HomeMy WebLinkAboutLOMA ESTATES BLK 3 LT 3
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
N~: '~/~ ~ H~ ~ ~ ~ N/~NC ~ Wastewater System: ~ New ~ Upgrade
Address: 5~ 'T~o~u ~ ~ ~ ABSORPTION FIELD
Phone: I NO. of Bedrooms: ~Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other
Total Depth from original grade:
LEGAL DESCRIPTION ~oilRati,g: ~,~ GPD~ ~ I
Lot: ~ BIock:~ ge ~Subdiv~i°n:~~ 3epth to pips botl~ m. from original,~grade: Ft, Gravel depth beneat~pipe Ft.
Township: Range: Section: Fill added ahoy,, original grade: Gravel length:
Number of lines: 0ista.~een liaes:
WELL: ~New ~ Upgrade G,a~widm: ~ Ft. ~ Ft.
Classification~r~V~f~(Private' A,B.C): Tot~l~bDepth: Ft. Casedl~lTO: Ft, Total absorption ~e~ ~ SQ. Ft. Pipe~o.~qmaterial:g
Pump Set at: Casing Height Above Ground:
~,e~: ~ ~.~ ~ ~ ,t. ~ ,,. TANK
SEPARATION DISTANCES ~ Septic ~ Holding ~ S.T.E.P.
To Septic Absorption Lilt Holding =ublic/Private Manufacturer: Capacity in gallons:
From Tank Field Stalion Tank s .... u,~, ~NcI~ .~filF~
Well- lb0 ~O ~ ~ ~ Material: Number of C~a,ments:
Sudace
w~t.~ ~ [o Id~ LIFT STATION
Lot ~t J~ j Size in gallons Manufacturer:
Line
Foundation I~ I ~ I "Pump on" leve~ at: "Pump off" level at: High water alarm at:
Cu~ainDrain ~ 0 ~ ~ Pump Make & Model Electrical Inspections pedormed by:
Remarks: BENCH MARK
'~ / Locatio~ and D~script[on~
Assumed Elevation:
ENGINEER'S SEAL
Department of Heal. and H~man~ervices approval
Reviewed and approved by: ~~~ Y~ Date:/-~/-~7 '~: ' ..
72-013 (Rev. 9/91) MOA 25
SWING TIES:
AC 21.5 FT AL 77.5 FT
BC JJ. 5 BL 59
AD J4.8 A~4 92.2
BD 42 BM
AE 57.5 AN 94.2
I BE 45 BN 65
BF 45
AG 75
BG 44.5
_ ~H 76.5
BH 45
2 ~ENCHES 40 FI L
I
~ ~2 FT TOTAL DEPTH
~ I ~ % 9FT ar ROCK
I I I~ ~50 GAL SEPTIC TA~~ ~H I
I
, ~ ~ ',
I
,
I
,
I ~,'~'-, No, CE aaa5 .,,~ / / -
',;~;~ ......... :...-~* / /.., .
TOBBEN SPURKLAND P.E. ~OT ~ ~OCE ~ ~O~A ~A~ SEPTIC SYSTEM AS BUILT
205 W 15TH. AVENUE DATE: DEC, 17, 1996
ANCH. AK. 99501 EDWARD
5241 FAU~US CIRCLE SHEET: 2/3 GRIB: 3537
(9~7~ ~79-~916
S~9605~5 P/D ~ 020-0~2-32 LOEO3032. DWG
Moni$or
Cleon Du'
C{eon Ou~
Sizondord ?menches:
2' Wide
dO' LonO
9' Sewem
3' Cover
Monitor
Cleon
Cleon
~ · 200 ~DW ~LITT~
~ILT BARRIER 88.0
I IJ(~l 78. 7
FLOW SPLITTER
INV ELE. 92.37
1~ SEPTZ'C TANK
72.~, NB SCALE
~ENCH MARK,
ASSUMED ELEV.
TOBBEN SPURKLAND P,E. II
~03 WlSth Ave
II
AnchoPo9e Ak 99501
77~ ~916
BLOCK 3 LO/VA ESTATE
ED YA£HAK
~£4~ TAUt~US CI£CLE
I I SEPTIC SYSTEM AS }}UILTS
]]lATE: ~EC, ./7~ ]~;
SHEET, 3/3 ~RI~, 3337
· , STATE OF ALASKA
' DEPARTMENT OF NATURAL RESOURCES
DIVISION OF MINING & WATER MGMT
LOCA'TJON OF WELL WATER WELL RECORD
LOCATIONISK~CH~ W~LL OWNER:
.....
