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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