HomeMy WebLinkAboutHUNDRED HILLS 1ST ADDITION BLK 5 LT 2
,. 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: ~--~'~ ~-~) I ~"/~ PID Number: 4~) 'P/~ I ~-1
Name~ I ~ ~ [ ~ ' Wastewater System: D New ~ Upgrade
Address:
~~. ~ ~ ~~ ABSORPTION FIELD
.Phone~ .~~ No.o~ooms: ~ Deep Trench ~ShallowTrenc~ed ~Mound ~Other
LEGAL DESCRIPTION so,, Rating: ~ ~[~ ~al Depth from origin~r~de:
~. ~GPD/Sq. Ft.
Lot~ Bloc~ ~~Subdivision:~ ~ Depth to pipe bottom from originally/grade: Ft. Gravel depth beneath pipe ~.~/Ft.
Township: Range: Section: Fill added above original grade: / Gravel length:
~ Ft. t.
WELL: D New D Upgrade Gravel~e?~ ~- [~1 Ft. ~ Ft.
Numbe~i~e~ Distance b~tween lines:
~fication (Private, A,B.C): Total Depth: Cased To: Total absorption area~ Pipe material:~
·
Driller: Date Drilled: Static Water Level:Ft. ~~ ~' Date installe~
Yield: Pump Set at: Casing Height Above Ground: TAN K
GPM Ft. Ft.
SEPARATION DISTANCES ~eptic ~ Holding ~ S.T.E.P.
To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons:
From Tank Field Station Tank Sewer Lines ~~~ ~ I
Well 10~/ 16~' ~ ~ ~ Materia~~ Number of Compartments:
Surface [~ l~¢'~ ~ ~ LIFT STATION
Water
Lot Size i~urer:
Line iD'+ I~ I~ ~ ~
Foundation ~ I ~l ~ ~ / "Pump on" level at: "~ High water alarm at:
CurtainDrain -'~' ~ ~~ ~ ~ Pump Make & Model Electrical Inspections performed ~
Remarks:~~ ~ ~ ~, ~~ BENCH MARK
Location and Description:
Department of Health~ Hume~rvices approval '~~~ ~ ..._
Reviewed and approved by: Date: -~
72-013 fl/91) MOA 25
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
NO.
72-013 A ~Rev. 9/911 MOA 25
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
ANDREPORTS
WELLINSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
ROBERT SHAFER, P.E.
ROGER SHAFER, P,E
October 20, 1992
CIVIL ENGINEERU
(907) 694-2979
FAX 694-1211
RECEIVED
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
REFERENCE:
OCT 2 0 1992
Municipality of Anchorage
Dept. Health & Human Services
Lot 4; Block 4; Hundred Hills Subdivision
Dear Susan,
Now that the septic system has been installed on the referenced
property we know how far it is from the "cutbank". (The natural
topographical change in grade is greater than 25%.)
As depicted on sheet 2 of 2 of the septic inspection report the top of
the cutbank is approximately 35 ft. from the existing leachfield.
However, due to the topography, this point is actually higher in
elevation than the leachfield bed. The point on the hillside at the
same elevation as the leachfield bed is approxi~tely 50 ft. away.
Therefor, effluent would have to travel 50 ft. horizontally to daylight
through the hillside. Given the heavy vegetation and organic soil
cover, and the fact that no confining soil layers were found to a depth
of 15 ft., we feel the possibility of daylighting is very small.
With this information we ask you to approve the situation as it exists
as opposed to placing fill over the hillside to increase the distance
to the cutbank as originally proposed.
Sincerely,
ROGER J. SHAFER, P.E.
RJS/tv
4~n~A C~l [: c~tWI:I2 I t3C~D f~IIITF 9[34 FAGI E RIVER. ALASKA 99577
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION: -'~L~-~i~ ~f'~ ~ ~
1
2
3
4
5
6
7
8
9
10
11
12
13-
14-
15
16
17
18
19
2O
Township, Range, Section:
SLOPE
WAS GROUND WATER
ENCOUNTERED?
L
IF YES, AT WHAT _ ~ 0
DEPTH;) P
Depth to Waler AIt~,~ ,
Monitoring?
