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HomeMy WebLinkAboutALPINE WOODS BLK 3 LT 3 ,I 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: ~k\ .x ~o~ ~...,,,.Z.,~_.~,.~ RID Number: ((-) ~/~- .L~ ~ Name: ~~ b"~ Wastewater System: ~New ~ Upgrade Address: /~/ W, '/J~ ~ ABSORPTION FIELD Phone~. ~ ~/~ ~No. of Bedrooms:~ ~ Deep Trench ~ShallowTrench ~Bed ~Mound ~Other Total Depth from original grade:~ LEGAL DESCRIPTION Sol, Rating: O-~ GPD/Sq. Ft. Lot: ~ Block: ~ Subd~vi~io~:~/~ ~ Depth to pipe bottom from ori~ ~rade: Ft. Gravel depth beneath pipe_, ~Ft. ~°wn'h'P: /~N I 3w Isection: ~ Fill added aDove original grade:o__ / Ft. Gravellength: ~ Ft. Number of lines: ~ Distance between fines: WELL: D New ~ Upgrade Gravel width: ~ Ft. I -- Ft. Classification (Private, A,B,C):~ ~1'~ TotalDepth: Ft. CasedTo: Ft. Total absorption area~o SQ. Ft. Pipe material: Driller: I Date Drilled: Static Water Level:Ft. InstallerS. ~0'~ ~C ~ Date installed: Yield: GPM IPump set at: Ft, Icasing Height AbOve GrOund:Ft. TANK SEPARATION DISTANCES ~eptic ~ Holding ~ S.T.E.P. TO Semic Absorption Lift Ho,drag PubUc/Private Manufacture~ ~ ~ Capacity ingallons: From Tank Fiet~ Station Tank Sewer Lines , Surface wat,r N~ E~ ~ ~ ~ LIFT STATION G?, /O Foundation /~/ ~/ ~ ~ ~ "Pump °n" level at: ~ "Pump off" 'evel at:_ I High wa~er alarm at: ur, ,n -- I Ora,n Remarks: BENCH MARK Location and Description: ~ ~ ~ ~)~  Assumed Elevation: Inspections performed by: ~~~ DateS: 1st ~/~~ 2nd '~ ~ ~ ~ ~. ~us~. Department of Health~Huma es approval ~'~b ... Reviewed and approved by at~o~~ ~"~:"~' ...... 72-013 (Rev. 9/91) MOA 25 -.~ Permit No. Page of Municipality of Anchorage 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 Legal Description: ~_o ~r '-5, I~/~ck 5 , A/(~in~, ~/oods £//D PIDNo.: _ 72-O13 A (2/91) MOA 25 ENGI NJ~F.~'S SEAL .-' ~ '. ~'...~,..~..... ;,,,.,~:~........ EARLE V. ".. CE- 1393 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 PERMIT PERMIT NUMBER:SW930332 DESIGN ENGINEER:POLARCONSULT OWNER NAME:DUFFY BRUCE JON OWNER ADDRESS:1001 WILDROSE COURT ANCHORAGE, AK 99516 DATE ISSUED: 8/26/93 EXPIRATION DATE: 8/26/94 PARCEL ID:01523425 LEGAL DESCRIPTION: ALPINE WOODS BLK 3 LT 3 LOT SIZE: 36628 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT~ 4 THIS PERMIT IS FOR THE CONTRUCTION 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 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: IT IS RECOMMENDED THAT THE DISTRIBUTION PIPE FOR THE BED BE PLACED AT THE MIDPOINT OF THE LATERALS (DUE TO THE 88 FT. RECEIVED BY: DATE: po'larconsult alaska, inc. ENGINEERS · SURVEYORS · ENERGY CONSULTANTS August 13, 1993 DHHS, Environmental Services, On-site Services P.O. Box 196650 Anchorage, Alaska 99519 Permit Review Officer Design and Construction Approval for On-site Sewer System at Lot 3, Block 3, Alpine Woods S/D. Dear Sir or Madam: Please accept the following design for review and permitting. The proposed system does not affect the current use of the adjacent properties and will have minimum furore impact. If you have any questions, please give me a call. David