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Home My WebLink AboutSIEFKER #2 LT A5A1te‘Q 44b1 4ta gsA 6a i cM3- ria - c.9 Municipality of Anchorage Page 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: 5'l,d q'70~,1 ~ PIDNumber: 0t5~- Name: ~]-~J'4-~] ~'F/~'~-~ Wastewater System: D New t~JJpgrade Address: ~o, ~'. ~,~ /~.~c//,~..~,=..~'k ~',5'/& ABSORPTION FIELD Phone: ~.~Z/~.~?~"~ IN°'°fSe~.~ms: I~ Deep Trench ~;~ShallowTrench [~Bed E3Mound r'lOther LEGAL DESCRIPTION soi, Rating: ]'2 GPD/Sq. Ft. TotalDepthfrom~gin/aigrade: L ~..~/~ /--BI°ck: ~.~.-~--~¢;'~'J~"~l~SUbdivision:~, ~ :)epth to pipe botio~m/original grade: Ft. Gravel depth beneath Township:~ I Range: I Section: ~ Fill added above(~original./, grade: Ft. Gravel length: ~//Zff I Ft. WELL.' ~')o.~?~_~.~[] New [] Upg~ ~ravelwidth: S/ Ft. Numbero~lines: Classific~on (Private, A,B.C): ~ Cased TO: !Total absorption area: ,~ Pipe material: I~'~U~/~/~ ~ Et. Ft. ~ 7~' SQ. Ft. .~.~'~*,/V/ Driller: ~ Date Drilled: Static Water Level:Ft. Installer:~l~ J~..~ ~=~T~Z_ Date installed:~:~ GR~ Ft. ,t. TANK SEPARATION DISTANCES ~,ptic [] Ho~ng : S.T.~.P. From Tank Field Station Tank Sewer LJ~es . We,,- IO~)'~ 10~[ ~,',, ,2£~ ~ater,a,:__<~_~F~. N.m~ero, Oomp~ent,: Surface Wa,er ')} \ UFT STATION. Lot Cur~ainDrain ' /~/~j.4j ~ /~_ ~e'l~'~ct~'°a"n'pe~t'°n~pe'°rmedb~: Remarks: £~.~3:r/~,,C. ~-~,~c ~, ~6~..~.~4 BENCH MARK Location and Description: ^ss~med ~isvation: Inspections performed by: $ s s ~N~N~SRINe Dates: lst'~ -,~'-~ ? Department of Health and Human Services approval Reviewed and approved by: ~ Date: - / / / ' 72-013 (Rev. 9/9t) MOA 25 P~,au~T N6 SW970212 PA~ 2 OF 2 Hunlcipo. Lit:y oF Anchor'age DEPARTHENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DOVISION P,D, Box 196650eAnchorcge, Ataskc 99519-6650eTe[ephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LOT A5A, SIEFKER S/D NO. 2 P.I.D. NO. 015-272-69 10' UTILITY EASEMENT TRENCH DBLZ 1000 GAL. SEPTIC TANK STi ST2 MT1 = 90.4'j EXST. WELL MT CO c02 = 98.5' · i 03 = 98.6' 02 93.5' 03 93.5' · WATEE: FOUND 85.9' 83.4' B.O.H. A B 50.5' 62.0' 51.0' 64.0' 51.0' 68.5' 51,0' 70.0' 51.0' 70.5' 40.5' 58.0' 41.0' 86.0' 41.5' 85.5' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH /LND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW970212 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:DEMERIS WILLIAM E & OWNER ADDRESS:3601 E. KLATT ROAD AMCHORAGE, AK 99516 /k PAGE DATE ISSUED: 7/25/97 EXPIRATION DATE: 7/25/98 PARCEL ID:01527269 LEGAL DESCRIPTION: $!EPK~R %2 LT A5A1 · LOT SIZE: 49470 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TAMK SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: THE ATTACHED APPROVED DESIGN. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 kND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGUI2kTIONS (18AAC72) AMD DRINKING WATER REGULATIONS (18AAC80). THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING WEATHER MUST BE EITHER: A. OPENED AND CLOSED ON THE SAME DAY B. COVERED, SEALED AND HEATED TO PREVENT FREEZING THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ~Z/~w~-- ISSUED BY: DATE: DATE: SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION 'rEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN ROBERTC. COWAN, RE. ROBERTA. SHAFER, EE. July 14, 1997 