E
SITE PLAN
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE '~' j (minutes/inch) PERC HOLE DIA~"I'ER ~ .~
TEST RUN BETWEEN ~'----~-- ~'~" :~;~::''¢' '~'' 'L~ii,:
FT AND FT t,!: :~]' '": '~
COMMENTS
S & S ENGINEERING ' ~-~/V~ CERTIFY THAT THIS TEST WAS PERFORMED IN
PERFORMED
BY:
17034 Eagle River Loop Road No, ;~(J4~ ~c::~- ~ Q~ ~ ~
ACCORDANCE WITH~i~R-~a~Ng~I~F~,GI-JIDELINES IN EFFECT ON THIS DATE. DATE:
LOCATION OF WELL
BOROUGH ~ SUBDIVISION
SECTION QTRS
~.;~TE OF ALASKA
DEPARTMENT OF NATURAL RESOURCES
DIVISION OF WATER
WATER WELL RECORD ~=/
LOCATION/SKETCH:
DEPTHS MEASURED FROM:r-]casing top I-]ground surface
BOREHOLE DATA:
~"~*~"~ Type and
, ...... ~! Color
Depth
From To
RECEIVED
OCT ! 6 1992
WELL OWNER:
WELL DEPTH: DATE OF COMPLETION
Depth of hole: /~O .ft
Depth of casing: /O~'~ ft ~ /--~" / ~-~
DEPTH TO STATIC WATER LEVEL:
ft beloW ~'top of casing
1-] ground surface
METHOD OF DRILLING: ~3ir rotary [] cable tool
[] other ~
OF WELL:'~[~domestic [] irrigation [] monitor
[] public supply [] other
CASING STICK-U/~! ~ "~--- ft. Diem: ~ in. to/~ ft
Casing type: ,~ ~_~ in. to /~D ft
WELL INTAKE OPENING TYPE:/~ open end [] screened
[] perforated [] open hole
Depths of openings: to ft
· TY-P--E:_ Diem: in.
Slot/Mesh Size: ~ Length: ft
iRAVEL PACK_T~PE:
Volume used: '~,
Depth to top:
GROUT T~r' Volume:
Depth: from ~ ft to ft
DEVELOPMENT METHOD: ~'~,
Duration: //~'~-~f
PUMPING LEVEL AND YIELD:
?~'"'- ft after / hfs pumping ~ ~ gpm
PUMP INTAKE DEPTH: ft Horsepower: __
WELL DISINFECTED UPON COMPLETION? ~;~;L YES [] NO
CONTRACTOR INFORMATION:
egister~d Business ~ame / /
STgnature of Auth'b~ized Resp,/,e~enta~ive Date
REMARKS:
PLEASE MAIL WHITE COPY OF LOG TO:
DNR/DIVISION OF WATER
PO BOX 772'116
EAGLE RIVER AK 99.577-2116
~..PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
P.O. BOX 196650, 825 "L" STREET, ROOM 502~ "
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW920156
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:JIM DEWINTER:~ -~ /~:
OWNER ADDRESS:7400 E. 20TH AVENUE
ANCHORAGE, ALASKA 99504
DATE ISSUED: 6/26/92
EXPIRATION DATE: 6/26/93
PARCEL ID:07819107
LEGAL DESCRIPTION: HUNDRED HILLS 1ST ADDITION BLK
4 LT 4
LOT SIZE: 109563 (SQ. FT.)
NUMBER OF BEDROOMS: 2 THIS PERMIT: 2
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD / 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 (18AAC80).
3. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL PROVISIONS:
1. PROVIDE TESTHOLE AND MONITORING AT SITE OF REPLACEMENT
SYSTEM.
2. FILL MUST BE ADDED TO PROVIDE 50 FOOT SETBACK TO SLOPE
IN EXCESS OF 25%. APPROVAL WILL NOT BE GRANTED UNTIL
ENGINEER VERI~I~ FIlL~ .]]~V} , '~ PLACEMENT.
June 8, 1992
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOIL TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
REFERENCE: Lot 4; Block 4; Hundred Hills Subdivision;
Request you issue a permit to install well and septic systems on the
referenced property as shown on the attached site plan.
The soils test used in the design of the septic system was performed
during the creation of the subdivision. Since the soils w~re shown to
be v~ry good, there is no reason to suspect variations, and this is
essentially a remote subdivision, we propose the second test hole
required for the alternate site be excavated during the development of
the property.
These are very large lots in this subdivision we do not anticipate any
adverse effects on n~ighboring properties by the installation of the
proposed well and septic systems.
If you have any questions or require additional information for your
review, please conta~ us.
Sincerely,
RJS/gm
17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577
· I"' = 60'
N 00'06'25"N # 00'03'5g'
.,mt
650.70 ~' t319.41
~0
82 1320.57
0
S O0 E S 00't2'21'E
VEl
E.~l.tuering, Architectural and Surveyin~ Consultants
.~_,ruin~ All o! Alaska
P,O. Box 774649
Eagle Rwer, Alaska 99577
(907) 694.3574
PERFORMED FOR: Hundred Hllls Sub'8, First Addition DATE PERFORMED: 7/14/87
LEGAL DESCRIPTION:
COMMENIS
rfg,¢ A:'r '4 ............... ~e~' ?t #3oz,
] SLOPE SITE PLAN
Topsoil
Silty Sand & Gravel
Sample ~11
GM, Silty Sandy
Gravel, Cobble
8" Minus
Some Boulders
1' to 1 1/2'
Vernon L. Roelft,
No. CE 5107
WASGROUND WATER
ENCOUNTERED?
