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Home My WebLink AboutT12N R3W SEC 25 SE4SW4NW4NW4 Municipality of Anchorage Page / o! '~' 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: ~'~/~/~'O/ ~(~ PIDNumber: ¢/7- ¢~/'~ Name: ~/J~V /~/ ~ ~¢ ~ Wastewater System: ~ New U Upgrade Address: L/~d/ '~z/~s~/~ ~: ABSORPTION FIELD '~c/t~P~n~= AK Phone: 3'I~-0~ ~No. of B~?om.: ~DeepTrenc, ~ShallowTrenc, ~Bed ~Mound ~Other Total Depth from original grade: LEGAL DESCRIPTION s°g""~"": Z O Lot: Block: Subdiv~ion: Depth Io pipe bottom from origin=l grade: Gravel depth beneath pipe Townshlp:/~ [Range: ~ ~Il Sectio~_ Fig added above/--°riginal/.¢grade: Ft. 'iAI'',/Gravel length:=z¢O Ft. Humber of lines: Distance belween lines: WELL: ~ New Q Upgrade Grav~width: ~ Ft. ~ /~ FL Pipe mater'ah Dr'gar: Date Drilled: StagcWaler [eveh Installer; Dale installed: u Casing Height Above Yield{ / Ft. ~ .~. TANK SEPARATION DISTANCES ~ s.p,, ~ Ho~n~ ~ S.T.E.P. To Septic Absorption L[a Holding Publlc/Pdva[( Manufacturer: Capacity In gagons: s~,,c~ ~ LIFT STATION Wafer /~ ~ /~/~ / ~lzeingallons: 'Manufacturer:~ Lot Foundatio. ~/ ~/ "Pump on" level'If" level at: ~High water alarm Curtain Drain ~ ~o/c' /~/Y~ ~ ~odel Electrical Inspections pedormed by: Remarks: BENCH MARK Location and Description: /~o pi, Inspections pedormed by: S & S EN~IN~IN~ Dates: 1~ ~ --~ ~ ~ ~~ RO~T C COWAN ':" 17034 Eagle River L~p Read, Ne. ~2nd &' 3 o.p~ [,,e~,~ CE - 8801' ~%e~/ , Eagle River, Alaska g95~ . .~c~ 8 _p~_ p~ ~ ~ ~',. . .."~.~ Department of Health.and Human ~e~ces approval - ,. ,~, ...... ~ ·~ ~ /0.~0 .~ '%~c,~::~'2-~~ Reviewed and approved by: ~~ Date: 72-013 (Rev. 9191) MOA 25 PSS~ ~o. SW980190 PAGE 2 OF 5 rviunicip~tit o? Anchor~oe DEPARTMENT OF HEAY_THAND HUI%AN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O, Box 196650 ®Anchorage, Alaska 99519-6650 · Te,[,e,ohome:, 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL SE4, SW4, NW4, NW4; SEC 25, T12N, RSW P.LD. NO. 017--421--25 I / ALT. SITE ~ .~ ~ -~ . ,, ",/~-~',~ . ..,.' ~-'~-~ ~RM]? ~0. SW980190 PAGE ':~ OF 3 Municipo, Ut; o~ Ancho~'o, cie DEPARTMENT OF HEALTHAND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.B. Box 196650 eAnchor~ge, Alask~ 99519-6650·Teteohone' 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL SE4, SW4, NW4, NW4; SEC 25, T12N, R3W P.].D. NO. 017-421-23 A B FCO 42.5' 23.5' ST1 43.5' 25.5' ST2 47.0' 32.5' BBL1 49.5' 36.0' BBL2 50.0' 36.5' C01 119' 64.0' MT1 116' 61.5' CO2 28.0' 70.0' MT2 29.5' 68.5' C03 46.5' 72.5' MT3 47.0' 70.5' C04 68.5' 55.0' STI ST2 ~/97.3' ~ 93.3'J I 125o GAL [~'93.1' [ S.T. J .... C03 = 92.41 CO1 = 94,6; GRADE--, C04 = 92,37 ~-C02 = 95.0 FINAL. \ C03 / \ MTI CO1 ~MT8 C04/ ~1/T2 C02 C04 = 89.2 ~ ~'" C02 = 92.2 J MT2 = 91.7' &8~IL6' WATER FOUND 8A~!' B.O,H. SCALE 1' = 40' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHOP~GE, ALASKA 99519-6650 ONiSITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW980190 DESIGN ENGINEER:S & S ENGINEERING OWNER NAS~E:SANDY ANDREWS RINE OWNER ADDRESS:4201SHOEHONI AVE. ANCHORAGE ALASKA 99516 DATE ISSUED: 6/19/98 EXPIKATION DATE: 6/19/99 PARCEL ID:01742123 LEGAL DESCRIPTION: T12N R3W SEC 25 SE4SW4NW4NW4 LOT SIZE: 108900 (SQ. FT.) NUMBER OF BEDROOMS: 5 THIS PERMIT: 5 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE I~3NICIPAL CODE C~PTERS 15.55 AND 