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HomeMy WebLinkAboutT15N R1W SEC 7 LT 64 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES {~/.~\ ~ Environmenlal Health Division 825 "L" Streei, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE r)ISPOSAL SYSTEM AND/OR WELl. INSPECTION TANKS SEPTIC l~ HOL.~ING TYPE O~ SYSTEM I.~ 'rRENCH ~1 BED ~,~ W. DRAIN : E~ OTHER 'D~'~"p~ I-~ p~,~ bottorn Ir~nT .... 1 olal depth from original grade or,g,nag,ade ~1 ~ F'[ ~ FT ~// FT ~ FT WELLS PRIVATE [] OTHER (Identify) Dale hlstallod: FT DISTANCES TANK FIELD WELL WELL kloO ~ 'h/oo / REMARKS: Inspections Porlomled by: -EaglcRIvor E,q 9id eer, idg~o,q/ices---- Date P, O. BOX 773294 I"agle River, Al( 99577 694-5195 I -.--.~ .'~'" ~::~-------~--"--- cortily thai 1his inspoclion municipal and State §uidelinos in elleck o~ ~lliS dale: ~' ~ ~ /~ ~ was perloroled according lo all 72 013 (3/85) ENGINEERING SEk, ~CES P. o. Box 773294 ~ EAGLE RIVER, ALASKA 99577 Phone 694-5195 JOB ~.-~ 7' ~ ~ SHEET NO. SCA~E OF GATE 3,5~/ ~RAYEL B~ T,D, / HSE W ND SEPTIC WELL AND SEPTIC SITE PLAN LEiGAL~ LOT 64, TI5N, Ri~, SEC,7 E]~/NER~MR, MARTIN ~/ILL. IAMS CE]NTRACTDR~ N/A ' EAGLE RIVER ENGINEERING P[] BX 773B94 EAGLE RIVER, AK, 9957] 694-5195 SERVICES SOUTH 100' SEPTIC AMINATES RIGHT DF WAY EXISTING LEACH FIELD NEW LEACH FIELD CLEANBUT -o SCALE 1'= 40~ PERFORMED FOR: LEGAL· DESCRIPTION: 1 2 3 4 5 6 7 8 9- 10 11 12 13 14 15 16- 17- 18- 19 20 MUNI'CIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. ~treet, A~chorage, A~aske 99501 264-4720 SOILS LOG - PERCOLATION TEST SLOPE SOILS LOG PERCOLATION TEST DATE PERFORMED: WASGROUNDWATER ENCOUNTERED? SITE PLAN Reading Date Time Net Depth to 'Fime Water Net PERCOLATION RATE_ ¢/'~.2 5-- TEST RUN BETWEEN FT AND _-- F¢ PERFORMED BY:__ EagleRve Engnee ! Se~lce$ P. 0, Box 773294 Eagle River, AK 99577 694-5195 i 72-008 {6/791 100 GRAIN SI~E! DISTRIBUTION TEST REPORT 90 80 70 ~0 20 10 0,1 OPENING GIZE - mm Y. 8RAVEL SILT 2.7 · 001 OLAY USCS Cl~ssi-~ic~tion ~ 60LLOID8 LL PI D~ D50 ~10 OC 0 SP HP T 5.51 0.767 0.2].15 0.79 1~.~ MATERIAL DESCRIPTION TYPE OF TEST 0 ORAVELLY SAND ~ ASTM D 422-65(?2) Pro,eot No.: 109¢D Ppo~ect: EAGLF RIVER ENGINEERING SERVICES O Locition: 64 Sec. 7 T15N R1W GRAIN ~;IMI" ]DISTRIBUTION TEST REPORT SPECIFICATZONS FOR ON ,S]iI'E SEPTIC SYSI'EM R~'rCOMMEN))EI LEACHFiELD DZMENS]:OIqS >~*>kSAND FILTIER NOT R[~i~IUI REE ]]ND][CATED WAI'IEt? TABLE. D U E T 0 S [:: VI{ ANALAY ~ I c., ANI) N(] EAGLE RIVER ENGINEERING SERVICES P. O. Box 773294 EAGLE RIVER. ALASKA 99577 Phone 694-5195 SHEET NO CALCULATED BY CHECKED BY -- sc^cE__~,~7~, OF DATE E:,EF'FIRTHENT HEFfl.."FH RNE:, FZNV~I~:EINFIIEN"FFIL .;'.OTEC:T]:CIN ...... ;REQI_I ~ REHENTS ' ':: ......... I ....FIT'[3N LOT 64. SECT-TiDN-F::LH ,-- LEGFIL E;RHE LOT :,Z~.E '~'~'~99 ,E;~I.IRRE FEET T'T'F'E OF :,LZL FIE~SOREFf'ZON S'¢STEt'i Z'.5: 1REN_.H _ .. ........ :,= HFIXZhiUH NUI'"tE~ER OF E~EDF'.OEd'"IS = ~: SOZL I;:FIT:(NEi ('~J F~ EF ...... THE: LENGTH E:,IHEI'.,I~ION Ibm THd LEENGTH ,'IN FEET::, 3F THE IRE. HL.H "3r~' DRFiINFIEI_B,. THE [:,EF'TI4 ElF FI TRENC:H OR F'I;T :IS THE E:,IE;TRF,ICE E;E'I"HEEN THE E;URFFICE [)F THE "~E' Z IJN[:, FINE:, THE BOTTOH OF THE E::.::C:R'¢FFI' I. 14 ':: :[ N FEET '" THE:F:E I'.E; NO SEET HIE:,TH FLR 1RENL. HE:,. ,: THE GRFI',,,'EL E:,E:F:'TH I E; THE: f'lI N I HUH E:,E:F'TH OF GRR',,,'EL E, ETI ~EEf I THE C~UTF'FI[_.L F' I F'E ~t[',l[:, THE E:=~-~'T'F~'~I'"t OF THE E:='=:CFI",iRT:[13N ,::IN FE:ET::,. ',--'- .... .P OF RN"r' ..,~_,fEH 14~TI4OUT F:[NRL [N~;F'ECTZON FIND FIF'F'ROVIql- E, HL.I...F 1LL ~ N ~ ':" ":' ' tEIEl FEET FOF: I~ F'E'.~',,,'FITE I.,.IELL..~ :L5:3 TO 2~.'~:1 FEE:T FOR I~ F'LIEL]:: i.,JELL E:,EF'ENE:'ZNG UPON THE TYPE OF PI..IEfl...[C: NELL. i,I]:N:[PIUH E:,ZSTRNCE FF:OH R F'R~',/FITE 14ELL TO FI F'R]:',,,'I::ITE 'SEHER L~NE ~2; 2~: FEET FINE:, _ "-',','11 '" Tn R L. UIIII-HZI'~ SEHER LZNE :[:5 '~5 FEET. HELL LOGE; RRE RE[;¢JZRE[::, RNE:, I1U.:,F BE I?E'TUI~:I'4EE:, TO THE [::,EF'I~RTHENT HZTH[I'.,I 'q:~ E:,FI'~% OF THE HELL. COHF'LETZON. O"FHE:R RD,.¢_I.[REIIENT: HFI¥ FIF'PL'¢ --=,FEL. ZF[..HI [LI~- Ri',II::, CON'5'f'i~'_Z'f'~ON D]:RGRFIHS Rf~:E FIVR~LRBLE TO llLIJRE F'ROF'ER ]: EBTZFr THFFF :J.: Z Rf"l FFIH~L.:[RR HZTH THE RE.~=.!U.[REJILNL F-iF' UN-=,.[1E =,ENER.., FIND HEL. L% F'C~RTH B'¢ THE I',IUNZ CZF'FILZT¥ OF ... [H_,IHLL THE _ ~._,lLrl IN I:I::C:O[~'B, FINZE [4]:TH THE L. uE.E:,. uN-=, 1~ E ...,El lEE .... ~_, TEl I HR'¢ REQIJ :[ [E:E ENLF:I~tGE:I"IEHT ]; F THE RE_,ZEE. N..E..k, REHODELEI::, TO :[NCLUE:,E HORE THRN 2: L, EERuuL1 .... FIF'F'~T;~NT IRf~I.,.I G HOFFHFIN / ~ f.,ISF'E:CT ~ ON H ~ STOR'¢ - 5EI.,.IER :L; E~ ~;E:HE:R 2 ' ':':' E~ E RZLLER HELl_ ~i L,I E1 I.,.IELL LOG E:,FITE "" It~ OgRVEL D~[F'~H ]~. 1HE H]N]I'I~'I [~piH OF (iF~VgL E:E]I'~EI~ 1ltD. OLITFALL PiPE ~TO ~C~ Ft~ET F[~ fl pLIE:LiC HELL DEPEND]NB UF'ON ll-l[ TYPE OF PLIDL]C HELL ~ LOG~; ~ ~E~LIIFCED RND HUST ~:E ~D~I.I~P ~0 IH~ DEPt~RIHEI~ HIIH]H IL~ ~FIYE, HE b~l.L ~Z'IF'LE1]ON, ',L ~P O HELL L~: D~IIE illlilillliliiiilI[iii:' O & E ENG,,4EERING & DFVELO, Box h0, Davis St., Eagle River, Alaska 99577 694-2774 or 688-2280 Russell Oyster 694-2774 SOIL LOG Performed for: MeilingAddress:. ,~,c'~.' ,~d:/X ~) 1 Legal Description: ~.~7- G/C, -~4c:. 7, TI-~','V'/ Depth (feet) Soil CharaCteristics Name:_57"z~-//'~/V' ~-., :5 /'~/Z}(--~'~ co ,dENT CO. Earl Ellis 688-2280 .Tel. N0. ¢~0¢- ~-~J3 / ,///~. "??~T~ '7 2 9 __ 10____ 11____ 13 .~-__ 14__~ 15~ 16~ PLOT PLAN PERC. TEST Ground Water Encountered: Yes____ No /""'_ If yes, what'depth Proposed Installation: Seepage Pit Drain Field __ Comments: ] Performed by: Date' .~//~/~o ~ Parcel I.D. # ©5 ! ~'(~ //._3 1. GENERAL INFORMATION Complete legal description i MUNICIPALITY OF ANCHORAGE DFPARTMENT OF HEALTH & HUMAN SERVICES Di~'ision of Environmental Services : On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERT~IFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWEI_LING HAA ~, Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Address Unless otherwise requested, HAA will be held for pickup, NUMBER OF BEDROOMS: Day phone Day phone TYPE OF WATER SUPPLY: Individual well Community welt Public water NOTE: 72-025 (Rev. 1/91) Fronl MOA If community well system, provide written confirmation from State ADEC attest- TYPE OF WASTEWATER DISPOSAL: Individual on-site X Holding tank Community om. site Public sewer NOTF: If cornmumty wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system· lng to the legality and status of system. 