HomeMy WebLinkAboutRIVER VIEW ESTATES BLK 2 LT 3
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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/']Ct:~0'¢'0~/ PID Number: 0'5'072-//4/
~ame: ' Wastewater System: ,~ New [] Upgrade
^ddreee: ABSORPTION FIELD
~ ~ No. of Bedrooms:
~ ~/w~, ~ ~77[ ~ ~UeepTrench ~ShallowTrench ~ed_~M°und ~Other
Soil Rating: Total Depth from original grade:
LEGAL DESCRIPTION
Lot: Block: Subdiv~ion: Depth to pipe bottom from original grade: Gravel depth beneath pipe
Township: Range:~I~ Section:~ Fill added above original grade:/,~ Ft. Gravel length:, ~7 ~ Fl,
WELL: ~ New ~ Upgrade Gra~e~ width: ~ Ft. Number/of lines: Distancecbetween lines:Ft.
Classification (Private, A,B,C): Total Depth: Cased To: Total absorption ares: Pipe materiah ~/~
Driller: Date Drilled: Static Water Level: Installer: Date installed:
Yield: Pump Set at: Casing Height Above Ground:
SEPARATION DISTANCES ~Se¢ic ~ Holding ~ S.T.E.P.
TO Septic Absorption Lift Holdin9 Public/Private Manufacturer: Capacity in gallons:
From Tank Field Station Tank Sewer Lines ~/~ ~
Well /~' /~// 2 ~ I~ Material: ~ Number of ~C°mpartments:
s,rf~c~ LIFT STATION
~ot ~ tp Sizo in oallons: Manulacturar:
Line /~ /~ ~ ~
"Pump on" level at: ~~ High water alarm at:
Foundation
/
7
Electrical
Inspections
performed
by:
Curtain
Drain
BENCH MARK
Remarks:
Location and Description:
Assumed Elevation:
Inspections performed by: Eagle River, Alaska ¢¢~I Dates: lst_X
Department of Healt urea cas appr~al/ .,,
Reviewed and approved by: ate:
72-013 (Rev 9/91) MOA25
Permit No.Sw930504 Page 2 of 2
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
Legal Descriptio~IVER VIEW ESTATES, BLOCK 2, LOT 5 PID No.: 05072114
FC0 --
C01
C02
COS
C04
CO5
MTt
C01 C02
N.T.S.
NEW 1250
NEW
1250
S,T,
UAL GRADE
INSULATION
92. l
SEPTIC TANK
i 86.1' NO WATER FOUND
100' WELL 2ADIUS
o WELL
4 BDR, M
HOUSE
72-013 A (1/93) '
OWNER OF LAND
i::'i' !i ': ' OC~C Co. O~a
,:SULLIVAN WATER WELLS
@.O. BOX 6?0272, OHUGIAK~ ALASKA 99667 · TELEPHON£ 68~.2759
ADDRESS [ ~ ~O ~C ~/~, ~ tJ~ ~ ~: STATI(' LEVEL DF WATER FF.
LEGALDESCRI~ION ag~ ' /~&~ R ~/')~} I~ DRAW DOWN F'[.
DATE- Started Ended ~ qO
GALS. PER fiR
KIN[) OF CASING
PERMIT NUMBER
KIND OF FORMATION: · .
From ~) Ft. to C), Ft. ~/'~'s'''O4 5'2'-'/~]/~ F~om
From.c~ Ft. to ~ ... Ft. O0 ~ddt~dd~,~ Fron,.
From J~'- Ft. to'q~:' Ft. ~2r?'[ ~d/~Udc, From~
From ['6 Et. to/JO Ft. ~c~)~i)c. lc' (;}'C/~G~: From
From
Fro,,,
From
From
From
Fro,.
Ft. to/~' .Ft.
Ft. to ,J~_Ft.
· Ft. to ~_d~Ft.
~Ft. to Et.
..... Ft. to ~ Ft.
From ..) g .?
From
From
Ft. to_,__Fl
Ft. to Ft.
Ft, to__~ Ft.
Ft. Io Fi,
Ft. to Ft
Ft. to Ft.
__ Ft, to Ft,
Ft. to Ft.
.Ft. to Ft,
Ft. to_ Ft.
Ft. to_ Ft
From Ft. to · Ft.
From Ft. to
From Ft. to Ft.
Ft
From Ft. to Ft.
Ft
From Ft, to Ft.
From Ft. to__ Ft
MISCL. INFORMATION:
': ' -7'o :-4 ~--- {o"
DRILLER'S NAME" /_.,t ~/ ,.t ......
