HomeMy WebLinkAboutNORTH WOODS UNIT 4 BLK 17 LT 3Northwoods FljNffm,A Block 17 Lot 3 #051-064-52 George P. Wuerch, Magor May 12, 2003 Anchorage Mumcipality ofAncho agp hiftge All-America City Building Safety Division i I111 2002 Jim Lewison 21631 Snowflower Loop Chugiak AK 99567 Subject: On -Site Water and/or Wastewater Permit. Permit Number: SW020198 Legal Description: Northwoods #4 Block 1'7 Lot "3 Dear Jim Lewison: An On -Site Water/Wastewater Permit, number SW020198, issued by this office for a single-family system, will expire on June 28, 2003. This permit was valid for 36§ calendar. days. If this was a well permit and the well has been drilled, a well log must be sent to this office for documentation of the installation and to close the permit. If this permit was for a wastewater disposal system, an original as -built inspection report must be sent to this office for review, approval and documentation. This as -built inspection report must be signed by the licensed Professional Engineer who inspected the installation of the system. As -built inspection reports are required to be submitted within 30 days of the completion of the system. If no system was installed under this permit, and you are still planning to install a well or wastewater disposal system, a new permit must be 11 obtained from this office''A new permit for a second year may - be issued for a fee of $100.00 if the renewal application is received on or before the expiration date of the original permit. When applying for a new permit, the fees are: $400.00 for a wastewater permit and $150.00 for a well permit. If you have any questions, please call this office at 343-7904. Sincerely, JYCross, P.E. Manager On -Site Water and Wastewater Program Enc: Copy of permit P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: (907) 343-8301 • Fax: (907) 343-8800 4700 South Bragaw Street • Anchorage, Alaska 99507 http: //\l'«'«'. ci. anchorage. ale. ns r' MUNICIPALITY OF ANCHORAGE r Development Services Department On -Site Water &Wastewater Program 4700 South Bragaw Street P.O. Box 196650, Anchorage, AK 99519-6650 (907) 343-7904 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Upgrade Date Issued: Jun 28, 2002 Expiration Date: Jun 28, 2003 Permit Number: SW020198 Parcel ID: 051-064-52 Legal Description: NORTH WOODS UNIT 4 BLK 17 LT 3 Design Engineer: 0003 S & S Engineering Site Address: 021631 SNOWFLOWER LP Owner Name: Jim Lewison Lot Size: 26659 SQ. FT. Owner Address: 21631 SNOWFLOWER LOOP Total Bedrooms: 3 Permit Bedrooms: 3 CHUGIAK , AK 99567-0000 This permit is for the construction of: ❑✓ Disposal Field 7 Septic Tank Holding Tank E] Privy E] Private Well E] Water Storage 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 DSD at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Received By: Date: G /A t /o z Issued By: 2( I Date: Ae r' Municipality of Anchorage Development Services Department Building Safety Division On -Site Water and Wastewater Program 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 www.cLanchorage.ak.us (907) 343-7904 ON-SITE SEWER/WELL PERMIT APPLICATION FOR A SINGLE FAMILY DWELLING Parcel I.D. 1� / " �� ��— Permit Number SW Property owner(s) J t m L� W t ort Day phone `a' S $1$ Mailing address (1) Z t l0 5 L J n 6w Mailing address (2) �!N)K Zip Code Legal description (Lot, Block & Sub'd.) L o� 3 �� j o alk CJs S i fl 4 Legal description (Section, Township & Range) Lot Size -fares/Sq.Ft. THIS APPLICATION IS FOR: Sewer Only Sewer and Well ❑ Sewer