HomeMy WebLinkAboutSUSITNA VIEW ESTATES BLK 2 LT 2MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
Pump Installation Log
Well Drilling Permit Number: _______________ Date of Issue: ____-____-____
Parcel Identification Number: ____-____-____
Legal Description Block Lot Property Owner Name & Address:
Pump Installation Date: _____-_____-_____
Pump Intake Depth Below Top of Well Casing: __________ feet
Pump Manufacturer’s Name: ___________________________ Pump
Model: _____________________________________
Pump Size: ____________hp
Pitless Adapter Burial Depth: _________ feet
Pitless Adapter Manufacturer’s Name: _________________________
Pitless Adapter Installer: ____________________________
Well Disinfected Upon Completion? XX Yes No
Method of Disinfection: _____________________________
Comments:
Pump Installer Name: __________________________________
Company: ___________________________________________
Mailing Address: ______________________________________
City: ___________________ State: __________Zip: _________
Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation.
On -Site Water and/or Wastewater System
Permit
MUNICIPALITY OF ANCHORAGE
Development Services Department
On -Site Water & Wastewater Program
4700 Elmore Road, PO Box 196650
Anchorage, AK 99519-6650
Telephone: (907) 343-7904
Permit Number:
OSP161241
Tax Code Number:
02009138000
Work Type:
SepticTank Upgrade
Permit Effective Dates: August 26, 2016 to August 26, 2017
Design Engineer:
PANNONE ENGINEERING SERVICES
Subdivision:
SUSITNA VIEW ESTATES
Site Legal Address:
SUSITNA VIEW ESTATES BLK 2 LT 2 G:3336
Owner/Address:
HARTH MARCIA A
PO BOX 110864 ANCHORAGE AK 995110864
Site Mailing Address:
4921 VIRGO AVE, Anchorage Lot Size in Sq Ft: 26664
Total Bedrooms: 3
This permit is for the construction of:
N Disposal Field Y Septic Tank N Holding Tank N Privy IN Private Well N Water Storage
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 (1 8AAC80),
3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services
Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours).
4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either:
A. Open and Close on the same day.
B. Covered, sealed, and heated to prevent freezing.
Received
Issued B�
M
MUNICIPALITY OF ANCHORAGE
Community Development Department
Development Services Division QD
On -Site Water & Wastewater Program
AUG 2 5 Z016
Phone: 907-34'3.
Fax: 907-343-
EKVtAVr,&jCNf ON-SITE SEWER/WELL PERMIT APPLICATION
Parcel I.D. 020-091-38
Property owner(s) Marcia Harth Day phone
Mailing address P.O. Box 110864, Anchorage, AK 99511
Site address 4921 Virgo Avenue
Legal description (Sub'd., Block & Lot) Susitna View Estates, Block 2, Lot 2
Legal description (Township, Range & Section)
Lot Size 26,664 Sq. Ft. Number of Bedrooms 3
APPLICATION IS FOR:
APPLICATION IS AN: TYPE OF DWELLING:
(E all that apply)
Absorption Field F -I
Initial F-1 Single Family (SF)
(w/wo ADU)
Septic Tank 1z
Upgrade FX]
Duplex (D)
Holding Tank El
Renewal
Multiple Dwellings
F-1
Privy F1
(SF and/or D)
Private Well F-1
Water Storage El
THIS APPLICATION INCLUDES
A VARIANCE WAIVER REQUEST FOR:
Distance:
I certify that the above information
is correct. I further certify that this is in accordance with
applicable Municipal Codes.
(Signature of property owner or authorized agent)
Perm it/Rush Fees: Waiver Fees:
Date of Payment: 12(a Na Date of Payment:
Receipt Number: obaRZA Receipt Number:
Permit No. 8�!)pjjd(?q1 Waiver No.
Permit App_-'- : - -
Pannone Engineering ServiceS LLC
Steven R. Pannone, Principal
Registered Professional Engineer
E-mail: steveCaDpanengak.com
-August 25, 2016
Subject: Susitna View Estates, Block 2, Lot 2
Tank Replace Permit Request &-4094AIJOf
Design Narrative
This is a design narrative for a permit to install an upgrade 10OOg septic tank to be issued for this
property. The existing tank is collapsing. it will be decommissioned per code and replaced. Currently the
lot is developed. The proposed system will utilize a replacement 10OOg septic tank that will be connected
to the existing drain field. This lot and the surrounding lots are served by private wells. There are no
wells within 100' of this system.
