HomeMy WebLinkAboutMACBETH BLK 1 LT 4
' ' 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: '~L~J~0~'~'1 PID Number: ~:)l~ .- ~ll - I ~
Name: ~e~ ~ ~K~ ~O~OA~ Wastewater System: ~New ~ Upgrade
Address:
t~o~o ~u~ ~u~ ~c~.~ ~ ~ ABSORPTION FIELD
Phone: I No.~ Bedrooms:
~-J~O ~ ~ Deep Trench ~ Shallow Trench DBed DMound DOther
Total Depth from original grade:
LEGAL DESCRIPTION so~ Rating: O, B GPD/Sq. Ft. J¢'~ -- ~' ~
Subdiv~ion: Depth to pipe bosom fram original grade: Gravel depth beneath pipe
Township: Range: Section: Fill added abov~ri~inal grade: Gravel length: ~ ~ I
~ ~ Ft. Ft.
Gravel width: ~t Number of lines: Distance baleen iin~:
WELL: ~XisT~ew ~ Upgrade ~ Ft. J ~ Ft.
Classification~ ~ ~E(Private' A,B,C): Total~Depth:/Ft. ~ TO: Ft. Total absorption ~area: SO. Ft. Pipe~material:~.~o~ /~0
Driller: ~ ~ate Drilled: S~ticWater Level:Ft. Installer:~ ~ ~1~ Dateinst~lled:/~O/I./~ ~
Yield: ~ I Pump Set at: Casing Height Above Ground: TANK
~ GPM I Ft. Ft.
SEPARATION DISTANCES i ~Septic~I<Tt~C'' m Holding m S.T.E.P. ~
From Tank Field Station Tank Sewer Lines ~
Material: ~ Numb~ts:
Sudace
Water IOO1+ /oo~+ Io~ ~+ ~ ~ LIFT STATION
Lot ,, Size~. --~ , ~
Line I0 ~l~ JO J~ ~ ~
Foundation jcl+ i1~ j~l~ ~ ~ "Pump °n" level at: ~larm at:
Cu~ain '~O~ ~~ Pum~ I Electdca[ Inspections pedormed bY: ~
Drain
Remarks: ~ T~t5 t5 ~ ~ ~o~ BENCH MARK
Location and Description:
A~um~ Elevation: ~ OO. O ~,
)~TEf~t~ O~ ~[~1~ TAN~ o~ ~/zz/~, ENGINEER'S SEAL
~ .e,.ee.e ~ e~eeeeeI
~. -- $~A~ JAMES~L~S ~,~j
~' ". CE ,"~
Depadment of Health and Human Se~iees approval t~: .... '.;.'.;~Z~
Reviewed and approved by: ~~ ~ ~~ Date: ~¢'~7-¢~ "[%~O,ESS'~:~
72-013 (Rev. 9/91) MOA 25
pE.. ,T """'BE": AS-BUILT DRAWING P^ROE ,.
SW980331 015-511-1
~ r--EXISTING TRENCH
~ PASSED AN ADEQUACY
NEW 'rREN~.H--% TH/MT. \ ~ '
2 BEDROOM ~ "'/~ C05 ~ ~ .....
UPGRADE ~ MT2~~ _ ........ ~ '
( '~ ~ fl/ ~ ~ '-
II
x I
t / ~ ~ ~F~%%,-~ SEPTIC TANK, VERIFIED ~J
~ ~ ~ F"OM CREEK
~ 0 ~ ~ .ORTH END M~ COl / SOUTH END
'~ ~'-- ~ E ~ ~C01 = 9227
~ ~ 26.0 -- ~r~ c02 = 92.27
MT1 14.2 --- ~ - 29,0
~ - ~ - ~ % ~-MT1 = 86.22
MT2 48.5 74.4 - u'r2 = 86.22
~l.&S~ WA~ A~ W~WA~.R CONS~T~S, ~C. ;~L
PHONE: (007) 3~7-6179/F~: (907) 5~8-5246
WPE OF WORK: [ ~A~M j~ ~v~
AS-BUILT DRAWING OF SEPTIC SYSTEM UPGRADE~/~<.~.~...4
=REPARED FOR: PHONE NUMBER: ~ *'- NO. 9608
RIORDAN 346-1 ~60 vO~~ "... C.E. ..-'
NR. · NRS. ~&t*.2"" ........
3ATE: , 0/8/98 ID~wN aY: Ism[: I
J.L.M. 1 = 40' 2 OF 2
at.&SXA WATE~t ~Z WASTEWATF. It CONSULTANTS, INC.
