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HomeMy WebLinkAboutPROSPECT HEIGHTS #1 BLK 3 LT 8AProspect Height Block Lot 8A #015-092-11 Municipality of Anchorage --over a 3 obi 0 Community Development Department Page 1 o 3 On -Site Water and Wastewater Program DEC 22 2011 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE;WASTEWATER INSPECTION REPORT Permit Number: OSP151062 PID Number: 051-092-11 ❑ New ❑✓ Upgrade Name: ABSORPTION FIELD Bruce & Judy Palmer ❑ Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 8151 Downhill Cir. Anchorage, AK 99507 ❑ Other Phone - _ Number of Bedrooms Soil Rating - Total depth from original grade 4 - GPD/SF Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade Ft. Gravel depth beneath pipe - Ft. Subdivision Block Lot Prospect Heights #1 3 8A Fill added above original gradeGravel Ft. length Ft. Township Range Section - Gravel width Ft. Beds: Number of Lines Distance between lines Ft, SEPARATION DISTANCES To Septic Absorption Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Lift Station - Tank Line - Ft? Ft. Well 147.7 N/A NIA N/A 132.8 TANK ❑+ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer - Anchorage Tank Capacity 1,250Gal. Surface Water - 100+ N/A N/A N/A Material Steel Number of compartments 2 Lot Line 63.2 N/A N/A N/A NA Foundation 24.6 N/A N/A N/A LIFT STATION Manufacturer Capacity Gal. Curtain Drain 50+ N/A NIA N/A Pump on level at Pump off level at High water alarm at Remarks Tank replace only in. in. in. - - Pump make and model Electrical Inspections performed by PIPEMATERIAL Housetotank 3034 Teldkto 3034 drainfield n Installer A+ Home Services Drainield 3034 COfMT 3034 Inspector Pannone Engineering Services, LLC. BENCHMARK (Assumed elevation) 100ft Inspection 4 1 Location and description dates: 7/8/;1015 2-_ Top of Finished Floor 3a 4m COMMUNITY DEVELOPMENT_ DEPARTMENT APPROVAL Engineer's Stamp Conditional Approval: Date AT 48 TH even nnome _ 1 Approved W4�t�tX Date — /��lfA CE 8149yr ., - • Inspection Report1-1-12.doc A B J o� j j FC 31.5 Q o 0 0 ,.,., o T1 41.0 34.0 0 w w w m'o w T2 46.9 42.0 / "- " oo DC 48.8 44.2 LEL7e.a EC1 56.3 52.5 E�. �s.o NEW 1,250 GAL SEPTIC TANK et- �a.z 7A � / 9A NOTES: PANNONE ENG SVC, LLC P.O. BOX 100217 ANCHORAGE, AK 99510 PHONE (907) 272-8218 FAX (907) 272-8211 —�oF q \\� r 1 �� " '"' qS l� %g�P Fy++ [j9 TH •.*I/ j... ... .. .... �........,,,.•„•••,,,• Steven R. Pannone / � c . CE 8149 .��� _ +ilii os... p \\ `�� Dote 2/21/201; RECORD DRAWING scale 1"=60'- P.I.D. NO 015 -092 -II PERMIT NO OSP151062 DRAWN BY: -*; PROSPECT HEIGHTS #1, BLOCK 3, LOT 8A BRUCE & JUDY PALMER 8151 DOWNHILL CIRCLE ANCHORAGE, AK 99507 NJC PLAN SheetOF 3 Permit Number: OSP151062 Tax Code Number: 01509211000 Work Type: SepticTank Permit Effective Dates: April 15, 2015 On-Site Water and/or Wastewater System Permit MUNICIPALITY OF ANCHORAGE Development Services Depadment On-Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Upgrade to April 14, 2016 Design Engineer: PANNONE ENGINEERING SERVICE Subdivision: PROSPECT HEIGHTS #1 Site LegalAddress: PROSPECT HEIGHTS #1 BLK 3 LT 8A G:2441 Owner/Address: PALMER BRUCE J & JUDY J 8151 DOWNHILL ClR ANCHORAGE AK 995070000 Depa r t 1tleI~ t Site Mailing Address: 8151 DOWNHILL CIR, Anchorage Lot Size in Sq Ft: 123275 Total Bedrooms: 4 This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy N 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 (18AAC80). 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 By:~ Issued By: MUNICIPALITY OF ANCHORAGE Community Development Department Development Services Division On-Site Water & Wastewater Program ON-SITE SEWER/WELL PERMIT APPLICATION Phone: 907-343-7904 MAR 3 ! 