HomeMy WebLinkAboutT12N R3W SEC 33 LT 137Dec 12 19 02.44p AnchorageWeil & Pump Set 90724307421 p.1
Pitless Adapter Installer:
Well Disinfected Upon Completion? Yes No
Method ofDisinfection:
Commeuts: fs
Pump Installer Naine:
A
Attention: The punt inst'Mle,- shall provide a pwnp installation log W the DSD within 30 days of pump installation.
Nark negich Ar.,—Iorac?e, AK 9SI50
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Pump Installation Log
I- Veli D riffing Permit N um ber: S'W Date of Issue:
Parcel Identification Number-, 0)9-2?2 - 10
Legal Description Proporty Owlaer Naine & Address:
k,
� � 1,
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-Tt�ZM P,3&j Sec 33 L137 ,5't
Pump Installation Date:
/ pl:",
Pump Intake Depth Below Top of Well Casing: /:Z�feet
A
Jj
Pump 'Vanufacturer'sName.- '7-t
1 :"f -
Pump ]Turkel: qvk!—L--
Pump Size /�Jqp
I
PitleSS Adapter Burial Depth: /,?,-feet
PitleSS Adapter A1311UhiCkUrers Nnme-
Pitless Adapter Installer:
Well Disinfected Upon Completion? Yes No
Method ofDisinfection:
Commeuts: fs
Pump Installer Naine:
A
Attention: The punt inst'Mle,- shall provide a pwnp installation log W the DSD within 30 days of pump installation.
MUNICIPALITY OF ANCHORAGE I
DEPARTMENT OF HEALTH AND HUMAN sERVICES
Environmental Health Division
825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELI'' INSPECTION REPORT
N~.,e DISTANCES
WELL
Address ~ TANK FELD
WELL
TANKS
TYPE OF SYSTEM ~
TRENCH ~BED ~ W. DRAIN ~ OTHER
~ PRIVATE ~ OTHER (Idontlfv~ / '' / ~ ] ~e,,~ >,~
~l~ssificatlon (A,B,C) Tolal Depth FT Cased to ~ ~
FT H,i ~
?~ Inspection Pedorm~d by:
M.niclp~l and State guidelines in ellecl 8~s date: _ ~ ~ : .
Health Depaflmenl Approval: / V
72-013 t3/851
I :l re:it:. NLulfl::lC>!l'." ~:'~c?O].2d:~
Ch,,.u~c:,r I',lau'ne~: I:R]iCHF~I:Rf)
c:,?:q:h~:u:: :i't:y~ :J .,, ',?SOO gal. :1 ~::~r~ ,, E:a.(::h s~u:.:H:)t' ]c
I: I',IF: Cilq'l DIH '1~!) l:::'1:.~ ] (:)R t"Et :t !il I ¢'.~lxll:) 2FID J: I'~ISI:>IEE; r ]: C)I',IS ~{Iy 1!:1",1(?i :I: NIZ[i:I::;'.
!:1:: ¢'.~1:: It:F.: IIERff:,:S~ CCd...I.. ::!~,z!.:2!,...q6[:~:l ¢.~ND I..IEhVE: ~:'~
DI VI:¢~I]C]I,,IS I:::'l::,:l:)l'.'l "11.11: E)l:,~]:I::~]:lxl¢'-~l.. Dl!;~!~ :l: (:.',lq I"ltt~i~'l' Eli!: DC]C:',tIPI!:I\FIIED C)lq 'I'l..ll:
f:~!i; ~)[.ll.~ I E)F.'./.d4]:I',IE):;,, II.I:[S I:::'[i:RH:[t I:'.:!; :[!:I![iLJI;~:D F:'()R ~:/ S[NEJl..E:
DNI 1.1 I:l\l[:i r:/l\lt) E:XI:"]F~'[i:!il C)lq
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...... ~.~(.. ti }3 ¥,' ,,
ALASKA e UIRO lm ,[1TAL CO[1TROL SeRUICe$, I C.
Enqineerinq $ ~nuironmenlol Studies
SPECIFfCATIONS FOR Bt(I) NASTENATER TREATMENT SYBTE,~I
LEGAL DESCRIPTION: BI.,~I ] 37 , T] 9N, R3N, S3
~ .0 Of, NI,KAL
· 2 The ) 'a ~[n~{s. sheets t t ~ -oup, h ? , shal[ be pal't o£
lthis specification.
