HomeMy WebLinkAboutCHAMBERS LT 81B1ooo
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
NAME
PHONE i ~=NEW
~¢~- 72~,-/: [] U.GRADE
MAI LING ADDRESS
LEGAL DESCRIPTION
gl, 7-/
LOCATION
Well . AbsorPtion area
I DISTANCE TO:
I-Z IManufacturer ~ .tO
~ .< I ZP~/V$,~";'"'
[Liq. capacity in gallons ....... Inside length
6.." I DISTANCE TO' IWen IDweH'ng
--~Z I ' I I
g _Z ¢ Manufacturer
C) Well ~ F undation
~ 'r DISTANCE TO:
~ ~. ~ I No of lines I Length of each line Total lenqth of lines
~Z~ '
~_~= I ! I
l- Top of tile to finish grade ,. Material beneath tile
I Length Width Depth
~ ~ ~-- Crib diamete~ Crib dept~
~ I"
~ Well Building foundation
I DISTANCE TO:
IClass Depth Driller
I
~ I Building foundation Sewer line
DISTANCE
TO
I
[ NO. OF BEDROOMS
j~wellin, I"ERM'T~°'¢~O
Material No. of com~tments
Width Liquid depth
PERMIT NO.
Material Liquid capacity in gallons
Nearest lot line
Trench w~b(~_~ inches
inches
PE~I~.,~ (~ ¢
Distance be~?~nes
Total effectiv4 absorption area
PERMIT NO.
Total effective absorption rea
Nearest lot line
Distance to lot line PERMIT NO.
Septic tank Absorption area(s)
OTHER
PIPE MATERIALS
SOIL TEST RATING
INSTALLER
REMARKS
~
'2-0 ~(~e;. 3/78)
DATE LEGAL
D--lo/ &':Z~ - ~,d_~V. 2 =6'
825 "L" STREET
ANCHORAGE, ALASKA 99501
(907) 264-4111
GEORGE M. SULLIVAN,
MAYOR
DFPA[~TP,/I['N¥OF HEALTH AND ENVIRONMENTAL PROTECTION
May 19, 1980
TO: Whom It May Concern
Subject:
T15N R1W Section 9
Lot 81 Chambers Subdivision - Chris Brown
The inspection report dated September 24, 1978 signed and
sealed by Earl Ellis shows an as-built drawing with a
twenty-eight(28) foot trench. The length of each line is
shown as thirty-two(32) feet.
On May 16, Charles Barr Excavating removed three(3) feet
of the leach line, capped the line and filled in the
trench. I performed the inspection. The trench is now
twenty-eight(28) feet long and twenty(20) feet away from
the utility easement.
If there are any further questions, please call this office
at 264-4720.
Sincerely,
Lynn Lindquist
Principal Code Enforcement Officer
cc: File
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PERMIT NO.
FIlJ[-4 II::IP~RLIT'T' ,:IF
DEPARTMENT: HEALTH AND ENVIRONMENTAL OTECTION
825 ~L~ STREET, ANCHORAGE, AK. DD50i
264-4729
L4ELL F'E~:f'I IT
( 789998 )
APPLICANT
LOCRTION
LEGAL
,:.l
LEE -.,JLLIVRN F'O BOX 1Lq..7 EAGLE RIVER
LOT 8-1 S~T'tSNR-1W ('('~_/I~fT)]:~L;,1S ~) LOT SIZE
694 2588
100000 SQUARE FEET
MINIMUM DISTANCE BETWEEN A WELL AND RNY ON-SITE SEWAGE DISPOSAL SYSTEM IS
t00 FEET FOR R PRIVATE WELL OR 200 FEET FOR A PUBLIC WELL.
WELL LOGS ARE REQUIRED AND MUST BE RETURNED TO THE DEPARTMENT WITHIN ~0 DRYS
OF THE NELL COMPLETION.
OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRRMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
F'ERI"I I T E::--:P I RES [:,EE:Er-IBEI:~: F_~::l.. 1'_-~- 7L::
I CERTIF'Y THAT
t: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET
FORTH B'¢ THE MUNICIPALITY OF ANCHORAGE.
.';': I WILL INSTALL THE S'~STEM IN ACCORDANCE WITH THE CODES.
