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HomeMy WebLinkAboutKNIK HEIGHTS BLK H LT 1 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: .~{,V ~ ~/-~ ~) PID Number: ~/~ ~ ~/ Name: ~ .~/~ Wastewater System: New ~ Upgrade Address: ~ ~~/) ~o/ ~/~ ABSORPTION FIELD Pho~__ ~ ,o. of B~oms: ~eep Trench ~ ShaliowTrench ~ Bed ~ Mound ~ Other Total Depth from original grade: LEGAL DESCRIPTION so~..~.~: /, ~ G,O~s~.~. /~ Lot: Block: Subdivision: Depth ~o pipe bottom Irom original grade: Gravel depth beneath pipe t ~' ~z ~ 5, ~ ~,. ~./ ~,. Township: Range: Section: Fill added above original grade: Grave~ length: -~ ~. ~ ~. Gravel ~: Number ~linos: Distance ~[w~n r~ne~: WELL: ~New ~ Upgrade ~/~ ~ Ft. ~ Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: P~/v~T~ ~ 1 ~,. ~ / ~,. ~O SQ. Driller~//~~ ~//~t~i~ Static Water Level: Installer: Date installed:~ Yield: /~ GPM Pump~Set at: Ft. Casing Height~Above Ground:Ft. TANK SEPARATION DISTANCES ~ptic a Holding ~ S.T.E.P. To Septic Absorption Lift Holding ~/Private Manufacturer: Capacity in gallons: Fro~ Tank Field Station T,nk Sewer Lines Material: Number of Compa~ments: Surface w~, ~, LIFT STATION Lot J Manufacturer: Une //~ ~/~ ~/p F°undat'°" ~ ~ ~/~ ~t~ "Pump °n" level at: 1~ Drain I Remarks: BENCH MARK Location and Description:  Assumed Elevation: Inspections pedormed by: ~ ~¢5 Dates: 1st EY/5//¢~' ~ 2nd ~/~1/~ ~ "~"~.... .............. .~'~'~"~ Department of Healt.~ Hum ices approval . Reviewed and approved by: ,, Date:/ ~' 72-O13 (1/91) MOA 25 Permit No, ~/~¢;~)/.~ Page 2 of__ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 345-4744 On-Site Wastewater Disposal System and/or Well Inspection Report Legal Description: KNIK HTS. LOT 1 BLK H PID No.: 017-572-01 SWINO TIES A-C = 45,6 8-C = 59.8 A-D = 75.1 B-D = 88.75 A-E = 75.6 B-E = 75,4 ° MONITOR TUBE o SEWER CLEANOUT WELL LEACHFtELD EASEMENT ELEVATIONS (NOT TO SCALE) 797 9/12/95 ENGINEEWS SEAL ........... '.:.:~, ~ %'. LOUIS A. BUTERA .' ~2 -. ~TATE OF ALASKA DEPARTMENT OF NATURAl, RF, SOURCES DIVISION OF MINING .& WATER MGMT ,i ..;~ , I ,' , .. , . , WATER WEM~ RF_,CORD LOCATION OF WELk ., ' .... _: .... ~: J_._ LOCATIO N/S~ ETCJ'h WELl, OWNER,' tin~o~, c, DEPTH5 MEASUPZ-D FROM:~cadng top [~ground surface ~WELL DEPTH: 'DATE O~ O'I~MFI~ION" I~OREHOtE DATA: ~ Del)tn of mslng:,~'.../_~_...ft Matmtal Typ~ and C, dor From To  DE,GTH TO STAT~ WATER LEVEL: ~ ~ /.,~":~ f~ ~Iow El' ~o~ of c~; D arou~ ~urface ~,~,__._~~ METHOD OF DRILLING: [~:~'alr rotary [] cajole tool / ~ '~ U$~ OF Wl~.L: .~_.~~~.~b~ _c~ ~ [] ~,,~,.~o!~ ~L INTAKE O~C~ /~ /~ 51e~eshS~e:, ~ngth: It /bl / ~ ~; ,~, . .......... ' ~P~G ~ A~ Y~ ~MP I~AKE ~ W~ DI$I~E~ UPON ~OMP~N? ~ ~ NO Health & Human 99503-5935 - - .... 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:SW950139 DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES OWNER NAME:HAGMEIER JOHN C & JUDITH A OWNER ADDRESS:12800 BAINBRIDGE RD ANCHORAGE, ALASKA 99516 PARCEL ID:01737201 LEGAL DESCRIPTION: KNIK HEIGHTS BLK H LT 1 LOT SIZE: 43500 (SQ. FTo) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 PAGE 1 OF DATE ISSUED: 6/30/95 EXPIRATION DATE: 6/30/96 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 (18AACS0) . 