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot A5A, Siefker Subdivision Addition No. 2 Request you issue a permit to upgrade the septic system serving the existing three bedroom house on the referenced property. A test hole was excavated and a percolation test performed. The approximate location of the test hole is located on the attached ske plan. At the time of excavation water was encountered at 13 feet, and after seven day ground water monitoring water was found at 12.5 feet. ~ We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/mg Enclosure 17034 NOF~I'H EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 I ~ / ~ L 7~ //F~ ~ PROPOSED WEL~3EPTIC~ 0 PERFORMED FOR: ~tl LLI ~t~'} LEGAL DESCRIPTION:'~'~) T 4 ..~ ~1 Municipality o! Anchorage 825 I Street Anchorage Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST ~ I~ F~ ~ Township, Range, Section: I 2 3 4 -- 5- 6- 7- 8- 9- 10- 11 12 13 14 15 16 17 18- 19- 20- COMMENTS WAS GROUND WATER ENCOUNTERED? O DEPTH? p SLOPE SITE PLAN E Oeplh to Water Alter la ~' Dale' f°/l~/'~ 7 MoAilorino? . Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE ~ / (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN (o FT AND "7 FT S & S ENGINEERING _./~. ~/r/ // PERFORMED B;~.~ ,-_-G~; .~..~..._-.. __._--i r .--=~' J ........ ~i. ~a I~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE~II~ ~TA~!~I~CIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) Percent Passing by Weight No. 10 # 16 No. 20 #50 m r.~ O.02mm Department of Environmental Quality 3330 C Street Anchorage, Alaska 99503 A INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM NAME ~'~ /C';,..,,~., ~,L,NG ADDRESS .~..~/7¢Z--~RHONE~?~'--I~ / DISTANCE ~ NUMBER OF FROM WELL ~ MANUFACTURER [~ MATERIAL COMPARTMENTS INSIDE LENGTH ~/ INSIDE WIDTH LIQUID DEPTH LIQUID CAPACITY /~ GALLONS. SEEPAGE PIT: NUMBER OF PITS LINING MATERIAL BUILDING FOUNDATION ADDITIONAL ABSORPTI ON DIAMETER OR WIDTH CRIB SIZE: DIAMETER NEAREST LOT LINE /' / LENGTH~, DEP1;I~ /'~ WELL: TYPE BUILDING FOUNDATION __ CESSPOOL APPROVED CONSTRUCTION NEAREST LOT LINE OTHER SOURCES DISAPPROVED DEPTH DIsT~FRoM: NEAREST SEPTIC SEEPAGE SEWER LINE TANK SYSTEM REMARKS DISTANCES: INSTALLED BY: PiPE MATERIAL: DIAGRAM Of SYSTEM LOT SLOPE: REMARKS: Forn EQ-031 PERMIT 510 - '"' I .... R. HFFLI_HNT P. FORTtN__ _,ER B0~*.', 1742 LOCRTION k.'~_RTT F.:0~D LEGRL LR._, '=' C E,H .... IEFKER _4JB,. [.IV LOT SIZE ~-4 i~,~ ,=, ._4.4._L4 SQLIRRE FEET T",r'PE OF SOIL HE,_,JEE, TIuN ~'~--,TEfl I=,. TRENCH MA~<IMUM NUME:ER OF BEERuOMb _,UIL RBTING (SQ FT,,BR)= tt5 THE REQUIRED SIZE OF THE :.,uIL RBSCRPTtCN -"¢--,TEN I.:,. [:,E F'TH= 1 l,-]"l LE[-~B3 TH-- ';"-- l--" - '." ~ -,.~:R .- EL [:,EF'~'Hi THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF R TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE GROUND RNC, THE E:OTTOM OF THE EXCRVRTION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIF'E BND THE BOTTOM OF THE EXE:RVRTION (IN FEET). REL;!L~ I F."EC' .,, SEPT I C: TR[-~=C S I ZE-= 10E'~E'~ i3RLLCl~-~S T~.