The URL can be used to link to this page

Home My WebLink AboutHAMANN LT 5B Municipality of Anchorage Page / 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 Na~~ ~. ~~~ WastewaterSystem: ~New ~Upgrade ~d~ ~~ ~t~ ~ ~~ ABS~PTION FIELD Phone: No.o~drooms: ~De~p Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other LEGAL DESCRIPTION SoilRating: ~-~PD/Sq. Ft. Total Depth from original grade~ / Lot: Block: ~~J Deplh l° pipe b°tt°m fr°m °riginalgra~: Gravel depth beneath pipe Township: ~ Range: Section: Fill added above original grade: I Gravel length: WELL: ~New ~ Upgrade Gravel width: ~/ Numb~rof lines: IDistancebet,eenJines: I C~ifica~ion (Private, A~,C): ~ Total Depth~ Oased To:. Tolal absorption area: P~ e ater~al D' r: ' .ate D~lled: Static WaterLeve,: Installer: Date installed:---- . Yield: Pump Set at: Casing Heigh~ Above Ground: SEPARATION DISTANCES ~optic ~ Holdin~ ~ S.I.E.~. To Septic Absorption Lift Holding ~ublic/Private Manufacturer¢ Capa~i~lons: Well /~ /~ ~ ~ ~/~ Material: ~~ Number~artments: Fo~daI,o~ ~ / ~/ ~ ~ ~ "~ump on'~ "~ump off' levol at: High waIar alarm at: CurtainDrain ~ W() ~ ~ ~ ~ =u~& Model Electrical Inspections performed by: Remarks: BENCH MARK Location and Description: I Assumed Elevation: ENGINEER'S SEAL Department of Healt~ ~nd Hum~ Services approval ~)?~,, ~,x ~0 Reviewed and approved by: ~ Date:i/' ~ 72-013 (Rev. 9/91) MOA 25 Permit No. SW920232 Page 2 of 2 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 Legal Description: HAMANN LOT 5B PID No.: 050611,57 co2 C01 9 1250 GAL · S~T., N.T.S. MT C04 85.5' 79.2! NO WATER FOUND · 4 BDRM HOUSE FOUNDATION fEW 1250 GAL. ~.~ co3 cm rco :EPTIC TANK ~ c~..~ s ^ SCAI.E 1" = 40' FcO 58.o 6.o co [67.o llS.o cm 70.5 20.0 co2182.o 128.o DBLi 83.5 29.8 DBL2 85.3 31.5 COaI i06.0 154.5 MTI 73.5 124.0 72-013 A (2/91) MOA 25 (gerlifieh Drilling by DOC Co. clba SULLIVAN WATER WELLS P.O. BOX 670272, CHUGIAK, ALASKA 89567 · TELEPHONE 688-2759 DATE - Started Ended PERMIT NUMBER t~ 6{.] ~ '~ DEl'TH OF WELL STATIC LEVEL OF WATER F'r. DRAW DOWN FT GALS. PER HR / KIN[) OF CASING KIND OF FORMATION: From ~ ) Ft. to From '~ Ft. to From From From-- From ~':~ ~:' From ·~ '~ ~ From From ./~'; ~'~ s,,';'( ,:t~Jc:. g,.From ~ Ft. to :t~A Ft. ,~//;-~"~ . ~fi~,od)~ ,.'< t) J~" c From '" ;~- ,x-~ From Ft. to Ft. ~/ ,,~,~ '~t' ~c' Jj.~" [ '" ~, ' __Et. to ;c~ .Ft. /,/~'~>2dJ???"'~ From ':,n' ~ / From /~;'t',~'] · >tf/'.t,.,' From From / ?'d Ft. to,!Q[) Ft. t~/:/Y:~:)£.,:-_ (?/4r?'/ From__ ~,- From{ /() FI. to '~,~¢ Ft. From .'>~.-> a Ft. to :~ '~>;~ Ft. /'~/:~/J,:~,iC &. [J/~..~ ~.. (';/)t~/"From From Ft. to -" Ft.t--~-,/r ..... ,'~;'3 .~ / ()J,%ql 4 From From Ft. to. Ft tv. o) (? ~l/?) From From /;" Ft. to -~'i b Ft. ,>,':'~2,:( '6C F. ,:~:,~, [ From From _Ft. to Ft. From From__Ft. to Ft._ From MISCL. INFORMATION: .::,"' ?-I >'? ...... /"::, i~, h.. ,-'-:'.', :/ (:'/'~;~ Et. to Ft. Et. to Ft Ft. to Ft. Ft. to Ft. Fl [o Ft FI. to Ft.. F! to Ft. ELto Ft. Et. to Ft. .Et. to ~.__Ft. Ft. to 2Ft. Ft. to Ft. Et. to Ft Et. to Ft. F" to--R--E¢'E ! VE D Ft. to Ft. Ft. to 00~. 