HomeMy WebLinkAboutGLACIER VIEW HEIGHTS #4 BLK 3 LT 2
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: SWq~ooz-I PIDNumber:
%me'~'r-/Z/C/,~.,, ,4~. /~¢a,~-~ Wastewater System: [] New [] Upgrade
"~ddress: ABSORPTION FIELD
~he~e~ No. of Bedrooms:
~/~O~ .I O~ ~ ~ Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other_
LEGAL DESCRIPTION soi, Rating: Total Depth from original grad~:
~, ~ GPD/Sq. Ft.
Lot: Block: , ~ Subdiv~ion: ~ Depth lo pipe boltom from original grade: Gravel depth beneath pipe
-I Section:
Township: ~ Range: Fill added above original grade: Gravel length:
WELL:~ New ~ Upgrade Grave~ width: Number of lines: Dista.ce between lines:
G Ft. / ~/~ Ft,
~lassiflcation (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: ~¢/~
_ ~lV~ /0( Ft. /6/ Ft. '~SQ. Ft. ~5~ /~203~ ~ V,C. --
Driller: Date Drilled: Static Water Level: Installer: Date installed:
Yield: Pump Set at: Casing Height Above Ground:!
/~ GPM Vk~~t, z .t. TANK _
SEPARATION DISTANCES ~Septio U Holding ~ S.T.E.P.
To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons:
From Tank Field Station Tank Sewer Lines ~C~ ~J ~
WelV //~ / it~t ~ Material: Number of Compartments:
su,~o~ '+ '+ LIFT STATION
Water / ¢ ~
~~ Manufacturer:
Lot
Line /O /O '+ ~ "~' ump on"/~level at: "Pump~
Foundation / ~ / / ~ / ... o~~~terl Hioh wa
alarm
at:
Curlain Pump Make & Model I Electrical Inspections pedormed by:
Drain ~0~¢ ~0~ ,
Remarks: BENCH MARK
Location ~nd Description:
FO O~P~T/om~ --
Assumed Elevation:
/oo .~ Fl,
ENGI~EE~ SEAL
17034 Eagle River ~,.;c,p , .,,..,
Inspections performed by: Eagle RIver, Alaska 995~7 Dates: 1st ~ -z
~ ~~ces a~al
Department of He__~~um~~ ~
Reviewed and approved b~~~ Da~~
Permit No.S'W940°21
2 2
Page of
Municipality of Anchorage
DEPAR'rMENT 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
GLACIER VIEW HEIGHTS SUBDIVISION //4,
05050126
Legal Description: BLOCK 3, LOT 2 PID No.:
~0) 98.~' ~2 FINAL GRADE ~
............................... ~......~F,~ .......... ~ ................... ~ ................ ..~ ........
9~.9~ ~ ~50 GA~ ~947,
N.T.S.
MT~ 91.0'~/
¢/~- 97.5'
94.0' C04
· 83.0' WATDI{ FOUND 1-17-94
A B
FCO g.0 10.0
CO1 11.0 16.5
C02 19.0 23.0
CO~
C04 89.0 89.0
MTi 23.5 34.0
MT2 89.5 88.5
HOUSE/ N
i0F LOWEST SECTION
OF [~OU NDAT~ON
1250 GAL.
SEPTIC TANK
BL
CO
SCALE l" = 40'
TR[ NCH
EN6 SEAL
72-013 A (1/93)
· rtifiei rill ng
b)
DOC Co.
SULLIVAN WATER WELLS
P.O. BOX 670272, CHUGIAK, ALASKA 99567 · TELEPHONE 688.2759
OWNER OF LAND
r~L ~ESCm~ON
DATE-Started Ended
PERMIT NUMBER
KIND OF FORMATION:
From~ Ft. to a~ Ft. (~'t44''t'~1~ '~r"~"ff~'~d~ From Ft, to
From~ Ft. toq , Ft. ~ 0~ ~Oe~ From~Ft. to~
From ~ Ft. to~ Et ~/(.~ f~/~ ~' ~O~ From~_Ft. to~__
From_~ ~ Ft.