Ausman, CE POLARCONSULT Attachments: On-site Sewer/Well Permit Application Site Plan, Sheet 1 of 4 System Design Calculations, Section, Sheet 2 of 4 Percolation Test, Sheet 3 of 4 Percolation Test, Sheet 4 of 4 $200 Check for Permit Fee 1503 WEST 33RD AVENUE · SUITE 310 · ANCHORAGE, ALASKA 99503 PHONE (907) 258-2420 · TELEFAX (907) 258-2419 polarconsult alaska, inc. 1503 West 33rd Avenue · Suite 310 ANCHORAGE, ALASKA 99503 (907) 258-2420 Fax (907) 258-2419 SHEET NO. / DATE CHECKED BY SCALE / DATE I ~: CE - 1393 te~eee~eee PRODUCT 204.1 (Single Sl'~etsl 2~5-1 (Paddedl ~e I~c., Grokm, Mass. 01471. TO Older PHONE TOLL FREE 1-80(}-225~380 polarconsult alaska, inc. SHEET NO. ~- 1503 West 33rd Avenue · Suite 310 ANCHORAGE, ALASKA 99503 (907) 258-2420 Fax (907) 258-2419 CHECKED BY DATE SCALE PRODUCT 2~1-1 (Single Sheels) 2~6-1 (Padded)/"'~7® Inc., Groton, Mass. Gl 471 To Order PODNE TOLL FREE PERFORMED FOR: LEGAL DESCRIPTION: © 2 3 4 7 8 10 13 14 15 17 19 20 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST ,A'~2/'r~' ~V/~,).5'TownShip, Range, Section: SLOPE ENCOUNTERED? S / L IF YES, AT WHAT ~ O DEPTH? '' P E SITE PLAN Depth to Water Alter Monitoring? Date: Il il I I,~T~*I I I ~ IIii I I I I IZ-"J~l ,/~ Gross Net Depth to Net Reading Date Time Time Water Drop ?~o,4~' ~/~ o - o" _ , ,~/~ ~ ~,.~ ~ ,, ,~;,~_ ;: z '~/(, /o ~ ~,~ ~/~" PERCOLATION RATE 2.7 (m~nutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN q FT AND 5 FT COMMENTS PERFORMED BY: /J~/~J'"T'7''////~k''~ ~0~I~'~/~/Aj I ~ CERTIFY THAT tHIS TEST WAS PERFORMED IN 72-008 (Rev. 4/85) PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE" RFORMED: LEGAL DESCRIPTION: © 2 4 7 8 10 13 14 1§ ~9 2O COMMENTS Township, Range, Section: SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT /~j) OL DEPTH.7 p E Deptl~ to Water Alter/// ~//~,~ ! Monitoring? Date: Reading Date Gross Net Depth to Net Time Time Water Drop I 8/~ ~0 .~ 20 s~c t" /" z..- ~/~' 'fo .~c zo ~ 2" /" ~ ~/~ fO ~c zo ~ 3" I" PERCOLATION RATE O' 3 {m,nutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN q FTAND '-~ FT PERFORMED BY: .,~,'q'7"~"~l~'['v/ ~-01~.5['///I/ I CERTIFY THAT THIS TEST WAS PERFORMED IN 72-008 (Rev. 4/85i polarconsult alaska, inc. ENGINEERS · SURVEYORS · ENERGY CONSULTANTS August 9, 1994 BRUCE DUFFY 1001 Wildrose Court Anchorage, Alaska 99516 Re: Septic Redesign for Lot 3, Block 3, Alpine Woods S/D Dear Mr. Duffy, In accordance with our proposal, Polarconsult has completed the redesign of the on-site septic system at the above property. Attached are the revised site plan, design calculations, and system profile view to replace the current ones. The amended design is adequate for a three bedroom single-family residence. It is a conventional shallow trench system with a length of 88 feet, a width of 5 feet, a total depth of 8 feet below original surface, and a gravel thickness of 3.5 feet, which includes the 2" gravel layer over the distribution pipe. The system uses a double compartment 1000 gallon septic tank. There are a total of 7 cleanouts required (including tank cleanouts) and one monitoring tube. The total