HomeMy WebLinkAboutHAMANN LT 18 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
Neme: r~,/~./'T ~/t%y Wastewater System: ~New ~ Upgrade --
~o of ~droo~s~
Phone: ~ ~¢ ~ ~ ~Deep Trench ~ Shallow Trench ~ Bed ~ Mound C Other
LEGAL DESCRIPTION so,, Rating: Total Depth from original grade:
LoL / ~ Block:~ ~ ~ ~Subdiv"si°n: Depth ~o pipe bottom~ ~fr°m original grade FL Gravel depth ~,benea~h~ pipe Ft~
~ Gravel width: Number of lines: Distance between lines:
WELL: ~¢r Q New Q Upgrade ~ F~ /
Classdicahon (Private, A.B.C) Tolal Oep[h: Cased To: Total absorption area; Pipe material:
Driller: Dale Drdted: Slahc Water Level Installer: ~/~% Dale inslalled:
Ymld:GPM Pump Se~ at: FI Casing He~gh~ Above Ground:Fl. TANK
SEPARATION DISTANCES ¢~.~io ~ Holding ~ S.T.E.P.
TO Sephc Absorption La~ Holding ~ubhc/PrwaleManulacturer: Capacity in gallons:
Well ~ //~ M.t.rlah ¢ 7~.4~ / Numbe~Compartments:
SurfaCewater ~/¢¢ ¢/¢¢' ,' .¢ ¢/¢¢ LIFT STATION
Lot
,} ¢ ~2~umD &if" lever at: ..... ~h water alar~ al:
Foundation %¢ 7% ~ ~" --
CurtainDrain -v ~¢ ~ ~/~ 4 /~ ~um~%del Electrical Inspeclions performed by:
Remarks: BENCH MARK
Location and Description:
Assumed Elavation:/ ~ ~ ~ ~,
Department of Healthand Human Services approval .,,~,.,.%,,, .......
Reviewed and approved by: ~ : Date:/D -2¢-:{~
72-013 (Rev 9/91) MOA 25
Permit No, SW970149 P~De 2
Hunicip~Li~y oP Ancho~9e
SEPARTHENT 8Y H(ALTH AND HUHAN SERVICES
ENVIRDNHENTAL SERVICES DIVISION
P.B, Sox 196650. Anchorage, Alaska 99519-6650 oTe[ephone: 343-4744
Dh-Site Was~ewa~er Disposal
System and/or We[[ Inspection Report
Legcd Description',LOT 18 HANANN SUB,
PID No,: 05062105
SCALE 1" ~
=60' ,, ALL SEPT[CS [00'
~///42,~ ~ FR~N WELL
ALL WELLS +100'
SWINGTIES
A-C = 52].8'
B-C = 90.9'
A-D = tOO.?'
B-D = 91.7'
ELEVATIBNS
(NDT TO SCALE)
DR IVEWAY
B
C ^
L
.~'~' SEPTfC TANK
[~TH2
[~rH1
TOP DF H~USE FDUNDAT[BN
ASSURED ELEV = 107.97
GROUND I
ALL WELLS +tO0'
FROM SEPTIC
ALL SEPTICS lO0'
FRON WELL
~ - TEST HOLE
PROPOSEO LF..&CHRELO
10/13/97
by
t:~O. DO~ 670272, CHUGIAK, AI..A~KA 99~7 · 7~L~PHON~
DEPTH
TAX INDENTIFICATION NUMBER 0~ ~- ! ~-
Is well located ~t approve~ permit location? ~' ~ No
Melhod of Drilling: ~J~ ~t~ ~ cable tool
Casing Type J'7~'~__VVall Thickne~s._~ inches
Liner l~pe' _ ~.
Casing Sfickup Abeve Grouted: ~ feel
Static Water Level (l'rom gN~uml level): ...... ~_~ _ feet
Pumping level: ....... feet aiter bm. pumping ..... gpm
Recover Rate: _ ~ O ~ __gpm
Method of Tesling:
W~II Intake O~eqing Type: ~pen End ~ Open Noie
~) Scceened: Slar[ ........... leto Stepped ........ feet
[~ Perorations S~arl fe~t Stopped feet
Grout TFp~: t~ ~, .-J. ~ Volume ~ 5 OL
Oep~h: [rom ..... (:~ ...... feet, ~o ...... feet
Pump Intake Depth'. ...........................