I SOIL LOG - PERC'O~TION TEST J ~'~",..,..........~:~~
PERFORMED FOR: , MR. · MRS. RIORD~, ~?~JAMES
DATE PERFORMED: 9/22/98
,
I TEST HOLE ¢1 ] ~t'."'" "
~EPTH ~
f ORGANICS
SOlk O~SSIFIOATIONS. pROPOSED SEPTIC UPGRADE~
~ 6W ~ OR6 (sE~ DESIGN, PAQE 2 OF
~ 6M ~ CL
6C OL ._ ~ ,
~ ~ ~ SW MH ~ , '/
~ SP CH '
SH OH o
DEPTH TO DATE ~ ,' ~ '~
11 DATE RE. lNG CL~K NET TIME WATER LEVEL NET DROP
TIHE (NINUTES) RE.lNG (INCHES)
12 9/23/98 ~ HOLE PRESOAKED :OR 4+ HOUR~ PRIOR TO TEST
3 10:5~
17
1 B.O.H. -
19t~ J ~RCO~TI~ ~TE 20 (HIN./INCH) PERC. HOLE DIA. 6" (I~HES)
2n. ~ TEST RUN B~EEN 9.25 FT. ~D 9.75 FT.
PERFOMED BY A~SKA WATER ~ WAST~ATER I,~ Xfer, , CERTI~ THAT
THIS WAS PERFOR~ED~ IN ACCORDANCE WITH ALL~ ~TE AND MONICIPKL GUIDELINES IN E~ECT ON THIS
DATE." DATE:
¥ I
PROPOSED TRENCH NOTE: THE CONTRACTOR IS RESPONSIBLE FOR HAVING THE
,TRENCH IS TO BE NORTH PROPER'[Y LINE FLAGGED BY A REGISTERED LAND ;
12 DEEP(MAXIMUM) BY SURVEYOR PRIOR TO CONSTRUCTION. _~
2' ,WIDE BY 45' LONG .... I ---- L
loo' CREEK SETBACK- _ -ACHFIELD
'-----L \ ~ / (SEPTIC ADEQ[JACY ON 7/5/
I (,SYSTEM PASSED FOR 2 BDRM)
~ ~ ~ FOR STRUCTUAL NTEGRI~
~ ~ FLOW DIVID~~T~ /~ IOOD GALLON SEPTIC TANK
~ N /~ ~ / ~uo~ I 'x IS OF POOR INTEGRr~)
7320 E. CHEWER HEIGH~ CIRC~. ~CHO~G[. AK 90504~.~X~ '
MACBETH SUBDIVISION, LOT 4. BLOCK 1, ~ .... : ....................... : ....
:~PE OF WORK:
~REPARED FOR: PHONE NUMBER: ~ -. 0E_7953 .,'
R~O.D~N ~-~ ~0 ~,".. . .-' .~
REVISED 9/29/98 J.L.M. 1 = 40' 2 OF 2 - ,e~
LOT 3. SOUTH LOT 4, SOUTH ~LOT--- 5, SOUTH LOT 6. SOUTH LOT 7. SOUTH
LAKE~OOD HILLS S/D LAKEWOOD HILLS S/O LAKEWOOD HILLS S/D ~KE~OOD HILLS S/D ~KE~OOD HILLS S/D
~ LOT 3 BLOCK 1. ~
~ UACB~ SUBD~ISION ; ~
,~ROPOSED SEP~C UPGRADE~ ~ ~ LU.'~T ~.~ ~'n~W ......
~ (SEE DESIGN PAGE 2 OF 2) ~
~ . ~ STONY BROOK S/D~
~-{-'-~-~,...- ................... f ~ ~ ', ~ ~XlSTIN~ SEPTIC SYSTEM
/ '- ~, ~¢ ~ CREEK~ ' ,, LOT , BLOCK 2,
j tt ~ ~~ ~, J { ~'ONY'BROOK S/D
J LOT 2A, BLOCK 1 ~ ~1 lOO' WELL ~DIUS ~LL N i ~
, .-...
LOT I BLOCK 2 ~ ~kQC~ ~ ~ ~ I
7520 ,. CHE.ER HEI,H. CIRC~. ~CHO,GE. AK 9g50'__¢~.
=EGAL DESCRIPTION: F~:" 49IU~
~ACBETM SUBDIVISION, LOT 4, BLOCK 1 ..................................
