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Home My WebLink AboutHIDDEN HILLS BLK 1 LT 8 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 REPORT 'T tNT PHONE J NEW '- UPGRADE NAME MAILING ADD~ESS LEGAL DESCRIPTION LOCAT,ON LO .L DISTANCE TO: Welll 0 Manufacturer ~ L q. capac ty ] ga OhS / C~ IF HOMEMADE: Manufacturer Well DISTANCE TO: I No ofl'nes ~ Lengthofeacbl'ne Top of tile to finish grade T~e of crib Crib diameter Absorption area Inside len§th Dwelling Fou nc~at, ion NoT I~ Total lengtb o,f lines Material beneath tile Dwelling , Material Wdt~ Material Nearest lot li}~ Trench :r~ ~.~-~ inches NO. OFBEDROOMS PERMIT NO. No. of compa,r~ments Liquid depth PERMIT NO. Liquid capacity in gallons Distance between lines ~_-~, (~ inches Depth PERMIT NO. Crib depth Total effective absorption area Building foundation Nearest lot line Driller Distance to lot line PERMIT NO. Sewer line Septic tank Absorption area(s) Total effective absorption area OTFIER PIPE MATERIALS SOIL TEST RATING INSTALLER REMARKS APPROVED DATE, LEGAL (Rev. 3/78)/! 72-013 F'E:F.:I'"I I T NO, £:,EPRRTMEN]" O -IEgLTH FIN[:, EN',,,'IF.:CINI'"IENTRL [ FFECTIFd'.4 ',E~25 "'L STREET., FINCHORRGE., ~:~K. 264-4720 ,:: 8]:005--.': ::, RF'PL t CI::II"4T LEGFIL F'FtT MICHEL L:=:E:± HI[:,[:,EN HIL. L'_E; N ': F..'THEF.'H L. I GHTL-] LOT SIZE T'¢PE OF E;3IL I=IE:SORF'TION =',T=,/EII IS: TF.:ENCH t"iFIXTMIJM NLIMBEF.~ OF' E, EE RUUII .... ]: SOIl_ RFIT]:NI] ,::SI;! FI .'I:,F... = J,~... THE REg!I...IIt~:E[:, '==.;IZE OF THE '=-;gIL RESOI:?F'TIOI'-4 '=7,"r'~;TEM IS: THE LENGTH DIMENSION I:F THE LENGTH (:IN FEET) OF THE TRENCH OR DRFIINFIELD. TFIE [.':'EF'TH FiF I:1 TRENCH OF.'. F'ZT ~2; THE DZSTRNCE BETFIEEN THE ::7, URFFICE OF THE GROLIN[) Re',IE:, THE BOTTON OF THE E',=-,;E:RVFITION ,::ZN FEET). THERE ZE; NO SET NZDTH FOR TRENCHES. THE GRFI',,"EL DEF'TH ZS THE MZNIMUM B'EPTH OF GRFI',,"EL BET[,~EEN THE OLFFFRL. L P.T. PE faN[:' THE BOTTOM OF THE E','";C:R',,,'RT Z 0N ':: ~ N FEET). E-]'.' E E;:." bi I E;-:' E [, :L-T. [E F' T :[ C: ~r' F-~ f-,t ~-=:: "= I = ...... -- ::L (? ~E:., PEF.'.HIT I:~PPLICFINT FIFIS THE RE=,F_I~=.,IE, ILIT,r TO INF'nF:'r,1 THIS [:,EF'F'tRTMENT DURING 'T'HIE II'.~:BTFiLLFITI01'.,I IN'BPE"_'I'IZN'5 OF faN'-/ [IELL=, FI[:,JRCENT TO THI2-.: ";'" '-"'"' F [. _ F I=F.'. T -r FIN[:, TFIE NUME',ER OF F::E%I[:,ENCES, THRT THE NELL NILL SER'v'E. MINIMLIM [:,ISTBNCE E:ETt.,.IEEN fa NELL RN[:, RN"r' ON-:~,ITE SE[,.IRGE [:'I~;F'OSRL :B'~":STEP'I IS .1.~.2~ FEET FOR R PRI',,,'FITE I,.IEI. J. OR 'iSR TO ;2C~ FEET FROM R PUBLIC: 1,4ELL DEPEN[:,ING iJF'ON 'T'HE '/"'¢F'E Of: PUBLIC ~,~ELI.... HINIMUM E:,I'.E, TgNCE FROM R F'R.f.',,,'gTE; IqELL TO g PF..'I',/FITE E;EI.,.IEF.: LINE IE; 2..=.., FEET fiN[:, 'l"0 g CI]HHUNIT'.r' SEWER LINE IE; '7.5 FEET. t.,.IEL.L. LOG:5 RRE F.:EI:;!UIRE[:, RN[:' MUE;T E:E RETURNE[:, TO THE [:'EF'FIRTIdENT I.,.tITHIN 20 [:'F~'T'S L-IF' THE: ['.IELL COMPLETION. OTHER RE6!UIREI'"IENTS I"1R'¢ FIPF'L'T'. SF'ECIFII]:RTII]d",IE] FIN[) CONSTRUCTII]I",I [:,IRISRRMS FIRE R',,,'I:~ILRBLE TO INSURE PROF'EF.: INS"FRL. LFITII]N. I C:E:RT I F"," THFIT ±: t RM FF~I"IILIgR WITH THE REQI.JIREHENTS FOR ON-SITE E;EWERS RND I.,.IELL. S RE; :BET F'ORTH B"r' THE MUNICIF'RLIT'¢ 0F' RNCHORRGE. 