HomeMy WebLinkAboutCOLONIAL PARK BLK 1 LT 9
.. 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: ~J ¢~ ~¢)o~o PID Number: O~'O - ~.o~_-
Name:
~o~? ~~T~ Wastewater System: ~'New ~Upgrade
Address:
t~ ~ ~,~ ~o~ ~.~.. ~ n~ ABSORPTION FIELD
Phone: ~ . ~11 ]No. of B~ooms: OD~pTrench ~ShallowTrench ~Bed DMound ~Other
LEGAL DESCRIPTION Soi,.at~n.: I.~ GPD/Sq. Ft. Total Depth fro~o~iginal grade:
Subdiv~ion: Depth to pipe bosom from original grade: Gravel depth beneath pipe
LOt: ~ Block: I ~O~1~ P~ ~ I Ft.~' F'.I
Township: ~II Range: ~II S~tion: ~ Fill add~ O.~lab°ve original_ iI grade: Ft. Gravel length: ~21 Ft.
WELL: ~a~,~ ~ Upgrade Gravel width: ~ ~ Number of lines: IDis~n~ ~.nlin~:
Ft. I I ~ Ft.
Clarification (Private, A,B,C): Total Depth: ~ Total absorption area: Pipe material:
~ Ft. ~ ~ SQ.~t. ~
Driller: ~,,,ed: Satic Water Le.,: Installer: Date insta~d~
Yield:~
I~n~,~,~,~ve ~0u~: TANK
/ GPU~ Ft.I
SEPARATION DISTANCES ~ Septic ~ Holding a S.T.E.P.
To Seotic A~omtion Lift Holding ~ubllc/Pri~te Manufacturer: Cap~ci~ in gallons:
From Tank Field Station Tank ~r Lin~ ~ ~ ~ ~ ~ I ~ O
. Numar of ~mpaRmen~:
Wel~ ~0~1~ JOOl+ ~ ~ ~51~ Material: ~Tea~
s~,~ ~ LIFT STATION
Water J O 0 t+ J O O I+ ~
Line ~ ~ ~ -- ~
Foundation ,it .~ __ -- __ "Pump on" level a~evel at: J High water alarm at:
Cu.ain ~-- ~O~'= ~"O,'~ PumpM~, IEl~rJ~llns~ions.do~"bY:
Drain ' '
Remarks: BENCH MARK
Lo~tion and Description:
Deg~ ~e T- Po~
Jum Election:
~&~-" A ~'""'.'f~<~....,
Inspections pedormed by: . -. ~.~.~. ~;=~ Dates: ls
-- . . ~le Riv~,~aska 99577 ~ ~ ~ ~:~% C~- 8801
department of Hea~h'd/~man~Se~Jces approval ~' ~"
Reviewed and approved by: ~Date: ~ -
2~
72-013 (Rev. 9/91) MOA25
P~.R~? NO. SW980050 ?AOX. 2 OF 2
MuniEip. o[itv oR AnchorcQe
DEPARTMENT OF HEALTH AND HUP~AN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.D. Box 196650 ~mchorage, Atask~ 99519-6650 · Teteohone, 343-4744
ON-S~TE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
LOT 9, BLOCK 1, COLONIAL PARK S/D
P.I.D. NO. 050-502-19
CITATION ROAD
WELLI 100' WELL RADIUS
EMENT FO WELL
FINAL
20' UTILITY EASEMENT
,NEW 1250 GAL.
SEPTIC TANK
DRAINFIELD
TH
A B C D
FCO 8.5' 43.0' - -
ST1 14.0' 38.0' - -
ST2 22.0' 34.0' - -
DBL1 24.5' 33.5' - -
DBL2 25.5' ~3,0' - -
C01 - - 100.5' 113.0'
~T1 - - 100.5' 106.0'
'C02 - - 185,0' 75.0'
~ MT2 - - 126.0' 76.0'
THIRD STREET
ST1 ST2
II
NEW ~94.6
1250 GAL ,
CO1 = 73.6'
C02 = 73.7~
GRADE--x MT1 COl /
C02 = 66.81J~
~71 = ss.o~ /
MT2 = 65.0'-J
NO WATER FOUND
59.0' B.0.H.
