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Home My WebLink AboutPROSPECT HEIGHTS #1 BLK 3 LT 1 0.-~-6 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 Permit Number: ~ 0 ~.~ .4' i, ] '.',_.:_ PID Number: (~[~ -~:~Z.-- (~) [ Name: ~U--~~ ~~ ~ WastewaterSystem: ~Now ~ Upgrade Address: 5q ~ ~~ ~ ~1~ ABSORPTION FIELD Phone: LE GAL D ES CR I PTI O N so,, Rating: Total Depth from od~inal grade: Block: Subdivision:' Oeplh lo pips bottom from original grade' Lo~: [ ~ P~osP~cr ~T~I . ~. Graveldepthbeneathplpe Ft. ~ Ft. Township: ~ Range: Section: Fill added above original grade: Gravel length: I I ~ Ft. ~ F~. WELL: ~ New O Upgrade Gravel ~: ~4~ Number of lines: IDistance~eenllnes: ~ ~. II - ~t. Driller: ~ ~ ~ ~ Date~l~j ~Drilled: StaticWater Level:Ft. Installer~1~~ ]] ' Date installed:11 ~/' Yield: Pump Se~ ~t: Casing Height Above Ground: ~-~ *~ ~~ ~. ~ F,. TANK SEPARATION DISTANCES ~Septic ~ Holding D S.T.E.P. To Septic Absorption Lift Ho,ding :ubl,c/Pr,vate Manu fact~ ~ T~ Capacity in gallons: From Tank Field Station Tank Sewer Lines ~ ~ ~ Material: ~ Number of Co~.ments: WeN 13~ {~O Surface Water NOUe IMO.~ LIFT STATION Lot + ~ Size in gallons: Manufacturer: Line /O0 -- Foundation [~ ~q "Pump on" level at: I "Pump off" level at: I High water alarm at: Curtain Drain ~o~ ~o N~ Pump Make & Model ~ Electrical Inspactlons pedormed by: Remarks: BENCH MARK Location and Description: EN~INEER'S.SE~L Inspections performed by: Dates: 1st ~b iq5 ¥¢ ":'~"~ ~ ':' Department of Health and Human Services approval ~.~:. ,~ \ \ N FT. TFI:BBEN SPURKLAND P,E. 203 ~/ 15TH. AVENUE ANCH. AK. 99501 Test Gte ~)- Test / / / ./ / LOT ! BLOCK $ PROSPECT HEIGHTS DWAYNE / / / SEPTIC SYSTEN DESIGN DATE, AUG. $~ 1995 SHEET, ~/$ GRID, ~441 S tondord Trench~ 55' LBNG FBTAL ~0' ~EEP 7' OF SEWER ROCK 3' mln. Cover 7 £eet oF Septic Rock UN~ER PIPE 55 I ~0 Monitor Clean 2000 gal Septic '~ank SPURKLAND P,E. 803 ~/15TH, AVENUE ANCH, AK, 99501 LOT ! ~LDCK 3 Pf~DSTECT HEIOHT£ ~W'A YNE SAKUMOTO ~EPTIC SYSTEM ASBUILT D^Te, nEC, ~ 1993 SHEET, 3/3 GRID, 2441 STATE OF A~ASKA DEPARTMENT DF NATURAL RE~OURCF..~I DIVI$10N OF WATER WATER W~L. RECORD LOCATION OF WELL · --' . .'1 / ..' '."....., " DE~H$ M~$URED FROM:~;I~ top ~gro~ suff;;e ~ DE.H: ' ~DATE OF Mate~l Type a~ Color Fram To . ~ .... fl belQw ~ top of ~ [ USE OF WELL=. ~ doma~ic B l~lgatt~n' ~ monitor Casina Wpe. . , ~. ~o~ft_ W~L INTAKE OP~INa TYPE= ~ open end ~ .arean~ ......... ~ pe~orated ~ open h01e .... j Depths of openings: .~ to ..... ft $CRE~ TYPE: Diem: . In. G~VEL PACK Municipality of Anoh r~Qe GROUT TYPE; Volume~ . Dept. Health & Hui~an ~ ~rwc~,8 Depth: from , ft to ,, ft Duration ~ .