2: I I.,.IILL INLg"F~LL TFIE S'¢:STEM IN RCCORDFINCE [,.IITH I-HE E:ODE~;. 3:: I LINDERSTRNB, ]"HRT THE ON-:SITE S~;EI.4ER 2;'¢:5'FEM ~'~Fl"r' RE6IUIRE ENL. FIRGEMENT IF' THE RESII}ENC:E IS REMCI[:'ELED TO INCLUDE MORE TFIRN :~: E:E[:'ROOMS. ',,,'4. E~ MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L, Street, Anchorage, Alaska 99501 264-4720 SOILS LOG - PERCOLATION TEST SOILS LOG PERCOLATION TEST PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 8 9 / ,~. r11 12 13 -14 15 16 17 18 19 2O SLOPE I I IIl+l I SITE PLAN ,VI~AS G ROUND WATER S! E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time ~ Water Drop "f HZO ?,10,§2 ~o'.~ ~. ,65 / IO',~'b ~ cb ,~ ,12. ' II; IR,'I¢ ~O ,5'3 ~ f,'3o;~o .~ .~6' PERCOLATION RATE 2 q (minutes/inch) TEST RUN BETWEEN C~) FT AND "J~'~' ET , '- ' . .,' . r ' : %:: : ( ~; :' ,"~ (' ',7~ ' , ~Permit I~: 820705 January 31, 1983 TO: Permih Applicant Subject: I,ot 8 Block i Hid!eh [Jills Subdivision A permih issued by this department for an individual well and/or on-site sewer system has expired as of December 3]_, 1.982. Permits are issued on a calendar year basis, as stated on the permit, by authority of Municipal Ordinance. If you have drilled the well, a well log needs to be sent te this department for documentation of the installation date and to close the permit° If a private engineer inspected the installation of the on-site sewer system, please have them send us the as-builts for our files and documentation. If there are any further questions, please call this office at 264-4'720. Sincerely. Robert C. Pratt, R.S. Acting Program Manager Sewer and[ Water Program RCP/1 j w enc: Copy of Permit SWP/057 THE:PIiii: :i: :5 i'-~[:~ :i;~i:T t,i ;I: iT,'T'H i::'[)F;: TH!E GF?Fi'v'!ii:!.... DEP'TH i: :5 'FHF..: H :!: i",! :~ h!L!i"! DEPTH [)F:' Fff.,E:, Ti. Iii: E',C:FTi:ff,i CfF:' THE E;:.:;CFF,,%-','!' i: !:)N <]:N U!::'Cff-,I THE 'i"'.r'PE 'F'(:) F! !4!i::L.L i...OGS EfF; THE HELl... OTHii:i;;il Fi:!~D::!U :[ PERHIT NO~ F:,EF'FIF.'.TMENT ~. HEFILI'H I~N[:, EN',,,'IROI'.~MENTFIL CITECTICIN 82.5 "'L.'" STREET., FINCHOF.:AGE., FIK. 264-472E~ #..'.if E=2 b L_ F' E~ F~: l'"1 Z T ,:: ~--'~2.':Elfl. E17' ) FIF'PL I I::BNT LOC:FIT I ON LEGFIL F'RTRICK J. MICHEL 4E'~9 P.I. LOT :3 E:I_.I-::: :L HI[:,E:,EN HILLS :gLIB NORTHERN LIGHTS LCIT SIZE 27'8-::~5i2 9995,99 SQLIFIRE FEE]" MINIMLIM B, ISTFII'.,ICE E:ETI4EEN FI I.,.IELL Bf.,ID RN'¢ ON-SITE SE!-,.!h]GE [:,ISF'OSFIL S'¢S]"EM IS J.E~O FEET FOR FI PRIVFITE WELL OF.: ±5E~ TO REs3 FEET FROM I=t PUBLIC !.,.IELL. [:,EPEN[:,ING UPON THE T'T'F'E OF F'LIBLIC HELL. MINIHUM DISTRNCE FREIM FI PRI',,,'FiTE .[4ELL TO FI PRIVRTE SEI. qEF.: LINE IS; ;=_:.'5 FEET RND TO t=~ COMI'"IUNIT'¢ SEP.IER LINE IS 75 FEET. WELL LOGS FIRE F. tE6!UIRED RND MUST BE RETURNED TO THE [.',EPRR]'HENT I.,.]ITHIN Z.':i?.~ [.'