HomeMy WebLinkAboutPRATOR BLK 12A LT 1
, Municipality of Anchorage Page [ of-2-..~
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: .~g3~0\8~ PIDNumber: ~,-~-
"~: ~ ~z~ Wastewater System: ~ New ~ Upgrade
Address:
~zo~ ~.~o~..~ ~ ABSORPTION FIELD
Phone: ~~ ~ ~ ~ NO. of Bedrooms:
(~ ~l-- 7~Z7~ ~ ~D~pTrench D Shallow Trench D Bed D Mound D Other
Total Depth from original grad9
LEGAL DESCRIPTION soil Rating: ~, ~ GPD/Sq. Ft.
Lot: Block: Subdiv~ion: Depth to pi~ bosom from original grade: Gravel depth beneath pipe
WELL: ~New ~ Upgrade Gravel width: ~t Number of lines: Distanm ~lw~n lin~:
~t. I
Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material:/
~t~ ~ Ft. t]~ Ft. ~O~ SO. Ft.
D~te Drill~: Static Water Le~l: Installer: Date insta~le~:
Driller: ~,~ ~ ~ ~S' Ft. ~~~
Pump ~t at: ~ing Height A~ve Ground:
~: G ~,~ ~ .~. ~, .~. TANK
SEPARATION DISTANCES ~septic D Holding ~ S.T.E.P.
To ~ptic ~tion L~ Holding Publlc~ri~te Manufacturer: ~paci~ in gallons:
From Tank Field Station Tank ~wer Lin~ ~~
~ ·.~/~/.~/~/~ Z~[ + Material: ~.~ Numar of ~mpa~ments:
Well-
Sudace ~+ [
Water ~oo ~ +
LIFT
STATION
LineL°t [~' ~ ~(~ ~/~ m' ~ Size in gall°ns: IManufacturec
CudainDrain ~ ~J &~ ~ectri~l Ins~ctions pedorm~ by:
Remarks: ~ ~ ~ ~ ~ BENCH MARK
Lo~tion and Description:
Assum~ E~evation:
ENGINEER'~ SEAL
lnspectionspedormedby: ~% ~~q Dates:lst ~ .~o~e~
~ 2nd ~ ~&
Dep~dment of Health ~nd Human Semites ~pprov~l
Reviewed and approved by: J/~/~/, ~Date:
72-013 (Rev. 9/gl} MOA 25
A-C=3F'.O'
B-C--06.0'
A-D=35.0'
B-D=68.7'
A-E=81,8'
B-E=94,5'
A-F=88,8'
B-F=IO0.4'
AS-BUILT
PRATI]R S/D, LOT i, BLOCK
TH
PRIMAFY SYS~
SYSTEM DETAILS/SITE PLAN Permit SV980189
PID~O17-093-09
LOT 1 ~ \
~ · WELL
34-479) SFD i '
\ ,
TH ff98-1
SYSTEM
EZ
~ -- tO00 GAL
FINAL GRADE
FILTER FAI~RIC'~NN
SEWER ROCK
47'
PREPARE]] FOR:
PAT ARNETT
2207 E, TUDDR RADD, SUITE 33
ANCHORAGE, AK 99507
(907)561-7827
FIELD BOOKS
COMPUTED:
BOUNDARY: LANG DRM'/N: KMD
STAKING: LANG CHECKED: KMD
ASBDILT: LANG
DWG, FILE:
ACAO FILE: 98060,DWG
OATE: 5/6/99
GRID: 5059
JOB No.: 98060
SCALE: 1' = 51
SCALE: NTS
20441 P?ARMIGAN BLVD.
EAGLE RIVEi% AK 995.??-8?36
[ (907)696-61H/i~AX (g07)696-8111
RLPINE DRILL 90? 345 0202
Ha~.10.1999 09;~1RH P01
STATE OF ALASKA
DEPARTMENT OF NATURAL flE$OURCI~
DIVISION OF MINING & WATER MGMT
WATER WELL RECORD
......."~~ I /2~ ~s ~w .... ~:.
.L~TIONISKBCH~ WELL OWNER:
" ~ 1~:~ '7"
... :.. ,, .. f .... ,.., ~
· .:.: -; . ..
~'~8~EB F~O~¢¢~ing top Oground ~urfao~ WELL DE~fH: BA~E Of CO~[~ION
....... ~epth of hole: ~ . ..ft
.'q ,. , _ ,.~;';' _ (t below ~ top of Casing B grou~
' ,,,.,':, ¢,,. ~ ,.,"/: MBHOD OF DRILLING: ~ etr rotary O cable Gal.
...... , ..... ..., ,/,/',. ~ other ............