Upgrade Q THIS PROPERTY CONTAINS`. Hot Tub ❑ Swimming Pool ❑ Therapy Pool ❑ Number of Bedrooms 3 Well Only ❑ Water Storage ❑ Jacuzzi ❑ Water Softening Unit ❑ I certify that the above information is correct. I further certify that this application is being made for a Single Family Dwelling and is ---W? in accordance with applicable Municipal Codes. !4 naW ,, S & 5 ENGINEERING (Signature of property owner or authorized agent) 17034 Eagle River Loop Road, No. 204 Eagle River, Alaska 99577 Permit Fees: Date of Payment: 1 r X"t( � Receipt Number: (Rev. 12100) Date of Payment: Receipt Number: S& June 14,2002 ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907)694-2979 FAX(907)694.1211 HEALTHAUTHORITY APPROVALS MUNICIPALITY OF ANCHORAGE SEWER&WATER Development Services Department MAIN EXTENSIONS P.O. Box 196650 Anchorage, AK. 99519 SEWER S WATER REFERENCE: Lot 3, Block 17, Northwoods S/D #4 INSPECTION It is requested that you issue a permit to install a septic system to serve the existin� ENGINEERINGSTUDIES three bedroom dwelling on the referenced property. ANDREPORTS A test hole was excavated and a percolation test was performed. The approximate location of the test hole is located on the attached site plan. At the time of excavation 5/20/02 water WELL INSPECTION was not found & after seven days of ground water monitoring the test hole was found to be &FLOWTEST dry. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve SITE PIANS areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent properties. ROAODESIGN If you require additional informatioll, please contact us. Sincerely, solLresr Robert C. Cowan, P.E. PERCOLATION TEST RCC/J hm Enclosures STRUCTURAL& MECHANICAL INSPECTIONS ONSITE WASTEWATER DISPOSALSYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP • SUITE 204 a EAGLE RIVER, ALASKA 99577 mArn ti W m� \\\ m A Z Q � a n 9 s $ SITE PLAN k �� 0 DESIGN m m N as D o .a GJ Vn A 0 O N O CZ M 7 = N mzO � IZ DOm O K Cy lV f0 C O �a O � Z = � I N � Zm O O l O Of0 A D� m RIa vraO ' ZmAO 0 Mw m N� / N Zm=Zmo = o< < mm pz—I Z zJp mm F,o m -I�p m F /t mm y (7p Z D mm D n D oTf.m � D 7 m m p m 0 A S O R' x OZ mo O Dp ZC rix OC mr NOm mDi0 mArn ti W m� \\\ m A Z Q � a n 9 s $ t - k �� 0 m m Yid I lld'H'�Sd ObAA y �g> < urnNA � (l' PDO NNb -JNA �O mJo b JO � oil x ® Cn O v p .- on 9 a �•� a W C+] F AJ ✓V � n � �J Iel C] O ^1 ^ a m U 1 1l��yJ O4 O"3 'Zom yy mm ��O aO te'?-e z -e Cm•nm moo O �•+ ^m.cm�czm Q oymmC'y..jy -3 kCaTJKr>ZN � L/ .00L'7i O � � � C'•I'� 'Z y a m,4aj x'Z�mz O vyo v,a m90 z�A os zm z zz zw .fi 4 mom.. 1 xom g 'L 0 < m L m�D m m N as o .a GJ Vn lld'H'�Sd ObAA y �g> < urnNA � (l' PDO NNb -JNA �O mJo b JO � oil x ® Cn O v p .- on 9 a �•� a W C+] F AJ ✓V � n � �J Iel C] O ^1 ^ a m U 1 1l��yJ O4 O"3 'Zom yy mm ��O aO te'?-e z -e Cm•nm moo O �•+ ^m.cm�czm Q oymmC'y..jy -3 kCaTJKr>ZN � L/ .00L'7i O � � � C'•I'� 'Z y a m,4aj x'Z�mz O vyo v,a m90 z�A os zm z zz zw .fi 4 mom.. 1 xom g 'L 0 Performed For: Legal Description: L Municipality of Anchorage Date Gross Time Development Services Department Depth to Water p� Building Safety Division Zj vZ o On -Site Water and Wastewater Program ��• 4700 South Bragaw St. P.O. Box 196650 Anchorage, AK 99519-6650 �d W W W.ci.anchoraoe.ak.us O (907) 343.7904 '- Soils Log - Percolation Test 10 t'L--w 15 O'j Date Performed tz ROBERT C. COWAN J ,t - CE -8801 Depth (Feet] Q/Z!sl�N�CS 1- 2- 3- 4- 5- 6- 7- 8- 9- 10-0. - 3-4-5- 6-7-8-910-Q 11- 12- 13- 14-- 15- 16- 17- 18- 19- 20- COMMENTS 1-12- 13- 14-_- 15- 16- 