.',FI'-r'S OF THE !-,.IELL COHF'LETION. OTHER RE6'!IJIREMENTS I"1F1'¢ FIF'PL'¢. SPECIFICFITIONS RN[:, COI'.,ISTRLll]:TION [:,IRGRRMS FIRE F:I'v'FtILRI=_:LE TO INSURE PROPER II'.,ISTFILLFtTION. I CERTIF"r' THRT ::1_: I Ri"l F'RMILIF~R WITH ]"PIE RE6!UIREMENTS FOR ON-SITE SEI.4EF.:S Ri"4E:' I.'.IELLS RS SET FORTH E:'¢ THE MLINICIPFILIT'T' OF FtNCHORFIGE. ':2: I I.,.IILL INSTF'ILL THE S'¢S;TEFI IN FICCOR[:'RNC:E ~,.IITH THE CODES. I L:;SL.IE[:, E .¢=-[:,FITE ....... 3001 Porcupine Drive (Ti one: 277-6615) Anchorage, Alaska 99501 WATER WELL RECORD D~,~g co~p.~y N~ Ve~~ s Dx'~L~i,i n~_?~ E~.t OCATION OF WELL, ] Please complete either ia, lb, or lc. la Borough I Subdi¥]sion LJ ~t BlockJiB / lb, Fraction Section NO. And]L Lr 1 j/ / / Itidden Hills Feet Below Surface 10 Top 100 WELL LOG [ Haterlal Type ,X~2i]TC~y s~.nd 10 100 1 LL~ q WATER WELL CONTRACTE, R'S CERTIFICATION: STATE OF ALASKA DEPART/tENT OF NATURAL RESOURCES U.S.G.S. Local tLo. Drilling Permit No. J Townshlp Range I Meridian N/S E/W 3. OWNER OF WELL: Barsema & Michel Address; T 4- WELL DEPTH: (completed) Surface 1 /~?(~ 150 ~t. ii'Test W, Il [~Other: Threaded ~elded 7, CASING: lbs/ft. 8, FINISH OF WELL: Type: O fainter: Slot/Hesh Size: Length: Set bet¥~en fl, and Fittings: STATIC WATER LEVEL: Ft. ~]Above [~B¢low land surface Type of tteasurem~nt: 10. PUHPING LEVEL below land surface ft, after' hrs. purnping ]0 g.p,m. ft. after hrs. pumping g.p.m. ~] In Approved Pit Hatcrlal; ur~Neat Cement [] Other: 13. PUHP: (if available) lip Type: [~Submers~ble L~jReclprocatlng ~,let ~Other: Water TeEnperature: This well was drilled under my jurisdlct~on and this report is N'ue ~o the best of my knowledge and beLieE: A] ..... l,~ N,o?l-','lell-Ve:cn's Drill:Lng 8c .bnb AA~2 Registered Business Name ContracL~nse R~F Add ..... S~¢A ]}ox 1~60 Anchorage, Alaska 99~07 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # Oll - 1 .1 - 1. GENERAL INFORMATION Complete legal description HAA# ~r I~D -~hl ~ I LL--q Location (site address or directions) Property owner Mailing address Lending agency Mailing address Agent Address Day phone Day phone Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well NOTE: 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. 72-025 (Rev. 1/91) Front MOA~21 Engineer's signature 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 Address gO 2~ ~ /~'"~ /¢ ~ ~-~,~ Date /O//O/'~7--- DHHS SIGNATURE Approved for'~t~ (~) bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Additional Comments ~ (~,z~,-¢c.27_..~7 Date By: 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. 1/91} Back MOA Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescription: k¢~ g, ~,KI ~ra~¢~ t-/;~1-'~_ ParcelI.D. A. WELL DATA Well type ~, Log present (Y/N) Total depth Sanitary seal (Y/N) ~ If A, B, or C. attach ADEC letter. y Date completed / .-~'~ Cased to ADEC water system number ~//~ '~-/~'S Driller Casing height Wires properly protected (Y/N) Date of test Static water level Well flow / ID Pump level FROM WELL LOG SEPARATION DISTANCES FROM WELL TO; Septic/holding tank on lot ! O~ Absorption field on lot !