2015 Gretchen Stuller Parcel I.D. 015-092-11 Property owner(s) Bruce Palmer Mailing address 8151 Downhill Circle, Anchorage AK 99507 Day.phone 907-243-8007 Site address 8151 Downhill Circle, Anchorage AK 99507 Legal description (Sub'd., Block & Lot) Prospect Heights #1, Block 3, Lot 8A Legal description (Township, Range'& Section) Lot Size 121968 Sq. Ft. Number of Bedrooms 4 APPLICATION IS FOR: ([~ all that apply) Absorption Field [] Septic Tank [] Holding Tank [] Privy [] Private Well [] Water Storage [] APPLICATION IS AN: Initial [] Upgrade [] Renewal [] TYPE OF DWELLING: Single Family (SF) [] (w/wo ADU) Duplex (D) [] Multiple Dwellings [] (SF and/or D) THIS APPLICATION INCLUDES A VARIANCE I 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 ~)r authorized agent) Permit/Ru~h Fees: Date of Payment: ~ Receipt Number: Permit No. Waiver Fees; Date of Payment: Receipt Number: Waiver No. Permit App_L'- :. :2.,~c: Pannone Engineering Services LLC Steven R. Pannone, Principal Registered Professional Engineer E-maih steve~panengak.com Municipality of Anchorage Development Service~ Department On-Site Water & Wastewater Program 4700 Elmore Road P. O. Box 196650 Anchorage, Alaska 99519 30 March 2015 Subject: Prospect Heights #1, Block 3, Lot-8A Septic Tank Upgrade Permit Request Ladies and Gentlemen: I am writing to request a permit to install an upgrade septic tank be issued for this property. The proposed system will serve a existing four (4) bedroom house. Currently the existing tank is in failure. The existing 1250g steel septic tank will be replaced. This lot is served by a private well. The surrounding lots are also served by private wells. There are no wells within 100' of this system. 1. Surface Water: There is no surface water within 100 feet of the proposed septic. 2, Topography: The proposed tank replacement is located on the northern portion of the lot. The surrounding topography generally slopes from east to west at approximately 2%-4%. 3. Drawing Markings: The Drawings are marked "For MoA Review Only". When written notification that the review is complete and that there are no further comments is received from MoA On-Site Department, the note will be removed and "Issued for Construction" drawings will be issued. The proposed installation will not affect the future development of the surrounding or existing lots. If you have any questions or concerns, please contact me at 272-8218. SincereJy, ...... Steven R. Pannone, P.E. Owner/Civil Engineer Mailing: P.O. Box 100217, Anchorage, AK 99510-0217 Physical: 332 East Manor, Anchorage, AK 99501 Telephone: (907) 272-8218 FAX: (907) 272-8211 , NO WELLS OR SEPTfC SYSTEMS / / ~\ ~ I / i WITHIN 200' OF PROPOSED TANK o°~ ,' REMOVE 12509 TANK (E) AND ' : ~ U, /REPLACE WITH 1250g TANK (P) . . FOR CONSmUCT~ON P,O. 80X 100217 AN6HORA6E, AK 99510 ~% ...... ';~ PHON~ (907) 272-8218 FAX (907) 272-82~1 PROSPECT HEIGHTS ~1, BLOCK 5, LOT 8A ~~ ~ ~ o15-o92-H BRUCE PALMER ~%S~% Cj ~ .... %~"%,' ,7 · ~ PERMIT NO. 8151 DOWNHILL CIRCLE '~¢~.~(¢~9%~ DSPXXXXXX PLAN ANCHORAGE, AK 99507 ~(~S(~ Sheet SPECIAL PROVISIONS TO SPECIFICATIONS 1. ALL CONSTRUCTION WILL 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 ON SITE WASTEWATER DISPOSAL SYSTEMS, 2. SCOPE OF WORK: INSTALL 1250g SEPTIC TANK. Z Ow k- <:0 0 ©J INSTALL 12509 SEPTIC TANK PROFILE ABBREVIATIONS CU cOPPER DESIGN PARAMETERS - DIP DUCTILE IRON PIPE INSTALL SEPTIC TANKLEGENDTH TEST HOLE NO. BEDROOM: 4 (600 gpd) WATER LINE/ FC FOUNDATION CLEAN OUT TANK SIZE: 12509 W WELL RADIUS T# TANK CLEAN OUT NO. C# CLEAN OUT NO. USE: -- SS -- NEW SEPTIC M# MONITOR TUBE NO. 12509 STEEL TANK R.I. RIGID INSULATION DCO DOUBLE CLEAN OUT DV DIVERTER VALVE FS FLOW SPL117ER BFG BELOW FINISH GRADE OG ORIGINAL GRADE FG FINISH GRADE TS&:V TOPSOIL &: VEGETATE NOT~S: PANNONE LNG SVC, LLC FOR CONSTRUCTION P.O. BOX 100217 ANCHORAGE, Al( 99510 .