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HomeMy WebLinkAboutSKYWAY PARK ESTATES BLK 3 LT 4 Municipality of Anchorage Page / of '~ DEPARTMENT OF HI--ALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Waste water Disposal System and/or Well Inspection Report :~ ~ ~/ J~ WastewaterSystem: ~ew D Upgrade Phone: ~. ~ No. of~ooms: . ~ ~ Deep Trench ~ Shallow Trench ed D Mound D Other WELL: ew D Upgrade ~t~ ~ Ft, ~L~ Classification (Private, A,B,C): Total Depth: Ft. Cased TO: Ft. Total absorption, ar~(~ SQ. Ft. Yield:GPM I Pump Set at: Ft. Ic"~n"""'~h'~°~ ar°""~:F,. TANK SEPARATION DISTANCES ~s~pt,~ u Ho~ino u Surf~o. ~ LIFT STA'rlON Lot Size in gallons: r: Foundation ¢ 51 ~ ~ ~ I" p" : ateralarma,. Our/aiR~ ~ ~ Pump Make & Model Electrical Inspections performed by: Drain Remarks: BENCH MARK Assumed Elevation:. 17034 Eagle Ei~et' Loop Road NOT~~ ~{ ~ [ ~ ~ ~ .... ~ Inspections performed by: ............. )ucu~' 1st ~. [~ ~...~ Heal~um~ices approval ' ~ ' ' Department Of Reviewed and approved ,' ~?~0~[SS~0~ 72-013 (1/91) MOA25 Permit NO. ~'JC~l~Yl~'~-' Page Municipality df 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 RECEIVED OOT 4 1991 Mu ,, ,y of Anchorage Oept. Heaith& Human Service~ 72-053A(2/91) MOA2§ e tifie rilting SULLIYAN WATER WELKS P.O. BOX 070272, CHUOIAK, ALAgKA 9058? , 'TELEPHONE O'~vN{-:R Of lAND _ ].LL? l/._c~' : ' , _L_ ....... · ...... Ji.--,~- , ADDRESS / '~ ~-- ~ ; "' ' ' LEL AL DESCRI~ION ,m~ ~'t~ DA~E · Started ......... Ended . f'~/~/ ......... GALS I'[R HR .... ~ ..... ,/ I)t.P'l'lt OF ',','LLL. ~, ~ ,- /),.q 4' d ~ ,¢, t PR.~,~ Dow~ FT - ................ KIND OF FORMATION: '-" ,'" C ' d '";."z~ ........ FrooI-D --- FI. to_ ;-.-'---- FI.- From ~' ~ro~. ~ .. . J:l. ' ' ' ' ' Fto,n 5 "~-' _Ft. to.~,~- Ft.. From .... J:t to__ .__ Ft.__ From_ _F(. lo ..... Ft.__ From Ft. to .... FI .................. From ..... Ft to .... Ft ....... From_ __ Ft. to ..... Ft.. Fro ril ..... Ft. lo-- From__ __Ft. to_ .__ Fl._ Fr ol'n ...... Ft. to__. FI From .... Ft. to .... Ft From_ . from Ft. t~ ..... Fi.. l:lom ..... Fl Itj ........ FI.__ Frrtpl ..... Ft From ..... ["I. to~__~]: l ............... From ..... ~t. lu .... Fl .... From .... Ft. From .... Fl Io .... Ft.~. .- From ..~ Ft lo .... Ft ............. From ..... i- ~, to ...... Ft ......... From ..... Fl. ~o .... F{. -~' Municipality ct Anchorage Dept. Health & Human Services btIS¢:L, INFORMATION: PAGE 1 OF 1 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:SW910154 DESIGN ENGINEER:S & S ENGINEERS OWNER NAME:QUAN LA LAY WOO OWNER ADDRESS:il841 TOY DR EAGLE RIVER, AK 99577 DATE ISSUED: 6/13/91 EXPIRATION DATE: 6/13/92 PARCEL ID:01914122 LEGAL DESCRIPTION: SKYWAY PARK ESTATES BLK 4 3 LT LOT SIZE: 59939 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 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 (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ENGINEER MUST NOTIFY DHHS AT LEAST INSPECTION. RECEIVED BY: ~~q ~~ 2 HOURS PRIOR TO EACH June 7, 1991 ROBERT 8HAFER, P,E, ROGER SHAFER CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER&WATER MAINEXTENSIONS SEWER&WATER INSPECTION ENGINEERINGSTUDIES ANDREPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN Municip~ity of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 4; Block 3; Skyway Park Estates PERMIT REQUEST NARRATIVE RequeSt you issue a permit to d~ a well and install a septic system on the referenced property in accordance with our at~ached design