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HomeMy WebLinkAboutHENKINS BLK 2 LT 1 Municipality of Anchorage Page I of 'Z 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: ~'c'J~J ~o~ ~'0 PID Number: Name:~1~' ~~-~ Wastewater System: ~ New ~Upgrade A~:. ~X ~70~ E~ ~~ ABSORPTION FIELD No. of Bedrooms: Phone: ~ -- ~O~ ~ ~ DeepTrench ~ShallowTrench ~ Bed ~ Mound ~ Other Total Depth from original grade: LEGAL DESCRIPTION ~oil Rating: J.~ GPD/Sq. Ft. Subdiv~ion: Depth to pipe boEom from original grade: Gravel depth beneath pipe Lot: I Block:~ ~{~ I' ! 7 Ft. O' ~ Ft. Township: Range: Section: -- Fill added above original grade: Gravel length: WELL: ~New D Upgrade Gravel width: ~ I Number of lines: Distance be~een lines: Ft. [ ~ Ft Clarification (Private, A,B,C}: Total Depth: ~:' Total absorption a[~: Pipe material: Driller: ~ ~ Drilled: Static Water Level: qnstaller:Ft. ~'~ Yield~~ GPM PumpSet at: Ft. Casing Height AboveGround:Ft. TANK SEPARATION DISTANCES ~eptic ~ Holding D S.T.E.P. To Septic Absoft[on Lift Holding Public/Private Manufacturer: Cspacityin gsllons: From Tank Field Ststion Tank Sewer Lin~ A~cH~e ~ IOoo ~Matedal: ~ Number of Compa~ments: Sudace Water IOOl+ /~+ -- ~ ~ LIFT STATION Lot ' , ' Size in gallons: I Manufacture: Line 1~ I -- -- -- Foundation Z~I~ ~1~ ~ ~ ~ "Pump on" level at: - ' . High water alarm ~t: Cu~ainDrain ~ , ~, ~ ~ Pu~ectri~l Inspections pe~ormed by: Remarks: ~ ~O~57e~ I' Lo~ LME BENC~ Location and Description: I A~um~ Elevation: ENGINEER'S S~L Inspections pe~ormed by: ~h~ ~~ W~ates: 1st Depadment of Health and Human Se~ices approval %*~".. ~-z~5~ ...~] Reviewed and approved by: ~~ ~ Date: /¢-3¢-¢~ 72-013 (Rev. 9/91) MOA 25 PER,,,Tsw980 80N.. R: AS ' BUILT DRAWING ~ [NOTE: THE WES~ AND NORTH LOT LINES M-r2~2 ~ <-.~ /WERE ~AGGED DURING EXCAVATION, / ~ ~ ST~ ~.7 ~2.~ ~ BaLl 18.8 -- 22.0 X ~ DBL2 18.8 23.1 ~ ~ C01 52.6 56.0 ~ ~02 ~2 1 104 2 : N~W I:O S:LON ( 90.92 ~FflC f~K 90.64 ~ = 87.S9(~p.)OM OF PIPE GROUNDWATER%~87 09 (~P)- ~ 82.56 HENKINS SUBBWISION, LOT 1, BLOOK 2 .... AS-BUILT 0F SEPIIC SYSTEM KIT VERCEL~ 696-7036 10/12/98 J.L.M. 1 = 40' 2 OF 2 A B FCO - - ST1 21.7 12.6 s'r2 19.3 __ 18,4 DBL1 18.8 22.0 DBL2 18.8 23.1 C01 52.6 56.0 MT1 53,1 57.7 ~-02 82.1 1_04.2 M__T2 8 ! ._2_ 103.2 MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-site Services Section Waiver Review Worksheet WR ~ ~l_~l%~D~D~ PID~ 051-292-16 HA~ Date Received: Oct 14, 1998 Legal Description: Lot 1 Block 2 Henkins Subdivision Engineer: Permit ~ SW980380 Jeff Garness, P.E., Alaska Water & Wastewater Consultants, Inc. 7320 East Chester Heights Circle, Anchorage, Alaska 99504 Applicant: Kit vercella Waiver Requested: Lot line waiver of 1 foot from the west and north property line to the new drainfield. Criteria: 1. Geology: Points: A. Water Table B. Soil Sorption C. Permeability D. Water Table Gradient E. Horizontal Separation TOTAL: 2. Special Conditions: 3. Other: Waiver is Granted: Waiver is NOT Granted: List Conditions or Reasons for above: Date: By: Name of Reviewer Rec ~: 04269/6198 Amount: $ 115.00 Date Paid: Oct 14~ 1998 Rick Mystrom, Mayor Municipality of Anchorage Department of Health and Human Services 825 '%" Street P.O. Box 196650 Anchorage, Alaska 99519-6650 http://www.ci.anchorage.ak.us November 2, 1998 Jeff Garness, P.E. Alaska Water & Wastewater Consultants, Inc. 7320 East Chester Heights Circle Anchorage, Alaska 99504 Subject: Waiver Request for Lot 1 Block 2 Henkins Subdivision Waiver Request #WR980074, PID #051-292-16, SW980380 Dear Mr. Garness: Your request for a waiver of the required 10 foot separation between an on-site wastewater disposal system and a lot line has been approved. The waived distance is 1 foot from the west and north property line to the newly installed drainfield. This approval applies to the existing on-site wastewater disposal system lot line separation only. Any future upgrade to the on-site wastewater disposal system will require all separations be met or another approval from this department. If there any further questions or concerns regarding this waiver, please call our office at 343-4744. S~ncerely, Daniel J. Roth Civil Engineer On-site Services ijw #7 Alaska Water & Wastewater Consultants, Inc. 7320 East Chester Heights Circle N Anchorage - Alaska 99504 Phone (907) 337-6179 - Fax (907) 338-3246 Consulting Engineers October 13, 1998 ,/~dNIL. IHALI I ¥ (.~- · 'mr~NMENfAL SERVICES DlVl$1(h' Municipality of Anchorage Department of Health and Human Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref.' Lot Line Waiver for Lot 1, Block 2, Henkins Subdivision To whom it may concern: We request that your department issue a 1 foot lot line waiver from the west and north to the new drainfield. On September 29, 1998, we contacted your department and received verbal approval for the waiver prior to the installation of the new drainfield. I am unaware of any adverse impacts this waiver would have on adjacem wells or septic systems. If you have any qt''';.''~ons, please contact us at 337-6179. Thank you for your assistance. Prelid6htv 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: Sep 23, 1998 Expiration Date: Sep 23, 1999 Permit Number: SW980380 Legal Description: HENKINS BLK 2 LT 1 Design Engineer: 0041 AK Water & Wastewater Consulta Owner Name: Kit Vercella Owner Address: PO BOX 770378 EAGLE RIVER , AK 99577-0378 Parcel ID: 05%292-16 Site Address: 019822 GILBERT RD Lot Size: 17860 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 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. Received By: ,~4~ ? ~:/~'/ Date: Issued By: ~..