HomeMy WebLinkAboutHYLEN CREST #3 BLK 6 LT 9
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Name DISTANCES
,,~/4, r~ SEPTIC ABSORPTION
Phone(s)~¢~_ Permit No. No.~°f Bedrooms WELL
Iota' 8Bl°ck ~ Su~O'vision --
Township, Range, 8ec~ion
AS-BUILT DIAGRAM IShow location ol well, septic system, properly lines, foundation,
TANKS N
Material No. ol Compa~ments
TYPE OF SYSTEM
~ TRENCH U BED ~ W. DRAIN ~ OTHER
Depth Io pipe botlom from Total depth Irom original grade
odginal grade ~ FI /~ FI
Fill added above original grade Gravel depth beneath pipe
Gravel length Gravel w~dlh
~- FT ~ FT
Total absorplion area Distance belween lines
~ ~ O SQ FI ~/~ FT
Number of lines Soil ra~ing ~ Pipe material
WELLS
EPT,
OF
HEA
~ PHIVATE ~ OTHEH
FT Cased to
Scale: .'ENGINEER'S S~AL
fee's' Inspections Pedormed by: ,' .' '
I cedify that this inspe~i0n was ped0rmed according to all ,
72-013 (3/85)
Dev. 0.0' -~
Pro_~f!le jj
1 2,8' gRND
5'8'%j rJJ-11n,ula~ed
Septic
'rank
5,50RND -
-'] Insulated
7,2 7,2 ~
we~, end East end
15,2'-- r.~
NO KNOWN CURTAIN DRAINS
NO STREAMS +100' 21.3'
SepfiC. __Sy.S___f_em Asbuilf
OWNER: Mike Quinn
JOB # 90-104'DATE:'-"i O_._ii_8._i~..0_~-_S_..c'__A_L_.~._ii_]i~ili-,~.;..-~
..................................... / / [ =4o
JEAGLE RIVER ENGINEERING SERVICES
AP,O. Box 773294
EAGL~ ~IVER, AK. 996??
(90'7) 694-5195 FAX: (90'7) 694-3297
Community Well +200'
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
OCT 1,9 1990
RECEIVED
· - MONITOR TUBE
o - SEWER CLEANOUT
H::JJN+~ - LEACHFIELD
.... EASEMENT
:': : ?':, . ' ;,
*':.;i'l~';; ;!.il .,.. ii' . i ~';'~I"I(; (,]) .. '; '"
.. :: I ,. ~ ~ , .:,:,:r~;:::;:, C:' r' .i.; i ,...~ i .~, I'!i' ~.:~, :':l;'i i~ ~}~ I., .~;.~.~, ,:;; ,..i ~ ~'i ]. ~';';',..;~i I:; .~{~ i.c.;;,,: il ,i. i i', o;,iii(.'(,!'~'~, ~.:i ~ ,.) ~. i' l'i c;, .~;ic.:' ;..~ 'i;:~ ~:':'* ;;;z:
::::,"<;'~' ,':';,i ,r .., I',i'; ~ ~::i ," I- ::';,, i 'i '? ,, , '; !;i' i'l!::L:':;~Pi;i"I/ I
MUNICIPAI.ITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG- PERCOLATION TEST
~.~ ,'gO! L~J LOG
PERCOLATION
TEST
PERFORMED FOR:
LFGAL DESCRIPTION:
DATE PERFORMED: ~/~/Tx/~ O
7-/~,',~ ,,'e/~., ~,~
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
COMMENTS
SLOPE SITE PLAN
I
- *~:--~ 7/I
WAS GROUND WATER S
ENCOUNTERED? ~-/~¢-P L
O
E
IF YES, ATWHAT 7 ~7~'
DEPTH?
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE '~' / (minutes/inch)
TEST RUN BETWEEN FT AND FT
PERFORMED BY:
72-008 (6/79)
Eagle River Engineer;ng ;,~ ",' ':',~
P. O. Sex 773294
Eagle River, AK 995*'
695-5195
Lou ]3ute?a,
P.O. Box 77329,1
Eagl~' Rivc~', Alaska 99577
Tol.pho~m (~.107) 69,I,dJ1.~)5
October 5, 1990
Mr. John Smith P.E.