17- 16- 19- 20- COMMENTS U M WAS GROUND WATER ENCOUNTERED? A/ Q s IF YES, AT WHAT DEPTH? ^_ L Depth to Water After p Monlloring? �qp E Date: N Ip li Reading Date Gross Time Net Time Depth to Water Net Drop �so� Zj vZ o 0 O 0 '- 10 D 0 0 — 30 30 1 n%2• i PERCOLATION RATE � (minW"Mch) PERC HOLE DIAMETER (r TEST RUN BETWEEN 5 FT AND _FT PERFORMED BY:% PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL �%✓` CERTIFY THAT THIS TESL WAS IN EFFECT ON THIS DATE. DATE: HEALTHAU FIORITV APPROVALS SEWER&WATER MAIN EXTENSIONS SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELLINSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOILTEST PERCOLATION TEST STRUCTURAL& WCHANICAL INSPECTIONS ON SITE WASTEWATER DISPOSALSISTENI DESIGN ROBERT C. COWAN, P.E. ROBERTA. SHAFER, P.E. CIVIL ENGINEERS (907)694-2979 FAX(907)694-1211 ON-SITE WASTEWATER DISPOSAL SYSTEM CONSTRUCTION PRACTICES and MATERIAL SPECIFICATIONS REFERENCE: Lot 3, Block 17, Northwoods #4 June 14, 2002 GENERAL: 1. The scope of this project includes the verification of the existing 1000 gallon septic tank and installation of a new 1000 gallon tank if necessary, and installation of a new trench to serve the existing three bedroom residence located on 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 Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. 4. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. 5. 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. SEPTIC 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. 17034 NORTH EAGLE RIVER LOOP SURE 204 • EAGLE RIVER, ALASKA 99577 Page 2 Lot 3, Block 17, Northwoods #4 June 14, 2002 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4 ft. of cover shall be insulated. 5. A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there 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. 6. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFIELD INSTALLATION: 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. 4. 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. Page 3 Lot 3, Block 17, Northwoods #4 June 14, 2002 5. 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. MINIMUM MATERIAL SPECIFICATIONS: 1. Any septic tank proposed for installation must be constructed by a Municipal approved septic tank manufacturer. 2. The following pipe materials are approved for use in septic system installations in the Municipality of Anchorage: Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes No ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Femco, or equal). 5. 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. 6. All leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements, which ever requirement applies. Page 4 Lot 3, Block 17, Northwoods #4 June 14, 2002 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: 1. 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. 2. 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. 3. 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/INSTALLER MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ` ENVIRONMENTAL ENGINEERING DIVISION 825 L Street - Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION NAME REPORT C . -r e V I-P� L - S PHONENEW MAILING ADORES �nAe-% p ❑UPGRADE `? O, ©x C 1a� LEGAL DESCRIPTION Lor 3 LOCATION W O Wi`!