.2
All mat:crisis and I~,orknlanshil)
l, equi~'ements of lhe blUllicipality of Anchopage,
gepartnten~ of Healt. h & Htlnlan Services (DII}IS), Lhe
conditions of the pcrmit, al~d all applicable rules al~d
regulaLions c t/l' 1' oil t 1 ~ ~[t effect.
1.3
A] ] excava kt Oils slid depths are advt .qor~ , slid are
to be verified or modified in Lhe field by Lhe
E lgilleel' of Jllsl)eck J ~lg agellCy.
I~ is the respon'aibtlit, y of the ppopepty owner
insla]lep Lo adhepe to approved dosJgD fop the
installation, Lo mail/lail~ Lhe specified separaCion
disiances and Ice have the approppJate JllSpec~Jolls.
t.5
~ L ts the responstbtlity of Lhe property owner of
i ns;al ] er to peport to the engJineor all~~ obsel'ved
conditions which ~,ould pul lhe syst:em in violation
of state or Mt~ilJcJpa] l'egH]atiolls.
1 .G
if the installation is noL [nsgected by an AEC.%
en!~Jneer. AECS will not be responsib]e fop the
installed system. All (~ll~:[Ileel' ~tk AECS should be
nulilbel' of illspeeLiolls ~haL ~,~ I l bc re(lulL'ed slid t o
explain what these inspections fei] I involve.
2.0 SEPTIC TANK
2. I
If there J.s an existing septic Lank il may be used
if it meets the capacity l'equir~~,lllellt lop the
cesidence. The stpuctural illt~gI'ity of thc! Lank
Illtls( be verified.
.0..2
The septic tank shall be a UPC apppoved
steel with bitumastic coa~ing and sci level
undistu~'bed soil . If the tank is buried at a
depLh oF 4 feet; or less, it mug[ be illsu[aLed ~iLh
an ovep]yJng layer of 2 inch burial type
polyst, yrene rigid board insula;[ion.
2.3
2.4
2.5
2.6
2.7
The septic lank shalt be a minin~um of 5 feel from
The septic tank and bed sha]i be a minimum of ]0O
feel: fponl any ppivaLe well or body of wa[cF, 150
feet from Class "C" wells, and 200 feet from Class
'A" or "B" wells, unless other~,ise speeifioci.
have prior approval[ or waiver by DIlIIS or Alaska
Piping shall be fitted l~i[h a mechanical
watel-1 ight caldor couplillg oil the outlet and iolet
of Iht~ sepiic hank. Piping shall be 4 inch solid
PVC ASTM 13 3034 or east i1'o11, sloped a nlJnJnlum of
1, d inch per I [heal fool on Lhe inle[ s [de and
inch per foot on the outlet side. if the piping
is buried at a depth of '1 feet er loss, i[ musU
insulated with an overlying layer of 2 inch burial
type potystypene rigid board i~tsulation.
C]eaaouts shal~ be installed as designated aud
capped with air tighl rain oaps (Jim Caps or
eqoJvalent) , and extend a miainium of 1 foot above
groulld level .
if a lift statiou is required i:t shall be a
combination lift slation septic tank poi' Anchorage
Tank and ifelding, ~lle. design. Specifications and
desige dra~x, Jngs are on file willh the municipality
3. 0 SEEPAGE BED
The grave [ fei' the bed shall be 0,5 to 2.5 inch,
No. 200 sieve. A] I subs~5 tut. es must have prior
13HHS approval ,
2 The bottom of the ,~.xcavat:ion shal} be lewd1 and
raked with the backhoe blade to ensure t. hat the
Sand, for leveling, shall have a SiZE distribution
~,h;[ch meetls the pe(lu[pelnentls of ~I[)A code
15.65.077,
fhe distribution pipe shall be perfora[.r~d ,t inch
['J~Jd PV( wJlh a nlJllimum crush strength of i500
3,5
3.6
3.?
3.8
pounds and shat] meet Lhe spilt'oval of DIIIIS Eot' usc!
as draJnfie]d pipe. Ali pipes shall be laid
level , aad si)aced accord i Ilg te t:he drawings .
