HomeMy WebLinkAboutLAKE HILL ACRES #6 BLK A LT 9
~,~.~., · DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
I ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
~ ~ UPGRADE
.
Li~cap~ciw_~n a~lla~ I~ida I~ngtk ~ ~idtk Liquid depth
/ ~ ~ ~ HOMEMADE:
~OZ~ ~ D'STANCETO: Well' 1~' / Dwelling PERMITNO.
O z ~ Manufacturer ' Material Liquid capacity in gallons
D~= DISTANCE TO: Well / c~ ¢~ Foundation Nearest]otline PERMITNO.
~ ~ ~ No. of lines Lengt~q ea n Total length of lines Trench width Distance between lines
~ -- ~ inches
~ Top of tilo to finish ~rade Material Bonoath tilo Total offectivo absorotion area
~ inches
~ ~ Length ~ 2 ~-~ Width / 2 / '~ D~tht ~, PERM~
~[n Type of crib Crib diameter Crib depth Total ef fective absorpti:g~a~. ~/
~ ~ W.~0 Buildin~,tioff ~ Nearestl?~e ~
DISTANCE TO: '~ / ~ "
~ Class e9 h Distance to lot line PERMIT NO.
m Building foundation Sewer line Septic tank Absorption area(s)
~ DISTANCE TO:
OTHER
PIPE MATERIALS
REMARKS .~ ~ ~ :: -- i:~ .....
-- I~ ~ .: ~ I , '~
'~cUm _ :' ~
.... . .,
'": / / ~T' , LEGAL
December 7, 1983
S & S Engineering
Star Route Box 196X
Eagle River, AK 99577
Subject: Lot 9, Block "A", Lakehills Acres, As-built
Dear Mr. Sha~er:
The as-built for the subject lot contains two different septic
system elevation diagrams. What was the depth o~ sand added to
the bottom of the bed? As soon as ti%is information is provided,
this department can accept the as-built.
Sincerelyw
Cory Wil[is, R.S.
Acting Sewer & Water
Program Manager
~M_UNICIPALITY OF ANCHORAGE~
Department' ~ Health and Environment~' ?rotection
825 L Street, Anchorage, AK. 99501
*' ~/'/ * * * HANDWRITTEN PERMIT * * *
Permit ~
AND/OR ON-SITE SEWER PERMIT
Applicant: (Jt~'.~"~''3/ /~// Mailing Address:
Location: Phone Number:
The Required S_ize of/t~D So~l ~sorp~on SFstem~Is: '
DEPTH LENGTH GRAVEL DEPTH - / WIDTH
The length dimension is the length(in feet) of the trench or drainfield. The
depth of a trench or pit is the distance between the surface of the ground and
the bottom of the excavation(in feet). There is no set width for trenches.
The gravel depth is the minimum depth of gravel between the outfall pipe and
the bottom of the excavation(in feet).
Permit applicant has the responsibility to inform this department during the
installation inspections of any wells adjacent to this property and the number
of residences that the. well will serve.
* * * TWO(2) INSPECTIONS ARE REQUIRED * * *
Backfilling of any system without final inspection .and approval by this department
will be subject to prosecution.
Minimum distance between a well and any on-site sewage disposal system is 100 feet
for a private well or 150 to 200 feet from a public well depending upon the type
of public well. Minimum distance from a private well to a private sewer line
is 25 feet and to a community sewer line is 75 feet. Well logs are required
and must be returned to this department within 30 days of the well completion.
Other requirements may apply. Specifications and construction diagrams are
available to insure proper installation.
* * * PERMIT EXPIRES DECEMBER 31. 1 9 8 3 * * *
Z certify that:
(1) I am familiar with the requirements for on-site sewers and wells as
set for~th by the Municipality of Anchorage. .
(2) I wi3J1~ i~stall the/6/ystem in accordance with codes. .