dated June 4, 1991. As can be seen from the soil logs th~e exist~ a good sandy gravel layer on the property to a depth of 6 ft. The soil~ below are silty sands with groundwater at 11 ft. to 14 ft. We propose the installation of an absorption bed type system with a maximum depth of 3 ft. to allow a 3 ft. receiving soil layer of sandy gravel below the bed. The lot slope is mi~mal with a grade of approximately 5% from Toy D~ve toward the back of the property. As can be seen from the s~e plan the adjace~ properties are vaca~. Due to the large lot sizes we a~icipate no adverse affect on the n~ighboring properties from the installation of the proposed w¢~ and septic system. If you have any questions or require addition~ information for your review, please co~act us. Sincerel 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 SCALE Municipality of Anchorage ~1/ DEPARTMENT OF HEA.TH & HUMAN SERVICE~ I 825 "L" Street, Anchorage, Alaska 99502-0650 / LE6AL DESCRIPTION: ~ ~ ~/~ownship, Range, Section: 1 2 3 4 5 6 7 8 9 10- 11 13- 14- 15 16 17 18 19 20 WAS GROUND WATER ~,. I ENCOUNTERED? ~~'*~(~_ S DEPTH? p E Moniloring? I '~ Dale: Reading Date Gross Net Depth to Net Time Time Water Drop / - PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER J~:~.~.~_~_ TEST RUN BETWEEN ~ FT AND "~ . FT COMMENTS ~¢¢--'r~'~ ',~-h¢ ~ ~ /F~ ¢'¢-¢-~=~t1¢~-~*,, S & S ENGIN~EiHNG / / .... ' ]' - ~702fi E',?~.~ P)"~ [ n~d Ho. 204 /1 -/ , pERFORMED~Ie Rlvo,', Ala,ka 99577 ~~ / - ' ~~- ~/ ~/ / ~ CERTIFY ~HAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICiPAL GUlDE~ECT ON THiS DATE DATE: 7~-008 (Rev. 4/85) / PEREORMED FOR: Municipality of Anchoraae ~ 825 L Street, Anchorage, Alaska 99502-0650 ~ SOILS LOG -- PERCOLATION TEST /"~ DATE P/ LEGAL DESCRIPTION:["-¢~' ~'~ ~:~\f-~./ ~.,J~k"~( Township, Ra.ge, Section; 1 2 3 4 5 6 7 8 9- 10- 11 12 13 14 15 16 17. 18- 19- 20- SiTE PLAN WAS GROUND W~ ENCOUNTERED? IF YES, AT WRAT DEPTH? Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLA'rlON RATE ~- Iminutes/inch) PERC ROLE DIAMETER .~, ~__ PERFORMED BY' ' ' ~;; C ' .~-' ' · ~ CERTIFY THAT :" "¢;M ;:i",;J;<~ 'Jwr Lu~'IJ I'*.d No. 204//'~ THIS TEST WAS PERFORMED IN NORTH---- --- -- 2 7 5.75 I Ii 2'7 5.75 2 00.00 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 APPROVAL F-OR A SINGLE FAMILY DWELLING HAA# ~-/~ ¢'~ ~ 1. GENERAL INFORMATION Complete legal description Lot 4; Block 3; Skyway Park Subdivision; Location (site add~'ess or directions) Property owner Mailing address' Lending agency Mailing address Agent Address Quan LaLay Woo Day phone 11841 Toy Driv6~ Anchoraqe~ Alaska 99503 Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual well XX 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: X× 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 ,,,o~-=~luN 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 suppty and/or wastewater disposal system Js in compliance with aJJ Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Address S & S ENGINEERING ~ 17034~Ea~le_~River Lo_~o~ Roa~(Ne~ Engineer's signature Eagle River, AJasJ~a 99577 ..... DHHS SIGNATURE -,- Approved for Disapproved. bedrooms. -- Conditional approval for Phone bedrooms, with the following stipulations; Additional Comments By: Date The Municipality of Anchorage Depadment 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~Y2~ ./  Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAl.. CHECKLIST Legal Description: L..OT ~-( J.~U(.~,, -..