HomeMy WebLinkAboutLILAC PARK BLK 2 LT 9 MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND t'IUMAN SERVICES
Environmental Heallh Division
825 "L' Street, Anchorage, Alaska 99502, Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
Nar~e DISTANCES
Address
c~5~90 ~/'~.do, O, C~e ~ fO'~ ~9~/d, TANK FIELD WELL
No. of :
Phone(s} ~ ~-~ f Permi[ No. Bedrooms WELL
~dOl~& ~- LOT LINE ~,~ / /O / Y2 /
LEGAL DESCRIPTION
Lot (~ Block ~ Subdl~sio~
~/8c ~a~ FOUNDATION
Township, Range, Section / ~ ~ /
~ i~ ~.~ ~/~%, ~//~- ~ AS-BUILT DIAGRAM (Show location of well, septic system, property lines, foundalion,
driveway, water bodies, etc.)
TANKS N
Capacity in gai~ons ...........
TYPE OF SYSTEM X~r~j
~TRENCH ~ BED ~ W, DRAIN ~ el'HER
.
o.~,n~, ~,~ ~. 3~ FT / / FT ....
Fill aOdeO above o~i~mal~,~_~raOe [t ~rawl Oepth gonoalhy, j~p~pe [1 ~
Gravel length Gravel width
~,S' FT ~ FT _
Tota, absorption area Distance between hnes D~ jf~ ~
~ F2 so FT ~/* FT
Number of lines J Soil rating Pipe ma[erial j)-~ . ~ ~'
WELLS .......... -"
PRIVATE OTHER {Identify} ~
Classilicah°n~A'B'C)~/~ Tolal Dep~h/~ FT Cased ~o~ FT
REMARKS: --
/ · / Scale: ~ ~O/~ ENGi~E~R~SSEAL
Inspections Pedormed by:
/,/~
Date:
I ~ ~ ~ ~ cmily Ihat Ibis inspa~li~n was p~dormed ~ccording 1o all
Mu.icipal ~,d Stats guideli.es in ellecl 0. this dale: ~///,~
Health DepaHment Approval: ~-'~ ~)~5~- g7 Date: /(J
72-013 (3/85)
ALASKA eFIUIROFlm I'ITAL COFITROL $1 RUICe$, IFlC.
~n§Jn~mn§ $ ~nuironmcnlal ~tudics
SPECIFICATIONS FOR A TRENCtt--TYPE IqASTEWATER DISPOSAL SYSTE.~I
LEGAL DESCRIPTION: LOT 9, BLOCK 3, LILAC PARK SUBDIVISION
~1.0 GENERAL
The Drawings, sheets ] thrn 4, shall be a part of this
specification.
1 2
All ma[:erials and workmanship shall meet the
requirements of the Nunicipality of Anchorage,
Department of Health & Haman Services {DHHS), the
conditions of the permit, and all applicable rules
and regulations carrently in effect.
! 3
All elevations and depths are advisory, and are to
be verified or modified in the field by the
engineer or inspecting agency.
1 4
It is the responsibility of the property owner or
installer to adhere to approved designs for
installation, maintain the specified separatJou
distances, and have the appropriate inspections.
i 5
IL is the responsibility of the property owner or
installer to report to the engineer any observed
conditions which would pu't the system in violation of
state or ~lunicipal regulations,
1.6
If the installation is not inspected by an AECS
engineer, AECS will not be responsible for the
installed system. An engineer at AECS should be
consulted prior to constructiou to determine the
number of inspections that will be required and to
explain what these inspections will involve,
2.0 SEPTIC TANK
2.1
If there is an existing septic tank, Jt may be
used it if meets the capacity requirement for the
residence, and the approva~ of 'the MOA.
2.2
The septic tank shall be a UPC-approved
two-compartment tank, constructed of 12 gauge
steel with bitumastic coating and set level on
undisturbed soil. If the tank is buried at a
depth of 4 feet or ]ess, it must be in.sulated with
an overlying layer of 2 inch burial type
polystyr'ene ¥igid boated insulation.
2.3 The septic tank and trench shall be a minimum of
2.4
2.5
2.6
2.7
100 feet from any private well or body of water,
150 feet from el. ass "C" wells, and 200 feet from
Class "A" or "B" we]Is, an.less otherwise
specified, Less than the required separation distance
must have prior approval or waiver by AI)EC or MOA.
The septic tank shall be a minimam of 5 feet from
the honse foundation, and a minimum of 5 feet from
the abso~ption area.
