HomeMy WebLinkAboutT12N R3W SEC 33 LT 250
/~" MUNICIPALITY OF ANCHORAGE
~ DEPART[VIENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME PHONE '7~~ [~NEW
DISTANCE '0: IWe], /~ I os Dwelling
~P <Z Manufacturer ~ ~fl ~ateria]o~ff~)~ No. of compa~ents
~ Top of t[~to finish graOe ~' ~*~ j~'~ ~' inches
,1~'
OTHER
~-~ ~/~~ .,
REMARKS '
,
72-013 (Rev, 3/78)
MUNICIPALITY OF ANCHORAGE
Department/A~ Health and Environmenta~protection
825 Street, ~_nchorage, AK. 3501
,. 264-4720
* * * HANDWRITTEN PERMIT * * *
Bermit
W~-~-R 0N-SITE SEWER PERMIT
~pplicant: ~u3{o~q ~C Mailing Address:
~ocation: Phone Number:
Legal Description: '~1~63 ~tx9 ~ac. B ~ ~o~ 2CO Lot Size: '~
Type of Soil Absorption System Is:
Trench: Drainfield: Seepage BeC: ~ Holding Tank:
Maximum Number of Bedrooms: ~/ Soil Rating(sq.ft/br) /~
The Required Size of the Soil A~sorption System Is: '
/.// / /
DEPTH LENGTH q~ m~ GRAVEL DEPTH , $~ WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
* * REQUIRED SEPTIC(HOLDING) TANK SIZE = /a$-O GALLONS * *
P~rmit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
o'f residences that the well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED
Backfilling of any system without final inspection and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
f~r a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a conLmunity sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER ~1~ 1 9 8 3 * * *
I certify that:
(1) I am familiar with the requirements for on-site sewers and wells
set forth by the Municipality of Anchorage.
(2)
.(3)
Signed:
as
I will install the system in accordance with codes.
I understand that the on-site sewer system may require enlargement if
the residence is remodeled to inc'lude more that 3 bedrooms.
~ ~/ Issued by: ~. ~/~'J~.~'~
Applican~ ,"Z/~,//3 ~//
Date:
PERFORMED FOR:
LEGAL DESCRIPTION:
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2O
SOILS LOG "'
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION p PERCOLATION
TEST
825 L. Street, Anc~norage, Alaska 99§0~ 264-4720
SOILS LOG - PERCOLATION TEST
SLOPE
WASGROUNDWATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
SITE PLAN
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE (minutes/inch)
PERFORMED BY: /J. X/:~ CERTIFIED BY:
ALASKA etlUI[NOFImffITAL COIIT[NOL SEIqdlCES,
~n§lneerinq 6 ~nuironmenl~l Studies
InC.
Supplemental Soils informaLion.
Subdivision ~/Z~J ~ ~ ~y~ Blook Z~/-' 2~-0
LOT
TH
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1200 U.Jesl 33rd Auenue. Suite J~ · Anchoraqe, Alaska 99503 · [907) 276-1361
ALASKA eliLIIROFlm FITAL COI TROL S F UIC S, IRC.
~nqin~rinq 6 ~.uironmenlal $1udi~s
SPECIFICATIONS FOR SEEPAGE BED ALTERNATIVE WASTEWATER
TREATMENT SYSTEM- T12N R3W SECTION 33
1.0 GENERAL
1.1 THE DRAWINGS SHALL BE A PART OF THIS SPECIFICATION.
1.2 ALL MATERIALS AND WORKMANSHIP SHALL MEET THE
REQUIREMENTS OF ANCHORAGE DEPARTMENT OF HEALTH AND
ENVIRONMENTAL PROTECTION PERMIT.
1.3 IT IS THE RESPONSIBILITY OF THE OWNER TO OBTAIN ALL
NECESSARY PERMITS OR EASEMENTS.
2.0 LIFT STATION (NOT USED).
3.0 SEEPAGE BED
3.1 THE GRAVEL FOR THE BED SHALL BE SIZED BETWEEN 0.5 TO
2.5 INCH AND RELATIVELY FREE FROM SILT OR SAND.
3.2 THE BOTTOM OF THE EXCAVATION SHALL BE RAKED WITH THE
BACKHOE BLADE TO INSURE THAT THE BOTTOM HAS NOT BEEN
COMPACTED DURING EXCAVATION. THE BOTTOM ELEVATION SHALL
BE PLUS OR MINUS 2".
3.3 THE DISTRIBUTION PIPE SHALL BE 4 INCH RIGID PVC OR
POLYETHYLENE. THE PIPES SHALL BE LAID LEVEL.
3.4 AN OBSERVATION PIPE SHALL BE PLACED AS SHOWN IN THE
DRAWINGS. IT SHALL BE RIGID PVC, ASTM 3033 D-3034. THE
SECTION SHOWN WITH HOLES MAY BE EITHER DRILLED 0.5"
HOLES @ 6 INCH CENTERS ON OPPOSITE SIDES OF THE PIPE
OR A REGULAR SECTION OF REGULAR PERFORATED
DISTRIBUTION PIPE MAY BE CLAMPED TO THE SOLID SECTION
WITH A NO HUB COUPLING OR SOLVENT JOINT. A RUBBER RAIN-
CAP (JIMCAP OR EQUAL) SHALL BE PLACED ON THE TOP THE
PIPE.
