HomeMy WebLinkAboutHAMANN LT 7BHamann
Lot 7
· 050- 611
-34
r~ . Municipality of Anchorage Page ~ of_~-'_
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: .'~-'~-~ ~:~ [ ~::~t~:3t ~:~ PID Number: ~~
~10 ~. ~~~~. ~.~~ WastewaterSystem: ~New ~Upgrade
Address: t~ t ~ ~~- ~' ~ ~' ABSORPTION FIELD
Phone: ~+.~~ ' [No. of~oms: ~eepTrench ~ShalmowTrench ~Bed ~Mound ~Other
LEGAL DESCRIPTION So,,.a.i..~ ~. ~ GPD/Sq. Ft. Total Depth from original g~e:~
Lot: ~ Block: Su~:~ Depth to pipe bottom from o~rade: Ft' Graveldepthbeneathpip~ Ft.
Township: I Range: ISection: Fill added above original grade: Gravel length:
WELL: ~ew ~ Upgrade Gravel~:~l~ ~tFt. Numberof lines:~ Distancebetweenlines:[~! Ft.
Class~ti~n (Private. A,B,C):~,~~ Total Depth: Ft. Cased To: Ft. Total absorption area.~Q. Ft.' ~~:~
Driller: Date Drilled: Static Water Level:Ft. I~~ ~~l~Date installed:l
Yield: GPM I Pump Set at: Ft. ~ Casing Height Above Ground:Ft. TANK '
SEPARATION DISTANCES ~Sept~c ~ Ho~din~ a S.T.E.~.
TO Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons:
~rom ~.~ ~,d St~tio~ ~.k S~,~e~ ~~~~~ ~
Well {0~t t0~l -- ~ ~ ~ Material:~~/ ~ Number of Compartments:
S,r~.ce ,+ -- ~ -- LIFT ST~
Lot
Line ~bl+ 101+ ~ ,,,, ~ Size in gallons: Manufact
FoundatioR ]~ , ~1 ~ __ ~ "Pump on" leve~'Pump off' level at: [ High water alarm at:
CudainDrain ~~ ~~ _ Pump Mak~del ~ Electrical Inspections performed by:
Remarks: ~~~ ~~ ~[~ BENCH MARK
,oc t, ripti
~ssumed.,ewt,on: ~O~ ~,
ENGIN~E~SEAL
Inspections performed b~~ ~l~l~ates:. _ 1st tO- [ -~l.~ ~'~ --.
2 n d J ~ '~' ~ I G'~u~'~
Department of Heal Hu rvices approval . '~.~ ~'-~..
Reviewed and approved by Date
72-013 (1/91)MOA 25
Permit No. ~ .~,~[ t ~ ~ ~ ~ Page ~ of ~
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
72-013 A (2/91) MOA 25
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
PERMIT NUMBER:SW910195
DESIGN ENGINEER:S & S ENGINEERS
OWNER NAME:BYERS RHIO H & BONNIE J
OWNER ADDRESS:18810 WAR ADMIRAL ROAD
EAGLE RIVER, ALASKA 99577
PAGE 1 OF
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMITf~kA
DATE ISSUED: 7/15/91
EXPIRATION DATE: 7/15/92
PARCEL ID:05061134
LEGAL DESCRIPTION: HAMANN LT 7B
LOT SIZE: 50474 (SQ. FT.)
NUMBER OF BEDROOMS: 5 THIS PERMIT:
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD / WELL 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 (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
ISSUED BY:
DATE:
DATE:
ROBERT SHAFER, P.E.
ROGER SHAFER
July 5, 1991
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
REFERENCE: Lot 7B; Hamann Construction
Request you issue a permit to dri~ a well and install a septic system
to serve the referenced property.
The property is currently vacant. It is a large lot with a gentle
slope from north to south. The proposed trenches are to follow the
existing contour of the land.
Due to the large lot sizes in the ar~a, we do not anticipate any
adverse effects on neighboring properties by the installation of the
proposed well and septic systems.
If you have any questions or require any additional information for
your review, please contact us.
Sin~~~
~RT A. SHAFER, P.E.
/gm
SOIL TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
SCALE
SCALE
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
COMMENTS
PERCOLATION RATE '~q (minutes/inch) PERC HOLE DIAMETER
TEST RUNi ~~~BETWEEN FT
Township, Range, Section: '~~SLOPE SITE
WAS GROUND WATER
ENCOUNTERED?
L
IF YES, AT WHAT O
DEPTH? p
Depth to Waler After 1,2...
Monitoring? Date:
-I
N
Reading Date Gross Net Depth to Net
'Time Time Water Drop
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERCOLATION
TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
DATE PERFORMED: ,--~//'~-/~
7-/~',~ /~ l~,j .C¢¢ /~'~
15
16
17
18
19
20
COMMENTS
SLOPE
SITE PLAN
WAS GROUND WATER S
ENCOUNTERED? /~)O L
O
P
E
IF YES, AT WHAT
DEPTH?