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 rec~la.'lior~,in effect o~ the date.(L~ this~in__spection. ~a~te rover ~,n~meern~ervl~8 Nameof Firm P.O. Box773294, Eagle Riv~, AK 9oz3~r'],,.~ Phone °/~/- Address Engineer's signature Date 7 -/~' -e 7 DHHS SIGNATURE ,?~Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments F' 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 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. 72~)25 (Rev. 1/91) Back MOA ~21 Legal Description: ~.-,¢ ,¢'~' MUNICIPALITY OF ANCHORAGE ENVIRONMENfAL SERVICES DIVISION Municipality of Anchorage DFPAIRTMENT OF HEALTH & HUMAN SEFtVIOE$ RE6EIV~ Environmental Services Division 825 L Street, Room ~02 · Anchorage, Alaska 99501 · (907) 848-4744 Heal!h Authority Approval Checklist ? Parcel I.D.:~' ! /g //,-? A. WELL DATA gVell type ~/~k.,~,¢; ~-~ Log present (Y/N) ~' ] I Date compteted Totaldepth_~,¢~ .f,~.,~./-,,~ ~Ca~edto_ ~-~/ Sanitaw seal (Y/N) ~ ~ FROM WEkL LOG If A, B, or ¢, attach ADEO letter. ADEC water system number Casing height (above ground) '~' Wires properly protected (Y/N). AT INSPECTION Date of test Static water level Well productien ~)'- WATER SAMPLE RESULTS: Coliform c~ Date of sample: Nitrate ?- ¢-7'7 g.p.m, /,. 7 g.p.m. Other baoteria Oolleeted by: _ B, SEPTIC/HOLDING TANK DATA Date installed ~,P/~' '7 Tank size Foundation cleaneut (Y/N) ~'-~' '. Depression (Y/N) Dateof Pumping 7" ia- ~7 Pumper ,,~/2 ,~' C, ABSORPTION FIELD DATA Date installed "~" '/'~ ? Soil Number of Compartments High water alarm (Y/N) Oleanouts (Y/N) y _ rating (~..p.d./~or ft2/bdrm) / ~ ~ System type Gravel thickness below pipe ~, ~- Total.depth Length /"// / Width _ 5'- / oO / Effective absorptk)n area ~ '7`7 '¢ i !Monitoring Tube present (Y/N) ~/ Depression over field (Y/N) Date of adequacy test 7 / ?/'7 ? i Flesults (Pass/Fail). /¢~' ~..r For ~3 bedrooms Fluid depth in absorption field before tect (in.); _ ~) Immediately after -~¢~ gal. water added (in.): Fluid depth. ,¢¢ (ins) Minutes I~ter: 6) Absorption rate = '/Y~-o g.p.d. Peroxide treatment (past 12 months) (Y 'N) /v/-1- 72-026 (Rev. 3/96)* If yes, give date D. LIFT STATION Date installed j Size in gallons Manhole/Access (Y/N) ~ "Pump on" level at* High water al~ *Datum Cycles tested' "Pump off" level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot +'/~o / Absorption field on lot /~'~ ~ Public sewer main /¢//4- On adjacent lots On adjacent lots Public sewer manhole/cleanout Sewer/septic service line Lift station ,/~/ /;4 SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation 3;~ / Property line ~o ~ Absorption field ,~ Water main/service line '~tc~ ~ .Surface water/drainage ¢./¢a ¢ Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ¢-/~ / Building foundation 3 ~ / Water main/service line Surface water Driveway, parking/vehicle storage area /Cd / Curtain drain .,'¢ /.4 Wells on adjacent lots ,~-,,~¢z~ / F. ENGINEER'S CERTIFICATION I certify that I in conformance with MOA HAA guidelines in effect on this date. Signature ~~ Engineer's Name ~-~-~,~,-/~ /-~, ~ ,-~, Date ~-/~¢¢ ? are HAA Fee $ ~ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)*