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Home My WebLink AboutBIRCH HILLS TERRACE #2 BLK 2 LT 1 Municipality of Anchorage Page // of_ 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 Name: Wastewater System: ~New ~ Upgrade Address: ABSORPTION FIELD Phone: ~ No. of~Bedrooms: ~Deep Trench ~ Shallow Trench ~ Bed Q Mound ~ Other Soil Bating: Total Depth from original grade: Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe Township: ~ Rang~. ~Section~ ~ Fill added above original grade: Gravel length: I WELL: U New ~ Upgrade Grave~ width: Number of lines: Distance between lines: ~ Ft. / ~ ~ ~ Ft. Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: Driller: Date Drilled: Static Water Level: Installer: Date installed: GPM~ Ft. Ft. SEPARATION DISTANCES ~Septic U Holding ~ S.T.E.P. To Septic Absorption Lift Holding =ublic/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank S .... Lines ~~ / ~ ~ ~/ ~/ Material: Number of Compartments: Surface Water ~A ~/~ ~/~ ~/A ~ LIFT STATION Lot Size in gallons: I Manu,act~rer:~/~ Foundation /~ CurtainDrain ~[~ ~/~ ~ ~ Pump Make & Model,~ Electrical Inspections performed by: Remarks: BENCH MARK Location and Description: Assumed Elevation: ENGINEER'S SEAL Department of Heal~an¢ Human Services approval 72-013 (Rev 9/91) MOA 25 LOT SYSTEM TERRACE ~2 / / / / / / /// Hi[LLS 0 ..... ~.54~38_ 0 PROPOSED ELECTRIC SERVICE LINE 806,90 A-C = 13,8' 3-C = 81,1' A-J3 = 18,3' B-J3 = 86,5' A-E = 40,8' B-E = 57,5' ]3-F = 98,0' F-G = 78,4' PREPARED SAM MORALES 11344 Terrace Hitts Anchorage, AK Dr, STEVEN R, PANNONE, P,E, P, ~, SOX 142025 ANCHORAGE, ALASKA 99514 874-0308 DATE: 9-~9-94 AS-BUiLT SCALD ~" = 50' AS-I}UILT IDETAILS WASTEWATER A]}SBRPTIBN SYSTErv1 LOT 1, ]BLOCK 2j BIRCH HILLS TERRACE lO00 GAL, S, T, FINISHED GRADE FILTER FABRIC~ BOTTOM BF PIPE SEWER ROCK BOTTOM BF TESTHOLE 40' TRENCH o M,T, 25,3 10 l, TANK BURIAL >4,0' ENTIRE FIELD COVERED WITH FABRIC 3, TESTHOLE EXCAVATED TO -16,0' DURING INSTALLATION TO VERIFY NO BEDROCK 6' BELOW TRENCH, PREPARED FOR: SAM MORALES ll'34,4~"~'erroce,Hi~ts Dr, Anchorage, AK.. STEVEN R, PANNBNE, P,E, P, B, BOX 142025 ANCHORAGE, ALASKA 99514 274-0308 DATE: 9-]9-94 ALE NOT TB SC AS-BUILT MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NLTMBER:SW940268 DESIGN ENGINEER:STEVEN R. PAN-NONE OWNER NAME:HUSA KRIS T OWNER ADDRESS:il344 TERRACE HILLS DR DATE ISSUED: 8/01/94 EXPIRATION DATE: 8/01/95 PARCEL ID:05014139 LEGAL DESCRIPTION: BIRCH HILLS TERRACE #2 BLK LT 1 2 LOT SIZE: 37545 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC 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) 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. SPECIAL PROVISIONS: DATE: /'/ 7-21-94 Department of Health and Human Services On-site Services 825 L Street, Suite 504 Anchorage, AK, 99501 On-Site Sewer for Sam Moralas Lot 1, Block 2, Birch Hills Subdivision Dear DHHS Attached is a request for an on-site sewer permit for a new residence located at the above address. The soils were tested on April 1, 1994. The test results indicated that the soils percolated at 1 to 2 min/inch. The water table was monitored for one week. There was no indication of water being within fourteen feet of the surface. No impacts to the surrounding properties are foreseen. Lots to the South and East have existing on-site sewer systems. Lots to the North and West are yet undeveloped. Water will be served to this lot by an AWWU Main located in the street west of the property. The proposed service line will be located greater that 25 feet from the soil absorption system. There is no evidance of any surface water on the lot or in the vacinity. The topography of Lot 1, were the system is being placed is generally flat. A gentle slope runs the length of the lot dropping from the north to the south, while in the east-west direction there is little grade change. At the east property line, the ground dropes off at an approximately 15% slope to the neighboring lot. The possibility of the proposed system contaminating the surrounding wells is negligible due to the area is served by AWWU as well as the soils being well drained. If you have any questions, please don't hesitate to contact me. Sincerely Steven R. Pannone, P.E. P.O.Box 142025 Anchorage, AK 99514 L: L~TT. I LoT'I · 't'-o UJ ~L,M~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: ---'-'-'-'-'-'-'-'-'~'~-.'"~ LEGAL DESCRIPTION: L.~'T ~ L.oc.~.,~.../"~li~C~J~LL~ownship, Range, Section: SLOPE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 SITE PLAN WAS GROUND WATER ENCOUNTERED? S L IF YES, AT WHAT O DEPTH? p E Depth t0 Waler Alter Monitoring? ~ C~ ~ Date: ~ _.