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Home My WebLink AboutNORTH WOODS UNIT 4 BLK 16 LT 15 Municipality of Anchorage Page / 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: ~ ~ ~(~)IZ¥~ PID Number: f~ l~) _ , _ ~, ~, ~. . steWater System: ew ~ Upgrade Addross~ ~d~ t~T~- [[~~~ ABSORPTION FIELD Phone: ~~.~ No. of B~oms: ~ Deep Trench ~ Shallow Trench ~Bed ~Mound ~Other Total Depth from original grade:~ LEGAL DESCRIPTION so, Rating: ~' ~J' GPD/Sq. Ft. Subdivision: Depth to pipe bottom from original grade; Gravel depth beneath pipe Fill added above original grade: Gravel length: Number qf lines: ~ Distance belwee~ lines: WELL: u New ~ Upgrade Gravel~,[~ ~ Ft. a~ I ~ Ft. ClassificationXate, A,B.C): TotalDepth: Ft. CasedTo: Ft. Totalabsorption ~ SQ. Ft. P, ei~~~ Driller: Date Drilled: Static Water Level: Installer: Date installed: GPMI Ft. Ft. SEPARATION DISTANCES ~epUc ~ Ho~d~n~ ~ S.T.E.P. To Septic Absorption Lift Holding Public/Privat~ Manufacturer: Capacity in gallons: From Tank Field Station Tank SewerLines ~~ ~ [~ ~ Well ~ ~1~ ~ ~- ~'+ Material:~..~ Number of Compartments: Surface Water 1OD~ I~'+ ~ ~ -- LIFT STOLON Lot~ ~ Size in gallons: Manufacturer: Gurtain ~ctrical Inspoctions po~ormed Drain ~( ,~¢ ~ d~ d' PumpMake&M0del Remarks: BENCH MARK Location and DescriptJon;~ 0¢ ~ '~~ Assu~e~ Elevation: ENGI~%%~EAL Department of Health and Human Services approval t. ~¢~... .., Reviewed and approved by: ~ ~¢ Date: /d--~ -9/ 72-013 (1/91) MOA 25 / Permit NO.., ~--'~':~iO I'~ Page Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES of ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 · Anchorage, Alaska 99519-6650 · Telephone: 343-4744 On-Site Wastewater Disposal System and/or Well, Inspection Report LegalDescription: ..17Jo1~.'r]-J' I, JC¢::~::>~ ~,JI-r'"lv', :E:~ I~ [,,-r i~---~ PIDNo.: ~143(~4~,~I 72-013 A (2/91) MOA 25 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 WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW910145 DESIGN ENGINEER:S & S ENGINEERS OWNER NAME:NORTHWOODS INC OWNER ADDRESS:709 W. INTL. AIRPORT RD. ANCHORAGE, AK 99518 DATE ISSUED: 6/10/91 EXPIRATION DATE: 6/10/92 PARCEL ID:05106427 LEGAL DESCRIPTION: NORTH WOODS UNIT IV BLK 16 LT LT 15, T15N, R1W, SEC 3 LOT SIZE: 23864 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD 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 (iSAACS0). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ~~ ISSUED BY: · .5 June 3, 1991 ROBERTSHAFER, P,E. ROGERSHAFER CIVIL ENGINEERS (9071694-2979 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 DISPOSALSYSTEM DESIGN Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Lot 15; Block 16; North Woods #4; "PERI, IT REQUEST NARP, ATIVE" Request you issue a p~rmit to install the proposed septic system as shown in our attached site plan for the referenced property. Although this is considered to be a dry part of North Woods Subdivision and we did not encounter groundwater within the test hole we performed, we propose the installation of a shallow absorption bed. Th~ property is served by the North Woods Water System with the key box near the road whereas our proposed septic system is near th~ rear of the lot. Since the soil conditions in the area are fair and there are no individual w~lls we anticipate no adverse effect on the neighboring properties by the installation of th~ proposed septic system. If you require add~ional information to complete your review, pleas~ contact us. ~BERT A. SHAFER, P.E. RJS/gm 17034 EAGLE RIVER LOop, SUITE 204, EAGLE RIVER, ALASKA 99577 SCALE Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: 1 2 3 4 5 6 7 8 9 I0 11 12 13- 14 15 16 17 18 19 WAS GROUND WATER ENCOUNTERED? L IF YES, AT WHAT O DEPTH? p I]opth l0 Waler After E ] Monitoring? _~ Date: ~'.~.~.4) Reading Date Gross Net Depth to Net Time Time Water Drop 20 - PERCOLATION RATE ~:2~es/inch) PERC HOLE DIAMETER __ TEST RUN BETWEEN ..~ ,~ND ~- FT COMMENTS PERFO ......... '~;" ~'~ ~." ~.~",~,~]~-- ~'"-~;70~Z~'~( ~,~ ..... ;"~'~,';"~ ~: ' '; /I/~/ ~ ~ CERTIFY THAT THIS TEST WAS PERFORMED IN 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST 1 2 3 4 5 6 7 8 9 10 11 12 13 14- 15 16 17 18 19. 20- I I~--'~, DATE PERF( Township, Range, Section: ,-~\~::~ t~' ,~, SLOPE SITE PLAN WAS GROUND WATER ENCOUNTERED? L IF YES, AT WHAT O DEPTH? p Deplh to Waler A..~.