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HomeMy WebLinkAboutSCIMITAR #3 BLK 3 LT 3�jGim�TA�SiD c ,cS\- \ S:) - %o �3 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 PHONE EWNEW SL[Ie'e'I Y'1 1^i6�l .�t1G. ❑UPGRADE MAILING ADDRESS P. o. C3ox 0qw'cf �, ILn. I� 1��7 LEGAL DESCRIPTION I� o .3 310 q 2 .'5(o lry, LOCATION NO. OF BEDROOMS DISTANCE TO: Well 1t7� Absorption area Dwelling 12' � PERMIT NO. 05- Uy� hCG-% I­_ Q Manufacturer Material SAY No. of compartments ~ Vl Liq. capacity in gallons Isao IF HOMEMADE: Inside length Width Liquid depth '-� DISTANCE TO: Well Dwelling PERMIT NO. Jzz Oz Manufacturer Material Liquid capacity in gallons LUX DISTANCE TO: Well 1 �D� Foundation ZS - Nearest lot line 71 C'` PERMIT NO. 7 �`-�v0 J w z z No. of lines Length of each line , 30 TUMHMTO+. +es Il Trensla width Distance between lines w F ( u E� IJP` ittches— L' F Top of tile to finish Material b grade i/ neath tile Total effective absorption area o �' inches (� S Length Width Depth PERMIT NO. W 0 < F wa Type of crib Crib diameter Crib depth Total effective absorption area in WWell DISTANCE TO: Building foundation Nearest lot line Class Ipr,VA-ie Depth Driller Distance to lot line PERMIT NO. J W DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER PIPE MATERIALS If 11``,, PVC SOI L TEST RAT] NG SS SF �,.� Aye ( t IS (� INSTALLER 5�ev� S REMARKS V M M ti tV OF A( i� 17�� +. a - _ i U i• 97C � i • ••P oaQ H ora U 0� R •Uaa • o.o ao..•q'. .Ris. • a se h 8 c .1 Corwin :41J'14 - s o• N . CE-5283 . � � . ,''SOF -. IQ��,' •v H l.ts � A7& D DATE LEGAL y a i- --�) oc-kc- 72,b19 (Rev. 3/78) V PERMIT NO: DATE ISSUED: APPLICANT: ADDRESS: CONTACT PHONE: 850007 ENGINEERED DESIGN . 01/08/85 SKAGGS CONSTRUCTION P O BOX 670690 CHUGIAK� AK 99567 688k2831 LEGAL DESCRIP: SUBDIVISION: SCIMITAR #3 LOT: 3 BLOCK: 3 ` RANGE: 1W ` � F:"" L_ JE �� Ell ����� NIT 01:�' H�(VLThl AND ENVONIMENTAL "IF Anchorage (MOA) and the State o{ Alaska. 2^ I will install the system in accordance with T��ION regulatio�s: 825 L STREET� ANCHORAGE, State o� Alask� requirements �or the set back dances from eny existing well, wastewater disposal system AK 99501 sewerage system on this or any adjacent or nearby lot, public IF A LIFT STATION ISINSTALLED IN 26,11 BY MO" BUILDING CODES� THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS~BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ^ PERMIT NO: DATE ISSUED: APPLICANT: ADDRESS: CONTACT PHONE: 850007 ENGINEERED DESIGN . 01/08/85 SKAGGS CONSTRUCTION P O BOX 670690 CHUGIAK� AK 99567 688k2831 LEGAL DESCRIP: SUBDIVISION: SCIMITAR #3 LOT: 3 BLOCK: 3 SECTION: 10 TOWNSHIP: 15N RANGE: 1W LOT SIZE: 47212 (SQ`FT, OR ACRES> I certify that: 1, I am {amiliar with the reCPO rements for on-site sewers and wells as set �orth by the MunicipaliIty oF Anchorage (MOA) and the State o{ Alaska. 2^ I will install the system in accordance with all KOA codes and regulatio�s: and in compliance with the designcriteria o{ this permit, 3. I will adhere to all MOA and State o� Alask� requirements �or the set back dances from eny existing well, wastewater disposal system o� sewerage system on this or any adjacent or nearby lot, public IF A LIFT STATION ISINSTALLED IN AN AREA COVERED BY MO" BUILDING CODES� THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS~BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DQNE BY ALICENSED ELECTRICIAN. SISNED DATE: / �~��-~� APPLICANT: SKAGGS CONS��UCTI�N � )\j_ ISSUED BY DATE: / ... ..... _... ..... ..... . ~. ..... �`� ' ���Z C: I IF"CAL.