3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY CALLING 343-4744 ( 24 HOURS ) (NOT REQUIRED FOR WELL ONLY PERMIT) 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 ISSUED BY: Louis Butera, P.E. Registered Civil Engineer June 21, 1995 Jim Cross, P.E. Manager, On-Site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AK 99519 Re: Knik Heights Lot 1, Block H Narrative & Permit Application Dear Mr. Cross: The proposed well mid septic system will have very limited impact on adjacent properties for the following reasons: 1. The surrounding lots are large, allowing sufficient room for septic sites. 2. Immediate neighboring septic systems are all +30' distance. 3. Reserve space is adequate, due to lot size. 4. Drainage will not be affected and is not a major consideration in our design. If you have any questions please call our office at 694-5195. Sincerely, ~ ~ Louis Butera, P.E. (7'3 ~ · ,< > \G:\WPDOCS\i 995\95-050A.NAR PO gn~: 77929d , I/,.aolo I~ivm. hlaqka qqg77 , Tolon}mno ttll~7~ gClA.glOg o ~av f0/371 t~CIA '~OIY7 LOT 9 LOT ]8 I TRENCH PROPOSED t t0x 1250 GAL I -'- ~] TANK ~ PROPOSED AC DR[VEWAY ~ LOT 1 ~ HOUSE LOT 2 SEPTIC GO VENTS 30' ~ TEST HOLE · - MONITOR TUBE o SEWER CLEANOUT ~ WELL PROPOSED LEACHFIELD NO KNOWN CURTAIN DRAINS EASEMENT WELL &:: SEPTIC SITE PLAN LEGAL: KNIK HEIGHTS LOT 1, BLK H OWNER: CONTRACTOR: HAGMEIER JOB// 95-0S0AI DATE: 06/21/9.SJ SCALE 1" = 60' A EAGLE RIVER ENGIN~£RIN¢ S£RWC£S P.O. Bom 773294 SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM LEGAL: Knik Heights Lot 1, Block H 1. The well and septic plan is for a single family residence only. 2. The drawing and or site plan shall be a part of this specification. 3. All materials and workmanship shall meet the Anchorage Department of Health requirements. 4. All soil tests are advisory to the design and are to be verified or modified in the field by the engineer. 5. All excavations and depths are advisory and are to be verified in the field by the contractor to meet Municipality of Anchorage requirements. 6. It is the responsibility of the owner to obtain all necessary permits or easements and to locate any adjacent multi-family wells. 7. The excavation is to be exactly in the area shown on the site plan, any deviation requires engineer approval. 8. It is always recommended that a surveyor locate the nearest lot line position and the location of any easements. TRENC~ 1. The 3. 4. 5. 6. o trench is to follow the natural land contour to maintain uniform total depth of the trench bottom. The bottom of the trench shall be level, plus or minus 1.5". The total depth of the trench excavation is not to exceed 14' at any point. The sewer line is to replace the existing sewer line that leads to the existing pit. The trench gravel is to be covered with typar fabric material. Soil or combination of soil and extruded board insulation to a depth of 3' or equivalent is to be placed over the leachfield. The area over the trench is to be finish graded to prevent ponding of surface water runoff. The septic tank and leach field must not be closer than 100' to any existing private well, 150' to any Class "C" well, or 200 feet to any community well. RECOMMENDED LEACHFIELD DIMENSIONS: TOTAL DEPTH = 14' GRAVEL DEPTH = 8' under pipe, 2" over pipe TRENCH LENGTH = 35' TRENCH WIDTH = 3' SOIL RATING = 1.2 GPD/ft2 BEDROOM CAPACITY = 4 SEPTIC TANK = 1,250 gallon minimum Twenty-four (24) hours notice required for all inspections. C:\WPWlN60\OLDDOCS\I995\95-050A.SPC EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, AK 99577 (907) 694-5195 JOB SHEET NO OF CALCULATED BY_ DATE CHECKED BY DATE SCALE Single Family 4 BedroOm Dwelling Knik Heights Lot 1, Block H 4 Bedroom Capacity = 600 GPD Soil Rate = 1.3 min/inch = 1.2 GPD/ft2 application rate for trench