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Home My WebLink AboutT15N R1W SEC 8 LT 62 Municipality of Anchorage Page I 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 Name: ~S ~IL~ Wastewater System: ~New D Upgrade TO~I Dept~ ff~m odg~l grade: Lot: ~'5. ~ OJ~k: Su~iv~ion: ~p~pi...om~monginalg=e: WELL: ~ ~New D Upgrade Gavelwidt~: I~ ;t % Yield: I Pump ~t at: I~ng ~'gm ~ Gmuna: SEPARATION DISTANCES ~$eptic ~ Holding a S.T.E.P. Wats, LI~ STATION Remarks: BENCH MARK Fo ............. Depadment of Health ~nd ~man ~ces approval ~ ~" ' Reviewed and approved by: ~ Date: ~'~ o - ~ ~ ' ~ Municipality of AncheraDe DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. ee× 196650 · Anchorage. Alaska 99519-6650 · Telephone: 34,3-4?44 On-Site Wastewater Disposal System and/or Well Inspection Report 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 PermttN°-.,~C'~) ~:)/::~LI Page ~t' 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 I unlcipallty of Anchorage '~ DEPARTMENT OF H~LTH & HUMAN SERVICES 825 'L" Strut, Anchorage, Alaska 99502~50 SOILS LOG -- PERCO~TION TEST FOR: LEGAL DESCRIPTION: '~' ~' LO~ 6 Z Township, Range, Se~ion: 6- 7 8 9 10 11 12 13 14 15 16 18- 19- 20- SLOPE SITE PLAN d WASGROUNOWATER ENCOUNTERED? IF YES, ATWHAT DEPTH? I~ph Io Wale' Nter aeail~ino? Daf** Reading Date Cross Net ~ Net Time Time Wate~ L~.l*~t Drop ~oo ' ~" ~.'. 40 i~,df~. ,.~- r~~' PERCOLATION RATE TEST RUN BETWEEN COMMENTS ACCOROANCE WITH ALI. STATE A)N'~MUNIClPAI. GUIDELINES IN EFFEC~TE. 72-008 (Re~. 4/85) -- {mmutes/mcl~) PERC HOLE DIAMETER" ~' II FI AND / FI CERTIFY THAT THIS TEST WAS PERFORMED IN oAt~ 3'ClLV ~, 19q~, 'McKay Well Drilling P.O. Box 878148 WLsilIm, A~kl 99687-7704 Ptlmm 37G-SOS8 WELL LOG AUTHORIZAT~ I hereby authorize McKay Drilling to proceed with the ~mve work. Pw/rneflt shill be made in the follow;ng manner: Rig up Minimum Balance due upon completion. pm'foot In the event it is neces~ry to in'tufa Ilgal proceedings to collect Iny ~mounts due on this con- tract, I agree to pay In Idditiorll sum of fiftemt percent (15%) of ~ original contract pric~ I~us attorney's f~e~, and cost for legal proc-edlng, RECEIVED Nm I~OV 2 5 1991] Municipality of Anchorage ~ Dept. Health & Human Services 11/21/98 SAT 10:07 [TX/RX NO 7983) MUNICIPALITY OF ANC]{OPJ%GE DEPARTMENT OF HEALTH AND ~ SERVICES P.O. BOX 196650, 825 #L" STREET, ROOM 502 ANCHORAGE, A/~ASKA 99519-6650 PAGE I OF ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT ~K~MBER: SW980171 DESIGN ENGINEER: OWNER ADDRESS ~PO'BOX '670434 CHUGIAK, AK 99567-0434 DATE ISSUED: 6/12/98 EXPIRATION DATE: 6/12/99 PARCEL ID:05109111 LEGAL DESCRIPTION: T15N RiW SEC 8 LT 62 LOT SIZE: 108900 (SQ. FT.) ~K]MBER OF BEDROOMS: 4 THIS PERMIT: THIS PERMIT IS FORT HE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHEDAPPROVED DESIGN. 2. ~ REQUIREMENTS SPECIFIED IN ANCHORAGE ~/UNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE ENGINEER MUST NOTIFY DH~S AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744'( 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 ~UST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND }{EATED TO PREVENT FREEZING 5. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: Permit No. P,.ge / 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 Legal Description: C/,~, ~O~-~Z. ~'~'/kJ ~--I/4~ ~ ~,,~ PID No.: /~E-8483 Permit No. 