Department of Health & Human Services
825 "L" Street
Anchorage, Ak 99502
RE: Lot 9 B!k 6 H¥1en Crest
Dear Mr. Smith,
The proposed septic system will not impact adversely any adjacent
properties. There is a community water system, so well setbacks are not
a consideration. The wastewater system is set back from the lot line
!0 feet and will not affect undeveloped Lot i0. Drainage in 'the area
is unaffected. The entire lot is usable for septic disposal, and our
replacement area is based on an addition of a lift station and field in
!ocetion shown.
If you have any questions or any further concerns please call me
at 694-5!95.
Sincerely,
Louis
-- Replacement Trench 0
Houee ~,
~ Houee
I
1,0DO gal, ~nk- ~ ~prox, Hauaa ~c
102' to a~ure ~ 21' Rooa ~ga · - MONITOR
o - S~R C~O~
NO KNOWN CURTAIN D~INS ~ ~ + - WE~
~=~=ttt=~- PROPOSEO ~CHR~
LEGAL: Hylen Crest Subdv. ~3 Lot 9, Block 6 ,~'%::.:~ +' ',. · ~', ,'~
CONTRACTOR: 'N/A .... 7~ ~5 ~~~7:
SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM
LEGAL: LOT 9, BLOCK 6, Hylen Crest
GENERAL
1. The well and septic plan are for a single family residence on]y.
2. The drawing and/on site p'lan shall be a part of this specfiffication.
3. Al] materials and workmanship shall meet the Anchorage Department of
Health and State Department O¢ Envlronmenta] Conservation
requirements.
4. A]] soil tests are advisory to the design and are to be verified or'
modfffied in the fie'id by the engineer.
5. All e×cavations and depths are advisory and are to be verified or
modified in the field by the contractor to meet Municipality of
Anchorage, Department of Environmental Conservation requirements.
6. It is the responsibility of the owner to obtain all necessary permits
or easements and to locate any adjacent multi-,family wel]s.
7. The e×cavation is to be exactly in ~he area shown on the site p]an,
any deviation requires engineer approval.
8. It is always recommended that a surveyor* 'locate the nearest lo~ line
position and the location of any easements.
TRENCH
1. The trench is to fol'low the natural land contour ro maintain uniform
total depth of the trench bottom.
2. The bottom of the trench shall be level, plus or minus 1.5"
3. The total depth o¢ the trench excavation is not to exceed 10' at any
point.
4. The trench grave] is to be covered with typar fabric material.
5. Soil or combination of soil and extruded board insulation to a depth
of 4' or equivalent is to be placed over the ]eachfie]d.
6. The area over the trench is ~o be finish graded to preven~ ponding
of surface water runoff.
?. The septic tmnk and leachfie]d must not be closer than 100' to any
existing private wel'l, 150' to any Class "C" well, or 200 feet to
any community we]].
RECOMMENDED LEACHFIELD DIMENSIONS
TOTAL DEPTH = 10' GRAVEL DEPTH = 8' TRENCH LENGTH = 35' TRENCH WIDTH = 30"
Soil Rating = ]60
Bedroom Capacity
Septic Tank Size
3
!000 gal'ion
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG -'PERCOLATION TEST
SOILS LOG
PERCOLATION
TEST
PERFORMED FOR:
DATE PERFORMED:
LEGAL DESCRIPTION: ~-~Z" ~ ,,,'~'~' ~
SLOPE SITE PLAN
5
6
7
8
9
10
11
12
13
[
I
WAS GROUND WATER S
ENCOUNTERED? "/~ L
O
E
YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
14
15-
16~
17-
18-
19-
2O
PERCOLATION RATE ~ ~ minutes/inch
TEST RUN BETWEEN FT AND ~ FT
COMMENTS
PERFORMED BY:
72-008 (6/79)
Eagle R!ver Enginooring 8ervic~r,
Eagle River, Al( g957;'
694-5195
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
Parcel I.D. #
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Hylen Crest Lot 9, Blk 6 ~& T 14 N, R 1 W, Sec. 8
Location (address or directions)
Eaqle River
(b) Property owner
Mailing Address
(c) Lending Institution
Mailing Address
Harry Oregson Telephone: (home) n/a
6~%12~L~mkeway Dazive, AnchQrage~: AK 9%5~2
n/a Telephom;
Business
(d) Real Estate Company and Agent n/a
Address
Telephone
(e) Mail the HAA to the following address: (or check here [], if hold for pick up,)
List contact person and day phone number below:
Pickup by Enqineer
2. TYPE OF RESIDENCE
Single-Family~ Number of bedrooms 3
3. WATER SUPPLY
Individual Well [] Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-site E2 Public [] Community [] Fiolding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality and status.