15.65 ~ THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) D. ND DRINKING WATER REGULATIONS (18ARC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 34314744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED D. ND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ~/~ //// Z ' DATE: ROgERT C. COWAN, P,E. CIVIL ENGINEERS June 9, 1998 (907) 694-2979 FAX (907) 694-1211 SEWER&WATER INSPECTION ENGINEERINGSTUDIES AND REPOR?S WELL INSPECTION & FLOWTEST ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE W~STEWATER DISPOSAL SYSTEM DESIGN MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: SE4, SW4, NW4, NWq; Section 25, T. 12N, R3W Request you issue a permit to install a septic system and well to serve the proposed five bedroom house on the referenced property. Two test holes were excavated and a percolation test performed. The approximate location of the test holes is located on the attached site plan. At the time of excavation 5/9/98, water was encountered in the test holes. After ground water monitoring, the seasonal high ground water level was found to be 8.5'. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas, or drainage patterns by the installation of the proposed septic system There are no points of contamination within the proposed well radius that can be seen on the attached site plan. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/mg Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 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 .... . ~ ~ ROBERT C. COWAN DATE PERFORMED: '~, ~. ~.'" Township, Range, Section: ~c9~ ~/~ ~ SLOPE SITE PLAN I 10- 11- 12- 13- 14- 15- 16- 17- 18- 20~ COMMENTS WAS GROUND WATER ENCOUNTERED? s tF YES. AT WHAT DEPTH? ~ /$~,~3 ~ P Depth lo Water After ~/ ~ /i//? ff MoniloriflD? Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE -~''~ ~ ir~,r, uteuinchl PERc HOLE DIAMETER TEST RUN BETWEEN /' ''~ ET AND ~}' ~ FT PERFORMED BY: 17034 Ea~le River Loop Road No. 2({4 CERTIFY THAT THIS TEST WAS PERFORMED IN Eagle River, Alaska 99577 r- ~ 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 ~' ~Z~N~.~ SOILS LOG -- PERCOLATION TEST ~ '/~ ~ 'Z ~ '/~ ~w'/~ Township, Range, Section: LEGAL DESCRIPTION:_ ~ ~ / SLOPE SITE PLAN I ~ I 7- ¢:?z_ A /J 1 2 3 4 5 6 7 8 9 10 11 12 13 14- 15- 16- 17 18 19- 20- COMMENTS WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Depth 10 Water After Monitoring? ~ '/~'" Date: Gross Net Depth to Net Reading Date Time Time Water Drop pj!c.~eA/~ ..¢/~,,/¢~ f/oD -- ¢" -. IlOl / iv,.; ./ 3/g" ¢,¢" /, c u J g '~ " W ",. //o '7~ 9 '//¢" ~ ~/~" PERCOLATION RATE ,L/ (minutes/inch) PERC HOLE DIAMETER __ TEST RUN BETWEEN //, C'~ FT AND c~, E-'~~ FT ACCORDANCE W~T~rI~i~;F,~S~)~j~~- GmDEUNES ,r~ EFFECT ON THiS OAT£. DATE: 72-008 (Rev. 4/85) Municipality of Anchorage Development Services Department Building Safety Division Qn-Site Water and Wastewater Program 4700 South Bragaw St, P.O. Box 196650 Anchorage, AK 99519-6650 www. cLanchorage.ak, us (907) 343-7904 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY.D ELLIN( Parcel I.D, ..~1 '7 -~3./-- ~-.~ ,'"~: ~G'EI~ERAL INFORMATION ; .. Cor~plete I~al .desct'iption ,.~ iL '1/-// ~. . Loc~tion (site addre? or directions) " Current Prope'~ty owner(s) "' Mailing address P.O. Expiration Date: Lending agency kl~/ '/~l,i Hw 'r¥ ,, $ ~ ¢t'.,,~,,., $?'