~'...oj q Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE __ (m~nutes/mch) PERC HOLE DIAMETER TEST RUN BETWEEN __ FT AND __ FT PERFORMED BY: ~'~;~'~-~likt'~J,"t'/¢ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: ~--/~ ~ PERFORMED FOR: Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST LEGAL DESCRIPTION: ~--t I~'~ "~.$"'"~ t T~-C~[ ~'I LL...~ Township, Range, Section: 1 2 3 4 5 7 8 9 10 11 12 13 14 15 16 17 18 19 20 SLOPE WAS GROUND WATER ENCOUNTERED? ~(~ S L IF YES, AT WHAT O DEPTH? p E Depth to Water After Monitorino? '-' C.~ ---' Date: SITE PLAN 3OMMENTS ~T ~-~ ~. ~ ~ Reading Date Gross Net Depth to Net Time Time Water Drop ~:~ I~" t" PERCOLATION RATE TEST RUN BETWEEN __ (minutes/inch) PERC HOLE DIAMETER ~ ~(~ FT AND ~ FT PERFORMED BY: ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4;85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: q-- ["~q 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 Location (site address or directions) Property owner Mailing address Lending agency Mailing address Day phone Day phone Agent Address Day phone Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: ~ 3. TYPE OF WATER SUPPLY: Individual well Community well Public water NOTE: TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site public sewer NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. '~' ," ,,, 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. NameofFirm ,~',~_.~,.c ~l~..~'~,,j,,~o,~ /~:::~,&_~' Phone' '~_=~-Zl-c~c~' Address Engineer's signature<,--~~~o'''- _ Date //'- J DHH'S 'SIGNATURE ~_' Approved for' ,~ ; Disapproved. Conditional approval for bedrooms. bedrooms, with the following stipulations: Additional Comments '3~h~ Mdni'ciP~lity of Ah~o~age Department of Health and Human Services (DHHS) issues Health Authority A~proval r-- , , · Cektificates based only upon the representations given in paragraph' 5 above by an independent Proi~ffssional engi.~?r~gistered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes a~'d the{~il~fidin~:i~s~i'tu'{ions in order to satisfy certain federal and state requirements. Employees of DHHS do not condu~Jt 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-O25(Rev. 1/91) Back MOA#21 Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST LegalDescription: /-(~ q~.~c~ /;J~l.[ '~z: ParcelI.D. O~'C>! ~ /~ ~' A. Well Data Well type<'-~d% c.t c_ Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. ADEC water system number Date completed Driller Cased to Casing height Wires properly protected (Y/N) FROM WELL LOG Date of test Static water level Well flow Pump level1 SEPARATION DISTANCES FROM WELL TO: / Septic/holding tank on lot Absorption field on lot Public sewer main Sewer service line g.p.m. AT INSPECTION ; On adjacent lots z g.p.m. '~- ; On adjacent lots Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Nitrate Other bacteria Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed c~ _ ~ _ 9 ~ Tank size Cleanouts (Y/N) ~ High water alarm (Y/N) Date of pumping t-~ ~,.~ Foundation cleanout (Y/N) ."~[ ~,, ~:~¢:> ~ Compartments Depression (Y/N) Alarm tested (Y/N) Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot To property line ~-.~t Suflace water/drainage On adjacent lots / ~c~ 'T Absorption field '~ ~ ~- _~--C~ -t- Foundation / o ~ Water main/service line "~ ~ ~ 72-026 (3/93)' Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Vent (Y/N) "Pump on" level at High water alarm level Meets MOA electrical codes (Y/N) Manhole/Access (Y/N) "Pump off" Level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot On adjacent lots Sudace water D. ABSORPTION FIELD DATA Date installed q -- cf -- .Length /-~ 0 ~ Width · TOtal absorption area z./c~ 'Date of adequacy test /'~ i. Water level in absorption field before test Peroxide treatment (past 12 months) (Y/N) Soil rating (GPD/FF) ! -Z ~/;r,,/ ~ Gravel thickness .~ -~ Cleanout present (Y/N) ~, E/4 ~.T~_) Depression over field (Y/N) Results (pass/fail) ~'~,..5-~ for ..~ ~.,~,~.'r~;C,~,"r~ If yes, give date System type qb e-~ 'T~ ~-ocl./- Total depth ,,' o ' Bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot "~/'~ To building foundation On adjacent lots / Surface water Curtain drain On adjacent lots /C,o TM Property line z./~. ~,, To existing or abandoned system on lot ~ Cutbank ..v/' r'~ Water main/service line Driveway, parking/vehicle storage area /~' (2::)" E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name .~--T-~,y~:- ~..~, Date //_~ HM Fee $ ' ,.'~ 00, o o Date of Payment I t-- 7-~ L~ Receipt Number ~ ~ ~ I ~ -7 7~"~._~ ) 72-026 (3/93)* Back Waiver Fee $ Date of Payment Receipt Number