HomeMy WebLinkAboutBLUEBERRY HILL BLK 2 LT 5050-
MUNICIPALITY OF ANCHORAGE
· DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVlRONIVlENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 99501 Telephone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
NAME PHONE I []NEW
Hamann Construction 694-2776I Ii'UPGRADE
MAILING ADDRESS
P.0. Box 617, Eagle River, Alaska 99577
LEGAL DESCRIPTION
Lot 5, Block 2, Blueberry Hill
LOCATION NO. OF BEDROOMS
Marc Dobkowski, Milehigh Rd. Mile 3.5 Eagle River {d. 4
DISTANCE TO: ] Well I Absorption area Dwelling PERMIT NO.
_o~ 98' 5' 25' 820785
I- 2 Manufacturer Material No. of compartments
~r~.~r Tank Steel 2
¢ Liq. capacity in gallons Inside length Width Liquid depth
1250 IF HOMEMADE:
~ ~ DISTANCE TO: Well Dwelling PERMIT NO.
~Z
O ~ ~ Manufacturer Material Liquid capacity in gallons
Well Foundation 40 ' 820?85
DISTANCE TO: 113 '
= ~ ~ N~ '~S PERMIT NO,
~ No. of lines1 Length of ~¢ine Total length of~ef Trench ~th Distance between lines
__ inches
~ ~ T~p of tile to fini¢ Crade Material beneat~ tile ~ Z 2 Z Total effectiv8 absorption area
~ Approx. p (varies) washed grave~ w- w inches 560 Sq, ft,
Length Width Depth PERMIT NO.
~ ~ Type of crib Crib diameter Crib depth Total effective absorption area
~ Well Building foundation Nearest lot line
~ DISTANCE TO:
M Class Depth Driller Distance to lot line PERMIT NO.
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
QTHER
PIPE MATERIALS
4" PVC, ASTM D3034
SOIL TEST RATING
125 sq. ft./bedroom
INSTALLER ~,,~
Hamann Construction
REMARKS
System placed in native ~-~_ , / ~ .
t J ~ .
material on leveled site
along steep gravel slope
~ ~ Vernon L. Roel~ · ,~-~
APPROVED ~~ DATE LEGAL~ot 5, Block 2, Blueberry Hill
72-013 (Rev. 3/78)
PERMIT NO.
I APPLICANT
LOCRT I ON
LEGAL
MUr~ ! C: ! PAL ! T'T'
DEPARTMENT O= HEALTH AND ENVIRONMENTAL ~ROTECTION
825 ' STREET, ANCHORAGE, AK.
264-4728
Or4--SITE SEWER LIPGRRDE PERMIT
( 828785 )
HAMANN CONSTRUCTION BOX 617 ~AGLE RIVER 99577
L5 B2 BLUEBERRY HILL
LOT SIZE 999999 SQUARE FEET
TYPE OF SOIL ABSORPTION SYSTEM IS: TRENCH
MAF(IMUM NUMBER OF BEDROOMS = 4
SO I L RATING < SQ FT/BR) = 1~'5
THE RE~JIRED SIZE OF THE SOIL ABSORPTION SYSTEM I~>__~/~
DEPTH= dL2 LENGTH= ~ GRR~'EL
DEPTH= 7
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).
.REQLI I RED SEPT I C TANK S I ZE= 1250 GALLONS
ii. 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 ) INSPECT IONS ARE REQU I RED
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 8 PRIVATE WELL TO A PRIVATE SEWER LINE IS 25 FEET AND
~ilTO A COMMUNITY SEWER LINE IS 75 FEET.
:i:OTHER REQUIREMENTS MAY APPLY. SPECIFICATIONS AND CONSTRUCTION DIAGRAMS ARE
AVAILABLE TO INSURE PROPER INSTALLATION.
I CERTIFY THAT
l: I AM FAMILIAR WITH THE REQUIREMENTS FOR ON-SITE SEWERS AND WELLS AS SET
FORTH BY THE MUNICIPALITY OF ANCHORAGE.
!i ~: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
~: I UNDERSTAND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLARGEMENT IF THE
RESIDENCE IS REMODELED TO INCLUDE MORE THAN 4 BEDROOMS.
__
APPL I CANT HAMAN~ CONSTRUCT I ON
........... V4. 0
[] SOILS LOG
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
825 L. Street, Anchorage, Alaska 99501 264-4720
SOILS LOG - PERCOLATION TEST
[] PERCOLATION
TEST
PERFORMED FOR: Marc Dobkowski
DATE PERFORMED= August 1 1, 1982
LEGAL DESCRIPTION:
1
2
Lot 5: Block ?;
GP, Fill Material
Light Brown
GM with some organics,
Fill Material
GP Light Brown
Native Material
7
8
9
Blueberry Hill
SITE PLAN
,-10
11
----~2
13
15
16
17
18
19
20
Tot.al Depth
Vernon l, Roelfs
No. CE 5107
WAS GROUND WATER
ENCOUNTERED?
COMMENTS
Marage under one
PSRFORMEO BY: Vernon L.
IF YES, AT WHAT
DEPTH?
72-008 (6/79)
end.
Roelfs
Reading Date Gross Net Depth to Net
Time Time Water Drop
RATE (minutes/inch)
TEST RUN BETWEEN
FT AND FT
le level house with
CERTIFIEDBY'~~ d .~~ DATE: 8-11-1982
April 6, 1978
Kenneth Cope
Box 4-307
Anchorage, Alaska 99509
Subject: Lot~Block 2 Blueberry Hills Subdivision
The water sample drawn from the above subject property
on March 30, 1978 shows a n~gative results for bacterial
growth.