~PE O'F WORK:
SITE P~N [ ~Jeffrey A. Gerness~
'REPARED FOR: ' P~ONE NUMBER: ~0~ '"- CE-7955
u.. · mo AN "-..
REVISED 9/29/98 J.L.M. I = 100' 1 or 2 ~rofes"~°~°~
MUNICIPALITY OF ANCHORAGE
Department of Health and Human Services
On-Site Services Program
825 L Street, Room 502
P.O. Box 196650, Anchorage, AK 99519-6650
(907) 343-4744
ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT
Upgrade
Date Issued: Aug 31, 1998
Expiration Date: Aug 31, 1999
Permit Number: SW980331
Legal Description: MACBETH BLK 1 LT 4
Design Engineer: 0041 AK Water & Wastewater Consulta
Owner Name: JOE & BRENDA RIORDAN
Owner Address: 11080 MUMBY CIRCLE
ANCHORAGE , AK 99516-
Parcel ID: 015-511-16
Site Address:
Lot Size: 41865 SQ. FT.
Total Bedrooms: 3 Permit Bedrooms: 2
This permit is for the construction of:
[] Disposal Field [] SepticTank [] Holding Tank [] Privy
[] Private Well [] 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 DHHS at least 2 hours prior to each inspection. Provide notification by calling
(907) 343-4744 ( 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.
5: The following specia! provisions.,
AT THE Ti~ 6F ¢~NS~UC~ION~ THE ENGINEER SHAEE PERFQRM A SOIL~ TEST IN ACCORDANCE
W TH AMC ~5 6~ ,~N~ ~BMi~ ~HE RES~E~S W ~H THE A~U [~ N~PE~ ~ ~EP~RT~
Alaska Water & Wastewater Consultants, Inc.
7320 East Chester Heights Circle ~ Anchorage- Alaska 99504
(907) 337-6179 ~ Fax (907) 338-3246
Consulting Engineers
August 14, 1998
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
On-Site Services Section
P.O. Box 196650
Anchorage, Alaska 99519-6650
Ref: Septic Upgrade Design for Lot 4, Block 1, Macbeth Subdivision.
To whom it may concern:
The existing 3 bedroom house is served by a private septic system and a private well. The existing
trench was Terralifted on 6/3/98. On 7/2/98, the trench had a adequacy test performed on it and
passed for a 2 bedroom house. We propose to install a 2 bedroom upgrade and replace the
existing septic tank if of poor integrity. Comments regarding the proposed upgrade design are
summarized as follows:
1. SOILS: Attached is a soil log (Leroy Reid, P.E.-10/4/85) which shows the soil profile, and
the percolation test result. Below the organics, the soil is silty sandy gravel (GM) to a depth of 12
feet (bottom of test hole). No groundwater was encountered during the excavation of this test
hole. One soil percolation test was performed between the depth of 2.0 to 2.5 feet which perked
out at a rate of 5.6 minute/inch. The soils were visually rated at 168 ft2/bedroom between the
depth of 2 feet and 12 feet. A groundwater monitoring tube was installed on 7/31/98 to a depth of
12 feet and a soil log was done (see attached). After 12 days, the monitoring tube was checked
and found to be dry.
2. TRENCH DESIGN:
a. Percolation Rate: 5.6 minutes/inch ~ 2.0 to 2.5 feet.
b. Allowable Application Rate: 0.8 gallons/day/fi2
c. Number of Bedrooms: 2 bedroom upgrade / 3 bedroom house
d. Design Flow: 300 gallons per day
e. Minimum Absorption Area: 375 ft2
f. Effective Depth: 4 feet
g. Reduction Factor = N/A
h. Width: 2.5 feet
i. Minimum Length: 2 ~ 25 feet long each / 50 feet total length
j. Effective absorption area = 400 ft~' (>375 ft2 OK)
k. Maximum depth = 8 feet
3. SURFACE WATERS: There are no surface waters within 100 feet of the proposed
upgrade.
4. TOPOGRAPHY: As can be seen on the attached topography site plan, the lot slopes from
approximately east to west at a grade between 20-25%. In short, there are no slope concerns
below the proposed upgrade area.
I am unaware of any adverse impacts this installation would have on adjacent wells or septic
systems. If you have any questions, please contact me at 337-6179, or 244-9612. Thank you
for your assistance.