1. Upgrade Tank Design.
a. See Sheet I of the design package.
2. Surface Water: There is no surface water within 100 feet of the proposed septic tank. The proposed
septic tank upgrade will maintain at least 100 feet from all surface water and drainage ditches.
3. Topography: The existing topography slopes from east to west at approximately 10% in the
vicinity of the tank. There are no steep slopes within 50' of the system and the replacement of the tank
will not change the slopes in the area surrounding the system.
The proposed installation will not affect the future development of the surrounding or existing lots. There
are no surrounding wells within 100 feet of the proposed septic location.
Mailing: P.O. Box 100217, Anchorage, AK 99510-0217
Physical: 332 East Manor, Anchorage, AK 99501
Telephone: (907) 272-8218 FAX: (907) 272-8211
SPECIAL PROVISIONS TO SPECIFICATIONS
ALL CONSTRUCTION SHALL BE INSTALLED AS SPECIFIED IN THE MOST CURRENT EDITION OF THE MUNICIPALITY OF
ANCHORAGE STANDARD SPECIFICATIONS (MASS) FOR COMPONENT PARTS AND MATERIALS USED IN CONSTRUCTION OF
.,C.N-SITE WASTEWATER DISPOSAL SYSTEMS.
2. SCOPE OF WORK: INSTALL NEW 1,000g SEPTIC TANK WITH DOUBLE CLEAN OUT BEFORE AND DECOMMISSION EXISTING
TANK PER CODE.
WELL (E)
I'JIV
WELL (E)
lt� 3 3 BR
f
BR
HOUSE
IV�
W--\ \N
W� LOT 2 (E)
W_� \N
COLLAPSING 10OOg SEPTIC TANK
DECOMMISSION PER CODE
INSTALL 10OOg SEPTIC TANK (P)
WITH DOUBLE CLEAN OUT
m
WELL (E)
ABBREVIATIONS
LEGEND
FC FOUNDATION CLEAN OUT
T# TANK CLEAN OUT NO.
—W— WATER LINE/
C# CLEAN OUT NO.
WELL RADIUS
DCO DOUBLE CLEAN OUT
OG ORIGINAL GRADE
SS — NEW SEPTIC
E EXISTING
NOTES:
PAMONE ENG SVC, LLC
P.O. BOX 100217 ANCHORAGE, AK 99510
PHONE (907) 272-8218 FAX (907) 272-8211
—'. �klk
OF Al,.4 1$
00
*
... .... ..... . . ...
Date
8/2,5/2016
TANK REPLACE
Scale
1"=50'
P.I.D� NO
020-091-38
DRAWN BY:
SUSITNA VIEW ESTATES, BLOCK 2, LOT 2�
DRM
MARCIA HARTH
4921 VIRGO AVENUE
Steven R. Panno.re
I .. CE 8149
It
PERMIT NO.
OSPXXXXXX
Sheet
PLAN
ANCHORAGE, AK 99516
..........
OFE ��
I OF I
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
MAM r -,n Alk
)NE
—NEW
1-J UPGRADE
MAILING ADDRESS
LEGAL DESCRIPTION
TA//51- V1 X6,L),
T
LOCATION
NO. OF BEDROOMS
oy
DISTANCE TO:
Well
Absorption area
Dwelling
PERMIT NO.
Ir
f -Z
W
Manufacturer
(S-z5sc.
Materi��
No. of compartments
Lin. capacity in gallons IF HOMEMADE:
/'Ooo , 1
41n,ide
length
Width
Liquid depth
--
�az
D
Dwelling
PERMIT NO.
0 z
=-<
f -
Manufacturer
Material
Liquid capacity in gallons
WX
E
DISTANC TO:
Well
Founda
/�ioq
Nearest lot Hn,
'5_ /_
PERMIT N'-
y' Z' '-.6 4/'
w
� iL
No. of lines
Length of each line
Total length of lines
32
Trench widtif
(o inches
Distance between
c, f-
C)
Top of tile to finish grade
I +-
Material beneath t�' a 7, -inelhe
Total effective ;b:Z�on area
-,4
w
Length
Width
-
Depth
PERMIT NO.