~) ~ Public sewer main I",/z''/A Sewer service line .~ / (2 g.p.m. AT INSPECTION ; On adjacent lots ; On adjacent lots ~2...'.~ "' Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform ¢ Nitrate Date of sample: _ Collected by: Other bacteria _ /'~ .. SEPT C/.O'D NG TA.K r ATA Date installed ~ f¢'/¢ <¢~/~ ,-~ Tank size ,/¢dFt~::) Compartments Cleanouts (Y/N) ,~ Foundation cleanout (Y/N) ? Depression (Y/N) High water alarm (Y/N) ~///~ Alarm tested (Y/N) Date of pumping / 0/,0_,,/¢] ~L_ Pumper r-/ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ID ,~ On adjacent lots To property line ,~ ~' -- Absorption field Surface water/drainage ~/~) ,~' / D'"~:~)Foundation -- Water main/service line 72-026 (Rev. 7/91) Fronl CONTINUED ON BACK PAGE Date installed Size in gallons Vent (Y/N) High water alarm level Meets MOA electrical codes (Y/N) "Pump on" level at Manufacturer Manhole/Access (Y/N) "Pump off" level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed ~) ~ ]0~¢:::~ /(~ ~ Length ¢25 Width c~--~ Soil rating (~ ~-~ Gravel thickness System type _Total depth Total absorption area Depression over field (Y/N) /%/ Results (pass/fail) '~ Peroxide treatment (past 12 months) (Y/N) Cleanouts present (Y/N) Date of adequacy test for ,-~ If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation On adjacent lots Surface water Curtain drain On adjacent lots /%/~) Property line To existing or abandoned system on lot Cutbank ~Ot~ 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. Engineer's Name Date lO HAA Fee $ Date of Payment Waiver Fee: $ Date of Payment Receipt Number MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING ParcetI.D.# L~\~ ~'~,~-,~b,-~ HAA# 1. GENERAL INFORMATION :. Location (si'te address or directions) ~.3/42 Ac,j/ ~'¢r-c/¢ Property owner Mailing address Lending agency Mailing address Agent N¢,~ c- Ad dress Day phone ~-7~ Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~ TYPE OF WATER SUPPLY: 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. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Fronl MOA #21 s~uewwoo IBUOp,!ppv :suo!~Blnd!~.s 8u!~olloJ eq~. q~!,~ 'SLUOOJpoq ~o~ IBAO.'ddB IBUO!I.!puoo -- 'pe^oJddBsJCl eUOqd JOt p@AoJddv ~] a~ln±¥NglS SHHa '9 · uol~oedsu! s!q~ jo e~Bp eq~, uo ],oejJ, e u! suop, BlnbeJ pub 'seoueu!pJo 'sepoo e~.~,S pub IBd!o!unlAI lie q~!~ eouB!ldUJOO u! s! uJe~,sAs IBsods!p Je~B~e~,se~ Jo/puB Alddns Je~,B^~ e~,!s-uo eq~. 'uop, oedsu! pus uo!:~.B6p, se^u! ALU LUOJ,t pUB Sel!,t ebBJoqou'¢ ,to ,fq!lBd!oiunlat eq~, LUOAt peu!B~qo uop, BLUJO,tU! eq~ uo pesBq ~,Bq~, A,t!Je^ Jeq~J n,t I 'u!eJeq pe~.eo!pu! eJn~.onJ~.s jo edam, pus suJooJpeq ,to jeqLunu eq~, Jo,t e~,enb@pB pus IBUO!