~Jp,[,,~_~. ,. Monitoring? - _c,-~./ Date: ~'"'~z~'~J~,i Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE__ TEST RUN BETWEEN ~ ~ AND ~ FT COMMENTS PERFORMEDBY:~70~:~:~:'~',~r~57~ I~/ / CERTJFY THAT TH, ~ag' .... ~' ~ ~ S TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELI~FFECT ON THIS DATE. DATE: 72-008 (Rev. 4/85) MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anci~orage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # 05106427 1. GENERAL INFORMATION Complete legal description NORTH WOODS ~4, BLOCK 16, LOT 15 Location (site address or directions) 2~625 SCt6Ztering Spt[zee Loop Property owner Mailing address: Lending agency Mailing address Agent Address ~'I ("~c~'¢~ ¼~-t-%/~r~'-(% L,~% Day phone 563-2278 709 W.., International Airport Road. Anchorage. Ak 99518 Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 3 TYPE OF WATER SUPPLY: Individual well Community well XX Public water NOTE: If community well system, provide written confirmation from State ADEC attest- lng 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 wastewate, r system, provide written confirmation f, rom 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 furtherverify 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 ail Municipal and State codes, ordinances, anc~ ~e§[El~l~tNCCt~ullfect on the date of this inspection. 17034 Eagle Ri,ver Loop Road No. 204 Name of Firm EaCe River, Alaska 99577 Phone ~/'¢- ~'? 7¢ Address Engineer's signature DHHS SIGNATURE ~' Approved for bedrooms. Disapproved. Conditional approval for 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 DH HS 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) 8ack MOA #21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: [L~.. ~/~frZ~; [~ [~:~,~[/~Parcel I.D. ~1 ~ A, WELL DATA Well type ~ Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump level If A, B, or C, attach ADEC letter. Date completed Cased to FROM WELL LOG ADEC water system number Driller Casing height Wires properly protected (Y/N) g.p.m. AT iNSPECTiONJNICiPAU~Y OF ANCHORAGE r~NVII[ONMENTAL SERVICES DIVISlOI~ SEP 2 7 1991 ! V £ D SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line ; On adjacent lots ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed ~;;~' I ~ -~-~ t Tank size !~"~(~ Compartments Cleanout~N) ~,x Foundation cleanou~N)y Depression (Yi~ High water alarm (Y/N) K_~/~. Alarm tested (Y/N) ~//A, Date of pumping' - ' ~,.~! j~; (/..~ .~_--b~t'~/ Pumper SEPARATION DISTANCES FROM SEPT C/HOLDING TANK TO: Well(s) on lot ~..)[ Ct. On adjacent lots ~¢'~LOr '-~ TO property line JO1''~ ~Z~---)' Surface water/drainage Absorption field I Foundation ~--~'~ Water main/service line ~,~ ~''~ 72-026 (Rev. 7t91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y/N) ,'Pump on" leVel at High water alarm level ~ Meets MOA electric~ SEPARATION D~ANCE FROM LIFT STATION TO: Well on Io~ On adjacent lots Manufacturer ,.,----~ "Pump off" level at Cycles tested Surface water D. ABSORPTION FIELD DATA Date installed '~ I~ ~ Length , ~l f Width Total absor~ption area I Pepr~s~i0~h Over field (Y(~ Results (pass/fail) I~1~[ '~'~W"~ Peroxide treatment (past 12 months) (Y/~)) [~ ' Soil rating ~)~ Z~'~--~'~.~.t,-'~'System type Gravel thickness ~,~ / Total depth Cleanouts present. N) ~ Date of adequacy test ~ ~ ~ · for ~ If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot I~//~-. On adjacent lots "~ / ~ Property line To building foundation On adjacent lots Cutbank ~ I..~ ~> Water main/service line Surface water Curtain drain bedrooms E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effec Signature s 17034 Eagle Ri~er Loop Road Engineer's NameE_~!e ~Ner, .~.!_~_~_~ Date HAA Fee $ /~.,~. ~2 0 Date of Payment Receipt Number 72-026 (Rev. 3/91) Sack MOA 21 ~fec.~. [e, of this inspection. '. Waiver Fee: $ Date of Payment Receipt Number ,-' Lt:~ L£'"~ ~ iL.~ ' r~ ~ ~'0) IJ t~. LF~ DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE DISTRICT OFFICE 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 September 24, 1991 WALTER J. HICKEL, GOVERNOR 563-6775 FOR: S & S Engineering PWSID 213001 My review of the records on file in this office reveals that the Northwood Subdivision Class "A" Public Water System, is in compliance with the provisions of 18 AAC 80.200, State of Alaska Drinking Water Regulations. Sincerely, Keven K. Kleweno Lead Engineer