S I GNED ' _~ ~
ISSUED B, ..... DATE_
Y]:. 0
& L DRILLING COMPANY
BOX 97, EAGLE RIVER, ALASKA 99577 · TELEPHONE 694-2588
:3
OWNEROF LAND c/2 ~._ /..~.,..9~:-,,o
ADDRESS
LEGAL DESCRIPTION ~dl ~] ~' c] 7'- / ~'"/~ ~l ccd
DATE- Started / Ended ~
PERMIT NUMBER 7~0 0 8
/
DEPTH OF WELL /~/'(~ ~:~
STATIC LEVEL OF WATER FT.
/
DRAW DOWN FT.
KIND OF CASING
KIND OF FORMATION:
From D Ft. to ~'~ Ft.
From ~ Ft. to ]'~ Ft.
From : ,:' Ft. to -~*'~'-,~' Ft. ("A-~T'
From,,"~-(; ~) Ft. to '7'-1' Ft.
From '::: ~4 Ft. to/~/' Ft.
/~t Ft.
From/' :~ ( Ft. to:
From: '){ Ft. to /~37 Ft.
From Ft. to. Ft.
From__.Ft. to Ft,
From__.Ft. to Ft.
From__Ft. to Ft
From__Ft. to Ft.
From Ft. to Ft,
From__Ft. to Ft.
From Ft. to Ft.
From__ Ft. to__ Ft.
From Ft. to Ft.
From__Ft. to__Ft.
~9-~--~0 0 ' ~r'~m(~ Ft. to.~Ft
~rom~Ft.~ to~Ft
From~Ft. to~Ft
From Ft. to~Ft.
From~Ft. to__Ft.
-rrom~Ft. to Ft.
From Ft. to Ft.
Fromm_Ft. to Ft.
From~Ft. to Ft.
From~Ft. to__Ft.
From~Ft. to__Ft.
From Ft. to Ft.
From Ft. to__Ft.
From~Ft. to__Ft.
From Ft. to Ft.
From Ft. to Ft
MISCL. INFORMATION:
DRILLER'S NAME
~J
Cl~ugJak, Alaska 99567
I'ho~e: 688-3085
· ~erformed for
Legal Description
Chri,-~ C. Brown
Lot 51~Section 9, T 15 N, R1W SM
l~ercolation Test
Date
Test Pit Location
157' ¥/ an~ 60' S NE Corner
0]
8
10
12
14 --
16 _
GZ
0'- 1.5'
red brown silty sandy gravel w/organics
(GM) 225
1.5'- 10.0'
clean well graded sandy gravel
with cobbles to four inches
( GW )
1i0 ft 2/bd'rm
lO.O'- 11.0'
I1.0'- 15.0'
silty fine sand ~
250 ft£/bdrm
clean welt fraded sandy f~-'avc!
with cobbles to e~_g, bt. inches
(GW) 100 ft2/bdrm
no wa!e? table encountered
-rotai depth this tes~ ]_~__ feet
AVEP~.GE ABSORPTION ARI]A REQUIRED FROM SOILS LOG = ~ 2gJ
ft.2/bdrm.
NET TIME (Hin.)
NET DROP (In.)
Perco]_ation rate
Signed
j\
825 "L" STREET
ANCHORAGE, ALASKA 99501
(907) 264-4111
GEORGE h;. SULLIVAN,
MAYOR
DEPARTMENI'OF HEALTH AND ENVIRONMENTAL PROTECTION
December 13, 1979
Chris C. Brown
Star Route Box 947-A
Chugiak, Alaska 99567
Subject: Lot 8lB Chambers Subdivision
Approval for your individual sewer and water facilities can
not be granted until the following items have been completed:
11 log submitted to this department.
&The water analysis report be delivered to this office
from Chem Lab, 5633 B Street, for our review.
(3) We have not received the as-builts of'the installation
of the of the s~r/l~y~ Please have the engineer
send us .the as-~u~ files and review.
If there are any further questions, please contact this office
at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Associate Specialist
RCP/lj w
cc: National Bank of Alaska
Pouch 7025 99510
FROM
MESSAGE
f 't:
~ .