- 1 -T`--V, C� IF:-,- ������1E." DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET: ANCHORAGE� AK 99501 � 264^4720 PERMIT NO: 840839 ENGINEEREDDESIGN DATE ISSUED: 10/03/84 APPLICANT: STEVE L. SKAGGS CONSTRUCTION ADDRESS: PO BOX670690 CHUGIAK� AK 99567 CONTACT PHONE: 688~2831 LEGAL DESCRIP: SUBDIVISION: SCIMITAR #3 LOT: 3 BLOCK: 3 SECTION: 10 TOWNSHIP: 151\1 RANGE: 1W LOT SIZE: 47212 (SQ"FT. OR ACRES) certiIy that: 1. I am �amiliar with the sewers and wellsas set �orth by the Municipality of Anchorage (MOA) and the State o� Alaska. 2^ I will install the system in accordance with all MOA codes and regulations� and in compliance with the design criteria o� this permit" 3. I will adhere to all MOA and State of, Alaska requirements �or the set back diistancres �rom any existing well� wastewater disposal system or publi- sewerage system on this or any adjacent or nearby lot, IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED� (2) AS-BUILTS WILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTIQN REPORT; AND <3) THE ELECTRICAL WORK MUST BE'DONE BY A LICENSED ELECTRICIAN" SIGNED^ DATE: APPLICANT: STEVE L" SKAGGS C0NSTRUCT' IOI'll ' ISSUED BY DATE: MUNICIPALITY OF ANCHORAGE e DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: dLJIJIJ +1 1 1v C, ki LEGAL DESCRIPTION: �CIMI C' 0111 3 t'f 3 N T� #3 -Pe(t�_ wcu-K SLOPE I+11 i ©L -"brown orc�an i 5 i IT 2 i + i ; cry 3 1 1 I 1 4fw l rm - c�f0.J2-� WI5C1t10 Qr�O SI �� 5 Wy JCSan1 6- 7 11 o'.1 aw-w.du3rad(d dean 9 d Uc1r�e. �andY �tav��,c�ry 10 e r ve A s541bdM ya SOILS LOG ❑ PERCOLATION TEST DATE PERFORMED: i L�� 11 ' WAS GROUND WATER S ENCOUNTEREDLDrv licP Net Time Depth to Water O 12 13 U a IF YES, AT WHAT E DEPTH? `- END 14 Date Gross Time Net Time Depth to Water Lkt 15 GNAT f�.K3 17 19 N J i.; 20 COMMENTS 6o I 75' I — /-3, SITE PLAN Reading Date Gross Time Net Time Depth to Water Net Drop ze PERCOLATION RATE (minutes/inch) TEST RUN BETVyEFN _ FT AND FT PERFORMED BY: D�-C1.� CERTIFIED BY: DATE: 72.008 (6/79) .V 3 r7 PERFORMED FOR: MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST LEGAL _ I H r11 DESCRIPTION: h Y► 8r'Y7�� �(� �X',1 Inl-fat Un k DEPT Er 60 Time Time Water Q 11 2- C.I k\ WAS GROUND WATER ENCOUNTERED? 3 a 4L1H & 16 7 ML dry,<i-��� I„kolk;A 4 1111 1 1 1 I 1 �'�',C'I-at ::I�Ai1 6'"1 END IF YES, AT WHAT 1(,84 `/J7 s ANA ML t:�f 6M )a i 1 .::❑ Lk v s - 0 Moro 9 SLOPE 13 U h Y► 8r'Y7�� �(� PERCOLATION - 14- 10 60 Time Time Water Q 11 C Q F C.I k\ WAS GROUND WATER ENCOUNTERED? n O 4L1H & 16 7 12 E VIROV'J,[uTAL P:2OTLCTI0114 END IF YES, AT WHAT 1(,84 DEPTH? 