due for this work is $300, as agreed to on 8/5/94. Thank you for giving us the opportunity to be of service and if you have any questions, please give me a call. Sincerely, Matthew Korshin POL^RCONSULT Disclaimer: The attached onsite septic system design was developed in accordance with generally accepted engineering practices and current Municipality of Anchorage design requirements. Polarconsult offers no warranty, express or implied, of performance or longevity of the system and is not responsible for damages associated with its performance or longevity. 1503 WEST 33RD AVENUE · SUITE 310 · ANCHORAGE, ALASKA 99503 PHONE (907) 258-2420 · TELEFAX (907) 258-2419 (907) 258-2420 Fax (907) 258-2419 D^~E polarconsult alaska, inc. s,E~,o. / OF Z 1503 West 33rd Avenue o~ Suite 310 ~/~///~ . ANCHORAGE, ALASKA 99503 CALCULATEOBY /~'"' OATE CHECKED BY I"= 90' PROOUCT 204-1 (Stogie Shell 206-1 (~ed) ~® Cc., Gn~oa, Uas~ 01471, To O~del PHONE TOLL FREE I '600'22~3a6 polarconsult alaska, inc. 1503 West 33rd Avenue · Suite 3:10 ANCHORAGE, ALASKA 99503 (907) 258.2420 Fax (907) 258-2419 CHECKED BY DATE ............................................................... .......... : .............. ........... i .......... ..... . ....... ............ ~ ............. ~. ............. ~ ............ ~ ......... : ...... ...~ ........ ~.~.; .......... .~....?.~ ~ ~ _ ~ ......................... ~ ........... ~...~.........,) ....... ~ ................ :.~......:_~..~ ........ ...... ,,,,.,,:. ........................... ~ ............................................................ .. . ~ ~ ~ ~~ ~ ................ : ....................... ,.~ ........ ~.,,~,,~ ,~...-~ ..... ............... ............. ~ ........... L...L~ .... ~ ~...~:...o~o..~..... ~. ~..~.~......~..~ .............. 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' ~"'t~' · ' ~e"~l~' ~t~ ~ed'so~ ..... b~.b~i~...]~ ~g.co~on ~e so~.~..~d.. or:not be able to be cons~cmd at ~I. ~e.loc~ons of~e soi~ ~,:monim~g we~; · " b~ed"o~"~e ~s~ed lOcationS of'~e 10t l~ ~h'm~Y'~' s~Je~t'to st~c~t ~r. ~ ~h, we r~ommend ~at mese ~o~ons ~L~e~fied by.a ~g~e~d. l~d~s~eyor pfior..~, s~e. ~..~-sY~..c~s~on--P°l~°n~lt'wi~''n°t''b~-'~p°mible''f°r d~ages ~soci~t~ wi~'e~o~ red,ting to ~e loca~n ~s~p~om. PR(XX,lCT 204-1 (9,r4# ~,m~l) 2Q~-1 (Piddld) ['~e lc- G~lod~ u~" 01471, TO Ofd~* PHOHE TOU- FREE 14Q0'225'43~0 MUNICIPAU'P~. Ok' ANCHORAGE DEPARTMENT OF HEALTH & HUMAN, SERVICES Division of Environmental Services ............... ~. :*On-Site. Services. Section' P.O. Box 196650 Anchorage;Alaska,--99519-6650 -- '- = 343-4744_ ........ :. ............ CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # (%~-3- ~o~ _,~, 1. GENERAL INFORMATION ' Co~nplete le;g*ai-description ~ ',::.' Location (site address or directions) /V/oo _ .... '-Day phone 3.:- ~PE OF WATER SUPPLY: - Individual well Community well ~., . .