72-025 (Rev. 7/88} Page 1 of 2
5. ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION ~
As certified by my seal affixed hereto and as of the validation date shown below, Iverifythat my investigation of this
Health Authority Approval 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 compliance with all Municipal and
State codes, ordinances, and regulations in effect on the date of this inspection.
Name of Firm
EAGLE RIVER ENGff)EERING SERVIOES
Address ~^¢., c mu~o ~ a~7~
.'"//~//'~/?/ P. 0. $0X 773294
Date
Telephone
6. DHHS APPROVAL
Approved for .~ bedrooms by
Approved ~/C Disapproved
Terms of Conditional Approval
Conditional
Date
TheMunicipalityofAnchorage Department of Health and Human Services(DHHS) issues Health Authority Approval
cerificated 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 tending
institutions in order to satisfy certain federal and state requirements. Employees of DHHSdo 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. 7/88) Back Page 2 of 2
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
I V ~ [~HECKLIST - FEBRUARY 1984 343-4744
FEB 1 2 19f;1 Legal Description: ~'-]-
A. WELL DATA
Well Classification cL""/¢~., ~--.¢ d'
Well Log Present (Y/N)
Total Depth Cased to __
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
To Nearest Sewer Service Line on Lot
Water Sample Collected by
Water Sample Test Results
Comments
Depl. I-]eal~.i~ &. Human Services
Date Completed
Depth of Grouting
If A, B, C, D.E.C. Approved (Y/N)
Yield
Pump Set At
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer Cleanout/Manhole
; Date
B. SEPTIC/HOLDINGTANK DATA
uate Installed /~'?~ Size /'¢..~o ?~,/ No. of Compartments
Standpipes (Y/N) ~ Air-tight Caps (Y/N) _
Depression over Tank (Y/N)
Pumping/Maintenance Contact on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water-Supply Well
.To Property Line / ~ /
To Water Main/Service Line 't-/~
To Stream, Pond, Lake or Major Drainage Course "¢/¢"'"
Comments
~ Foundation Cleanout (Y/N) 2"
Date Last Pumped "'/~"~'"
'~' "~ ; for ~/"~
Temporary Holding Tank Permit (Y/N) ~/,~
To Building Foundation
To Disposal Field .,5'"
72-026 (Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed /~//¢q¢
Width of Field ~ /
Square Feet of Absortion Area
Depression over Field (Y/N)
Results of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well ¢ ;.z~,~ /
To Building Foundation /~
Lot /~/4
To Water Main/Service Line 'f/~'"
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
Type of System Design
Length of Field i;~b'/
Depth of Field /¢ /
Gravel Bed Thickness ¢~' /
Statndpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line ? ~
To Existing or Abandoned System on
; On Adjoining Lots '~-~
To Cutback (if present)
D. LIFT STATION ~//.q
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test.
Date
MOA No. ¢¢,¢-- ~r
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines ii0 e.ffect on the date of this
Signed
Company
Receipt No. "~ ~/-'~' q ~'~
Date of Payment ~ ~ '~- ~ (
Amount: $ [ "¢~~/
72-026 (Rev. 7/88) Back
Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
DEPT. OF ENVIRONMENTAL CONSERVATION
~ ~ 3ES.[ERN ..... ~.~ ..... OFFICE
360]. C STREET, SUITE 322
ANCHOI~GE, ALASKA 99503
WALTER J, H/GKEL, GOVERNOR
563-6775
Pebruary 7, 1991
FOR:
Eagle River Engineering Services
P.O. Box 773294
Eagle River, AK 99577
PWSID: ~213289 (H¥1en Crest--Eaqle River)...
~[y review of the records on file in this office reveals that the
Hvlen Crest Subdivision C].ass A Public Water System is in
compliance with the provisions of 18 AAC 80.060, State of Alaska
Drinking ~ater Regulations.
Sincerely,
T'~mothy A. Karnousk~
Environmental Eugineer
KKK: pf
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