Pump Size ................ hp ~and Name
Well Disinfected Upon Commie{ion? ~ ~ No
I. Driller'9 Name
ATTENTION: It is the responsibility of tl~e proper~ gwner to submit a cop~ of lbo well log to the prope~ authorizy_
Of Anchorage: Depat[m~n[ of Health & Human 8e~ices and/or Depadment of ~nvironmental Cense~afion
Depadment of ~nvironme~[al gonse~atiorl.
--,,ECEIVED
........ --j-b N ....................
Municipality of Anchorage
P/ (? ('0/-'c-'
!
PAGE
MUNICIPALITY OF ~NCHORAGE
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:SW970149
DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES
OWNER NANE:SMITH PERNIE R
OWNER ADDRESS:1515 MARTEN STREET
ANCHORAGE, ALASICA 99504
DATE ISSUED: 6/24/97
EXPIRATION DATE:
PARCEL ID:05062105
LEGAL DESCRIPTION:
HAFL~NN LT 18
LOT SIZE: 182952 (SQ. FT.)
NUMBER OF BEDROOMS: 6 THIS PERMIT: 6
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 MUNICIPAL 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 DHHS 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 MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
1 OF
6/24/98
1
SPECIAL PROVISIONS:
ISSUED BY:
Eagle River Engineering Services
Louis Butera, P.E,
P.O. Box 773294 (907) 694-5195 tel
Eagle River, AK 99577-3294 (907) 694-3297 f~
May 30, 1997
Jim Cross, P.E.
Manager, On-Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: Hamann Lot 18
Narrative & Permit Application
Dear Mr. Cross:
The proposed well and septic system will have very limited impact on adjacent properties for the
following reasons:
I. The surrounding lots are large, allowing sufficient room for septic sites.
2. hnmediate neighboring septic systems are all +30' distance.
3. Reserve space is adequate, due to absorption capacity.
4. Drainage will not be affected and is not a major consideration in our design.
If you have any questions please call om' office at 694-5195.
Sincerely,
Louis Butera, P.E.
MUNiCiPALITY OF ANCHORAGE
~NVIRONMENTAL SERVICES DiViSION
RECEIVED
\1997\97-028-NAR.DOC
EAGLE RIVER
ENGINEERING SERVICES
P.O. Box 773294
Eagle River, Alaska 99577
(907) 694-5195
ERES Project No.: 97-028
Calculated By: LB
Date: 6/11/97
Legal: Hamann Lot 18
Single Family 6 Bedroom Dwelling
TEST HOLE
Deep Trench Subsurface Wastewater Disposal Field
Water use at 150 gallons per bedroom = 900 gallons
Percolation rate = 1.22 minutes per inch
Wastewater application rate = 1.2 gallons per day per square foot
Required absorption area = 750 square feet
Trench width (VV) = 3 feet
Gravel depth (D) = 9 feet
Required length = Required absorption area / 2 / D
Required length = 750 / 2
Required length = 42 feet
Total Excavation Depth = 12.0 feet
/ 9
·
/
~ - TEST HOLE
· - MONITOR TUBE
o - S~ER CL~NOUT
+ - WELL
NO SURFACE WATER ~SEMENT
NO KNOWN CURTAIN DRAINS ~ PROPOSED L~CHFIELD
~- EXISTING L~CHFIELD
W E L L/S E P TI C S IT E P LA N
LEGAL: H~monn Lot 18
JOB~ 97-028 DATE: 5/50/97I SCALE 1" = 10C
k EAGLE RIVER ENGINEERING SERWCES
P.O. Box 77329~
(9o7) s94-s ¢ ss ~x..
Eagle River Engineering Services
Louis Butera, P.E.
P.O. Box 773294 (907) 694-5195 tel
Eagle River, AK 99577-3294 (907) 694-3297 fax
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LEGAL: Hamann Lot 18
5/30/97
A. GENERAL.
1. The well and septic plan are for a single family residence only.
2. The drawing and or site plan shall be a part of this specification.
3. All materials and workmanship shall meet the Anchorage Department of Health and State
Department of Environmental Conservation requirements.
