Loading...
HomeMy WebLinkAboutGLACIER VIEW HEIGHTS #4 BLK 2 LT 11 Municipality of Anchorage Page / of ~' 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: 5~ ~,~C) [I ~ PID Number: _~0 - ~0 N~: R~ ~ ~ so~ Wastewater System: ~New D Upgrade Address~4~ Ct'~l~ ~A ~,v¢¢ ABSORPTION FIELD Phone: ~o. of Bedroo~: D Deep Trench ~ Shallow Trench D Bed D Mound D Other Total Depth from original grade: LEGAL DESCRIPTION SoilRating: /. ~ GPD/Sq. Ft. ~' ? / Lot: ~ Block: ~ ~ (~/~Subdiv~i°n:'~/~/' ~ Depth ~o pipe bottom~,from~original grade: Ft. Gravel depth beneath~,pipe~ Ft. Township: Range: Section: Fill added above original g~: Gravel length: , Ft. CZ Ft. Number of lines: Distance belween lines: WELL: ~New O Upgrade Gravel width: ~ Ft. / ~ FL Classification (Private, A,B,C): Total Depth: Cased To: Total absorption ~ Pipe material: . Date Drille.: Static Water Level: Date installed~ Pump Set at: Casing Height Above Ground: Yield: %~> ¢~" ~k*oO¢~ .,. ~ ~,. TANK SEPARATION DISTANCES ~Septic C Holding ~ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines ~ %~_ I ~/ Material: S~/ Number of Compadments: % we,- /00~4' /OO+ -~ ~ 2b ~ S..ac~ LIFT STATION Water /0~ 1¢ ! [~ ~+ .... LineL°t / ~ ~ /~ /~ .... Size in gallons: Manufacturer: Foundatio~ /¢ ~. /~ ~ .... "Pump on" level at: ~~vel al: High water alarm at: CuAainDrain /D~ ~ ] ~ ~ _~ ~ ~ Pum~~ J ~ctri~l Inspections peHormed by: Remarks:~ ¢~.~ ~o~ q ~¢~¢~ '~ % ~ BENCH MARK Location and Description: ~ Assumed Elevation: · * , ~ I . ~ ZI : ""' ENGINEER'S SEAL Inspections pedormed by: E~ ~ ¢~~ Dates: 1st ~/zZ/¢~ ,.'.~-.;~..;.,.- 'a ~e 6E7116 Depadment of Health and Human Services approva~ "*~'"¢~"',,~/¢/¢~..'%-$~' '¢ "~'~'" Reviewed and approved by: ~~ ~' ~ Date: 1°'~'~ 72-013 (Rev. 9/91) MOA 25 AS-BUILT SYSTEM DETAILS/SITE PLAN Permit SW980117 GALCIER VIEW HTS~ S/lO, BLBCK 2, LET 11 PII)~i050-501-35 ~ ' FINISHED GRADE B-D=48,1' ~ : A-F=65,8' ~ ~ L TANK Xx SEWER RBCK ~.~. PREPaRE~ FBR', ~' ~ ~ I. RBBERT BENSBN ~J49 TH~ '~. ~ i8646 O,TATIBN ~ .~A / / .~~ S ...... "' LANG C.ECXEmKMD 30441 PTARMIGAN BLVD. '[ ~ /~/~. ~ ~u~,,,: o,,[: ---- i EAGLE RIVER, AlE 99577-8736 ~ ~ [~O~ssS~0¢~¢ ~ LANC 9/~Z/98 ' ac*~nu:97105.DWG aG, aG: 97105 {90?)696-6111/FAX {907)696-8111 !._~CII'~[ ID ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 SOILS LOG- PERCOLATION TEST 2- 3- 4- 5- 6- 7- 8- 9- 10- 11- 12- 13- 14- 16- 17- 18- 1% 20- SEE ATTACHED SITE PLAN FOR HOLE LOCATION Was Ground water encountered? ,A-'/D What depth?.~v/,,~ Depth to water after monitoring:? [)ate 55,0. bk. Reading Date Gross Net Depth to Net Time Time Water Drop I'ercolatior~ P, ato Test P, un 13et,.veen (rain/in) Perc klole Diameter __ feel and feet [, Kenneth M. Duff us, certify that this test was performed in accordance with all Slate and Municipal guidelines in e[fect on this date: 09/20/1998 12:09 6963249 L & B INC IJLLIV I WATER V,/ELL OWNER OF LAND LEGAL DESCRIPTION PERMIT NUMBER TAX INDENTIFICATION Is well located at Method of Drilling: Depth of wll; C:.aalng Type r31ameter Liner Type: Ca,~ing Stlckup Above Gr Stath= Water Level (from Pumping level; feet Recover Rate: Method of Testing: Well Intake O! [] Screened; Star~ ~ Perforations Start Pump Intake Depth: Pum Well Disinfected Method of Disinfection: Comments: BOX 670372, CHUOIAK, ALASKA eCSC?, TELEPHONE 066-2769 ~ aJ BORE HOLE DATA /,~ DEPTH Date of Issue ~ = j 3~- ~P armit location? ~"~es [~ No [~"~ry [~ cable tool ,11 Thickness ~ches, depth_.