The URL can be used to link to this page

Home My WebLink AboutLAKE HILL ACRES LT 11 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 NAME MA'L N6^?'DRESS D B,STANCETO: IW"" ~ Abs°rpti°~ '~7 ~ ~ Manufacturer Liq. ~ I F HOMEMADE: Insid~ length PHONE Dwelling ~'/,~ Material Widt h~=~._.__ Manufacturer Material DISTANCE TO: WeU ./~'/~ Foundation /~/~ INearestlot~ /~ No. oflines '/, Length of e~.G~lSe / Totalleng~f~ees/ .Trenchw~ Top of tile to finish grade ~ /~ IMaterialbeneathtne ~S inches Width ~ Depth Crib dapth Crib diameter Well De pt.~h ~, . Building foundation [] UPGRADE DISTANCE TO: NO. OF BEDROOMS No, of compartment~L¢' Liquid d ept h..~ PERMIT NO. Liquid capacity in gallons Distance between lines Total effe. ctivR,..absorp_4C~?n area PERMIT NO. Total effective absorption area Building foundation Nearest lot line Sewer line Distance to lot line Septic tank PERMIT NO. Absorption area(s) OTHER PIPE MATERIALS I Fi~AE LER REMARKS DATE LEGAL PERMIT NO. RF'F'L I F':RNT ~.~t~t~;--~..~_'~t~.tE- LOC:RT 1 ON LEGRL Lti LAKE HILL RE:RES DEPRRTblENT C 'HEALTH AND ENVIRONMENTAL . .OTECTION 825 "L'" STREET, BNCHORAGE, BK. 9L~50± S'FRR RT ~2 E ELE LOT SIZE 9999?9 SQUBF.:E FEET T'-,"F'E F~F SRIL RBSORF'TION SYSTEM IS: TRENCH I IFt;.',Ii'IUM NUMBER OF BEDROOMS = 3: SAIL RATING ,:.'SQ FT,/BR)= ~10 THE REQLIIRED SIZE OF THE SOIL RBSORPTiON SYSTEM IS: [>EF"TH= ~: LEi'-4GTFt= ,7":~- r:- . - . , -- _ _z F-.H -.- EL [:.EPTH= 4 'THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRAINFIELD. THE DEPTH OF B TRENCH OR PIT iS THE DISTBNCE BETWEEN THE SURFBCE OF THE GROUND BND THE BOTTOM OF THE EXCBVATION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRAVEL DEPTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN THE OUTFBLL PIPE BND THE BOTTOM OF THE EXCRVATION (IN FEET). ~:E,g!Li l- F4E[:. SEF'T I C: TR~-.~k~' :='-i l- ZE= t ,.----,£-,i.-'-r--t ,.]RI LC,~'-4S F'ERMIT RPPLICRNT HRS THE RESF'ONSIBILITY TA INFORM THIS DEPRRTMENT DURING THE INSTBLLATION INSPECTIONS OF BN'.r' WELLS R[:,JBCENT TO THIS PF.:OPEF.:TY AND THE NUMBEF.: OF RESIDENCES THAT THE WELL WILL =,EF..,,E. T ~.l Ci .:: ':- ;:. BRCKFILLING OF RN'¢ '"]YSTEM WITHOUT FINRL INSF'ECTION RN[:, RF'PRCI'v'RL BY THIS [:,EF'RRTMENT WILL BE SLIE:JEC:T TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R WELL RND ANY ON-SITE SEWAGE DISPOSBL SYSTEM IS ±00 FEET FOR B PRIVBTE HELL OR ±50 TO 200 FEET FROM B PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL. MINIMUM DISTBNCE FROM B PRIVATE HELL TO A PRIVBTE SEWER LINE tS 25 FEET BND TO B COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS BRE REQUIRED BND MUST BE RETURNED TO THE DEPBRTMENT WITHIN ~0 DBYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MBY BPPLY. SPECtFICBTIONS BND CONSTRUCTION DIBGRBMS BRE AVAILABLE TO INSURE PROPER INSTALLBTION. I CERTIFY THRT l: I RM FBMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS fiND WELLS AS SE]' FORTH BY THE MLINICIPBLtTY OF BNCHORAGE. 