13 SOILS LOG ❑ PERCOLATION - 14- TEST Time Time Water - - Drop n C Q F DEPS OF FIS 4L1H & 16 7 E VIROV'J,[uTAL P:2OTLCTI0114 SFE 1(,84 1g 1 .::❑ Lk v s 19 �\ JX SOILS LOG ❑ PERCOLATION - Depth to TEST DATE PERFORMED: o I.L.U!.l CIA___L_LS_L_i_ I. Reading Date Gross Net Depth to Net Time Time Water - - Drop n C Q F DEPS OF FIS 4L1H & E VIROV'J,[uTAL P:2OTLCTI0114 SFE 1(,84 P, Lk v s 20 c.:. •. PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND - FT COMMENTS LCC E. l I � PERFORMED BY: 72.008 (6/79) CERTIFIED BY: DATE: /° / 67 MUNICIPALITY OF ANCHORAGE +.r DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED ,fid SOILS LOG ❑ PERCOLATION - .SLOPE - TEST DATE PERFORMED: N0 ad.IG 'l SITE 14 DESCRIPTION: .JC:1I1XIMI' UT\IT --j 1-0 1 -:-3 J -)in - .SLOPE - 'ILEGAL 1 11#7 16 DEPTH.. 17 2-1 I °6° o alio Sw - �I1bC GC' )) 3 o 0 00 �Z C Cct f: c mill)ir 5 ¢' lxl lvl -�_ ° ° 0 ° 5 -fif SIM Iz� p o (,COGS.L Ivrlr�� i�� 6 0 7 ° D p Seep O.t o 8 0:0 10- 0 END END 11 WAS GROUND WATER S ENCOUNTERED? L ^5L' O 12 P E IF YES, AT WHAT �•77 r 13 DEPTH? SITE 14 Date Gross Time Net Time Depth to Water Net Drop 16 17 °' 18 IG, -�_ 19- 9 20- 20 SITE PLAN Reading Date Gross Time Net Time Depth to Water Net Drop I I PERCOLATION RATE l-nI ' r TEST RUIN BETWEEN COMMENTS II l�Vri� 1 06, I I# 6L( 4 I1 qfu Y_YI.Yt � r Ito ' � Ia C1 hn It. 40 hl'i - 070 MAAJA)e PERFORMED BYPL . C, etr CERTIFIED B 72.008 (6/79) (minutes/inch) FT AND FT DATE: �� 7 I l CORWIN & ASSOCIATES, INC. CONSULTING ENGINEERS 1549 E. TUDOR RD., SUITE 204 ANCHORAGE, ALASKA 99507 (907) 561-6151 SPECIFICATIONS FOR WASTE WATER DISPOSAL SCIMITAR UNIT 3 Lot 3 Block 3 1.0 GENERAL 1.1 The drawings shall be part of this specification 1.2 All material and workmanship shall meet the requirements of Anchorage Department of Health and Environmental Protection 1.3 All excavations and depths are advisory and are to be verified or modified in the field by the Engineer 1.4 It is the responsibility of the Owner to obtain all necessary permits or easements 1.5 The gravel for the drainbed shall be screened to the sizes indicated on drawings 1.6 The septic tank or bed must not be closer than 100 feet from the well /'/1 y�/7 CORWIN & ASSOCIr' ;, INC. Consulting Eng1l,--.rs 4321 Grape Place Suite 204 ANCHORAGE, ALASKA 99504 JOB //VI I�j 7 (9 LTJ-I1LV L7� SHEET NO. �i OF— CALCULATED BY DATE CHECKED BYnfT DATE _ �, SCALE ' . 1 PRDM 291ees Inc, Gwtm. Mau 01171. P i'�/ -/ CORWIN & ASSOCIV INC. Consulting Enginw'_rs11 4321 Grape Place Suite 204 ANCHORAGE, ALASKA 99504 SHEET NO. --i OF CALCULATED BY DATE CHECKED BY � `� DATE— SCALE SCALE / I • 15 , PRDDJCT 2M ees Inc, C,o1m, Man 01111. ,:, 6 � `7 �vr ttrp :u )) rtutug,�og DOC Co. dba SULLIVAN WATER WELLS P.O. BOX 272, CHUGIAK, ALASKA 99567 • TELEPHONE 688-2759 OWNER OF LAND ADDRESS - LEGAL DESCRIPTION '''`-- DATE - Started Ended " PERMIT NUMBER KIND OF FORMATION: DEPTH OF WELL STATIC LEVEL OF WATER FT. DRAW DOWN FT GALS. PER HR - 0 KIND OF CASING - From Ft. to `'+ Ft. ^ O From Ft. to - -Ft. From ;a Ft. to Ft. ^` From, Ft. to Ft. N�ORpGE From Ft. to_'_:__r Ft. -2 �' From Ft. to _,hllnofOF A �.r.'., From Ft. WFNTA PROTECTIOb1 From Ft. to E� „ ' _ r From is Ft. to ' �" Ft. -`. �`oc = ` From Ft. to_____�yB n �i 19c�J From = _ Ft. to ` ' Ft. % r -r i �= From Ft. to 11,'xL From Ft. to Ft. T^ + ` S <'', -? r 'From Ft. to From Ft. to Ft. From `Ft. to Ft. From ` r - Ft. to Ft.!. a .i ` r ,_ , �' From Ft. to Ft. From Ft. to Ft. h3 -R T �'� :^ From Ft. to Ft. From w= r� Ft. to `From Ft. to Ft. r From - Ft. to—Ft.