2. B 1995 Munic)panty oi Dept. Health & Human ~erwces DRILLER'S NAME '' ~ , : ' PAGE 1 OF 1 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW920232 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:SLENKAMP DAVID A & DIANE L OWNER ADDRESS:17034 EAGLE RIVER LOOP RD. EAGLE RIVER, AK 99577 DATE ISSUED: 8/14/92 EXPIRATION DATE: 8/14/93 PARCEL ID:05061137 LEGAL DESCRIPTION: HAMANN LT 5B LOT SIZE: 53746 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION 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 MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: THIS SEPTIC SYSTEM MUST BE INSTALLED IN ACCORDANCE WITH THE APPROVED ENGINEER'S DESIG%DATED 7/29/92. August 12, 1922 ROBERT SHAFER, P.E ROGER SHAFER, P.E. CIVIL ENGINEERS (9071694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municipality of Anchorag~ DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Str~t P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 5B; Hamann Subdivision; R~qu~st you issue a permit to dri~ a w~ll and install a septic system in a¢cordanc~ with th~ attached site plan to serve the referenced property. Th~ soils t~st used in the d~ign w~re originally p~rformed for the r6cent platting of th~ property. The t~st hol~s have b~6n monitored with no groundwater ~ncount~r~d. As can b~ seen from the site plan there is sufficient room on the property for several s~pt~c upgrades if necessary. We do not anticipate any adverse effects on n~ighboring properties by th~ installation of the proposed s~ptic system.. Sincerely, ROGER J. SHA~ER, P.E. RJS/gm 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 SCALE Municipalily of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG-- PERCOLATION TEST PERFORMED FOR:~ ~. ~ ~~ ~ DATE PERFORMED: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 $ & S ENGINEERING COMMENTS SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? L IF YES, AT WHAT O DEPTH? p E Depth lo Waler After Monilorino? ~ Dale: "~'"~ Gross Net Depth to Net Reading Date Time Time Water Drop ,, PERCOLATION RATE ~"' ~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FTAND 7 FT 17034 Eagle River Loop Read No. 204 ~"~"--~ ~/~/~"~'~ CERTIFY THAT THIS TEST WAS PERFORMED IN PERFORMED B~ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT O THIS DATE. DATE; Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMEi : . --~ ~ DATE LEGAL DESCRIPTION:~¥~~N& ~;:::~, ~Township, Range, Section: 1 2 3 4 5 6 7 8 9 10- 11 12 13- 14 15 16 17 18 19 20 COMMENTS 821 $ ENGINEERING SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p E Depth to Water Alter IYI0nilorino? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND ~' FT 17034 Eagle River Loop Road No. 204 PERFORMED BY: ..... I CERTIFY THAT THIS TEST WAS PERFORMED IN I ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT THIS DATE. DATE: ~ · ~--~' ,~. MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES : Division of Environmental Services '-'"~' ',.' ,: ' .. ,' ' ?'--- :~';.;~ On-Site Services Section ;, ar : ~ · --'.." ........... ~.~' ~>~ ...... 343--4744 .... . ~r' :. : ' .' ~; ~.. r' .' CERTIF CATE OF HEALTH AUTHOR TY ' '. '.r~>. ~::. ~ ' ':''. APPROVAL FOR A SINGLE FAMILY DWELLING _ GENERAL I INFORMATION .,.. .