DEPTHS
M~SURED
FROM~cesing top ~groun~ surtace WELL DEPTH: _ , ~
DATE
OF
COMPL~ION
Depth of hole:~ ft
BOREHOLE
DATA;
D~pth
~aterial Type ~nd Color From To · ~ ''
· DEPTH TO STATIC WATER L~EL;
METHOD OF DRILLING: ~'air rotary ~ cable tool
~ .~ /~ ~ other .,,, ,.,,
~/ 1..~. USEOF WEL~domestic ~ irrigation ~ monitor
WELL INTAE OPENING TYPE: ~ open end g SOtesnea
._ ~'pertorat]d ~ open hole
__. - Depths of openings: fl~ to t/~ Jt ~L
SCREEN TYPE; Diam: in.
Slot/Mesh Size; r.. Length: ft
GRAVEL PACK TYPB:
~ VoJume used; .. Depth to top: .
GROUT TYPE: Volume;
Depth: from ft to ft
DEC 19 19% PUM.IUe AND.YJ Lm
' " "uman 8ervJc, PUMP INT~E DEPTH: ft Horsepower:
WELL DISINFECTED UPON COMPL~ION? ~YES ~ NO
CONTRACTOR INFOR~J~ATION: REMARKS:
n¢',j~st~Aea uusiness Name"' / ~" /~ ....
/~' ' ~ / ~ '~ ~ o~ ~ / PLEASE MAIL WHITE COPY OF LOG TO:
~-~~//~~ /"-~ ~' 7~ DNR/DIVISION
~gnEture of Amh~r~ed Respres~tative ' ~,~ __~INI~ ~ WAT~E M~MT
~ Da... ~Ol C St, Suite 800
ANCHORAGE AK 99503-5935
Phone (907)269-8639, Fax (907)562-13B4
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 1
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW960355
DESIGN ENGINEER:TOBBEN SPURKLAND, P.E.
OWNER NAME:TEALL DORCAS
OWNER ADDRESS:5241 TAURUS CIRCLE
ANCHORAGE, ALASKA 99516
PARCEL ID:02009232
LEGAL DESCRIPTION:
LOMA ESTATES BLK
3 LT 3
LOT SIZE: 46064 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
DATE ISSUED:10/22/96
EXPIRATION DATE:10/22/97
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 ( 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:
RECEIVED BY:
DATE:
DATE:
T SPU KEAN
203 W 15th. Avenue, Suite 203
ANCHORAGE, ALASKA 99501
(907) 279-3916
Fax (907)-276-6013
SEPTIC SYSTEM DESIGN
LOT 3 BLOCK 3 LOMA ESTATE
EDWARD YARMAK
Municipality of Anchorage October 9, 1996
Department of Health and Social Services
820 1 Street
Anchorage, Alaska 99501
We are submitting an application for the installation of a well and septic system for this lot. The submittal consist of
three (3) drawings showing the present improvements on the lot and the adjoining properties, (sheet 1/3), the
proposed improvements of the lot, of which only the well and septic system are subject to this permit application,
(sheet 2/3), and a schematic of the septic system, (sheet 3/3). Soil logs and percolation tests of applicable testholes
are also enclosed. The septic system design is based on the following:
No Ground Water or Impervious Layer to 18 ft.
Use Standard Trench
Soil Rating. 48 min/in = .45 gal per sq.fffday
No. of Bedrooms 4
Required Area per Bedroom: 150/.45 = 333 sq.ft..
Total area required: 4 x 333 = 1332 sq ff
Testhole depth 18 feet
Bottom Rock At 12 feet
Top Rock At 3 feet
Rock Depth 9 feet
Total Trench Length 1332 / 18 = 74 ft
Use 2 trenches at 40 ft. each
SYSTEM CONFIGURATION
STANDARD TRENCH
TOTAL LENGTH 2 x 40 FT
TOTAL WIDTH 2 FT
TOTAL DEPTH 12 FT
ROCK DEPTH 9 FT
COVER 3 FT
1250 GAL SEPTIC TANK
The installation of this septic system will not prevent wells from be installed on the adjacent lots.
There are no developed or natural surface / sub surface drainage courses on this lot.
The proposed septic system will not change the general slope of the area. Ponding and/or concentration of surface
runoff will not result from this installation.
