system shall comply with AWWA standards. Pipe shall be type K copper with sizes as indicated on attached sketch. Pipe shall be buried a minimum of 10 feet. All underground splices shall be flare fittings. #2 a depth of 300' to the pump and an assumed drawdown of 200 feet total. loss is as follows: he= 200' hf=425 L.F. of 1" pipe= 103' 20 psi minimum discharge pressure== &61 Total head loss= 349' Peak demand for 4 dwelling units is 1260 CPH. Use 3 H.P. pump (Pioneer submersible Model A-35 or equivalent) Water Storaee Water storage shall be accomplished with a diaphram type storage tank (42 gallon capacity) in each dwelling unit. Tanks shall be precharged to 20 psi and will preclude the necessity of air volume control. Shut—off valves will be located in each dwelling unit served. 0 0o 0 17 H0 a W Q i Ei N E4 A F E4 Ei H H JJ H m 8 r.: rl > w rn: N rd . w w (dd N! J x COi J .,4: � • i ! a,! ai N: LU roi .x+ Oi J V o" N i G: ro! M! >: rdi tn: U : �i 41 ! Hi y/ v; Gi "7 0o 0 17 H0 a W Q i PON Ei N E4 A F E4 Ei H H JJ H t'a N 8 w f+ rl > w rn: N rd . w w (dd N! q x COi .,4: � • i ! a,! ai N: ..�:.,4: U! roi . 00i OTi Oi ra V > N i G: ro! M! >: rdi tn: U : �i 41 ! Hi v; Gi gin: a! u E N! ro! ro: Cor a .7i .Ci Gj .O! O! 14; Mi O Ni U! X; t`i b-tn w� O! PON E w F Ei Ei N E4 A F E4 Ei H H JJ H t'a N 8 w f+ rl > w G N rd . w w (dd N q x N Cl) 3 .bi aC t)i W Ni ! Oi ra V > N i N' 1�.:j M! >: rdi tn: U : �i 41 ! Hi a! u E N! ro! ro: Cor a gE ro: 0 0 0 0 0 0 0 0 0 0 F4 w� w w w w w w N h : N i M ! �T i .O: kOi W : N 00 M M: m mi O: Oi O; Ni Cl) i Mi m; M mi CZ .7i v: H H F F N H N H F E w F Ei Ei E+ E4 H F E4 Ei H H H H w k+ w w w w w w w w w w Ni N M1 M! M i M! Mi Mj �71 .0 0 0 0 0 0 0 0 0 0 0 0 id O A 0 N �! 8! i o U ; U: i w : 4J : *0 ' b j cd j G >: ro v •oi •0 >, G is ? rd roi 1 rai Gi Gj N i Gi cc: rroi iii I N c7i , > to i m ! U): ! >> ! H >t P5 >i a H�; ro! O j cd ! W! ro : N cd'c A i N i C7 i F+: C7: H : U i fZ E : Ln ! U U: v); r+ ' 00 i LA i Ni 4a to ! �D ! 00: 0, r-4: H! r-1 ; r -t ! r -4i Ni NI HHHF FH F FHHHHHHH &4 HH 00 i. Ln N: r•1 i L/) i .D i 00 i x N r'1 i M j %0 i n i r•+ ra i (y): ra ; r -t w w O A N fU r+ aCEIVED U Ea UN 41991 6 inaiity of An horfic b C v N 0 $4 4+ LH 0 G to b 7 0 x 14 v ca ro S N; 7A 8• I p. I sr°Qv T FI V) LeG.ji D14, _I__�_ T— 11111 ti7r1111c—Ld�7-E �2 L/.vim' O -k pf I - Il ":"T.R':£,. —,•,. :. •' ,O bbl •c.,.•� •l �� Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division a 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 f� Health Authority Approval Checklist Legal Description: �T s 4/ouc z LA-IL.4 Parcel I.D.: Oil -1,33 — 44 �gl���llSll7nlAJo. 7 A. WELL DATA Well type P1 �`�IIf A, B, or C, attach ADEC letter. ADEC water system number 2! (a � Log present (Y/N) T Date completed 10%/131 Total depth Sanitary seal (Y/N) Date of test Static water level Well production Cased to FROM WELL LOG 9— p.m- Casing height (above ground) Wires properly protected (Y/N) AT INSPECTION WATER SAMPLE RESULTS: Coliform ® Nitrated Other bacteria Date of sample: 7/3 Collected by: 74 B. SEPTIC/HOLDING TANK DATA Date installed Tank size /000 Number of Compartments g.p.m. 0 � Cleanouts (Y/N) Y Foundation cleanout (Y/N) Depression (Y/N) A /-JHigh water alarm (Y/N) Date of Pumping S ,3 7 Pumper pL4 A& b0*Q44-4� C. ABSORPTION FIELD DATA Date installed /0A,0/61 Soil rating (g.p.d./ft2 or ft2/bdrm) /S-® _r=1_11 -System type i < o Length YO Width Z' Gravel thickness below pipe L Total depth /0 Z `� N Effective absorption area �0(7 FT: Monitoring Tube present (Y/N) l Depressionoverfield (YIN) �3 RASS 1 r bedrooms Date of adequacy test 9% Results (Pass/Fail) For 00 Fluid depth in absorption field before test (in.); 0 Immediately after`4ogal. water added (in.): /0 Fluid depth Q (ins) Minutes later: Z4 MLS, Peroxide treatment. (past 12 months) (Y/N) 72-026 (Rev. 3/96)" Absorption rate = > ,0 g.p.d. If yes, give date D. LIFT STATION N o nl U- Ohl LV'r Date installed Manhole/Access (Y/N) High water alarm level at* Size in gallons "Pump on" level at* *Datum "Pump off" level at* Cycles tested E. SEPARATION DISTANCES / ` -' % SEPARATION DISTANCES FROM WELL ON LOT TO: i4 o �" Csu �°J or Septic/holding tank on lot Absorption field on lot Public sewer main On adjacent lots On adjacent lots Public sewer manhole/cleanout Sewer /septic service line Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Foundation r Property line / Absorption field Water main/service line 5 r Surface water/drainage > i00 r Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: o ° Property line I® Building foundation Water main/service line Surface water > /®®° Driveway, parking/vehicle storage area r`.ir}oin r7roin /l E)/il's ©f3.Crav" Walls nn nriianpnt Intc 110 F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records in conformance with MOA HAA guidelines in effect on this dater Signature n F,042 Engineer's Name r"{ j a C- HDL 30 a% :f•+U G70 ° LO r- / g 6 -< 111, i Date L z, HAA Fee $ S00,00 Waiver Fee $ Date of Payment 6I3L,9 -1 Date of Payment Receipt Number Zl gfg!� Receipt Number 72-026 (Rev. 3/96)* are Time APPLIC" `?VT FILLS OUT UPPER HAIL ONLY Property Gwner _ 1! 0 PA h t G . (, ((rte y Time Zone MailingAddress , `12 �. SP_. V i-. � Zip Code ) Q = Buyer YV1 a, d-- yvl xf , �; �+ c3 UJ✓ , Address ""tU ✓�-rs- C - Zip Code Lending Institution OLe L�,d-e +LSOA Phone Inspector Inspector Addresss, Zip Code �,tQM Realty Co. BAgent 1 17xNAt�l1G �!..t-"r✓ — �e vt �l.{-t iJ C. ft.� r / Phone Address 5� ;-� 11 CA% `-"� - Zip Code �' ' j J Legal Description �, :� � � efc.-fG L st,.�L:' Street Location - ( ) CONDITIONAL APPPR L' Type of Residence [;I °Ingle Family ❑ Multiple Family ( No. of Bedrooms ❑ Other BY: Water Supply ❑ Individual v {,�� ATTACH WELL LOG. A well log is required for all wells drilled since June 1975. LJ Community - - For wells drilled prior to that date, give well depth (attach log if available). ❑ Public Utility Well to Tank Septic Tank Size / c) cJv Sewer Disposal O'Tndividual _ Year Individual Installed: ❑ Public Utility When Connected to Public Utility: ❑ Holding Tank NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date (� Inspector Inspector Inspector Inspector Field Notes: ( 3) APPROVED BEDROOMS - - -`CONDITIONS OF APPROVAL - - ( ) DISAPPROVED - ( ) CONDITIONAL APPPR L' b DATE BY: - Soils Rating Date Sewer Installed Well To Absorption Area Well Log Received C—lvyyt4zly�' - / a " � l 9 Well to Tank Septic Tank Size / c) cJv 72023 (3182)