HomeMy WebLinkAboutSCIMITAR #2 BLK 2 LT 29 MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF REALTH & ENV(RONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchora§e, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME
P~ONE ~ L~'NEW
,¢~ ~'..~.'~; E~ UPGRADE
MAILING ADDRESS
LEGAL DESCRIPTION
LOCATION
Well Absorption area Dwelling
F- Z Manufacturer ~ Material
I ~ ~l c capac tv n ga Ions Inside length Width
7 I 'd ,FHOMEMADE: I I
-J Z l____~(~ DISTANCE TO'. I Well J~[)welling
~ ~ ~ ~ Manufacturer Material
/ Well Poundation · Nearest I~t line
~ · ~ No. of lines Length of each line
<~ I~ ~o~~grade
Length
--
Type of crib
--
DISTANCE TO:
STANCE TO:
NO. OFBEDROOMS
PERMIT NO.
Liquid depth
PERMIT NO.
Liquid capacity in gallons
PERMIT NO. ~:~:..~ ~,~/,~ _
Distance between lines
Total effective absorption area
Widtb Depth PERMIT NO.
Crib diameter Crib depth Total effective absorption area
Well Building foundation Nearest lot line
Building foundation
Driller
Sewer line ~.~ ,~. ~
Distance to lot line , PERMIT NO.
Septic tank ~ / I Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
Post-It'" brand fax transmittal memo 7671 I#ofpages ~
Co. Co.
~pt. ~:~ ~7~
APPROVED
DATE
72-013 (Rev. 3/78)
n
0
0 0 0 0 0 0 0 0 0 0 0 0 ~
Department
825
MUNICIPALITY OF ANCHORAGE
~ Health and Environmenta' 7rotection
= Street, Anchorage, AK. ~9501
264-4720
* * * HANDWRITTEN PERMIT * * *
WELL AND/OR ON-SITE SEWER PERMIT
.,~ 600<,, Mailing Address: /~3 ~W / ~ e '7
L~gal Description: ~ ~ ? ~D ~JO~-J~C[
·' ~ ~ ~""Lot Size: _
T~pe of Soil Absorption System Is:
Trench: ~ Drainfield: Seepage Bed= Holding Tank:
Maximum Number of Bedrooms: _%~ _ Soil Rating(sq.ft/br)
The Required Size of the Soil Absorption System Is:
DEPTH (~ LENGTH
x GRAVEL~DEPTt~ ,i~:'~ WIDTH
The length dimension is the length(in feet) of the trench or drainfieldo 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(HO12D'F~'~')' TANK SIZE = /5-~L' 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 8 3 * * *
I certify that:'
(1) I ~m familiar with the requirements for on-sit~ 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 r%sid~n6~/remodeled to
SWP/024(1/81)
include more that 3~..edrooms.
ate:
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alasl(a 99501 264-4720
SOILS LOG -- PERCOLATION 'rEST
[] PERCOLATION
TEST
PERFORMED FOR:
SLOPE
SITE PLAN
10
11
13-
WAS GROUND WATER
ENCOUNTSRED?
IF YES, AT WHAT
DEPTFI?
14-
15-
16
17
18
19
Gross Net Dopth to Net
Reading [3ate 'rime Time Water Drop
20
PERCOLATION RATE (minutes/inc
TEST RUN BETWEEN FT AND FT
COMMENTS ~/~~'d'~~f~-- ~.~]~~, ?~M.~' ~ ~/~/~ ~
72-O08 (6/79)
MUNICIPALITY OF ANCHORAGE
DFPARTMENT 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, #
1, GENERAL INFORMATION
Complete legal description
CERTIFICATE OF HEALTH AUTHORITY
A'PPROVAL FOR A SINGLE FAMILY DWEI. LING
o - 32-47 AA#
Lot 29; Block 2; Scimitar Subdivision #2
Location (site address or directions) 201 07 Tulwar Drive
ProPerty owner Larry & Terry Gall Day phone
!. Mailing address p_n: Rn¥ 6717~ P. hugiak: A~ 99567
Lending ~gency Day phone
Mailing address '
688-2435
Agent Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
NOTE:
3~
Individual well xx
Community well
Public water
If community well system, provide written confirmation from State ADEC attest-
lng to the legality and status of system.
'TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
×~
If community wastewater system, provide written confirmation from State ADEC
attesting to thP, legality and status of system.
72-O25 (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 al~ Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection.
