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Home My WebLink AboutPTARMIGAN ROOST BLK 2 LT 8 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: ,~_,~__%o~,L~f~ ~_,~.c~ PiD Number: ~,L-~t<"3 Name: ~ ~ p~ ~ I Wastewater System: ~New ~ Upgrade Address: ~0, ~ ~lO~O~ ) ~'// ABSORPTION FIELD Phone: .~ ~. J '~7/ ~--~'~7 No. of Bedrooms:~ ~DeepTrench B Shallow Trench BBed BMound ~Other Total Depth from original grade: LEGAL DESCRIPTION SoilRating: /, ~ GPD/Sq. Ft. ,L°t: ~ Block: ~ ~1 Subdivision:~~ ~ / Depthtopipebottomfro~originalgrade:~, ~ Ft. Graveldepthbeneathpip~,5 Ft. Township: I1 Range''~VV Seoti~ ~ Ft. Ft. Fill added above original g~: Gravel length: Number of lines: Distance belween lines: WELL: ~New ~ Upgrade Gravel width: ~ Ft. / -- Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area:.~ Pipe material: ~.~ !~5 ~. 1'7 Ft. .¢0 SQ. Ft. Pvc ,* ~ , Date Drilled: StaticWater Level: Installer: Date installed: Driller: H~ P~i//~ ¢~ ~O Ft. O~ · / Pump Set ~' Casing Height Above Ground- TANK Yield: ~ 5 GPM ~ ~ Ft. ~ Ft.' SEPARATION DISTANCES ~Septic ~ Holding ~ S.T.E.P. To Septic Absorption Lift Holding ~ublic/Privale Manufacturer: ~ Capacity in gallons:~ From Tank Field Station Tank Sewer Lines r~ Well /z~i /~1 ~ ~ ~ Material: ~ Number of Compartments: ~ Surface water ~ ~,~ ~ ~ ~ LIFT STATION Foundation / ? / ~OI ~ ~ ~ "Pump one' lever at: "Pump off"~evel at: High ~ter alarm at: °u"ai - I - Drain ~ ~ ~ Pump Make&Model Electrical lnspections performed by: Remarks: BENCH MARK Location and Description: ~ ~~ eA /, "' Inspections performed by: ~].r~,~/~ Dates: 1st ~ ,;~// Department of Heal~ and Human Services approval ~".. ....... Reviewed and approved by: .~~~ Date:/2-/~-~ ~f~"~'~"~:~~, '"~"'"' 72-013 (Rev 9/91) MOA 25 Permit No. Page of 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: qs,// DP-.vog' 4~ Co5 co(. Co7 72~)13 A (2/91) MOA 25 HEFTY DRILLING Well Water - It's naturally betted 3540 AKULA DRIVE TELEPHONE: ANCHORAGE, ALASKA 99516 {907) 345-0593 Date Drilled : 8-4-93 Static Water Level 20 Draw Down NIA Feet Feet Type Material Drilled: 0 ft. to 3 ft. Top soil John McDonald Gallons Per Minute 3 1/2 Total Feet of Casing 19 3 ft. to 17 ft. Clay w/rocks 17 ft. to 140 ft. Bedrock 140 F~-_ to 145 Et Soft ba~__rcck to 1~ ~t_ ne~_rcck to Water at 140 to 145 ft. to to to I'IEFi'Y I~I~IL.UNR' 3540 AKULA DFIlV~ (907) 345-0593 PAGE MU CIPALIT OHO GE I P.O. BOX 196650, 825 "L" STREET, ROOM 502 ~CHO~GE, ALAS~ 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW940329 DESIGN ENGINEER:POLARCONSULT ALASKA, INC. OWNER NAME:MCDONALD JOHN C & SANDY J OWNER ADDRESS:16200 SANDPIPER DR ANCHORAGE, ALASKA 99516 DATE ISSUED: 9/01/94 EXPIRATION DATE: 9/01/95 PARCEL ID:02004276 LEGAL DESCRIPTION: PTARMIGAN ROOST BLK 2 LT 8 LOT SIZE: 67801 (SQ. FT.) NUMBER OF BEDROOMS: 6 THIS PERMIT: 6 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC 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 (24 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 PROVISOS: __~ RECEIVED BY~ ISSUED BY: ~ DATE: DATE: q-l- e¢ unicipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 July 8, 1994 John C & Sandy J Mc Donald PO Box 110805 Anchorage, Alaska 99511 Subject: Lot 8 Block 2 Ptarmigan Roost Subdivision Permit #SW930202, PID #020-042-76 The subject permit, issued July 7, 1993 by this office for a single family well and/or on-site wastewater system, has expired as of July 7, 1994. A new permit must be obtained from this office for a well and/or on-site wastewater system NOT installed by the expiration date. If you have drilled the well, a well log must be sent to this office for documentation of the installation and to close the permit. If a licensed Professional Engineer has inspected the installation of the on-site wastewater system, the original as-built inspection report must be sent to this office for review, approval and documentation. All inspection reports must be submitted within 30 days of construction completion. When applying for a new permit, the fees are: $320.00 for an on-site wastewater permit; $120.00 for a well permit and $440.00 for a combined on-site wastewater and well permit. If you have any questions, please call this office at 343-4744. ..