~..c~..:.,'. ' ::~ '~ NOTE"::lf communi~ WasteWaterS~tem,. prOvide wri~en 'confirmation from State ADEC a~esting ~o t~e legali~ and sfatus of s~stem. ~ ' 72-025 (Rev. 1/91) Front MOA #21 STATEMENT 0F.. INSPECTION BY ENGINEER AS certified bymy'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. Name of Firm 90 i~r'~G'[3L Phone ...... Comments The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority: :::'.: Approval' C~...r~ificates based .only upOn the representations given" in 'p-a~g~aph i'5 'ab0~e by. 'an i. ndependent ,:i ? professional engineer registered in the State of.A!as..ka.~ The DHHS does this as a COUrt _esY t.o purchasers of homes?:~ and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not'?: co.nduct inSpect, ionsor;analyze data before a certificate is issued. The Municipality of. Anchorage: is not~ responsible for errors or omissions in the professional engineer's work. ~ - 72-025 (Rev. 1/91) Back MOA~¢21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Z 3, ~ 5, ,~/I°i'r~ ~'v/c~Js' $/~ Parcel I.D. A. Well Data Well type ~,~ Log present (~) Total depth Sanitary seal (Y/N) Date of test If A, B, or C, attach ADEC letter. ADEC water system number Date completed Driller Cased to Casing height WELL LOG Static water level ~ Well flow ~ Pump level1 "~ SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line WATER SAMPLE RESULTS: Coliform Nitrate Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed ~/7..~/~ ~/ Cleanouts (Y/N) 'Y High water alarm (Y/N) '"'- Wires properly protected (Y/N) AT INSPECTION g.p.m, g.p.ml-l-I ; On adiacent lots : O °ent lots _ Public sewe~x~,n hole/cleanout Petroleum tank'x, ~__ ~'~h ~acteria Collected by: Tank size //) 00~ ~ l_ Compartments Foundation cleanout (Y/N) ¥ Depression (Y/N) Alarm tested (Y/N) Date of pumping '-- Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot +,2-0CO /~"7/-- On adjacent lots ''~ ~-OO I~L- To property line 6 '~' f::~'/- Absorption field ,~-0 /'~7L- Surface water/drainage /L/~-~ ~,~., Foundation //C,') f:::::-J-' Water main/service line /1//~1~/w/~ ~-/~ 72-026 (3/93). Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed /yO'r~ Size in gallons Vent (Y/N) ~ "Pump on" level at -- High water alarm level -- Meets MOA electrical codes (Y/N) '" SEPARATION DISTANCE FROM LIFT STATION TO: Manufacturer Manhole/Access (Y/N) "Pump off" Level at .Cycles tested - Well on lot ~ On adjacent lots Surface water - D. ABSORPTION FIELD DATA Date installed ~/~//~ ~Z' Soil rating (GPD/FF) Length ~) ~'- Width ~'-~ F'~- Total absorption area 7~Z~L~ ~./L. z Cleanout present (Y/N) Date of adequacy test 4/o7~ ~¢~ir¢o/ Results(pass/fail) Water level in absorption field before test ~ Peroxide treatment (past 12 months) (Y/N) /V Gravel thickness ¥ ~--~- Total depth ~¢- 7 ~g-TL' Depression over field (Y/N) ~ for - Bedrooms After test -" If yes, give date -" SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation 33 i'~"~. On adjacent lots Sudace water Curtain drain On adjacent lots Property line To existing or abandoned system on lot ./'~/,.'~-- Cutbank /~r/¢ Water main/service line Driveway, parking/vehicle storage area /.~ /~../L. E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineeds Name Date HAA Fee $ Date of Payment Receipt Number Waiver Fee $ 72-026 (3/93)' Back '¢?? 7. Date of Payment Receipt Number