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 WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW980030
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:FOLLETT RODNEY G
OWNER ADDRESS:19638 CITATION RD
EAGLE RIVER, ALASKA 99577
DATE ISSUED: 3/12/98
EXPIRATION DATE: 3/12/99
PARCEL ID:05030219
LEGAL DESCRIPTION:
COLONIAL PARK BLK
1 LT 9
LOT SIZE: 35640 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT:
THIS PERMIT IS FOR THE CONSTRUCTION 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 ) (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.
PROVI S IONS:
RECEIVED BY:
DATE:
ISSUED BY: DATE: 3 -/2--/08
ROBERT C. COWAN, RE.
ROBERTA. SHAFER, RE.
February27,1998
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694-1211
HEALTH AUTHORITY
~PROVALS
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
DISPOSAL SYSTEM
DESIGN
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
P.O. Box 196650
Anchorage, AK. 99519
REFERENCE: Lot 9, Block 1, Colonial Park Subdivision
Request you issue a permit to upgrade the septic system serving the existing four
bedroom house on the referenced property.
A test hole was excavated and percolation test performed. The approximate location of
the test hole is located on the attached site plan.
At thc time of excavtion, no water was found ar~ after seven day groundwater
monitoring, the monitoring tube within the test hole has been checked and found to be
ary.
Attached is thc proposed upgrade design.
We do not anticipate any adverse effects on neighboring wells, septic systems or
drainage patterns by the installation of the proposed septic system.
If you require additional information, please contact us.
Sincerely,
Robert C. Cowan, P.E.
RCC/jkn
Enclosure
17034 NORTH EAGLE RIVER LOOP ° SUITE 204 ° EAGLE RIVER, ALASKA 99577
50' SITE PLAN DESIGN
.... HILLCREST LANE o'~°~"~"~'~ c~~o. ' '~;m
O~z~m~ 0
,.~Z~ ~ II
~ Om
~ '
~ 1°, t~
~ ~,~ ,~
o ~' '
~z~
' o~o~
~ z
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2 0/..
3
4
7
$
10
13
14
15-
17
18
20
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
' (EN~~ ~1~
:/'
DATE PERFORMED':; ' ."-~".~.J.l,t"~.~ ~
Township, Range, Section:
SLOPE SITE PLAN
WAS GROUND WATER ~ J
ENCOUNTERED? N 0
S
L
IF YES, AT WHAT ~ 0
DEPTH? P
Moniloring? Date:
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE __ (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN L{. FT AND__~' FT
COMMENTS
,//2/
PERFORMED BY: 17A~4 F~_.~le River L~p B~a M~ ~
· ire , Alaska ~ 5
ACCORDANCE WIT~ ~AT~AND MUNI~]~ GUIDELINES IN EFFECT ON THIS DATE.
CERTIFY THAT THIS TEST WAS PERFORMED IN
DATE: ~/~. / '~ ¢
72-008 (Rev. 4/85)
ROBERT C. COWAN, RE.
ROBERTA. SHAFER, RE.
HEALTH AUTHORITY
APPROVALS
SEWER &WATER
MAIN EXTENSIONS
SEWER&WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ON SITE
WASTEWATER
DISPOSAL SYSTEM
DESIGN
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694-1211
REFERENCE: Lot 9, Block 1 Colonial Park Subdivision
February 27, 1998
GENERAL:
The scope of this project includes the installation of a five foot wide drainfield
to serve the existing four bedroom residence on the referenced property. The
existing septic tank is to be excavated, pumped., crushed, and abandoned; and
replaced with a new 1250 gallon septic tank. The existing leachfield is to be
abandoned completely.
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.
o
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.
o
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 shitSing of the
tank.
All standpipes on the septic tank shall extend a minimum of 12 inches above
final grade.
4. Septic tanks installed with less than 4 ft. of cover shall be insulated.
17034 NORTH EAGLE RIVER LOOP · SUITE 204 ° EAGLE RIVER, ALASKA 99577
Page Two
Lot 9, Block 1, Colonial Park Subdivision
February 27, 1998
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, shall be to clean toward the leachfield. The second cleanout shall 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 (roughed-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 soil backfill.