2: I WILL INSTBLL THE SYSTEM IN ACCORDBNCE WITH THE CODES. ~: I UNDERSTAND THRT THE ON-SITE SEWER SYSTEM MBY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THBN S BEDROOMS. S I GNE[:,: RF'PLICRNT OTTO. & M.J. LOWE ISSUE[:' BY__ _DRTE__ V4. 0 :';";*'~)~¢~N' THE T'~E OF PU8LIC ~ELL. ~; I H~LL ~N~F~Lk THE 5YSTEH ~' " MU~IblPALITY OF AI~CHOR~,GE -- DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG -- PERCOLATION TEST SLOPE 2 3 'SOILS LOG PERCOLATION TEST SITE PLAN .. 10 11 12 13 14 15 16 17 18 19 20 No. 1457~E COMMENTS PERFORMED BY: WAS GROUND WATER ~ O I~_ ENCOUNTERED? O P E IF YES, AT WHAT DEPTH? Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~ 0 (minutes/inch) TEST RUN BETWEEN FT AND--~ FT CERTIFIED B erAfle rfll g Eog 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 Ended : ' · ~'~ , ; :.: .: ,-, ~ DEPTH OF WELL ' ' , ~ .--, ~,: ..... %~'c'~/:STATiC LEVEL OF WATER FT, DRAW DOWN FT. GALS. PER HR ' ' ' ' : KIND OF CASING ; ' ' - KIND OF FORMATION: From From From From Ft. to · Ft. Ft. to ~'-~,,. Ft. Ft. to ] %--Ft. - From ;-' Ft. to '? ;~ Ft. From , Ft. to .: ,:.' ,Ft. From__Ft. to C' '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 From From From From ' ,' ": ~' From From From From From From From Ft. to Ft. to Ft. to Ft. to Ft. to Ft. to Ft. to Ft. to Ft. to Ft. to __.Ft. to Ft. to Ft. to Ft. to Ft. to Ft. to Ft. to Ft. Ft. Ft Ft. Ft. Ft. Ft. Ft. Ft. MUNI~IiPALITY OF ANCHORAGE: DEPT. OF HEALTtl 8: ENVII~.NM,':NTAL PROTECTION ECF. i: ED Ft. MISCL. INFORMATION: September 22, 1983 Municipality of Anchorage Department of Health & Environmental Protection Pouch 6-650 Anchorage, Alaska 99502-0650 ATTN: Laura Ward MUNICIPALITY OF ANCHORAGE DEPT. OF HR/",LiiJ C: ENViRONP./I:N~ AL RECEIVED RE: Inspection Report for On-Site Sewer Disposal System Permit No. 830093 Dear Ms. Ward: In August of this year, we had an on-site septic system installed on our property in North Peters Creek. Attached you will find an inspection report on said septic system, completed by S&S Engi- neering of Eagle River. You will note that the report, as well as the permit are in the names of Otto & M.J. Lowe. We purchased the property from Mr. & Mrs. Lowe in July of this year. I've spoken with Mr. Lou Buckholdt of your Eagle River office and he said he would change the name on the permit to Roseann Mourtsen. Since we will be drilling a well within the next month, I con- tacted your Anchorage office to determine the placement of a septic system (if any) across the road from our lot. In talking to Terry, of your Anchorage office, I found out that there is some confusion as to Lot numbers in the subdivision. In order to help you record our septic system and our well on the proper lot, the following is all of the information I have available regard- ing the property location: Lot 11 Lake Hill Acres Subdivision SE 1/4 Lot 2 BLM Lot 2, Plat P-374 One of the questions Terry asked