. Day phone b~~. ,T'-qlo 7 Day phone Mailing address Real Estate Agent Day phone Mailing Address Un/ess otherwise requested, HAA will be held by DSD for pickup. NUMBER OF BEDROOMS: ,5' TYPE OF WATER SUPPLY: ' Individual Well [] Individual Water Storage [] Community Class Well [] Public Water System [] TYPE OF WASTEWATER DISPOSAL: Individual On-site Individual Holding tank Community On-site Public Sewer [] [] [] [] The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) for proposes served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a pdvate or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a pedod of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B we!Is or a public water system. The Municipality of Anchorage is not responsible for on'ors or omissions in the professional engineer's work. 4. 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, based on procedures outJined in the Health Authority Approval Guidelines for this application, shows that the on- site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further vedfy 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. $ & $ ENGINEERING Name of Firm 17034 Eigle River L~op Read No. Address E~l. River, Alaska Engineer's Printed Name /~0 ~ ~.,~.7- ~'. ~"¢..) ~.,,~/ DSD SIGNATURE '"/ Approved for Disapproved. Conditional approval for bedrooms. Phone ~o~ ~:)-~/ 7~ bedrooms, with the following stipulations: Additional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory X Maintenance Agreements Supplemental Engineer's Report Other Odginal Certificate Date: Municipality of Anchorage Development Services Department Building Safety Division On-Site Water & Wastewater Program 4700 South Bragaw SL P.O. Box 196650 Anchorage, AK 99519-6650 www. ci.anchorage.ak, us (907) 343-7904 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: $'lg ' /q / S w q't / N~ V,f ~, N ~ '/~/ / $ ~ c . 3. ~'/ T I ~. .'.*'/ /t ,~ ~ Parcel ID: WELL DATA · Well type i°,~t va r/t D=e 7). To~i depth 3 q ~[ Date of fest Static water level Well production Ol 7- 'v~.l If A. B, or C provide PWSID # -- Well Log (~N) Sanitary seal (~/N) Casedto <j4~ ft. Casing height (above ground) I~"~ in. FROM WELL LOG AT INSPECTION '7 I,,/, g.p.m, g.p.m. WATER SAMPLE RESULTS: Coliform ~:~ ,colonies/100 mi. Arsenic; mg./1. Nitrate q. ) 7 mg./I. B. SEPTIC/HOLDING TANK DATA Tank 'ryp~teflat ~-~ r~ c / $ T~ L ~J . .. ~ ~ ..:.'. .. Tank size: ! g*eo gal.' .:' :Number of Compartments Foundaflon'cteanout (~) "f~' ~ Depress on over tank (~d~ Date of pumping* q / ~ / ~*:~'- '~' ...... Pumper I Sa/l- C. ABSORPTION FIELD DATA' "'h/' ' Date instaJled' . e ~' ' Sc~il rating r ft21bdrm) /. Other bacteda 0 colonies/100 mi. . ~.& S ENGINEERING Co ec~ea mlTe~4 ~d~ Rh., LoopR~dNe.~04 Eagle River, Alaska t~577 Date installed 6/~d /gl ~' ¢leanoute (~4) ¥¢ $ High water alarm (Y(~ ,~ ~ System type J'../4 ~.t ~ ~ Gravel below pipe ~- $- ff Total depth ~ ff. Eft. absorption ama ? y'O ft2 Monitoring tube Vf.J' Date of adeduacy test c~ll'~/O ~' Results~-----s~_ ail) P~";J Fluid depth in absorption field before test DA,/ in. Water added.