MUNICIPALITY OF ANCHORA(~;
ENVIRONMENTAl. SERVICES DIVISION
OCT 09 1996
RECEIVED
VACANT
LOT ~
VACANT
LET 3 I L~TT 2
~ ~ ' VACANT
~ ~ I
/ /
/
VACANT ~ VACANT
/
/ >LOT 9
~ 49th /
S£ALE~ f" = lO0 F~, No, CE aaa5
/
/
1
LITT ]
EXISTING IMP£DVEMENTS ~/~
TOBBEN SPURKLAND P.E. II
II
203 W 15TH. AVENUE
ANCH. AK. 99501
(9071 279-..s? 1~,
LOT 3, BLOCK 3 LOMA ESTATE
EDWARD YARMAK
52~! TAURUS CIRCLE
I I SEPTIC SYSTEM DESIGN
DATE: SEPT. 12, 1996
SHEET: 1/$ GRID: 5337
%
%
P~OPO£E~
P£OPO£EP T, eEN£HES
2 T/eENCHES dO FT
1£ FT TOTAL JgEPTN
9 FT OF /~ZTCK
1250 6AL SEPTIC TANK
P~ZTF~ £UIL~IN6 SITE
%
50 75 100
I' = 50 FT,
®
49Us
N SPURKLAND
No. CE-~5
125 150
(907),_,'-"~c'.., ,.,,..,zn ! 6
TOBBEN SPURKLAND P.E. II
II
203 W 15TH. AVENUE
ANOH. AK. 99501
(907~ 279-:~916
PROPOSED IMPROVEMENTS
I
I
TIVE SYSL I
I
I
OPD£EB
>- 1frei1
i
i
/
LOT 3, BLOCK 3 LOMA ESTATE
EDWARD YARMAK
5241 TAURUS CIRCLE
SEPTIC SYSTEM DESIGN
DATE: SOOTY 12, 1996
SHEET: 2/5 GRID: NB37
Moni~:or
Cleon Ou
Cleon Hut
W/de
40' Lon9
Deep
Sewer rock
Cover
Monli:or
Cleon Ou
Cleon ZTut
1_/250 9al Septic ~onk
z 200 FLDW SPLITTER
ND SCALE
FLOW SPLITTER
ND SCALE
SEPTIC TANK
BENCH
ASSUMED ELEV,
TOBBEN SPURKLAND P,E,
a03 W15th Ave
Anchopage Ak 99501
LI2T 3 BLOCK 3 LOMA ESTATE
ED YA£MAK
$24! TAU£US CIRCLE
SEPTIC SYSTEM DESIGN
DATE: SEPL
SHEET, 3/3 GRID, 3337
PERFORMED FOR:
Municipality of Anchorage
DEPARTMENT OF HEAL-TH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
z :~ '-% ~' '[ENGINEER'S SEAE' t~.~ [
PERFORMED%.??- ~ .... ; ~:,5;~) - .
DATE
LEGAL DESCRIPTION: LDH - Township, Range, Section:
I
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
2O
COMMENTS
SLOPE
WAS GROUND WATER ti__
ENCOUNTERED?
S
L
IF YES, AT WHAT O
DEPTH? p
E
SITE PLAN
Oeplh lo Water Alter i
Moniloring? ~ Oale:
~1~ Date Gross Net Depth to Net
~'~/&/1 Time Time Water Drop
PERCOLATION RATE '~1~ (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~ FTAND ?)~FT
.ERFORMEO.Y: __,
,~ CERTIFY THAT THIS TEST WAS PERFORMED IN
72-008 (Rev. 4/85)
Municipality of Anchorage
DEPARTMENT OF HEAL'TH & HUMAN SERVICES
825 "L" Street, Anchorage. Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
4
8
10
11
12
13
14
15
16-
17-
18-
19
20
COMMENTS
Township, Range, Section:
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED;'
S
L
IF YES, AT WHAT O
DEPTH;) p
E
Depth Io Waler Alie!
Date Gross Net Depth to Net
Time Time Water Drop
PERCOLATION RATE ~/~:~ (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~ FTAND
PERFORMED BY:~, ~.5 -- '~P 'f"~ CERTIFY THAT ]'HI§ TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATI-.'. DATE: ~/~/~ ~
72-008 (Rev. 4/85J
iCUN~oPALITY OF
MUNICIPALITY OF ANCHORAGE
DEPArTMeNT OF HEALTH & HUMAN S[~VlO[~
Division of Environmental Se~ices
On-Site Se~ices Section
P.O. Box 196650 Anchorage, Alaska 99519~C
343-4744
Parcel I.D.
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Complete legal description
Location (site address or directions)
Property owner
Mailing address
CD a 4Nc-/ Dayphone
t
Lending agency
Mailing address
Day phone.
Agent
Ad dress
Day phone
2. NUMBER OF BEDROOMS:
3. TYPE OF WATER SUPPLY:
Unless otherwise requested, HAA will be held for pickup.
NOTE:
Individual well
Community .well
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.