Ensure the silt barrier covers the entire gravel surface before placing backfill.
Monitor tubes shall be of four (4) inch diameter, installed approximately in the
locations shown on the design, and extend a minimum of 12 inches above final grade.
The portion of the monitoring tube extending through the gravel shall 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.
MINIMUM MATERIAL SPECIFICATIONS:
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:
Page Three
Lot 9, Block 1, Colonial Park Subdivision
February 27, 1998
Type of Pipe Perforated Solid
Cast Iron Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM FS10 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
Use of a type of pipe other than listed above must be approved by the inspecting
engineer.
Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical
Company Styrofoam HI or equal).
Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco,
or equal).
A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed
between the final leachfield gravel layer and the native soil backfill.
All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3%
passing the//200 sieve.
When sand is being used as a filter material, its gradation specifications must conform
to current M.O.A. or D.E.C. requirements.
INSPECTIONS:
Typically there will be a minimum of three (3) inspections 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.
Page Four
Lot 9, Block 1, Colonial Park Subdivision
February 27, 1998
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. If necessary, a
pre-construction meeting will take place on-site. The inspecting engineer will not coordinate,
direct or control in any way the contractors activities.
The owner shall contract with the contractor to perform the work outlined in these
specifications and plans and in accordance with the attached M.O.A. permit. There will be no
contractual arrangement existing between the contractor and S & S Engineering. S & S
Engineering shall be the owner's representative and will inspect the work as stated above to
document the contractors activities. Final acceptance of the contractors work rests with the
owner and the M.O.A.
S & S Engineering shall have no liability to the owner or to others for acts or omissions of the
contractor or any other persons performing work on this project or the failure of the contractor
to carry out the work in accordance with these construction documents. S & S Engineering's
inspecting engineer will not be responsible for the construction means, methods, techniques,
sequence, procedures or the safety precautions incident to this project.
CONTRACTOR/INSTALLER
Percent Passing by~Weig.~ht ~
0
t~ I,o I,o 0
I/2" ~ .
u2,, I~'
oo 4 .~.
#8 IOO~
#16
No. 20
~ ~0
No. 40
~ 50
No. 60
~ 80
No.100
No.200
0.02mm
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
IPHONE I [~'NEW
MAILING ADDRESS
LEGAL
LOCATION NO. OF BEDROOMS
~ DISTANCE TO: /~0% AbsorPtion~a q Dwelling /~ ~, ~,
~ ~ Manufacturer Material No. of compartments
~ ~ ~iq. c~p~citv in g~llons Inside leng~ ~idt~ Liqui~ ~epth
Manufacturer Material ~iquid ca~acit~ in ~aHons
a Well
~ DISTANCE TO:~ /~ le~of,ines Trench wi~/.../~ inches Distance between lines ~
~ ~ Z No. of lines Lengt~f~c~line Total
~ ~ ~ Top of tile to finish grade ~ Material beneath tile Total effective absorpti~a~ea
Length Width D~th PERMIT NO.
/
~ ~ Tgpe of crib Crib diameter ~th Total effectiue absorption area
m Well Building foundation Nearest lot line
~ DISTANCE TO:
~ Class ~ ~ ~ D~ / ~//~ Driller Distance to lot line PERMIT NO.
~ ~/ [ ' ~ng ~n~ati~ Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
REMARKS
_ .
A..ROVE~ ~ ~_~a~ ......~/// /Z~A~ LEGAL
72-013 (Rev. 3/78)
GAAB-HD I
GPr:ATER ANCHORAGE AREA BOROI~H
HEALTH DEPARTMENT
E'A~ ---
327 LE ST. ANCHORAGE, ALASKA 99501 279-2511
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
NAME ~' ~,L ~' ~' , ,, ~/Z.~ ADDRESS
SEPTIC TANK:
DISTANCE FROM WELL
LIQUID CAPACITY
GALLONS.