~En ( 2 ], I [-~SPEE:-T I n][-~S RF.'E F-:EL-'::!!J I F-:E[:, BML. LFILLING OF Hr'J~' _,'~-_,TErl 14ITHOUT FINRL IN_,FEuTIuN RND RPF'ROVRL B"r' THIS DEF'RRTMENT WILL BE =,LIE, JEUT TO PRO.:,EL. UTION. MINIMUM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE BISPOSRL SYSTEM IS ±00 FEET FOR R PRIVRTE WELL OR 200 FEE~ FOR R PUBLIC NELL. NELL LOGS RRE REQUIRED RND MUST BE RETURNED TO THE DEF'RRTHENT WITHIN ~0 DRgS OF THE WELL COMPLETION. SPECIFICRTIONS RND CONSTRUCTION DIRGRRMS RRE RVRILRBLE TO INSURE PROPER INSTRLLBTION. PER,"11 T '-.."F-iL I C.., FE, R oD[-~E YER~: FF~£11~I I SSLnE I CERTIFY THRT ~L: I RM FBMILIRR WITFI THE REQUIREMENTS FOR ON-SITE SEWERS RND NELLS RS SET FORTH B'¢ THE MUNICIPRLIT9 OF RNCHORRGE. 2 I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES. ~:: I UN[:,ER~TRND THRT THE ON-SITE SEWER SYSTEM MRV REQUIRE ENLRRGEMENT IF THE RESI[:,ENCE tS REMODELED T0 INCLUDE MORE THRN 3: BEDROOMS. ...... ...... ~IGNED: RFFLICRNT ~'.. F~ FORTtN -_----___._,,...___,___..___'__ / JEROME STREET A-5 A-5B TH 1~ A- 5C ~\. · CKD: DWM DATE: 7-12-76 SCALE: 1"=3' Location Diagram R,P. Fortin Anchorage, Alaska GRID: PROJ. NO OWG. NO. TH 1 TH 2 6-29-76 0.0' 6-29-76 ORGANIC MATERIAL ORGANIC MATERIAL 0o0f 1.51 SILT W/TRACE SAND 4.0' GRAVELLY SAND W/SOME SILT SILT W/TRACE SAND AND GRAVEL SAND W/TRACE SILT AND GRAVEL 8.07 SILT 11.0' GRAVELLY SAND TO SANDY GRAVEL TRACE SILT ---- 11.5' 14,0' SILT W/TRACE SAND GRAVELLY SILT No Water Table 20.0' PD This Log Represents the Soil Conditions within Lot A-5B of Siefker Subdivision Anchorage, Alaska 18.5' GRAVELLY SILT No Water Table This Log Represents the Soil Conditions within Lot A-5C of Siefker Subdivision Anchorage, Alaska Log of Test Hole R.P. Fortin Anchorage, Alaska 656263 TIME 1:00 1:01 1:02 1:03 1:04 1:05 1:06 1:07 1:08 1:09 1:10 1:15 1:20 1:25 1:30 1:40 1:50 2:00 PERCOLATION TEST R.P. FORTIN R & M NO. 656263 ELAPSED TIME 0 1 1 1 1 1 1 1 1 1 5 5 5 5 10 10 10 DROP INCHES 0 0 1 2 0 1 1 0.5 0.5 I 1 3 2 1.5 1.5 2.5 2 2 60 Min%%tes 24.5" Total Drop Test Hole #2 Lot A-5C $iefker Subdivision Anchorage, Alaska WATER WELL LOG FOSS DRILLING 1336 Ingra Street Anchorage, Alaska 9950! STATIC WATER LE~EL._~_~__PT. YIELD FEET OF DRAWDOWN. REMARKS (}AL.PER.MIN. WITH to __tO , to to to __to to . to MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF iNSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date ?/~'--/~;~3~ 1. GENERAL INFORMATION (a) Legal Description (include lot. block, subdivision, section, township, range) (b) , (c) · i Location (address o'r directions) Applicant Name ~.~lw~, ~'_'-ln~--,? l_._~ Telephone: Home ~ Business "--------' Applicant Address Applicant is (check one): Lending Institution I-'1; Owner/builder, S. Buyer []: Other [] (explain}; Telephone ~'~i : ( ) Lending Institution Address ;II~ (e) Real Estate Company and Agent ~:~! Address ~elepnone i~i!~.~ :~: (f) Mail the HAA to the following address: i TYPE OF RESIDENCE Number of Bedrooms , WATER SUPPLY Other :i~lnd vidual Wel Commun ty [] Public [] t corn munity well system, must have written confirmation from the State Department of Environmental g to the legality and status. Public[] Community [] Holding Tank [] iystem, must have written confirmation from the State Department of Environmental legality and status. 72-025 · ENGINEERING FIRM PROVIDI~I D~A NSPECTIONS, TESTS, FILE SEARCH, AND INFORMATION 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 shows that the on-alta 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 ali Municipal and State codes, ordinances, and regulations in effect on the date of this !nspection. Name of Firm ¢V~ [-~'r~'~,ac~-r-~ ~ C~.