me was in regard to which addition we were in. There is no mention of this being part of the Original or Addition 1 to the subdivision. If you require further information, please contact me by mail at: Roseann Mourtsen P.O. Box 4-18 Anchorage, Alaska 99509 If you need to talk to me, please feel free to telephone 277-4651 (home), 279-8491 (work). We will be submitting the well log as soon as the well drilling is completed. Thank you for your help. Very truly yours, Roseann Mourtsen '~ E~llq rC'ii~ALiTY 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 NAME / PHONE ~ ~NEW MAILIN~ ADDRESS ~ LEGAL LOCATION NO. OF BEDROOMS ~ Well ~J~ I Absorptio~ ~ Dwelling ~/~ PERMI~ C~ ~ ~ ~ DISTANCE TO: , ~N ~ Manufacturarf_~ ~ - Ma~e~ _- No, of compartment~ ~ Liq.,/C? ~ ~P~i~ ikqalJons IF HOME.DE: Inside !ength .~ ~idt~ Liquid d~ Well '~//, Dwellina PE~ITNO. ~ ~ , D STANCE TO: O Z ~ M~nufacturer ...... ."-:: ~" ~aferial ' ~ '4 .- . :. [ -- k liquid c~pacity in gallons .~_S DISTANCE TO, Well ~:~ 5~ Foundation: ~J>~ inches/~' ~O' ~ ~ ~ No. of lines Length / Distance between lines -- ' . / of Total ,eng~fCe, Trench w~ ~ Total eff~ti~abso~on, area ~ ~ ~ Top of tile to finish grade ~ I ~ Material beneath tile ~ Length Width ~// Depth PERMIT NO. ~[~ ~ Type of crib Crib diameter ~ Crib depth Total effective absorption area ~ Well Building foundation Nearest lot line ~ DISTANCE TO: ~ ~. ,D Distance to lot line PERMIT NO. ~ ~ISTA~CE TO: Buildin~ foundation Se~er Iin~ Septic tank ABsorption OTHE~ SOIL TE ~TING ..~ / I~STALLER REMARKS ~ . ;,.K~t~~/,~, ~- I'~ 7~ ~-~ ~ /--C / APPROV~' t~ //. 1' DATE LEGAL : ~'~:~ ~ E~INEERING PiUFI · r__- 1' PFIL ]; T'¢ L'IF' FINCI IORIR~--iE ° WELL f-~NO ,..'~N--~'~ Z TE SEWER pERI'~ I l' TFiENCH ' i ~C~ R~ ~E ~3TTOI-I OF THE ~ ~HE ~TTOM OF THE EXC~VRT(ON (IN FEET). F'~IT RppLIci~-tT ~ ~E R~SPON~[SILITY TO t~Ut48~ OF RESID~2ES TH~T THE NELL 14ELL ~ERVE. ~,~:FILLINO OF ~Y ~¢~TE~t ~4ITH~J~ F/N~L E, EPRRTN~T MILL BE '~JB./ECg TO UPON THE T'¢PE OF PUBLIC NELL TO R C0l~f'¢ S~14~ L~N~ [S 7~ FEET. 'OF FH~ M~LL C~3~LETIF~]. I CERTIF'S¢ T,,F~.'T n~,¢-,-- ¢'. ~-'~,~-~,'~ ¢~m~d ~'? Tm~ P~--~T:~LI ,~,L~ LiE .......... '2: ! '" ' .,~,.~_~t~,'~¢' ' ~ Parcel I.D. # /~.~-/'- (")~- ~ 1, GENERAL INFORMATION Complete legal description MUNICIPALITY OF ANCHORAGE ~ DEPARTMENT OF HEALTH & HUMAN SERVICES Division of Environmental Services On-Site Services Section MUNiciPALiTY OF ANCHoP, AGE P.O. Box 196650 Anchorage, Alaska 99519-6650ENVl--. 343-4744 ~UN~ENTAL SERVICEs DIVISION CERTIFICATE OF HEALTH AUTHORITY S 'P 72 1997 APPROVAL FOR A SINGLE FAMILY DWELLING Location (site address or directions) ~ ~y/~C~ 7 ~ ~'~ /~ 1 ~ ~. '-~'/ Property owner /~X~'~/~'(-~rl~_ /~/oF~'~,'--- Dayphone &Tpzl Mailing address Lending agency Mailing address Day phone Agent Address Day phone 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. 