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SAND LAKE #2 BLK 4 LT 31
�'l01\- \35aa. Municipality of Anchorage Page 1 of 3 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: 2W970302 PID Number: 01113522 Name: Spinell Homes, .Inc. Wastewater System: ® New ❑ Y Upgrade Address: ABSORPTION FIELD 9210 Vanguard Drive Phone: 344-5678 No. of Bedrogms: 4 �1 Deep Trench ❑Shallow Trench ❑Bed ❑Mound ❑Other LEGAL DESCRIPTION soil Rating: Total Depth from original grade: 1 4 ' 1 .2 GPD/Sq. Ft. Lot: 31 Block: Subdivision: 4 Depth to pipe bottom from original grade: Gravel depth beneath pipe Sand Lake No. 2 5.5 Ft. 9 Ft. Township: Range: Section: Fill added above original grade: Gravel length: 3 0 1 Ft. Ft. WELL: ❑ New ❑ Upgrade Gravel width: 4 Number of lines: Distance between lines: Ft. 1 Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: PWSID 218539 Ft. Ft. 540 SO. Ft. ASTM D3034, F-810 Driller: Date Drilled: Static Water Level: Installer: Date installed: Ft. Sanders & Sanders 9/19/97 Yield: Pump Set at: Casing Height Above Ground: - TANK GPM Ft. Ft. SEPARATION DISTANCES 0 Septic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift HoldingPublic/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines Anchorage Tank 1,250 Well >100' >100' N/A N/A >100' Material: NumNumTwoofCompartments: Surface >100 >100 N/A N/A >100 LIFT STATION— N/A Water Lot >5' >10' N/A N/A N/A Size in gallons: Manufacturer: Line Foundation > 5 ' > 10 ' N/A N/A N / A "Pump on" level at: "Pump off' level at: High water alarm at: Curtain None on P opert Pump Make &Model Electrical Inspections performed by: Drain Remarks: BENCH MARK Location and Description: lower floor level Assumed Elevation: EkGl�REAL _ 0' j 49 TH. f9� Inspections performed by: A. Harala Dates: 1st 9/19/97 °y° . 2nd 9/19/97 sr °, MICHAEL E. ANER018 3rd 3/19/98 .° 438i E' Department of Health and Human Services approval r .,° Reviewed and approved by:T_;�>�Date: 72-013 (Rev. 9/91) MOA 25 DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 a Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: LT 31 , BLR 4 Sand Lake S/D, No. 2 PID No.: 01113522 133�IiS JI10V3S 0 M .00'09 5 i 49 TH *0' ?........• .. MICHAEL E. ANDERSON J �� s�.• 4381•E y� i-- - — — - — - -7 LReserv_e_site_, .00'09 LEGEND SPI Septic Pump, compartment 1 SP2 a 11 it 2 C Clean out MT Monitor Tube •�• .0'S IN .00z W A B w S2 30.2 19.8 C4 29.1 42.1 r- C5 41.5 23.6 MT 41.0 25.0 o'S %'LO .oa► .o'S O O C.? �.k` , 1109 r-1 •H N fa -W rp 3> �N N PLAN AS -BUILT SCALE 1" 20' v .F � I � i 49 TH *0' ?........• .. MICHAEL E. ANDERSON J �� s�.• 4381•E y� i-- - — — - — - -7 LReserv_e_site_, .00'09 LEGEND SPI Septic Pump, compartment 1 SP2 a 11 it 2 C Clean out MT Monitor Tube 0 /Q6 ' 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: LT 31 , BLR 4 Sand Lake S/D, No 2 PID No: 0111 3522 1,250 Tank 17L E-1 9� 41, s a 8S o Z 3K! Ln F WILT MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW970302 DESIGN ENGINEER:ANDERSON ENGINEERING OWNER NAME:PARTUSCH LAWRENCE E OWNER ADDRESS:8316 SEACLIFF STREET ANCHORAGE, ALASKA 99502 PARCEL ID:01113522 LEGAL DESCRIPTION: SAND LAKE #2 BLK 4 LT 31 LOT SIZE: 6750 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: PAGE 1 OF 1 5 Ty l R ✓J Foe G lex AF DATE ISSUED: 9/09/97 EXPIRATION DATE: 9/09/98 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 ( 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: RECEIVED BY: ' la""'L l/ -PCS DATE: q` ii �qj ISSUED BY: Gfj `/ l,Y� DATE: �^ August 23, 1997 Municipality of Anchorage Department of Heath & Human Services 825 "L" Street Anchorage, AK 99502-0650 Subject: Lot 31, Block 4, Sand Lake Subdivision No. 2 Septic System Design Impacts to Adjacent Properties Dear On Site Services Engineer: We hereby apply for a permit to install a new septic system on Lot 31, Block 4, Sand Lake Subdivision No. 2. The attached site plan and backup documentation identify the location, size and components of the new septic system