I-
w FL
Type of crib
Crib diameter
Crib depth
Total effective absorption
area
W
DISTANCETO:
Well
Building foundation
Nearest lot line
Clas
19'1 v.474
Depth
Driller
Distance to lot line
777
MIT NO.
DISTANCE TO: I
Building foundation
Sewer line
Septic tank
Absorption areas)
OTHER
PIPE MATERIALS
SOILTESTRATING
/
INSTALLER
A%wzcoe tdlce
REMARKS
f
11-M ttr7
t-�
Z"j C
�A
4
APPROV D DATE LEGAL
0- / / - f-2- �
72-013 (Re.. 3178) U
�
1B.-H."! 4 T. 10 7, ED F=7 1=1 104 CO F-'A F1 Fi 0 EZ
'
� ENTQ, HEALTH AND ENVIRDNMENTHL( ROTECTIOH
825 'L/ STREET, ANCHORAGE, HK, 99501 0��l[}
�264-4720 � 311
V/0YF^�--- 0���][1-G�� �����EF��,��UENE Fit Uc/'E��l�,1I[-1-/1^'��
PERMIT #{}\7( 820504 ) ��
APPLICANT MAN CONTRACTING SRH BOX 35228 99502 5-1456«]y
LOCATION L2 B2 SUSITNF| VIEN
LEGAL L282 SUSITNH VIEW L` '6 1-\ LOT SIZE 22
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS SOIL RATING (SQ FT/BR)
THE REQUIRED SIZE OF THE SOIL ABSORPTION SYSTEM IS: "
ElsEEK&A-1-0- EJEEK-FF-11— 4-
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH DR DRRINFIELD.
THE DEPTH OF H 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),
FPEEFS _101PAIRC 15171TEE7 ... 0.120=21
PERMIT APPLICANT HAS THE RESPONSIBILITY TO INFORM THIS DEPARTMENT DURING THE
INSTALLATION INSPECTIONS OF ANY HELLS ADJACENT TO THIS PROPERTY AND THE
NUMBER OF RESIDENCES THAT THE WELL WILL SERVE.
17 21 N li F"�IEH(07- X C31?AE�
BACKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION AND APPROVAL BY THIS �
DEPARTMENT WILL BE SUBJECT TO PROSECUTION. ^
�
MINIMUM DISTANCE BETWEEN H WELL AND ANY ON-SITE SEWAGE DISPOSAL SYSTEM IS
100 FEET FOR H PRIVATE 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 CONI'MUNITY SEWER LINE IS 75 FEET.
OTHER REQUIREMENTS MAN' APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
10"IFF7KIn! :1 -7* J., IF`�"E.,.a;
I CERTIFY THAI'
1: I HM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
]: I UNDERSTAND THAT THE D@ -SITE SEWER SYSTEM MAY REQUIRE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN ] BEDROOMS,
SIGNED:__________...____________._
APPLICANT NAM CONTRACTING
ISSUED BY
�
�
f IL bw Tom 00".
/
AND WELLS AS SET
ENLARGEMENT IF THE
V4.0
(24.
(f-i;4j1j r jl,J�14
M
17jf--�N�:J
8,Y! 140-1411;
LOF 222??v WURN& FY
MIL MIMI VSY FYZSR)- 129
EZ L. A t- 4
KEN FSQTj a, rNK rwinai Op r>p�cwmu-x
z:��p
OR �-if Gsfwjv
flw_- I rim Ix-- '-'XC,1V9 r I 1_0 I N Fkk� 0.
