HomeMy WebLinkAboutLAKE RIDGE TERRACE BLK 9 LT 5
Municipality of Anchorage Page
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: fA,,' ?'~o.3, FI PID Number:
Name:~/C,~ ! /:>~.~ Wastewater System: [] New¢ [] Upgrade
Address: I'-/ ~--/.Z ~,'../,Z /~/; £.~,~ ~,~. ,~-ABSORPTION FIELD..,.
Phone: No. of B..~ooms: [] Deep Trench [] Shallow Trench [] Bed~und [] Other
LEGAL DESCRIPTI ON sot, Rating: Tot~th from original grade:
GPD/Sq. Ft.
Subdivision: Depth to pipe boltom from original grade: .~avel depfh beneath pipe
Township: J-~"/~' Range: ~[. W Section: ~ ~ Fill added above original g~ Gravel length:
Ft. Ft.
WELL: ~"*'"~ ~ New ~U~ Gravel width: ~ Number of lines: Distance between lines:
Ft. Ft.
Classification (Private, A.B,C): ~pth: Cased To: Total ab~Area: Pipe material:
/ Ft. Ft SQ. Ft.
Driller: ~ Date Drilled: Slatic Water Level:Ft In.r: Date installed:
Yield: / GPM Pump Set at: Ft Casing Height Above Ground:Ft TAN K
SEPARATION DISTANCES ~ Septic ~olding ~ S.T.E.P.
TO Seplic Absorption Lift Holding =ublic/Pevale Manufacturer: Capacity in gallons:
Well ~ ~ ~ ~, ¢~, Material:/T~z Number of Compa~ments:
s~f~ +/~' +/~' LIFT STATION
Water
Manufacturer:
Lot ~, ,
Line ~ ~ Size in gallons:
Foundation / ~ ¢ ~ "Pump on" level at:~: ~ High water alarm at:
Cu~ain Drain ~ I ~, ,~. Pum~ [Electrical Inspections performed by:
Remarks: ~ ~.2 ~,.~¢ ~.~., BENCH MARK
Location and Oescription:~
Assumed Elevation:]~, ~ ~,
Inspections performed by: ~.~ Dates: 1st ~-/~'f~
Health Human Services approval ~;~'..
Department of and ~X~g",....,.."
Reviewed and approved by: ~//~ ate:
Permit No.SW970281
Page 2 o? 2
Municipctity oF Anchorage
DEPARTMENT BF HEALTH AND HUMAN SERVICES
ENVlRBNMENTAL SERVICES DIVISION
P,O. Box 196650 oAnchorage, Atask6 99519-6650- Tetephone: 343-4744
On-Site Wostew~ter Dispose[ System ~nd/or We[[ Inspection Report
Legcd Description:LAKE RIDGE TERRAGE LOT 5 BLK 9 PID No,: 05132310
--HAROLD LOOP-----
1' IRON PIPE~r'ORTAIN DRAIN
[] 150.00 %
4000 ng~[ Tc~nk
HSE
20' UTILITY EASEMENT pp
150.00
N 89°49'0" W /
ELEVATIONS
(NOT TO SCALE>
RE)~AR
UN])EVELBPED
SWING TIES
A-C = 38.1
B-C = 32.3
1" 40'
SCALE =
9/19/97
ENGINEER'S SEAL
_~' ?,?-r:.. ............. r"'/
~..' '-.,o. ~
~'.co:..' 49 T._~.H j¢li~
¢¢~".LOUIS A. 8UTERA.'"o.,
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT
PERMIT NUMBER:SW970281
DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES
OWNER NAME:SKARE DANIEL A & VERDELLA MAY
OWNER ADDRESS:P.O. BOX 770364
EAGLE RIVER,ALASKA 99577
PARCEL ID:05132310
DATE ISSUED: 8/28/97
EXPIRATION DATE: 8/28/98
LEGAL DESCRIPTION:
LAKE 'RIDGE TERRACE BLK
9 LT 5
LOT SIZE: 234577 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT:
THIS PERMIT IS FOR THE CONSTRUCTION OF:
HOLDING TANK SYSTEM
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 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT)
4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL
ABSORPTION SYSTEM UNDER CONSTRUCTION DURING FREEZING
WEATHER MUST BE EITHER:
A. OPENED AND CLOSED ON THE SAME DAY
B. COVERED, SEALED AND HEATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
Eagle River Engineering Services
Louis Butera, P.E.