Piping shall be fitted with a mechanical
watertight calder coupling on the outlet and inlet
of the sept.ic tank. Piping shall be 4 inch solid
PVC ASTM D-3034 or cast iron, sloped a minimum of
1/4 inch per 1,inca1 foot. If the piping is buried
at a depth of 4 feet or' less. it must be insulated
with an overlying layer of 2 inch bur~at 'type
polystyrene rigid board J nsulation.
Cleanouts shall be instal]ed as designated and
capped with air--tight rain caps (Jim Caps or
equivalent), and extended a minimum of 1 foet
above ground level.
I:[' a lift station is required it shall be a
combination lift station septic tank per Anchorage
Tank and Weldlng, Inc. design. Specifications and
design drawings are on file with tile Muaicipality
and the engineer.
3.0 ABSORPTION AREA
3.1
The gravel for the trench shall be 0.5 to 2,5
inch, screened Pock with less than 3 percent
passing the No. 200 sieve. All substitutes must
have prior DHHS approval.
3,2
The bottom and sides of the excavation shall be
raked with the backhoe blade to ensare that it has
not been compacted during excavation. The bottom
elevation ',~ha].l be level.
3,3
Monitor standpipe(s) shall be placed as shown in
the drawings, and shall be 4 inch r~gJ.d PVC ASTM
D--3034, or cast iron. Thc sect_ion sho~n ~th
holes may be 0.5 inch holes drilled on 6 inch
centers on opposing sides of the pipe, or a
regular section of perforated sewer pipe clamped
'to a solid section with either a ao hub coupling
or a solvent joint. A rubber rain cap (Jim Cap or
3.4
3.5
3,6
equivalent) shall be installed over the top of the
pipe .
The distribution pipe shall be perforated 4 inch
PVC with a minimum crush strength of 1500 pounds
and shall meet the approval of I)HttS for use as
drainfield pipe. All distribution pipes shall be laid
level .
Trenches may be paralleled, but must bare a
minimum separation distance between the trenches
of 10 feet or 2 ~5mes the gravel depth {which ever
is greater). 75 feet is the maximum al]o~ed
linear length of any trench,
If the final grade over the trench is less than 4
feet above gruvel, insulation is required, using
burial type polystyrene rigid board insulation,
There shall be 1 inch of insulation for every foot
of soil less than the required 4 feet of cover,
but 'there mast be at least 24 inches of sol] cover
even though insulation is used. The solid pipe
extending from the septic tank 'to the drainfield
shall also have a minimum of 4 feet of cover or an
equivalent layer of insulation to prevent freezing
of the line.
3,7 Filter fabric is required.
4.0 INSPECTIONS
4 1
A minimam of two inspections are required for the
installation of the trench. The first inspection
will be of the open excavation to assure that 'the
system is installed in the proper soil strata.,
correct depi;h and meet minimum specified design
parameters.
4 2
The second inspection will be after placement of
the grave], monitor standpipe and distribution
pipe to verify proper installation and position
prior to backfill.
4 8
The inspectien of th(; septic tank iustallation can
be incorporated with any one of the above listed
inspections .
4 4
The lift station will require either an MOA electrical
inspection or certification by a licensed electrician,
depending on whether the building code applies to this
part of the city.
ALASKA ENVIRONMENTAL
CONTROL SERVICES, INC.
1200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
SHEET NO. J OF
CALCULATEDSY ~" ~'(~' DATE
CHECKED BY DATE
SCALE
ALASKA ENVIRONMENTAL
CONTROL SERVICES, INC.
1200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561-5040
JOB
SHEET NO. OF
~. ~/~ '? ~ ~,-_~
CALCULATED BY DATE
·
.... ~ .... .~.. ........... ~. ..... ~ ...... ........ ....
vCV f ~,e"~ _TI._.~,.. ~e'~""~'J~I~GINEER'S SEAL)
Munici alit ofAnchora e
DEP P Y g 825 "L" Street, Anchorage, Alaska
801LS LOG -- PERCOLATION TES~
PERFORMED FOR: A~~:
LEGAL DESCRIPTION: ~ ~2 4l/e~ P~ [~ Township, Range, Section: ~/~ /~ S ~ S Z ~,
SLOPE SITE PLAN
5 ~ ~:' ....
6
7
8
9
10 WAS GROUND WATER
ENCOUNTERED?