�, 'IF e^ LOOS NO. OF BEDROOMS DISTANCE TO: vz Manufacturer Well OFF SrcE Absorption area Dwelling PERMIT NO. aQ a��rSl�lwl2 t�-T- w F REESZ Material N Liq, capacity in gallons. STe£`. Noof compartments , rL ✓ IF HOMEMADE: Inside length Width Liquid depth DISTANCE TO: Well Dwelling =-F Manufacturer PERMIT NO. Material � Liquid capacity in gallons � Well ' DISTANCE TO: Foundation ,e w �-- 2T s Nearest lot line PERMIT NO. LL No. of It Length of each line 1O ~ z W Total len th of lines Trencji width F -1k abWitt-rTe" A/ A ?y x 147'-iaehes ¢ ro Top oft to finish grade Distance betwseen lines O Material beneath the 3p Total effective abso ption area Length Width Depth inches U, 12g UJ a Type of crib Crib diameter Crib depth PERMIT NO. Lu Total effective absorption area W DISTANCE TO: Well Building foundation Nearest lot line _j Class Depth Lu Driller w Distance to lot line PERMIT N0. DISTANCE TO: Building foundation Sewer line Septic tank Absorption areas) OTHER �. ?VC SOI LSO I L T�— 'Z40 INSTALLER ((���� �= REMARKS 1!9,T. X72-073 (Rev. 3/78) / K_ 3. L 6 3 ' ~ j "ll U V-9 1- ������ �� .���7- 1:3 ,x uEp/iK;MENT OF HEHLTH HND ENVIRONMENTAL PROTECTION 825 'L' STREET/ ANCHORAGE, 8K 99501 ` 264'^472 0 � 8NCHQRHQE 694-2I ]-1 � EAGLE RIV��R � � - � ` 3p�� T 7� E3Z949Z�� � ���-L� �7E� r1 I7 PERMIT NO. 8]�089 � ^^ APPLICANT: �SKAGQS CONSTR PHONE: ADDRESS: PO Do, -,j D ` � CHUG IH�/ HK 99567 ' LEGAL DESCRIPTION - SUBDIVISION: NORTHWOOD #4 BLO{�K:� �7 LOT: '� LOT SIZE 0 SQ FT, TDWNSHIP ` ' � ~'` � � - RANGE: - SECTION: - MHXIMUM NUMBER OF BEDROOMS � ] SOI� - TING = 1]8 ~^8 1]8 (SQ FT �BR) LISTED BELOW HRE T�E OPTIONS HVHILHBL� �� YOU IN DESIGNING �OUR�SE�/IC ' SYSTE� CHOO�E THE O - ^~ ' r/ _~ OF -TION THAT BEST FITS YOUR SITE. ` SEPTIC . �..... �..... .... ..... ~..... ~._. ..... `__... ..... WIDTH 2.5 FT. LENGTH = 6�.0 Fl[ TOTAL DEPTH 60 F^[ ! NOTE ! ^ REQUIRES INSULATION GRAVEL DEPTH � I0 FT. ! NOTE ! ~ MAY REQUIRE LIFT STATION GRAVEL \/O�UME =� 22.] CU.YDS TANk' SIZE = 1,000.0 SRLLQNS (TWQ COMPHRTMENT TANK') WIDTH i Q 0 F'[ ' LENGTH� ]60 F`[ TOTAL DEPTH 50 F^[ ya� QR8YEL DEPTH � Q 5~ T. GRRYEL VOLUIE 24.0 CLI. YDS. TANK' SIZE = 1,00Q.0 GAILLONS (^ o �OMP8RTMENT TFINK) 1-41 E -,u E-.: ��r=# i-- rr.,q �I EE L- F-".- C-- E:-: 1:3 1��� WIDTH 50 FT. LENGTH 58, 0 FT � ' TOTAL DE�PTH �� 6� 0 F4'* T ' GRAVEL uErTM 2. 0 F^[ GRAVEL VOLUME 26 8 CU.YDS. THNK SIZE � �, � # GHLL�NS (TWO C8MPHRTMENT TANK) ... ... ..... ��... .... ���.... ����... ��..... ICERTIFY THAT: �- I HM FHMILIHR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WB -LS HS -SET FORTH BY THE MUNICIPALITY OF ANCHORAGE H� ND THE STATE OF HLHSKH I ' 2. I WILL.WILL.INSTALL THE �M Y�T�INHCCORDHNC�� ��ITHTHE CODES HNDHHY�� RECEIVED 8 COPY OF THE CODE SUMMARY AND DIHGRHM ATTACHMENTS PS PART OF THIS PERMIT. I I UNDERSTAND TI HT THE ON^SITE SEWER SYST|M MHY REQUIRE ENLARGEMENT IF THE RESIDENCE IS' REMODELED TO INCLUDE MD~[ THHN -] BEDROOMS c M PERy1IT APPLICANT HAS THE RESPONS��IE3-ILITY TO INFORM PERSONNEL DURIN� THE INSTHLLRTION INSPECTIONS OF HNY �ELL.S HDJA(�ENT TO THIS HN[} ` THE.NUM8ER OF RESIDENCES TH�T THE t --JELL WTLL SERVE n PROPERTY IF O LIFTSTF\TION IS INSTRLLED, Hy� ELECTRICHL�PERMIT APD INSPECTIQN �UST BE ODT8INED. 8S�BUILTS 'ANNOT BE �P^ROVED W1T�OUT AN ELECTRICAL � REPORT. THE' EL�CTRICRL ~[}RK M�ST BE B� A L� T INSPECTION n LICENSED ELECTRICIAN. SIGNED: \ :SSUFD BY SK�G�S CONSTR \L�- Department,�UHealthLand OF ANCHORAGE 825 L Street, Anchorage, AK. j501 `l 264-4720 Permit # j(O6 # # HANDWRITTEN PERMIT # # # WELL AND/OR ON-SITE SEWER PERMIT Applicant: eY_C^,y-' Mailing Address: P Q %OY �1 Location: (V y, d ( V Phone Number: (4k- �-f pp'�. Legal Description: (,., 3 � � L rya 1' WtkOgt Size: — Type of Soil Absorption System Is: Trench: Drainfield: ✓, Seepage Bed: Holding Tank: Maximum Number of Bedrooms: 3 Soil Rating(sq.ft/br) The Required Size of the Soil Absorption System Is: DEPTH �_ LENGTH R _ GRAVEL DEPTH _ - WIDTH The length dimension is the length(in feet) of the trench or drainfield. The depth of a trench or pit is the distance between the surface of the ground and the bottom of the excavation(in feet). There is no set width for trenches. The gravel depth is the minimum depth of gravel between the outfall pipe and the bottom of the excavation(in feet). * * REQUIRED SEPTIC(HOLDING) TANK SIZE _100 GALLONS GALLONS # # Permit applicant has the responsibility to inform this department during the installation inspections of any wells adjacent to this property and the number of residences that the well will serve. # # # TWO(Z) INSPECTIONS ARE REQUIRED # Backfilling of any system without final inspection and approval by this department will be subject to prosecution. 4inimum distance between a well and any on-site sewage disposal system is 100 feet Eor a private well or 150 to 200 feet from a public well depending upon the type )f public well... Minimum distance from a private well to a private sewer line Ls 25 feet and to a community sewer line is 75 feet. Well logs are required ind must be returned to this department within 30 days of the well completion. )ther requirements may apply. Specifications and construction diagrams are available to insure proper installation. * * * PERMIT EXPIRES DECEMBER 31, 1 9 3 3 # # # I certify that: (1) I am familiar with the requirements for on-site sewers and wells as set forth by the Municipality of Anchorage. (2) I will install the system in accordance with codes. (3) I understand that the on-site sewer system may require enlargement if the residence is remodeled to include more that 3.bedrooms. Signed: C 1J�� GGGj 5 Issued by: (7s, M�_ App 1 i t -- ----- 4. Date: SeW�P'/024 (1/81) r t u) SOILS LOG r--1 MUNICIPALITY OF ANCHORAGE �` rp f� ae , DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTIONPERCOLATION / TEST 825 L. Street, Anchorage, Alaska 99501 264.4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: SX -11,966S E,Xc A 114 7-I/16 DATE PERFORMED: S 6 LEGAL DESCRIPTION:�r/J SLOPE SITE PLAN 1 2 (GA1� 5t1-�y (7rec�e:l - `3roarl ! Se-dte. __*4 4- 5 6 7 8 9- 10- 11 - 12- 13- 14- 15- 16- 17- 20 213- 14- 75- 16-17- 20 (6m) Sd+V 6mue l - 6n_-1 OF C. ; Reid, t. 2251-E 'EGROUND ND IF YES, AT WHAT DEPTH? oil Reading DateGross Time Net Time Depth to Water Net Drop 3•0- 137 .3.302 I) �- 3 !� 07 y 3;13 L(0 a: 1 5- 1 5, e 2 .6 m) ,yo PERCOLATION RATE 4/�,. (minutes/inch) ,,� ''} / T S-IRUN QBE EEN �' FT AND • FT r COMMENTS Q-Jp �% —'�—tet f '.� � 0 'r� 0'..�� f o 40 E's P,(1j, r.. . PERFORMED BY: 6REf_U /%tJ/•j-rr7. CERTIFIED BY: DATE: 72.008"(6/79) ALASKA O1101101111611TAL COnTROL SMICCS, Inc. Engineerinq 6 6nuironmental Studies PERCOLATION TEST DATA SHEET CLIENTCicP�C,C.SxCta�YAn�4 DATE \Z—Q - g ADDRESS t� +I14g1 Nxx ZIP CODE C\Cl S(o'I LEGAL LOCATION Uo-- 3 �lpC� \'� bio-kzn. olJS TOTAL DEPTH OF HOLE ft. ZONE TESTED q-6 ft TO 4 ft �F riea•. e READING # CLOCK TIME NET TIME DEPTH TO DATUM (t� NET DROP RATE (min/in) 4 ,�•:o AO .of,� t;l� iv Vii U6vz% 06 FINAL PERCOLATION RATE !