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
PAGE 1 OF
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW930504
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:HANSEN MAURICE R & REBECCA L
OWNER ADDRESS:9413 HILAND ROAD
EAGLE RIVER ALASKA 99577-9411
DATE ISSUED:12/28/93
EXPIRATION DATE:12/28/94
PARCEL ID:05072114
LEGAL DESCRIPTION: RIVER VIEW ESTATES BLK
3
2 LT
LOT SIZE: 97080 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
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 (iSAACS0).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 OR 343-4681 AFTER BUSINESS HOURS
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:
RECEIVED BY: ~,k~J DATE:
ISSUED BY: / ~-- ~bc~ DATE:
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E,
December 8, 1993
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: River View Estates Subdivision, Block 2, Lot 3
Request you issue a permit to drill a well and install a septic system to
serve the proposed four bedroom house on the referenced property.
Test holes were excavated and percolation tests performed. The approximate
location of the test holes are located on the attached site plan. The monitoring
tubes within the test holes have been checked and 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 ant/c/pate any adverse effects on neighboring
properties by the installation of the proposed septic system.
If you have any questions, or require additional information for your review,
p/ease contact us.
:. ~%afer, P.E.
~'V RAS/LSU/Isu
17034 NORTH EAGLE RIVER LOOP o SUITE 204 ° EAGLE RIVER, ALASKA99577
/
/
/
/
/
UTIL. WALKWAY
20' ,'~ ESMT.; ~.55
ON-SITE WASTEWA TER DISPOSAL SYSTEM
CONS TRUe TION PRACTICE$
and
MA TERIAL SPEC/FICA TION$
REFERENCE: River View Estates Subdivision, Block 2, Lot 3
GENERAL:
1.
The scope of this project includes the installation of a 1250 gallon septic
tank and five foot wide drainfields to serve the proposed four bedroom
residence for the referenced property.
Construction shaft be in accordance with the approved site plan and design
drawings; Municipal permit with any spec/a/provisions or conditions; and aft
applicable State and Municipal Wastewater Disposal Regulations.
The contractor shaft be responsible for obtaining any necessary
underground utility locates.
Unless specifically agreed otherwise, the property owner shaft be
responsible for final grading areas subsequently depressed from soft
settling. On aft leachfield mound systems, the property owner shall be
responsible for ensuring a sa tisfactory vegetation growth o vet 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.
SEPTIC TANK INSTALLA T/ON:
A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shaft include two 4" cleanouts for pumping access.
The septic tank shaft be sufficiently bedded to prevent settling or shifting of
the tank.
Aft standpipes on the septic tank shall extend a minimum of 12 inches
above final grade.
Page Two
River View Estates Subdivision, Block 2, Lot 3
December 8, 1993
Septic tanks installed with less than 4 ft. of cover shaft 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 there shall be
two adjacent cleanouts (unless an effluent pumping system exists within the
septic tank). These cleanouts shaft be located on undisturbed soft not more
than 10 ft. from the tank. The first cleanout, in line, shaft be to clean toward
the leachfield. The second cleanout shaft be to clean toward the septic
tank.
Final grading over the septic tank shaft 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 shaft 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.
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 m/n/mum of 2 inches of cover over the pipe.
A silt barrier must be installed between the final gravel layer and the native
soft backfill. Ensure the silt barrier covers the entire gravel surface before
placing backfill.
Monitor tubes shaft be of four (4) inch diameter and installed approximately
in the locations shown on the design. The portion of the monitoring tube
extending through the gravel shaft 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
River View Estates Subdivision, Block 2, Lot 3
December 8, 1993
MINIMUM MA TERIAL 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:
.Type of Pipe Perforated Solid
Cast Iron Yes
ASTM D3034 (PVC) Yes
ASTM F810 (HDPE) Yes
ASTM D2652 (ABS) Yes
Yes
Yes
No
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).
Septic tank inlets and outlets shall be fitted with watertight couplings
(Caulder, Fernco, or equal).
A permeable nontoxic silt barrier (Typar 3401, M/raft 140N, or equal) must
be installed between the final leachfield gravel layer and the native soil
backfill.
All 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, it's gradation spec/f/cations
must conform to current M.O.A. or D.E.C. requirements.
Page Four
River View Estates Subdivision, Block 2, Lot 3
December 8, 1993
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 p/ace, but may not be backfilled
before this inspection.
The second inspection must be conducted after the placement of the
silt barrier, grave/, 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
instal/at/on of multiple trenches, sand filters, pressurized distribution systems, etc.
Thus, the inspecting engineer is to be contacted at least24 hours prior to the start
of construction. If necessary, a pre-construction meeting will take place on-site.
SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L, Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
PERCOLATION
TEST
PERFORMED FOR: SO ~.~"~
LEGAL DESCRIPTION:~-~O'~ '~
1
2
3
4
5
6
7
8
9
10
11
12
13
SLOPE
WAS GROUND WATER , \
ENCOUNTERED? ~l~)
IF YES, AT WHAT
DEPTH?
DATE PERFORMED:
SITE PLAN
14
15
16
17
18
19
2O
Reading Date Gross Net Depth to Net
Time Time Water Drop
',,o t
PERCOLATION RATE
TEST RUN BETWEEN
I L~ (minutes/inch)
~-'~-~--~ FT AND ~' ~ F
PERFORMED BY:
CERTIFIEDSY: / ' /'%~
\
DATE:
;.~,.d,~ l?;ver, Alas!ca 99572'
72-008 (6/79)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Ancherage, Alaska 99501 264-4720
SOILS LOG- PERCOLATION TEST
SOILS LOG
PER CO LATION
TEST
PERFORMED FOR: ~'~c~'~,.~-~--~
LEGAL DESCRIPTION:
9
10--
11
12
13
14
15
16
17
18
19
20-
SLOPE
2
SITE PLAN
/
/
/
I _
WAS GROUND WATER
ENCOUNTERED?
DEPTH?
Reading Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE ~ ~-~ (minutes/inch)
TEST RUN BETWEEN ~9~'%'~"-FT AND "~'~' FT
PERFORMED BY:
72-008 (6/79)
S & $ I~NGINE~RING
1 ;"034 Eagle River Loop Road No. 204
Eagle J~iver, Alaska 99577
CERTIFIED BY:
DATE:
::-.. _~,4L~7,...::':....;_;...~:'d?~,~,~ _.....'.;,.Division:of Environmental 8e~i~es.-::~
': ':.-.-.: 7.. _' . .- ,..' P,O, Box 196650 ';Anchorage, Alaska~*99519~650
, :. ,:'-h;~: ;; ~;~--- - .~;.-:v. CERTIFICATE
' ' . APPROVAL FOR A SINGLE FAMILY DWELLING_'
:.:--,' L-j~_ ;.::~:~(~&0c~t!on (s~te ad~ress or d~rectmns)
: ~ :¥?:~-.~?~?.~:~:?,?':;~'(;'.5?-/~L.".~{'.::Z~ ~- '. ::. ::'~: :._ ~ .' _./E~.~,5._. A~
..', ..,'='...A--Y<* Z-,~L*~:i~X:e~-!g~*:~%¢ .~-~-5,:. .' · ~. - ' .~.,_~ ..-.:, .: ,-: -:- .'r: ~- :; 'Z.--*-/L,-:.:, .~.}.~;.
..... :.: .... :--~: ~.mn.':~a~..'-?,' H . 5 ox 94./5 .... .:- Eag~.:g~v~,.- :.AK_.:_99~7-7c--;_
-:.- : .. xxx
Individual well
CommUnity well ..............
communi~ well-system,~: provtde :wHRen
:~(~.;~lng: to.the legah~.and status of syst~,
' ::t caffesting to t e eg '~ and statu system.
72-025 (Rev. 1/91) Front MOA
' 5.,'~",; STATEMENT~.OF INSPECTION-BY ENGINEER
. :-' `..L:~`!:.~..::i:;!:~`~;;A.~.~.e~.rtified:.~9~r~y;s~a~x.ed:he..r~tb:.and*~s~f~ih`e~.`v~4id~ti~3:nd~i~
~. investigatiOn of.this Health:'Authorit¢.' ApproYal'~i~ll~ifibn shows thatthe 'on-site water supply
and ~pe of structure indicated herein. I fu~p~r, yori~ that based on the information obtained from
the Mu'nicipali~ Of Anchorage flies andfrom my inves~ation and inspection, t~e on-site water
supply and/or wastewater disposal system i~ in compliance with all Municipal and State codes,
ordinances, and ro~ulafions in ~ff~t on tho dato of this inspection. .
........... ~am~ 6f ~irm~::'~:~"5:"~ ~ t~l~'' ' .... ' -'-" ' '
...-- -~.~....--..,-.¢...--..;.: ..._...,:., ,-::-'. ..-..-.-.. .:. :.. ; .-L~. :'L-?-,'-'...~'- . ... / . - . . .....
. . .,, -:";:~'~:_ ..~ ....... :;.;-,~ ...... ;.,-.??: ~...:, -~-.' ...... ....... :..-;. ....... ¥.--::._:.:: ...... .-
72-025 (Re~. 1/91) Back MOA ~1
Municipality of Anchorage
DePartment of Health and Human Services
~ :i; ,'~i~?" ; :: ·
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description: ~-- o~ ~ ¢)~-~ 7- ¢--,,,~...,J,~-¢ ¢~o-~ Parcel I.D.