-~?... . ..... / -~ ......... Complete legal description Lot 5B; H~n~'S~d~v~s~on~,~:~, :.~.., ~. ...... ~ ......... ~ .... ~ ............ ~,,~.., Ron & Charlotte af r ~:. ,-,,,'-'~,~ ........ ~j~:~.llnn address,~,,.'~ ~ P.O.. Box 770228 ......... "~-'.';"" ::~?~gent/~; :"' '~ ~: Unless otherwise requested, HAA will be held for pickup. 2?: NUMBER OF BEDROOMS: 4 ~ 3.--. TYPE OF WATER SUPPLY: Individual well ........... XY~X ' -": .- ' --..._ Community well ............. ;~c · -' '- ............................ Public water . · . :::~-~:'~i~ NOTE:-- If community well system, provide written confirmation from State ADEC at~est- ing to the legafity and status of system. 4;' TYPE OF WASTEWATER DISPOSAL: Individual on-site ..: ..... ~ Community on-site ":~:?'::"*'" ~-?-'~ i',: ' :" " .. *q '?: Public'sewer ........... ~; NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/01) 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 Ar~c!?~age'ifile~'~nd from my investigation, and inspection, the on-site water .i 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. , ::.. ;. ....... ~.-.. - -': ~"' S & S ENGINEERING ~ Name of Firm f / Phone' ~(~'~'-~¢'~' ~ . . . l/u;s4 l=agle I~iv~oop R~d NO, 204 ~ddress , Eagle~Rlver~l~a'~k~' 9¢$~~'~ ~.:-"; · -' 6.:_.,DHHS SIGNATURE · ..... '~ ~X Approved for bedrooms, Disapproved. . ., . bedrooms, with the following stipulations: Conditional approval for '-*~ '-- Additional Comments · ~'~.~ ~ ~ Tho Munic}pali~'of¢~nchora~o Dspa~mont of Hoalth and Human So~icos (DHHS) issuos Hoalth Authori~ .. ~. App[ogal~ --..,,.Cedi~a~s 'based only upon the representations given in paragraph 5 above by an independent p rofe,~ib~l engin~r r~gistered in the State of Alaska, The DHHS does this as a cou ~esy to pu rchasem of homes -~"~ and t~'~lr lending institutions in order t0satis~ ce~ain federal and state requirements. Employees of DHHS do not conduct inspoctions or analgx~ data ~oforo a ce~ificat~ is issuod. Tho Municipali~ of Anchorage is not rosponsibl~ lot orrors or omissions in ~h~ profossional onoineo~s work. 72-025 {Rev. 1/91) Back MOA ~1 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 · Anchorage, Alaska 99501· (907) 343-4744 Health Authority Approval Checklist Lcgal Description: ~-&'~Z~ //~ ~ ~9 ~4::>. Parcel I.D.: Ao WELL DATA Well type /)~/~/~/~ If A, B, or C. attach ADEC letter. ADEC water systeln nulnber Log presen%) /I/~' -~ Date completed O'~/¢,---~/ Total depth , .~ /--/o t Cased to ~/-/- t Casing height (above ground) Sanitary seal(~xl) J/~'~- Wires properly protected (~q) / AT INSPECTION FROM WELL Date of test ~/p~ Static water level ff / /5. ~5'~' 'z-/-4 ~r ~ Z J/~ ,~ ~ _r Well production '~, ~'~ g.p.m. ~ T ?~'5' 7'~ .,~ g.p.m. WATER SAMPLE RESULTS: Coliform ~ Nitrate /, ~zZ ~ Other bacteria Date of sample: //b, ff-/~',.,C' Collected by: B. SEPTIC?~-?-L'_-"~--N~ TANK DATA , Date installed 6'12~/aA.~ Tanksize/~-~-O Number of Compartments ~:~ Cleanouts(~q)/ Foundation cleaaout ~I) y& ,5' Depression (Y~ /O o High water alarm~Y4N~ Date of Pumping Od~7' ,~Z /~7,q-D~Pumper <,/. ABSORPTION FIELD DATA Date installed ¢,/X Length Width Effective absorption area Date of adequacy test "~ System type ~Fr.