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 NOTE: 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 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 Engineer's signature KND Engineering 20441 Ptarmigan Bvd. Phone Date DHHS SIGNATURE Approved for Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments 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 DH HS 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 f¢21 MUNiCiPALITY Oi: ANCHORAGE Municipality of Anchorage ENW~O~NTAL DEPARTMENT OF HEALTH & HUMAN SERVICES $£p 1 2 Environmental Services Division 825 L Street, Room 502. Anchorage, Alaska 99501. (907) 34~E IV E D Health Authority Approval Checklist Parcel I.D.: A. WELL DATA W~ll type ~ Log present (Y/N) Y Total depth ~ .~. / / Sanitary seal (Y/N) ~ If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to .~-..~ / FROM WELL LOG Casing height (above ground) z.//~ Wires properly protected (Y/N) Date of test Static water level Well production AT INSPECTION g.p.m. /72. g.p.m. WATER SAMPLE RESULTS: Coliform ¢ Nitrate Date of sample: B. SEPTIC/HOLDING TANK DATA Date installed ~-2~,~ Tank size ,,/~) Foundation cleanout (Y/N) Date of Pumping C. ABSORPTION FIELD DATA Date installed ¢/~ Length ~ ~/ Width D./D Collected by: Effective absorption area Depression (Y/N) ~ Pumper ._//¢¢~. ~.~r~ Other bacteria Number of Compartments ,~ Cleanouts (Y/N).__ High water alarm (Y/N) '""---- Soil rating (g.p.d./fF or ft2/bdrm) Gravel thickness below pipe ~ ~,~.~ Monitoring Tube present (Y/N) / 2-,~ ~ ¢ 7 Results (Pass/Fail) ~ Date of adequacy test Fluid depth in absorption field before test (in.); Fluid depth 7~ (ins) Minutes later: Peroxide treatment (past 12 months) (Y/N) ~,/Z:~ System type /~,~/~-~',~ .~ Total depth · Depression over field (Y/N) For ~.~ bedrooms Immediately after ¢?¢) gal. water added (in.): Absorption rate = y/70 '/' g.p.d. If yes, give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycles tested / Size in gallons "Pump on" Level at* *Datum "Pump off" level at* E, SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on Lot Absorption field on lot /0~ ~ Public sewer main Sewer/septic service line On adjacent lots On adjacent lots Public sewer manhole/eleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation ,/~:¢) 4-- Property line / ~ .,c Absorption field / Water main/service line .~ ~ Surface wateddrainage /DD + Wells on adjacent lots SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: / / Property line /~) -h Building foundation /E~) -/-- Water main/service line / Surface water //f.'~ ~ ¢' Driveway, parking/vehicle storage area Curtain drain /~ ~'¢' Wells on adjacent lots ENGINEER'S CERTIFICATION I certify that I have determined thru field inspections and review of Municipal records in conformanjc1 with~AA guidelines ineffect on this date. Signature ~-~. ~ Engineer's Name ,~m,,~.~,'~ v,,.