REPLY
Redif~prm® 4S 471
SIG NED
SEND PARTS 1 AND 3 WITH CARBON INTACT -
PART 3 WILL BE RETURNED WITH REPLY.
DATE
POLY PAK (50 SETS) 4P471
?0o. 4-~
0
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2., qq 7q .... . , x,
J~O '
Easement to be vacated i///////~
"7 6 8 D JUL 1. 1. 1984
!
r-Do
97077
•
•_ Municipality of Anchorage °y
On-Site Water and Wastewater Program F AUG (4
U D'
t.
(907) 343-7904
Certificate of On-Site Systems Approval ` of 6 S
Parcel I.D. 051-103-46 Expiration Date: (2--I _1
1. GENERAL INFORMATION
Complete legal description Chambers Block 1 Lot 81i6-
Location (site address) 22532 Chambers Ln.
Current Property owner(s) John & Luella Sutherland Day phone
Mailing address PO Box 671850 Chugiak, AK 99567
Real Estate Agent Day phone
2. TYPE OF DWELLING:
El Single Family (w/wo ADU)
❑ Duplex
❑ Multiple Dwellings (Single Family and/or Duplex)
3. NUMBER OF BEDROOMS: 3
4. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL:
Individual Well Individual
Individual Water Storage ❑ Holding Tank ❑
Community Class Well ❑ Community ❑
Public Water System ❑ Public Sewer ❑
WaiverNariance request for: Distance:
Received b � i � ,�!L.. _;��r � _ � J Date: /////
COSA to be released to the engineer,unless otherwise requestedb Re :ngineer.
COSA Fee $ 5AC Waiver Fee $
Date of Payment g/a(1/15— Date of Payment
Receipt Number 021 i(O 5 Receipt Number
COSA# o d9/3S/ Waiver#
5. 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, based on procedures outlined
in the Certificate of On-Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater
disposal system is (are) 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(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at
the time of installation.
In conducting an adequacy test, I attempt to provide a thorough,conscientious engineering analysis of the system in accordance with MoA COSA
guidelines and regulations.The reported results describe the performance of the system under the conditions encountered at the time of the test,
and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soil
condition,ground water levels that may fluctuate during the year, and the water usage of the family being served by the system.These conditions
are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not guarantee future
performance of the system,nor do they guarantee that there are no hidden defects or encroachments.Therefore we cannot provide any warranty
for future performance, nor can we estimate remaining life of the system. The content of this report is for the sole benefit of the owner listed
above.
Name of Firm Pannone Engineering Services LLCPhone (907) 272-8218
Address P.O. Box 100217, Anchorage Ak. 99510
Engineer's Printed Name Steven R Pannone Date 8/23/2017
.4110.es,
OF A&QS-k
AOC ��)"."-
"4.- 9���,f
49- �\ •.* 4
6. DSD SIGNATURE
v•-• I •Steven K. Ponnane.•
System #1 Approved for bedroomsOlti pdt--
•. CE-8149 •��/
System #2 Approved for bedrooms
9,67:5'k
mss•.,
Disapproved �� `*OFFSStP ;
Conditional approval for bedrooms, with the following stipulations:
•
ON-Silt
\h!NS-VE\N ATE c.
� +-� � -� Original Certificate Date. ^3 '
The Municipality of Anchorage Development Services Division (DSD) issues Certificates of On-Site Systems Approval (COSA) based only
upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality
of Anchorage is not responsible for errors or omissions in the professional engineer's work.
7. ATTACHMENTS:
COSA Checklist X Nitrate Advisory
Septic System Advisory Arsenic Advisory
Well Flow Advisory Other
COSA blue sheet r - _
If more than 1 septic system is on the lot:
COSA Checklist# 1 of
Structure served by this system '
Certificate of On-Site Systems Approval Checklist
Legal Description: Chambers Block 1 Lot 81 Parcel ID: 051-103-46
A. WELL DATA
Well type Private If A, B, or C provide PWSID# Well Log (YIN) Y
Date completed 1/19/1978 Sanitary seal (Y/N) Y Wires properly protected (Y/N) Y
Total depth 147 ft. Cased to 147 ft. Casing height (above ground) 1 2+ in
FROM WELL LOG AT INSPECTION
Date of test 1/19/1978 6/9/2016
Static water level 38 ft. Unknown* ft
Well production 40 g.p.m. 5'8+ g.p.m.