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From___Ft. to Ft.
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From_ Ft. to Ft.
From ,,Ft. to Ft.
From Ft. to Ft.
From Ft. to. Ft
From_ Ft. to Ft __
From .Ft. to Ft.
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to 7~ Ft.
,o q,5 Ft.
to / ~a'~',Ft.
From
From _
From
From
From
From
__Ft.
Ft.
Ft.
Fi
Ft
Ft.
Fl.
Ft.
__Fl,
Ft.
Ft. to Fl
_Ft. to Ft,
_ _Ft. to___Ft,
F' '0 ~'t': r L' I V ED
....
__Ft. to____Ft.
Ft. to FdUL .2 5 1994
Ft to M uqJf2~y_ot
Anchorage
' ' -q-v~-~;~'~gTvF;~-Human Serviuus'
Mil,mC L. INFORMATION:
PAGE 1 OF
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW940021
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:MORGAN PATRICIA M
OWNER ADDRESS:38470 GRIGGS88
LEBANON, OREGON 97355
DATE ISSUED: 2/04/94
EXPIRATION DATE: 2/04/95
PARCEL ID:05050126
LEGAL DESCRIPTION: GLACIER VIEW HEIGHTS #4 BLK
3 LT 2
LOT SIZE: 44952 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL 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 (iSAAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS
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.
SPECIAL PROVISIONS:
RECEIVED BY: · " ~>--
ROBERT SHAFER1 P.E.
ROGER SHAFER, P.E.
January 28, 1994
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SiTE PLANS
ROAD DESIGN
SOIL TEST
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 'L' Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
REFERENCE: Lot 2; Block 3; Glacier View Heights Subdivision
Request you issue a permit to drill a well and install a septic system
to serve l'~heproposed four[~oo~houseon'bhe referenced pro~y.
Test holes were excavated and percolation tests performed. The
approximate location of the test holes are located on the attached site
plan. At the time of excavation water was encountered in test hole #1
at 13 feet and in test hole 92 at 13 feet. After seven day ground
water monitoring water was found at 13 feet and 14 feet, respectively.
This property has enough area for a future septic upgrade which can be
seen on the attached site plan. We do not anticipate any adverse
effects on neighboring properties by the installation of the proposed
septic system.
If you have any questions, or require additional information for your
review, please contact us.
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
A. Shafer, P.E.
./LSU/jk
Ref: MOASINGLET
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577
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ON-SITE WAST~ATER DISPOSAL
CONb~IRRUCT ION PRACTICES
MATERIAL SPFX]IFICATIONS
~CZ: Lot 2; Block 3; Glacier View Heights Subdivision
1. The scope of this project includes the installation of a 1250 gallon
septic tank and five foot wide drainfields to serve the proposed four
bedroom residence for the referenced property.
2. Construction shall be in accordance with the approved site plan and
design drawings, Municipal permit with with any special provisions or
conditions, and all applicable State and Municipal Wastewater Disposal
Regulations.
3. The contractor shall be responsible for obtaining any necessary
underground utility locates.
4. 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.
5. 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.
SEP~ICTANK INSTALLATION:
1. A septic tank is to be constructed by a certified septic tank
manufacturer. Construction shall include two 4" cleanouts for pumping
access.
2. The septic tank shall be sufficiently bedded to prevent settling or
shifting of the tank.
3. All standpipes on the septic tank shall extend a minimum of 12 inches
above final grade.
4. Septic tanks installed with less than 4' of cover shall be insulated.
Page Two
Lot 2; Block 3: Glacier View Heights Subdivision
January 28, 1994
5. 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' 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.
6. Final grading over the septic tank shall be such that a positive slope
exists away from the septic tank.
ABSORPTION TRENC]]/DRAINFIELD INSTALLATION:
1. 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.
2. 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.
3. 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.
