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Home My WebLink AboutRABBIT CREEK VIEW & HEIGHTS BLK 2H LT 16A Municipality of Anchorage Page DEPARTMENT OF HFALTH 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: "~I('2~.3'O~.~_~ ,..~ PIDNumber: ~- ~ ~ c~ _ Name: "~:~ {~l ~l ~ Wastewater System: D New ~Upgrade Address: I~ ~A~L %~ .. ABSORPTION FIELD Phone: No. of Bedrooms: _~ ~ Deep Trench ~ Shallow Trench ~ Bed ~ M~und ~ Other LEGAL DES CRI PTI O N so, Rating: Tota~ Depth from orl0Jnal grade: ......... G PD/Sq, Ft. ~ot: Block: Subdivision: ..... Depth to pipe bottom from original grade: Gravel depth beneath pipe Township: Range: Seclion: Fill added above original grade: ~mvel length: Gravel depth: Number of lines: 01stance ~lween lines: WELL: ~ New ~ Upgrade Ft. Fi, Classification (Private, A,B,C): Total Depth: Cased To; Total absorption area: Pipe m~'~erlal: Ft. Fi, SQ. Ft. Driller: Da{e Drilled: Static Water Level: installer: Date Installed: Pt. Yield: Pump Set at: Casing Height Above Ground: SEPARATION DISTANCES ~ Septic ~Holding ~ S,T.E.P. TO Septic Absorplion Lift Ho[ding 3uhlic/Private Manufacturer: ~ Capacity 10gallons: From Tank - Field Station Tank SewerLines ~ I ~ ~ K , , Material: Number of Compa~ments; Surfsce Water Mo~< LIFT STATION Lot Size In gallons: Manufacturer: Foundation~- ~ "Pump on" level at: "Pump off" level at: [ High w~ter alarm at: Cu~ainDrain ~[0~ Pump Mako& Modol~} Eloctrlcat Inspoctiona pedormod by: ~omarks: B~GH kocafion an~ Assumed Elevation: ............. Fh Inspoctions ~erformo0 b~: ~ ~ Datos: ~st.t ~/~ ~ ~epartment of Healt~¢~ Hu~rviees approval Reviewed and approved by~/G~, ~ Date:/, 72-013 (1/91) MOA 25 LOT 3 // LOT 4 Ltl? i7 ¢ / \\ / ~ /... \ \ /50 0 / N CU \\.. i!i!ii::/'q~ / \~'/-- 4000 GAL, HOLDING TANK ~ ~: :::::::::::::::::::::: ...... ~ ............ ~ · LOT I5 LOT 14 LOt I3 I SO lO0 150 EO0 £CALE, 1' = 100 rT, LOT Il 300 m i r f:BBBEN SPURKLAND P.E, 03 ~/ 15TH, AVENUE NCH, AK, 99501 ~. .......... 16345 CARL STREET SEPTIC SYSTEM ASBUILT DATE, BEC, 8, 1993 SHEET, 2/2 GRID, 3~°40 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 WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW930476 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:METSKER LISA A OWNER ADDRESS:16345 CARL ST ANCHORAGE, ALASKA 99516 DATE ISSUED:il/12/93 EXPIRATION DATE:il/12/94 PARCEL ID:02003284 LEGAL DESCRIPTION: RABBIT CREEK HEIGHTS BLK T i[6 2 L LOT SIZE: 38922 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: HOLDING TANK 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 OR 343-4681 AFTER BUSINESS HOURS 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. SPECIAL PROVISIONS RECEIVED BY: /~/~ iSSUED By: ~~ / DATE: /1 /,~/q~ - DATE: //-/2- - ~/ _ S pL;F~[L_~-~bI~, F~_ L~- W. DIMOND BLVD. ANCHORAGEs ALASKA 99~02-3~04 1907) 279~.3~1A Municipalit'y of Anchorage Division of Environmental Health Department of Health and Social Services 820 i Street Anchorage~ Alasl..'