Monitor' standpipes shal] be placed as shawn itl tile
drawings. They shall be [ inch rLgid PVC ASTM
D-303d, ap east iron. The sect:Jan showll with
hofes may be either drilled 0,5 inch holes on 6
inch centers on opposing sides of the pipe, or a
section o~ regular pev~opated sewer pipe ~ay be
of the monJtop l:ube shall ])e ]()called ill gpave]
aa]y, The portion of pipe al)ave khe sel~ep Pock
sha]] be solid. A rubber raincap (Jim Cap ap
equivalent) shall be placed .vel' khe Lop of Ihe
pJ pe,
Insulalion is required, using burial ttype
polystyrene rigid boat'd iasalation, Thel'e shall
be 1 tach of [nsu]atioll tau every foot: of %o~t
tess than the pequJ red 4 feet of cover, bat there
must be aL least 24 inches of soil even though
insulation is used, The selid pipe extending f~'om
Lht, sept. ic tank to the dpatnfield shall also have
a iii2DJ[iiiiiii o~ 4 feet of covet' o~ al~ eq~liva]ent
layer of insular:ion combined with soil.
Tile side slope of the mound shall be slope 1 fast
vel'tical to ,3 feel hot-izontal .
Tile bed shall be planted with a whJ te ciovet' sad
i;e¢l rescue mix. o~' with Kentuelcy b]uegl'a~';s.
4.0 ] NSPECT]flNS
This bed ;x,i 1 1 require a minimnni of I. ht'ee
inspections, The iii'st inspection will be of the
open excavation, to gtSSllPO thee tile system ;is
instal led i a the pl'apel' :;oJ 1 sErata , cot'l'eCk depLh
4.2
The secand Jnspectian will be after placement af
gravel, monitor standpipes, aad distrtbation pipe,
to vet'ify proper Jnstallatioa ~Uld position of
pipes prior to backfill .
4.3
'File thit'd inspection t<i]] be al'tot final backfill
grading and seediil~; to ensnre that aduquate soil
cove~' has been provided over the bed .
4 . 4
The inspection o~P the septic tank o~' liCt stat[on
ins[allal:ion Can be JllCOl'pol'aLt~t/ with ally olle of
the above I[sted inspections.
4.5
The lift station wJl] require either an MOA
eJeclr'ica] ]ngpeet:[on of cePtificat[oI~ by a
licensed e]ectpician depending on whelher the
bui [ding code app[ies to this part of the city.
ALASKA ENVIRONMENTAL
CONTROL SERVICES, INC.
1200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
!
SHEE~NO. OF
CALCULATED BY_ DAT£
CHECKED BY DATE
SCALE
CONTROL SERVICES, INC.
1200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
JOB
SHEET NO. OF
CALCULATED BY DATE
CHECKED B~ OATE
SCALE
C
/°
Z
11
71
-4
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TES'r
DATE PER EOR~rvl~:~2/~'
LEGAL DESCRIPTION;
Township, Range, Section:
1
2
3-
4-
5
6
7
8
9
10
11
12
13-
14-
15-
16---
17
18
19-
20-
SLOPE
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Depth le Waler ADer
Meniloring? ,/~£ Dale:
SITE PLAN
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE
(minutes/inch) PERC HOLE DIAMETER __
TEST RUN BETWEEN -- FTAND FT
PERFORMED BY: /~ , /~¢' . ~"' I ~ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON TI-eS DATE. DATE: ~ /~ 0//.¢ ~$
72-008 (Rev. 4/85) ~'~,._~¢ / '
INC.
SUPPLEMENTAL
SUbDiViSION ~-/~^J f~.~ L..~ ,.~'f~
SOILS INFORMATION
LOT~/~//~//~ BLOCK ~
1
2
3
4
5
6-
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
3
4
5
6
7
8
9
10
11
13
14
15
16
17-
18-
19
2O
3
11
12
I 15
/
/
/
/ 17
18
19
20
1
2
3
/
/ 5
6
7
8
9
10
11
12
13
14-
15-
~z
~o
Gr TER ANCHORAGE AREA BOROI H
D~yARTMENT 0F ENVIRONMENTAL QUALI,
3500 TUDOR ROAD ANCHORAGE, ALASKA 99507 270-8686
INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM
N AME.~'/~'~'~___..~.f~¢~:~ ~_~,.. _ ~.~/~'~.~ ....... ADDRESS Z.'.'.'.'~.~/' ~'~' PHONE-~Z '7
LOCATION ~",.~/~_~z_~_,.~__ _~?~2~:~~'_ ~"r~''~' ....... LEGAL DESCRIPTION -.'~__~./'~-/(-~,-;~,
SEPTIC TANK:
DISTANCE FROM WELL_ ~'~
LIQUID CAPACI/Y ./~'~ ~ GALLONS.