> (min/in) PERFORMED BY\7EtfN0 "I OJest 33rd �iuenue, Suit 9 Anchorage, Alaska 99503 • 1907) 276-1361 MUNICIPALITY OF ANCHORAGE • Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING Parcel I.D. # C)f�' � 'cloj_l- ,, HAA # lA (�SSL) rS, 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) (b) Property owner `�`� r'A 214,4/ Q Telephone: (home) Business Mailing Address `24 kir3 I — ef-t fes— "n 5�1 (c) Lending Institution Telephone Mailing Address (d) Real Estate Company and Agent'�T fes` j i S 1 t__s Address 9> -IL- ""19 S-7:7 Telephone (e) Mail the HAA to the following address: (or check here if hold for pick up.) List contact person and day phone number below: S & S ENGINEERING 17044 Fagla River Loop X62d"20 Eagle River, Alaska 99577 2. TYPE OF RESIDENCE Single-Famillo< Number of bedrooms 3. WATER SUPPLY Individual Well ❑ Community Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to th legality and status. - 4. SEWAGE DISPOSAL On-site' Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 72-025 (Rev. 7/88) Page 1 of 2 ENGINEERING FIRM PROVIDING INSPECTIONS, TESTS, FILE SEARCH, DATA AND INFORMATION 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 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 S & S ENGINEERING Address7-02 Cagle River Loop Road No. Eagle River, Alaska 99577 Date Telephone C ,Y 6, DHHS APPROVAL C Approved for—bedrooms b Date—'C Approved Disapproved ,. p Conditional Terms of Conditionai Approval /�DI�kS J The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval cerificated 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 orderto 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. 7/88) Back Page 2 of 2 i MUNICIPALITY OF ANCHORAGE (MOA) • '� Health Authority Approval (HAA) MU OF ANCHCCktIECKLIST - FEBRUARY 1984 ENVIRONMENTAL SERVICES DIVISION 343-4744 ML 17 1989 - Legal Des�c\\ription: � A. WELL DATA R E C E I V R Well Classification If A, B, C, D.E.C. Approved �7N) t— Well Log Present (Y/N) Date Completed Total Depth Cased to Depth of Grouting Static Water Level Casing Height Above Ground Electrical Wiring in Conduit (Y/N) SEPARATION DISTANCES FROM WELL: Yield Pump Set At Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) To Septic/Holding Tank on Lot Z X0`-1' - ; On Adjoining Lots To Nearest Edge of Absorption Field on Lot I+-,-- ; On Adjoining Lots To Nearest Public Sewer Line To Nearest. Public Sewer Cleanout/Manhole To Nearest Sewer Service Line on Lot Water Sample Collected by Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA ; Date Date Installed 17Z 1'l Size 1 tO�ao/No. of Compartments 2 '� Standpipesa/N) _Air -tight Caps4-,9/N) _Foundation CleanoutMN) _V__ Depression over Tank (Y&� p r_3 ate Last Pumped Pumping/Maintenance Contact on File (Y/N) N ;for Holding Tank High -Water Alarm (Y/N) 1_� b Temporary Holding Tank Permit (Y/N) NIA SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK: To Water -Supply Well '/ To Building Foundation To Property Line 1 r::> I"'- To Disposal Field_ To Water Main/Service Line b I A, i To Stream, Pond, Lake or Major Drainage Course 4- Comments1o1►6�Cz 72-026 (Rev. 7/88) Front Page 1 of.2 er /� C. ABSORPTION FIELD DATA 1_1� ,f Soils Rating in Absorption Strata 2'00'521 :r�a-- Type of System Design ` Date Installed 'k—ce:r's l Length of Field 4'77 Width of Field Depth of Field,'s / Gravel Bed Thickness d7• ) Square Feet of Absortion Area j t Z�Statndpipes PresentqY/N) T— Depression over Field (YAP Date of Last Adequacy Test Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water -Supply Well I� To Property Line To Building Foundation To Existing or Abandoned System on Z 1 Lot it,; On Adjoining Lots To Water Main/Service Line 1 r_-;� f.,k.