~///~ / ~. ~~ Date: Alaska Water & Wastewater Consultants, Inc. 7320 East Chester Heights Circle - Anchorage - Alaska 99504 (907) 337-6179 ~ Fax (907) 338-3246 Consulting Engineers September 18, 1998 Municipality of Anchorage Department of Health & Human Services Division of Envkonmental Services On-Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 Ref2 Septic Upgrade Design for Lot 1, Block 2, Henkins Subdivision. The existing 3 bedroom house is served by a private septic system and by a private well. The existing drainfield is surcharged and must be upgraded. Two test holes were excavated to the east of the existing septic system. Comments regarding the proposed upgrade design are summarized as follows: 1. SOILS: Attached are the logs which shows the soil profiles, and the percolation tests results. Below the organics, the soil is a GW/SW material to a depth of 5.5 feet in test hole #1 and 5.0 feet in test hole #2. At 5.5 and 5.0 feet, the soils transition to a GM/SM material to a depth of 11.5 feet (bottom of both test holes). Groundwater was encountered during the excavation of the test hole #1 at a depth of 8.5 feet. Two soil percolation tests were performed in each test hole (see attached soils log for percolation results). We propose to install the upgrade drainfield in the upper strata of the soils. It is our opinion that there is enough sand in the insitu soil to negate the use of a sand filter. A soil sample can be provided if required by your department. Please advise with guidance of any action your department will require. 2. TRENCH DESIGN: a. Percolation Rate: <1 and 4.44 minutes/inch b. Allowable Application Rate: 1.2 gallons/day/ft2 c. Number of Bedrooms: 3 d. Design Flow: 450 gallons per day e. Minimum Absorption Area: 375 ft2 f. Effective Depth: 0.5 feet g. Reduction Factor = N/A h. Width: 5 feet (minimum) i. Minimum Length: 80 feet j. Effective absorption area = 400 ft2 (>375 ft2 OK) k. Maximum depth = 1.5 to 2.0 feet (on uphill side, remove all organics) 3.' SURFACE WATERS: There are no surface waters within 100 feet of the proposed ~upgrade. 4. TOPOGRAPHY: The general topography in the area of the proposed upgrade is a 5 to 10 percent slope running from approximately east/southeast to west/northwest, in short, there are no slope concerns. 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. ~~~~~MSincerely' I A~l~//I '-Teffr ~'~.G mess, P.E., .S. Pres: t t..f) ,' / ,' ..... -.-_. '~'"'~" / ? ~ / / / '"'--...~ / .......... / %-- /,,, -....... / ... / /,, ,o,-,, ..._ ~ / ~- / ?%.. '~'4,,,~.,o~,~ '-'~./ '--LJ / -~ -.... I ~"~-,~ // PROPOSED SEPTIC UPGRADE~. ND~q/E'Lo/~'""'D ' / ~-.~.,/ / (SEE DESIGN, PAGE 2 OF 5)-7~ ~ ~ ~.