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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)*