Sincerely,/] / ~[/'
Pres~ ~t
"' I
LOT 3, SOUTH LOT 4. SOUTH LOT 5, SOUTH LOT 6, SOUTH LOT 7. SOUTH
I LAKEWOOD HILLS S/D LAKEWOOD HILLS S/D LAKEWOOD HILLS S/D LAKEWOOD HILLS S/D LAKEWOOD HILLS S/D
~ LOT ~ BLOCK ~. I
~ MA~BET~t' SUBDIVISION I i
\
I pROPOSED SEPTIC UPORADE-~ [ t lOT 2 BLOCK 2
] (SEE DESIGN PAGE 2 OF 2) I[ t I ~n~,v'oonn~
,-, ~-~ ............. I ! ~'--EXISTtNG SEPTIC SYSTEM
r,: ,,, -*~- ,. ~, ~,,~-"-:,
; ti ~' l ~ CREEK--~ ~l I LOT 1 BLOCK 2~
/ LOT 2A, BLOCK 1. ',t 1t__160' WELL RADIUS ..... lN ! ~ STONY BROOK S/O '~.
~ LOT ~, BLOCK 1.
LOT I, BLOCK 2, ~ LOT 2, BLOCK 2, ~ STONY BROOK S/D
~CBL~H SUBDMSION UACBETH SUBDI~S~ON ~ ~
7~20 E, CHE~E~ HEIGH~ ~IR~. ~HO~E, AK
LEGAL DESCRIPTION: PHONE: (907) 3~7-6179/F~: (907) 3~-32~6~)~'"'~ ~ ~..
,,c,~TH suamv~s~o,. LOT ~. ,LOCK ~, ~_=.:_.,~, ~ ..= ....
MR. ~ MRS. RIOEDAN 546-1560 ~_ -...
~,~.. ..........
DAT[:8/i 4/98 9~WN ~: J.LM. Isca-E: m
1 = 100' 1 OF 2
PROPOSED TRENCHES
TWO TRENCFIES THAT ARE
8' DEEP(MAXIMUM) BY
2' WIDE BY 25' LONG
EACH, (50' TOTAL LENGTH),
ADD4 OF SEWER [
100' CREEK SE
TO BE F'IELD VERIFIED
\
I INSTALL ZABEL \
FLOW DIVIDERS
INSTAL[_ DOUBLE C/~O---'~ ~ ......
BETWEEN THE TANK~'~
AND THE FLOW DIVIDER
!
!
I
I
NOTE: THE CONTRACTOR IS RESPONSIBLE FOR HAVING THE
NORTH PROPERTY LINE FLAGGED BY A REGISTERED LAND
SURVEYOR PRIOR TO CONSTRUCTION,
~OXIMATE LOCATION
OF 1985 TEST HOLE,
~TING LEACHFIELD
(TERRALIFTED ON 6/3/98)
'SEPTIC ADEQUACY ON 7/3/9~
PASSED FOR 2 BDRM
' ~-100' CREEK SETBACK
WELLo
100' WELL RADIUS
ALASKA WATER AND WASTEWATI~-R CONSULTANTS, 1'NC.
7320 E. CHESTER HEIGt-tl'~ CIRCLE. ANCHORAGE, AK 99504
PHONE: (907) 337-6179/FAX: (907) 338-5246
~GAL DESCRIPTION:
MACBETH SUBDIVISION, LOT 4, BLOCK 1,
1YPE OF WORK:
DESIGN OF SEPTIC SYSTEM UPGRADE
PREPARED FOR: PHONE NUMBER:
MR. ac MRS. RIORDAN 546-1560
DATE: IDRAWN 't~': ISCALE: I PAGE:
--CT EXISTING TANK
FOR STRUCTUAL
AND REPLACE WITH NEW l
1000 GALLON SEPTIC TANKI
IIF NECESSARY' I_--
'P'i~}~OSED 1000 GALLON I
SEPTIC TANK (INSTALLI
F EXISTING SEPTIC TANK I
IS OF POOR INTEGRTY.)I
\
I
\
N
\
\
I
I
I
LOT 4, SOU
LOT 7,
HIL
LOT 2,
STONY
1, BLOCK 2,
BROOK
BLOCK 2.
SUBDIVISION
STONY
i~lON:
MACBETH SL
TYPE OF WORK:
MR. &
100'
AI~ggA WATER. & WASTEWATER CONSULTANTS, INC. ~,. oF'
~:o ~. ~ ~. ~,~o,. · ~,~,o.,~, ^~ o~o~ .~-.c~...;,"r'":-~:n.