.a 99501 Subject: Holding Tank Installation Lot 16, Block 2 Rabbit Creek Heights October 27, 1993 Ge_~ ~ti emen; During an HAA inspection -For this lot it was obserwed that the tank was severely surcharged. Standing water was observed on the Steel monitor pipes were driven to a depth of ten ~eet. Water was immediately obsmrved 2 to 3 Yeet below surface. AYter 24 i~ours the water level, was i.5 ~eet below top o~ ground. A standard soil absorptior~ system can not be installed on this ~ et. Tobbep~ Spurkland P.E. ~x I~ / / Ltl? 3 / LZTT 4 \\\\ / L[77 15 ~ LE7? 1£ L[?T iI L[77 13 L[TF 14 250 300 TDBB~ SPUR~'LAND P~ ' ~03 ~/ 15TH, AVENUE'' Ipr ~,; ~cK e ~zr c~rrK H~:~z~ll SEC 1 TI1N ~3~ ANCH AK 99501 ~=~ I i ~6~5 CA~L 2T~EET ~ l SEPTIC SYSTEM DESIGN m DATE, UCC. L~7, 1993 I SHEET, 1/3 GRID, 3240 [ I CONDUIT RAIN CAP TYPICAL PUMP ACCESS GAL VANIZED LZg, 4 FL OF COVER OVER TANK CAULDER COUPLIN6 TYPICAL fl2 ALARM PANEL DIRECT BURIAL VIRE 1" PVC CONgUIT £,67 HIGH ~¥A TER ALARM MERCURY S~FITCH FLOAT 6.3 17.1 STANDARD 4000 GAL, ANCHORAGE TANK ORENCO STANDARD ALARM SENTINEL IT 12SI 9 VT 675i W, D~M[]NI) BI_VI}, ANCH. Al<, 99502-3904 LISA METSKER ~n~ v4m-~n~ ....... 16345 CARL STREET SEPTIC SYSTEM DESIGN II SHEET II NAME MAILING ADDRESS LEGAL DESCRIPTION L'F i6_ LOCATION MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAl_ PROTECTION ENVIRONMENTAl_. ENGINEERING DlVlglON 825 L Street- Anchorage, Alaska 99501 Telephon, 264-4720 ON-SITE SEWAGE DISPOSAl. SYSTEM AND/OR WELL INSPECTION REPORT DISTANCE TO: Liq. cap ' DISTANCE 1-O: Manufacturer /7- _ c:/z~_< -- ¢ ! J Absorption ar~a I DISTANCE TO: I No. of lines / Length of each I,~ine Top of tile to finish grade ~/ Dwelling NO. OF BEDROOMS PERMIT NO. IF NOMEMADE: Inside length Width Liquid depth Well Dwelling PERMIT NO. - Liquid capacity in gallons Type of crib Crib diameter DISTANCE TO: Well Class Depth DISTANCE TO: Building foundation OTI4ER PIPE MATERIALS Depth Crib depth Building foundation Sewe~ line SOIL {ATING 'NSTALLER ~'Y' o v~vzwz-Z~ REMARKS effective absorption area tJve absorption area Nearest lot line Distance to lot line Septic lank LEGAL [] SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST [] PERCOLATION TEST LEO^LOESCR,PT,ON:. kr;fl I(o ~/k Q ~-z~bb:-k (¥cck 1 2 3 4 5 7 8 9 10 11 12 13 14 15 16 17 18 19 20- COMMENTS PERFORMED BY: 72-0011 (6/79) ENCOUNTERED? IF YES, AT WHAT DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE (minutes/inch) TEST RUN BETWEEN FT AND ----. FT WATER WELL RECORD STATE OF ALASKA DEPARTMENT OF NATURAL RESOURES Division of Geologi¢ol 8~ GeophysicBI Surveys LOCATION OF WELL (Please complete either ID, lb or ic.) ~IDISTANCE ANO DIRECTION FROM ROAD INTERSECTIONS Rabbit Creek Heights Street Address end Are~ of Well Locofion 2. WELL LOG Material Type _ gray ~ clay silty~g~avcl silty~sand, gravel~ water Feet Below Surface Top Bottom 0 22 2.2 hard silt y.~/_gravel [Lenses of sand & gravel An hard silt H20 I6. WATER WELL CONTRACTOR'S CERTIFICAIlON: Orilling Permit No. A.D.L. No. Township N['~ Ronge E L~lMorldian 2o_1 OWNER OF WELL: Forrest Glen Metsker Address: 4. WELL DEPTH: (final) [ 5. OATE OF COMPLETION __2_~____f,. I __?___ -- - -82~ 6. [] Cob[o fo01 [C~Rotory [] Driven [~] Dug D Auger J~dotted E~Bored [~] Other: 7. UTE: [~' Domestic [~[ Public Supply [] Industry [] Irrigotlon [~ Rechorge L~ Commericol [] Test Well [~ Other: 8. CASING~ L~ Threaded [~ Welded dicta.. 