NO '5tHr 1.1100H FQ19!
mw wrH to rmc mimmum O�Frfi PIF'
fHE 93T FOM OF rHw qXCOwn r o -IN 04
nmumv
pVRMty SypUlayr !+tS fl-�_ ma 0EPARAwym
fi).THIS PRVIP-�Dk_f'y ;VVID 11�
OF MOJ_
T 1_1
1Moi:"Er_r1Qri '�MRCIVVT_ r"Y MIS
01 CH HIM & ON -*�S! P� fe
A
LOG SASr FOP PRLYHY9 MY OT t5W 209 FEEY FRON F
0 ' I
jpia�j r-kz Oet--_ t);� :Ei C
013nince FASS A Pumm !.1 __ ju R PRIYATE TQWW� LUMIC V5 L r r4,
IY I - t tb� i o 0"3' 'o!H77-!
;#10 CQj4'4Fj-j1_fI_'f
IM :VT5
RVRLLT__1_!H Ff-,
c (CA UCT V! 010-1 im I?
FOR On-Mv MWEPT AND WILL! AS jEr
E 514 SAIN It. Iir- 1-1 E "Hk H*k4 J i _-i
Ry rWk jwjjjjj:jFN%jry OF ANCHOMM-
MY tj rw
V"Ar rm ON -silk 50
E N!� 'H132;E MAN
-----------
/ -V V4.
_> 7f -14_("
Gy ---- -------
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SOILS LOG
PERCOLATION
TEST
PERFORMED FOR: MarA�kovidcl -DATE PERFORMED: Codq-3Z
SLOPE
LEGAL DESCRIPTION:
11(oo-or
2 - -VO-I'v
3
4-
5 -
6 -
7
8
9
10 -
11
12 -
13-
14-
15-
16-
17 -
18-
19-
20-
I
(GP)-qr-aVe1--5uhC1 rlx�,Are
V;SLtO114 rafed@120n/
Mirm
WAS GROUND WATER
ENCOUNTERED?
-TWO-1-sand rn"riurv-
I'S Lkb I I q ra-fed I F Y ES, AT WH AT
I Zb D/8drrn DEPTH?
Reading
Date
G ross
Time
Net
Time
Depth to
Water
Net
Drop
PERCOLATION RATE
TEST RUN BETWEEN
72-008 (6/79)
,�,?q I
j bs -.
'A
Blk'21,, Sitsitna
'6
%v bepili of Hbl;
NIX
e r f rif d
. M"
t 3 gall et'! 01
i punipi I esLI at.,
ok ra 0
—d d ron
ti
,aaw 0 comp etl
A
Dcpdk'fi� &t frok,
ace
oroand suil
3 0-. IiiIi,
tI.30 -5
T010
it, .;i.
42
0 TIOLZ
A"i
4P %:�T&.
46' TO' —ell
5 5
"To
TOa
1.5 1
caki-ing
skn7d:- Q b ,,"e
ra
�,W
i','- W. I �Grziiiv,6 Slj-i�Lht.lv Sa.�div
ii�,;; TiVII-A
Bo'dro'dXv: ica ruir s -0 e ;.,seaYage -L n sporadic
V,
k
Av
6
T
IH_j
T.
8R .& U131i'l
�A
j! jj MZi 17on �rac —n --z
Ao B
i,,., I ISUAi iai 36EIt'
"
L—
"ch .. gwo-).
GREATLIZ ANC1101 AQ ARI -A BORM 1
OepartmetiL of Lnviromi!Qntal 06—i-I'LY
3330 V' Street
Anchorage, Alds[La 99A-3
SM11S IAM I'l-AMIATION TE1,ST
Performed for ;Mtp Perfort;jed -8/27/7-5-
.1eiler
Legal Description:-Iot�--2,- Block. 2-,- -S.usi-tna--Vi-ew--F-atate-s--
lhis form reports: Soi Is log Percolation
Depth
Feet
I - Topsoil
2 - sp
'3 - sp
4 - SW
5 SW
SW
7 ML
8 - ML
- ML
- ML
- ML
12 -
13 -
14 -
53
S/0 V.)O
3%
Was ground water encountered? Ye -s---,--- If yes, at wiiat depth? 10 k - f t. --
�e a d i n g
Da te
Gross Time
Net Time Dep-th to Waotr
--
L------
------------------
---------
------ --------
percolation rate mi nu ce.
Proposed installatio - n . CePalle Pit Drain lield .—X ---
Depth of Inlet Depth to bottom of pi t or trench
C014IIElITS:
re��f�:06�-Mme- By Ak Geological C e r t i f i ed By
EQ 040 (6/74) Consultants, Inc.