(z~ gal. Elapsed Time: ~'/~ min. Final fluid depth~''/a in. Absorption rate >= Any rejuvenation traatment (past 12 mo.) (Y/N & type) ~.,,4. /c ,,, ~ ~, ,-, Depression over field /~ 0 For ~ bedrooms New depth Dey in. -)~O g.p.d. If yea, give date -- D. UFT STATION Date installed Size in gallons Manhole/Access 'Pump on' level at Datum in. "Pump off' level at High water alarm level at Meets alarm & circuit requirements? in, E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot / 0 o / Absorption field on lot /O0 Public sewer main /J //4 Sewer/septic sewice line On adjacent lots On adjacent lots /00 '"/ Public sewer manhole/cleanout Holding tank /v//,4 G, ENGINEER'S CERTIFICATION I cerffiy that I have determined through field inspecUons and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name C. Oate HAA Fee $ Date of Payment Receipt Number (Rev. 12/01) Waiver Fee $ Date of Payment Receipt Number SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation ~ Property line 10o -/- Absorption field Water main ~/,a/ Water service line /0 'f Surface water Welt~ on adjasent lots / 0 o ~ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line I O0 t.../_ Building foundation / 0 L~ Water main WatarSewiceline /O ~ Surface water /00 t.?_. Ddveway, paddngNehidestorege Curtain'drain'~J 0,~- '~/(~/ow~, Wells on adjacent lots / 0 O ~' coMMENTS" "' ~" Aug-29-02 09:26A FORTUNE PROPERTIES, INC. 907 265-9191 P.03 EJt-N"EMEN~ ,~ ~' z SE 1/4. SW 1/4. I k Nw NW PLOT PLAN ASBOILT ~ SCALE I' ' 50' GRID ze4o Prolecf Nc). ~e- ~54 Kenneth G. Lan-. 17;51_ George Bell Circle, Anchorage, Alaak(~ 99515 ~l (907} 522-6476 Phone Registered Land Surveyor {907) 522 4625 Fax ~ ~..~L~ s; ~/~ ~ ~/4, ~ 1/~. ~ )/4, ~c. 2~sT~~, ~. s~p~o~. ~e~ ~ wl~ln ~e ~ I~ aha aa not ~ ~TO ~ p~p.~ ~.~.:...~ ...... :....~ .. .. . ~. WELL FLOW TEST DATA CLIENT: ,~"'/~ N ,0 ¥ ~.~,~.~ f ·. ":~' LEOALDESCRIP.IION: ~tH,~q~q~/ ~. ~ WELL DEPTII: ~ ~ ~. CASING DEPZtI: ~ ~ DA~E DRILLING COMPLEIED: ' ;tlOBEm' C. COW/94. I;E. nORERrA. SI IAr ER. PR. CIVIL ENIGINEEI~ (907) 694-2979 TAX (907) 694-1211 DATE: MISC. DATA: TEST DATA: CASING IIEIGIIT: ! ~ "9- SANITARY SEAL: ~' W1RES IN CONDUIT: red GRADING O.K..' r,~¢~a~' BACTERIA AND NITRAIE SAMPLES COLLECTED (dale): ~'/~,e/ [¢_~.,.~.__ CLOCK TIME io:, .... _ METER PUMPING DEPTIi to READING RATE wATER REMArKs (GAL) (OPM) (Pti o ~.~,~ - I ,~s pump c,~ I~EsULls: wELL cURRENTLY PRODUCES O, f~ oPM WI111A ~oH ' DRAWUOWN tEstED BY: ~ 0 b C . FLoW RAIE NOT OUARANTEED-SUBSEQUENT VARIATIONs CAN OCCUR. 110,14 14ORTII t:J~GLE RIVER LOOP · SUITE 204 i EAOLL RfV~R./tL~SKA 99511 Municipality of Anchorage Development Services Department Building Safety Division On-Site Water and Wastewatcr Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 xwvw.ci,anchoragc.ak.us (907) 343-7904 Water Well Advisory Health Authority Approval # 020475 During a recent Health Authority Approval on-site inspection and test of the potable water supply well on Block , Lot of T12N, R3W, Sec. 25, SEI/4, SWI/4, NWl/4, NWl/4, subdivision, the well's productivity was determined to be 0.6 gallons per minute. The minimum well productivity required by this Department (AMC 15.55) for a 5-bedroom residence is 0.52 gallons per minute. Although the subject well currently exceeds this minimum requirement, all parties concemed are advised that the production capacity of the well may fluctuate. Restriction of non-critical water uses such as washing cars and watering lawns and gardens may be required. This advisory must be attached to all copies of the subject Health Authority Approval.