(3) I~der~ tha~/the on-site sewer system may require enlargement if
Qh~ re~ce/~/remodeled to include more that/2~bedrooms.
y icant
EXCAVATION
ROBERTA. SHAFER
WORK CIVIL ENGINEER
694-2979
Specifications for elevated bed alternative waste water treatment
system.
I. General
A. Ail excavations and depths are advisory and are to be verified
or modified'in the field by an engineer.
B. Ail materials and workmanship shall meet the requirements of
Anchorage Department of Health and Environmental Protection
permit.
II. Lift Station ¥~ ·
A. The stock material for the lift station shall be either
galvanized steel (AS~M A-4444-76) or aluminum culvert, capable
of .burial to l0 feet.
B. The 24 inch pipe for the lift station shall have a welded
water tight bottom of th® same-thickness and composite as
'the culvert. ~ ....
C..The top cap shall be rain tight and fastened with screws.
D. Ail electrical fittings and connections in the lift station
'shall meet the requirements for a water tight service.
E. The sump pump shall be capable of delivering approximately
-10 GPM. at a head of 20 feet.
F. The sump pump shall be suspended not less than 6 inches, off the
bottom of the lift station with a chain or nylon line.
.III. Seepage Bed
A. The gravel for the bed shall be .screened to sizes of ~ inch
to 2% inches.
B. The berm around the seepage bed shall be constructed of im~
permeable material, and on a slope of 1 foot vertical per 2.5
feet horozontal.
C. The bottom elevation of the bed shall be plus or minus 2 inches.
D. The insulation required shall be dow extruded blue styrofoam
insulation board of the 2 inch' thickness, or equal.
SRB 1'96X EAGLE RIVER, ALASKA
EXCAVATION
WORK
l.__ FT STAT ION
ROBERT A. SHAFER
CIVIL ENGINEER
694-2979
-}ROUND ·
~ABLE
VAR'
TO'
BED
CHAIN_.
NYLON
2" T0 4" '
COUPL
,OR
ROPE
SI L1CONE
CAUL KING
../r--METAL .CAP
:k.,,-SC R EW $
EMA 4 BOX
CONDUIT
EAT LAMP
-- PUMP-POWER
CORD
VAR'lAB LE
HEAT LAMP
FOR
J- (/DRAIN HOLE---
8
2'¢ PVC PIPE
SUMP PUMP"
~' M:E'f'AL PLATE
WINTER USE,
SRB 19GX EAGLE RIVER, ALASKA
ARM CORD
S IL LCON E
CAULKING ~
PVC PIPE FROM'
SEPTIC TANK
~F ILLET WELD
ALL AROUND
EXCAVATION
WORK
%~-F__~'-F~(._ --F-P,,-r"-..ll< - I boo
12... × $'.?_..
t~PC_oxt nq
PERFORMED FOR:
LEGAL DESCRIPTION:
2
3
4
7
8
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
SLOPE
~.~(~1LS LOG
[] PERCOLATION
TEST
~fd,~r / f /
SITE PLAN
.---- J/~
10
11
12
13
14
15
16
17
18
19
2O
No.
WAS GROUNO WATER '~/~) [
ENCOUNTERED? / 0
IF YES, AT WHAT ~ / P
E
DEPTH?
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
(minutes/inch)
COMMENTS
TEST RUN BETWEEN FT AND FT
CERTIFIED BY:
DATE:
( eriifieh Drilling?': og
by
DOC Co. dba
SULLIVAN WATER WELLS
P.O. BOX272, CHUGIAK, ALASKA 99567 · TELEPHONE 688-2759
OWNER OF LAND
ADDRESS ~ : ~
LEGAL DESCRIPTION
DATE - Started / ?'
PERMIT NUMBER
DEPTH OF WELL __ .... '
STATIC LEVEL OF WATER FT.
~ f ;, ~' ...... ,:'~ ..... DRAW DOWN FT.
