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HomeMy WebLinkAboutPROSPECT HEIGHTS BLK 2 LT 7 , 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: S'~o ¢-¢d 9~'(~ PID Number: Name: /~¢¢~ D, ~ ~'~.~ /. ~/~u/~ Wastewater System: ~ New [] Upgrade Address: 7/~/ S',~w /~.. ~,~. ~,~,~,.¢~.~; ~,~ ~/~ ABSORPTION FIELD Phone: I NO. of Bedrooms: I ~ ~ Deep Trench [] Shallow Trench [] Bed [] Mound [] Other LEGAL DESCRIPTION sci, Rating: Total Depth from original grade: O.~' ~Pwsq. Ft. Lot: Block: ,? Subdivision: De..DI~o pipe boltom from original grade: Gravel depth beneath pipe Township: I Range: [ Section: Fill added above original grade: Gravel length: I ~ Ft. (~o~'' Ft. WELL: [] New [] Upgrade Gravelwidth: Number of bnes: Distan~enlines: ~ ' ~- Ft. / Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: ~ /~'~,¢ {/'.,~7'¢" Ft. Ft. '7 ~0 SQ. Ft. ~ ~'~'X41 /.~ Driller: Date Drilled: Static Water Level: Installer: Cate installed: Ft. fl~/12EC2.fd'Z¢ Z~o'$, /?.._ Yield: Pump Set at: Casing Height Above Ground: GPM F. Ft. TANK SEPARATION DISTANCES ~Septic [] Holding [] S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines /~J~_.,=-~O/2~¢~..~.~ /~"-~/J/¢_ [~ ~ Material: Number of Compartments: Well /¢O '4- 1¢O *-f ~ ~ ~_~.z..~, ~'7'E'e-~-- Surface Water /(2d 'e /oo'+ -- -- LIFT STATION Lot ~/i. ~.~ Size in gallons: Line /,¢ /~3 ~ ~ Foundation I ,, "Pump on" level at: "Pump off'~Te~J~t: I High water alarm at: CurtainDrain '- _,A~d/I.J~ /~--./U :2,~¢,4,* - Pump Make& Model I Electrical Inspections performed ~ Remarks: BENCH MARK Location and Description: Assumed Elevation: ENeLNEEB'S SEAL ,?;¢?. ~ ,... 17034 Eagle River Loop Road, No, 204 ,~-~ : Inspections performed by: Eagle River, Alaska 99577 Dates: 1st /z. / - q% '" "~'~': 2nd /z - ~- ¢.~ ~- . ........ Department of Healtl~and Human Services approval ' , ~ Reviewed and approved by: Date:/2 -21~9J'~ ~:'"": 72~013 (Rev. 9/91) MOA 25 Permit No. SW950456 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: PROSPECT HIEGHTS, BLOCK2, LOT 7 PID No.: 01513318 . CO 1 COg NEW ..... S.T. 100' WEL~J 2~' WELL 4 BDRM HOU~E A FLOOR A FC0 i25.5 67.0 C01 i35.0 65.5 C02 i43.5 67.5 C03 ~115 116 C04 39.5 69.5 MT1 i114 115.5 C02 C0 83.5 :C04 1250 GAL SEPTIC TANK MT1 203 NO WATERiFOUND TRENCH 72-013 A (1/93) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW930456 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:YOUNG DEWEY D & JERRI L OWNER ADDRESS:7101 SOUTH PARK DR. ANCHORAGE, AK 99516 DATE ISSUED:10/30/93 EXPIRATION DATE:10/30/94 PARCEL ID:01513318 LEGAL DESCRIPTION: PROSPECT HEIGHTS BLK 7 2 LT LOT SIZE: 91200 (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 (iSAACS0). 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 DATE: DATE: ROBERT SHAFER, P.E. ROGER SHAFER, P.E. October 15, 1993 CIVIL ENGINEERS (907) 694-2979 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 SOILTEST PERCOLATION TEST STRUCTURAL & / ,MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEAL TH AND HUMAN SERVICES 825 'L' Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Prospect Heights Subdivision, Block 2, Lot 7 Request you issue a permit to drill a well and install a septic system to serve the proposed four bedroom house on the referenced property. Test holes were excavated and percolation tests performed. The approximate location of the test holes are located on the attached site plan. The monitoring tubes within the test holes have been checked and found to be dry. This property has enough area for a future septic upgrade which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, or require additional information for your review, please contact us. /~ert A./ RAS/LSU/Isu E.Shafer, P. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 SCALE SITE PLAN ON-SITE WASTEWA TER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MA TERIAL SPEClFICATIONS REFERENCE: Prospect Heights Subdivision, Block 2, Lot 7 GENERAL: 1. The scope of this project includes the installation of a 1250 gallon septic tank and a leachfield trench to serve the proposed four bedroom residence on the referenced property. Construction shall be in accordance with the approved site plan and design drawings; Municipal permit with any special provisions or conditions; and all applicable State and Municipal Wastewater Disposal Regulations. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed Otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. SEPTIC TANK INSTALLATION: A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. Page Two Prospect Heights Subdivision, Block 2, Lot 7 October 15, 1993 Septic tanks installed with less than 4 ft. of cover shaft be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shaft be to clean toward the leachfield. The second cleanout shaft be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. o A silt barrier must be installed between the final gravel layer and the native soft backfill. Ensure the sftt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter and installed approximately in the locations shown on the design. The portion of the monitoring tube extending through the gravel shaft be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page Three Prospect Heights Subdivision, Block 2, Lot 7 October 15, 1993 MINIMUM MA TERIAL SPEClFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes ASTM D3034 (PVC) Yes ASTM F810 (HDPE) Yes ASTM D2662 (ABS) Yes Yes Yes No Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). Septic tank inlets and outlets shaft be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, M/raft 140N, or equal) must be installed between the final leachfteld gravel layer and the native soil backfill. Aft leachfield gravel (sewer rock) shaft be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. When sand is being used as a filter material, it's gradation specifications must conform to current M.O.A. or D.E.C. requirements. Page Four Prospect Heights Subdivision, Block 2, Lot 7 October 15, 1993 INSPECTIONS: Typically there will be a minimum of three (3) /nspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3, The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction, ff necessary, a pre-construction meeting will take place on-site. Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL D E SC R I PT I O N .'~[~-~ 1 2 3 4 5 6 7 10 11 12 13 14 15 16 17 18 19, DATE ~F Township, Range, Section: //' SLOPE SITE PLAN WAS GROUND WATER ~b ENCOUNTERED? S IF YES, AT WHAT DEPTH? p E Monitoring? _J~ Dale: Gross Net Depth to Net Reading Date Time Time Water Drop 20 ~ ~;),0,~'"~, PERCOLATION RATE ~ ¢''~'' (minutes/inch) PERC HOLE DIAMETER "~ ~¢ u~4 Eagle Rive~ Loop Road Ne. 2~ - -J ..... =--.' ~77 ~~ HIS EST WAS PERFORMED IN PERFORMED B~a~l~ ~--. Al .~ a~ ERTIFY THAT T T Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCR IPTION:~)~J7 1 3 4 5 6 8 10- 11 12 13- 14--- 15 16 17 18 19 20 DATE PE~C i~'~ ~'°/~/L~L(/~ Township, Range, Section: SLOPE WAS GROUND WATER ~'[ I~ ENCOUNTERED? /,J,j SITE PLAN ~ L IF YES, AT WHAT O DEPTH.:) p E Deplh to Water~Al~ ~J ~ Monitoring? _l./J~--- I Dale: Reading Date Gross Net Depth to Net Time Time Water Drop ,,/o ~ ,' ~'~ J" PERCOLATION RATE --~ (minutes/inch) PERC HOLE DIAMETER ~r~- TEST RUN BETWEEN COMMENTS ~/'-'~ IY E~T ~agle River, Alaska ACCORDANC~ ATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19- 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 SLOPE /,,¢--,5 SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? O P E Gross Net Depth to Net Reading Date Time Time Water Drop 20- COMMENTS PERCOLATION RATE TES~T RUNiBETWEEN FT AND (minutes/inch) -- FT 72-008 (6/79) 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. # 1. GENERAL INFORMATION Complete legal description Lot 71 Block 2~ Prospect Hgigfl~s Location (site address or directions) 10250 Prospect D~ve Property owner Mailing address Lending agency Mailing address DEWEY YOUNG 10250 Prospect Drive Anchorage, Day phone AK 99516 346-3401 (h) 344-6022 (w) Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. T~'PE OF'WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: XXX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 {Rev. 1/91} Front MOA#21 ~ATER WELL ~Dv~$ORY, During a recent Health Authority Approval on-site inspection and tester the potable water supply well on Lot ~ Block ~ of /"/~-C7- /-/A=/~u~/~f Subdivision, the well's productivity was determined to be /o~ gallons per minute. The minimum well produc~tivity required by this ~epartment (AMC 15.55) for a ~ bedroom residence is D ~, gallons per minute. Although the subject well currently exceeds this minimum requirement, all part'ies concerned are advised that the production capacity of the well may fluctuate. Restriction of noncritical water uses such as washing ca~s and ~at~ring lawns and gardens may be required. This advisory must be attached to all copies of t~e subject Health Authority Approval. Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Lo7- A. Well Data Well type ~ I u"/~ ~-'(~.. Log present ~.J,~) ~ Total depth /-1L~.? Sanitary seal(~) ~5' Parcel I.D. If A, B, or C, attach ADEC letter. ADEC water system number Date completed /O/o~ / ~' Driller r'l- ~,J ~¢/--/C.(._./~ Cased to .~ / Casing height / /~ Wires properly protected ~) AT INspEcTION ~E~ ~-~E LoG ~.p.m. ~.p.m. ; On adjacent lots FROM WELL LOG Date of test /0/ ~ / ~' '~ Static water level /,.'~ C~ ~ Well flow [ Pump level1 (/J'~ SEPARATION DISTANCES FROM WELL TO: Septic/~n.~ tank on lot / Absorption field on lot Public sewer main Sewer service line ; On adjacent lots irt_/_ z Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate /{~ /~//-~ Other bacteria Collected by: .<::~ '~-~" ~--z-'-"~2(~//,_)~o~:~/~j G B. SEPTIC/HOED1N~ TANK DATA Date installed /~/ ¢ / ~ Cleanout~/N) High water alarm (Y~ z/Jo Date of pumping ~/~-/~,JE~ 5'¥'5-/'~/ ~'~,J Y/~lPumper SEPARATION DISTANCES FROM SEPTIC/H~t-BiNG-TANK TO: Well(s) on lot /(DO /'/~ On adjacent lots To property line ? 0/"/-' Absorption field Surface water/drainage /~© Tank size /~'0 ~4L. Co~ Compartments ~-- Foundation cleanout~) ~$ Depression (Y(~ ..LJ~ Alarm tested (Y/N) ~- Foundation / 0 Water main/service line 72-026(3/93)° Front CONTINUED ON BACK PAGE M-W DRILLING, Inc, P.O, l~o~ 110378 · 10,330 Old Seward Highway (907) 349-8535 ANCHORAGE. ALASKA 99511 P.01 Wall OwnerL Location $e££ Moreland DRILLING LOG Domestic _ .. __Use o[ Well ..... (address of: Towr~hip, Range, Section, if known; or distance main roe& Lot 7 Blk, 2 Prospect Heights g 6" 42,7 Size of ca, in Depth of Hole .... feet Screen ( ); Periorate~ ,( ...... ) D~cribe ~cr~on or porfo~itio~~ Wdl pumping' tost a~ I g~g~ of drawdo~' from static t~¢eL. Oct obA~:; 8:~,¢ ~1993 Daie of completion . ..;-':] ?'7 ' ' ~th in £ee[ from ground surface 56 Cased to. .feet Finish of well (check one) open end ( X ); hours witL____ 10~.%__ ft, o ,TO 2 2 .TO 15 ,,]~5 ,TO. 45 45 TO 53 53 ,,'_T0 56 56 165 .TO 165 .... 'TO. WELL LOG TOg. TO_ __TO_ ,TO. .TO. TO. Gi'F~ de,tails of formation.* penetrated, size of material, color and hardne.~s CS,G ~ cickUp G~.~,e.~.{ & Sand C. LIFT STATION /~-)D~J~ P/'Z'ES~[~"J~-- Date installed Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) SEPA~TI~STATION TO:  On adlacent lots D. ABSORPTION FIELD DATA Date installed ! ~ / ~/~ Length (~'" Width Total absorption area /~(~ Date of adequacy test .~/~ Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) / SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Wellon lot /0© To building foundation ~ ~ f On adjacent lots Surface water /' ©~ ~ 4-- Curtain drain Manufacturer / Manhole/Acoe~ ..~Pump off" Level at ./~Cycles tested Sudace water Soil rating (GPD/FF) (~, ~ System type /-~-~/~ Z,~- r Gravel thickness ~ /' Total depth Cleanout present~N) ~'~-~ Depression overtield (Y/t~) Result.~ail) pM~_~ 7~- ,for ~ ~ Bedr~ms After test ~/~ ~ ~~ If yes, g~e date On adjacent lots / O O r_/._, Property line / O To existing or abandoned system on lot Cutbank J'g,>~J~- /~/z_~,~/-.~Watermain/service line /O/'~- Driveway, parking/vehicle storage area ~/'"~-" E. ENGINEER'S CERTIFICATION guideline; HM Fee $ ;~(g~ ~'~) Date of Payment ~' '---,/'7~'Z7~ Receipt Number ~ ~ ~/~"-D'~--~, Waiver Fee $ Date of Payment Receipt Number 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 com.~Jia~ce with all Municipal and State codes, ordinances, and regulations in effect on the d~ th~ inspection. Name of Firm ~ Phone L~Z'zfz'- ~'7~ Address ~...._~ ~34 Eagle ," ce ~ ~ ~ ~/ EngineeCs signat~8~' l_ ~ ~ Dat~.~ :;,,~..~ .~ . .. 6. DHHS SIGNATURE Approved for ~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: By: 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 tending institutions in order to satisfy certain federal and state requirements. Employees of DH HS 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 (Rev. 1/91) Back MOA ¢~21