~ { PAGE 02 Jnd level): hrs. pumping gpm End ~ Open Hole Stopped foot Stopped feet o /¢"O z~ feet Brand Name lotion? ~s (~ No .feet ATTENTION: It I~ the of Anohorage: Departme Department of Drlller'~ Name /~'/,.4~ ~"'"~"'"'~' ~Olbility of tho property owner to submit a copy of tho well log to the proper euthority. Municipality & Human 8ervices and/or Depmtment of Environmental Conservation, MatSu Ben)ugh: MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box '196650, Anchorage, AK 995'19-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM /WATER SUPPLY PERMIT Initial Permit Number: SW9801t7 Design Engineer: 0070 KND ENGINEERING Owner Name: Robert Benson Owner Address: 18646 Ciation Drive Eagle River, AK 99577- Date Issued: May 15, 1998 Expiration Date: May 15, 1999 Parcel ID: 050-501-35 Legal Description: GLACIER VIEW HEIGHTS #4 BLK 2 LT ['~ Site Address: Lot Size: 45151 SQ. FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: ~] Disposal Field L~ Septic Tank l~ Privy i¢~ Private Well Holding Tank Water Storage 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 (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. 5. The following special provisions. K~D ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 May 7,1998 RECEIVED Municipality of Anchorage Dept. of Health & Human Services On-Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 MAY 8 1998 Munioipality of Anchor~age Dept. Health & 14uman Services Subject: Modify Well Site - Glacier View Hts S/D, Block 2, Lot 11 Gentlemen: The owner has requested that we relocate the well in order to provide a shorter distance for the service line to the house. We have therefore enclosed a revised drawing relocating the well west of the proposed house. There are no septic systems within 200' of the proposed well except as noted. We do not expect that there will be any adverse effect on adjacent lots by the development of the well in this location. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, i~l~}¥J D Engineering uffus, P.E. attachments: Wastewater Absorption System Details/Site Plan WELL a WASTEWATER DISPE]SaL SYSTEM DEYAILS/SITE PLAN 6ALCIF'R VIEW HTS, S/D, BLOCK 2, LOT 11 VACANT / ~.ss~ ~ ~ NU PUBLIC WELLS WITHIN 200' OF PRDPOSED SYSTEM, ND PRIVATE WELLS WITHIN 200' DF PRDPDSEB SYSTEM EXCEPT AS NDTED. ND SEPTIC SYSTEMS WITHIN 200' DF PRDPDSED WELL EXCEPT AS NOTED. MEA STATION VACANT DESIGN DETAILS 4 BDRM X 150 GPD = 600 GPD 600 GPD/1.P GPD PER SQ. FT. (1.6 MIN/IN.)= 500 SO. FT (500/(6.5'(D) X 2) (6.5' GRAVEL) = 38.5 FT. TRENCH USE 38.5'(L) X 6.5'(D) X 2'(¥1) TRENCH To~c~[ depSh oF sys~cem Is 9.0' From original or,de. To,at depth oF 9m~vet Ioetow dls~ribu~ion pipe is 6.5' . NBTES: 1. USE 1250 GALLDN SEPTIC TANK. INSULATE TANK IF <4' CBVER. 2. INSULATE TRENCHES WITH ~' HD BURIAL FBAM.. 3. [SUN I RA~ I UN WILL LNSUNL MAXIMUM ~/. bLU~'L lin I U 4, ADDITIONAL FILL WILL BE ADDED OVER SYSTEM TO ACHIEVE HIN, 3' COVER IF REQUIRED. PREPARED FBR: ROBERT BENSBN 18646 CITATION DR, EAGLE RIVER, AK 99577 SC~R: 1#= 100' F IEt_D BOOKS co~Pu~o: ~ouN~Y oR~: KMI) S~AX'BC: CHBEKED: KMD ~0441 PTARMIGAN BLVD. *s~,~ o*~: rev 5~/?. I~AQLE RIVLR, AK 99577-8736 ~¥'~- ~' ~: ~: SW0159 ,c*,, ,.,u:: 97105. DWG ao,, ~.: 97105 (go?1696-611t/F~ (907~696-8111 ~ND ENGINEERING 20441 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 (907)696-6111/FAX (907)696-8111 April 29, 1998 Municipality of Anchorage Dept. of Health & Human Services On-Site Services Section P. O. Box 196650 Anchorage, Alaska 99519-6650 Subject: New sewer/well permit - Glacier View Hts S/D, Block 2, Lot 11 Gentlemen: On October 23, 