MATERIAL / , , COMPARTMENTS
.- /~ / LIQUID
INSIDE LENGTH ' LJ'NSIDE WIDTH DEPTH__
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS
OUTSIDE DIAMETER
OR WIDTH '/1~ / LENGTH / ¢ /
, DEPTH
LINING MATERIAL
NEAREST LOT LINE
..... DIS.TANCE FROM WELl
TOTAL EFFECTIVE ABSORPTION AREA (WALL AREA)
BUILDING FOUNDATION .
/""~ SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELl
NUMBER OF LINES
ABSORPTION AREA
FOUNDATION , NEAREST LOT LINE
DISTANCE BETWEEN LIN.~F-~,--'~''~''~ TRENCH WIDTH
-~"'"'""'~. FT. LENGTH OF EACH LINE
TOTAL LENGTH
· OF LINES
IN. TOTAL EFFECTIVE
DEPTH: TOP OF TILE TO FINISH GRADE
DEPTH OF FILTER MATERIAL BENEATH TILE.
IN. ABOVE TILE
WELL: Typ(I,/~7' /.4~ ~-~'~ 7-
NEAREST
LOT LINE SEWER LINE
DEPTH
SEPTIC
, TANK
DISTANCE FROM
BUILDING FOUNDATION.
SEEPAGE
· SYSTEM
WATER
SAMPLE
CESSPOOL
NEAREST
OTHER
, SOURCES__
DISTANCES:
-,-, (
DATE
DIAGRAM OF SYSTEM
APPROVED
Permit
Applicant: ~-~O-Ti~I ~t~ ~--~)i~%~-Mailing Address: ~ ~'~'-~.
Location: Phone Number: ~3 c( ~ -- ~15 4-]
Legal Description: a ~ ~ I ~c~{O~;~ I ~O~ ~!~ Lot Size:
Type of Soil Absorption System Is:
Trench: ~ Drainfield: Seepage Bed.' Holding Tank:
Maximum Number of Bedrooms: Soil Rating (sq. ft/br) /~
The Required Size of the Soil Absorption ~ystem Is:
! /
MUNICIPALITY OF ANCHORAGE
Department ~ Health and Environmenta ?rotection
825 '5 Street, Anchorage, AK. ~9501
264-4720
~ ' ' * HANDWRITTEN PERMIT
NELL AND/OR ON-SITE SENER PERMIT
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall Pipe and
the bottom of the excavation(in feet).
~ ~ REQUIRED SEPTIC(J40~NG) TANK SIZE = 17']15)~'-3~ GALLONS ~ ~
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the well will serve.
~ * "TWO(2) INSPECTIONS ARE REQUIRED"" ~
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
· ~ ~ PERMIT EXPIRES DECEMBER 1 9 8 3
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set forth by the Municipality of Anchorage.
(2) I will install the system in accordance with codes.
(3) I understand that the on-site sewer system may require enlargement if
the~esidence ~s remodeled to include more
Signed: ~~ ~/
Issued by:
Date:
tha 3 bed~
SWP/024 (1/81)
G**B-.b-, GREATEI~ ANCHORAGE AREA '_~)ROUGH CaseNo.
HEALTH DEPARTMENT
32~/Eagle St. Anchorage, Alaska 99501
279-2511
SEWAGE DISPOSAL SYSTEM
NAME OF APPLICANT~ 2,
RESIDENCE ADDRESS / 0
LEGAL DESCRIPTION
APPLICATION TO INSTALL: SEPTIC TANK
TO SERVE THE FOLLOWING FACILITY
FINANCED THROUGH
- APPLICATION & PERMIT
MAILING ADDRESS PHONE NO.
LOCATION OF INSTALLATION ¢,a~r>-~,~ ,,
/,/" , SEEPAGE PIT. ~ , DRAIN FIELD. , OTHER
e___
PERCOLATION TEST RESULTS ANTICIPATED DATE OF COMPLETION
BELOW TO BE FILLED OUT BY HEALTH DEPARTMENT
THIS IS TO SERVE AS '~-~-~ , PERMIT TO '- ~. ,'~ d , (~, -
AS DESCRIBED BELOW. SIZE OF UNIT TO BE SERVED ~" /~-~-~,~ ~/
...... SEPTIC TANK SIZE /'0"~'0~ TYPE_.~J:;'_. SEEPAGE AREA '~' ;YPE
DIAGRAM OF SYSTEM
DISTANCES:
Health Auth0dt¥
I certify that I am familiar with the requirements of Greater Anchorage Area Borough Ordinance No. 28-68 and that the
above described system is in accordance with said code.