~_/,,,~..,...' PHONE (907) 272-8218 FAX (907) 272-8211 ~',6"'~.'.~01" ~'"'.'~-fl I' ScoeNTS ~ ..... 'CS:NV'~.,,,¥/· ¢ ~.,.,:,. ,,,o ALFRED BENNETT~no...~.e ~.~'.~. JERMIT NO. 9700 BUDDY WERNER DRIVE f~,¢~.. ,,?~.~.~,17..~.,._.~-~,. )sPxxxxxx ANCHORAGE, AK 99507 .~it,~£¢M,;::~-~,~,..,,.~ Sheet DESIGN DETAILS DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMEN'rAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~ ~.~ '~ ,~T/-- ~/~Y (~" _Z/~- ~] UPGRADE MAILING LEGAL DESCRIPTION LOCATION NO. OF~DROOMS ~ ~ DISTANCE TO; I ~ell [ 00/ + ~bsorp,io~ar~a Dwellin~ O ~ PE..IT NO.  ~anufacturer ~ ~ Mate~ No. of ~m~artments Liq. capacity in gallons Inside length Width Liquid depth ~ ~$O ~FHO~DE: ~ ~ DISTANCE TO: Well Dwelling PERMIT NO. O ~ ~ Manufacturer Material Liquid capacity in gallons ~ DISTANCE TO; Well /OO/ + Founda~n5 / NeareSl~e, + pE~Td~a ¢ q ~ -- O Total ~n~h~f lines Trench width Distance between lines ~ ~ Z No, of lines ~ Length of each~ne -- _~ inches ~ Top of tile to finish grade q 5e , .aterial beneath tile ¢ ~ Total effective absorption area a inches ~ ~ O Length Width Depth PER~IT NO. ~ ~ Type of crib Crib diameter Crib depth Total effective absorption area a Well Building foundatiou Nearest lot line ~ DISTANCE TO: ~a DISTANC~ TO: Building foundation Sewer line Septic tank Absorption area{si OTHER PIPE MATERIALS ~ ~ '~, ) SOILTESTRATING / ~ : ¢ ~0 INSTAELER ~ REMARKS ~' ~ APPROVED DATE LEGAL PERMIT NO. ( 780484 ) APPLICANT _ROGER DALRVMP~ LOCRTION BUDDY WERNER DRIVE LEGAL LOT 8R 8K ~ PROSPECT HTS 'I'VPE OF SOIL RBSORBTION SVSTEM IS: TRENCH MAXIMUM NUMBER OF BEDROOMS = 4 DEPARTMENT OF HEALTH FIND ENVIRONMENTAL PF. tOTECTION o,=.. '"L" ...TREET, ANCHORAGE., AK. C~~~-- :--~. X T'E ..__. . ....., ... ,~ / , ~',"~' ':'" F'-''"~''-' ''' LOT SI~E 'i.';'±9~]~. S6.d__~=IF.".E F'~E[T, ~ · SFIIL RATING (SL.':! FT,."BR)= '165 THE F,:EF.,.!I_IIRED SIZE OF THE SOIL ABSORPTION S"r'STEM IS: [:, E F'l' H == :l.k_--i L_ E ~-,~_3'l"H = :.~6 ,3RR%-'EL. []:-, l:---_ F' 7' F~ = ~]; THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF a TRENCH OR PIT IS THE DISTANCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRVRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL. BETWEEN THE OUTFRL. L PIPE AN[) THE BOTTOM OF THE EXCAVATION (IN FEET). PEF,':MIT AF'PLICRNT HR.=-, THE RE~FUNz, IE, ILI] 'r TO INFORM TFIIS [:'EPARTMENT DIIRING THE INSTRLLFITION IN=,FEL. TILN.=, OF ANY WELLS N[.JMbENI TO THIS PF.'.PEE] ~' RN[:' THE NUMBER OF F,.E_,IDEHL. E.=, THAT THE WELL WILL SERVE. T&-~] ,::.;--Z" ::,I t'ql_-_. F.'"- "FZL. T- -- ][ C~t'-,t'}_; RF-:E F.:: [-],]:.~ Et I F-:; F'[: " ....... ' ' F ' ,' - B 'T' E, HL.t...FILLING OF I~]N'¢ S'¢S'FEM WITHOLIT FINAL INSPECTION RND HFPF.,_I,ML THIS [EFHETi'IENT WILL BE ~IIB.TEI~:T TO PR--'q, EC TION MINIMUM DISTANCE BETWEEN R WELL RND RNa; ON-SITE SEWAGE DISPOSRL. SYSTEM IS &00 FEET FOR A PRIVRTE WELL; OR ±50 TO 200 PEEl' FROM R PUBLIC WELL DEPENDING UPON THE T~PE OF PUBLIC WEL. L. OTHER REQUIREMENTS MA9 APPLV. SPECIFICATIONS AND CONSTRUCTION DIAGRRMS BRI?' AVRILABLE TO INSURE PROPER INSTAt_LRTION. F'EI;~:~--1 I T E,'--::P I Ri. ES] [:,E~-~::Ef-IBEF.: _-----::IL.. I CERTIFV THAT :t.: I AM FAMILIAR WITH THE RE6!UIREMENTS FOR ON-SI'rE SEI4ERS AND WELL'_-] FIS SET FORTH B'.? THE MUNICIPAL. lTV OF ANCHORAGE. 