A. Well Data
Well type
Log present((:~?N)
Total depth '~ ~. ~-~
Sanitary seal (~)
FROM WELL LOG
Date of test
Static water level
Well flow
Pump level1 ~\/-
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed ~ -~l ~ Driller
Cased to (_cc, ~ Lo"' casing height
Wires properly protected ¢~4)
AT INSPECTION
SEPARATION DISTANCES FROM WELL TO:
Septic/heldi~g tank on lot
Absorption field on lot
Public sewer main ~,~-
Sewer service line
g.p.m. / g.p.m.
,; On adjacent lots'
; On adjacent lots \
Public sewer manhole/cleanout ~.~,
Petroleum tank
WATER SAMPLE RESULTS:
Coliform ~)
Date of sample: ..<"-~
B. SEPTIC/HOL-BtNG TANK DATA
Date installed
Nitrate O. I Lb
Collected by:
Other bacteria (-~
$ & S ENGINEERING
17034 Eagle River Loop Roa~ No, 204
Eagle River, Alaska 99577
Tank size 1%5o Compartments
Foundation cleanout ~/N) ,¢ Depression, (Y~i)
~%' Alarm tested (Y/N)
~//~- L~6V[ Pumper
Cleanouts Y~N)
High water alarm
Date of pumping
SEPARATION DISTANCES FROM SEPTIC/HC, LD;NG TANK TO:
Well(s) on lot I.[? ~' t On adjacent lots
To property line l o Absorption field
Sudace water/drainage ~, o ~
Foundation
Water main/service line
72-026 (3/g3)' 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 electrical codes (Y/N) ~
SEPA~N~SEI~OM LIFT STATION TO:
Wefi~n lot On adjacent lots
Manufacturer
Manhole/Access (Y/N)
O~ted
Surface water
D. ABSORPTION FIELD DATA
Date installed ~ .--'-5 ~
Length ~ '7 /
Total absorption area
Date of adequacy test
Water level in absorption field before test
Peroxide treatment (past 12 months) (Y~) /-
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Soil rating (GPD/Ft2)
Width 5- ' Gravel thickness
75'-0 ~/ Cleanout present ~N) ~/
~J/A '/'/~ ,J Results(pass/fail)
After test
,/
If yes, give date ~/A
System type
Total depth
Depression over field (Y,~ .--(
for "'//~j/ Bedrooms
Well on lot /c,
To building foundation
On adjacent lots
Surface water
Curtain drain
On adjacent lots /o~ ' .c Property line
To existing or abandoned system on lot
Cutbank .so ' ¢' Water main/service line
Driveway, parking/vehicle storage area
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
Signature
Engineecs Name
Date
HAA Fee $ ~E'L3 ~ d~)
Date of Payment
Receipt Number
72-026 (3/93)* Back
~"~4~,,,'' ':',,,
:, % .' J,~ ..',.,
,1 , ; .:.::.~,¢,,~,¢ :::~,,:::,:::::;,~ ~.
~;L"'~:~"'"(',~~ (}.:~, ... ,...~' .::~'
?~ -~ ~ ROSERT C, COWAN ~,~ ~]
'~ ~c~ ",. ,,,",",', <~
Waiver Fee $
Date of Payment
Receipt Number
Olient 8ample ID ~3
Cl~en~ Name $ & ~
Ord.rsd By BOB
proDect Name
Pro]act~
pWaID UA
CT&E Environmental Services Inc.
Laboratory Division '
Laboratory Analysis Report
WAT~
Printed D~%e 05/10/95 ~ 13:20 hrs.
Colleo~ed Date 05/07/~ ~ ~2:30 hrs.
Received Dat~ 05/08/95 ~ 11:15 hrs.
Technical Director 8TEPH~N C. EDE
Released B ~.---~-~---.~
Sample Relnarkm: SAMPLE COLLECTED BY: RAY
QC Allowable EX~. Anal
Nitrate-N 0.10 U ~/L EPA 353,2 10. 05/0a/9~ CMR
Bee ,gp~oiel Insgruceions Above UA = Unava~leb[e
~ee S&mple Remarks Above NA = Not
undeteoted, R*porg~d valuo is ~he pres%leal quall~i~ica, tloll limit. LT - L~ Than
200 W, Potter Drive. Anchorage, AK 99518-1605 --Tel: (907) 562-2343 Fax: (907) 561-5301
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