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:
LEGAL DESCRIPTION:
1
2
3
5
8
9
~'?~'1( C~ .',..I. ,~_'~ DATE PERFORMED:
SLOPE
l
SITE PLAN
Ii I /I ?,
10
11
12
13
14
15
16
17
18
19
20
COMMENTS
No. 1457-E ~
WAS GROUND WATER
ENCOUNTERED? , ~ ~) SL
O
P
E
IF YES, AT WHAT
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
72-008 (6/79)
RA
TEST RUN BETWEEN
CERTIFIED
MUNICIPALITY OF ANCHORAGE
DIVISION OF ENVIRON~NTAL HEAJ~TH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR HEALTI:I &UTRORITY APPROVAL CERTIFICATE
Location (address or dSr~ctlons). ~
Telephone - Home Business
Applicants Address
(c) Applicant is (check one) Lending Institution ~--~; Owner/butlder~;
Buyer~--~; Other~(explain);
(d) Lending Institution Telephone
Address
(e) Real Estate Co. & Agent
Telephone 6 ~'~' ~-'RO~ C;
8RB 196X .~
2. Type of Residence
Single-Family.~.
Number of Bedrooms
Multi-Family ~--~
Other (describe)
3. Water Supply
Note: If community w~ll system, must have written confirmation from the State
Department of Environmental Conservation attesting to the legality and status.
4. Sewage Disposal
Note: If community well system, must have written co~irmation from the State
Department of Environmental Conservation attesting to the legality and status.
[Page 1 of 2]
e
5. ~,ngineering Firm Providin Ins c it OhS Tests File Search Data and .Information
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 shows .that the on-site
water supply and/or wastewater disposal system is safe, functional am~ adequate for
the number of bedrooms and type of structure indicated herein. I further verify that,
based on the information obtained from the M~nicipaltty 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 regula-
tions in effect on the date of this inspection.
Name of Firm ..~ ....
Address ,,:,,OLE R~VEB, AI.A-SKA
DHEP Approval
Approved for
Approved ~
bedrooms
Telephone
Disapproved
Terms of Conditional Approval
CAUTION
THE MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENT~ PROTECTION
(DHEP) ISSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIONAL ENGINEER REGISTERED
IN THE STATE OF ALASKA. THE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF HOMES AND
THEIR LENDING INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDERAL AND STATE REQUIRE-
MENTS. EMPLOYEES OF DHEP 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.
(DHEP SEAL)
RR4/ej/D18
[Page 2 of 2]
7-19-84
ao
MUNICIPALITY OF ANCHORAGE
HEALTH A[rlIiORITY APPROVAL
CHECKLIST - FEBRUARY 1984
Well' Classification ~/~,~
Well Log P~esent (~/~
Total Depth-3 ~) -' / Cased to
Static Water Level ~-;
Casing Height Above Ground /~
Electrical Wiring in Conduit~(Y~
Separation Distances f~cm WeIl:
To Septic/Holding Tank cn Lot /~)0 %
To Nearest Edge of Absoz~ption Field ~n Lot
To Nearest Public Sewer Line /J
Date Completed ~ g<[ ~ ~i
~O ! ~5 Depth-of G~outing
Pump ~t At ~
~ Sanit~y ~al on ~sing ~ .