*, , _ Date ~' / ~7.. \c17 Waiver Fee $ Date of Payment Receipt Number HAAFee $ Date of Payment Receipt Number 72-026 (Rev, 3/96)* K D AS-BUILT SYSTEH DETAILS LAKE HILL ACRES SUBDIVIS[ON, LET 11 A-C=80,4' B-C=54,1' A-D=43,3' E-D=64.8' A-E=70,5' B-E=106.5' A-F=66,0' B-F=102.6' co E TING TANK BDR/ SFR SCALE: 1' = 50' THIS IS AN AS-BUILT OF WORK PERFORMED BY OWNER TO BRING SYSTEM INTO COMPLIANCE WITH CODE. NOTES: 1. FOUNDATION CLEANBOT HAD BEEN BURIEB ANB WAS UNCOVERED, 2, OWNER INSTALLED CLEANOUTS AT BOTH ENDS OF TRENCH, 3, POST TANK CLEANOUTS ALSO INSTALLER AT THIS TINE, 4, OWNER INSULATE~TRENCH & TANK WITH 2' HD BURIAL FOAM, 5. OWNER INSTALLED FABRIC OVER TRENCH. PREPARED FOR: MARK & RAMONA NORMAN 24307 RAMBLER ROAR CHUGIAK, AK 99567 KND ENGINEERING 20441 PTARMIGAN BLVD EAGLE RIVER, AK, 99577 (907)696-6111/Fax (907)696-8111 DATE: 9/11/97 ]DRAWING N SCALE: AS NOTED[ 97065-Sl NORTHERN TESTING LABORATORIES, INC. 3330 INDUS"RIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 456-9116 ', FAX 456-3125 8005 SCHOON STREET ANCHORAGE, ALASKA 99518 (907) 349~1000 · FAX 349-1016 KND Engineering 20441 Ptarmigan Blvd. Eagle River, AK 99577 Report Date: 09/05/97 Date Arrived: 09/01/97 Date Sampled: 09/01/97 Tine Sampled: 1630 Collected By: KD Attn~ Ken or Dee Our Lab #: A151716 Location/Project: Lk. Mill Acres Your Sample ID: Lot 11 Sample Matri×~ Water comments: Lab Number Method Parameter Definitions *~ present in Blank Above Regulatory Max Estimated Value Matrix I~terferenCe LOSt tO Dilution MDL = Method Detection Limit Date Date Units Result * MDL Prepared Analyzed A151716 SM 4500E Nitrate-N mg/L <MDL 0.10 09/04/97 Reported By Daniel J, Bacon Operations Manage~ SEP 09 ~97 0B:00PM MTL ~MCHOR~E P.3/5 NORTHERN TESTING LABORATORIES, INC. 3330 iNDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 456-3116 · FAX 456-3125 8008 SCI lOON STREET ANCHORAGF, ALASKA 99518 (907) 349-1000 · FAX 349-1016 DRINKING WATER ANALYSIS REPORT FOR TOTAL COLIFORM BACTERIA KND Engineering 20441 Ptarmigan Bird, Eagle River AK 99577-3736 Phone Number:. Fax Number: Collected by: KD Sample Type Routine Method of Analysis: Membrane Filtration (SM 9222 B) Comments: Date Received: Date Analyzed: Date Reported: Next Sample Due: Comments S = U POS = ND = TNTC = CG = HSM = SA = Old = R = NT = No Test * # Colonies/100 mi Sample Sample Total* Fecal Other* HPC** Date Time Coliform Coliform Bacteda Result 9/1197 Time Received: 18:00 9/2J97 Time Analyzed: 14:00 9/9/97 Time Reported: 14:23 Satisfactory Unsatisfactory Positive Test Result None Detected Too Numerous To Count (>200 Colonies) Confluent Growth Heavy Sediment Masl~ng, Results May Not Be Reliable Sample Age >30 Hours But <48 Hours, Results May Not Be Reliable Sample Age >48 Hours, Too Old For Analysis Resaml3[e Required ** # Colonies/mi Lab~ Location Comments 911197 16:30 0 ND 0 NT 9II/97 15:45 0 ND 0 NT AC§585 Lot~'l Lake H~I A~res Satisfaebry AC5631 Let tl Glenn View SaUsfaotory Sherr[ L Trask Environmental A~laly~ Northern Testing Laboratories, Inc Anchorage, AK 9~9/97