Net Orop
Cn C?p C-kN-
Time
APPLIC--,,NT
FILLS OUT UPPER HAI.-.0NLY
qt
Time
Date
Property Owner
AAA Rlj A
IWA C A/ /e IV L� 1 C
Phone
MaO�g Address
t? A
5/
Zip Code
3 '1'5
Buyer
Address
Zip Code
Lending Institution
C'�
Phone
Address
Zip Code
F I
(3) APPROVED BEDROOMS
DISAPPRMED
Realty Co. & Agent
I
) CONDITIONAL APPROVAL*
DATE — / / - e 3 '-1
Phone
BY:
1?
Address
42.1 /V I /V 0
Zip Code
Legal Description
f114
Street Location
z-
TAIA- A
Type of Residence
Well Log Received No
g Single Family
/0-
El Multiple Family
No. of Bedrooms—
El Other
Water Supply L, --3W (kA,�U,LoA A
,W� Individual
let j -140
�ArH WELL LOG. A well log is required for all wells drilled since June 1975.
FF
El Community
-
_,It, drilled prior to that date, give well depth (attach log if available).
0 Public Utility
Sewer Disposal
-0 Individual
Year Individual Installed:
'El Public Utility
When Connected to Public Utility:
1-1 Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
Cn C?p C-kN-
Time
Time
Tim
qt
Time
Date
Date
Date
i
1 �-[
Date
- -- C
k 91 '�Q
Inspector
InspecR
Inspector
-
Inspector A
Field Notes: a-
M
DFPT ()' -171 A
ENVIR0;4!v.-j-A.. -0 EILTION
1982
RECEIVED
F I
(3) APPROVED BEDROOMS
DISAPPRMED
*CONDITIONS OF APPROVAL
I
) CONDITIONAL APPROVAL*
DATE — / / - e 3 '-1
BY:
C
oqs�
0
ltkA
f114
Soils Rating
Date Sewer Installed
1
Well To AbsorpItIon Area
Well Log Received No
Septic Tank Size 1600
/0-
WelltoTank 10C)
72 023 (31M)
CHEMICAL & G&�OGICAL LABORATORIES
10`�-'ALASKA, INC.
Broth 48 hours:
TELEPHONE (90-2794014 ANCHORAGE INDUSTRIAL
CENTER 1- 0
274-3364 5633 8 Street
0
0
Membrane Filter: Direct Count
Drinking'Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
TO BE COMPLETED BY LABORATORY
WATER SYSTEM:
Final Membrane Filter Results
Collform/10"I
Reported By
Analysis shows this Water SAMPLE to be:
T11110-
I.D. NO.
)'),)
P1, Satisfactory
�414,
[I Unsatisfactory
water System Name Phone No.
Sample too long in transit; sample should
r\� l� y
not be over 48 hours old at examination
Mailing Address
to indicate reliable results. Please send
K), 4
-6ew sample.
City State Zip Code
= = =1 I
Date Received
SAMPLE DATE:
Mo. Oay Year
Time Received
SAMPLE TYPE:
Analytical Method:
• Routine
• Check Sample (for routine sample
EJ Fermentation Tube
with lab ref. no. 0 Treated Water
0, Membrane Filter
• Special Purpose 0 Untreated Water
I
SAMPLE Time Collected
NO. LOCATION Collected By
1
2
3
4
5
06-1220 (b)
Rev. 1978
Date Collected —
DCAn IMATRUCTIONS
BEFORE
Lab Ref. No. Result* Analyst
ED
M
-i FT -1
*No. of colonies/ 100 .1. or No, of Positive portions,
BACTERIOLOGICAL WATER ANALYSIS RECORD
Source—
a.m.
Broth 24 hoursi—
Broth 48 hours:
COLLECTING SAMPLE Multiple Tube Report;
—20ml Tubes PositheafTotal lbrin] Portions
Membrane Filter: Direct Count
—collform/looml
Verification: LTB
BOB
Final Membrane Filter Results
Collform/10"I
Reported By
Date
T11110-
a.m.
p.m.