~. PUMPINa L~EL AND PUMP INTAKE DEPTH: ~ DIS~FEOTED UP~~ COMPL~ION? ~YE~ ~ NO CONTRACTOR INFORMATION: ,qm~,egis~d BUs!ness Nam~,/,~' ~' ...... S gFgnature of Authorized R~spreser3r. ative " REMARKS: PLEASE MAIL WHITE COPY OF LO~O: DNRIDIVISION OF WATER po BOX ~72116 " EAGLE RIVER AK 99577-2116 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:SW930364 DESIGN ENGINEER:TOBBEN SPURKLAND, P.E. OWNER NAME:SAKUMOTO DWAYNE R & ANNE S OWNER ADDRESS:5941 KEYANN CIRCLE ANCHORAGE, ALASKA 88504-4479 DATE ISSUED: 9/14/93 EXPIRATION DATE: 9/14/94 PARCEL ID:01509201 LEGAL DESCRIPTION: PROSPECT HEIGHTS #1 BLK 1 3 LT LOT SIZE: 87556 (SQ. FT.) NUMBER OF BEDROOMS: 6 THIS PERMIT: 6 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD / 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 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 ISSUED BY: J~ DATE: DATE: LOT SF'E]~:~LF~:O F~_ ~-- 205 W 15th. Avenue, Suite 206 ANCHORAGE, ALASKA 99501 (907) 299-59i6 SEPTIC S¥STEN DESIGN BLOC~{ ~i PROSF~EC1- DWAYNE SAKUMAT0 HEIGHTS No Ground Water or Impervious Lmyer to 16 ft. Soil Rating. From test July 16~ 1993 > I min/in Sand at 10 feet qua!i~ies as ~ilter sand. See sieve analysis Required Area per Bedroom: 150/1.2 = 125 sq.ft.. Testhole Total Depth 16 Less 6 feet 10 Less 4 Cover 6 Rock Depth USE 5 Number of Bedrooms Length of Trench 6 6 x !25 / i0 = 75 SYS ~ k~ CO~FiGURATiON STANDARD TRENCH TOTAL LENGTH ~u~AL WIDTH TOTAL DEPTH ROCK DEPTH COVER SEPTIC TANK 75 FT. 2 FT. i0 FT. 5 FT. 5 FT. 2000 GAL. The installation of this well and septic system will not impact adjacent lots. The welt location conforms to the siting of the existing wells in the area~ and will not prevent the adjacent tot owners from developing these lots or replacing the existing septic systems. Jner'e are no developed or natural surface / sub surface courses on this or the adjacent lots. The proposed septic system will not change the general slope of the area. Pending and/or concentration of surface runoff will not result from this installation. PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 10 11 12 13- 15 16 17 18 19 20 PERFORMED BY: ~' ~'~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST Township, Range, Section: m [?~ , '~,~ SLOPE SITE PLAN WAS GROUND WATER I'~J ENCOUNTERED?J\JO IF YES, AT WHAT DEPTH? Depth to Waler After / Monitoring? ~ Date: Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE ';~2'~ (minutes/inch) PERC HOLE DIAMETER ! II ,~TEST RUN BETWEEN FT ,¢,ND __ FT I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: /¢~ ~ I~. I q .~ § 6 7 8 9 10 11 12 13 14 15¸ 18 19 20 COMMENTS Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES [.~.~¢~, ~. 825 "L" Street, Anchorage, Alaska 99502-0650 ~'m ~OIL~ LOG -- PERCOLATION TE~T ,1~?. Township, Range, SeCtion: SLOPE SITE WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT L DEPTH? pO E Depth to Water After lYlonitorino? Dale: I- N Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE .~",~ ,/ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN FT AND FT CERTIFY ;[~HAT T_HiS TEST WAS PERFORMED IN ACCORDANCE WITH l ALL ST A TE AND MUNICIPAL 72-008 (Rev. 4185) PA£1 LdT ~ / / TDBBEN SPURKLAND P.E. 203 W ]5TH. AVENUE ANCH, AK. 99501 LOT ! BLOCK 3 PROSPECT HEIGHTS SEC. IS, TJ21V, R3~ B~/AYNE £AKUN£T£ PTIC SYSTEM DESIGN DATE; AUO, 31, 1993 ~---ET, 1/3 GRID, -°441 N SCALE; 9O l~ = 60 Fr. 1£0 150 REPLA£EMENT PRIMARY 180 $000 GAL SEPTIC TANK Well TDBBEN SPURKLAND P,E, 203 W 15TH. AVENUE ANCH. AK, 99501 LOT I BLOCK S PROSPECT HEIGHT SEC.13, TI£N, R3W B~/AYNE SAKUMOTO SEPTIC SYSTEM DATE, AUG. SL 1995 GRID, 2441 75 S tondard Trench~ 75' LDNG FDTAL I0' DEEP 5' DF SEWER R~7CK 4' mln. Cover ~000 ~ol Septic ~onl< Cleonoufs Mimo£1 i40 ~ UNDER PIP£ ]BBEN SPURKLANB P,E, E03 W15TH, AVENUE ANCH. AK, 99501 LO T i £LZTCK 3 PROS TEC T H£ISHTS DW~YNESAKUMOTO SEPTIC SYSTEM DESIGN DATE, SEPL I 1993 SHEET, 3/3 GRIg, 2441 OBOV ~ uJo~j uo!~LuJ!juo9 ua~!~ ~p!~o~d 'u~,~sA's ~4~s~ ,~!un~u~uoo jl :q_l. ON J~M~S o!lqnct ' -isaj~e OBC1V ~1E1S u. loJj uo!le~JJl, lUOO u~1~!,l~ ~p!AoJd '~UelS.,(S I1~/~/(~!unuJuJoo ~1 Jel. eM o!lqnd II~M/~I!unLULJUO0 el!s-uo ~,!unwwoo ~ue~ bu!plOH e~!s-uo lenp!A!pUl :1~/$0d$10 I::I'~J.VM~IJ.$¥M JO ~ldAJ. :3.LON · dn~lo!d ~o.~ pleq eq II!~ VVH 'pe,~senbe~ es!/~eL/lo SSalUR sse~pp¥ IleM lenP!^Jpul :A'IddrlS I:EIJ.¥M JO ~ldA.I. :SINOOI:IQ~18 40 I:EIGINI'IN euoqd XBQ ~uel~V sseJppe 8U!l!elAl euoqd AeO euoqd XOueBe 5u!pue-I sseJppe BUll!eR J~)UMO ,~),JGdOJ c] Og99-61. g66 e)iselV 'el~eJoqouv oggg6L xo~] 'O'cJ uop, oeS seo.AJeS e~S-uo seolAJeS lelUeLUUOJ!AU:~ Jo UO!S!A!C] S301AbFIS NVRRH ~ H±'IV~H -I0 .LN:IIAIJ.~IVcl3Q 39VI:IOHONV JO AIIqVclIOINrlR 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 verifythat based on the information obtained from the Municipality of Anchorage flies 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 -i ~ Address ~-¢ Engineer's signature DHHS SIGNATURE /X Approved for ~ Disapproved. Conditional approval for bedrooms. Phone Date bedrooms, with the following stipulations: Additional Comments By: J OM-('-L ~ ,'~--)L 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 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. , 72'025(Rev. 1/91) Back MOA~21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: LoT' I, A. Well Data Well type Log present (Y/N) Total depth Sanitary seal (Y/N) Parcel I.D. O [~ - 09~L-- O/ If A, B, or C, attach ADEC letter. ADEC water system number Date completed ~'/1'/I ~% Driller /~L~/P~ Cased to ~ ~ Casing height ~2 ~ '/ FROM WELL LOG Date of test C/ /Ic{ l C~ :~ Static water level L~ '7 Wellflow ,=,~. ~ (~ ~/,~[2a Pump level1 ~ 7 Wires properly protected (Y/N) AT INSPECTION g.p.m. 1 6 1994 RECEIVED SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot 17a ~ Absorption field on lot J '7~O ; On adjacent lots ; On adjacent lots Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform Date of sample: ~-'//- B. SEPTIC/HOLDING TANK DATA Date installed ~/r'7 Cleanouts (Y/N) "/ High water alarm (Y/N) Date of pumping Nitrate Public sewer manhole/cleanout Petroleum tank N O ~/ -~- ~,~ I~ Other bacteria Collected by: ~ ~-~ Tank size ,,~.