~T~. Telephone Address ~ I ~.~(~ ~., ~ ~--~"~ ~,,lC, h~C-,Ox~'~~- Date --~ Approved for Approved . ~- Disapprov~ · Terms of Conditional Approval Engineer's Seal Conditmnal CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Approval certificates based solely upon the representations given in paragraph 5 above b engineer registered in the State of Araska. The DHEP does this as a courtes' institutions in order to satisfy certain federal and state requirements. Employees of DHEP do not con; analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors ( professional engineer's work. Page 2 of 2 72-025 ( 11/84] WELL DA'fA , 264-4720 Legal Description: ~_~'~t ~'i== tC~?~_ MUNICIPAUTY OF ANQ'IOJ~,A~;~ DEPT. OF HEALTH & ENVIRONMENTAL PROTECtiON SEP05 Well Classification ,~ .l~_~t ~J'te~l'~' ifA, B, C,~D.E,C. Approved (Y/N) Well Log Present (Y/N) ~"~ · Date Completed' ~ Yield Total Depth ~5,? ~' Cased to ~',~' '/ Static Water Level _'7~ · Casing Height Above Ground Electrical Wiring in Conduit (Y/N) 'h~e~,~ Separation Distances trom Weft: ~ To Septic/Holding Tank on Lot Depth of Grouting Pump Set At Sanitary Seal on Casing (Y/N) Y~ Depression Around Wellhead (Y/N) ~"~, To Nearest Edge of Absorption Field, on Lot '] J --~ /~"~; On Adjoining Lots To Nearest Public Sewer Li'ne t~-3 [~" To Nearest Public Sewer Cleanout/Manhole _~ ~ ~ TO .Nearest Sewer Service Line on, or Water Sample COllected by ~ ~- : Date ~/~/~ ~ Water Sample Test Resul~ ~&~ ~/ [~(~) ~'~"'~'~ ;On Adjoining Lots B, SEPTIC/HOLDING TANK DATA Date installed Standpipes (Y/N) Depression over Tank (Y/N) Pumping/Maintenance Contract on File (Y/N) ~/l~ ; for Holding Tank High-Water Alarm (Y/N) ~ ['~. Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding TankL TO Water-Supply Well ~k'~ [ ~ ~ TO Building Foundation(::) ,'~ 47 j To Property Line '~ ~''~''' To Disposal Field To Water Main/Service Line ~-.~' ! .J Course Comments Size { O~X:) ~ No. of Compartments ~'-~Air-tight Caps (Y/N) ~"~3,Date LastF°undati°npumped Clea~j~u. t To Stream, Pond, Lake, or Major Drainage Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata I/~'/~a?'~' /__~t_ .~ '/ Type of System Design Date Installed ,'~'/5/'7~, 6r~S. ,P~I~~) Length of Field Z?/'/ Width of Field '~ , '. ~ Depth of Field ~,,~%~,v~ Gravel Bed Thickness ~=~" Standpipes Present (Y/N) Date of Last Adequacy Test Square Feet of Absorption Area Depression over Fiele (Y/N) Results of Last Adequacy Test Separation Distance from Absorption To Water-Supply Well ~ f % % ~ / To Building Foundation ~t ~ ~ r To Property Line 2~O TO Existing or ~,/6a~n~(~ned Sys,em on Lot ~,5 j~:~- ; On Adjoining Lots To Water Main/Service. Lir~e ~O~' ~ ~'~ '~To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course ~ ~ ~ To Driveway, Parking Area, or Vehicle Storage Area Comments ~ ~ ~ ~ ~ ~ ~ :~?,~.L~,~ D. LIFT STATION Date Installed ~ Dimensions Pump On Level at / /' High Water Alarm Level..~'/~ ~..~. /'~ /, Vent(Y/N) TE ;:;;rtcf oral Co (~y/N, ~""~ -- ~" Pu;ping Cyc~ ~.u~y Test. Meets MOA ~' ~heck ~ormittod B~Oroom ~atin~ ~ainst H~ Boquest ' ce~ifY t ha~e ch~e~,;r conformed to all M~/AA gu,delines in effect on the date of this inspection. Signed ~~ Date Company ~~ ~~ No. Receipt No. Date of Payment Amount: $ Page 2 of 2 72-028 (11/84)