5 in. to_~_L~-___ ft. Oeplb Weight lbs./ft. 9. FINISH OF WELL: Type: Diameter': Slot/Mesh Size: Lenglh :. Sol between fl end fl. ~o. STAT,C WATER u-:vEL: 20 [] Above or [~ Below land surface Dote Equipment used: II. PUMPING LEVEL below land surfoce end YIELD LJ-O ft. offer ___h,'~. pumping 1~0~ g.p.m. ft ~Jflor ____hrs. pumping ..... g.p.m. i2.6ROUTING Well Grouted: [~ Yes [] No Materiel: ['~ Neat Cen'~onl [] Other: 13, PUMP: (if available} HP Length of Drop Pipe ft. capacily _____g.p.m. E3 Subm. [~ Jet [~ Centrifical [] O,her Iq. REMARKS: 15. Water Tompernt ....... o [-~ F [[~ C This well was drilled under my jurisdiction end Ihis report is true to the besl of my knowledge and belief; Vein' s Drilling Regislered Business Nome Conlro¢l License Number Add .... : SRA Box 1560 Anchorage, Alaska 99507 Signed: Form OZ~WWR (11/81) Dote: Authorized Represenfetlve Copy Distribution: WHITE'-Stah~. DGGS, PINl(-Dritler~ CANARY-Customer 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 Parcel I.D. # CERTIFICATE OF: HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 020-032-84 HAA# HA930756 1. GENERAL INFORMATION Complete legaldescription Lot 16 Block 2 Rabbit Creek Heights S/D Location (site address or directions) 16345 Carl Property owner Mailing address Lisa Metsker Day phone 345-7521 (h) 269-6417 16345 Carl Anchorage 99516 Lending agency Mailing address Day phone Agent Carol Don:bi]it % ReMax Address Day phone 257-0116 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: Three (3) XXXXXX If community well sy~;tem, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site NOTE: XXXXXX Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev 1/91) Front MOAIt21 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/orwastewaterdisposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein, lfurtherverifythatbased 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. Nameof Firm Tobben Spurkland, P.E. Phone 279-3916 203 West 15th Avenue I1206 Anchorage, Alaska 99501 Address Engineer's signature Date Note: This is a typed corrected copy from DHHS original files. Any Questions, please call 343-4744, Laura J. Montgomery DHHS SIGNATURE xxxx Approved for three (3) Disapproved. Conditional approval for 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. (Rev. ~/91) ~3ack MOA ~21 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. # O ~..(::) ~ C) ,~,-~L .- GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent ~.-~. %,~. Address Day phone _Z~L/.Y'- '7 b'o'L ) l-I Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: v' If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 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. 1/9I) Front MOA #21 ')poM s2eeu!bue '.~uo!ssejoJd sql u! suo!ss!tuo JO sJoJJe Joj elq!suods@J ~ou s! ebeJoqouv 1o /`],!led!o!unlq aq.L.'panss! s! e]~o!J!~eo e eJojeq e]ep eZ/,leUe Jo suo!),o@dsu! ~onpuoo ~,ou op SHHQ jo seeAoldLU3 'siueweJ!nbeJ e]e),s pus leJepeJ u!epeo ,~s!),es oh ~epJo u! suo!],n~l]su! bu!puel Jleq], pus sauuoq jo sJeseqoJnd o),/,sap noo e se slq), seop SHHQ Sql e)~SelV jo e],e~S eq~ u! paJa],s!6eJ Jesu!bus leUO!SSejoJd ],uepuedepu! ue /,q e^oqe g qdeJ[~eJed u! ua^lb suo!~e),ues@JdeJ eq~ uodn /,lUO paseq se~eo!J!peO le^oJdd¥ /,I!JOLI),nv q~leaH senss! 