~ / ~ ~ ~/.z! ~ ; ' ~- '.my, e- '~'- / \ i ~ z ./,,%y/,t / ,' ~-'"~'~' '~..../. '~ L "~ / ,I I;'7,; I k,,z,~.,.. N' ,to "-~... ~ ;' / ~o,- \~,ous~- / /,^/ ',~-..... '~ ....~ - 0. \ - -up "~--.. ,' / ...... -.-..- -,~-~ /-/--'"--..... .Z% / // / / --.-_.. // ..... .. /x/' ........ ,,.~. "'4,,%,. ~" /-,/~ ......... '°' --.... . /'"-~.. '"~",¢~.. // -"-->---~:c:~ ' / ~--// / -.-.._. //:" .~.. / D'/ 7320 E. CHESTER HEIGH'rS CIRCLE, ANCHORAGE, AK 99504 ~.~(/ PHONE: (907) 337-617g/FAX'. (907) 358-3246 ~ """" %;¥%. ,^ ; Jeff re~/ KIT VERCELLA 696-70;56 O~,i.,, ". .-" \ ~ I ,k,'l/ "~ ~ .,,/' n-~..~ ' mSKA WA~R A~ WAS~WA~ CONSmTA~S, ~C. ~A~ ~sc~vr~o~,, HENKINS SUBDIVISION; LOT 1, BLOCK 2, ~E~I~N OF THE ~EPTI~ ~Y~TE~ UPGRADE J .... ~ ....... KIT VERCELLA 696-7036 DA'ri:9/18/98 ~w~ BY: SCALE: PAGE: J.L.M. 1 = 50' 2 OF 3 M~o n-TI II ~ ~PPb~Nf P~OM ~PJlC fat,& PLAN NOf~ fh~/v'C,X!M~A P~FIH Af h~P{ ] POINflS'FO ~ 2 Pl~l~f (OH fi'HILL ~),J /~.!. OhgANI~5 ~ TO ~ ~MOV~O, J PROFILE VIEW ALASKA WATER & WASTEWATER CONSULTANTS, INC. 7320 E. CHESTER HEIGHTS CIRCLE, ANCHORAGE, AK, 99504- PHONE: (907) 337-617g/FAX: (907) 5.38-3246 LEGAL DESCRIPTION: HENKINS SUBBIVISION, LOT 1, BLOOK 2, POPE OFu~ DETAIL OF PLAN AND PROFILE OF DRAINFIELD PREPAREO FOR: PHONE NUMBER: KIT VERCELLA 696-7056 JDF~WN BY: J SCALE: J PAGE: DATE: o/18/98 .AL&SR, A WATER. & WASTE, WATER CONSULTANTS, INC. ~. OF' ~i [SOIL LO(:; - PERCOLATION TEST] ~'~ -~_~ :.~7~ LEGAL DESCRIPTION: HENKINS SUBDIVISION; LOT 1, BLOOK 2, '"'! ............... DATE PERFORMED: 9/11/91] ~j". ~ir-7953 ." GW-SW .... GM~ CL PROPOSED sEP-rlc U,OPAO~%-~.  GC ;OL i(SEE DESIGN, PAGE 2 OF S)--d ~.-~ ~ SC I DEPTH TO DATE :GROUNDWATER ////~" DATE READING CLOCK NET TINE WATER LEVEL NET DROP TIME (HINUTES) READING (INCHES) UPPER 2 4:24-:.30 2 MIN 30 SEC O" 6" q]ENC:I-] 5 4-:25 6" .... 4- 4:27:30 2 MIN 30 SEC O" 6"____ 6" 5 4-:28 ..... 6 4:30:.30 2 MIN 30 SEC O" 6" 6" LOWER 2 4-;4-4- 30~MIN. 5 1/4-" 3/4-" ~BEN'CR-- ,3 4-:4-5 5 5:16 6" 19-- PERCOLATION RATE <1 & 40 (NIH,lINCH) PERC. HOLE DIA. 6" (INCHES) (UPPER) (LOWER) 20- TEST RUN BETWEEN ,3.0-3.5 FT. AND 6.0-6.5 FT. COHMENTS' PRESOAKS STARTED AT 11:00 A,M. (9/14-/98) PERFOMED BY ALASKA WATER &: WASTEWATER I, , CERTIFY THAT THIS WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EI-I-ECT ON THIS DATE. DATE: DEPTH TO DATE GROUNDWATER 8.5 g/11/96 6.5 9/14-/98 AL&SKA WATEI~ & WASTEWATFR CONSULTANTS, INC. PHONE (907) 337-B179 * FAX (907]) ISOIL LOG - PERCOLATION TESTJ .~...:F,(~/_Tt/'~'".?~I,_ - ,-,,_,,.....,..._ LEGAL DESCRIPTION: HENKINS PERFORMED FOR: KIT VERCELLA ~.-"~':.j,. "F'l ..... ~ ........ TESH HOLE #2 DEPTH i (f.at) ORGANICS PAGE 1 OF 2 GW_SW :~'::": ', GP ML GM CL PROPOSED SEPTIC UPGRADE GC OL (SEE DESIGN, PAGE 20E ~ $p CH ~TH~.~ ~ ~ ~ / GM-SH GROUNDWATER IWlTH TRACES DRY 9/11/gB OF CLAY/SILT ~.~ ---9/14/98/~. 