Ended / :·3 ~ GALS. PER HR ? :.:" ~
KIND OF CASING ~' 2 ~,.. "."
KIND OF FORMATION:
From ~' ; Ft. to
From '(' Ft. to /'~ ,,,
From ? ~) Ft. to
From ." Ft. to
From :( ':' Ft. to 7'/ Ft.
From__Ft. to ,Ft.
From ; / Ft. to Ft.
From__Ft. to Ft.
From__Ft. to Ft.
From__Ft. to Ft.
From Ft. to Ft
From__Ft. to--Ft
From__Ft. to Ft
From__Ft. to__Ft
From__Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft
Ft. to Ft
_Ft. to.___Ft
Ft. to Ft
Ft. to Ft.
From__Ft. to Ft,
From Ft. to Ft
From__Ft. to Ft
From Ft. to__Ft.
From__Ft. to__.Ft.
From Ft. to Ft.
From Ft. to.--.Ft,
From__Ft. to.__.Ft.
From__Ft. to Ft.~
From Ft. to Ft._
From Ft. to Ft.
From Ft. to Ft.
From Ft. to Ft.
MISCL. INFORMATION:
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 10t, block, subdivision, section, township, range)
Lot 9; Block A; Lake Hill A~ ~
Location (address o_r d, irections)
22227 Banner
(b)
A~'H.F.C.~I01264
Property owner ~.
Mailing Address
Telephone: (home).
Business
(c) Lending Institution
Mailing Address
Telephone
(d)
Real Estate Company and Agent JACK WHITE COMPANY ATTN: Lori Crowder
Address 10928 Eag£~_ Riv~ Ro~d~ Eag£~ Ri~ A~. 99577
Telephone 694-5500
(e) Mail the HAA to the following address: (or check hereX~, if hold for pick up.)
List contact person and day phone number below:
$ & $ ENGINEERING
17034 Eagle R~ver Loop Road No. 21:t4
Eagle River, Alaska 99577
2. TYPE OF RESIDENCE
Single-Family [~ Number of bedrooms
3. WATER SUPPLY
Individual Well G]X Community [] Public []
Note: f commun ty. well.system, must have written confirmation from the Stat9 Dep.artmento! Environmental
· C0ns~va~i~i a~t~t'ii~g' t~:tl~' egality ~nd status. ' ' ' ~ '
4. SEWAGE DISPOSAL
On-site I~ Public [] Community [] Holding Tank []
Note: If con~mun'ity well system, must have written confirmation from the State Department of Environmental
Conservation attesting to the legailty and status ....
72-025 (Rev. 7/88) Page 1 of 2
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'IYAOUSd¥ Sl4Ha '9
A. WELL DATA
Well Classification
Well Log Present ~N) .
I
Total Depth ~! Cased to
Static Water'Level
Casing Height Above Ground
Electrical wiring in Conduit ~;~1)
SEPARATION DISTANCES FROM WELL:
To Septic/Holding Tank on Lot
MUNICIPALITY OF ANCHORAGE (MOA)
Health Authority Approval (HAA)
CHECKLIST - FEBRUARY 1984
343-4744
Legal Description:L...~_. [~ ~'¢;~[.".
If A, B, C, D.E.C. Approved (Y/N)
V' . Date Completed 1¢\ f
Depth of Grouting
Pump Set At
Yield
Sanitary Seal on Casing~N)
Depression Around Wellhead (v.~
; On Adjoining Lots
To Nearest Edge of Absorption Field op Lot
To Nearest Public Sewer Line ~ ~¢
To Nearest Sewer Service Line on Lot ~.