[SOIL LOG - PERCO~TION TEST]
LEGAL DESCRIPTION: MACB~H SUBDIVISION; LOT ~. BLOCK 1. ~ ,~, ~ ~~
DATE PERFORMED: 7/31/98 ~."I...I CEd /953 .."
J TESTHOLE ~] J Q~:'*'""'. , .........
DEPTH ~
(feet) :~ ORGANICS
~ SOIL C~SSIFICATIONS
l~ 6W ~ OR6 ISITE P~I
~ GP ~ ML
GM~/ CL
~ ~ SW
' SP CH
SM sc ~.
W/SOME GRAVEL
DEPTH TO DATE
SROUN~WATER
DRY 8/12/98
11 DATE READING CLOCK NET TIME WATER LEVEL NET DROP
12 MO BE
19 PERCO~TION ~TE. - (NIN./INCH) PERC. HOLE DIA. 6" (INCHES)
-- - ~
2
/~//~ ~
COHNENTS:
PERFO~ED BY A~SKA WATER · WAST~ATER., .. ~ L'/~ ~ ~ ~ . CERT.~ THAT
THIS WAS PERFORME. ,~CORDANCE WITH ALL ST~* CD ~UNIOIP~DELINES IN b~hECT ON THIS
DATE. DATE: ~1'~''~
DEPTH TO DATE
GROUNDWATER
DRY 8/12/98
' ' ~ MUNICIPALITY OF ANCHORAGE
~ DE'P~,RT~IENT OF HEALTH AND HUMAN SER¥.~,ES
Environmental Health Division
'~* 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
N.~ DISTANCES
~,~ e /~"~' ~'~ ~ T0 SEPTIC ABSORPTION
WELL
Address~F~0M ~ TANK FIELD
Phone(s)I Permit NO. - ~ INc. of Bedrooms WELL ~O~
'~ ' LOT LINE
LEGAL DESCRIPTION
Block Subdivision ~. , ,~
Lot ~ / /ff~C ~' FOUNDATION
Township, Range, Section AS-BUILT DIAGRAM (Show location of well, septic system, property hnes, foundahon,
~ ~ ~ /) ~/ ~ ~/~ driveway, water bodies, etc.)
TANKS
~anulactu[er Capacdy m ~allons
Material No. of Compadments ~¢~¢
TYPE OF SYSTEM '~C ~, '~ ....
/
~TRENCH : BED :TotalW. DRA'Nfrom original grade: OTHER ~,
D~pth to p~pe bottom from depth
Fill added above origmal grade Grail depth beneath p,pe
'~ ~ FT ~ ,+ ET
Total absorption area i Distance between lines ~' ~'~
Installer Date installed
WELLS
~ PRIVATE ~ OTHER (Identify)
Classification (A,B,C) Total Depth Cased to
FT FT ,: ,'
Scale: : ENGINEER'S SEAL
inspections PeHormed by:
I /~- ~¢:~ ' ce.ily that thia inspcction was pcdormed ,sc0rding t0 all
Municipal and S~delines in elfect 0~ ~te: t/'- l/" '"%~' '
Health Oepadmenl Approva~~<~-'~ ~~ ~ Date~
ALASKA ENVIRON/'~NTAL
CONTROL SERVICI:o, INC.
! 200 West 33rd Avenu. e, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
JOB /~07 ~ Z~Z~¢,~ /
SHEET NO
CHECKED BY
SCALE / :~?0
DATE.
DATE
MUNICIPALFfY. · OF.' ANCHORAGE
DEPT, OF '.HEALTH &
ENVIRONMENTAL PROTECTION
-!-_.8 0"6"1986
RECEI'V'ED
DEPARTMENT OF HEAL. TH AND ENVIRONMENTAL PROTECTION
825 L STREET, ANCHORAGE, AK 995(])1
264-4720
PERM I T NO:
DATE ISSUED:]
L.~. 6~.,8
10/0'7/85
APPL.. I CANT
ADDRESS:
CONTACT PHONE
JOE RIORDAN
1524 (]ARA LOGP
ANCHORAGE., AK
.]45-4677
99515
LEGAL DESCR I F':
L 0 T S I Z E:
MAX BEDROOMS:
SLJBDIVISION~- MACBETH
SECTION." 2 TOWNSHIP:
1.'0A (SQ.FT. OR ACRES)
3
LOT: 4 BLOCK: 1
].iN RANGE: 3W
L. isted below ape the option:,~ available to you in designing your septic:
system. Choose the option tha'E best fits yOLU* site.
