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HomeMy WebLinkAboutNORTH SLOPE #2 BLK 5 LT 17 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 Permit Number: ~C/~pc/~,~//~ PID Number: ~'D- .5'~'/' Name: ~ ~/~/~ Wastewater System: ~ New ~ Upgrade .~ ~. ~ ABSORPTION FIELD Address:~ ~' ~~ No. of Bedrooms: ~ ~ Deep Trench ~ShallowTre~ch ~Bed ~Mound ~Other Phone: I Total Depth from or g hal gra~e' LEGAL DESCRIPTION so,,~..~: ~' ~ GPD/Sq. Ft. ~,// ' .-- ~,~ I' Lot: ~ ~ Block: ~ Subdiv~ion: Depth to pipe boEom from original grade: Gravel depth beneath pipe ~'~/~ ~ ~,~' ~ ~,~ ~t. ~,~ - 2.~ F~. Township: ~ Range: ~ Section: Fill added above original grade: Gravel length: I I WELL: ~ New ~ Upgrade srave~ width: Number of lines: DisUn~ ~n Classification (Private, A.B,C): Total Depth: Cased To: Total absorption area: Pipe material: ~ ~;~ /~/ ~. /3/ ~. 7~ ~s~.~t. Date Drilled: Static Water Level:Installer: J Pump Set at: ~ ~sing Height A~ve Ground: J SEPARATION DISTANCES ~Septic O'Holding D S.T.E.P. To Septic Abso~tlon Lift Holding Public/Privet, Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~, ~ Wel~ /~ I~ J00I ~ -- ~ ~ Material: 5~E¢ / Number °f ~mpa~ments: Sudace Water /OD ' ~ ~' ~ - -- - LIFT STATION Lot Size in gallons: ~ Manufacturer: Line lot ~ /&l ~ ~ ~ Foundation /~ ~ /~1~ __ -- __ "Pump on" level at: ~,eve, at: ~ High water alarm at: Cu~ain p~ i ~ctri~l i~p~tions pedormed by: Drain /~ ~ J~ ~ ~ ~ Remarks: ~ ~ ¢~ ~. BENCHMARK  Assumed Elevation: ENGINEER'S SEAL ~ ~ .~ ~ ·e Inspections pedormed by: ~ ~hc~/~ Dates: 1st ~-2 r- ~ E ~~ 2nd ~'~~$ ~ Depadment of Health and Human Se~ices approval -~z.-~ Reviewed and approved by: ~"'~/~,~ P/¢Z~ Date: (Rev. 9/911 MOA 25 AS-3UILT SYSTEM DETAILS/SITE PLAN PermPc sw980118 NBRYH SLBPE S/D, ADD, fi2, LBT 17, BLBCK 5 PID~OSO-581-P1 ~-~=50,5' ~ FINAL GRASE A-E=55,4' E ........... o% ~ A-F=67,6' $ B-F=4a,3' ~/ ~AN~ ~ SEWER RBCK $-G=43.3' ~ ~ _~ TRENCH, c-a=ss,3' I S-H=54,6' SCaLZ, NTS C-~=71,8' SEWER RECK a,~, I t OF 44~- ~o.o, ~ ¢~N PREP~RE~ FUR, ~*~ ' ~ '" ~ ~, CRalO WALTERS FIELD BOOKS COMPU~EO: ~~ ENGINEERING s~Amo: SEWARD c.~cx~: KMD *S~U,L~: SEWARD OAT~: 12/19/98 SAGgg RWgg, AX 995?7-8?36 *c*onm98058.DWO ,OB~.., 98058 (907)696-6111/F~ (907)696-8111 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 .......... ,I , -~:- 'i Performed ior: Project: SOILS PERCOLATION TEST Craig Walters No.r.t_hslope #2 Elk 5 Lot 17 TEST HOLE # . 98-3 2- 3- 4- 6- 7- 8~ 9- 10- 11- 16- 17- 19- ORG- rootmat layer GM/SM- cobbles to 24" Increase density w/depth B.O.H. SEE ATFACHED SITE PLAN ] FOR HOLE LOCATION Was Ground wat~ encountered? NO Depth to water after monltoting? DRY What depth?Date? NA { -Reading Date Gross Net Depth {(~" Net Time Time W~t?r Drop___ 6 1:17 10mJn 4 3/8" 10/16" * Water Added Percolation Rate 8 . (mtn/in) Perc Hole Diameter TeSt Run Between. 3 feet and _ 4 feet 1, Kemleth M. Duffus, certify that this test was performed in accordance with all State and Municipal guidelines effect on this date. MUN/C/PALITY OF ANCHORAGE Department of Health and Human Sen/ices On-Site Sen/ices Program 825 L Streef, Room 502 P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Permit Number: SW980118 Design Engineer: 0070 KND ENGINEERING Owner Name: Craig Walters Owner Address: 2700 West 66th Ave Date Issued: May 15, 1998 Expiration Date: May 15, 1999 Anchorage, AK 99502- Parcel ID: 050-581-21 Legal Description: NORTH SLOPE #2 BLK 5 LT 17 Site Address: Lot Size: 102950 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] Septic Tank [] Privy [] Private Well Holding Tank 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 engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. ~D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 April 22, 1998 