2: I WILL INSTALL THE SVSTEM IN FICCORDFtNCE WITH THE CODES. ]:: I UNDERSTAND THAT THE ON-SITE SEWER S~r'STEM MAY RE6.'UIRE ENLARGEMENT IF' THE RES I [:'E(~? REM ~F~TO~. i I"~]iL U [:'E i~0~ THAN 4 E:EDROOMS, 4040 "B" STREET ANCHORAGE, ALASKA 99503 (907) 278-1551 May 24, 1978 W.O. #A18452 -Grid #2441 Roger Dalrymple Box 3-176 Anchorage, Alaska 99501 Subject: Subsurface Investigation for sUitability of.. On-Site Sewer, Lot 8A, Block 3, Prospect Heights Subdivision Dear Mr. Dalrymple: Transmitted herein in accordance With your instructions, are the results of the above referenced investigation as performed. by us on May 23, 1978. The scope of this project is the investigation for suitability of an on-site sewerage system. .~ Included in this transmittal are: Test Hole Location Sketch Test Hole Log Explanatory Information Figure 1 Table A Sheets 1-3 The exploration was conducted using a continuous flight solid stem auger. The rig is owned.and operated by Denali Drilling, Inc. Drilling was supervised 'and the test hole · logged by Mr. O.M. Hatch, geologist for Alaska Testlab. The log of the test hole is included as Table A of this report. In interpretinq the loq, it would be helpful to utilize the explanatory-information contained in Sheets 1-3 of the report. When drilling was completed a 3/4" slotted PVC pipe was inserted in the hole to aid in determining the free water level. For the percolation test, the test hole was filled with water and left overnight to saturate. On returning the next day, the hole was refilled .with water and the-drop·.in the water level carefully monitored over the next 60 minutes. This procedure is not a standardized percolation test, however, we understand that the Municipality of Anchorage, Department of Public Health and Environmental Protection prefers tests performed in this manner to evaluate a site for a proposed on-site sewerage system. Test Hole #1 Table A Date: 5/22/78 Logged by: O.M. Hatch WO #A18452 Depth in Feet From To 0 1.0 1.0 3.0 3.0 16.0 Soil Description F4, brown Peat, Pt., damp, soft. F4, brown Sandy Silt, ML, wet. F2, brown Slightly Silty Very Gravelly Sand, SP/SM, poorly graded, all sand sizes present, damp, medium density, rounded to subrounded~! particles to 3". Bottom of Test Hole: Frost Line: Free Water Level: 16.0' None Observed None Observed REMARKS: Layer from 1.0' .to 3.0' wet from thaw water. Soil is siltier below 12.0'. Mr. Roger Dalrymple May 24, 1978 Page 2 Using the above test, the observed minimum percolation rate was 10.0 minutes/inch. No water table was observed during drilling. It should be noted though, that the free water level normallY flUCtuates seasonally and with precipitation. We hope this report meets your present needs. If we can be of further service, please feel free to contact us. sincerely, ALASKA TESTLAB~ Robert Co Stinnett RCS:bjc enclosures APPROVED: Melvin R. Nichols, P.E. Laboratory Manager Test Hole Lo9 - Description Guide The soil descripttons shown on the logs are the best estimate of the soil's characteristics at the time of field examinatton and as such do not achieve the Frecision of a laboratory testing procedure. If the log includes soils samples, those samples receive an independent textural classification in the laboratory to verify the field examination. The logs often include the followmg items: Depth Interval - usually shown to 0.1 foot, within that zone no significant change in soil type was observed through drill action, direct observation or sampling. Frost Classification - NFS, Fl, F2, F3, F4, see "Soil Classification Chart" Texture of Soil - An engineering classification of the soils by particle stze and proportion, see "Soil Classification Chart", note the proportions are approximate and modifications