~cerely, ~ JaYmes Cross Acting Program Manager On-site Services cc: Polarconsult Alaska, Inc. 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 WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW930202 DESIGN ENGINEER:POLARCONSULT OWNER NAME:MCDONALD JOHN C & SANDY J OWNER ADDRESS:1524 SHIP AVE. ANCHORAGE, AK 99501 DATE ISSUED: 7/07/93 EXPIRATION DATE: 7/07/94 PARCEL ID:02004276 LEGAL DESCRIPTION: PTARMIGAN ROOST BLK 2 LT 8 LOT SIZE: 67801 (SQ. FT.) NUMBER OF BEDROOMS: 6 THIS PERMIT: 6 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 (18AAC80). 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4329 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. polarconsult alaska, inc. ENGINEERS · SURVEYORS ° ENERGY CONSULTANTS DHHS, Environmental Services, On-site Services P.O. Box 196650 Anchorage, Alaska 99519 June 21, 1992 Attn: Re: Permit Review Officer Design and Construction Approval for On-site Sewer System at Lot 8, Block 2, Ptarmigan Roost S/D. Dear Sir or Madam: Please accept the following design for review and permitting. The proposed system does not affect the current use of the adjacent properties and will have minimum future impact. If you have any questions, please give me a call. David Ausman, CE Attachments: On-site Sewer/Well Permit Application Site Plan, Sheet 1 of 4 System Design Calculations, Section, Sheet 2 of 4 Percolation Test, Sheet 3 of 4 Percolation Test, Sheet 4 of 4 $200 Check for Permit Fee 1503 WEST 33RD AVENUE · SUITE 310 · ANCHORAGE, ALASKA 99503 PHONE (907) 258-2420 · TELEFAX (907) 258-2419 polarconsult alaska, inc. 1503 West 33rd Avenue · Suite 310 ANCHORAGE, ALASKA 99503 (907) 258-2420 Fax (907) 258-2419 CHECKED BY DATE " ..~0 SCALE, ! -- polarconsult alaska, inc. SHEETNO. CHECKED BY SCALE 1503 West 33rd Avenue · Suite 310 ANCHORAGE, ALASKA 99503 (907) 258-2420 Fax (907) 258-2419 - OF ~- DATE PERFORMED FOR: LEGAL DESCRIPTION: 1 O 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 19 20- COMMENTS Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT OEPTH? Deplh to Waler After Reading Date Gross Net Depth to Net Time Time Water Drop / C~/E ?e eSOA K. ~ ~:o~ j ~:~ ~ r~ ,~ ,, PERCOLATION RATE ": L'~'l¢~ (mmutes/,nch~ PERC HOLE DIAMETER TEST RUN BETWEEN /'~ FT AND ~ FT PERFORMED BY: 7~/~U,'"',~2 t,~J~r~"'/b~,~l ¢/~/' J __~~/~"~"'"~'~RTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE; 72-008 [Rev. 4/R51 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE LEGAL DESCRIPTION: 3 4 5 6 7 8 9 10 11 12 13 14 15 16- 17- 18 19 20. Township, Range, Section: SLOPE WASGROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p E Oepl~ iD Waler Alter Momlormg? COMMENTS PERFORMED BY: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THiS DATE. DATE; 72-008 (Rev. 4/85) PERCOLATION RATE (m~nuteszJncl3) PERC HOLE DIAMETER TEST RUN BETWEEN Z_~ FT AND S FT. I '~'~J~ ~'~-'~ C, ERTIFY THAT THIS TEST WAS PERFORMED tN Reading Date Gross Net Dec)tn to Net Time ~me Water Oro~3 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SER~/ICES 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- (~L~ ~- ~(,~ HAA# ~, ~'~-~- I L~ ~_' GENERAL INFORMATION Complete legal description Lot 8 Block 2 Ptarmigan Roost Subdivision 96295 Location (site address or directions) 1 6200 Sandpiper, Anchorage, AK 9951 6 Property owner Mailing address Lending agency Mailing address Agent None Address -- John & Sandy McDonald. P.O. Box 110805, Anchorage, AK Seattle Mortgage 4300 B Street~ Anchorage, AK Day phone 345-1887 99511 Day phone 562-5626 99503 Day phone -- Unless otherwise requested, HAA will be held for pickup, NUMBER OF BEDROOMS: 6 TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: 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: x 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 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-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 inves_ti_gation 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 _D~Z D~.o~-sult±nq ~.nq±nee~c$ Phone 344-1385 Address ~800 ]~. .m°~n~',~lv~_. Su-i-~e/-5 5,//~ncho~.age, AK 99515 DHHS SIGNATURE Approved for ~ Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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 DHHS does this as a courtesy to purchasers of homes and their lending institutions in order, to satisfy certain ¢edera and state requirements. Employees of DHHS do not conduct inspectiOns or analyze data before a certificate is ,Ssued. The Municipa ity of Anchorage is not responsible for errors or omissions in the professional engineer s work. 72~)25 (Rev. 1/91) Back MOA*F21 W.O. 96295 Municipality of Anchorage ~ DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 MUNiCIPALI'P/OF ~ENVIROh~4ENTAL SERVICES DIVISION Legal Descriptiou: Lot 8, Roost A. WELL DATA Well .Wpe Private Log present (Y/N) YES Total depth I 6 5 ' Sanitary seal (Y/N) YES Health Authority Approval Checl~'list NOV 0 1 1996 Subdivision a_~ ~ .... If A. B, or C, attach ADEC letter. ADEC water system number Date completed 8 - 4 - 96 Cased to qg' FROM WELL LOG Date of test 8 - 4 - 93 Static water level 20 ' Well production 3.5 g.p.m. Casing height (above ground) I ' - 6" Wires properly protected (Y/N) YES AT INSPECTION 10-28-96 WATER SAMPLE RESULTS: Coliform 0 Date of sample: 1 O - 2 8 - 9 6 B. SEPTIC/HOLDING TANK DATA Date installed 9- 1 5- 9 6 Tank size 2 0 0 0 Foundation cleanout (Y/N) YES Date of Pumping 1 0 / 3 1 / 9 6 C. ABSORPTION FIELD DATA Date installed 9-1 5- 9 4 Length 60.4' Width 3' Effective absorption ama 750 Date of adequacy test I 0 - 28- 96 Fluid depth in absorption field before test (in.); 0" Fluid depth 0" (ins.) Minutes later: 1440 Peroxide treatment (past 12 months) (Y/N) NO 21' 2.5 g.p.m. Nitrate 2.4 Other bacteria 0 Collected by: Dee High Depression (Y/N) NO Pumper A+ Home Service Number of Compartments 2 Cleanouts (Y/N) YES High water alarm (Y/N) NONE Soil rating (g.p.d./ft2 or ft2flodrm) 1 . 2 Gravel thickness below pipe 6.5 ' System typeDEEP TRENCH Total depth 10 ' - 10" Monitoring Tube present(Y/N)YES Depression over field (Y/N) NO Results (Pass/Fail) PASS For 6 bedrooms Immediately after 0 "gal. water added (in.): 1 / 45 Absorption rate = 900 g.p.d. If yes, give date -- mo LIlT STATION Date installed Manhole/Access (Y/N) High water alarm level at* J Size in gallons j /~_ "Pump ou" level at* *Datum Cycles tested /~ SEPARATION DISTANCES "Pump off' level at* SEPARATION DISTANCES FROM WELL ON LOT TO.' Septic/holding tmtk on lot _~ 2 3 ' - 6" Absorption field on lot _1 4 8 ' - 6" Public sewer main _ NONE Sewer/septic service lin~ 1 0 5 ' : On adjacent lots 1 0 5 ' + ; On adjacent lots 1 0 5 + Public sewer manhole/cleanout NONE Lift statiou N/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 1 8 ' Property line + 5 0 ~ Absorption field 8 ' Water main/service line 6 6 ' Surface water/drainage > 1 0 0 ' Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation. 4 ~ ~ Surface water _ > ~ 0 0 ' 110'+ Curtain drain _ NONP, Water main/service line 8 9 ' Driveway, parking/vehicle storage area 1 5 ' Wells on adjacent lots > 1 1 0 ' Property lirte + 2 0 ' HAAFee $ xYff~ ~ d~ Date ofPayment ~ [/] /% Receipt Number ~ ;2,~ ~ &-- (~.~ ~,~ ~--q ) Rev. 8/95 OSS: haa.wk.doc Waiver Fee $ Date of Payment Receipt Number F. ENGINEER'S CERTIFICATION ~ ~;~.~x~ Ice . . . .~, ,,5 ....... ~ ~ in c i~:~ t~;~ ~ m~pe~s a~y.re~iew of Municip~ ;at th~;;¢~gb~ are ugmeer~ N~e _~e~ ~ ) ~ o~ ~ Date t~/~t/ q~ ~t~~~' .................................................... ........................ 2;_", ~XC~' -.~'