- To Cutback (if present) A To Stream, Pond, Lake, or Major Drainage Course g''A— To Driveway, Parking Area, or Vehicle Storage Area fib' + Comments D. LIFT STATION Date Installed Size in "Pump On" Level at High Water Alarm Level at Tested for Meets MOA Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) ""Check Permitted Bedroom Rating Against HAA Request' "Pump Off" Level at Vent(Y/N) ng Cycles during Adequacy Test. I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the d&te of this inspection._ Signed s & S ENGINEERING Company 17034 Eagle River Looe Road No. 2u4 a Date MOA No. Receipt No. /VI_73 ;7�2,f Date of Payment 2-1 �2 `6P Amount: $ 1;7d, 00 Receipt No. _ Waiver Fee: $ Date of Payment 72-026 (Rev. 7/88) Back Page 2 of 2 ,al STEVE COWPER, GOVERNOR i DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE WESTERN DISTRICT OFFICE 563-6775 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 0 DATE: July 14, 1.989 PWSID: 213001 To Whom It May Concern: According to the records on file in this office, the Chugiak Utilities/Northwoods Water System, is in compliance with the State of Alaska Drinking Water Regulations, Thank You, Cindy Thomas, Environmental Engineer CT: gd Time APP.LICNT FILLS OUT UPPER HAL ONLY Time -Property Owner _T & DCOAStrtistion Phone Halling Address BOX 2524 Palmer AK zip Code 99645 745-2731 Buyer Russell and Venessa Madigan Inspector Address Zip Code Inspector Lending Institution Alaska Pacific Mortgage Coppany Phone Address P. Box 520 Anchorage, AR Zip Code 99510 276-3110 Realty Co. &Agent Totem ReA1ty, Inc. -Del Crowder Phone Address 724 E. 15th Avenue Anchorage Ak Zip Code 99501 272-0571 Legal Description Lot 3, Block 17 Northwoods IV Street Location NHN Loop Road p.. BY: �.3C�{� ir.J Type of Residence Soils Rating 7202313182) Date Sewer Installed L t `l '�3 Ek Single Family ❑ Multiple Family ❑ No. of Bedrooms Septic ze d v Other Water Supply ❑ Individual - �t/ ATTACH WELL LOG. A well log is required for all Wells drilled dune P9 Community �- since 1975. ED Public Utility For wells drilled prior to that date, give well depth (attach log if available).: - Sewer Disposal 6d Individual ❑ Public Utility Year Individual Installed: 1983 ❑ Holding Tank When Connected to Public Utility: NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. Time Time Time Time Date Date Date Date Inspector Inspector Inspector Inspector Field Notes: 2 a S - 'No --f MUNICIPALITY OF DEPT. OF HEALTH & ENVIRONMENTAL PROTECTION RECEIVED ( T) APPROVED BEDROOMS 'CONDITIONS OF APPROVAL ( ) DISAPPROVED ( )CONDITIONAL APPROVAL' DATE I - /(o - 8 �{nn^^ p.. BY: �.3C�{� ir.J Soils Rating 7202313182) Date Sewer Installed L t `l '�3 Well To Absorption Area Well to Tank® Well L7Tank Septic ze d v January 12, 1964 T & D Construction Box 2524 Palmer, Alaska 99645 Subject: Lot 3, Block 17, Worthwoods IV Approval for the individual sewer and water facilities cannot be granted until the following items have been completed. '5 0 The permit for the installation of the on-site sewer system wall expire December 31, 1983. Vie have not received the as-builts of the installation in this office. if a private engineer inspected the system, please send us the report � w(�� for our files and review. z (2z i Skaggs Construction Company needs to get the correct legal descriptions to this office. Please notify this Department for a reinspection when the noted discrepancies have been corrected. If there are any further questions, please call this office at 264-4720. sincerely, Cory Willis, R.S. Acting sewer & Water Program Manager CW90/ej/El