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 RECEIVED iViunicipality of Anchorage Dept. Health & ~u~an Services Subject: New sewer/well permit North Slope S/D #2, Lot 17, Block 5 Gentlemen: The owner has requested we proceed forward to obtain a well and septic permit on the subject lot. On March 31, 1998 we dug two testholes for the proposed new system. The results of this test and water monitoring are attached. The lot will be served by individual well. We propose to install a 5' wide gravity fed shallow trench. Additional fill will be placed over the system as required to provide a minimum of 3' of cover when complete. There is sufficient area for the primary and reserve fields within the radii of the testholes for the proposed four bedroom single family residence. There are no public or private wells within 200' of our proposed system location except as noted. There is neither surface water within 100' nor any curtain drain within 50'. We do not expect there to be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, II~bqD Engineering attachments: On-Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test WEFL WASTEWATER NBRTH SLBPE LnT '14 K D LOT 17 DISPOSAL S/D, ADD, SEPTIC iAPPROX, TH #98-1 · PROPOSE SEPTIC NO PUBLIC WELLS WITHIN EO0' OF PROPOSED SYSTEM, NO PRIVATE WELLS WITHIN 800' DF PROPOSED SYSTEM EXCEPT AS NOTED. NO SEPTIC SYSTEMS WITHIN 200' DF PROPOSED WELL EXCEPT AS NOTED, SYSTEM DETAILS/SITE ~8, LOT 17, BLOCK 5 VERIFY PRIOR TO VACANT 4 BDRM X 150 GPO = GO0 GPO 600 GPO/O,8 GPO PER SQ, FT, = 750 SQ, FT (500/(59) X 0,64(RF) (2,5' GRAVEL) = 94 FT. TRENCH To~[ depth o£ system is 3,0' Crom original §tilde, Total depth o? grovel betow dis~ribu~ion pipe Is 2,5' , NDTES~ 1, USE lPSO GALLON SEPTIC TANK, INSULATE TANK IF <4' COVER, 2, INSULATE TRENCHES WITH 2' HD BURIAL FOAM,, 3. CONTRACTOR NVILL ENSURE HAXINUN 2% SLOPE TNTO SEPTIC TANK, 4, ADDITIONAL FILL WILL 3E ADDED DYER SYSTEN TO ACHIEVE MIN. 3' COVER IF REQUIRED, PREPARED FOR: CRAIG WALTERS 2700 W, GGt;h AVENUE ANCHORAGE, AK 99502 FIELD BOOKS COMPUTED; I~OUNDARY: __ ORA'CfM: KMD STAKiNO: SEWARD CHECKED: KMD ASBUILT: -SE:WARD 4/28/98 SE703 98038 Sco. Le: V= 100' PLAN VA {907189~-'8111/~AX (907)~6-8111 AOAD FILEt 98038.DWG ~~ ~NGINEERING g0441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 .$ 825 "L" S~reet, Anchorage, Alaska 99502-0650 SOILS LOG ~ PERCOLATION TEST ~.'~ 15:~'... ~ · ..';.~ cA'rE PERFORMED:~~ SLOPE SITE PLAN ENCOUNTERED? ~,O,H, 2 3-- 4-- 5 6 7 8 9 10 11 12 13- 14 15 16 17 18 19 20 $ IFYES, ATWHAT //~t~ (~ DEPTH? P E Moniloring? ~, ~ Dale: Gross Net Depth to Net Reading Date Time Time Water Drop / - /o,, 7--. .-~ I1,// ~ ID"', ' - ? ~ /~,,: ~ - /b't. - COMMENTS ACCORDANCE WITH ALL STA~AND MUNICIP~UIO~LIN~ IN EF~EC~ ON ~1~ DALE. ~AiE: 72-008 (Rev. 4/85) Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Slreet, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST ~. CE 7~ I 3-- 4 5ome ar~qe,~.r"~, 6 7 8 WAS GROUND WATER 10 ENCOUNTERED? ~F Y~S, ATWHAT DEPTH? Depth to Waler A~er 7 / 13 M0niWing? Gross Net Depth to Net ReadingDate Time Time Water Drop / 3-.W-~3 II :o5 - /D . _  "~ 1'/ : 7 ~, .?"/[,," // ~ ~ /~,~ ~ ,, ~ '/I ~ ~ ~ -/~, 14 15 16- 17 18 ]9 20 PERCOLATION RATE ~?'~ {m,nuleszmch) PERC HO~'E DIAMETER T~ T RUN BETWEEN ~-' FT AND "~ FT ERFOR ED :/' "D l TH,S TEST W^$PERFORMEO ,N ACCORDANCE WITH ALL S"fA~AND'MUNICIP~//UIDELINES IN EFFECT ON THIS DATE. DATE: 72-00,8 !Rev. 4/851 Parcel I.D. # 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 GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailin. g address Agent Address Day phone Day phone Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: ~ TYPE OF WATER SUPPLY:. Individual well Community well Public water NOTE: TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. Public sewer ' :: ' If community wastewater sy~s. tem, provide written confirmation fr°m State ADEC attesting to the legality and status of system. ' ·. 