proposed to serve the four bedroom home to be constructed on the lot. The lots in this subdivision are very narrow and little area exists for the systems. The lot will be served by a Class C Water System with the well located as shown on the Area Map. ADEC has issued a waiver of the normal protective radius from 150' to 100' to the well. A copy of the waivers and the certificate to construct the Class C Well are attached for your review. The testhole placed in the area of the proposed absorption trench revealed well graded sands with a percolation rate of less than 1 minute per inch. No groundwater was noted during excavation nor during the ensuing monitoring period. We are therefore proposing placement of a 25' long by 10' effective depth deep absorption trench for disposal of septic effluent. The material encountered in the test hole is a well graded sand with a much larger than 51% component passing the No. 4 Sieve. A sand liner is therefore unnecessary in this case. A study of wells in the area indicates a low level of nitrate content in the water. The ground surface of the lot slopes from west to east at a grade ranging from 1% to 5%. The surface of the ground in the area of the new trench is fairly flat. No conflicts were noted between the new trench and any wells Lot 31, Block 4, Sand Lake No. 2 August 23, 1997 Page Two in the area with the protective radii as modified by ADEC. If the system is constructed as designed the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the area. 3. The system, if constructed as designed, will have no adverse impact on reserved space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern w i I I be maintained. Sincerely, Michael E. Anderson, P.E. Attachments C4 0 Z6 96 /SEACLIFF STRE T AREA MAP SCALE 1" = 20' I- k 1 1% --- I 40 N, 0 0 Fn fit /it fit %0 x x z co % 10 0 0 10 (A 10 0 0 0 X—X—X—x—x—x—X-Lx— e 10 �00 F— JI 0 11 10 11 10 0- • C04 c? 103 ;02 10, 103 to, Od, 00 199 loz ----- L------\ 10' ELtCTRIC ESMT. C4 0 Z6 96 /SEACLIFF STRE T AREA MAP SCALE 1" = 20' LOT 23 LOT 22- �. LOT 21 m N m- n m r At co NgTF S�rF I Qlp��� >TH LOT 30 LOT 32 FOUR BEDROOM / HOME I I I s F f SITE PLAN A: z , f j fv SCALE 1" v 20' SEACLIFF STREET;>:�".`. MONITOR TUBE 0 25' LONG X 10' EFFECTIVE DEPTH ABSORPTION TRENCH WE 1,250 GALLON SEPTIC TANK 0 IN, FOUNDATION CLEANOUT FOUR BEDROOM HOME SYSTEM PLAN NO SCALE SEE SITE PLAN FOR EXACT CONFIGURATION LOT 31, BLOCK 4, SAND LAKE SUBDIVISION N0. 2 DESIGN FACTORS: Four Bedroom Home Perc. Rate: LT 1 Min./Inch Application Rate: 1.2 GPD/SF SYSTEM REQUIREMENTS: Deep Trench System 1,250 Gallon Septic Tank 10' Drainfield Rock 4 Bedrooms X 150 GPD / 1.2 GPD/SF 500 SF of Absorption Area 500 SF/20 SF/LF (Absorption Area) = 25 LF Trench Length Therefore: Construct a Deep Absorption Trench With One Lateral 25' in Length with 10' of Drainfield Rock Beneath the Lateral. Distribution Pipe in Trench Placed at 3.5' Below the Original Ground Surface. SAcir.L. ; Ggar�xrr c� 3 � TI 1, F�EfL�L G. Route flow EP TRENCH SECTION,C�y& (NO SCALE)y`r NOTE: Grade Area Over Trench to Drain Away. Minimum 3' of Cover over Septic System. �'XA, f. �.. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION TEST PERFORMED FOR: Spinell HomesDATE / LEGAL DESCRIPTION: 3 �/ v Ar^clI-Ctk'-Township, Range, Section: DEPTH 'VG 5ula�% j(f0 L SLOPE SITE PLAN 2- 3- 4- 6- 7 3 4 67 C-4 /S 7� Z 13- Ell Net Time Depth to Water 14- 41517 7 3: 281/'1 15- 17- s 4.%Z l.11 1o.qq t .I 3+ 33 :10 , 5" Ell WAS GROUND WATER A' ENCOUNTERED? IV S IF YES, AT WHAT L DEPTH? p E D40 to Water Abr mmoring? u4lIr2'i Gate 3 Reading one Groff Time Net Time Depth to Water Net Drop 7 3: 281/'1 s8 s 4.