. I~
Reading Date Gross Net Depth to Net
Time Time Water Drop
L
IF YES, AT WHAT ~ O
12 DEPTH? p
13 Monitoring? ,Z,4'? Dale: ~,~
14
15
16
17
18,
19-
2o- j_/
PERCOLATION RATE (minules/inch) PERC HOLE DIAMETER
PERFORMED BY: ~' ' ~'" J I CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, DATE: _ ~/g//~' ~)
72-008 (Rev. 4185) / ' /
:IUIROFIm:ITAL COF1TROL $1~RUICI~$, Ir'lc.
~n§in~¢rin§ $ ~nuironm~nlol SlucJics
1200 UJcsl 33rcJ Auenu[ $uii¢ B,, Anchoracl¢. Alosk~ 99503 ,[907) 561-5040
TO
JOB
ALASKA ENVIRONMENTAL
CONTROL SERVICES, INC.
1200 West 33rd Avenue, Suite B
ANCHORAGE, ALASKA 99503
(907) 561.5040
SH.~T .0. '~ O~ '--/
Z.
CALCULATED BY DATE
CHECKED BY.
SCALE / ''/~-~ ,,.~ '"'
DATE
M,,W DRILLING, Inc.
90. Box 110378 # 10330 Old Seward Highway
ANCHORAGE, ALASKA 99511
DRILLING LOG
Well Owner~ KE}i DO.IA_'?,OJS~,.Y/B..~£:,A;:,,D "'~ ..... ~ ~ '
_..Use of Well_
Location (address off Township, R~ge. Section, if known; or distance main road Lo~ 9 b!k, 2 Lilac~Subc!i~;ision - Anchorage
Size of casina__ 6
Static water level
Screen (
Describe screen or perforation_._ N/A
Well pumping test al: 6 , ,,gall6~as pei~' ~
of drawdown from stati~ level. ,,2
: 'j ?i : .; ,.
Da~e of comple~ion___~uaua_ ..... ~:: ' ~ ~
. Depth of Hole_/.-.1JJJ~feet Cased to~J.~.9____~eet
13/~ St, (Sh~ (below) land surface, Finish o~ well (check one) open end (
); Perlurated ( ,, ,,),
(minute) for. 2 kours with
WELL LOG
Y, );
Depth in feet from
ground surface
,. 2 TO 18
18
20 ..TO.~I ! 5
]./.,.5. TO. 158
15
.... TO
TO
G ve:dotails of formations penetrated, size of material, color and hardness
____TO .
...... TO
, ~TO
.... --TO __
NWWA Certified Contractor
.TO
1 --CUSTOMER
Parcel I.D. #
MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
1, GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Locabon (address ~r.d~rectfons). ,.
(b) Property ~wr~' '_/~'~'~¢d" '?'.~,,~,J~;~,r',~--t' Telephone: (home) ,'~'~/.J'-,2./"~/~Business
Mailing Address:': :~ 2'~',~¢' 'i.i,~'¢,~,,~ ~/,.~
· , , .,:,' ¥ t ,,~ ' ' --
(c) Lending Institution' " Telephone
Mailing Address
(d) Real Estate Company and Agent
Address
Telephone '"
(e) Mail the HAA to the following address: (or check here FI. if hold for pick up.)
List contact person and day phone number below:
2. TYPE OF RESIDENCE
Single-Family/~ Number of bedrooms
3. WATER SUPPLY
Individual Well [~ Community [] Public []
:... ;:.No!e: If community well system, must have written confirmation from the State Department of Environmental
' ' c6'nservation attesting to th legality and status. ' ': ~:'' " ' . :' ·
4. SEWAGE DISPOSAL
On-site~ Public [] Community [] Holding Tank [] ' :::
' Nol~: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality and status.
72-025 (Rev. 7/88) Page I of 2
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MUNICIPALITY OF ANCHORAGE
Department of Health & Human Services
DIVISION OF ENVIRONMENTAL SERVICES
343-4744
CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF
ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING
Parcel I.U. Cf ~,'~/,~- - ¢.~// -- ZF...? HAA # i-I ~ ~'~ ~. L~f~7~ \ \
1. GENERAL INFORMATION (Must be completed prior to submittal)
(a) Legal Description (include lot, block, subdivision, section, township, range)
Location (address or directions)
Mailing Address. '~5-¢O .~'r;g~
Telephone: (home),~*~..r~ ,)g'JZ' Business
(c) Lending Institution Telephone
Mailing Address
(d) Real Estate Company and Agent
Address
Telephone
(e)
Mail the HAA to the following address: (or check here.~, if hold for pick up.)