~oun,t 'e,t~s 9! Lue~sAS leSOds!p Je],e~e),sB~ Jo/pus Alddns Jo~B,~ e~!s-uo eq~ ~,Bq~. s~oqs uop, Bo!ldde IBAoJddv ,SJJoq~nv q~leeH slq~ ,to uop, Bep, se^u] ALU ~Bq~, ~Me^ I '~oleq u~oqs e~.Bp UOp, Bp!IB^ eq), ,to sB pub o~,e~eq pex!,t,tB IBeS AuJ Aq pe!,tRJeo sV M=~=~NIIDN~I A~l NOI.LO~dSNI 40 .LNBIN::I.L¥.L$ Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: ~. ~,, 151 ~ IDDShf ~/ /Z.L_~ Parcel I.D. A. WELL DATA Well type ~'E't Y/] TE Log present (Y/N) Y Total depth 1,5'O Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. Date completed Cased to ~O Date of test Static water level Well flow Pump level FROM WELL LOG I0 SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot JOS' Absorption field on lot ./0 c~ ' Public sewer main '~ /oo Public sewer service line ?o C,O, To C,O, ADEC water system number _~J,/~. Driller VEI~N'5 Casing height Wires properly protected (Y/N) g.p.m. z AT INSPFCTION o m 122 < ~ (o:7 g.p.m.~ /2.7 / ; On adjacent lots ~' /o0' ; On adjacent lots ~8 ' ¢~ c,o, Public sewer manhole/cleanout_ ;~/oo Petroleum tank WATER SAMPLE RESULTS: Coliform _ ('2 cc,( / foo/~.Z Date of sample: 8/(~ t/~ / _ Nitrate /, 7 raj4,/--~' Other bacteria Collected by: ~L~TToP T~C/¢ B. SEPTIC/HOLDING TANK DATA Date installed /-/r Cleanouts (Y/N) High water alarm (Y/N) Date of pumping Tank size 1<9o0 ~/]z. Compartments Foundation cleanout (Y/N) Y' Depression (Y/N) ~' fl'~ Alarm tested (Y/N) /k/ N SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s)onlot Io, F,' F¢o~ C,O, Onadjacentlots Topropertyline h'¢~rom c,o. Absorption field S Surface water/drainage ~>/oo ~-/oo Foundation 12 ?~- /}~ ~'r, Water main/service line ~ 80 72-026 (Rev. 3/91) Front MOA 21 CONTINUED ON BACK PAGE C. LIFT STATION N, ~. Date installed Manufacturer Size in gallons Vent (Y/N) High water alarm level "Pump on" level at Manhole/Access (Y/N) "Pump off" level at Cycles tested Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length ,2,.5 ~ Width Total absorption area Depression over field (Y/N) Results (pass/fail) F~ :~ S Peroxide treatment (past 12 months) (Y/N) Surface water Curtain drain No~46' og$~£¢~:~ E. ENGINEER'S CERTIFICATION Soil rating ~ ~'/~D~.~ System type Gravel thickness ~ ' Total depth Cleanouts present (Y/N) Date of adequacy test ~/~/¢// for bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /OR ' Ff~tn C,o . 'Fo building foundation ~.D ~ On adjacent lots ~> 20' Cutbank On adjacent lots ~ /ou If yes, give date /~ ¢~-, Propertyline 5/¢ ,.-¢',%,/~ ¢,o. To existing or abandoned system on lot ~',/~, NC ¢~, Water main/service line ~ $o Driveway, parking/vehicle storage area I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. ~. ~%THEODORE F. /.500RE ,~ ~:~.~ '. CE - 3589 ,' ~ ~z Signature Engineer's Name Date ~/" / HAA Fee $ Date of Payment Receipt Number Waiver Fee: $ Date of Payment Receipt Number % ~o ~ F'~,. MUNICIPALITY OF ANCHORAGE , DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION I ENVIRONMENTAL ENGINEERIN(3 DIVISION 825 L Street- Anchoreqe, Ale~km 99501 Telephone 264-4720 -- ON*SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT ~IAILINGADD~ESS f . ', n / ~ , DESCRIPTION V --) .......... ~ O. -- . L~q, cepeclty in gallon~ Iol,de Irnqth W~dth ' ~iquid ~pth ' ~ ~ IF HOME'DE: DISTANCE TO: Well ~wellinq PERMIT NO. Manuf~turer