Phone
Alaska Water
W'~a~.waler Conauiian~,
Anchorsge, AK ~9~04
Name of'Firm
Address
Engineer's signature
Date
Wastewater Consultants, Inc.
Shall be PAID $ 5-~5~'~0 ~
or prior'to, closing for the
Engineering Services Provided,
DHHS SIGNATURE
~ Ap.proved for TH/~EE
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 DHHS 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.
DEPARTMENT OF: HEALTH & HUMAN SERVIQf4(-~
Environmental Services Division
825 L Street, Room 502 · Ancherage, Alaska 99501 · (907) 343,~,~..b
Health Authority Approval C;hecklist
UNIT #2, LT 29, BK 2 Parcel I.D.:
051-132-47
Legal Description:. SCIMITAR S/D;
A. WELL DATA
Welltype_ PRIVATE
Log present (WN)
Total depth 65.5'
Sanitary seal (Y/N)
Date completed 9J26/63
Cased to 51' (TO BEDROCK).._ Casing height (above ground)
If A, B, or C, attach ADEC letter. ADEC water system number__
YES
YES
YES Wires properly protected [Y/N)
FROM WELL LOG AT INSPECTION
__ 9/2B/83 5/6/99
15' ~7'
1.0 (EST.'~ g.p.m, 4-.6
Nitrate . -~ rn~//... Other bacteria
Collected by: A,W.W,C,, INC,
System
type
5' Gravel Ihickness below pipe ,36" __Total depth 7' - 7.5'
Effective absorption area 2._97 SO FT _ Monitoring Tube present (Y/N)YF,r-;_ Depression over field (Y/N) NO
Date of adequacy test 5/6/99 Results [Pass/Fail). PA~ For. 3 bedrooms
Fluid depth In absorption field before test (in.); 0" Immediately after860 _ gal, water added (in.):_ 31"
Fluid depth O" (ins) Minutes later 70
Peroxide treatment (past 12 months) (Y/N). NONE KNOWN
72-026 (Rev. 3/96)*
Absorption rate = 450+ g.p.d.
If yes, give date -
Date of test
Static water evel
Well production _
WATER SAMPLE RESULTS:
Coliform
Date of sample:
B. Si~PTIC/HOLDING TANK DATA
Date installed __ 12/8.3
Feundation cleanout (Y/N)
Date of Pumping 5/6/99
C. AI~SORPTIC)N FIELD DATA
Date installed__ 12/85
Length 33' _Width _
Pumper JR PUMPING __
g.p.m.
Tank size_ 1of)f) Number of Compartments 2. Cleanouts (Y/N).YES
YES Depression (Y/NJ __NO _ High water alarm (Y/N) N/A _
D. LIFT STATION ~
Date installed Si '
Manhole/Access (Y/N) "Pum__.~e~l~"~at* "Pump off" level at*
High wateratarm level at* ~ *Datum
E. SEPARATION DISTANCES
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
SEPARATION DISTANCES FROM WELL ON LOT TO:
1 OR'+
100'+
N/A
25%
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation 5'+ Property line 5'+
Water main/service line 1(3'+ Sun'ace water/drainage 1 (30'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Property line 1
Surface water
Curtain drain
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cleanout N,/A
Lift station N/A
Absorption field ,5'+
Wells on adjacent lots 100'+
Building foundation 1 o' Water main/service line 10'+
100'+ Driveway, parking/vehicle storage area 1
NnNE KNOWN Wells on adjacent lots 1
HAA Fee $ '~0
Waiver Fee $
Date of Payment ~ ,-oOJ~ ~-~-~ d_~) ~ Date of Payment
Receipt Number .z~'~)~_~__.j ~.~ ~-~('~ ) Receipt Number
72-026 (Rev. 3/96)*
F. ENGINEER'S CERTIFICATION
I certify that Fl~aveld~/~rnir~ ~ ~ fie/d inspections and review of Municipa/ reco.~ha .~.,~,.~,.~[~tems are
in conform~ce w~O~.~A idelines in effect on this date. ~ ~;" ~ ~
. ·
Signature( ~~ ~~~.
Engineers Name ~ .JF,,~ ~. ~,F,, ~ ~....~
Alaska Water & Wastewater Consultants, Inc.