72-025 (Re;. 1/91) Front MOA~ff21 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 2~ Engineeffs signatu~~ ~~ DHHS SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. Phone ~-~ /// Date bedrooms, with th-e 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. 72q)25(R~v. 1/91) Back MOA~¢21 Legal Description: A. WELL DATA Well type ?,,w~,e Log present (Y/N) Total depth / Sanitary seal (Y/N) Municipality of Anchorage R, iA~E Cv_~E ! Vic) c) ~E~ DEPARTMENT OF HEALTH & HUMAN SERVICES 0~ Environmental Services Division 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907)N~-u~ . ' ENVIRONMI~NTAL SERVIL.~,S DIVISION Health Authority Approval Checklist If A, B, or C, attach ADEC letter. ADEC water system number Casing height (above ground) Wires properly protected (Y/N) Date completed Cased to / --~ / ~ Date of test Static water level ~ / Well production WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed .~Z Foundation cteanout (Y/N) Date of Pumping FROM WELL LOG g.p.m. AT INSPECTION g.p.m. Nitrate ~-~ ~ ~/-~ Other bacteria ~) Collected by: ~/~ Tank size /! ~ ~-~) Number of Compartments '~ Cleanouts (Y/N) Y Depression (Y/N) /'V/ High water alarm (Y/N) --- Pumper C. ABSORPTION FIELD DATA Date installed Length 5'P, 'b/~ 5"'0' Width Effective absorption area -~'~) Date of adequacy test Fluid depth in absorption field before test (in.); gal. water added (in.): Fluid depth ~ Absorption rate = g.p.d. Soil rating (~ft~ or fF/bdrm) ~' ~ System type -~'~'~//~ ?~'~ -~. Gravel thickness below pipe 2, ~ -2, ~' ~Total depth Monitoring Tube present (Y/N) ~ Depression over field (Y/N) Results (Pass/Fail) For / bedrooms Peroxide treatment (past 12 months) (y/N) If yes, give date 72-026 (Rev. 3/96)* LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level Cycles tested *Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot /~ Absorption field on lot Public sewer main /-"/~ Sewer/septic service line On adjacent lots On adjacent lots Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation //~ /~- Property line /D/~- Absorption field. '/~ /+ Water main/service line 2 ~- /'ff Wells on adjacent lots ///~3 /--~- Surface wateddrainage /D~ /; SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line /~ /'/- Building foundation / ~/''/- Water main/service line Surface water /~ '~ / 2- Driveway, parking/vehicle storage area Curtain drain /D ~ //- Wells on adjacent lots ,/~ ~ ~ ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal recerds~ ins onatureC°nf°rmance,,~-~-~~~~//~OA HAA guidelines in effect on this date. En°gineer's Nar~e /~¢,k~ H -¢ -~ ~ HAA Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ .. Date of Payment. Receipt Number NORTHERN TESTING LABORATORIES, INC. 3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 {907) 456-3116 ·FAX 456-3125 8005 SCHOON STREET ANCHORAGE, ALASKA 99518 (907) 349-1000 · FAX 349-1016 POUCH 340043 PRUDHOE BAY, ALASKA 99734 (907) 659-2145 · FAX 659-2146 KND Engineering 20441 Ptarmigan Blvd. Eagle River, AK 99577-3736 Attn: Client ID: ~ ©~V~.~\ Client Project #: Source: NTL Lab#: A159574 Sample Matrix: Water Comments: Report Date: 12/31/98 Date Arrived: 12/22/98 Sample Date: 12/22/98 Sample Time: 14:00 Collected By: Kelly ** Legend ** MRL = Method Report Level MCL = Max. Contaminant Level B = Present In Method Blank E = Estimat~ Value M = Matrix Interference H = Above MCL D = Lost To Dilution Date Date Method Parameter Units Result MRL Prepared Analyzed SM 4500 NO3 Nitrate-N mg/L <MP, L 0. i0 12/30/98 Reported By: Wendy M. Mitchell Senior Chemist RECEIVED JAN 5 1999 Oept. Neaith & Huraan Services