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HomeMy WebLinkAboutNORTH WOODS UNIT 4 BLK 15 LT 10 Municipality of Anchorage Page I of '~, 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: ~ '~6o~,~ t PID Number: Name: L~o~ A~o~ Wastewater System: ~New ~ Upgrade Addres3: e.o. g~x .~o~5 c~o~,~,~7 ABSORPTION FIELD Phone: ~ ~ - ~ O~ ~ NO. of Bedrooms: ~ ~ Deep Trench ~ Shallow Trench ~ Bed ~ Mobnd ~ Other LEGAL DESCRIPTION so, Rating: Total Depth from original grade: O,~ GPD/Sq. Ft. ~ I Lot: j ~ Block: . ~ubdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe Township:__ ~Range: ISection: Fill added above original grade: Gravel length: ~/ / r° r~ L WELL: [x,5~ D New D Upgra~ Gravel width: Number of lines: Distance betweenlines: Classification (Private, A,B,C): ~ Cased To: Total absorption area: Pipe material: Driller: ~ Date Drilled: Static Water Level: Installer:~ [ ~ ~ Date installed: ~ I Pump Set at: I Casing Height Above Ground: SEPARATION DISTANCES ~Septic D Holding ~ S:T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity{n gallons: From Tank Field Station Tank Sewer Lines ~0~ ~E TANI~ I 0~0 Material: Number of Compa~ments: Sudace Water JO0'+ Joo~ -- -- ~ LIFT STATION LineL°t ~ ~ ' ~ I ~ ~ ~ Size in gallons:I ~ Manufacturer:~ Remarks: BENCH MARK Location and Description: k A~D ~ ~ Assumed Elevation: S & S ENGINEEEIN~ Inspections performed by:.~-= -. ., . .... uates: 1st Department of Health and~umpn Se~ices approval ,:.....-..... ...... Reviewed and approved by:~ ~~¢~~ Date' 2/T~ ~".-~ ...... 72-013 (Rev. 9/91) MOA 25 Permit No. SW950291 2 Page Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION 2 of P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well'lnspection Report LOT 10, BLOCK 15, NORTHWOODS S,/D #4 05106403 Legal Description: · ., PILl NO,: 8T1 S'[';~ MT2 C 6 C05 MT1  / INSULATiDN · 10o~ a~ ~eo~, ~o~ SEP' C ,7' .f TAN~ 8~.8'/ ~ 8g 8' ~ 85,3' NO WATER ~UND A B I I J ST1 36,5' 6' ~ ST2 ~7' 12' C01 ~7.5' 14' J ~ c02 ~8' ~ 5' ~ J / - FD 41' 21.5' J R~(SJ5~ ~NEW TF'.ENCH C05 46' 36.5' ~ co~ C04 54.5' 24.5' u~ ~.~, .~ C05 '47' 67' cog 38 ~' 6~' ~ ~A2~;~ GROUN~ MT2 36' 63' I J % / co~~c°~ ~NEW 1000 GAL ~ ~2 ~ J ~ s~[ SEPTIC TAb K ~ I / BDRM . :,~ ,,, ,], SHELTERING SPRUCE LOOP MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES TELEPHONE ~43-4200 7 5 7 (~ NOTICE OF VIOLATION Please take notice that the undersigned authorized representa-  of the Director has reason to believe that on or about ~V~'~RV o~/'/ ,19=/b , at or near the followin~l: APPROX flVIATE LOCATION ADDRESS: Cie ~4~ ~IM~ ~ ~LVE~ ~ITMIN ~M~ ~UNI~I~ALITY OF ANOMO~A~ DI~ UN~WFULLY: . which is a separate violation of S ~1~,~,~.~1 . o~ [ne ~ncnorage uooe OT Mrolnan- ces each and every day such condition exists. A COPY OF THIS NOTICE HAS BEEN SERVED UPON: AT IN THE FOLLOWING MANNER: ~ by personal service ~ 2. by certified mail 3. by posting this notice on or about the location described herein when such person.cannot be found after diligent effort to do so. If the violation or viol~tionF referred to herein have not been corrected by ~ 1~- ! ~ , 19 q/~ , legal proceed- ings may be initiated as provided by law. Dated this ~l day of ~ ,19 fig. NAME TITLE 70-004 (Rev. 8/88) DISTRIBUTION: WHITE--Department CANARY--Violator s s SUITE 204 ,,o~ ,. ~ .v~ ,ooP ~ R E C E I V E D ~GLE ~R, ~S~ 99571-78~ D Munic~pality of Anohorage ept. Health & Human Services HEALTH AUTHORITY APPROVALS EXCAVATI~O CIVIL WORK AR~NOED/ADEQUA~Y TESTS/SOIL TESTS WATER & SEWER LI~ES & ~AI~ EXTEnSIOnS O~-SITE INSPECTIONS DATE OF MESSAOE ROUTINO SYMBOL TI~OF MESSAGE REPLY , From: DATE OF REPLY J ROUTING SYMBOL SIGNATURE OF REPLIER TITLE OF REPLIER RETAINED BY ADDRESSEE PAGE 1 OF MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW950291 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:HOUSTON TROY A & ANGELA M OWNER ADDRESS:lB635 NEVA CIRCLE EAGLE RIVER, AK 99577 PARCEL ID:05106403 DATE ISSUED: 9/25/95 EXPIRATION DATE: 9/25/96 LEGAL DESCRIPTION: NORTH WOODS UNIT IV BLK 15 LT 10 LOT SIZE: 23846 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONSTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK 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 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: ROBERTC. COWAN, RE. ROBERTA. SHAFER, RE. September 11, 1995 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SIT;: WASTEWATER DISPOSAL SYSTEM DESIGN MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 10, Block 15, Northwoods S/D %tV Request you issue a permit to install a septic system to serve the ?#~.~ bedroom house on the referenced property. Two test holes were excavated and percolation tests performed. The approximate location of the test holes are located on the attached site plan. At the time of excavation no water was encountered in the test holes and after seven day ground water monitoring, the monitoring tubes were found to be dry. This property has enough area for a future septic upgrade which can be seen on the attached site plan. We do not anticipate any adverse effects on neighboring wells, septic systems or drainage patterns by the installation of the proposed septic system. This property is served by a Community Water System. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/gk : Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 o o~.-] © 0 40' OOT r'_O -- ZE,_{''< ix, o~ C) ..-~ r'rl --I P'I SITE PLAN VOYLES BLVD. 1 UP-GRADE. J 8 o 'T' o~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 ~H 6 7 8 9 10 11 12 13 14 15 16 17, 18- 19 2O COMMENTS ~'~I,-V-~" /,..~¢,,r~,~o~ship, Range, Section: ~-~ ~ 4 SLOPE ENCOUNTERED? , SITE PLAN IF YES, AT WHAT ~"'~/~ DEPTH? E Depth to Water A~r I · Monitoring? P'~; ~' Dale: ~.2'~'~.--- Reading Date Gross Net Depth to Net Time Time Water Drop --z.- ~,.l~- ~ ~,~ ~ ~ls* ~/~, '/~ 'Y'"' PERCOLATION RATE TEST RUN BETWEEN -- (minutes/inch) PERC HOLE DIAMETER FT AND ~' FT PERFORMED BY: S & S ENGINEERING 17334 Eagle Rive~ Loop Road No ACCORDANCE WITH A!~__S~,],~'[J~.~A:~ID~[JNICIJ~A[..C~UIDELIN~:~"~'i'I~EFFECT ON THIS DATE 7~2-008 ~Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: PERFORMED FOR: LEGAL DESCRIPTION:~:,~' ~,t.~ L," 1 2, 3 4 6, 7 8 9 10, 11 12 13 15 Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L' Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE PERFORMED: Sip ~. ,d~ SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? IF YES, AT WHAT DEPTH? Date Monitoring? Time Net Depth to Net Time Water Drop 16 17, 18 19 ROIERT C, ¢OWAN CE - 8801 2O COMMENTS )/~)'FPERCOLATION RATE TEST RUN BETWEEN -- (minutes/inch) PERC HOLE DIAMETER __ FT AND ~" FT PERFORMED BY: 17034 Eagle River L~p ~a.& ~_ ~1 ~ CERTIFY THAT THIS TEST WAS PERFORMED IN Eagle River, Alaska 995~ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~ ~ ~- ~ ~ 72- 0 ROBERT C. COWAN, RE. ROBERTA. SHAFER, PF HEALTH AUTHORI'Pf APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 REFERENCE: Lot 10, Block 15, Northwoods S/D ~IQ September 11, 1995 1. The scope of this project includes the installation of a 1000 gallon septic tank and two five foot wide drainfields to serve the proposed three bedroom residence for the referenced property. 2. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wast.water Disposal Regulations. Se J The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSAL SYSTEM DESIGN TANK INSTALLATION 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577 Page Two Lot 10, Block 15, Northwoods S/D ~ September 11, 1995 e Septic tanks installed with less than 4 ft. of cover shall be insulated. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield ther~ shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10 ft. from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/D~AINFIELD INSTALLATION= 1. Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (ruffed-up) before gravel (sewer rock) placement. 2. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. 3. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Se Monitor tubes shall be of four (4) inch diameter, installed approximately in the locations shown on the design, and extend a minimum of 12 inches above final grade. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page Three Lot 10, Block 15, Northwoods S/D ~ September 11, 1995 MINIMUM MATERIAL SPECIFICATIONS: Any septic tank proposed for installation must be constructed by a Municipally approved septic tank manufacturer. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: ~ Perforated Solid Cast Iron ASTM D3034 (PVC) ASTM F810 (HDPE) ASTM D2662 (ABS) Yes Yes Yes Yes Yes No Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). St Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. Se Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the ~200 sieve. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A, or D.E.C. requirements. Page Four Lot 10, Block 15, Northwoods S/D~g September 11, 1995 INSPECTIONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. ® The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. e The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required. Especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractors activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractors activities. Final acceptance of the contractors work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/OWNER 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ~,~'i - o(,~t _ O~ HAA# 1. GENERAL INFORMATION Complete legal description Lot 10; Block 151 Northwoods IV Location (site address or directions) Property owner Mailing address Leroy Alde.~.man P.O. Box 670045 NHN She¢.tering Spruce. Loop Chuqiak, AK Day phone 688-3403 ChugZak, AK 99567 Lending agency Mailing address Day phone Agent Address Day phc ne Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well 'NOTE: XXX Public water If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: NOTE: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system, 72-025 (Rev. 1/91) Fr0nl MOA #21 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. Name of Firm Address Engineer's signature s & S ENGINEERING 17,3,34 -";'u:- ~,;,-, L~p' Road Eagle River, Alaska 99577 Phone Date / / ~z-~_ / tl ~ DHHS SIGNATURE k Approved for Disapproved. Conditional approval for bedrooms. S bedrooms, with the following stipulations: Additional Comments By: Date c~\--~) 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 Alaska 9950 Legal Description: A. WELL DATA Well type ~.t, 'IFA, Logpresent (Y/N) Total depth Sanitav number FROM WELL LOG Date of test Static water level Well production WATER SAMPLE RESULTS: - g.p.m. Coliform C'ollecte:d by: B. ~oLDING TANK DATA Date installed /°/01~/qS- Tanksizei': ]oeo ' Number, of COmpartments Foundation cleanout (~/N) ~'t $ !~! DepressiOn (yi~'~::~ o High water alarm (Y~ Date of Piimping /d ;~?-,v~,,/ pum er ~ C: 'ABSORPTION FIELD DATA Vateinstalled - S il ' rD , ra g ~or fi fodrm), O- . System type ~ ~-,~ c Width ~ ., Gravel thickness below pipe ; (0 Total:depth Other bacteria 'Effective absgrption area ¢ S" o Monitoring Tube present~ Y¢J~ Depression:o~er field (Yt~)' Date'of adequacy test A~/4 - m ~ ' ~ Results~(Pass/Fail)~ ' i , For ~oom~~: ;. inabsorption field before testii(in: added On.): , · Fluid depth Fluiddepth '~: - -- ~ = ~ ' g.p.d. Peroxide treat ~fi~t 12 moilths) (Y~): '- If yes, give date ~ /S~ptic/holding tank'on!ot - Absorption PUblic ~eWer ~main SEPARATIO] Building-foundation Surface water ~i~ Curtain drain [C Signature - HAAFee $. ~-~ ' ~ Receipt NUmber-