to the soil group due to stratification, inclusions and changes in properties are included. Moisture Content -. this is a qualitative measure: d_~, no or little apparent surface moisture, damp. moisture forms portion of color, less thau plastic limit, wet, no free water, often soft, if cohesive soil, saturated, free water may be squeezed out, ifa free draining soil; dilarent at natural moisture content, if a non-plastic silt or fine sand. (The moisture content is further defined by reference to PI, LW, NP, M%or dilatency.) Density - refers to more-or-less non-cohesive soils, such as sand gravel mixtures with or without a fine fraction, derived from drilling action and/or sample data; usually described as: very loose, loose, medium dense, very dense. General intent is to portray earthwork characteristics. Stiffness - refers to more-or-less cohesive soils and fine grained silts of ~ clay-silt groups. Derived from drill action and/or sample data. Very soft, soft. stiff, very stiffand hard are commonly used terms. Particle size - The largest particle recovered by the split spoon is 1-3/8", Shelby tube Y', auger flights (minute-man) 2", Auger flights (B-50 hollow stem) 6"-8". Larger particles are described indirectly by action of tile drdling and are referred to as cobbles, 3" to 8", or boulders 8"+. Therefore when reviewing the gradation sheets, if any, the description on the hole log must be considered for an:indication of larger particles. Unified Sod Classification - This is i two letter code. See Unified Classification sheet for further definition. In some cases AASHO and/or FAA soil classifications may be shown as well as the unified. Atterberg Limits - useful for fine grained and other plastic soils. :PI; natttral moisture content believed to be less than plastic limit Pi+; natural moisture content believed to be between plastic and liquid ~-mits L__.~; natural moisture content believed to be greater than liquid limit · NP; non-plastic, useful as a modifying description of some silty ~t~rials. Dilatency - is the ability of water to migrate to the surface of a saturated or nearly saturated soil sample when vibrated or johed -- u~ed as an aid to determine if a fine grained soil is a slightly or non-plastic silt or a volcanic ash, Rock flour - finely ground soil that is not plastic but otherwise appears similar to a clayey silt. Organic Content - usually described as Peat, PT, sometimes includes discrete particles such as wood, coal, etc. as a modifier to an inorganic soil. Quantity described as; trace, or an estimate of volume, or, in case :of all organic, - as Peat. This may include tundra, muskeg and bog material. Muck - a modifier used to describe very soft, semi-organic deposits usually occuring below a peat deposit. Amorphus peat - organic particles nearly or fully disintegrated. Fibrous Peat - organic particles more-or-less intact. Bottom of Testhole - includes last sample interval. Frost Line - seasonal frost depth as described by drilling action and/or samples at the time of drilling. Frozen Ground - other than frost line, described by samples, usually includes description of ice content, often will include modified Unified Classification for frozen soils - this is a special case related to permafrost studies. Free Water Level - The free water level noted during drilling. This is not necessarily the static water table at the time of drilling or at other seasons. Static Water table determination in other than very permeable soils requires observation wells or piezometer installations, used only in special cases. Blow/6" - The number of blows of a 140 weight free falling 30" to advance a 2" split spoon 6"; the number of blows for a 12" advance is. by definition, the standard penetration. M% - natural moisture content of the soil sample, usually not p-'~'rformed on clean sands or gravels below the water table. Type of Sample - . S.