~essi~ ~nd ~l~ad (~
; On Adjoining Lots /WO
l/k ; On Adjoining Lots /~O
To Nearest Public Sewer
Cleanout/Manhole /-~ /T~- To Nearest Sewer Service, Line/on Lot
Water Sample Collected By~'~(_~£/~q~d//~ ; Date
Water Sample Test Results ~ ~.~ /~i~ ~'0 ,~ ~
B. SEPTIC~ TANK DATA
Standpipe ~ ~/~
Delmression Over/ r Tank
Ai~-tight CapsdY~
Date Last Pumped
No. of Ccapa~tments 2
Foundation Cleanou )
Pumping/Maintenance Contract orl File (Y~/~ ; for ~x_z//q
Holding Tank High-Water /klarm (Y/N~/fl- T~mporary Holding TaDR Permit
Separation Distances from Septic/Holding Tank:
/
To Water-Supply W~ll //~ ~ To Building Foundation ...... /g
To Property Line /O e./. To Disposal Field 7 f
To Water Main/Service Line
Course
Commnts /~30 ~7 ~
.To Stream, Pond, Lake, c~ Major Drainage
[Page 1 of 2] 2-15-84
C. ABSORPTION FIELD [~%TA
Soils Rating in Absorption Strata
Date Installed ~/~ ~
Width of Field 3~ t~
Square Feet of Absc~ption A~ea
/Os- '~/_~' Type of System Design
th of Field 2 ~ /
~p~ of Field /~ /
Grail ~d ~i~ss ~ ~ ~
Stan~ims ~e~nt~)
Depression over Field (~ Date of Last Adequacy Test
Results of Last Adequacy Test
Separation Distance f~cm Absc~ption Field:
To Water-Supply W~ll /~3 ~ To P~operty Line /O
S7/
To Building Foundation
Lot /L/~/~"~ ; On Adjoining Lots
To Water ~rvice Line ~¢n3 ~ To Cutbank(if
To Stream/Pond/Lake/c~ Majo~ DrainaGe Course
To Driveway, Pa~king A~ea, ca~ Vehicle Stc~aGe A~ea
Ccm~ents /~3 '~ ~; /~
To Existing or Abandoned System
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" La~l at
High Water Alarm I~vel at
Tested for
Electrical Codes (Y/N)
Di~nsions
/ / Manhole/Access (Y/N)
~/' /,~/~p Off" Level at
~,,/ ~¢] Vent (Y/N)
Pumping Cycles du~ing Adequacy Test.
M~ets ~DA
Cca~ents
** Check Pe~Ttitted Bed~ocm Rating A~3ainst HAA ~quest **
I certify that I have checked, verified, c~ ~onfc~-m~d to all MOA
on the date of this inspection.
[PaGe 2 of 2]
Da te//~ ~/~
MOA NO~. /
2-15-84
~ ~3~j~ICIPALITY OF ANCHORAGE_ ....
825 L Street - Anchorage, Alaska 99501 FEB
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-4720R E C E I V E D
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Complete all parts on page 1. Incomplete requests will not be processed. Please allow ten (10) days for processing.
1. PROPERTY OWNER i PHONE
Dewey SmithI 694=2331
MAILING ADDRESS
4th & Hillcrest
PROPERTY RESIDENT (If different from above) PHONE
2. BUYER PHONE
Douglas Rush
MAILING ADDRESS
% J.C. Penney's
3. LENDING INSTITUTION PHONE
Ala~.ka.:Mutual Savings Bank
MAILING ADDRESS
~4. REALTOR/AGENT I PHONE
Larry Mauldin % Jack White CompanyI 277-1553
MAILING ADDRESS
3201 C Street 99501 ~ ...... ~ , ......
,.-5. LEGAL DESCRIPTION
~-~t 9 Blv~k '~ Colonial Park Subdivision
STREET LOCATION
4th & T~illcrest - Eagle
6. TYPE OF RESIDENCE
SINGLE FAMILY
[] MULTIPLE FAMILY
7. WATER SUPPLY
INDIVIDUAL*
[] COMMUNITY
[] PUBLIC UTILITY
8. SEWAGE DISPOSAL SYSTEM
:~× INDIVIDUAL/ON-SITE**
[] PUBLIC UTILITY
River
NUMBER OF BEDROOMS
[] One [] Four [] Other
[] Two [] Five
~ Three [] Six
* ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, give well
depth (attach log if available.)
**If individual/on-site, give installation date 19 69
If system is over two (2) years old an adequacy test is required
by this Department.