NO
S
L
IF YES, AT WHAT 0
DEPTH? p
E~
Depth te Wate~ AJter
Memtering?
A
SE SIT]'~ tLAN I-
N
I
Gross~ Net Depth to Nat
Reading Date Time\ Time Water Drop
?erc
1 ?/15/87 M, 31 ~/4'5 1 1/Z"
Z 7/15/87 Z:3Z:tl3 Z~ sec
Monitor ~ -
l /IZ*l~'f lZs4~
PERCOLATION RATE 0. ~$~ Im,nutes/,nch) PERC HOLE DIAMETER 6"
TEST RUN BETWEEN 4 FT AND ~ 1 /2 F7
PERFORMED BY:
WL
1"= 60'
SCALIF
Parcel I.D. #
MUNICIPALITY OF 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
APPRQVAL FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Complete legal description
Lot 4; Block 4; Hundred Hills Subdivision
Location (site address or directions) Mile ~7.8+-,-Hiland Road
Property owner
Mailing address
Lending agency
Mailing address
Jim DeWinter' Day phone 333-5877
7400 E. 20th Avenue; Anchoraqe~ Alaska 99504
Day phone
Agent
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 2
TYPE OF WATER SUPPLY:
Individual well x
Community well
Public water
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system. ~
72-025 (Rev. 1/91) Front MOA #21
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 regulations in effect on the date of this inspection.
$ & S ENGINEERING
Name of Firm
Address
Engineer's signature
17034 Eagle River Loep Road NO: 2~0~_ ~
Ea~lle River, Alaska 99577
DHHS SIGNATURE
_~ Approved for
Disapproved.
Conditional approval for
Phone
Date t c~ - [ k,~-~l '~.
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
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.
72~025 (Rev. 1/91) Back MOA #21
Municipality of Anchorage
Department of Health & Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: ~c' '~..~(..~ ~
A. WELL DATA
Well type--'~-\V/~'~ If A, B, or C, attach ADEC letter. ADEC water system number
Log present4~)'N)
Total depth
Sanitary seal,N)
Date completed (~¢:~ --~..~;>~ ~ "J.~ Driller
Casedto '~ ~ Casing height
Wires properly protected(~)%l) "7
Date of test
Static water level ~.~ I
Well flow ~C>
Pump level ~
FROM WELL LOG
SEPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer serwce line
g.p.m.
AT INSPECTION
; On adjacent lots
; On adjacent lots
Public sewer manhole/cleanout
Petroleum tank I'~ ~
WATER SAMPLE RESULTS:
Colifc rm ~- Nitrate
Date of sample:
~,~1 ~'~ [¢ Other bacteria
Collected by: ~ ~ ~ ~-~[~ I~--J
B. SEPTIC/HOLDING TANK DATA
Date installed
CleanoutS~~N) y
High water alarm (Y/N)
Date of pumping
Tank size ~ ~c:~:~;:) Compartments "Z...-
Foundation cleanou~) y , Depression (Y~
Alarm tested (Y/N)
Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot ~ c>'2.. I On adjacent lots
.,'TO property line ~, ~
AbSorption field
Surface water/drainage
-F- Foundation
water main/service line
72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
"Pump on" level at
Man ufactu rer
Manhole/Access (Y/N)
"Pump off" level at
Cycles tested
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed
Length
Total absorption area
DepreSsion over field (Y~?
Resu Its.~[~2.fail)
'~'~ ~ .~ ~-~'Z--~ Soil rating O .'~ ~ System type ~---~
\
Width ~""~' Gravel thickness ~ ~ Total depth
Cleanouts present ~C~'N)
Date of adequacy test
for ~
Peroxide treatment (past 12 months)
*'/ If yes, give date '""-""'
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot
On adjacent lots \ ~ Property line
To building foundation
-- To existing or abandoned system on lot
On adjacent lots
Surface water
Curtain drain I~/~'
W~tter main/service line
Driveway, parking/vehicle storage area
E. ENGINEER'S CERTIFICATION
Signature
Engineer's Name
Date
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
5 & $ ENGINEERING
17034 Eagle River Loop Road NO. 2~4
Eagle River, Alaska 99577
HAA Fee $ / '~ , d~
Date of Payment
Receipt Number
Waiver Fee: $
Date of Payment
Receipt Number
Collsct~d ; OC~ 14 92 S 1~:00 h~m,
R~twd : OCT It ~2 ~ 15:55 h~s.
BFO{ ;
O~d~red ~y ~R. B~AFER
O.lI r~l/1 EPA 3~3.2/30C o 1.0
8~mpls ROUYI~ SAMPLE COLLECTED NY: ~.W.