__P, refers to 2" split spoon driven into the soil by 140 pound weight, a disturbed sample, S~ thin wall tube, "Shelby" used to obtain undisturbed samples of fine grained soil, ~i~ "grab" disturbed sample from auger flights or wall of trench, C, cut sample, undisturbed sample from wall of trench· Dry Strength - a useful indicator of a soil's clayey fraction, N=None, L=Low, M=Medium, H=High ~ -- The samples are placed into apparently similar groups based on color and texture and are arbitrarily assigned a group letter. Further disturbed tests including Atterberg Limits, grain size, moisture4iensity relationship, etc. may be performed on the group and are assumed to reflect the general distrubed characteristics of the soils assigned to 'the group. This is an important phase of the soil analysis and is used to .:'staudardize the various qualitative determinations and to reduce the ' number of quantitative tests necessary to describe the soil mass. .SOIL CLASSIFICATION CHART 30% GRAVEL CLAY CLAYEY OR SILTY CLAYEY CLAYEY SILTY SILTY CLAYEY SILTY SAND GRAVELLY SAND GRAVEL SANDY GRAVEL \/ SAND GRAVELLY SAND DY GRAVEL GRAVEL 0 10 20 30 40 50 60 70 80 90 100 GRAVEL (+#4 SCREEN) % BY WEIGHT ~NONFROST SUSCEPTIBLE SOILS ARE INORGANIC SOILS CONTAINING LESS THAN 3% FINER THAN 0,02 mm. · GROUPS O F F ROST-SUSCEPTI BLE SOl LS: F1 GRAVELLY SOILS CONTAINING BETWEEN 3 AND 20% FINER THAN 0.02 mm. - ' F2 SANDY SOILS CONTAINING BETWEEN 3 AND 15% FINER THAN 0.02 mm. F3 a. GRAVELLY SOILS CONTAINING MORE THAN 20% FINER THANO:02 mm. AND SANDY SOILS (EXCEPT FINE SILTY, SANDS) CONTAINING MORE THAN 15% FINER THAN 0.02 mm. b, CLAYS WITH PLASTICITY INDEXES OF MORE THAN 12. EXCEPT VARVED CLAYS. F4 a, ALL SILTS INCLUDING SANDY SILTS. . ~ :.. . b, FINE SILTY SANDS CONTAINING MORE THAN 15% FINER THAN 0~02 mm: r_, LEAN CLAYS WITH PLASTICITY INDEXES OF LESS THAN 12. d, VARVED CLAYS. PERMI~~ NO. ...... -~- "---- & I' ~--I!,,~ JI.. ! "IF- IJ~ DEPRRTMENT ~'~ HERLTH RND ENVIRONMENTRL~"F,'OTECTION 825 " STREET~ RNCHORRGE~ 264-4720 NELL PERr-1 I T 788_?.3:2 ) 8PF'LICRNT ROGER DRLRYMPLE BOX ~-i76 RNCH 274-i485 LOCRTION CORNER GLRCIER & 8LPINE LEGRL L 88 B ~ PROSPECT HTS, SUB LOT SIZE 12~275 SQURRE FEET MINIMUM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS 100 FEET FOR R PRIVRTE WELL~ OR 150 TO 200 FEET FROM 8 PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL, WELL LOGS 8RE REQUIRED RND MUST BE RETURNED TO THE DEPRRTMENT WITHIN ~0 DRYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE RVRILRBLE TO INSURE PROPER INSTRLLRTION. F'ERM I T F.'-<F' I REiS [)ECEr-IE:ER ----<l.. 1-~TE: I CERTIFY THRT l: I RM FRMILISR WITH THE RE~UIREMENTS FOR '~ ~ '- c ~ EN-:,ITE :,EWER-. AND WELLS AS :,ET FORTH BY THE ~UNICIPRLITY OF RNCHORRGE. WITH THE CODES. V~. 2 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. # ~)l_z-~-¢-~,°l~-I\ ~'~ 1. GENERAL INFORMATION Complete legal description not Block 3; Prospect Heights Subdivision Location (site address or directions) 9500 Buddy Werner, Anchorage, Alaska Property owner Mailing address Lending agency Mailing address Dr. Royce Morgan Day phone 346-3315 9500 Buddy Werner, Anchorage, Alaska Day phone Agent Colleen Moening/JACK WHITE COMPANY Address 3201 c Street, Anchoraqe, Alaska 99503 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 ~ TYPE OF WATER SUPPLY: NOTE: Day phone 762-3105 Individual well xxx Community well Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. xxx 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 the legality and status of system. 