10~ J 11 j DATE READING CLOCK NET TIME WATER LEVEL~ NET DROP ~ TIME (HINUTES) READING (INCHES) ~B,O.H. 6 12~ 9/lf/98 I 4:20 UPPER 2 4:30 10 MIN. 2 4 ~:40 10 MIN, 3 1/2" 2 1/2" 14 ~ 5 4:40 6 4:50 10 MIN, 3 1/2" 2 1/2" 6" 15 -- 7 4:50 16-- 8 5:00 -10 MIN. 3 3/4" ~ 1/4" 9 5:00 17-- 10 5:10 10 MIN. 6" 11 5:10 18-- 12 5:20 10 MIN. 3 3/4" 2 1/4" 19-- PERCO~TION ~TE 4.44 (HIN,/INCH) PERC. HOLE DIA. 6" (INCHES) / TEST RUN BETWEEN 2.5 ~. AN~/ LO FT. 20~ //I/ COMMENTS: PRESOAKS STARTED AT 11:00 A.M. (9/1 / /// ~/f7 PERFOMED BY A~SKA WATER ~ WASTEWATER ', ~ .~g' ~ , CERTI~ THAT THIS WAS PERFORME~ I~ ACCORDANCE WITH ALL STAT~,D ~DNICt~UIDELINES IN EFFECT ON THIS DATE. DATE: ?/l"/e~ // DEPTH TO DATE GROUNDWATER DRY g/11/gB 8.5 g/14/gB AI.A, SKA WATEIL & WASTEWATEI~ CONSULTANTS, INC. PHONE (907) 357-6179 s Fa,)((907) 33B-324§ J SOIL LOG - PERCOLATION TEST I LEGAL DESCRIPTION: HENKINS SUBDIVISION; LOT 1, BLOCK 2, DATE PERFORMED: 9/11/98 ~e~, .. ...- .,~ DEPTH (f..O TEST HOLE ~2 '~ro f ess~O~ 1_i PAGE 2 OF 2 2-- SOIL C~SSIFICATIONS ~ 3-- ~ ~ ~GP ~ML ~. ~ i GM CL  PROPOSED SE~IC UPG~DE 4-- 0 GC~, OL {SEE DESIGN, PAGE 2 OF ~--~ SW HH H?~~~~ ' 5- ~ / , . 7-- ~ ~ GROUNDWATER ~ ~.0' 9/18/98 Ex~ .. lO-- ~ 11 ~ ~ DATE READING CLOCK NET TIHE WATER LEVEL NET DROP TIME (NINUTES) READING (INCHES) 6" 0 9/14/98 I ~:17 12- LOWER 2 4:47 30 MIN. 1 3 I 3 4:48 ~ 4 4:18 ~0 MIN. 4" ~ 2" 1~-- ~ ..... 5 4:19 ~ 6 4:49 30 ~IN. 4" 2" 19-- PERCO~TION ~TE 15 (MIN./INCH' PERC. HOLE DIA. 6" (INCHES) / 20-- TEST RUN BETWEEN 5.5 ~ ,~ ~. A~ 6.0 FT. co...N=S: ,:OO // ///L,/ DATE. DATE: DEPTH TO DATE GROUNDWATER DRY 9/11/98. 8.5 9/14/97~_ ~.0' 9/18/98 GREA,ER ANCHORAGE AREA BOR,.JGH Department of EnvironmentsI Quslity 3330 C Street Anchorage, AIssk8 gg503 INSPECTION REPORT ON-SITE SEWAGE DISPOSAL SYSTEM MAILING ADDRESS /~¢/~._ (~-I~'~'i,, PHONE ~,~'~- LEGALDESCR,PT,ON bi tg ~ l.~.,~b.,: SEPTIC TANK: DISTANCE EROM WELL ! INSIDE LENGTH NUMBER OF MANUFACTURER ~ ~" MATERIAL .~.~_ ~ COMPARTMENTS INSIDE WIDTH LIQUID DEPTH ~ LIQUID CAPACITY J~'(~GALLONS. RAIN FIELD: DISTANCE FROM WELL FOUNDATION NEAREST LOT LINE TOTAL LENGTH,~:2 OF LINES NUMBER OF LINES I DISTANCE BET.W. EEN LINES ~'~/~ TRENCH WIDTH'~(¢~ IN. ABSORPTION AREA Li~L'I 0 SQ. FT. LENGTH OF EACH LINE i DEPTH OF FILTER DEPTH: TOP OF TILE TO FINISH GRADE '~) MATERIAL BENEATH TILE TOTAL EFFECTIVE IN. ABOVE TILE ~- IN. WELL: CONSTRUCTION BUILDING ! NEAREST I NEAREST ~JF SEPTIC FOUNDATION 7,~ , LOT LINE /-<~ ~ SEWER LINE J¢C.~ , TANK CESSPOOL ~--"'~' OTHER SOURCES APPROVED DISAPPROVED REMARKS DEPTH __ DISTANCE FROM: SEEPAGE SYSTEM DISTANCES: i sEWER LINE DEPTH: ~,,~- DIAGRAM OF SYSTEM "' -.iF:'i B:i",i(!i"i i"i :')" ivii:i[N :; i: J")J",l ]' :!i'; "i'bt~:~: J..i::.F,!i'iJ'i !'"i ,:: 'i .'.,. !:::F'iii:7'F ::' I')F::' 'l'HFii: ' [' JE: j:;: J%! iii: J'q I::)Fi: I'::,I:;i:FJ :[ J",ff:' ]: ]i~:l .