system Required Absorption Area = 600 gpd / 1.2 application rate = 500 square feet 500SF / (8' rockx2) -- 35' Trench Dimensions: Gravel Depth = 8' Gravel Length = 35' Total Depth = 14' G:\WPDOCS\1995\95-050A.CAL Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR= LEGALDESCR~PT~ON= ~O'/' / ~-- // 2 3 4 5 6 7 8 9 10 11 12 13 14- 15 16 17 18 19 D/zY ~D~v~4 COMMENTS Township, Range, Section: SLOPE SITE PLAN WAS GROUNO WATER ENCOUNTERED? S L iF YES, ATWHAT O DEPTH? p E Depth to Water Aller_ Monitoring? ~ r~ Oate: Reading Date Gross Net Depth to Net Time Time Water Drop / ~//?/9~ _~-~ z... '" /.7.: o,~ 7, ~ " ~ ',- ?" & " g '" .17.;/~ 7, ~" ~ ':- ?" &" q "' /7~; 17 7. 7" ~.- ? ', (¢" PERCOLATION RATE TEST RUN BETWEEN /'"'~ (minutes/tach) PERC HOLE DIAMETER _ -- FT AND ~ FT ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: . MUNICIPALITY OF ANCHORAGE ~ DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services ' .... -- '- :~'-:-:'::-~,~ '.: On-Site Services Sect on .... .-,C~,,._~ . - -: -...- P.O. Box 196650. Anchorage, Alaska 99519-6650 '. ".-':.- :~:' 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 017-372-01 1. GENERAL INFORMATION -. Complete iegaJ description Knik Heights Lot 1, Block H Location (site address ordirections) 13000Bainbridge Road, Anchorage .'Property owner "J0~;~c~eier Const Co Inc Day phone 248-6789 Mailing'a'ddress' 220_¢'Cl'eveland. Suite 201, Anchorage, Ak 99517 Lend'ing agency N/A - Mailin~'~dd~ss "':;: / -Agent N/A Day phone ~-~ ..:-::-. :.,_,.. - ~:;.. Unless otherwise requested,: HAA Wll! be held for Dlckuo., .'.' ·; ~ - : ':...; '.:..':--,~:..~,'~;;,.\~?..,~:~ - : '--.-;-.,~,:..',~; ,','-"- .-'-,..~:" ,-,-:...-~.",'~-:-t~?,=r.,.h~... -.:'.~:.--.. .":. . ,,,~. - - .... -. - .".'.-, . - .'- -.-7;',7~-~:7:~'~.','~-' :-,..'?.-<"-, ...... .':- · .'.; ?,:':'~; <',%? ' .... ' ' ' - ,. ,..,.,. ,, 8.,,.~.,,TYPE OF WATER SUPPLY. .;:: ...... "' ':"' ................ "' ....... ~ '" ' ""' ;::,¢Tt% - ?;:¢ ',- ' - . · ' :;- "'-' '~'~?(:*"¢'" '"' " "- . :,_.?,.; :... E tern, p de written confirmation from State ADEO :. ing to the legahty and ~tatus of system -. ' - -': ~,.p- .'.:.- :-.',~u ,*,, 4, .. TYPE OF WASTEWATEt ~IS~OSAL: · : ' '"-¢~-'"'(~'",".'.'a'" '~- ,' '- :';'u ~ ~ ~.' ; ... .., ...:..._. ..... .., ,,.. .' .:: ;.-;'::~-. ?,.,,:'.~;;;:;;,:'~-: ¢:.: :.:. ;;.,-, Commbnity:0n:~ite': ¢ ';¢'-;. ' ,-~.;'-:. '--'. ', ..... '-. ~u~ ~ ;~;~ *~" ..... '. :-" ': ' ,. -'-'. - '- ' .7~' ¢///'~1 "='4-)~(" : · "(-.'~,:;: ,;..':'.'%%.;';-:~::';',;' '5'' :'~'.'.'-:';'.. - :' ;.-'¢¢:' ':~' ~u~=: ? ' ~r communitywastewater s~tem, provide written confirmation from State ' -,' ;?..'; :'."~ '." *'"" -'-'*' attesting to the:~g~l~'tY ahd status Of system,.." ':- ;"' ' ..y-':i¢ '%' .' Day phone ' 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 i and/or wastewater disposal system'is ~afel fur~cti0nal and adequate for the number of bedro°m~ 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. 694-5195 Name of Firm Eagle River Engineering Services Address P.o. Box 773294. Eagle River, Ak EngineeCs signature ~ DHHS SIGNATURE ' ~/' Approved for 99577 Phone bedrooms. D sapproved. - .... ~' ,,. ". '. ' . . .... ~...:-.,:-~ r .;,.'... '. '' . Conditional approval fOr,," Date ' "'-' -bedrooms, with the following stipulations: Additional Comments .... , Date /¢) - ~.. '. . : .. ,, · .. ; :,:- ~!:. ~2rAo ,~,llfv nf ~.h~ra~'e'~'D~*O'artr~en~'of 'Ft~altl~ a'nd H~man Services (DHHS) iss6es Health Authority · ':'~%~;~roval C~"~'iii'~,a'~l~;~'~ed (~n'ly"'u'ppf~'.t~e'[,gp.resen. t~.t.!0nsl given in p.aragraph 5.'abo. ve by .an indep..endent · . i?p.'