- From Ft. to —Ft. -- From '' Ft. to ` "Ft. �' ' e i<" r `'J From Ft. to Ft. From Ft. to Ft. From Ft. to Ft. From Ft. to_Ft. T Gr `r From Ft. to Ft. r_ f ' From Ft. to Ft From Ft. to Ft. `�' ° r From Ft. to Ft. From - Ft. to Ft JW DRILLER'S NAME (-% POST OFFICE BOA 42 - CHUGIAK, i LASKA 99567 ••.1.9071688.3199 Customers Name�/��S Addres81-10 City, Zip1`9n/c7Z0I1� G e- 19/. Date — I Lot -Block / n `%�`" Subdivision<�'c t�i%� c�✓1, r/, City, Borough O,4_e.alY . Yak' Depth of Well Type of PumpF�i �/�/✓� /J90 ���� d//� Pump Setting 9 Water Head.in Feet Draw down Head in Feet Rate Flow Per Minute Rate of Flow Per Hour First Hour_,5-k 2nd Hour 3rd Hour 171,2- 4th 71,24th Hour 5th Hour 3 �� 6th Hour 3� Tested By:�lti H /�.JG ✓ �4� G/c WE SERVE ALL ALASKA r Py (i)iz' a ANCHORAGE 1 L{ii OjF5 hp*X,(l�'!isV��pY6y1nE N'21+AL LTUL6i'([)�/� P !Nr 4 4 OF ?. 8� 'i�:-idJ ENVI ON, f�LV 1Lld.� PROTECTION =r A,iN i3::TIHOR- _t"Y APPROVAL CERTIFICATE Application Date ) aciude. lot, block,) jsubdivision, section, tow z�ship, range) dd ass or direction -S) ?a , pp,je.anto Name i ,,<.. Telephone Home Business - Applicants Address T % 7 ` i 7`i (e) Applic�a�n�t�•�is (check one) Lending Institution ; Owner/builder'—< ; Buyer F__T ; Other (explain); �W (d) Lending institution Telephone �^ Address (e) Meal Estate Coy & Agentm Address 'telephone _ (f) Mail the HAA to the following address: 20 Type of Residence Single -Family Pfulti-Family Number of Bedrooms 3. Water Su� Individual Well Community Other (describe) Public Note: If community well, system, must have written confirmation From the State Department of Environmental Conservation attesting to the legality and status. 4. sewage Disposal Onsite Public Community Holding Tank Note: If community well system, must have written confirmation from the State Department of Environmental. Conservation attesting, to the legality and status= [Page l of 2] a. Engneering Firm Providing Inspections, Tests, File Search, As certified by my seal affixed hereto and as of the validation date= verify that gay investigation of this Health Authority Approval shows that the c,)'..` water supply and/or wastewater disposal system is safe, functional and adequat:r,. ,., the number of bedrooms and type of structure indicated herein.- I further verify based on the information obtained from the Municipality of Anchorage files and foc, ,u investigation and inspection, the on-site water supply and/or wasteuater disposal system is in compliance with all Municipal and State codes, ordinances, and regula- tions in effect on the date of this inspection. Name of Firm lK4c_ ,a � , t � ,._ Telephone m r, L� Address Date F �-, (� � ✓''� C: - //p ppcb�fc 6. DREP Approval Approved for It r';' bedrooms Approved Disapproved NCINEEi::; Pr7�j, r r.e .3. Com,ln 3 iA. CE1233 :;_ABy ,��� CDate -- Conditional Terms of Conditional Approval _ -_ -- -- -- - —--------—�-._n CAUTION THE MUNICIPALITY OF ANCH RAGE DEPARTMENT OF HEALTH AND ENVIRONMME TOLL (DUEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE ATIONS GIVEN ITN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER IN THE STATE OF ALASKA. HE DREP DOES THIS AS A COURTESY TO PURCHASERS