~' ' ~" USE OF WELL:.·~ domestic ~ IrrigatiOn ~ monlto.r
~,~(~,~ , ~ e ~ public SuPply ~ other
. ,,,, , / / ~P ~r .
' '.,'~- ~ ' ~ c~s~,~ s~,c~:..: ~. ~: ~ ~n.
<:. ¢,~ ..... ,,, X,.'.,.,, ,... ~...
/'¢' ' r; WELL INTAKE OPENING TYPE: ~ open end ~ ~or~ned
;~ . . ~ ' · ,,
~:¢'.'~,.,.*'"'. ...... (::' 4'.:'-l '¢ / O,¢~ ~lot/Mesh Size: Length: ::.
'" ~.:.,' ~, / GRAVEL PACK TYPE:
~,<,: ,.-.~¢ ~,, ,,o,..:,, ,.. /¢ ~ Volume us~?., , D~,t, to top: '
~. O Depth: from ftto ' f
g,,;. ,.... ~ . Duration: ~ '~ *'r',
PUMPING L~EL AND YIELD:
. ,,,,, , .. MAY 1 3 ~99 ~O,.~ft al[~[....~ hrs pumpln~ ~.. ,':.,.,~pm
Municipality of Ant !~rage ' ' PUMP INTAKE DEPTH: ft Horsepower:
, Dept. Health & Humar ~'ervice~ WELL DISINFECTED UPON COMPL~ION? ~
., , 'X.~. ~ ' ~ ,.~ ............ ',: '
C{~'NT~TOR INEORMATION: REMARKS:
.;,;j :' ~ .~ ~. .; .~ ,. ..... ..
E.:.
~., ~'~,"~'" s,~-"'.-, t.~..,.,...,..,~..,¢.,,~ .....
'~,~ "~"~'~"~,// ",? ,,...., ..,,,.~.,...~ ,,.. ,.......,......
.,;.~~/~./~ ~¢ ~¢ PLEASE ~AIL WHITE COPY' OF LOG
~s~l:A~t~0rized Respresen~tive 3601 C St, Suite 800
ANCHORAGE AK 99603.5936
Phone (9071266-863{i, Fax (90TI662-1
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 3LND WASTEWATER DISPOSAL SYSTEM PERMIT
PAGE 1 OF 1 ~
PERMIT NUMBER:SW980189
DESIGN ENGINEER:KND ENGINEERING
OWNER NAME:MARQUEZ WILLIAN F & CYNTHIA D
OWNER ADDRESS:6740 MARQUEZ CIR
ANCHORAGE i~LASKA 99507
DATE ISSUED: 6/19/98
EXPIRATION DATE: 6/19/99
Pi~RCEL ID:01709309
LEGAL DESCRIPTION:
PRATOR BLK 12A LT 1
LOT SIZE: 40924 (SQ. FT.)
NI/MBER OF BEDROOMS: 3 THIS PERMIT:
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORD/LNCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIRENIENTS 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.
SPECIAL PROVISIONS:
(907)696-6111/FAX (907)696-8111
June 17, 1998
Municipality of Anchorage
Dept. of Health & Human Services
On-Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519-6650
Subject: Prator S/D, Lot 1, Block 12A - Well and Septic Permit
Gentlemen:
Following a request from the owner, on April 25, 1998 two testholes for the
proposed on-site septic system were dug. The results of these tests are attached. The
lot is to be served by individual well as indicated on the attached site plan.
As indicated on the site plan the system can be served by gravity. A 1000-gallon tank
will be installed for the proposed 3-bedroom residence. Additional fill will be placed
over the system to provide a minimum of 3' of cover when complete if required.
As indicated by the site plan drainage arrows, natural drainage is away from this site
and will be maintained after construction. There is no surface water within 100' of
the proposed installation. There are no known curtain drains within 50' of the
proposed installation. No public or private wells exist within 200' of the proposed
installation excepted as noted on the drawing. This on-site septic system should
have no adverse effect on development of adjacent lots.
If you have any questions, please contact me at 696-6111/FAX 696-8111.
Respectfully submitted,
~fu--~s p E~~~ng
Kenneth M. Du ,
Attachments:
On-Site Well and Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
WELL WASTEWATER DISPOSAL SYSTEM DETAILS/SITE PLAN
PRATBR S/D, LOT 1~ BLOCK 12A
· WELL
VACAI
L~
· WELL
LOT P
TH fl98-1
ND PUBLIC WELLS WITHIN 200' OF
PROPOSED SYSTEM.