~ ~OC p/ Total depth // Monitoring Tube presen (Y~)//F6' Depression over field (Y4~) /V'o Results (Pass/Fail) ~ For ~/ bedrooms Fluid depth in absorption field before test (in.); depth ~ (ins.) Minutes later: Fluid Peroxide treatment (past 12 months) (Y~J3 hmnediately ,after 7~ gal. water added (in.): Absorption rate = ~:- g.p.d. If yes, give date ~------~'--' O ~ 77. l q ff 4~ Do Lll~ STATION Date installed Manhole/Access (Y/N) High water alarm level at* "Pump o~ '~Pulllp ofF' level at* ~Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: ! Septickh~}di:.~.tank on lot /~ ~ / Absorption field on lot /'~g ~f Public sewer nmm gewer.4septic service line On adjacent lots .; On adjacent lots Public sewer manhole/cleanout Lift station Surface water/drainage ddtg,d~--- Wells on adjacent lots SEPARATION DISTANCES FROM SEPTIC/~ TANK ON LOT TO; ~ / Building foundation 2. O Property line ,2 ~,Z ~ Absorption field Water-mm~service line SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: ! Building fmmdation /0 Water main/service line Snrface water Curtain drain Z ~ ~ ~ Wells on adjacent lots /~O t Propc~, line /~ / F. ENG~ER'S CERTIFICATION ] certify that ] have dete~field inspectionx and review of Municipal records Signature ~/ / ~ ................................................................................................................. ;~r~-,tXTrt (-:.~,~** ........... HAAFee $ t3~ ' ~ WaiverFee$ Date of Payment //~ Z~~ Date of Payment Rev. 8/95 eSS: haa.wk.doc CT&E Ref.~ Matrix Client Sample ID Client Name Ordered By Project Name Project~ PWSID CT&F Environmental Services Inc. La bo rat o ry D ivisio n ~'~'~'~'.~',~,~'~'.~',~J,~,~'.~.~'.~'~'.~JJ~JJJJJ~JJ~~~ Laboratory Analysis Report WATER LSB H~3uNN S/D-KITCHEN SINK SCi~FER, RON UA WO~< Order 19331 Printed Date 1!/03/95 ~ 12:22 hrs. Collected Date 10/30/95 · 15:00 hrs. Received Da=e 10/31/95 ~ 12:10 hrs. Technical Director STEPHEN C. EDE ' Sample Remarks: SAblPLE COLLECTED BY: RAY. QC Allowable Ext. Anal Parameter Results Qual Units Me~hod Limits Date Date Init Nitrate-N 1.46 mg/L EPA 353.2 10. 11/01/95 CMR See Special Instructions /~bove UA - Unavailable ~ See Sample Remarks ~%bove NA - No~ ~%nalyzed U'= Undetected, Reported value is the practical quantification limit. LT - Less Than D = Secondary dilution. GT ~ Greater Than 200 W. Po~e~ D~ive, Anchorage, AK 9951 8-1 605 -- lek (907) 5~2-2343 ~ax: (907) 561-5301 ~NV[RONMENTAL FACILITIES IN ALASKA, CALIFORNIA, FLORIDA, ILLINOIS. MARYLAN0, MICHIGAN, MISSOURI, NEW JERSEY, OHIO, WEST Ronaid A, Sharer P~O. Box ?70228 Eagle aivex~ Alaska 99577 Municipality Of Anchorage De/sartment of HeaLth & l,,{ulaan Services Reference.~ Lot 5B Hamann Subdivision Health F~ut;horxty ~pprova.i Dear Sir~ As the o~ners of 5he wefexenced property~ ue can test~-Fy to %he fact ~haC ~he septic system and meli on our p¥opercy uere not p~aced into service until late October 1994,: If you have any questions coneernin9 this matter> please contact [ne at $ork~ (907) F53-.~2693 (1. coated on a~iI. menderf Air P~orce 8ase)~ or ah home 696~0682. Sincere} y ~{~ ~~ sharer