%Z l.11 1o.qq t .I 3+ 33 :10 , 5" 20 g 0 PERCOLATION RATE1 g " (minutesimehy PERC HOLE DIAMETER TEST RUN BETWEEN FT AND S FT COMMENTS Testhole presoaked prior to test. Material encountered in testhole well graded sand. > 51% passes No. 4 Sieve. PERFORMED BY: �/ / 1 IL°� /�" IFY THAT T IST T WAS PERFORMED IN ACCORDANCE WITH ALLSTATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE DATE% 11J 010m.'A,GC, . DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN PUBLIC SERVICE OFFICE 555 CORDOVA STREET ANCHORAGE, ALASKA 99501 July 23, 1997 Mr. Michael E. Anderson, P.E. Anderson Engineering P.O. Box 240773 Anchorage, AK 99524 TONY KNOWLES, GOVERNOR (907) 269-7505 RE: Lots 21, 22, 31, 32 Block 4 Sand Lake Subdivision No.2; Request For Waiver of Horizontal Separation Distance, Class "C" Well, and Stormwater Plan Review. AWPSA Project Nos. 9721 -WV -174-050, 9721 -DW -174-139, and 9721 -WW -133-331. Dear Mr. Anderson: This letter is in reference to the materials received in this office June 20, and 23, 1997, regarding a stormwater plan review, and a waiver request for a lesser horizontal separation distance between a proposed class "C" source well and supporting on-site wastewater disposal systems to serve the above referenced lots. The Department has completed its review of the submitted materials which included a cover letter, site plan, surrounding soils logs, surrounding well logs and a history of water quality sampling in this area. Based upon a review of the submitted information the Department has the following comments concerning approval or nonobjection of this project: Stormwater Plan Review: From the information submitted a limited amount of fill material was to be removed for development of the above referenced lots. A verbal nonobjection was given to Mr. Randy Ross with the Municipality of Anchorage, Department of Public Works Project Management and Engineering to issue the fill permit. This nonobjection was based upon a review of the completed ADEC stormwater pollution prevention and plan review checklist, and profiles of the developed lots which indicated appropriate best management practices for the"treatment and management of stormwater runoff. Horizontal Separation Waivers: After reviewing the submitted information it appears that the minimum separation distances proposed between the new class "C" well and supporting wastewater disposal systems should present minimal threat of contamination. However, the density of surrounding on-site App,roval to Construct section verifying this Department's approval. This approval does not imply the granting of additional authorizations nor does it obligate any other state, federal, or local regulatory agency to grant required authorizations. Thank you for your cooperation with this Department. If there are any further questions regarding the above, please do not hesitate to call. Sincerely, %�,� -4, Michael Lu, E.I.T. Environmental Engineer MLU/ph a%v VNM ionx.w attachment cc: Randy Ross, MOA/DPW/Project Management & Engineering STATE OF ALASKA DEPARTMENT OF ENVIRONMENTAL CONSERVATION CONSTRUCTION AND OPERATION CERTIFICATE A. APPROVAL TO CONSTRUCT for PUBLIC WATER SYSTEMS Plans for the construction or modification of Lots 21 tr 17, g>9f4 Sand La& T Su�divtt.e�. W- IIY- 139 public water system located in AcJ,.nv%aq- Alaska, submitted in accordance with 18 AAC 80.100 byhave been reviewed and are Q approved. ❑ conditionally approved (see attached conditions). F 13 .�1 moi ---t ee eIIL— H4 7/&71/97 TRS DATE Y if construction has not started within two years of the approval date, this certificate is void and new plans anc specifications must be submitted for review and approval before construction. B. APPROVED CHANGE ORDERS Change (contract order no. or tleecriptive reference) Approved by Date C. APPROVAL TO OPERATE The "APPROVAL TO OPERATE" section must be completed and signed by the Department before any water is made available to the public. public The construction of the water system was completed on (date). The system is hereby granted interim approval to operate for 90 days following the completion date. TITLE ,,. __ . _, DATE BY 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. Tm.E DATE DISTRIBUTION: 1. WHITE • ENGINEER (Complete Section CI 2. YELLOW • WATER SYSTEM FILE (Complete Seeticn CI 3. PINK - ENGINEERIMUNI•BOROUGH (Complete section C1 .