DEPTH TO PIPE BOT]"OM (FT.) 4.0 4.0 4.0
GRAVEL DEPTH (F"T. > 4. () ('.)..~'= .~,"'. 5
TOTAL DEPTH (FT.) 8.0 4.5 7.5
':3RAVEL WIDTH (FT.) 2.5 20.0 5.0
DRAVEL L.,I=NGTI4 (F:"I'.) 65.0 39.0 ,.~6,,
aRAVEL VOLUME (CU. YDS. ) 27. I 2S,, 9 4 1 .'5
T'ANK SIZE (GALS) 1,000.0 ~..~ 1,000.0 ~'~ 1~000.0 -~..~
~%U:L RATING (SQ. FT. /BR) 172 ~72
.~.~- TANI.::: MUST HAVE AT LEAST TWO' COMPARTMENTS
]: c:er"Lify that:
1, 'I am Camil:i. ap with the r'equipements £op on-site sewens and wells as set
eot'th by the Municipality oF Anchor'age (MOA) and the State o~' Alaska.
2. I will install the system in accoPdance with all M{DA codes arid ~egulations,
arid in compIiance with the design ct'itek*ia oF this per'mit.
3. I will adhe~-e to all MOA and State of Alaska Pequir'emen{s eof the set back
distances fr'om any existing Well, wastewatep disposal'system of public
sewerage system on this or. any adjacent of neanby lot.
4. I under-stand that this permit i-s valid fo~ a max:imum o¢ 3 bedrooms and
any enlapgement will r'equir'e an additional i~e~*mit.
I;F A LIFT STATION IS INSTALbE]) IN AN AREA COVERED BY MOA BUILDING CODES,
I"HEN (1) AN ELECTRICAL I='ERMIT AND INSPECTION MUST BE OBTAINED; (2) AS-GUILTS
gILL NOT BE APPROVED. WITHOU"I" AN ELECTRICAL INSPECTIGN REPORT; AND (3) THE
ELECTF4ICAL ~ORI< MUST BE DONE BY A I....ICENSED ELECTRICIAN.
............. - .........
~ I GNED DATE:
~F'PLICAN]': JOE RIORDAN
P.O, BOX 6650
ANCHORAGE. ALASKA g9502-0650
(907'~ 264-4111
TON v KiL~O WLE$
DEPARTMENT OF HEALTH & HUMAN SERVICES
January 10, 1986
TO: Permit Applicant
Subject: Permit # 850658
Lot 4 BLock 1 Macbeth Subdivision
A permit issued by this Department for an individual well and/or on-site
sewer system has expired as of December 31, 1985.
Permits are issued on a calendar year basis by authority of Municipal
Ordinance. A new permit must be obtained from this Department for any
well and/or on-site sewer system not installed by the expiration date°
If you have drilled the well, a well log needs to be sent to this
Department for documentation of the installation and to close the permit.
If a private engineer inspected the installation of the on-site sewer system
the original as-built inspection report(three part form) must be sent to
this office for review and approval,and for documentation.
If there are any further questions, please call this office at 264-4720.
Sincerely,
Susan E. Oswalt
Program Manager
On-site Services
SEO/ljw
enc: Copy of Permit
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
(ENGinEER'S SEAL)
PERFORMED FOR:
DATE PERFORMED:
LEGAL DESCRIPTION:
/_~,,t- ,~ Township, Range, Section:
2 ~] ~
3
4
5
6
7
8
9
10
11
12
13
14-
15-
16-
17
18
19
2O
COMMENT8 "-~ ~
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED?
IF YES, AT WHAT
DEPTH?
Depth lo Water After
Monitoring? Date:
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
~minutes/inch) PERC HOLE DI,,~'vlETER
TEST RUN BETWEEN ~ FT AND '~- '~£?~ FT
ACCORDANCE WiTH ALL STATE AND MUNICIPAL GUIDELINES IN~'EFFE~-r ON THIS DATE. DATE:
72-008 (Rev. 4/85)
WATER WELL RECORD
STATE OF ALASKA
DEPARTMENT OF NATURAL RESOURES
Division of Geological a Geophysicol Surveys
Drilling Permit No.
(Please iete either la, lb or lc.) A.D.L. No.
-- Anch MacBeth 4 1 --of--of--of-- SO W[]
-
DISTANCE AND DIRECTION FROM ROAD INTERSECTIONS $. OWNER OF WELL:
Pratt Const.