72-025 (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 all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address ENGINEERING 17034 Eagle River Loop Road No, 204[ r~;v~., A!~_*[c', 9°.577 ' '" "'" Engineer's signature DHHS SIGNATURE Approved for z~ Dis,approved. Conditional approval for Phone 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. Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST A. WELL DATA : . Well type {'~uCr?~. . If A, B, or C, attach ADEC letter. ADEC water system number Log present (~N) V~-S Date completed ,..~-,'?, [-3r'8 Total depth ~00 · Cased to c.~0 r~ Casing height Sanitary seal (~)/N) FROM WELL LOG Date of test Static water level Well flow Pump level SEPARATION DISTANCES FROM WELL TO: Septic/h~:mg tank on lot Absorption field on lot Public sewer main ~J//'l-r Sewer service line ,~(~ /OO '/- Wires properly protected AT INSPECTION /0~ g.p.m. /6'1 ; On adjacent lots ; On adjacent lots /nO 7- Public sewer rnanhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform {~ Date of sample: Nitrate B. SEPTIC/H'~L~"~G TANK DATA Date installed '-~ - ~1 -~ ~ Tank size ~___~,O r~ff-/.,~ Other bacteria Collected by: ,~ ~ ~ Compartments Cleanouts ~N). 0/"3 E High water alarm (Y/~)~ Date of pumping Foundation cleanout (~/N) Depression (Y/(~ Alarm tested (Y/~:~. Pumper /~¢-/-/ SEPARATION DISTANCES FROM SEPTIC/~ TANK TO: Well(s) on lot f/on t~ TO property line (0 + Surface water/drainage On adjacent lots Absorption field foo %, lO0 './ Foundation /0 ,t- /O /' Water main/service line ~O 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION / // ~Size in gallons ~ Vent (Y/N) Manufacturer Manhole/Access (Y/N)  "Pump off" level at High water alarm level Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length ~0 Width Total absorption area Depression over field (Y/~.)~ Results (~)s/fail) -2,o BF' Soil rating /~ S~//&,~ System type Gravel thickness ~ / Total depth Cleanouts present (~)'N) O~J ~.¢ ~ 0¢¢~ Date of adequacy test ~ ~.-~ for ~ bedrooms Peroxide treatment (past 12 months) (Y/(~ /~O7 If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water Curtain drain /~O/'~ On adjacent lots /00 ~ Property line To existing or abandoned system on lot Cutbank /00 -/- Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA g~idelines in effect on the date of this inspbction. S & S ENGINEERING 17034 Eagle River Loop Road No, 204 Signature Engineer's Name Date HAA Fee $ /~ .?¢¢d Date of Payment Receipt Number Waiver Fee:4~'' Date of Payment Receipt Number t · MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHORAGE DEPT OF I !~ALTi'~ &  DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTL[~)RON~EN~ L ' 'i-~CTION 825 L Street - Anchorage, Alaska 99501 i~ ~,L · ENVIRONMENTAL ENGINEERING DIVISION Telephone 264-4720 REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEW~E~R~F!~C~ ~l¥l~~L) DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed, Please allow ten (10) days for processing. ,1, PROPERTY OWNER Home 344-1750 I PHONE DAY, Richard L. and Sally M. Work 277-2~61 MAILING ADDRESS PROPERTY RESIDENT (If different from'above). PHONE ~..' BUYER PHONE SAIv~ MAILING ADDRESS SAME or NHN Buddy Werner Drive, Anchorage, AK 99507 3. LENDING INSTITUTION PHONE ~laska Mutual Savings Bank Attn; Debbie Johnson 274-3561 ext. MAILING ADDRESS P. O. Box 1120, Anchorage, Alaska 99510 4. REALTOR/AGENT I PHONE N/A I MAILING ADDRESS 249 5. LEGAL DESCRIPTION L8A, B3, Prospect Heights Subdivision STREET LOCATION NHN Buddy Werner Drive~ Anchorage, AK 6. TYPE OF RESIDENCE I~ SINGLE FAMILY [] MULTIPLE FAMILY 99507 NUMBER OF BEDROOMS [] One ~ Four [] Two [] Five [] Three [] Six [] Other 7. WATER SUPPLY ~ INDIVIDUAL* *ATTACH WELL LOG. A well log is required for all wells drilled [] COMMUNITY since June 1975. For wells drilled prior to that date, give well [] PUBLIC UTI LITY depth (attach Icg if available.) 