1997, we excavated two testholes for the subject property. The results of these tests and water monitoring are attached. We propose to install a 2' wide deep trench. We encountered water in testhole #2 during excavation and after monitoring at approximately 10' below ground level. Testhole #1 was dry during excavation and after monitoring. Due to the elevation differences in the testholes we do not anticipate water in testhole #1. Additional fill will be placed over the system to provide a minimum of 3' of cover when complete. This lot drains from north to south approximately 10-15% which is away from the proposed house and any surrounding wells. We propose to drill the well east of the house and septic area. There are no public or private wells within 100' of our proposed system location. There is neither surface water within 100' nor any known curtain drains within 50'. We do not expect that there will be any adverse effect on adjacent lots by the development of this system. If you have any questions, please contact me at 696-6111/FAX 696-8111. Respectfully submitted, ~(71~ L~ Engineering attachments: On-Site Well and Sewer Application Wastewater Absorption System Details/Site Plan Soils Log/Percolation Test WELL D WASTEWA1-ER GALCIER VACANT /"~,~. il ND PUBLIC WELLS WITHIN EO0' DF PROPDSED SYSTEN, NO PRIVATE WELLS WITHIN Ego' OF PRDPOSE~ SYSTEH EXCEPT AS NOTED, ND SEPTIC SYSTEHS WITHIN EO0' OF PROPOSE~ ~ELL EXCEPT AS NBTE~, 3ISPBSAL SYSTEH DETAILS/SITE VIEW HTS, S/D, BLOCK 2, LOT 11 WELL PLAK OPOSED VACANT NEA STATION DESIGN DETAILS 4 BDRW X 150 GPD = 600 GPD 600 GPD/1,8 GPD PER SQ, FT. (1,6 WIN/IN,)= 500 SQ, FT (500/(6,5'(3) X 8) (6,5' GRAVEL) = 38.5 FT, TRENCH USE 38,5'(L) X 6.5'(3) X a'(W) TRENCH Tote[ depth o? sys~cem is 9,0' ?rom original 9rede, To~a~ dep~ch oF gp~vet below distplbu~lon plpe Is 6,5' , NFITES~ 1, USE 1~50 GALLON SEPTIC TANK, INSULATE TANK IF <4' CI]VER, INSULATE TRENCHES ~/ITH a' HD BURIAL FI]AM,, 3. CONTRACTOR WILL ENSURE WAXlNUW aZ SLI]PE INTO SEPTIC TANK, 4. ADDITIONAL FILL ~/ILL DE ADDED OVER SYSTEN TB ACHIEVE WIN, 3' COVER IF REQUIRED, PREPARE]} FOR: RODERT 3ENSON 1B646 CITATION DR, EAGLE RIVER, AK 99577 FIEI D []OOKS COMpU]FD: DOUNO^R¥:_ DaAV, N: KMD .SLAKING: __. CtlECKEO: KMD ow~. aLE: ~mo: SW0159 Ac~o nm 97105.[)WG oou ~o.: 97105 ScctLe: 1"= 100' lNID LN(,INIi ERIN(, 2~04.41 PTARMIGAN BLVD. EAGLE RIVER, AK 99577-8736 /907/696-Gni/FAX /§07/696-8111 PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DEPTH ' 5 8 9 10 11 12 13 14 17 18 19 2O DATE PERFORMED: Township, Range, Section: ~ ¢/ SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT /~/ L DEPTH? /r · pO E Oepth to Water Alle~)/..~ /~ Monitoring? Date: /D/~O ~ Reading Date Gross Net Depth to Net Time Time Water Drop ~ .~: 1 ~, ~ ~ ,'~ ~ ~" / FZ~" PERCOLATION RATE // ~ ~mmutesnnch) PERC HOLE DIAMETER ~ // TEST RUN BETWEEN ~ FTAND 7 __F~ PERFORMED BY ~4J~'//)~,.YD/"~l.~ic',~.c'"z~4.¢.":'¢ I ,'¢'~/2-"~t¢//-.~/~ CERTIFY I'HAT THIS TEST WAS PERFORMED - . // ~" 72-008 (Rev 4/85) Municipality o! Anchorage DEPARTMENT OF HEALTH & FIUMAN SERVICES 825 "L" Streel, Anchorage, Alaska 99502 0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: '~) ~) '~ ~(:;;'~") LEGAL D E SC R ' PTION: ~-c/;¢zY DEPTH 4 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20- SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED?[¢¢~'~ IF YES, AT WHAT DEPTH? s /O' p E Depth Io Waler ADer Monitoring7 PERGOLA lION RA~E ~'~4~, ~? 