P.O. Box 773294 (907) 694-5195 tel
Eagle River, AK 99577-3294 (907) 694-3297 fax
August 18, 1997
Jim Cross, P.E.
Manager, On-Site Services
Municipality of Anchorage
P.O. Box 196650
Anchorage, AK 99519
Re: Lake Ridge Terrace Lot 5 Blk 9
Narrative
Dear Mr. Cross,
The proposed holding tank installation will have very limited impact on adjacent properties for the following reason:
Because it is a holding tank and the waste is hauled off.
If you have any questions please call our office at 694-5195.
//'-~incerely,
Louis Butera, P.E.
\ 1997\95-109-HLDGTK-NAR.DOC
S 89o49,0,,E~
4000 ~{
20' UTILIW ~5[HgNT pp
150.00
~e~A~ N 89~49'0'' W
~ - TEST HOLE
· MONITOR TU~
o SEWER CLEANOUT
~ WELL
~ ~ - EASEMENT
NO SUR~AC~ WA~R ~ROPOS~D L~ACH~IELO
~- ~XISTING L~ACHFIEL~
WELL/SEPTiC SiTE PLAN
EAOL~ RIVER, AK. 99577 %~%~ss~o~~
(907) 694-5195 FAX: (907) 694-3297
SPECIFICATIONS FOR ON-SITE HOLDING TANK SYSTEM
LEGAL: Lake Ridge Terrace Lot 5 Blk 9
A. GENERAL
The well and septic plan are for a single family residence only.
The drawing and or site plan shall be a part of this specification.
All materials and workmanship shall meet the Anchorage Department of Health
and State Department Of Environmental Conservation. requirements.
All soil tests are advisory to the design and are to be verified or modified in the
field by the engineer.
All excavations and depths are advisory and are to be verified or modified in the
field by the contractor to meet Municipality of Anchorage, Department of
Environmental Conservation requirements.
It is the responsibility of the owner to obtain all necessary permits or easements
and to locate any adjacent multi-family wells.
The excavation is to be exactly in the area shown on the site plan, any deviation
requires engineer approval.
It is always recommended that a surveyor locate the nearest lot line position and
the location of any easements.
HOLDING TANK
1. Holding tank is to be accessible to pumping vehicles.
2. The tank is to be a tank that is approved by the Municipality of Anchorage with
corrosion prevention standard, for septic tank as per Uniform Plumbing code.
3. The holding tank must have a six (6) inch diameter standpipe with an airtight cap
to provide pumping access. The standpipe must extend at least twelve (12) inches
above the surface of the ground.
4. The holding tank must have a watertight manhole to provide access to the interior
of the tank. The manhole must be at least twenty (20) inches in diameter.
5. The holding tank must be equipped with a high water alarm which registers both
visually and audibly inside the dwelling. The alarm must be positioned to allow at
least three hundred (300) gallons per bedroom of additional storage after the alarm
has been activated.
6. The holding tank is to secured against fioatation, utilizing tie-downs to 4 concrete
anchors, with dimensions 2' x 2' x 8', to be purchased at Klondike Concrete in
Chugiak, Alaska.
Existing septic tank and pit to abandoned to code.
Alarm and wiring to be per Municipality of Anchorage electrical code.
BEDROOM CAPACITY
HOLDING TANK SIZE
=3
= 4,000 gallons
Twenty-four (24) hours notice required for all inspections.
