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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.