OF THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE MENTS° EMPLOYEES OF D3EP DO NOT CONDUCT INSPECTIONS OR ANALYZE DATA CERTIFICATE IS ISSUED. THE MUNICIPALITY OF ANCHORAGE IS NOT RESPONSIBLE; OR OMISSIONS IN THE PROFESSIONAL ENGINEER'S WORK. (DHE,P SEAL) RR.4/e j/D18 PROTECTION REPRESENT - REGISTERED HOMES AND REQUIRE - BEFORE A FOR ERRORS [Page 2 of 21 7-14-84 DEPT. OF HE.ALIn a MUNICIPALITY OF ANCHORAGE (M IRONMENTAL PROTEaION6 HEALTH AUTHORITY APPROVAL ( HAA) 'F E 3 2 j 719SJ CHECKLIST - FEBRUARY 1984 RECEIVED Legal Description: A. WELL DATA 4_3 6 Well Classification Pr'V.'-6_ If A, B,.cr C. D.E.C. Approved(Y/N) Well Log Present (Y/N) j Date Completed �s/ Yield Total Depth S o D' Cased to X -7 z ' Depth of Grouting Static Water Level 3y Pump Set At %5� Casing Height Above Ground Sanitary Seal on Casing (Y/N) Y Electrical Wiring in Conduit (Y/N) }� Depression Around Wellhead (Y/N) �U Separation Distances from Well: To Septic/Holding Tank on Lot /U 7 ; on Adjoining Lots >iuo' To Nearest Edge of Absorption Field on Lot %b e' ; On Adjoining Lots >/Do ' To Nearest Public Sewer Line To Nearest Public Sewer Cleanout/Manhole h o n c To Nearest Sewer Service Line on Lot Water Sample Collected By /VI, o'/L�,� _; Date Z - 2- - 0 Water Sample Test Results Ccmmnts B. SEPTIC/HOLDING TANK DATA Date Installed/- 2z-11,3 Size /SOO No. of Ccapartments 2 - Standpipes (Y/N) Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N) v r Depression over Tank (Y/N) ,0 Date Last Pumped Pumping/Maintenance Contract on File (Y/N) ; for Holding Tank High -Water Alarm (Y/N) - Temporary Holding Tank Permit (Y/N) - Separation Distances from Septic/Holding Tank: To Water -Supply Edell 102 To Building Foundation 10 To Property Lire ao To Disposal Field To Water Main/Service Line To Stream, Pond, Lake, cr Major Drainage Course n Comments � Receipt # :_� ,. , 67 r/ nDate Paid: 11"a-40'1 Amount: 7 S o%r [Page 1 of 21 O 2-15-84 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 06 Type of System Design Date Installed I - z 2 - f35 Length of Field 3(,t Width of Field I e3' Depth of Field J'&" !T Jap ac � ( LLS Gravel Bed Thickness I' Square Feet of Absorption Area s -F Standpipes Present (Y/N) Y� Depression over Field (Y/N) Date of Last Adequacy Test Results of Last Adequacy 'lest { Separation Distance from Absorption Field: To Water -Supply Wall to e5r To Property Line ro To Building Foundation 2-q, To Existing or Abandoned System on Lot_ lnone__ ; On Adjoining Lots >�5o' To Water Main/Service Line _ __ To Cutbank(if present) To Stream/Pond/Lake/or Major Drainage Course h,,v,e To Driveway, Parking Area, or Vehicle Storage Area tz;o Continents D. LIFT STATION Date Installed Size in Gallons Dimensions Manhole/Access (Y/N) "Pump On" Level at "Pump Off" Level at High Water Alarm Level at Vent (Y/N) Tested for Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes(YM) _ Cormnents ** Check Pepmi.tted Bedroom Rating Against HAA Request I certify t4_t I he checked, verified, or conformed to all MOA HAA Clidelires in effect on the date of this i pection.�� Signed �L Date/,4N .°...�Company C r��I� ,fetfZ MOA No. 5�� 1S c , °EER5ea It jIKBl/d5/s vn w°e3 ,. [Page 2 of 21 2-15-84