3.5 THE GRAVEL SHALL BE COVERED WITH A LAYER OF UNTREATED
BUILDING PAPER OR A NONWOVEN FABRIC SUCH AS MIRAFAR
FIBRETEX 200 GRADE, OR POLY-FILTER X OR EQUAL.
3.6 IF INSULATION IS REQUIRED THE INSULATION SHALL BE DOW
EXTRUDED BLUE STYROFOAM BOARD OR ARCO GEOFOAM
EMBANKMENT INSULATION BOARD OF THE THICKNESS SHOWN
ON THE DRAWINGS.
3.7 THE TOP OF THE BED SHOULD BE PLANTED WITH A
WHITE CLOVER AND RED FESCUE MIX.
ALASKA ENVIRONMENTAL
CONTROL SERVICt~-"INC.
1200 West 33rd Avenue Suite B
ANCHORAGE. ALASKA 99503
Phone 276-1361
JOB
ALASKA ENVIRONMENTAL
CONTROL SERVICC-~', INC.
1200 West 33rd Avenue Suite B
ANCHORAGE. ALASKA 99503
Phone 2764.361
SHEETNO.
OF ~'
DATE
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF iNSPECTION FOR HEALTH AUTHORITY APPROVAL
OF ON-SITE SEWER AND WATER FACILITY
264-4720
Application Date
GENERAL INFORMATION
(a) Legal Description (include lot, block, subdivision, section, township, range)
L~:,T' ,:~,.¢.,_,,. :: ,~_~w-~ :-~ ':l,<~!'/ ,,~:':~.~ :, ~-~-"
Location (address or directions)
(b) Applicant Name4q~ ~/~.,;~ Telephone: Home Business
Applicant Address
(c) Applicant is (check one): Lending Institution []; Owner/buildert[~; Buyer []; Other [] (explain);
(d) Lending Institution
Address
(e) Real Estate Company and Agent
Address
(f)
Telephone
Telephone ,
Mail the HAA to the following address:
TYPE OF RESIDENCE
Single-Family~ M u It i~h/~[]
Number of Bedrooms ~ ~"~- ~
Ot~er
3. WATER SUPPLY .
Individual Well.~ Community [] Public []
Note: If community well system, must have written co, nfirmation f, rom the State Department of Environmental Conservation
attesting to the legality and status. ~,, \ ~
4. SEWAGE DISPOSAL , i i ,
Onsite~' Public [] Community [] Holding Tanb[]
Note:/' ~lf community well system, must have written confirmation from th~ State Department of Environmental Conservation
attesting to the legality and status.
' ' 72-025 ($1/84)
Page 1 of 2
5. ENGINEERING FIRM PROVIDINg., INSPECTIONS, TESTS, FILE SEARCH, DA~ AND INFORMATION
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 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
Address
Date
Telephone
Seal
DHEP APPROVA~.~ bedrooms bY~
Terms of Conditional Approval
"\ ' CAUTION
The Muncipality of Anchorage Department of Health anu Environmental Protection (DHEP) issues Health Authority
Approval certificates based solely upon the representation~given in paragraph ~ above by an independent professional
engineer registered in the State of Alaska. The DHEP does,this as a courtesy to purchasers of homes and their lending
r~stitutions in :)rder to satisfy certain federal and state requirements. Employees of DHEP 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.
Page 2 of 2
72-025 (i 1/84)
CONSULTING ENGINEER TELEPHONE: (907) 279-3916
RESIDENTIAL WELL INSPECTION
LEGAL: LOT 250, SEC. 33, T12N, R3W
LOCATION:
1.2 MILE RABBIT~ CREEK ROAD
OWNER:
GENE JACKSON
TYPE OF WELL:
SINGLE FAMILY
WELL LOG AVAILABLE:
NO
INSTALLATION REQUIREMENTS MET: YES
PUMP YIELD:
8-9 GALLONS PER MINUTE
DATE OF INSPECTION: OCTOBER 13, 1986
TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 8
GALLONS PER MINUTE WHILE THE DRAWDOWN WAS
MONITORED WITH AN ACOUSTIC PROBE. THE WELL
WAS PUMPED TILL THE DRAWDOWN STABILIZED. STATIC WATER LEVEL WAS
FOUND AT 99 FEET BELOW TOP OF. CASING. AFTER 30 MINUTES OF PUMING
THE WATER LEVEL STABILIZED AT 107. THE WELL WAS PUMPED FOR AN
ADDITIONAL 30 MINUTES WITHOUT ANY DROP~ IN WATER LEVEL. THE WELL
RECOVERED 100 % IN 12 MINUTES.
TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON
OCTOBER 14, 1986. TEST WAS NEGATIVE.
TEST RESULT:
THIS WELL MEETS THE REQUIREMENTS OF THE
MUNICIPALITY OF ANCHORAGE.
The Municipal requirement for well flow is 150 gallons of water
per bedroom per 24 hours.This well surpasses this requirement.