ND PRIVATE WELLS WITHIN 200' OF
PROPOSED SYSTEM EXCEPT AS NOTED,
ND SEPTIC SYSTEMS WITHIN ~00' OF
LOT 1
TI
, K [3
i i~k_ _~L73_ _pa _~5_~- ....................
DESIGN DETAILS
3 SDRM X 150 GPO = 450 GPO
VACANT
450 GPO/.6 GPO PER SQ, FT, (17,8 MIN/IN,)= 750 SQ, FT
(750/(2'(W) X 8'(D)) (8.0' GRAVEL) = 46,9 FT, TRENCH
USE 1 TRENCH - 47 (L) X 8' (W) X 8'(D)
Total depth oF system is 11,0' From ori§inal grade,
Total depth oF gravel below distribution pipe is 8,0' ,
NE]TES~
1. USE lO00 GALLON SEPTIC TANK, INSULATE TANK IF <4' COVER,
INSULATE TRENCHES WITH 2' ND BURIAL FOAM,
CONTRACTOR WILL ENSURE MAXIMUM 2% SLOPE INTO SEPTIC TANK,
4. ADDITIONAL FILL WILL BE ADDED OVER SYSTEM Tn ACHIEVE
MIN, 3' COVER IF REQUIRED,
PREPARED FOR:
PAT ARNETT
2207 E. TUDOR RAOD, SUITE 33
ANCHORAOE~ AK 99507
(907)561-7887
FIELD BOOKS
COMPUTED:
BOUNDARY: LANG DRAWN: KMD
STAKINB: LANG cHEcK£O: KMD
ASBUILT: LANG
DWB. FILE!
^CaD FILE: 98060.DWG
d^~E: 6/15/98
grid: 3039
JOB NO.: 98060
Sc(lie: 1'= 100'
PAGE 1 OF 2
~~) ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)696-6iii/FAX (907)696-8111
D
WASTEWATER
PRATBR S/]], LDT
TH
SYSTE
DISPRSAL SYSTEH DETAILS
1, ]}LBCK isa
3 ]} ]3Rhl
O0 GAL,
PRBPB
TP1/
PREPARE]] FOR:
PAT ARNETT
3207 E, TUDBR RAB]], SUITE 33
ANCHBRAGE, AK 99507
(907)561-7837
FIELD BOOKS
COMPU II_B:
BOUNDARY: LANG DRAWN: KMD
STAKING: LANG CHECKED; KMD
^SBU,LT: LANC
DWG. FILE:
ACAD FREE: 98060.DWC
DATE: 6/15/98
BBID: 5059
JoB No.: 98060
PAGE 2 DF 2
~~ ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(90?)696-61il/FAX (907)696-8ili
SLOPE SITE PLAN
1
2
3
4
6
7
8
9
WAS GROUND WATER /
10 ENCOUNTERED?
S
11 IF YES, AT WHAT ~ ~)
DEPTH? . P
12 E
Depth to Water After .----,
13 Monitoring? ~--'"['&/ Date: ~'-/~Q~r~
Gross Net Depth to Net
Reading Date Time Time Water Drop
~ ;ql /~/,~ ~" q~"
lo,'o~ /~ .,~,~~ ~,, ~//~.
14
15
16
17
19
PERCOLATION RATE /7'(~ (mmutes/,nch) PERC HOLE DIAMETER
72-008 (Rev. 4/85)
Municipality of Anchorage ~ ' ' -~5~"P~'/~ '~' *
TownshiP~LR~nEge, Secti°n: ~/ S~:~LAN
1
2
3
4
5--
6
7
8
9
10
11
12
13
14
15
16
17
18
19-
20-
/
WAS GROUND WATER ./~
ENCOUNTERED?
S
OEPTH? P
E
Monitoring/ f~'Y~ Dale:
Gross Net Depth to Net
Reading Date Time Time Water Drop
/ ¢- ~-~ ,~ :~5- ~- ~" -
~. q: .~ ~ lC) ~ ,'~ /: ~ ~ / ~,/]~ "
G ~ :5~ ID ~//'~ ~ ~" ~//~"
~ ~;~ - ,,' ,.
PERCOLATION RATE /,~, ~ (minutes/inch] PERC HOLE DIAMETER
TEST RUN BETWEEN ~ FT AND
COMMENTS ~ 5 ~ ~ . J .
72-008 (Rev. 4/85)
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. # 017-093-09 HAA ~¢
1. GENERAL INFORMATION
Complete legal description
Prator S/D Lot 1, Block 12A
Location (site address or directions)
Pat Arnett
Property owner
Mailing address220? E. Tudor Road, Anchorage, AK 9950?
Lending agency
Mailin. g address
Day phone 561-7827
Day phone
Agent Day phone
Address
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 3
TYPE OF WATER SUPPLY:'- .