¢of~,~iona engi~' .~'r,e'~istered in'th~.St.,at9 of Alas. kg.: T. he DHHS does this.as a courtesy to purcnasers of r~omes a~d,~hi~i~:l~hdin~l"!~r~stf{utions in order to satisfy'certain federal and state requ,remen, ts.. E .m..ploy, e~.s o! DHHS .do no! conduitS' inspe'd%ions or analyze data bef. orea certificate is issued. The Mumclpauty o~ ancnorage ~s not responsible for errors or omissions in the professional engineer's work. 72.~25 (Rev. 1/91) Back MOA ~21 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES Environmental Services Division 825"L" Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Legal Description: A. WELL DATA Well type /2,/d/V.,~'~ Health Authority Approval Checklist A, B, or C~ attach ADEC letter. ADEC water systeul nunlber Parcell.D,: /5)/~7- ,.~7~' ~O,/ Log preseut (Y/N) _ Total depth 7/? / Sauitary seal (Y/N) Date completed Cased to ~ / . Casing height (above ground) ~/-/~_// Wires properly protected (Y/N) Y~---~ D 0 FROM WELL LOG AT INSPECTION Date of test Static water level / Well production / / WATER SAMPLE RESULTS: g.p.m. Coliform '~ Nitrate Date o£ sample: /~//51/5)ff'--- Collected by: B. SEPTIC/t4OLDING TANK DATA Date installed 0~ff~//?~ Tamksize_ ./:2-~g) NumberofCompartmeuts_ ~_,--_Cleauouts(Y/N) Foundation cleauont (Y/N) __ ~ 5 Depression (Y/N) ,Z/t9 High water alarm (Y/N) Date of Pumping /5/~//t) Pumper ,A//,4 C. ABSORPTION FIELD DATA Date iustalled Length _~ ~ / Width Effective absorption area Date of adequacy test ,Az/~//t/ Soil rating (g.p.d./ft2 or fl2/bdrm) _~_' ~-~ System type ~ / Gravel thickness below pipe ~/, / / Total depth / Monitoring Tube present(Y~) ~ Depression over field (Y~) Results (Pass/Fail) ~/~ For ~ bedrooms Fluid depth in absorption field before test (in.); ,A//,gl hnmediately after gal. water added (ill.): FMddepth /"///3r (ins.) Minutes later: ::: ' Ab,~;i'PtiOn rate = .g.p.d. Peroxide treatment (past 12 months) (Y/N) ,A//~ If yes, give date LIFT STATION /V//~ Date installed ~nw-----~'~/~ Manhole/Access (Y/N) ~q~'fi~ level at* ~Pump off lcwl at* High x~mr~ *Datum E. SEPARATION DISTANCES Septic/tm,!ding tm~k on lot Absorptiou field on lot Public sewer main SEPARATION DISTANCES FROM WELL ON LOT TO: 2L/~Q(~ / ; On adjacent lots v~//90 / On adjacent lots fi,//.,4 Public sewer manhole/cleanout Se~ev/septic service line ~ ~-~-~ ! Lift station SEPARATION DISTANCES FROM SEPTIC/IrtOLqDING TANK ON LOT TO: Building foundation 7~ ~ / Property line "/~/tQ / Absorption field Water mare/service line 7~/(~ / Surface water/drainage /~/tg0 ~Wells on adjacent lots 7 /DO / /,90 / SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Building foundation ~//~ / Water maim'service line -/~ /~ / Surface water 7~/00 / Driveway, parkiug/vehicle storage area '~//9 Curtain drain.jffYZ/~ ,ff~/P,4l,/g~ ,fi/~Wells on adjacent lots 7~/~)(~) / Property line F. ENGINEER'S CERTIFICATION ~..:.,..7'~ ~ ,~ '..~ 'h~. ~, I certi[.9 that I have r&termined thrufield inspections and review of~fullicioal rea~at'th~b;~x~:v&~nr are in conformance. * ,ith MOA lt:M g uiclelines in effiect on this date. ~ 6~ '..* ~,~:~*'~ ; ~.-~ % , ~.c~ Oa Date /0 - .* ¢- ~'F ~2".., ..,~"~$~~ ............................................................................................................ 23~~2 ............... HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Paymeut Receipt Number Rev. 8~95 OSS: haa.wk.doc