Address:
$?reet Address a~d Area of Well Locofion
2. WELL LOG Feet Below 4. WELL DEPTH: (finGi) 5. DATE OF COMPLETION
su,f~ 188 ". 11 -
Materiel Type Top Bottom
silty till cobbles 0 35 6. ~Cebre fool ~Rofory ~Driven ~Dug
silty ~ard pan 35 65 ~Auger ~detted ~Bored
silty gravel 65 8~ 7. USE: ~ Dome,tic ~ Public Supply ~ Industry
sand little gravel 85 96 ~ Irri$ot,on ~ ..cherg. ~ CommeHcel
brn till 96 105 ~ TesfWel, ~ Other:
gravel2 till 105 140 8. CASING: ~ Threaded
gray silty clay gravel 140 1 65 diam. ~ In. to~ ft. Depth Weight lbs./ft.
.~a~dpan ~e~ ~ 1~5~ ~ ~ 17~ diam. in. to~ft, Depth Stickup~ft.
_~ra~ silt-seep 175 185 e.~.,sH oF WELL:
__gravel sandy H20 185 188 T~,,: open hole
Slot/Mesh Size: Length:
~otal depth ~88' 20 gpm s,~ ~.t... ~t. a.~ -.
Backfilling . Gravel pack
*o. ST~T,C WA~E, LEWd: .. / /
,- ~ O? ~[c~O~G~ ~ Above or ~ Below land surface Date
~U~' 'E~ ~ ,._ ~0~,~ Equipment used:
~&[O~'[~:t~ .. ~ II. PUMPING LEVEL below land surface and YIELD
~CV_~ ~ ~-- ,2.GROUTING Well Grouted: ~ Yes ~ NO
M~tert~l: ~ Neat Cement ~ Other:
IS. PUMP: (if available) HP
Length of Drop Pipe ~ft. capacity ~g.p.m.
14. REMARKS:
16. WATER WELL CONTRACTOR'S CERTIFICATION:
15. Water Temperature ~o ~ F ~ C
This well was drilled under my jurisdiction and this report is true to the best of my know~edge and belief;
AZa~~eZZ/~e:~~ s D:i[Zi~g ~ ~..~-A~ ~AA~9-,
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHECKLIST- FEBRUARY '1984
264-4720
MUNICIPALITY OF ANCHORAGE
DEPT. OF HEALTH &
ENVIRONMENTAL PROTECTION
FEB 0 6 198(i
Legal Description:
WELL DATA
Well Classification ~'~/~"'~" If A, B. C, D.E.C. Approved (Y/N)
Well Log Present~N) Date Completed //~ '~'/--~.~"" Yield
Total Depth /'~,~ / Caseq to /~' /
Static Water Level /'~' /~"~
Depth of Grouting ,~//,~
Pump Set At
Sanitary Seal on Casin6N)
Depression Around Wellhead (Y~.,~
Casing Height Above Ground
Electrical Wiring n Condui (Y~)
Separation Distances from Well:
To Septic/Holding Tank on Lot
!
,//~ : On Adjoining Lots ,/~"~
/.,~2.-' "
; On Adlo~mng Lots
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line , ~,'~'///¢ To Nearest Public Sewer
Cteanout/Manhole' ~////~ To Nearest Sewer Service Line on Lot
Water Sample Collected by ,/~"¢/'~ /~" /'~'I/E3j/ ; Date
Water Sample Test Results .~/'~$/~/fd~,~
Oomments~/~)~'~-~ Z~r'//~rZ- ~',~
B. SEPTIC/HOLDING TANK DATA
Date Installed
Standpipes~N) Air-tight Capsi~N)
Depression over Tank (¥~
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding/Tank:
To Water-Supply Wel
To Property Line ~ /
To Water M~in/Service L~ne
Course
Size /~/'~ ~;'~ No. of Compartments
Foundation Cleanou.~/~ )
Date Last Pumped
Temporary Holding Tank Permit (Y/N) '~'//'~
To Building Foundation /'7-
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Comments
72-026(11/84)
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/~"~
Results of Last Adequacy Test
Separation Distance from Absorption Field:
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness 4
Standpipes Presenting)
Date of Last Adequacy Test
To Water-Supply Well
To Building Foundation
Lot /t///,~
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
To Property Line
To Existinfg or Abandoned System on
; On Adjoining Lots ,~ "~
To Cutbank (if present)
,//,,
Comments
LIFT STATION //
te Jnstat~~' Dimensions ~ _
"S iF~err~; (~',', °LneSv e, a, ~__ M a ;~ ~ 'me/pA Co~f: s:~:~ Na)t : :
High Water Alarm Level at ~'~'~__ Vent (Y/N) . _ _
Tested for ____ ~ring Adequacy Test. Meets MOA
Electd'cal Codes (Y/N) ~
Comments ~
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I ha~che~ked, v/e~rified, or conformed to all MOA and.HAA guidelines in effect on the date of this inspection.