4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer.
5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet
Municipality of Anchorage, Department of Environmental Conservation requirements.
6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any
adjacent multi-family wells.
7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer
approval.
8. It is always recommended that a surveyor locate the nearest lot line position and the location of any
easements.
9. Any remaining open test hole excavations shall be filled.
B. SEPTIC TANK
1. Septic tank shall have a minimum capacity of 1,750 gallons and be a MOA approved design.
C. TRENCH
1. The trench is to follow the natural land contour to maintain uniform total depth of the trench bottom.
2. The bottom of the trench shall be level, plus or minus 1.5".
3. The total depth of the trench excavation is not to exceed 12' at any point.
4. The effluent line within the trench shall be laid level within 0.03'.
5. The trench gravel is to be covered with typar fabric material.
6. Soil or combination of soil and extruded board insulation to a depth oft or equivalent is to be placed
over the leachfield.
7. The area over the trench is to be finish graded to prevent ponding of surface water runoff.
8. The septic tank and [eachfield must not be closer than 100' to any existing private well, 150' to any
Class "C" well, or 200 feet to any community well.
RECOMMENDED LEACHFIELD DIMENSIONS:
TOTAL DEPTH = 12' GRAVEL DEPTH = 9' under pipe, 2" over pipe
TRENCH LENGTH = 42' TRENCH WIDTH = 3'
SOIL RATING = 1.2 GPD/ft2 BEDROOM CAPACITY = 6
SEPTIC TANK = 1,750 gal rain
Twenty-four (24) hours notice reqnired for all inspections.
\1997~97-028-spc.doc
LEGAL DESCRIPTION:
?
12
14
18
19
20 ·
COMMENTS
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG ~ PERCOLATION TEST
DATE PERFORMED:'
Township, Range, Section:
WAS GROUND WATER
ENCOUNTERED?
Loose
IF YES, ATWHAT
DEPTH?
Depth Lo Waler After
Moflil~rinll?
SLOPE SITE PLAN
Reading Date Gross Net Depth to Net
Time T~me Water Drop
Io
Io
PERCOLATION RATE ~.. ~-'~ (m~nules/inch) PERC HOLE DIAMETER .~"
TEST RUN BETWEEN _ '~ FT AND 8 FT
PERFORMED .qY; M'~' J~ I ~C P',~c 5 ~'~-~--~-ERTIFY THAT THIS TEST WAS PERFORMED iN
ACCORDANCE WITH ALL STATE AND MUNICiPAL GUiDELiNES iN EFFECT dN THiS DATE. DATE,
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR: ~) / '/'~-- y
CEGAL DESCRIPTION=, pS ~. ~ /./~
DATE PERFORMED:' O~ - '~%- ~'7
Township, Range, Section:
1
2
3
4
5
6
7
8
9
10
'11
12
13
14.
15
16
17
18
19
20
COMMENTS
T P,/kC..E
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED;:'
IF YES, AT WHAT
DEPTH?
Oepm to Water Alter
Monitoring?
Reading Date Gross Net Deoth to Net
Timo Time Water Drop
5 ~'.~ · ~!~
'GM-
PERCOLATION RATE ...~-,,'~ ~ (minutes/inch) PERC NOLE DJAMETER ~" ~
TEST RUN BETWEEN ~ FTAND ~ ~FT
PERFORMED BY: /~/', ~ ~
ACCORDANCE WITH ALL STATE AND MUNICIPAL
Parcel I.D. #
1.
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
425?Dd~_/~\, NAA# ~ ("~ ~:~ ('~ ~ '~ "~
GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner
Mailing address
Lending agency
Mailing address
Agent ~-'
Address
Day p h o~n e...9~,~ ,~¢
Day phone
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
TYPE OF WATER SUPPLY:
Individual well
Community well
NOTE:
Public water
If community well system, provide written confirmation front State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
NOTE:
Public sewer
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system.