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 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 ~-~ i~P¢ ~--/~t
Address ~0
Engineer's signature
DHHS SIGNATURE
~ Approved for
Phone
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 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. 1t91) Back MOA¢¢21
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SE,B~I~^L,r~
Environmental Services Division ENVIRONMENjA~
825"L" Street, Room 502 · Anchorage, Alaska 99501 · (907)
Legal Description:
A. WELL DATA
Well type
Log present (Y/N)
Total depth
Sanitary seal (Y/N)
Health Authority Approval Checklist
/:~K 3, Lo 1~.4 ~ Parcel I.D.:
Date of test
Static water level
Well production
If A. B, or C, attach ADEC letter. ADEC water system number
Date completed Ii/f It'll tl ~'
Cased to ~ o,~ ! ~
FROM WELL LOG
Casing height (above ground)
Wires properly protected (Y/N)
AT INSPECTION
WATER SAMPLE RESULTS:
Coliform N/~
Date of sample: ~'/~0/q 7
Nitrate
Collected by:
Other bacteria c~ /"'} I'~
B. SEPTIC/HOLDING TANK DATA
Date installed 11/~5/qt~
Foundation cleanout (Y/N)
Date of Pumping IM//&
Tanksize /aO-~O Number of Compartments A Cleanouts(Y/N) .
Depression (Y/N) 1~4 High water alarm (Y/N)
Pumper
7
Co
ABSORPTION FIELD DATA
Date iustalled 1 ¢¢~ / q/~.
Length ~ 0 ~ Width
Soil rating (g.p.d./fl2 or
v~ / Gravel flfickness below pipe
System type ~J-'/ct.44
Total depth
Effective absorption area
Date of adequacy test
Me.toting Tube present(Y/N) _
Results (Pass/Fail) lq/Fi
Fluid depth in absorption field before test (in.);
Fluid depth / (ins.) Minutes later:
Inunediately after~gal, water added (in.):
Absorption rate = ~'/ g.p.d.
Depression over field (Y/N)
For ~4//4' bedrooms
Peroxide treatment (past 12 months) (Y/N)
If yes, give date
Do
LIFT STATION ~N.}/~
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Size in gallons
"Pump on" level at*
*Datum
"Pump ofF' lcvel at*
Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/l'~ tm~ ou lot
Absorption field on lot
Public sewer main
Sewer/septic service line
; On adjacent lots
· On adjacent lots
Public sewer manhole/cleanout
Lift station
SEPARATION DISTANCES FROM SEPTIC/-I.t'OL-t~NC:r-T4rN'K ON LOT TO:
BuiMing foundation e:~(,> I Property line ~ ~ I Absorption field 'c~O ¢
Water main/service line ~d~ Surface water/drainage--'~'1'/I~ Wells on adjacent lots ~ O1>!
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Buildiug foundation ~2 t Water main/service line ~ ~ ~ t
Surface water /',4/~ Driveway, parking/vehicle storage area ]g,~
Curtain drain ~d/O Wells on adjacent lots J 140' Property line
F. ENGINEER'S CERTIFICATION ::'
I certqfi that I have determined thru field inspections and review of Municipal records
m conJbrmance with MOA IL,M guidelines in effect on this date.
EugmeersName Io ~ ~Ou~b~¢~ ~m
--
HAA Fee $
Date of Payment
Receipt Number
Rev. 8/95 OSS: haa.wk.doc
Waiver Fee $
Date of Payment
Receipt Nmnber
JLIN-02-1997 i?~ ii CT~E ESI
~1~ cT~E Envimnme.Zal Services Inc.
RNE:HOR~qL]E
;T&£ Re[#
]lent Name
'roject Name/#
'lient gample ID
Aatrix
)rdered By
,WSID
~'~le Remark:
972683001
Tobben Sp~kland P. E,
3/3 Loma Estate
3/3 Loma £stute
Drafting Water
Client PO#
Printed Date/Time 06102/97 16:25
Collected Date/Time 05/30/97 08:30
Received Date/Time 05/30/97 09:00
Technical Director: Stephe. C. Ede
Tote[ geliform
k~lts Dbte Date l~it
PQL Um{t5 Method ...... ~ -- -
0.93~ O.lO0 mg/L SN]8 &5OO-NC3= 10 ~nax 05/30/9? JkJ
05/30/97 RAh~
g50~ ~/O COLI ¢0[/!00 NL. $Ht8 9222g
_TWhl-06-1997 OE-',: 47
CTT_"~E ES 1 RHCHEiRRGE
dl~l~[~ CT&E Environmer~tal Sem.,ices Inc-
CT&E Ref.#
Client Nmne
Project Name/#
Client Sample ID
Matrix
Ordered By
PWSID
S~mple Rema¢:~;
9'1283. 10(}2
Tobben Spurkl~ud P, E.
N/A
Loma Estate LI'3 Bik 3
Drinking Water
Client PO#
Printed Date/Time 06/06/97 08:32
Collected Date/Time 06/03/97 15:10
Received Date/Time 06/03/97 t6:40
Iechnical Director: Stephen C, Erie
cot,- ~SCimk S~I8 722~S 06/03/97 RtdV