WATER SAMPLE RESULTS:
Coliform ,' � ,7 colonies/100 mL Nitrate i`L-- mg/L
Arsenic , ug/L Date of sample. 8/21/2017 Collected by PES
B. SEPTIC/HOLDING TANK DATA
Tank Type/Material Septic/Fiberglass Date installed 9/24/1978
Tank size 1 ,000 gal Number of Compartments 2 Cleanouts (Y/N) Y
Foundation cleanout (Y/N) Y Depression over tank (Y/N) N High water alarm (Y/N) N
Date of pumping
8/21/2017 Pumper Sanitary Pumpers
#C a.' I V\ roQV f .S.f:' '7
C. ABSORPTION FIELD DATA }APV' L.�
Date installed 9/24/1978 Soil rating (g.p.d./ft2 or ft2/bdrm) 110 SF/BR System type Deep Trench
Length 2- ft. Width 4.2 ft. Gravel below pipe 6 ft.
Total depth 10.4 ft. Eff. absorption area Monitoring Monitoring tube Y Depression over field N
Date of adequacy test 6/9/2016 Results (Pass/Fail) Pass For 3 bedrooms
Fluid depth in absorption field before test 0 in. Water added 461 gal. New depth 0 in.
Elapsed Time: 80 min. Final fluid depth 0 in. Absorption rate >= 450+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (Y/N & type) No If yes, give date
D. LIFT STATION
Date installed Size in gallons Manhole/Access (YIN)
"Pump on" level at in. "Pump off" level at in. High water alarm level at in
Datum Cycles tested Meets alarm&circuit requirements?
E. SEPARATION DISTANCES
WELL ON LOT TO:
Septic tank/lift station on lot 100+ On adjacent lots 1 00+
Absorption field on lot 100+ On adjacent lots 100+
Public sewer main 75+ Public sewer manhole/cleanout 100+
Sewer/septic service line 25+ Holding tank 100+
Animal containment areas 50+ Manure/animal excrete storage areas 100+
SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5+ Property line 5+ Absorption field 5+
Water main 10+ Water service line 10+ Surface water 100+
Wells on adjacent lots 100+
ABSORPTION FIELD ON LOT TO:
Property line 10+ Building foundation 10+ Water main 10+
Water Service line 10+ Surface water 100+ Driveway, parking/vehicle storage 10+
Curtain drain 50+ Wells on adjacent lots 100+
F. COMMENTS
* Landscaping feature around wellhead prevent access.
Sanitary seal intact and wires protected.
G. ENGINEER'S CERTIFICATION ,rte~�`'�,`
I certify that I have determined through field inspections and �A:r • . •:hyo,
review of Municipal records that the above systems are in *; , • /\ • *06
conformance with MOA COSA guidelines in effect on this date. ‘ 31 . �
��
Engineer's Printed Name Steven Pannone •:Steven �� I5annnne
Date 8/23/2017 0,-/-. CE-8149 /
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ASBUILT SEWARD & ASSOCIATES LAND SURVEYING 694-0829
I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCA"/1, 30 .� ��
FOLLOWING DESCRIBED PROPERTY: •'�' OF i11�'4§
4/%? r.�.s1.- . DATE-
AND THAT NO ENCROACHMENTS EXIST kD CEPT AS .ro k�...• v.7
s �
INDICATED_ IT IS THE RESPONSIBILITY OF THE /�� .ir'.•'4
OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: s
EASEMEN TS, COVENANTS, OR RESTRICTIONS /�G��.'-- .„ r _
WHICH DO NOT APPEAR ON THE RECORDED SUBDI— ---• 0. % a,,ne 6tk Sewar y �a
VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB' .„•. Ls-s O •
1 ANY DATA HEREON BE USED FOR CONSTRUCTION 3.r .t-1%:-.7,77. J• 5�4"
/./"Z-Z OF FENCE LINES, OR FOR ESTABLISHING BOUND- Di3AVYN, �''h,`t'•'":: =