The assessment of the condition of this well applies only to the
conditions as of this date. The flow rate of the well may change
due to subsurface conditions that may not be observed from the
surface, and changes in land use and other factors that may
impact the conditions of the aquifer feeding the well.
I~ i~.r~[~ ~203 w. 15th AVE "C" SUITE 203
~ ~ ~ ANCHORAGE, ALASKA 99501
· CONSULTING ENGINEER TELEPHONE: (907) 279-3916
SEPTIC SYSTEM ADEQUACY TEST
LEGAL:
LOCATION:
OWNER:
RESIDENCE:
WELL:
SEPTIC
SYSTEM:
LOT 250, SEC. 33, T12N, R3W
1.2 MILE RABBIT CREEK ROAD~"~J.'' ~' ?-,~
GENE JACKSON ~...~.~
PRIVATE, ON SITE
FROM MUNICIPAL RECORDS:
TANK: GREER STEEL, TWO COMP. 1250 GAL.
ABSORPTION SYSTEM: BED
ABSORPTION AREA: 756 SQ. FT.
SOIL RATING: 125
INSTALLATION DATE: JULY 1983
DATE OF PUMPING: OCTOBER 16, 1986
DATE OF TEST:
OCTOBER 13, 1986
TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND
WITH 2.5 FEET OF COVER AND WITH 46 INCHES OF
LIQUID. CLEAN OUT BETWEEN TANK AND BED WAS 3 FEET DEEP AND DRY.
MONITORING TUBE IN BED WAS 51 INCHES DEEP AND WITH ONE INCH OF
SLUDGE.
450 GALLONS OF CLEAN WATER WAS ADDED TO THE CLEANOUT
WHILE THE WATERLEVELS WERE MONITORED. TANK LEVEL REMAINED
CONSTANT, WHILE THE LEVEL IN THE MONITORING TUBE ROSE TO 4.75
INCHES. 90 MINUTES AFTER ADDING THE WATER THE LEVEL IN THE
MONITORING TUBE WAS 1.5 INCHES. THE SOIL HAD ABSORBED THE WATER.
TEST RESULT:
THIS SYSTEM MEETS THE CODE REQUIREMENTS OF
THE MUNICIPALITY OF ANCHORAGE.
The operational life of all septic systems depends on the local
soil conditions, groundwater levels that may fluctuate during the
year, and the water usage of the family bein9 served by the
system. These conditions are outside the control of the evaluator
of this septic system. We can therefore not give any estimate of
how long the system will continue to meet the operational requi-
rements of the Municipality and State.
A. WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
*r,;~r'TH AUTHORITY APPROVAL (HAA)
i~uNICiPALtTY 0~: A
EPT Of: HE^LIH b
D · . .,,,-,TECTK~,~HECKLIST - FEBRUARY 1984
ENviROH~NTAL ~'~'~ 264-4720
RECEWE. '" ....... ' ...... "'
Well Classification
Well Log Present (Y/N)
Total Depth //O
Static Water Level
Casing Height Above Ground
Electrical Wiring in Conduit (Y/N)
Separation Distances from Well:
To Septic/Holding Tank on Lot
Date Corn pletel~ A' Bj;,~D.' E'~ved (Y/N)Yiel//'~(~ '{~ [ t4~/
Depth of Grouting I~ 0 ~ J"~
Pump Set At I O'7 '1"
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N) ,'~
To Nearest Edge of Absorption Field on Lot ~_.,~C7r7b
To Nearest Public Sewer Line
Cleanout/Manhole
Water Sample Collected by
Water Sample Test Results
Comments
; On Adjoining Lots ./0~
; On Adjoining Lots .~'t~~)
./~/A/~/. To Nearest Public Sewer
.,~///~ To Nearest Sewer Service Line on Lot
~-~'~/~/,~/v/<~A ; Date /0//
,, /
B. SEPTIC/HOLDING TANK DATA
Date Installed '~
Standpipes (Y/N)//
Depression over Tank (Y/N)
Size ./"~'/~ No, of Compartments ¢
Air-tight Caps (Y/N) Y Foundation Cleanout (Y/N)
~ Date Last Pumped lO/'~/'~/~s
Y
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well '~.~2~/74.
TO Property Line ~'~17L'
TO Water Main/Service Line
Course ~
Comments
;for
Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Page I of 2
72-026(11/84)
ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/N)
Results of Last Adequacy Test (
Separation Distance from Absorption Field:
TO Water-Supply Well /~--¢~(7/1E
Type of System Design
Length of Field ~--~ ,~ ,._ ..z ~,
Depth of Field ~Z 7 ~ _
Gravel Bed Thickness 0~/I
Standpipes Present (Y/N)
Date of Last Adequacy Test
To Properly Line ~ ~
To Existing or Abandoned System on
; On Adjoining Lots ,~
To Cutbank (if present) ~ /
To Building Foundation
Lot //0/'~
To Water Main/Service Line /~/?L
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I have checked, verified¢/r conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signed Y~t'c~Cf~'/ Date
Company -- MOA No. '
Date of Payment /~/[~ ~"~
Page 2 of 2
72-026 (11/84)