4. Monitor tubes shall be of four (4) inch diameter and installed
approximately in the locations shown on the design. 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.
5. 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 SPMC]i~ICATIONS:
1. Any septic tank proposed for installation must be constructed by a
Municipally approved septic tank manufacturer.
2. The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
Page Three
Lot 2; Block 3; Glacier View Heights Subdivision
January 28, 1994
T~pe of Pipe Perforated
Solid
Cast Iron Yes Yes
ASTM D3034 (PVC) Yes Yes
ASTM F810 (HDPE) Yes No
ASTM D2662 (ABS) Yes Yes
Use of a type of pipe other than listed above must be ~pproved 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, Fernco, or equal).
A permeable nontoxic silt barrier (Typar 3401, Mirafi 140/N, or equal)
must be installed between the final leachfield gravel layer and the
native soil backfill.
Ail 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.
2o
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.
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
Page Four
Lot 2~ Block 3: Glacier View Heights Subdivision
January 28, 1994
meeting will take place on-site. The inspecting engineer will not coordinate,
direct or control in any way the contractor's 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
contractor's activities. Final acceptance of the contractor's 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
Municipality of Anchorage
DEPARTMENT (DF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
ENGINEER'S SEAL) '
'
LEGAL DESCRIPTION: ('~L/:I~,~J% dlEY~//~.. ~2., ~?('?,) Township, Range, Section:
/ SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
I F YES, AT WHAT ~?~:~[/"'~
DEPTH? ~ [3'
1
2
3
4
5
6
7
8
9
10
11
12
13-
14
15
16
17
18
19
2O
OepthtoWaterAilermonilorin9? /,'~ f Date: ~'"(l~.~
Gross Net Depth to Net
Reading Date Time Time Water Drop
.51/o -- 5 ,/.~ ,, -
!ad to~,¢ 6%"
COMMENTS ~ - --
S & S ENGINEERING ,.'"" //
,/u,se ~agm myer t. oop aoac~ No,204 r,~'--~
PERFORMED BY' I=adle Iilv,r Al~lr3 ~77 ,,/-""- /1~ .¢-' ' CERTIFY TNA~ THIS TEST WA8 PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL 6UI~ELI~¢~E~T ON THIS DATE. DATE:
72-008 JRev. 4/85)
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5
6
7
8
9
10
11
12
13
14-
15
16
17,
18
( E.,N..-GI NB E P~'~ SEAL)
DATE PERFORMED':
(.Jll.~.a ~T5/ /_.~2, ~_.~) Township, Range, Section:
SLOPE
WAS GROUND WATER
ENCOUNTERED?
IF YES, ATWHAT
DEPTH?
Deplh to Waler Aft~r I
Reading
19
SITE PLAN
Date
Gross
Time
~ .
Net
Time
lO II
Depth to
Water
6 %1"
""¢ t/B
Drop
PERCOLATION RATE ~ ~m d'u9 inch) PERC HOLE DIAME ER _ _
'TEST RUN BETWEEN
COMMENTS //
PERFORMED BY: ~Je ~iveF. Alack. ~q~7~ i ~' ~ ~ .... OERTIFY THAT TEllS TEST WAS PER ORMED
/1~/
I I :~-,THI DA~E DATE
ACCORDANCE WI~H ALL S~ATE AND MUNICIPAL GU DELNE¢ '~F~T
/
72-008 (Rev. 4/85)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVICES.
Division of Environmental Services
On-Site Services Section
P.O. Box196650 Anchorage,'Alaska 99519-6650
· 343-4744
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. #
1. GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner'
Mailing address
Mile 4.5 Eagle Rivet Rd.
Ea~le Glacier Loop & Columbia Gla~i~r Loop
EAGLE VENTURES Day phone 696-5534
P.O. Box 771822 Eaqle River, AK 99577
Lending agency
Mailing address
Day phone
Agent
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 4
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
XXX
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
, ~',~' .:.. '. ; ~,, '
,' /~ ',. .~..