7 tm,nutesnnchl PERG HOLE DIAMETER / (Rev 4/851 Gross Net Depth to Net Reading Date Time Time Water Drop ¢' ~ :2o ~,'n,~ ~ >:~" *//~ " MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES 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 1. GENERAL INFORMATION Complete legal description Location (site address or directions) Property owner Mailing address Lending agency Day phone Mailing address Agent Day phone Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 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: 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 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 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 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. KND Engineering Name of Firm 2~1 Pta~'migan ~lva, Phone /¢ ¢~' -~/// Add ress Eagle r~iver, AK 99577-8726 Engineer's signature /'~/~ - -~' :~-~ Date DHHS SIGNATURE P/" Approved for -7"/'/'/~E~ bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additiona~ Comments 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 DH HS 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. 724Y25 (Rev, 1/91) Back MOA ~ - Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICE,~u I~IICIPALI Environmental Se~ices Division ',"'mONMENTAL SERVICES 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist Legal Description: ~,oJr It ~/[/-, ~. C~/O4' l'e~' ~,~-~ ~ Parcel I.D.: A. WELL DATA Well type Log present (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed. Cased to ~/--~' / t Total depth ~'Zl Sanitary seal (Y/N) ~ FROM WELL LOG Date of test Static water level Well production Casing height (above ground) Wires properly protected (Y/N) _ ~' AT INSPECTION / g.p.m. / g.p.m. WATER SAMPLE RESULTS: Coliform Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed (~/~2- ~.~ ,//~Tank size / / Foundation cteanout (Y/N) _ Date of Pumping Nitrate Other bacteria /pO 0.~_ N umber °f O'°.?Pa..-4~'~'""--~-"¢- -- Clean°uts (Y/N) ' Depression (Y/N)~/~__Hg-/~g~'water alarm (Y/N) Pumper ~ - C. ABSORPTION FIELD DATA Date installed ~,/£Z'~/~ Soil rating (g.p.dJfForft~/bdrm) /' ~-- System type_.¢'/¢¢///0~ -/d"~ Length -7/,- Width _ 2.~ Gravel thickness below pipe 7 _Total depth /;.~, / -_ Effective absorptio--ln~rrea-~,'f Monitoring Tube Present (Y/N) Y Depression over field (Y/N) /~' .. Date of adequacy test_ /// Results(Pass/Fail)_//// For_ / bedrooms Fluid depth in ab-sor~ before test (in.); __ I~tely after, gal. water~d (in.): _ Fluid depth /,/ (ins) Minutes later:/'/ Absorption rate =// g.p.d. Peroxide treatment (past 12 months) (Y/N) ,// If yes, give d~e/ 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested Size in gallons / "Pump on" level at* /"Pump off" level at* *Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot / © C) ~ -P Absorption field on lot I~O ~+ Public sewer main ,,/0- ~1 ~ Sewer/septic service line ~-~ ~'~' On adjacent lots /'~)~ ~L On adjacent lots JOE) ''~ Public sewer manhole/cleanout ,/~O SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation //~)/4- Property line /~ '-~ Absorption field /~ Water main/service line ,~. ~5 --/- Surface water/drainage //D~ t~ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line / E) -k Surface water /(~(2 t''k Curtain drain / D D ~-~ Building foundation /~) ~ Water main/service line Driveway, parking/vehicle storage area Wells on adjacent lots /~ O ~4~ F. ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review in conformance with MOA HAA guidelines in effect on this date, Signature ,~-~~. _/~~ Engineer's Name Date ,/ Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)*