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
Note: have told Larry Maulding, re: perc and pump, has list of
adequacy engineers.., lw
~ THIS SIDE FOR OFFICIAL USE ONLY .._~
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
INSPECTOR
INSPECTOR
INSPECTOR
DIRECTIONS:
NUMBER OF BEDROOMS
1. TYPE OF RESIDENCE
[] SINGLE FAMILY
[] MULTIPLE FAMILY
2, WATER SUPPLY
[] INDIVIDUAL
[] COMMUNITY
[] PUBLIC UTILITY
Connection Verified
3. SEWAGE DISPOSAL SYSTEM
[] INDIVI DUAL/ON -SITE
[]PUBLIC UTILITY
Connection Verified
I--ISeptic Tank or []Holding Tank
Size: /~) O O If Tank is homemade
give dimensions:
TYPE OF TANK
TOTAL ABSORPTION AREA
4. DISTANCES
WELL TO:
Absorption Area to nearest Lot Line
[] ONE [] THREE [] FIVE
[] TWO [] FOUR [] SiX
PERMIT NUMBER
DEPTH OF WELL
DATE DRILLED
LOG RECEIVED
PERMIT NUMBER
DATE INSTALLED
INSTALLER
SOl LS RATING
MATERIAL ~
Septic/Holding Tank IAbsorption Area
[] OTHER
lSewer Line I Nearest Lot Line
5. COMMENTS
II
~ APPROVED FOR 3 BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
[] DISAPPROVED
IBY (Tit~__~ ~ ~
DATE
LEGAL DESCRIPTION
72-010 (Rev. 3/78)
GREATER ANCHORAGE AREA BOROUGH
Department of Environmental Quality
3330 "C" St., Anchorage, Alaska 99503 - 274-4561
REQUEST FOR APPROVAL OF
INDIVIDUAL SEWER & WATER FACILITIES
1. Type of Inspection: CMRO VA FHA CONV ,/~
2. Property Owner: ~c~) ~.~ ~
Mai-ling Address: ~, .]~
3. Name of Buyer: ~~_~/~ '~'~~/~. --- "
Mailing Address: ~ ~]~-C)--.~7/~]3.~/~2~ ~e~y~j~c~.~-~ja ~~'
4. Name of Lending Institution: . r~ .'~ ~D_j/_Phone~ ,
Mailing Address:
Name of Realtor or Agent:
Mailing Address: ~,~.~0/
Phone
o
Type of Facility to be inspected:
Water Supply
Type of Supply: Public Utility Individual
If Individual, number of dwellings presently served
If Individual, depth of well
Sewage Disposal System
Type of System: Public Utility
If Individual, date of installation
No. Bdrms.
Individual (on-site)
EQ-037 (!/74)
ME'C!~NI ~.AL ENGINEER
DAVI~ SLENKAMP
694-9055
ENGINEERING
~Ct~NICAL ENGINEERS
CIVIL ENGINEERS
SRB 196X Eagle River, Alaska 99577
CIVIL ENGINEER
ROBERT A. SHAFER
694-2979
20 February 1979
Dewey Smith residence,
~th & Hillcrest, Lot 9,
Block 1, Colonial Park
Subdivision
Jack White Realty Co.
ATTN: Larry Mauldin
3201 C Street
Anchorage, Alaska 99503
MUNICIPALITY OF ANCHORAG~
DEPT ¢): ,'u. ?,
ENVIROI',;MF_?,i q. TION
FEB 2 3
RECEIVI D
Dear Mr. Mauldin,
A sewer system adequacy test was performed on the referenced property
per your request.
The septic tank serving the referenced three bedroom residence wa~ pumped
on 16 February 1979 and verified to have a capacity of 1,000 gallons.
The seepage pit was charged with 500 gallons of water. Perculation
over a 24 hour period, as recorded on 17 February 1979 resulted in the
removal of approximately 96'5 'gallons or an average of 32'1 g~llons per
bedroom.
On the basis of the above survey and test, it can be concluded that the
system (septic tank and seepage pit) is adequate.. Since the septic
tank had not been pumped for an extended period of time, I recommended
that caustic soda be added to the tank and it be repumped in approxi-
mately tWO weeks.. , ,. ~ .//~~/,/~ ~
1 Incl . . . · E
Invoice
Dept of Health & Environmental
Protection
Alaska Mutual Savings Bank, Minnesota
Benson Branch