Individual well []
Community well []
Public water []
NOTE:
lng to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
, .H01d!ng'mnk ..
Community on-site
Public sewer
NOTE:
If community well system, provide written confirmation from State ADEC attest-
If community wastewater system, provide written confirmation from State ADEC
attesting to the"legality and status of-system. · '
72-825 (Rev. 1/91) Front MOA #21
o
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-sitewater supply
a nd/or wastewater disposal system is safe, functional and adequate for. the number of bedrooms
and type of structure indicateo 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 d sposa s~]stem: s n comp lance with a Muhlcipal and State codes,
ordinances, ah'd' ~gulati0hs in 'eff~'~'t }5ri {~i~'~l¥'/~°f'this inspection.
696-611 l
KND Eng~neenng
Name of Firm . Phone -.
20441 Ptarmigan Blvd., Eagle River, AK 99577
Address
Engineer's signature ~ ' Date
DHHS SIGNATURE ' '
/// Approved for '7-'P/R££ bedrooms.
Disapproved. .
Conditional approval for
5/8/99
bedrooms, with the following stipulations:
Additional Comments
By:
Date ~''-' / 3 - ? q
The Municipality ofrAnchorage Department of Health and H~Jman:Services (DNHS) ssues Health Authority
Approval Certificates based only upon'the repr~.s~n~at-ion~' ~iv~n in ParagraPh .5 ~ab0~ by an' ir~;P~ndent
professiona engineerregisteredin, tbeStateofA aska TheDHHSdoesthisasacourtesytopurchasersofhomes
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.
72-025 Re~;.1/91) .~a¢~.; MOA~21 ,',',. : ' ....................................................................
Municipality of Anchorage MAY 1 ;5 1999
DEPARTMENT OF HEALTH & HUMAN Sr::RVl~+°~lPALiTY OF ANCHOI~
Environmental Services Division ~NVII{ONMENT^L.~ERVICE$ DIVI
825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744
Legal Description:
Health Authority Approval Checklist
Prator Lot 1, Block 12A
Parcel I.D.:
A. WELL DATA
Well type Ind.
Log present (Y/N) Y
Total depth. 405'
Sanitary seal (Y/N)
Date of test
IfA, B, or C, attach ADEC letter. ADEC water system number
Y
Date completed
Cased to 116'
FROM WELL LOG
6/22/98
6/22/98
Casing height (above ground) 2'
Wires properly protected (Y/N) Y
AT INSPECTION
Static water level
45' TOC
6
Well production
WATER SAMPLE RESULTS:
0
Coliform
Date of sample: 5/10/99
B, SEPTIC/HOLDING TANK DATA
Date installed 6/29/98
Foundation cleanout (Y/N)
New
Date of Pumping
Nitrate
g.p.m.
Collected by:
g.p.m.
C. ABSORPTION FIELD DATA
Other bacteria
KND Engineering- DLD
Tank size 1000 Number of Compartments 2 Cleanouts (Y/N)__ Y
Y Depression (Y/N) N
N/A
Pumper
High water alarm (Y/N):. N/A
Date installed 6/29/98
Length 47' Width 3'
Effective absorption area 808 S.F.
Date of adequacy test New
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./ft2 or fF/bdrm) 0.6 g/d/S.Fsystem type Deep Trench
Gravel thickness below pipe 8.6' .Tota depth 12-13'
Monitoring Tube present (Y/N). Y Depression over field (Y/N) N
Results (Pass/Fail) N/A For 3 bedrooms
Immediately after ' . gal. water added (in,): __ -
Absorption rate ::: g.p.d.
If yes, give date. -
72-026 (Rev. 3/96)*
LIFT STATION
N/A
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Size in gallons _
"Pump on" level at*
*Datum
"Pump off" level at*
Cycles tested
SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELLON LOT TO'.
SePtic/holding tank on lot 100%
Absorption field on lot
Public sewer main
Sewer/septic service line
On adjacent lOts 100'+
lO0'+
100% On adjacent lots
N/A Public sewer manhole/cieanout
lO0'+ Lift station N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation [0% Property line [0'+ Absorption field
Water main/service line 25'+ Surface water/drainage ]00%
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line _ ]0% Building foundation ]0%
Surface water
Wells on adjacent lots
100'+
Curtain drain No Known
Driveway, parking/vehicle storage area
Wells on adjacent lots 100'+
F. 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 ~ · ~
Kenneth M. i~fffus, P.E.
Engineer's Name
5/11/99
Date
N/A
5'+
100'+
Water main/service line ?,5'+
25'+
are : - ~
HAA Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number