~ c>o Compartments Foundation cleanout (Y/N) 7 Depression. (Y/N) /'Y'/"/5~_ Alarm tested (Y/N) I"'//x/-~- Pumper h'//,~,~ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: r-/ Well(s) on lot ! ;~O To property line '> ~ ~ Surface water/drainage On adjacent lots ) ~ c.~ Foundation Absorption field .P..C:) Water main/service line 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION ['"//Z~ Date installed Size in gallons Vent (Y/N) High water alarm level Meets MOA electrical codes (Y/N) "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed P,///7/P ~ Length ,-~ ~ Width Total absorption area 7 ~(-~ Date of adequacy test /'~//~- Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Soil rating (GPD/FF) Gravel thickness Cleanout present (Y/N) Results (pass/fail) 7' System type Total depth Depression over field (Y/N) for After test If yes, give date Bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot ] To building foundation L~ L On adjacent lots Surface water Curtain drain [V~ ~ ~-- On adjacent lots ~/'z~.~ Property line To existing or abandoned system on lot Cutbank N~-'/¢ Water main/service line Driveway, parking/vehicle storage area "2 E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effectf. ~n~. .the ,'date. of this~inspection. Signature Engineer's Name ~~ ~--~d¢~--~z_H/ "~-~-~ Date HAA Fee $ ',~oo ~ Date of Payment ,~¢/&- 2 5~/ \ Receipt Number Waiver Fee $ Date of Payment Receipt Number Commercial Testing & Engineering Co. Cji ent c ...... ,.~,=a!O.!.~.' '.ID :L1 E:} t'!a'l:.?,: i × : ~'PA t g.o. Environmental Laboratory Services ~'~'~~.d?~?~-,~-~,~,~ RI{:POR? c:,~' ANAI,¥SZS 5633 B Street : 94.0C70.,-1 Anchorage, AK 99518-1600 PROSPECT I~i;:tGHTS Tel: (907) 562-2343 Fax: (907) 561-5301 :TOBBEN SPURi~[,AND, P.E. I'IORK O~:'de~' :TOBBEt4 SPUI~E,AND Pi~J.n'bed Date :02/1.5/94 0 10~21. h:cs. ' Col.].eci:.ed Date :02/11/94 ~ 12:15 hz's. : RoteS. veal Date :02/11/94 0 i4:00 : UA Technical. ~)(; A],l. owab.~e, Ext. Aaal Pa:t?arm~l;e'c-. : . Rosu' ts Qum]. Unit:~, Hot:hod ~i,m:i.ts Date Date ....................................................................... : ...................... , ........ Z:]: ................. 2.2 ....... ; ..................................................................... Nl.'hz:al;e.,-N 0,10 U rog~L. F/PA 353.2/300,0 1.0 02/14 : ................... t.lA -.:: UnavaJ.].abl.e See Samp.l,e ~effti31?~s Ahoy(! NA =,: Not Ana:t.~/2, ed !lnde'kect. ed, Repo~?t. ed va].ue is the pcae'b:i, ca.!. quani:.i.f'J.cal:.ion ti. mit, I:,':(' = [,~='~¢' 'ih¢~n' ' ' ~' ~ Member of the SGS Group {Soci~t~ G~n~rale de Surveillance) ENVIRONMENTAL FACILITIES IN ALASKA, COLORADO, FLORIDA, ILLINOIS, MARYLAND, NEW JERSEY, OHIO, UTAH, WEST VIRGINIA