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 ~ Legal Description: [/.S. ~7-~.. '~-~ ~-/~ ~ ~PID NO.: · Permit No. Pege ~ Municipalit7 of Anchorage DEPARTMENT OF' HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION Legal Description: ~/°'~' ~ ~ 7T~'/,~ ~.l ~LJ ~;:) ~/{/I PID No.: _of ~ P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well Im~ee4ien Fiepe~ ,-, ~........../:.,~ ~',, DEPARTMENT OF H~LTH & HUMAN SERVICES~* ?~H~~. ~.~ ,25 'L' S~,L ~,c~o~,. A~ ~o '. -- ...~..~.;'~.. ~ SOILS LOG PERCO~TION ~ST DATE ~eS, ~ ~ Township. Range.~e~ion: ~ ~1~ ~.~. S,OPE SITE PLAN 1 2 3 4- 5- 6- 7- 8- 9o 10- 11 13- 15- 16. 17 18 19 20 COMMENTS WAS GROU.D WATER .~ ENCOUNTERED? s IF YES, AT WHAT DEPTH? E · It PERCOt.~TION RATE 0*[Z'~''(mlnUte~ln~) PERC HOLE DIAMETE~ ~ ADCO.0A.CEW,THA''STATEA.OMu.,c,.'".. ,DE',.E.,.E..EC.O.J,SDAT. 'OAT"' , i I LOT 581 I I~ LOT 59 LOT 60 J --- I I ~ 89 57 oo E 329.89' (P) 329.93' I~ ~ ~ ~ ..... '.~~ 11o s,~t~ LOT 63~ ~' 'M: . ~x~ ,~=~-=~ ''--' 145' ' ~Proposed ~rain ~e~ ~ ~' / D~in ~eld I t ~ ~ ---- I ~] I~ S 89'57'13" E 329.84' (P) ~ P~oposed shop LOT se ,-~ol~'~o,-,~ ~OT S? I LOT I Io I I , I , I LEGEND - Drainage ~ow x 153.1' Spot [levot~on, ~$umed Eosements of record, o~er then those ~hown on U. $. Patent No. 1217558, ore not shown hereon, ~ ~49th ~op,,y: u.s. Lot ~. s,~tio, 8. T. ~S N.. ~. ~ W., ~,,*,,,,~-,,,,, ..... ,,,,,,,,,,,,,~. ,,~ Potent No. 1217558, and that the improvements situated theron ~ ~ % ~;net/M. ~itf;etd easemente on so~d prope~ except OS indicated hereon. /~-~-~ -' /~ ~ ~e~ ~;s 1st d~ of June. 1998. Palmer. ~ u~%, ~0.~ 8921 ** ~A ~",,, ,,,'~ ~ole: ~ Job No. ~eld ~ook: '¢~ ~] .............. ~ ~ 1' - 100' g8-14 gs-o1 '~ESSI~~ ~e: Drown / Checked: Cl;ent: ~ ~ ~ 06~01 ~98 J~ H~S s 89'57'00" E 329.89' (P) 329.93' (R) SHOULDER Of PAVED ROAD 50' R.O.W. LOT 62 ~08,896 SO, FT. / ~c~ ~ ,~ Well/ 4~ Sept~ Rise.. ~ -. · ~' .. .. ~ ~s'.4' 86.8' [ ~' --Deck 2-Sto~ . 133,8' ' · ~ 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # {'"'?-~ \ - r,'C~ ~'- ~ \ .AA #~,'~ GENERAL INFORMATION Complete legal description U.S. Lot 62, Section 8~ T15N, RIW, S;M. Anchorage Recording District Location (site address or directions) North Birchwood Loop to Sunset Blvd. Second House on the left. Prope~ owner Mailing address Lending agency Mailin. g address Agent None Address Rpnne~ ~ ~h~l~ n~ Dayp~one 770.7R~7 4511Folker #12B; 'Anc. , Alaska 99507 N~tion~l Bani< of Alaska Day phone 376-5355 581W. Parks Hwy; Wasilla, Alaska 99654 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: X If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system·- 4. TYPE OFWASTEWATER DISPOSAL: NOTE: Individual on-site X Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC .... attesting to the legality and status of system. 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 Archf~e Gidd f. nRs Phone 373-0270 Address . Engineers signature DHHS SIGNATURE ;)~ Ap. proved for Date ///~/~5 / / bedrooms. Disapproved. Conditional approval for 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 pumhasers 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. RECEIVED Municipality of Anchorage NOV 2 5 19~ DEPARTMENT OF HEALTH & HUMAN SERVICESJ~UN~C~PAu~ OF Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Legal Description: A. WEU. DATA Well type private Log present (Y/N) YES Total depth ~/0~;:) ~e-1L' San~ary se~ (Y/N) YES Health Authority Approval Checklist U.S. Lot 62, Sec.8 TI5N R1W S.M. ParcelI.D.:. If A, B, or C, attach ADEC letter. ADEC water system number Ds,, completed Cased to ~ ~,_-~- Casing