6901 Debarr Road, Suite 2B ~ Anchorage ~ Alaska 99504
Phone (907) 337-6179 ~ Fax (907) 338-3246
May 10,1999
Larry and Ten'y Gall
P.O. 671703
Chugiak, Alaska 99567
Subject: Well Test and Septic Adequacy Test at Lot 29; Block 2; Scimitar S/D Unit #2
Dear Mr. & Mrs. Gall,
Per your request, we performed a well flow test and a adequacy test on the subject septic system.
Our findings are summarized as follows:
The septic system was installed in the fall of 1983. On the day of our inspection, 5/6/99, the
sump at the end of the drainfield was found to be dry (bottom of sump was 49 inches below
invert of drainpipe). The septic tank ~vas pumped by J.R's Pumping prior to the test. Eight
hundred & sixty (860) gallons of water was introduced into the leachfiel& The first 222 gallons
of water caused the liquid level to rise thirty two (32) inches. When the next 638 gallons were
added the level stayed the same. Approximately one hour later the sump was found to be dry
indicating all the water had been absorbed. Based upon this data, it can be concluded that the
drainfield has an absorption capacity of greater than 450 gallons per day, as required for a three
(3) bedroom house.
The well was drilled on 9/26/83. On the day of our inspection the, 5/6/99, the static water level
was found to be at 27 feet below the top of the casing (BTC). Ooe thousand one hundred & forty
seven (1147) gallons was pumped fi'om the well in approximately four (4) hours. The static water
level did not drop throughout the entire test. Based upon this data, it can be concluded that the
well will produce 4.6 gallons/minute for a 4 hour period.
If you have any question, or we can be of further service, please call us at 337-6179. Thank
you for your business// /
09/23/99
THU 10:27 FAX 0896499
VISTA REAl, ESTATE. ER
{~]oo2
2-
AS-BL~I.LT
I hereby certify th,~t ! haye su~eyed the following des~'ribec~ "!
~eh~age R~ord~ ~t~, A aska, ~d ~ha~ the improv~
~en~ ii~t~ the~on ~ wi~in the pm~ ~s and ~o not
overlap oi en~ach on the p~ lym~:adj~nt theretb; that
no knpmvements on pm~y I~g ad~t ~e~ encroach
on tho pm~es ~ q~s~on ah~ ~hat th~ a~ no roadwayS,
· amm~[on lines or other ~ib~ ea~ments on. said'pm~y
excepl as. indented hereon.. '-. '
Dated at ~1~ River, ~aska '
~ ' ~ ~ ~x ~, E~le ~ver, Alask~ ~5~
SEP-23-§9 11:08 FROM'CTE ENVIRONMENTAL
zt~[~. C T&EEnvironmentalGerviceslnc.
$615301 T-182 P.O2/OZ F-$1Z
995122002
AK Wa~r & Was~cwa~er Comul~n~ inc.
N/^
~cimiTar SD2 L2g B2 Outside lib
Drinking Wmr
Client
Printed Datet'l~le 09123199 11:02
Collected l~te/Ti~e 09/20/99 12:22
Ret, elved I~TodTtme 09121199 09:30
T~Amlcal DireCtor; Stephen C. Ede
ALLowabLe Prep Ar~tysis
units Ha~I LimiTs pare 0are Init
O.SO0 U 0.~00 r~/L EPA ~(lO,O 10 mx
O9121199 09/~1/99 SCL
Propey Owner
Mailing Address
Buyer
Address
APPLI6 ~IT FILLS OUT UPPER HAl ONLY
t_. i'~ \¢/~'/ l~'~' ~'- ~--<~ [~% ~''' LC Phone
Address
Zip Code
Phone
Zip Code
Realty Co. & Agent Phone
Address Zip Code
Type of Residence
' Single Family
~ultlple Family No. of Bedrooms~
Water Supply
._~4~, Individual ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975.'
L3 Community For wells drilled prior to that date, give well depth (attach Icg it available).
[] Public Utility
Sewer Disposal ·
[] Public Utility When Connected to Public Utility:
E3 Holding Tank
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PfIOCESSING (;AN BE INITIATED,
Ti¢fle
Time Time Time
Date Date Date Date
Inspector Inspector Inspector
Field Notes:
Inspector
(~) APPROVED BEDROOMS ) DISAPPROVED
( ) COND~T~ONA. ~PROVA.'
BATE J~Jf-
"CONDITIONS OF APPROVAL
Soils Rating Date Sower Installed
Well To Absorption Area
Well to Tank
Well Log Received
Septic Tank Size