Community on-site - ·
. , ., ,/~ .~ .. ~,~. <-. ., ,
Public sewer .... . ...... ?, ,,, ,,,,- t ,,..-~,~.:. .... -..
NOTE: If community, wastewater system, provide written confirmation from Sta~e. ADEc
attesting to the legality and status of system.
72-025 {Rev, 1/91) Front MOA#21
4. TYPE OF WASI'EWATER DISPOSAL:
Individual on-site XXX
· ." · ' Holding~a'nk .,-- '. ~, ' : ' -
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 Muhicipality 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 a.nd,regu,lations,., in effect ¢ his i~spection.,.,.. :, , .. :~ -
S & S ENGINEERING
Name of Firm
Address
Engineer's signature
DHHS SIGNATURE
? Approved for ¢
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:..',: ·
Additional Comments
"- The Municipality of,~(~horage 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 DHHS 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...!:,~ : ,,:: i., : ':: ' ; '
72-025(Rev. 1/91) Back MOAtY'Zl ' : . ,':: '' '
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description' ----c,¢'Z-- Parcel I.D.
·
A. Well Data
Well type
Log present ~N)
Total depth / o / /
Sanitary seal ({~) /
If A, B, or C, attach ADEC letter. ADEC water system number
Date of test
Static water level -~/--¢ J
Well flow / '~"-
FROM WELL LOG
Pump level1 UJ IZ_
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot / / ~ ~
Absorption field on lot / ~ ~ ~
Public sewer main
Sewer service line '~,~- ~ ~
Date completed Driller
Cased to ~O /~ Casing height
Wires properly protected ~N) /
AT INSPECTION
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank
WATER SAMPLE RESULTS:
Coliform ~
Date of sample:
Nitrate
Collected by:
Other bacteria
El. SEPTIC/HOLDING TANK DATA
Date installed ~ - & ~ ?/¢¢
Cleanouts (~N) ¢
High water alarm (Y/.~
Date of pumping
Tank size / 2--~ Compartments
Foundation cleanout {~N) / Depressiop (Y~
/d' Alarm tested (Y/N) "[//~-
/'//,4- Pumper Z.~: ~;_s ~--,~/.,~--~ ( ///~,
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot / I ~ ~ On adjacent lots
To property line /O Absorption field
Surface water/drainage / O 0 / 4-
Foundation /0 ~
Water main/service line
72-026 (3/93)' Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed Manufacturer
Size in gallons Manhole/Access (Y/N)
Vent (Y/N) "Pump on" level at "Puj.r~:~-e~vel at
High water alarm level ~~
Meets MOA electrical codes (Y/N)
SEPARATION DIS%~SE'F~ROM UFT STATION TO:
~ lot On adjacent lots Surface water
D, ABSORPTION FIELD DATA
Date installed
Length ~ /
Total absorption area
Date of adequacy test
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y~
Soil rating (GPD/FF) z~,
Width ~" / Gravel thickness
75~B /¢ Cleanout present ~'4) ~¢/
~_.¢I- ~/''/E~,--/ Results~/fail) f¢',4¢ 5'
System type ~,'/,¢¢~--~
3 · Total depth
Depression over field (Y/.._~
for '/7/ Bedrooms
After test
If yes, give date
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot / / ~ ! On adjacent lots
To building foundation /~ ~
On adjacent lots -~ ~' / ~- Cutbank
Surface water /O o f w-
Curtain drain 'U/,,~
Propertyline
To existing or abandoned system on lot
/
Water main/service line
Driveway, parking/vehicle storage area
E. ENGINEER'S CERTIFICATION
Signature ~ ?&~ r~Sa~N,G. I~ ~ :E..~ .'. ,N _/_/_/~ 2~
HAA Fee $ k._~' O0' '~¢-
Date of Payment ~' ~ "~ ~ ), ~.
Receipt Number ~.L.,_2-~ ~.~ ~--k..~7
72-026 (3/93)' Back
Waiver Fee $
Date of Payment
Receipt Number