Material Liquid c~ity Well F ou-,~Uon Ne~rett lot ll~ Length Width Depth ~ NO. Ty~ of crib Crib diome(et Crib ~Ih Total eff~ti~ Well Building f~nd~tio~ Nearer lot DISTANCE TO: DISTANCE TO: Building foundation Se~r line Septic tank A~or~ti~ OTHER .... SHAFT, : NAME ,~;ott and LEGAL DFSCRmPTrON Lot .;cve:~ (7), 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 REPORT, JPHONE ............... J 24 }-:~486 ')2502 '.n [1), "Ed(Nh ';ii.I;: '~bd. OTHER PIPE ~A T ~'~ SOIL TEST~iI~ATIN~-~-[i- -~--'-~-'-: ..... :': "-': :-7'- ' / ~P ;,,'/:~u...: ['.'i:u;:l) t':'," / .,.~ q~i~Fg~ ................................... 22 ft M.~,.,,a, teal j[~J NEW --~ ~ UPQRADE NO. OF BEDROOMS 3. N O, of compartments _ ]?la PERMIT NO. -- ......... 840804 abtg[~tion area 01' PERMIT NO, ? 100+ f~ DEPT. OF IENVIRONMENTAL CONSERVATION ANCHORAGE/WESTERN DISTRICT OFFICE 437 "E" STREET, SUITE 200 ;.NCHORAGE, ALASKA 99501 274-2533 Septen~ber 27, 1984 Mr. Tony Barter, P. E. 5331 Tudor Road Anchorage, Alaska 99501 SUBJECT: Waiver Horizontal Separation Between Well and Septic Tank, Lot 7, Block I, Hidden Hills S/D (8521-WA-036) Dear Mr. Barter: The Department hereby amends the subject waiver from 88 feet to 80 feet horizontal separation between the well and septic tanks located on the subject property and on Lot 6, Block I. BEE/dd Sincerely, District Engineer Static ilater Level 0 feet fee t fee t t',,.& Shtrloy Aldtld,e l.ot q BU~.I Gallons Pe~ Minute Total Feet of t'aei.~ 1 ~n , 'Date'Drllledg Static Water Level, Draw Down, fee t . feet Callons Per Minute Total Feet of Casing_ ~50 ~ue ~terial %0 I/, ' q ,r t Hefty Drillin~ B.R.A. Box 1553 H A ~chor~, ge ,Alaska 995O7 Tom Fink, Mayor / tunicipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519~6650 343-4744 September 12, 1991 Ted Moore, P. E. Flattop Technical Services 14350 Echo Street Anchorage, Alaska 99516 Subject: Waiver Request for Lot 8 Block 1 Hidden Hills S/D Waiver Request ~WR910039, PID ~011-121-33, HA910369 Dear Mr. Moore: Your request for waiver of the required 100 foot horizontal separation of a septic system to a private well has been approved. The approved separation distance is 95 feetj from the well located on Lot 8 Block 1 to the leachfiled on Lot 7 Block 1, and 0 feet to the lot line on the north property line abutting Lost Circle. This waiver approval applies to the existing septic system to well separation only. Any future upgrade to either will require all separation distances be met or another approval from this department. Sincerely, Daniel J. Roth Civil Engineer On-site Services Concur: ~ ~ /~hn Smi t h,//P .~ErV.