[). "."i~ji:.!' i';,J:::?"i'i.4 f"li.::' !:;;! "['{": !: r,~ ¥'" r)i:;;t I:::'?T ]?:; "b~::' i) :[ ?i'F:INC!E E?,E'r'i4EE:N THE: '::: iF;?F:f::uT:i:E ElF' THE "i'F..ii.:~' (~i'~:F:!VE:i ~::,E:t:::'TH 'i ';:; Ti-d::: b'i 'i' '., 'i' J'"i i,' I::,F[F'TH "F:' ":i ;' :: ',,'F' !~:E"FI4IEZEN 'T'J...iJ.~: ": F:'F~ t F:' 7f i.;:~i (iiii!::ii... % · NORTHWEST EXPLORATION SERVICES, INC. 702 West 32nd Avenue · Anchorage, Alaska 99503 o. Telephone (907) 272-2716 August 27, 1976 Mr. Joe Blair Dept. of Health and Environmental Protection 2516 E. Tudor Road Anchorage, Alaska 99504 RE: Soils Log for Mr. Kit Vercella as per our telephone conversation of 8/27/76. Dear Mr. Blair: Attached please find a soils log performed by us for Mr. Kit Vercella on August 26, 1976. The average perc rate as determined by visual inspection was 177 ft.2/bdrm, as shown. A percolation test was attempted in the interval from -6.5 to -8.0 feet, but was unsuccessful in that the dense, silt~, sandy gravels (GM) found below -7.0 feet prevented us from excavating a perc test hole to the proper depth. As a result, we would recommend a septic system permit be granted locating the leach trench in the upper seven feet of sandy gravels; which we feel are of adequate permeability and thickness. In order to insure that the trench is located in these acceptable materials throughout its entire length, we will have someone from our office inspect the open trench prior to placement of the sewer rock. In the event the acceptable sandy gravels are not found throughout the length of the trench, your office will be notified immediately so that remedial steps can be taken. We hope this plan of action will meet with your approval in that we feel it will be less expensive for Mr. Vercella and result in an adequate on-site sewage disposal system. Should you have any questions regarding this matter, please feel free to call me. Sincerely, NORTHWEST EXPLORATION SERVICES, INC. Steven A. Johnson Engineering Geologist Attach. SAJ/gp Contract Drilling for Foundation investigation, Soil Sampling, Rock Coring, Grouting and Waterwells MgNICIPALITY OF ANCHORAGE Departmen[ of Healhh and Environmen[al P~.otecffion SOILS LOG PERCOLATIO~ ?EST Performed for Legal Descripnion 0 8 ~ 10 121 14 16¸ Kit Vercella Date Performed Lot 1, Block 2, Henkins Subdivision 8/27/76 Red-brown, sandy silt (M~) Perc rate = 275 ft.~/bdrm. Gray-brown, sandy gravel w/some silt and cobbles to 6 inches (GW) Perc rate = 135 ft.2/bdrm. / Perc test attemoted in this interval Gray-brown, dense, silty, sandy gravel w/cobbles to 1 foot (GM) Perc rate = 250 ft.2/bdrm. Total Depth = 16 feet No warier table encountered. A¥~RAGE PERC RATE FROM SOILS LOG = 177 ft.2/bdrm. Date Net Drop minute Percolation Rate by A & L DRILLING COMPANY BOX 97, EAGLE RIVER, ALASKA 99577 · TELERHONE694-2588 OWNER OF LAND ADDRESS LEGAL DESCRIPTION ~L/4 /), /.o'7" / DATE - Started t ot/.