List contact person and day phone number below:
2. TYPE OF RESIDENCE
Single-Family~ Number of bedrooms
3, WATER SUPPLY
Individual Well/1~) Community [] Public []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to th legality and status.
4. SEWAGE DISPOSAL
On-sitej~¢ Public [] Community [] Holding Tank []
Note: If community well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legality and status.
72-025 (Rev. 7/88) Page 1 of 2
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A. WELL ~ATA
Well Olassifioation_
Well Log Presen~N) Date Completed
MUNICIPALITY OF ANCHORAGE (MOA) ~
Health Authority Approval (HAA)
CHECKLIST- FEBRUARY 1984
343-4744
Legal Description: ~'~' /~.~
If A, B. C, D.E.C. Approved (Y/N)
~-I?¢~ . Yield ~
Total Depth
Static Water Level _ /~
Casing Height Above Ground
Electrical Wiring in Conduit ~N)
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line
To Nearest Sewer Service Line on Lot
Water Sample Collected by /,
Water Sample Test Results _,~¢.¢-/: ~'~
/ ?~ Cased to /,~Depth of Grouting ~?,~ ~-,,~¢,~,,, ·
Pump Set At u~,/c ~, ~,~,~ .
Sanitary Seal on Casing(C~N)
Depression Around Wellhead (Y/~
; On Adjoining Lots
//P / ; On Adjoining Lots
To Nearest Public Sewer Cleanout/Manhole
;Date
B. SEPTIC/HOLDING TANK DATA
Date Installed/¢¢2 /~,,/¢¢~ Size /J~ o
Standpipes ~N) Air-tight Caps/~N)
Depression over Tank (Y/~
Pumping/Ma ntenance'.Co~tact'on File (Y/N)
Holding Tank High'Water Ala~m (Y/N) A,'~
No. of Compartments '~
Foundation CleanoutLCC/N)
Date Last Pumped ~,¢~-* ~
AJ,//~ ;for
Temporary Holding Tank Permit (Y/N)
SEPARATION'DISTANO~S FROMS~PT C/HOLDING TANK:
To Water-S,upply Well /.~'~ /
To Property Line. ~' , , ~/-~ /
To Water Main/Service Line ',.~ 2~¢'¢
To Stream, Pond, Lake'or Major Drainage Course
To Building Foundation
To Disposal Field
.~ /00/
Comments
72-026 (Rev. 7/88) Front Page 1 of 2
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed
Width of Field
Square Feet of Absortion Area
Depression over Field (Y/~
Results of Last Adequacy Test
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Statndpipes Present
Date of Last Adequacy Test
SEPARATION DISTANCE FROM ABSORPTION FIELD:
To Water-Supply Well
To Building Foundation
L o t "~J/¢
//O /
To Water Main/Service Line
To Stream, Pond, Lake, or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments ~ /.'o ,-J'¢~-~,/~,o..,.~.;/~.-,
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots .-~ /~¢ /
To Cutback (if present)
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Dimensions ¢~--m-~
Ma n h ole/.A~c,e~_ _
//) ~P Off" Level at __
_~'~'-. Vent (Y/N) _
~/'"'~ /'~- Pumping Cycles during Adequacy Test.
Meets MOA E~. (Y/N)
Comments
**Check Permitted Bedroom Rating Against HAA Request** ~. ~,.
Icertifythatl have checked, verified, or conformed to all MOA and HAA ~d~ e~Oi&~.on the date of this
Seal
Receipt No. A~ L~ ) ~/ LI%~'~ Receipt No.
Date of Payment /- ~/ Waiver Fee: $
Amount: $ ,/'~) ~
72-026 (Rev. 7/88) 8ack
Date of Payment
Page 2 of 2
CHEMICAL & GEOLOGICAL LABORATORIES OF ALASKA, INC.
5633 B STREET · ANCHORAGE, ALASKA 99518 · TELEPHONE (907) 562-2343
FEDERAL TAX I.D. #92-0040440
AIiSL;/:~'t'L; i','~',}'0P,'f ?d' :.;M,IPD; fro: ;'lotk 0r(lt~r !; 32{i'~8 ]bat? P~op~t Pi:~mted: Jhf! 3 ?J: t} [0:09
s, S}? ,!.I.; (,0M.¢;C¢I';i) 31' L. kl~lD,