Municipality of Anchorage
DEPARTMENT OF H~LTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
DATE PERFORMED: ~--~ /-q ~
~ ~/~ ~ange, Section: Township,
WAS GROUND
ENCOUNTEREC
IF YES, AT WH.~
DEPTH.;'
Depth to Water Alter
Monitoring;' __
Reading
I
P~GOkATION
SLOPE SITE PLAN
6
7
8
9
10
11
12
13
14
15
16
17
IND WATER
S
P
E
Dale: ~-~7
Gross Net Depth to Net
Reading Date Time Time Water Drop
I 5--22~,~, 13.'~ c~ z~,
~ /?,'~ ~ ~//~
18-
19-
20-
)N RATE /kO (minutes/inchl PERC HOLE DIAMETER
TEST RUN BETWEEN /,~ FTAND ~' ~ FT
COMMENTS
PERFORMED BY: ~-'XC~'5- ,~:~=~'~"~-- CER',FY THAT TH,S T~ST WAS.E.FOR~ED
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES iN EFFECT ON THIS DATE. DATE:
PERFORMED FOR:
1
2--
3
4
5
7
8
9
10
11
12
13
14
15
16
17
18
19
20
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage. Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
DATE PERFORMED:
/.,=n-J- ~'/'~Cla'~'nge
Township,
Section:
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED? Y~'~
S
IF YES, AT WHAT /. f ~
DEPTH? ~'' ~ p
E
Oeplh to Water Alter_ /
Monitoring7 ~'-.b"- Dale:
Gross Net Depth to Net
Reading Date Time Time Water Drop
~ / ~,'~ ~ ~ *lid
TEST RUN BETWEEN
__ (m~nutes~inch) PERC HOLE DIAMETER --
FTANO '~'~'~ FT
COMMENTS
PERFORMED BY:~.--_~ _~c'- ~._ ~_~j~ I ~'~r~-~'~'~-~- ~--~' CERTIFY THAT THIS TEST WAS PERFOR~EO IN
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.# 051 323 10
1. GENERAL INFORMATION
Complete legal description
L~iKE RIDGE TERRACE, L5 , B9
Location (site address or directions) 14212 HAROLD LCOP
Property owner DANi~;~, & V~jN_;F;f,TA t'vtA~ S~
Mailing address P.O. ~OX 21494, ANCHORAGE,
Lending agency CT~Z NOR?GAGE
Mailing address
Agent Rg-yu~x
Address
Day phone
99521
696-3028
Day phone 696-0701
Day phone 257-0171
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: 3
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE:
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) Front MOA #21
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/orwastewaterdisposalsystem is safe, functional and adequate for the number of bedrooms
and type of structure indicated herein. I furtherverifythatbasedontheinformationobtainedfrom
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
Eagle River Engineering Services
Address ,-, n n ~-~,-~n,~
Engineer's signature
Phone 694-5195
Date 9-19-97
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 DHHS does this as a courtesy to purchasers of homes
and their lending institutions in order to satisfl/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 ~21
MUNICIPALITY OF ANCHORAGE
~.NVIRONMENTA~ ,SERViCES DIV~
Municipality of Anchorage R~'D 1~1~7 ~
HEA . & HUUA SERVICES 7
Environmental Services Division ~ ~ ~--- ~)
825 L Street, Room 502. Anchorage, Alaska 99501 .(907)~¢~ ~
Legal Description:
A. WELL DATA
Well type
Log present (Y/N)
Total depth
Sanitary seal ¢;~N)
Health Authority Approval Checklist
/(,~¢'.¢~ 7-~'~'"',~¢-~ '/-''¢ /~ ParcelI.D.:
if A, B, or C, attach ADEC letter. ADEC water system number
Date completed
~-,-~/Cased to d-- ~' ~ Casing height (above ground)
Wires properly protected
Date of test
Static water level
Well production
FROM WELL LOG
AT INSPECTION
g.p.m.