-. 4. GOLDENROD • MUNI•BOROUGH (Complete section A) 18-0407 (Rev. 111631 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES g 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 fJ Parcel I.D. # 01113522 HAA # r \ 9 800 1. GENERAL INFORMATION Complete legal description Lot 31, Block 4, Sand Lake Subdivision No. 2 Location (site address or directions) Property owner Lawrence E. Partusch Day phone 344-5678 n,,,,;,;,,,, �Ae4r000 8316 Seacliff Street Anchorage, AK 99502 Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: Four (4 ) 3. TYPE OF WATER SUPPLY: Individual well Community well xxx 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) Font 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 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 furtherverify 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 Anderson Engineering Phone P.O. Box 240773 Anchorage, AK 99524 Engineer's signature n" --L (f 6. DHHS SIGNATURE Approved for/ V2 bedrooms. By: Disapproved. Conditional approval for Additional Comments NUTlr 522-7773 Date 3/20/98 TH c......... �.:.• ,..;.moi. MICHAEL E. AND RSdN 1-E bedrooms, with the following stipulations: Date 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 orderto 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. 72-00 (Rev. 1/91) Back MOA 021 ` Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Mi Environmental Services Division ✓t3llNI�IFALIrrar 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 34:=—W%VMTAL©ICE�Iv Health Authority Approval Checklist MAR 1-9- 1998 Legal Description: rot 31 , Block 4 , Sand Lake Parcel I.D.: 01 11 352 crilmn No. 2 _. A. WELL DATA Well type If A, B, or C, attach ADEC letter. ADEC water system number 21853 9 Log present (Y/N) Date completed Total depth Cased to Casing height (above ground) Sanitary seal (Y/N) Wires properly protected (Y/N) FROM WELL LOG AT INSPECTION Date of test Static water level Well production g.p.m. g.p.m. WATER SAMPLE RESULTS: Coliform 0 Nitrate Non Detect Other bacteria 0 Date of sample: 3/12/98 Collected by: A. Harala B. SEPTIC/HOLDING TANK DATA Date installed 9/19/97 Tank size 1 ,2 9 0 Number of Compartments 2 Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y Depression (Y/N) N High water alarm (Y/N) Date of Pumping New C. ABSORPTION FIELD DATA Pumper Constructi Date installed 9/19/97 Soil rating (g.p.d./ft2 or ft2/bdrm) 1 .2 System type Deep Trench Length 30' Width 4' Gravel thickness below pipe 9' Total depth 14 1 Effective absorption area 540 SF Monitoring Tube present (Y/N) Y Depression over field (Y/N) N Date of adequacy test New Const Results (Pass/Fail) Bass For 4 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)" rooms D. LIFT STATION - None on Lot Date installed Manhole/Access (Y/N) _ High water alarm level at' _ Cycles tested E. SEPARATION DISTANCES Size in gallons "Pump on" level at' *Datum "Pump off" level at` SEPARATION DISTANCES FROM WELL ON LOT TO: - Public Water System 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 LOTTO: Foundation >51 Property line > 5 ' Absorption field >51 Water main/service line > 10 ' Surface water/drainage > 10 0 ' Wells on adjacent lots >100' SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line > 10 ' Building foundation > 10 ' Water main/service line > 10 ' Surface water >100' Driveway, parking/vehicle storage area >10' Curtain drain None on T,nt Wells on adjacent lots > 10 0 , F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records 4� t%oV`&-f stems are in conformance with MOA HAA guidelines in effect on this date. Signature M"Ld--� E��� Engineer's Name Michael E. Anderson, P.E. �'4{-�fi .' Date 3/20/98 pr . MICHAEL E ANDS -ASO ; , %�J''• 4381•E 'd w "k HAA Fee $ 3oo_c)c Waiver Fee $ Date of Payment - 2— r� 6 Receipt Number < 72-026 (Rev. 3/96)* 3,5' _-3 `f (7 � 26 Date of Payment Receipt Number