. Gross Net Depth to Net
Reading Date Time Time , Water Drop
i " u;/,,, /,~..-., .2 z/_ ',/,~, 7,//~
PERCOLATION RATE ~ 7 (minutes/inch) --- -~'~' ~
TEST RUN BETWEEN' q"-~- FT AND -'~'~-~-~ FT
PERFORMED BY:
72-008 (6/79)
Eagle R!v0r Engineering Services
P. 0. Box 7732gd
Eagle ri;var, AK 99577
69&-5195
CERTIFIED BY: ~~:~ DATE:
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
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Complete legal description
Lot 7 B; Hamann Subdivision;
Location (site address or directions)
NHN Hamann Road
Property owner
Mailing address
Lending agency
Mailing address
Agent
Address
P.O.Box 771064 Eagle River, Alaska 99577
694-9681
Day phone
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
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:
XX
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 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 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
S & S ENGINEERING
Address 17034 Eaole
Eagle River, Alaska 99577
Engineer's signature
Phone
DHHS SIGNATURE
/~ Approved for .~
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with
the following stipulations:
Additional Comments
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 DH HS 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 f¢21
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
Parcel I.D.
A. WELL DATA
Well type
Log present~/N)
Total depth ,~-
Sanitary seal ~/N)
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed '37) I Driller
Cased to °~5' L,," Casing height
Wires properly protected ~)'N) y
FROM WELL LOG
Date of test
Static water level
Well flow
Pump level
AT INSPECTIOltI~UNICIPALITY OF ANCHORAGE
' ENVIRONMENTAL SERVICES DIVISION
/DEC 1 8 i991
// IVE O
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot \
Public sewer main
Sewer service line ~.~'
; On adjacent lots [ C>c~ ~'
', On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS:
Coliform
Date of sample: ~-/.. _ ~ \ ~o~ \
Nitrate
B. SEPTIC/HOLDING TANK DATA
Date installed
Cleanouts k~/N)
High water alarm (Y~
Date of pumping
Collected by:
Other bacteria
S & $ ENGINEERING
17034 Eagle River Loop Road No. 204
Eagle River, Alaska 99577
Tank size ~'C~o /--~-t~ Compartments
Foundation cleanout {~/N) y Depression (Y~
Alarm tested (Y/N)
Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot JO~ ~ On adjacent lots
To property line ~ ~ I '/'' Absorption field
Surface water/drainage / o c> ~ +'
/ C) o ~ ~' Foundation
Water main/service line
/4-
72-026 (Rev. 7/91)Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
"Pump on" level at
High water alarm level
Meets MOA electrical codes ~.M-)
ROM LIFT STATION TO:
Well on lot
On adjacent lots
Manufacturer
Manhole/Access (Y/N)
Surface water
D. ABSORPTION FIELD DATA
Width
Date installed
Length ~ ?---L~ ~
Total absorption area ~'~.-
Depression over field (Y~
Results (pass/fail)
Soil rating
O, L,, ~'P~/~-r
Gravel thickness
Cleanouts present~'N)
Date of adequacy test
for
System type
Total depth-~
bedrooms
Peroxide treatment (past 12 months) (Y/~ /~1 ' '~ ':
E ARATION DISTANCE FROM ABSORPTION FIELD TO:
Well On lot jO 7.- '
To building foundation
On adjacent lots
Surface water '~0~ I +-
Curtain drain
If yes, give date
On adjacent lots /'Do ~ ~
,~: Property line
'"2- 6- '
To existing or abandoned system on lot
Cutbank *J//~ Water main/service line
Driveway, parking/vehicle storage area
]o I~
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effe~c~~o~f, this inspection.
S & S ENGINEERING
17034 Eagle River L~p Road Ne, 2~
Signature .... ,- ~, .... ~,..,.. oo=.v
Engineer's Name
HAA Fee $ / ~ Waiver Fee: $
Date of Payment /~-~/ Date of Payment
Receipt Number ~ ~~ ~~P Receipt Number
72~26 (Rev. 3/91) Back MOA 21
by
DOC,:Co. dba
SULLIVAN WATER WELLS
DATE- Started Ended "7/
PERMIT NUMBER
P.O. BOX 670272, CHUGIAK, ALASKA 99567 · TELEPHONE 688-2759
STATIC LEVEL OF WATER
DRAg' DOWN FT.
GALS. PER HR "~
0
KIND OF CASING · ~ ~
OD
KIND OF FORMATION:
From,,~
From ~
From '~
From __
From c~ ~)
From/~C~ ?
From
From ["7
From ~/7
From ~/5
Ft. to C~ Ft. C/~'/~¢ U ' From .
Ft. to4' , Ft. O'U~~ ~0~'O~,J From.
. , ~ ~J ~rom Ft.
~Ft. to__Ft. ()~ ~a t~g From
~rom
to ~/~ Ft. /)~~ ~o~C~ From
From? (-91 Ft.
From ,Q ~, ~t.
From~ o O Ft.
From Ft.
From.Z!~
From~ 7.~
Ft''°----RF~ r C IV i::: D,,,t. '-
Ft. to__Ft
Ft. to i~EC 1 B 1931
t,, Mun[qipality ot Anchorage
Ft. to Ft.
__Ft. to__Ft
MISCL. INFORMATION:
~3 g '/ 7~74~