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O=IdSNI 40 .LNii]IN::I.L~flS 'S Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: A. Well Data Well type ~"~ If A, B, or C, attach ADEC letter. ADEC water system number Log present (Y/N) '7/ Date completed 7 / ~ ~ Driller Total depth "7z7/ ! Sanitary seal (Y/N) % Cased to FROM WELL LOG Date of test '-('¢.¢--[,~. [~C~ ~ Static water level ~ (~ Well flow [ _(~ Pump level1 SEPARATION DISTANCES FROM WELL TO: ~/holding tank on lot Absorption field on lot ! '~7/7/ Casing height Wires properly protected (Y/N) "/ AT INSPECTION g.p.m. ~, '~ g.p.m. ; On adjacent lots ; On adjacent lots Public sewer main Sewer service line Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform (~ Date of sample: f I I~- Nitrate ~ .J~ Other bacteria Collected by: ~ ,~ ,.~-~ 'd Date installed I~/I/~ ~ Cleanouts (Y/N) ~,/ High water alarm (Y/N) Date of pumping Tank size &/(¢~.~ Compartments Foundation cleanout (Y/N) ~'// Depression (Y/N) F,/ '",///,x~ Alarm tested (Y/N) / · Pumper SEPARATION DISTANCES FROM 8~i~/HOLDING TANK TO: Well(s) on lot To property line .'~ / Surface water/drainage On adjacent lots Absorption field "~ / o-~ Foundation ,,~ ['~/,,Z:~ Water main/service line 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots D. ABSORPTION FIELD DATA Date installed Length Total absorption area Date of adequacy test Width Manufacturer Soil rating (GPD/Ft2) Gravel thickness Cleanout present (Y/N) Results (pass/fail) Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N). Manhole/Access (Y/N) "Pump off" Level at Cycles tested SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water Curtain drain E. ENGINEER'S CERTIFICATION Surface water System type Total depth Depression over field (Y/N) for After test If yes, give date On adjacent lots Property line To existing or abandoned system on lot Cutbank Water main/service line Driveway, parking/vehicle storage area I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect On the date of this inspection. Bedrooms HAA Fee $ Date of Payment Receipt Number 02 72-026 (3/93)* Back Waiver Fee $ Date of Payment Receipt Number COMMERCIAL TESTING & ENGINEERING CO. ENVIRONMENTAL LABORATORY .=SERVICES chemlab Ref.~ Client Sample ID :L16 B2 RCH Matrix Client Name Ordered By Project Name Project4~ PWSID REPORT of ANALYSIS :WATER :TOBBEN SPURKLAND, P.E. :TOBBEN SPURKLAND : : :UA 5633 B STREET ANCHORAGE, AK 99518 TEL: (907) 562-2343 FAX: (907) 561-5301 WORK Order :'/3192 Report Completed :~.1/16/93 Collected :11/12/93 @ 13:30 hrs. Received :11/12/93 @ 16:10 hrs. · ' E Technical Dlrector:ST~HE~ Released By: Sample Remarks: ROUTINE SAMPLE COLLECTED BY: T.S. Allowable Ext. Anal QC . ,~ L~mits Date Date Init Parameter Results Qual Units ~=~-~ ' _ ............... Nitrate-N UA = Unavailable * See Special Instructions Above NA = Not Analyzed ~* See Sample Remarks Above Less Than U = Undetected, Reported value is the practical quantification limit. LT = GT = Greater Than D = Secondary dilution. ~S Member of the SGS Group (Soci6t6 G6nbrale de Surveillance) ENVIRONMENTAL SERVICES IN ALASKA, COLORADO, UTAH, ILLINOIS, OHIO, MARYLAND, WI-ZST VIRGINIA, NEW JERSEY, SOUTH CAROLINA