Signed ~'~';' ~-~'""~- Date ,~' ~'~ ~
Company /~'~' MOA NO. ~'~" ¢~
Receipt No. "~"7 ~/ .~ /
Date of Payment ,~-(~ ~~"(,,'
Amount: $ ~. ~ o_._~
Page 2 of 2
72-026 (11/84)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTEC. ,N
DIVISION OF ENVIRONMENTAL HEALTH
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL
· OF ON-SITE SEWER AND WATER FACILITY
GENERAL INFORMATION
(a)
Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
(b) Ap~l~agtNarn~,,.~.E~' ~t0/~1~ Teiephone;Home,.~¢-~G~ Bus,ness
iq)', Applican~is (cheCk one):,be~ding Institution Q; Owner/builder~; Buyer ~; Other ~ (explain);
(d)' Le~[n~stlJutlon ~' g '~ Telephone
A~r~.~;;~:-:~,, ,t~'~'' ,~,~ ?~
-'.' .' .rtr
(e) Real Esta~ ~p~fiy and Agent
Address
Telephone
,(f) Mail the HAA to the following address:
TYPE OF RESIDENCE
Stngle-Family~ Multi-Family []
Number of Bedrooms ...3
Other
3. WATER SUPPLY
Individual Well"J~J. Community tm] Public []
Note: I1 comm unity well system, must have written confirmation from the State Department of Environ mental Conservation
attesting to the legality and status.
4. ' SEWAGE DISPOSAL
Onsite~l~ Public [] Community[] Holding Tank []
-~ · Note: f community well system, must have written confirmation from the State Department of Environmental Conservation
? attesting to the legality and status,
72-025 .t 1/84)
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 ano inspection, the on-site water supply and/or
wastewater disposal system is in corn pliance with all Municipal and State codes, ordinances, and regulations in effect on
the date of this inspection.
Name of Firm
Date
DHEP APPROVAL
CAUTION
The Muncipatity of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority
Approva~ certificates based solely upon the representations given in paragraph 5 above by an indeoendent professional
engineer registereo m the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending
institutions in order to satisfy certain federal and state req uirements. Employees of DHEP do not conduct inspections or
analyze data before a cerhficate is issued. The Municipality of Anchorage ~s not responsible for errors or omissions in the
professional engineer's work.
Page 2 of 2
72-025 {11/84)
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
TELEPHONE (907) 562-2343 5633 B Street
~ Anchorage, Alaska 99518
Drinking Water Analysis Report for Total Coliform Bacteria .
TO BE COMPLETED BY WATER SUPPLIER
[] PUBLIC WATER SYSTEM I.D.#
~I~PRIVATE WATER SYSTEM
.am, ~'~ bO ~? ~__~ Phone No.
Mailing
City State Zip Code
Mo. Day Year
SAMPLE TYPE:
~;[ Routine
[] Check Sample (for routine sample
with lab ref. no.
[] Special Purpose
) .[] Treated Water
Untreated Water
SAMPLE
NO.
2
31
4
$
LOCATION
MUt.i;C:?,".L!ZY C~F ANCHORAG~
DEPT. OF HEAL1'H &
~:NVtP. ONMEFITAL pRoT[CTIOII
Time Collected
Collected
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
t~Satisfactory
Unsatisfactory
[] Sample too long in transit; sample should
not be over 30 hours old at examination
to indicate reliable results. Please send
new sample via special delivery mall.
Date Received
Time Received
Analytical Method:
Membrane Filter
* No. of coloniesll00 mi.
Lab Ref. No. Result*
I r-~
I ~
I r-~
BACTERIOLOGICAL WATER ANALYSIS RECORD
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Membrane Filter:. Direct Count
Verification: LTB BGB
Final Membrane Filter Results ~~a
Reported By te
Time:
Collformll00ml
Collformll0Oml
/- _~-~
I ~"~ a.m.-.
TNTC = Too Numberous To Count
. OB = Other Bacteria