Water Sample Collected by ¢,Af~ ~ ~::::J~-/~/N/~-~I/'[~ ; Date
Water Sample Test Results ~ ~ ~'~/ "'
Comments
\\ g::;' ; On Adjoining Lots ~ O~:;IJr-
To Nearest Public Sewer Cleanout/Manhole g/~
B. SEPTIC/HOLD'lNG TANK DATA
Date Installed Size /O~'d No. of Compartments
Standpipes (:~N) y Air-tight Caps~Z;TN) ~' Foundat~_~ Cleanout~¢~/N)
Depression over Tank (Y/¢~ /w/ i/ Date Last Pumped '"~- ~
Pumping/Maintenance Contact on File (Y/N)/ ./ //} ; for ~ /
Holding Tank High-Water Alarm (Y/N) f~' Temporary Holding Tank Permit (Y/N)
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK:
To Water, Supply Well '~ c::'~~ To Building Foundation /'0 !
To Property Line / ~ ¢'- To Disposal Field
To Water Main/Service Line /~ /4-
To Stream, Pond, Lake or Major Drainage Course / 42c~ ~ '~
Comments ''~ .'~)~-1~::~ Ii~,,/' ~J ~_.,~ ~---~,~L::~(:>~::~t._ ~('~,rJ~
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
Results of Last Adequacy Test
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
-~ ~ ~ Statndpipes Present(C~N)
/'-/ Date of Last Adequacy Test
f
SEPARATION DISTANCE FROM ABSORPTION FIELD:
1.'o Water-Supply Well
3'0 Water Main/Service Line
To Stream, Pond, Lake, or Major Drainage Course
1''o Driveway, Parking Area, or Vehicle Storage Area
Comments '~ y ~m'l"-~--~-q-1 ~'~~
7
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots ~'~:::~/~
.//
To Cutbac~ (if present)
/ --/-
D. LIFT STATION
Date~
Size in Gallons ~
"Pump On" Level at ~
High Water Alarm Level at
Tested for
Meets MOA Electrical Codes (Y/N)
Comments
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
~ Vent (Y/N)
~ Pumping Cycles during Adequacy Test.
**Check Permitted Bedroom Rating Against HAA Request**
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect:q:)l~?the.~ate of this
inspection.
Date
MOA
Receipt No.
Date of Payment
Amount: $
72-026 (Rev. 7/88) Back
Receipt No.
Waiver Fee: $
Date of Payment
Page 2 of 2
MUNICIPALITY OF ANCHOP~AGE
DI~ISION OF ENVIRONMENTAL HEALTH
DEPARTMEN~ OF HF~L~H AND ENVIRONMENTAL PROTECTION
APPLICATION FOR h~JtLTH A[II~ORITY ~i~PROVAL CERTIFICATE
1. C~neral Information
A~plication Date
(a)
(b)
Leoal Description (include lot, block, subdivision,~section, tgwD~sJTip,~ r~n~e)
Loc~tion (ad,ess o~ directions) ~
(c) Applicant is (check or~) Lending Institution ~ ; Owner/builder~;
(d) Lending Institution / ~>%/7~-~/~:/~? Telephcr~
Ad.ess )f
(e) Real Estate Co. & Agent
Address
Telephone
2. Type of Residence
Single-Family ~
Number of Bedroca~
3. WateF Sup~p_~
Individual Well ~
Multi-Family
Other (deScTibe)
Comaunity ~ Public
Note: If cr~,~unity w~!l system, must have written confirmation from t~he State
Department of Environmental Conservation attesting to the legality and status.
Is the ~ll'adequate fo~ the number of hedrocms specified in ~-his HAA . )
~_~e Disposal
bnsite ~. Public ~ Community ~ .Holding Tank
Is the wastewater disposal system adequate for the
[Page 1 of 2]
2-15-84
5. Engineering Firm Providinq Inspections, Tests, D~ta and Information
I certify tha~I'~e checked, verified, or conformed to all MOA HAA Guidelines in
effect on th~ date~th~s, ins~ecti?n.