72~025 (Re','. 1/91) Front MOA ~t21
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
?.O. ~o~ 22~, ~ ~,~ ~2~ Phone
Address
EngineeCs signature
DHHS SIGNATURE
J Approved for -~'
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
~//,- ~ Date
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 DH HS 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.
72-O25(Rev. 1/91) Back MOAt-21
Municipality of Anchorage ,/~.~J~
DEPARTMENT OF HEALTH & HUMAN SERVICES JUL 0 6 1999
Environmental Services Division w~ur,lK=,ti,'ALIT¥ OF ANCHOJ,
825 L Street, Room 502 · Anchorage, Alaska 99501 · (9~~RVlC~S DWlSION
Health Authority Approval Checklist
Legal Description:
A, WELL DATA
Well type ,'~/z/V,,-4'z8
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Parcel I.D.:
If A, S, or C, attach ADEC letter. ADEC water system number
Casing height (above ground)
Date completed
Cased to / '-~-~ /
Y
Wires properly protected (Y/N)_ ~.~
Date of test
Static water level
Well production
FROM WELL LOG
AT INSPECTION
g.p.m, g.p.m.
WATER SAMPLE RESULTS:
Coliform
Date of sample:
B. SEPTIC/HOLDING TANK DATA
Date installed ~ -~ '7 '? Tank size
Foundation cleanout (Y/N)
Date of Pumping /,¢/,4 __
Nitrate ~,'545 Other bacteria
Collected by:
~...2~,-.~ Number of Compartments ~ Cleanouts (Y/N)
Depression (Y/N) r,J High water alarm (Y/N). /v/.,1
Pumper ~
C. ABSORPTION FIELD DATA
Date installed ? ~ 5*
Length ~ ~ Width
Effective absorption area 757~ //5
Date of adequacy test
Fluid depth in absorption field before test (in.);
Fluid depth ~ (ins) Minutes later:
Peroxide treatment (past 12 months) (Y/N)
Soil rating g~._~p..d,/fl~ff~r ft2/bdrm) /
Gravel thickness below pipe
Monitoring Tube present (Y/N)
Results (Pass/Fail)
System type.
Total depth
_ Depression over field (Y/N) __
For (~,
Immediately after ~gal; water added (in.):
Absorption rate = ---- .g.p.d.
If yes, give date -~-
bedrooms
72-026 (Rev. 3/96)*
LIFT STATION
Date installed
Manhole/Access
Size in gallons
"Pump on" level at*
*Datum
"Pump off" level at*
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on' lot /O'"d~ /
Absorption field on lot /~ /
Public sewer main /v
/
Sewer/septic service line '/~ o
On adjacent lots f' /5~;~ "
On adjacent lots z~/o~"
Public sewer manhole/cleanout /¢' I ~
Lift station /v' 1 ,A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation _~-~ ~ Property line ,~3- ~ Absorption field ~/z.~
Water main/service line ¢-/o t Surface water/drainage -/-/0~¢ Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Property line ~:;O / Building foundation
Surface water '/-z ¢ ~) '
Water main/service line /-/~ /
Driveway, parking/vehicle storage area
Curtain drain
Wells on adjacent lots /-/~ /
ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and review of Municipal
in conformance with MOA HAA guidelines in effect on this date.
Signature
Engineer's Name
Date
HAA Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
T~96g PO~/03
sample Rema !'k~? ....
PDuttxl lS',~t¢/Tm~e 05119199 17:52
Cu~l~d ~a~l~ime 06/16/99 ~5:54
Receivc~ l~tetrime 06117199 10:50
JUN-21'§9 0T:36 FRO~CTE Efl¥1RONF, E~TAL ~61§301 T"96Z P.O~/O~ F~OB
Drinking Water Armlysb R.epor~ for Fot~.l Coliform Bacteria 2~,. po.,~ o~.,~
I
SAMPLE D;xTg:
SAMPLE TYPK
wi~h Jab ~[
gA~IPkE LOCA'~ON
Year
FO gE COMPLETED BY LABO~&TOR. Y
I:m mlmliable
Sam0h: ~oo long in
~ ~mpt¢ ~ia S~ial~el,v¢~ mmL
~ACT~I~IOLOG[C;~L WATER ANAL, YSIf$ RECORD
~'~t C~ti~rm Confltm~bn