WATER SAMPLE RESULTS:
Coliform
Date of sample:
Nitrate O./~,~ M
Collected by:
Other bacteria
B. SEPTIC/HOLDING TANK DATA
Date installed ¢-/~'-¢? Tank size ~/0o~/¢/ Number of Compartments
Foundation cleanout(Ci!~N) ~'~.~
Date of Pumping
O. ABSORPTION FIELD DATA
Date installed
Len ~th-n~~ Width
Effective absorption area
Date of adequacy test
Fluid depth in absorption field before test (in.);
Fluid depth (ins) Minutes later:
Peroxide treatment (past 12 months) (Y/N)
-~ 72-026 (Rev. 3/96)*
Depression (Y~I~ ,,c,',~ High water alarm(~q)
Pumper /¢-/'/~
System type
Soil rating (g.p.d./ft2 or ft2/bdrm)
Gravel thickness below pipe
bedrooms
Cleanouts ¢~)
Monitoring Tube present (Y/N)__
~s/Fail)
gal. water added (in.):
Absorption rate ~ g.p.d.
If yes, give date ~
Total depth
Depression over field (Y/N) __
For
LIFT STATION
Date installed
Manhole/Access (Y/N)
,/1//,,'~ Size in gallons
"Pum~
High water alarm Jevel at* ,,~-~'"'~ *Datum
E. SEPARATION DISTANCES
"Pump off" level at*
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic~tank on lot
Absorption field on lot
Public sewer main
On adjacent lots ¢/¢¢ ·
On adjacent lots ~ /~'~ '
Sewer/septic service line
Public sewer manhole/cleanout .,/'f.//4
Lift station
SIEpARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation
Property line ~ ~ Absorption field ,'"~'~
Water main/service line
SI=PARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line
Surface water
Building foundation ~ice line
~ Driveway, parking/vehicle storage area
Wells on adjacent lots
F. ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and review of Municipal
in conformance with MOA HAA guidelines in effect on this date.
Signature
Engineer's Name ~'~ ,,,,;-
Date
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
~t~, CT&E Environmental Services Inc.
CT&E Ref.# 974977002
Client Name Eagle River Engineering
Project Name/# N/A
Client Sample ID Lot 5 B9 Lake Ridge Terr.
Matrix Drinking Water
Ordered By
PWSID 0
Sample Remarks:
Client PO#
Printed Date/Time 08/29/97 16:11
Collected Date/Time 08/25/97 15:30
Received Date/Time 08/26/97 09:25
Technical Director: Stephen C. Ede
Parameter Results PQL Units Method
Nitrate-N
Total Coliform
Allowable Prep Analysis
Limits Date Date Init
0.100 U 0.100 mg/k SM18 4500-NO3F 10 max
POS. FOR TC/ NEG. FOR EC/ 100 ml SM18 9223B
08/27/97 JBL
08/26/97 TMW
NORTHERN TESTING LABORATORIES, INC.
3330 INDUSTRIAL ~WEhlUE FAIRBANKS, ALASKA 99701 (907) -156 3~ 16 ,, FAX 456-3125
8005 SCHOON STREET ANCHORAGE. AI_ASKA 99518 (907) :349 1000 ,, FA)( 3,19- 1016
DRINKING WATER ANALYSIS REPORT FOR TOTAL COLIFORM BACTERIA
Eagle River Engineering Services
P.O. Box 773294
Eagle River AK 99577-3294
Date Received: 9/4/97 Time Received: 15:30
Date Analyzed: 9~4~97 Time Analyzed: 16:00
Date Reported: 9/9/97 Time Reported: 15:20
Next Sample Due:
Comments
Phone Number: ( )696-7375 S
Fax Number: ( )694-3297 U --
POS =
Collected by: TJN ND =
TNTC =
Sample Type Untreated Routine
CG =
Method of Analysis: Membrane Filtration (SM 9222 HSM =
B) SA =
Comments:
Satisfactory
Unsatisfactory
Positive Test Result
None Detected
Too Numerous To Count (>200 Colonies)
Confluent Growth
Heavy Sediment Maskinq, 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
Resample Required
Old =
R =
NT = No Test
* # Colonies/100 mi ** # Colonies/mi
Sample Sample Total* Fecal Other* HPC**
Date Time Coliform Coliform Bacteda Result Lal:¢ Location Comments
9/4/97 13:56 0 ND 0 NT AC6078 Lake Ridge Terrace, Lot 5 Satisfactory
BIk 9
Sherd L. Trask Environmental Analyst
Northern Testing Laboratories, Inc Anchorage, AK
9/9/97