~*}//-1~__ Ended PERMIT NUMBER / ~ ~ ~r ·, DRAW DOWN FT. GALS. PER HR KIND OF CASING .<._...~ DEPTH OF WELL STATIC LEVEL OF WATER FT. / KIND OF FORMATION: From ~) Ft. to ~ Ft. Or-;~cr4d//~6%~ From__Ft. to From 5 Ft. to t '~ Ft. c~..L,d'[' From Ft. to From [ ~ Ft. to ~'~:~ Ft. F~z/../~-' ~ &;~(*~d-~,' ~ ~-/~'From Ft. to c~' 557',~ ~ From ,~ c> Ft. to ') .~ Ft. ~ ~'z~ ~-&~ / ~Y~rom~.Ft. to From :~-~ Ft. to /~5~' Ft. ~ ¢Y&~/.7,~ Frmn~.Ft. to From .) ~ Ft. to .. Fromm. Ft. to~ From Ft. to~Ft From~Ft. to~ From Ft. to Ft Fromm_Ft. to~ From Ft. to~Ft From~Ft. to~ From Ft. to~.Ft. From~Ft. to.~ From Ft. to Ft. From' Ft. to~ From Ft. to Ft. From Ft. From Ft. to Ft. From Ft. to.~ From Ft. to Ft. From Ft. to.~ From~Ft. to__Ft. From~Ft. to From Ft. to Ft. From Ft. to~ From~.Ft. to Ft. From Ft. to Ft. Ft. Ft. Ft. Ft. Ft. Ft. Ft Ft. Ft Ft. Ft Ft .Ft Ft, Ft. Ft. MISCL. INFORMATION: FIRII I FR'~ NIAM1r? / ": ! 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 Parcel I.D. # CERTIFICATE OF HEALTH AUTHORITY- APPROVAL FOR A SINGLE FAMILY DWELLING GENERAL INFORMATION Complete'legal description Lot 1; Block 2; Henkins Subdivision Location (site address or directions) Properly owner Mailing address Kit Vercella 19822 Gilbert Rd. Chugiak, AK Day phone 3011 Laurence Court Bend, OR 99701 'Lending agency Mailiqg address Agent Address Day phone Roger Morris/Prudential Vista 16635 Centerfield Drive Day phone Eagle Rivert- AK Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3 ';' 3. TYPE OF WATER SUPPLY: NOTE: 689-6464 XX 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. XX 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-O25{Re¥.1/91) Front MOAiK21 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 verifythat based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water suppl~/and/or wastewater disposal system is in corn >liance with all Municipal and State codes, ordinances, and regulations in ef~i~t~ia~l~-~3f is inspection. Name of Firm ?' Wastewater C~onsuttaty~ ~ Phone ~? ~7-~/~]~ 6 Disapprove. Condftional approval for bedrooms, with th~ following stipulations: Additional Comments Date qfl 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 pu rchasem 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-{)25(Rev. 1/91} Back MOA~21 Legal Description: A. WELL PATA Well type PRIVATE Log present (Y/N) Total depth 5;5.25' Sanitary seal (Y/N) ,, CEIVI:u Municipality of Anchorage JUL 1 5 1999 DEPARTMENT OF HEALTH & .... HUMAN SERVIMu~ALiTY OF ANCHORAGE Environmental Services Dlwslon ~NV~ON~ENTAtSERVlCES 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist HENKINS S/D; LOT 1, BLOCK 2 Parcel I.D.: 051-292-16 Date installed 9/29 - 10/1/98 Soil rating (g.p.d./ft2 or ft2/bdrm) Length 80' Width Effective absorption area 400 sq. Date of adequacy test NEW 5' Gravel thickness below pipe ft. Monitoring Tube present (Y/N)~ Depression over field (Y/N) .... Results (Pass/Fail) - For .