~-~ ~'¢ ~rogram Manage On-site Services ljm:~6 FLATTOP TECHNICAL CIVIL & ENVIRONMENTAL ENGINEERING * ENERGY CONSERVATION & ANALYSIS TItEODORE F. MOORE, P.E. 14530 ECHO ST. PH: (907) 345-1355 August 19, 1991 ANCHORAGE, ALASKA 99516 RECEIVED M.O.A. DHHS P.O. Box 19-6650 Anchorage, AK 99519 Dem' Sffs: AUG 2 0 1991 Municipality of Anchorage Dept. Health & Human Services By means of tlfis letter we m'e requesting a waiver of the normally required 100 foot separation distance between a private well and a soil absorption system down to 95 feet for the existing sepm'ation between the well serving Lot 8, Block 1, Hidden Hills S/D and the soil absorption ri'erich on Lot 7. We m'e also requesting a waiver allowing the septic system on Lot 8 to be within 0 feet of the north property line abutting Lost Circle. A site plan is enclosed to assist you in your review, along with copies of relevant backup documents and an application for a HAA certificate for Lot 8, Block 1, Hidden Hills S/D. According to the driller's log, the well on Lot 8 was completed in June of 1983 and has a total depth of 150 feet, with the first reported water at 125 feet. On August 8, 1991 the static water level stood at 122 feet below the top of the 2' high casing. Steady pumping of 937 gallons of water from the well at the maximum pump output of 6.7 gpm caused the water level to be drawn down to 123 feet, but no fm'ther, and the water level returned to 122 feet within 1 minute after the pumping was stopped. This drawdown and recovery behavior is consistent with a high volume aquifer with a negligible slope, and in fact all of the nem'by well logs indicate similar total depths and static water levels. Water samples collected on August 6 were satisfactory showing 0 coliform or other bacteria per 100 ml., and 1.7 mg/1 of nitrate-N. The wastewater disposal system serving this lot was installed in April of 1983 and according to the as- built inspection report consists of a 1000 gallon septic tank followed by 25 lineal feet of soil absorption u'ench containing 5 feet of sewer gravel. While the inspection report states that all components of the system are 5 feet from the property line, our measurements form the survey as-built indicate the standpipes for both the septic tank and the trench m'e approximately 4.5 feet from the property line. Plotting of a logical waste line from the tank to the trench indicates that the ~ench is probably very close to the property line. Since the property line abuts a dedicated street R.O.W., there will be no adverse impacts on other potential systems by granting the requested lot line waiver down to 0 feet. During the course of our adequacy test, the trench accepted 937 gallons of water without ever backing up into the monitor tube. The wastewater disposal system on Lot 7 was upgraded in September of 1984 from a seepage pit to a 36 foot long x 5 foot wide soil absorption drainfield containing 2 feet of sewer gravel beneath the distribution pipe. The as-built inspection report indicates that the trench is 100+ feet from the well, which appem's to be true for the well on that lot, but apparently the inspector overlooked the fact that the cleanout at the east end of the drainfield is only 98 feet from the well on Lot 8. Our waiver request for 95 feet is to allow for possible underground projection of that ddrainfield beyond the cleanout pipe. At the time this upgrade was done, the engineer requested and