~Y-.,v,i, vr4.,,,, If)£~ Parcel I.D. pl,l'~ A. WELL DATA Well type Log present (~) Total depth Sanitary seal C/N) If A, B, or C, attach ADEC letter. Date completed Cased to (~ I Date of test Static water level Well flow Pump level FROM WELl.. LOG [0 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot [0';~ ~ 1%5r Sewer service line ~Co~ Absorption field on lot Public sewer main ADEC water system number Casing height Wires properly protected .~N) g.p.m. ; On adjacent lots ; On adjacent lots _ Public sewer manhole/cleanout Petroleum tank . ' WATER SAMPLE RESULTS: Coliform (~ Nitrate Date of sample: I/2.[c~?.-. Collected by: Other bacteria Date of pumping B. SEPTIC/HOLDING TANK DATA Date instalred ¢J~')r"~l _Tank size J~"~© ~'"¥~- Compartments Cleanouts (~'N)" ¢'J~.S FounDation cleanout ~N) _ Y~ DepressiOn (Y(~ High water alarm (Y~__ ' .¢'~(5 Alarm tested (Y/N) ¢~,.) 6~ ~,',/&'Z' ~,,J~ Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot 10"~ ' On adjacent lots To property line //0 ' "/' ADsorption field Surface water/drainage ~0 ,~ I O0 ' ~" Foundation lO'+ .Water main/service line 72-026 (Rev, 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION ~j~ Date installefl.. Manufacturer Size in gallons~ / Manhole/Access (Y/~"'"/ .-~"Pump off" level at Vent (Y/N) ~ ~n" level at High water alarm level ' "'""~'~_ C.~ycles tested Meets MOA electrical codes (Y/N) ~ SEPARATION DISTANCE FROM L~TO: Well on lot j../ On adjacent lots __ Su~ D. ABSORPTION FIELD DATA Date installed ~ I'll c~ I S(Yd rating ('~ Length ~"~ ~ Width Total absorption area Depression over field (Y/~> Results (pass/fail) for Peroxide treatment (past 12 months) (Y~ /%)0 If yes, give date SEPARATION DISTANCE FROM A~SORPTION FIELD TO: Well on lot I'~© On~djacent lots I~o + Property line To building foundation ~% ~ ~ To existing or abandoned system on lot ~0~ ~O~ ~ ~ r ,, Onadjacentlots ~ ~ Cutbank ~ O ~ Water main/service line Surface water ~00 ~rive~ay, parking/vehicle storage area /0 Curtain drain ~ON~ ~O~ ~ E. ENGINEER'S CERTIFICATION I cedify that I have checked, verified, or conformed to~MOA and HAA guidelines in e~ate of this inspection. Signatu re 17034 ~,~le River Loop Roaa Ne. ~ ~W:' 4 9~ ~ , EagleR:ver, Alaska99577 ~; ;*,.~'~ ",' Engineer s Name __~__ "% ~,~ ,~,~,(~.~ ~. ~ Date · -- .~ ' '~.. ~,~ {, ~_. ...... .,L ~Xx~~ HAA / Waiver Fee: $ Date of Payment /~ ~ ~ / Date of Payment Gravel thickness ~ (~r~.~. P~PE Totaldepth /~- Cieanouts present (~YN) ~'...C Date of adequacy test ~..~(~F_ ~P:~ 4-- bedrooms 72 026 (Rev. 3/91) Back MOA 21 CHEMICAL & GEOLOGICAL LABORATORY A DIVISION OF COMMERCIAL TESTING & ENGINEERING CO. 5633 B STREET ANCHORAGE, ALASKA 99518 TELEPHONE (907) 562-2343 ANALYSIS RESULTS fez INVOICE t 50032 Chemlab Ref,# 92,0025 Somplo ~ 3 Matrix: WATER FAX: (907) 561-5301 Client Somple ID Colleetnd Received Preserved with L4 B3 SKYWAY PARK Client Nome :S & S ENGINEERING UA Client Acct :SNSEMGP JAN 2 92 @ 11:50 hrs. BPOt : JAN 3 92 @ 12:45 hre. Req# : AN REQUIRED Ordered By : PO# :NONE BECEIVED Analysie Completed : JAN 6 92 Bend Reports to: Laboratory Supervleor : STEPNEN C. EDE 1)3 & S ENUINEERINO Parameter Neeulte Unite Method Allowable Limits NITNhTE-N ND(O.IO) m~/1 EPA 353.2 10 Sample ROUTINE SAMPLE COLLECTED BY: N.J,S. 1 Testa Performed Bee Special Instructions Above UA-Unavailable ND- None Detected '* See Sample Remarks Above Nh- Not Anolyzed LT-Lees Then, GT-gzeater Then Member of the SGS Group (Socl~t~ GOn(~rale dO Surveillance)