8. SEWAGE DISPOSAL SYSTEM J~INDIVIDUAL/ON-SITE** **If individual/on-site, give installation date ld-~ '~(~. . If system is over two (2) years old an adequacy test is required [] PUBLIC UTI LITY by this Department. NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED, 72-010(3/78) February 29, 1980 ~. CHEMICAL & Gi~,..~OGICAL LABORATORIES t. 'ALASKA, INC.~. .~ ' TELEPHONE (907)-279-4014 ANCHORAGE INDusTRIAL CENTER 274-3364 5633 B Street Drinking Water Analysis Report for Total Coliform Bacteria TO BE COMPLETED BY WATER SUPPLIER WATER SYSTEM: Water System Name I.D. NO. Phone No. Mailing Address City State Mo. Day Year Zip Code SAMPLE TYPE: [] Routine [] Check Sample (for routine sample with lab ref. no, ) [] Special Purpose [] Treated Water [] Untreated Water SAMPLE NO. I I LOCATION Time Collected Collected By TO BE COMPLETED BY LABORATORY Analysis shows this Water SAMPLE to be: [] Satisfactory [] Unsatisfactory [] Sample too long in transit; sample should not be over 48 hours old at examination to indicate reliable results. Please send new sample. Date Received Time Received Analytical Method: [] Fermentation Tube [] Membrane Filter Lab Ref. No. Result* Analyst I I I-T-I *No. of colonies/lO0 mi. or No of Positive portions READ INSTRUCTIONS BEFORE COLLECTING SAMPLE 06-1220 (b) Rev, 1978 BACTERIOLOGICAL WATER ANALYSIS RECORD Date Collected Source Lab. NO, 24 Hours 48 HOUrs ConfirmatorY 24 Hours 48 Hours EMB Multiple TUbe Report~ Membrane Filter= Direct Count Verification= LTB. Final Membrane Filter Results Reported By. Broth 24 hours= Broth 48 hours.. 10ml Tubes Positive/Total 1Omi Portlolle Collform/lO0ml _BGB Collform/].O0ml · Date ~arch 5, 1980 R~enar~ L./Sally M. Day % 3606 Rhone Circle ~xchorage, Alaska 99503 Subject: Lot 8A Block 3 Prospect Heights Subdivision Approval for your individual sewer and water facilities can not be granted until tl%e following items have been compteted~ (1) A well log submitted to this depart~n~ for our (2) ~e water a~alysis report be delivered to this office from Chem Lab~ 5633 B Street, for our review. If there are any f,~t~b3~r questions~ please contact this office at 264~4720. Sincerely, Robert C. Pratt~ nssoclate Specialist }~CP/ljw Alaska Mutual Savings Bank % Debbie Johnson Post Office Box 1120 99510 THIS SIDE FOR OFFICIAL USE ONLY DATE RECEIV.~D . INSPECTION APPOINTMENTS TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE NUMBER OF BEDROOMS "~ SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER [] MULTIPLE FAMILY [] TWO ~ FOUR [] SIX PERMIT NUMBER 2. WATER SUPPLY "~, ~) ~ INDIVIDUAL DEPTH OF WELL [] COMMUNITY DATE DRILLED [] PUBLIC UTILITY Connection Verified LOG R EC EIV~x~.~, 0 3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER ~ INDIVIDUAL/ON -SITE DATE INSTALLED ~PUBLIC UTILITY Connection Verified I N STA L ~,E~R '~Septic Tank or ~ Holding Tank ~) Size: tc'-~ If Tank is homemade SOILS RATING give dimensions: TYPE CE TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES Septic/Holding Tank IAbsorption Area Sewer Line I Nearest Lot Line I WE LL TO: Absorption Area to nearest Lot Line 5. COMMENTS [~f~PROVED FOR ~ BEDROOMS ~[~__ CONDITIONAL APPROVAL (letter must accom~'~certificate) DISAPPROVED p ,~ ~/,.~ DATE 3--'~[ iBY(Title} ~'-~'~/ LEGAL DESCRIPTION 72-010 (Rev. 3/78)