height (above ground) Date of test Stefic water level Well production WATER SAMPLE RESULTS: col~orm ~ Il TmF~-c'Toe-¥ B. SEI~rlo/HOLDING TANK DATA Date instelled 7Ill/98 Found~,fion deanout (Y/N) Wires pmberly protected (Y/N) YE~ FROM WELL LOG g.p.m. AT INSPECTION 2.2 g.p.m. ~nu~es Date of Pumping NONE ABSORPTION fiELD DATA Da~ InsUred 7/] ]/c?8 Len~ 40~t Tank ~ze 1250 Number of CompaJlments 2 Cleanoute (Y/N) YES Depression (Y/N) NO High water alarm (Y/N) NO/NA Pumper NEW CONSTRUCTION-HOUSE NEARLY COMPLETE AS OF 11/21/98 NO OCCUPANTS OR t~ OF SEPTIC SYSTF~I 6(IQFr2 ManltodngTubepmsent(Y/N) yFC[ Depre~ionowrfield(Y/N) NO Fluid dep'd~ in absorption field before test (in.); NA Fluid depth NA (ins) Minutes lete~. Perax~ ~eatment (past ~2 monms) (Y/N). NA Immediately after gal water added (in.): A~oq~on rate = g.p.d. If ~, glv~ d~e D. UFT STATION Date installed Size in gallons IVlanhol~Ao~ss (Y/N) High water alarm level et* Cycles Msted E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septt~holdlng tank on lot 1 2/,fr Absomfion field on lot 145ft Public sewer main 200£¢~- Sewer/septic sewlce line ] 05fr. 'Pump on" level at* *Datum On adjacent lots On adjacent lots ]0Oft+ Public sewer manhole/cleanout lift station none SEPARATION DISTANCES FROM SEPTIC,/HOLDING TANK ON LOTTO'. Foundation 12ft Properly line 65£t Abso~ption field Watermaln/sewlcellne :)~.;r. Surfacewater/drainege 10Oft+ SEPARATION DISTANCE FROMABSORPTION FIELD ON LOTTO: Property line lOft Surface water lOOft+ Cu~aln drain 20Oft+ 'Pump off' level at* 1 ~ft Wel~on adjasentlots l~ft* Building foun"~lfion 33ft Wate~ main/service line Driveway, paddng/vehicle storage area Wells on adjacent lots Waiver Fee $, Date of Payment Receipt Number RecelptNumber ~4~' l'~0 Well Flow Test: November 21, 1998 U.S. Lot 62, Section 8, TISN, RIW, S.M. From Well Log: Total Depth~100 feet Amount of C, aslng Above Gro~d=l.5 feet Performed by Archie Giddln~, P.E. P,O. Box 872024 Wasilla, Alaak~ 99687 (9O7)373-O27O T'~ae Water Level Flow Volume (fl) below top (gpm) (gal.) 12:43pm 31 7.5 0 12:56 85 7.5 97 · 1:06 .... 7.5 97 1:09 85 7.5 120 1:29 ... 7.5 120 1:36 85 7.5 172 1:56 ~ 7.5 172 2:02 85 7.5 217 2:22 ~ 7.5 217 2:29 85 7.5 270 2:49 7.5 270 2:56 85 7.5 322 3:16 ., , 7.5 322 3:23 85 7.5 375 3:43 7.5 375 3:50 85 7.5 427 4:10 ~ 7.5 427 4:17 85 7.5 480 4:37 ~ 7.5 480 4:44 85 7.5 532 Start well pump Water level (~ pump intake Shut-offpump/recovery Start pump Shut-offpump/recovery Start pump Shut-offpump/recovery Start pump Shut-offpump/recovery Start pump Shut-offpump/recovery Start pump Shut-off pump/recovery Start pump Shut-off pump/recovery Start pump Shut-off pump/recovery Start pump Shut-offpump/recovery Stat pump Shut-offpump/end test Total Flow=532 gallons/Total Time~-241 minutes Well Production=2.2gpm RECeIVeD ~OV 25 1998 Municipality Ot Anchorage Dept. Health & Human Se~ices · .4~r~' ,, CT&E Envlronmentzl Sen~ce~ Inc. CT&E ReC# Client N~me Client Sample Ordered By 9867970O1 GidcUag, 4,$ L 62 Sec 8 TISN RIW S.M. OtugJak-Hose Bib Drln~'t.g Water Client PO// Prfnted D~teJT[m. 11/24/98 CoilectM Dataf]Ffme 11/19/98 0~:45 R~.~ived Date~lme 11/19/95 09:20 Technical D/rector: Stephen C. Ede Sample RematJcs: Atto~ibt. Prep Analysis Parameter Re~utta POL Units ~ethed Limits Date Date Init Totlt Cotifom 0 cot/lO~ ~la ~l 11/19~ ~ RECEIVED f ,~ ,:- NOV 25 1951~ ' , Municipality of Ancno'rage --: ,"'-~ ' Oept. Health & Human Se[vices TOTI:L 11/24/98 TUE 16:19 [TX/RI NO 7994]