INSIDE LENGTH
NUMBER OF
COMPARTMENTS
~ ~-.~'_~ ...~-...~/~.~,~./.r.d~ LIQUID
INSIDE WIDTE]~___ DEPTIq
SEEPAGE SYSTEM: SEEPAGE PIT:
NUMBER OF PITS __ / .OUTSIDE DIAMEIER OR WIDTH ~'-~.~ LENGTH ~'~"¢~'~ . DEPTH
LINING MAIER[AL__~/~ . DISTANCE FROM WELt /_~Z) ~ , BUILDING FOUNDATION
NEARESt lot LINE~/~X /~$4_~.. tOtAL EFFECTIVE ABSORPtiON AREA (WALL AREAI__~~ 0f(- ~_SQ. FT.
TILE DRAIN FIELD:
DISTANCE FROM WELL FOUNDATION .__ , NEAREST LOT LINE
ABSORPT/~.~"~RE.M_ SQ. FT. "~EENu-=~F] OF EACH LINE
DEPTH: TOP OF TILE TO FINISH GRADE DEPTH OF FILTER MATERIAL BENEATH TILE
W E L p~,.~/,~/)~..~ ~ 2'),..~'J'~.
T Y P - _F..-~.z-~/,4'..'*.;~'/~- --''~- DEPTH~ /
NEArESt ~/~ sePnC
LOt uNe~~ , SEWER UNe ,t~N~
TOTAL LENGTH
, OF LINES
IN. TOTAL EFFECTIVE
IN, ABOVE TILE __
DISTANCE FROM ~'~'2 ~2/¢'. WATER
,BUILDING FOUNDATION.. ~'¢J--~- _SAMPLE ~'~/~'~."f-"/~, NEAREST
/ SEEPAGE / OTHER
/[]/~ , SYS]EM___/~, CESSPOOL.~ SOURC~
DISTANCES:
z'z) ~ ~/~w x~
DIAGRAM OF SYSTEM
' -' ' '- ---'
~___~_~_ --~ _ ~
G.A.A.B.
GREATER ANCHORAGE AREA E~OROUGH
SEWAGE DISPOSAL SYSTEM -- APPLICATION AND PERMIT
NAME OF APPLICANT "~/~//r~,'/~''52 '~///~"S~ MAILING ADDRESS ~/~'~-~'~' ~k~J~'
SOIL TEST RESULTS/~//I/~ ~'~/L~2~)~' NOTE, THIS PE~I'r ~s NOT VALID WITHOUT SOIL
.......... DRAIN FIELD ./~2 /
DRAIN FIELD
........ DRAIN field/~ /
CONFORM 'ro BOROUGH REGULATIONS REGARDING INSTALLATION.
I CERTIFY 3HAT [ AM FAMILIAR WITH THE REQUIREMENTS OF GREATER ANCHORAGE AREA BOROUGH ORDINANCE NO. 28-68 AND THAT THE ABOVE
FORM NO. EQ'01 6
GREATER A'CHORAGE AREA BOROUGH
DEPARTMENT OF ENVT'~n~ ~., ~,
...... ,E,IT,~.. QUALITY
3330 "C" Street
ANCHORAGE, ALASKA 99503
Case #
Performed For ~Nct~,,ao C, []>AU,~ Datel~ Performed 9-4-19~'3
Legal Description: Lot ! ~/ ,&,l-o-e4<- Gu4~d.,i-wi.~en.¢}~c.~-5,Tl. ZM~-~__W_ .....
This Form Reports Soils LOg~F -F~,_T~g~_~&tL~%~cz,~Percolation~ ' ~ ~ Test
f~F[ .~,~ T~E2 · --
- Soil Test Must Be Logged To ~ Be,ow P~oposed Seepage System
Soil Characteristics
Depth
Feet
Was Ground Water Encountered?_lO_o _.
If Yes, At What Depth?
Reading Date Gross
Percolation Rate Minu~te
Proposed Installation: Seepage
Depth of Inlet Dep
COMMENTS:
Depth to H20
N_.e_t_ DroPl
Pit Drain Field
~o beC,om of Pit or TrencE- ........
--~-e-s-t- Performed