~ Fluid depth in absorption field before test (in.); - Fluid depth - (ins) Minutes later: - Peroxide treatment (past 12 months) (Y/N) NONE 72-026 (Rev. 3/96)* 1 ,? System type .5' Total depth 3.2' - 4-.2' NO bedrooms Immediately after - gal. water added (in,): - Absorption rate = - g,p.d. KNOWN If yes, give date - lt3CJO Number of Compartments 2 Cleanouts (Y/N) YFR Depression (Y/N) NO High water alarm (Y/N) NO Pumper - If A, B, or C, attach ADEC letter. ADEC water system number N/A YES Date completed 10/8/76 Cased to 5;5.25' Casing height (above ground) 12"+ YES Wires properly protected (Y/N) YES AT INSPECTION 9/29/98 ;56' g.p.m. 9,0 g.p.m. FROM WELL LOG 10/8/76 7' 0 Nitrate 1 · 94 mq-,LT_, Other bacteria Collected by: A.W.W.C.. INC Date of test Static water level Well production 15 WATER SAMPLE RESULTS: Coliform d - Date of sample: 7/9/99 B. SEPTIC/HOLDING TANK DATA Date installed -9~Tank size .Foundation cleanout (Y/N) YES Date of Pumping NEW C. ABSORPTION FIELD DATA D. LIFT STATION ~ Date installed N/A Size in gallons Manhole/Access (Y/N) "Pump~ "Pump off" level at* High water alarm level at* ~'Datum E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot Absorption field on lot Public sewer main Sewer/septic service line 100'+ On adjacent lots 100'+ 100'+ On adjacent hots 100'+ N/A Public sewer manhole/cleanout N/A 25'+ Lift station 100'+ SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation 5'+ Property line 10'-I- Absorption field Water main/service line 10'+ Surface water/drainage 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line 1' * Surface water Curtain drain Wells on adjacent hots 5'+ 100'+ Building foundation 10'4- Water main/service line 100'+ Driveway, parking/vehicle storage area 10'+ 10'+ NONE KNOWN Wells on adjacent lots 100'+ * WAIVER GRANTED/~I 1/2/98 (# WR980074) ENGINEER'S CERTIFICATION ~1 ~ .:~_~%~.~,,_ Icertifythatl heCtOr, ti~e~fiel~inspectionsandreviewofMunicipalreco~a; ~~~msare in conforman~ with ~ ~ ~ideli~s in effect on this date. ~' ~/~~ ~ Signature ~ ~ ~~ ~':'~ ~ ~ ~%~ ~ Engineer'sName ~ / ,/ JEFF GARNESS ,¢ ....... ~-~ ¢ , ............ HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 3/96)* CT&~ Ref,# Client Name Projec~ Nnmel# 093~0~00! AK W~er & Wa~tewa~er con~ul~ras Inc. Henkms SID ~t 1 Blk 20~id~ Hos~ Bib Drinking W~er o Clie~l PO~ Primed Date/Time 07/14t99 13:31 Coil.'ted Da!ce/T~me 07/09/~ 0S:25 T~hni~{ Dire~or: ~phen C, ~de ___ ~ate [n~; ~,g/L EPA 300.0 ~0 ff~x 07/0§/~ 07/09/99 SCL