was granted waivers from D.E.C. allowing the Lot 7 well to be within 80 feet of the septic tanks on Lots 6 and 7. The site plan used in granting that waiver showed the em'lier crib on Lot 7 to be 92 feet from the well on Lot 8, however the D.E.C. did not specifically addi'ess that sepm'ation distance in granting theft waiver. The soil absorption ddrainfield on Lot 7 appears to be functioning properly, with no indication of past daylighting. The following is a breakdown of how waiver assessment points could be assigned using the criteria promulgated by D.E.C.'s SCRO in July of 1985. Criteria Distance to water table (121' - 12' = 109') Soil Sorption (predominantly silty sand) Pe~Tneability (predomiuantly fine sand) Water table gradient (basically level - see analysis above) Horizontal sepm'ati0n (95') Total points assigned Points 7.05 2.5 1.5 2.9 2.8 16.7 Based on this point analysis it appears that the waiver can safely be granted without concern as to contamination of the well on Lot 8. Additional mitigating ch'cumstances not dh'ectly addressed by the waiver point assignment procedure m'e that almost the entire soil column above the aquifer consists of silty sand which is the equivalent of a hundi'ed foot thick sand filter. Also the D.E.C. waiver granted for Lot 7 can be construed as a de-facto recognition that reduced separation distances on lots in this subdivision can be allowed without public health concerns. Please give me a call if you have any questions regm'ding this submittal. cc: Paul Young Sincerely, Ted Moore, P.E. APPLIC FILLS OUT UPPER HAl, ONLY Mailing Address /~.-(;) ? ~/ , ~, / /¢. ]'1 ~ ~' /) ...... : // ~(' Zip Code ,/~ ~- ¢> Phone Address Legal Description Zip Code Zip Code Zip Code Phone Phone Street Locatio~ / ¢ S ~' q: / /~ c/_ ,: Type of Residence .~ Single Family -) Multiple Family No. of Bedrooms ..~ ~ Other Water Supply I ndividual Community [] Public Ulility ATTACH WELL LOG. A well Icg is required for all wells drilled since June 1975. For wells drilled prior to that date, give well depth (attach Icg if available). Sawer Disposal ' Individual Public Utility [] Holding Tank Year Individual Installed:_ 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 inspector Field Notes: Inspector Jnsp6oJor Date c. 2 MUNICIPALITY OF ANCHoI~AGE DEPT. OF HC_ALTH & ENVIRONMENTAL PROTECTION APPROVED BEDROOMS ) DISAPPROVED ( ) CO N DITIgN A L A, PPROVA L' [)ATE _7~/:/~ ~/~ - .~7,¢~._____ 'CONDITIONS OF APPROVAL RE !V£D__ Soils Rating Date Sewer Installed Well To Absorption Area Well to Tank tWell Log Received Septic Tank Size MUNICIPALITY OF ANCHOF::AGE DEPAIKFrvlI£NT OF HEALTH AND ENVIRONMEN'FAL PROTECTION 825 I.. St~eut, Ancherage, AM~ka 99501 264-4720 SOI!.S LOG -- I-dERCO A"i-ION TEST [ EGAL OESCIdP'rlON: * ' 1 ' ~ % t 15 16 17 18 19 2O St_OPE SI1 E PI.AN 4' Gross Net I Depth to ~ Net Rea(.mg Date F~rne Time ' Water ~ Drop ~' 'UO ?...!0,E~2 ,u,.q~. ,:,- b, 3 : PERCOLATION RA-I E ..... ~ L~ --~ (r'ninutes/inch] .3- _::,:.._ TEST RUN BETWEEN ...... FT AND FT