Signed~ ~_ _
Name o~.~ Telephone
Date
( ENGINEER SEAL)
6. DHEP Approval
Approved for
Approved ~
~sappro~d~--1
Conditional
Date
Terms of Conditional Approval
The Municipality of Anchorage Depa~tn~nt of' Health and Environmental Protection dces
not guarantee the continued satisfactory performance of the water supply and/or the
wastewater disposal system. This approval indicates that, as of the validation date
shown above, based on the data and information furnished by an engineer registered in
the State of Alaska, the water supply and wastewater disposal system is safe and func-
tional for the p~mbe~ of kedrccms and type of structure indicated.
(DHEP SEAL)
7' Mail ~,/7
/
t~ollowing a~ess:
KB2/d5/s
ao
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AIrI~ORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
Well Classificatiga5 ~ ~
Well Log P~esen/iY~/~J
Total Depth ~ Y Cased to
Static Water Level S /
Casing Height Above Ground
Electrical Wiring in Condui (y~/
Separation Distances f~c~ Well:
To Septic/]~~ on Lot~ //~ ~
To Nearest Edge of Absorption Field on Lot
To Nearest Public Sewer Line /~/h~
; On AdjoiniJg Lots C{/~/FC]
! ? On Adjoining Lots {z[
TO Nearest Public Sewer
Cleancut/Manhole /~///~ TO Nearest Sewer Service Line on Lot ~d~
Water Sample Collected By ~>~ ~////~F/~; Date ~,/~//~ Z/
Water Sample Test Results ' -~ ~7 ~/~-,'~ ~73,~ ~ / /
Be
SEPTIC/~TANK DATA
Date Instal~d //~/_~ Size /~P~. NOo of Ccn~pa~tments
Stan~i~J~, ~ ~ir-tight ~ps~ _ Fou~ti~n Clea~out~
~pression o~ Ta~ ~ ~te ~st ~d /~ ~
P~ing~aintenan~ ~n~a~ on File J~~' ; for ~//~
Holding Ta~ High-Ware= ~a~ (Y~/~ Te~=a~ Holdi~ Tank Pe~t
~p~ation Distance f=~ ~ptic~olding Ta~:
To Wate=-Supply ~11 /~ To ~ilding F~ndation /~ /
To Property Line /~ ~ To Disposal Field ~ /
TO Water Main/Service Line ?O " r To Stream, Pond, Lake, cs Major D~ai~:age
Counts
[Page 1 of 2]
2~15~84
C. ABSORPTION FIELD DATA
Soils ~ating in Absorption Strata
Date Installed
/ /
Width of Field / ~
Square Feet of Absorption/~ea
Depression ove~ Field
Results of Last Adequacy Test
/~-- Type of System Design/'/~//~Jf3
Length of Field ~'~:~
~p~ of Field ~ /
Grail ~d ~ickness
Stan~i~s ~esen~$.
~te of ~st A~a~ Test
Separation Distance f~cm Absorption Field:
To te.-Supply //O To omrty /
TO Building Foun~tion ~--/ To Existing or ~ndo~d System
Lot ~/,/~ ; ~ ~joining ~ts ~ /~ .~.c2
To ~/~vi~ Line /~ ~ ~- To ~t~(~f ~e~nt) ~/ /~
To St~e~ond~ke/~ ~jo~ ~aina~ C~ /~ /~$
To ~iveway, Pa~king ~ea, ~ Vehicle St~a~ ~ea ~ ~
D. LIFT STATION
Date Installed
Siz~ in Gallons ~ / //~
"Pump On" Lavel at /~/ ~]~L
High Wate~ Ala_~m Leve/1 ;t / I ]
Tested for
Di~re ns ion's
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles du~ing Adequacy Test.
Electrical Codes (Y/N)
Cc~[rents
Meets MOA
** Ch~ck Permitted Be~ocm Rating A~ainst HAA Request
I ce~t~.fy that I ~ checked, ve~fled, o~ confo~m~ to all MOA HAA Guidelines in effect
Company'!./~'/' - - MOA No,
[Page 2 of 2]
2-15-84