The sewer systm on the same property shows no evidence
of a f&&ling system.
This letter does not constitute a~ approval from this
department.
If there are any further questions, please contact this
office at 264-4720.
Sincerely,
Robert C. Pratt, R.S.
Sanitarian
",:i,..-~'~'~, ~- ?~ .DEPARTML. ,'-0~',~- HEALTH-.AN]3 ENV{RONMEN L PROTECTION
~~'~ - ' ~ ~ 2 64 -4 72. 0 '
~ -'_ / -: Da. ived: L --
2. Time % 3. Time
Time 2.30 p.m. % ....
Date 3-2-0-78 Monday ' ~ -Date . _ Date
Insp pratt ~ ' ' _ ' ' Insp ,,,
. RE, Q U~S T FOR, APPROVAL. OF- INDIVIDuAL-SEWER, ....... AND- wATER. FACILITIES
Lendina Instituti°n Re Uest: Al&ska Bank of ~ommerce
Mailing Address: -~ ~hone..~- 276 2701
-Property Owner: Kenne~thA. CoPe' _ phone: 694-2393
Mailing AddresS: ~BOx 4-3'07 99509
Legal Descri
~ Single ~Family-ResidenCe: _(x). _ Number of Bedrooms:..Four
Multiple: Family ~Residence. ( ) Number- of. Bedrooms:
Welt System: Individual Well (x) Co.unity/public System ( ) '
Permit ~ ~ DePth of WetI 385' Well Log on Eile ( )
, COnstruction . BaCterial Analysis - ~ ,.
_ Sewage DispoSal sYStem: -On-site System ( ( )
Permi't ~ ', ,-Installed 1968 .. Installer .... ,
Septic Tank Size Manufacturer ....
Absorption Area Soils Rate Material
Distances: Well to Septic Tank .to Absorption Area
to Sewer Line Nearest Lot line Absorption Area
to Nearest LOt Line _
· MUNICIPALITY OF ANCHORAGE ~'--~
264-4720
.....~equest for Approval of Individual Sewer and water Facilities
1. Property Owner:
Mailing Address:
,,?hone:
e
Name of Buyer:
Mailing Address:
Lending Institution
Mailing Address:
Phone:
Phone:
Se
Realtor/Agent:
Mailing Address:
Legal Description:
Street Location:
Phone:
Single Family Residence:
Multiple Family Residence:
Number of Bedrooms: 4 Number of Bedrooms:
Water Supply: *Individual Well
If Individual Well, well depth
Public/Community System ( )
Public System ( )
If Community System, name of system
Sewage Disposal System: *~n-site System
If On-site System, date of installation:
*NOTE: A well log is required on ALL wells drilled since 6/75.
** If on-site sewer system is over two(2) years old, an adequacy
test is required by this department.
A fee of $25.00 must accompany each request before processing
can be initiated.
3/77
Affadavit Attached: (') ' Letter Attached:
Approved: . ' Date ..
Disapp Da ts
.i~' -- , · . ~ . . ~ . , ,~
Department Worksheet:
(e3e),sod snld) ,~O£--IlVIN O31.-IIJ. B33 BO:I J.d1333B
Municipality of Anchorage
Development Services Department .
Building Safety Division ·
On-Site Water and Wastewater Program '~~
4700 South Bragaw St.
P.O. Box 1~6650 Anchorage, AK 99519-6650
.. www. ci.anchorage.ak.us
(907) 343-7904
CERTIFICATE OF HEALTH AUTHORITY APPROVAL
FOR A SINGLE FAMILY DWELLING
Parcel I.D. _0~50 -- ~0~... I"7
GENERAL INFORMATION
Complete legal descriptio"n /-0'7'
Location (site address or directions)
Current Property owner(s) ~^VLL ~' '1'~ ~,~
Mailing address
Lending agency
Expiration Date:_June 15, 2004
Day phone
Mailing address
Real Estate Agent ~VA hol~ ~I-I,,
Mailing Address ~A.~: eb" ~L.'a.,f L'/~'~ ~ ~
Un/ess otherwise requested, HAA will be held by DSD for pickup.
NUMBER OF.BEDROOMS: .. ~
Day phone
3. TYPE OF WATER SUPPLY: ' Individual Well
..... !ndividual Water Storage
Community Class __, Well
Public Water System
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
Community On-site
Public Sewer
The Municipality of Anchorage DeveloPment Services Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 4 by an independent professional civil
engineer registered in the State of Alaska. CertifiCates of Health Authority Approval are required for the transfer of
title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water
supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority Approval are
valid for 90 days from the date of issue for propedies served by.a private o~ Class C well and may be reissued with
new water sample results. (Certificates may be reissued for a pedod of Up to one year with valid water samples.)
Certificates are valid for one year for properties served by Class A or B wells or a public water system. The
Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work.
e
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,
based dn procedures outlined in the Health Authority Approval Guidelines for this application, shows that the on-
site water supply and/or wastewater disposal system is(are) safe, functional and adequate for the number of
bedrooms and type of structure indicated herein. I furthe'r~verify that based on the information obtained from the
Municipality .of Anchorage files and from my investigati~'n and inspectio, n, the on-site water supply and/or
wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances,
and regulations in effect at the time of installation.
Name of Firm i ¢~ j,~,,
Address ~-0'~b I,~ 1~-~
Engineers.Printed Name
bedrooms.
DSD SIGNATURE
Approved for
Date 0"/t~ )o ~ ..
Disapproved. . -
w,z,x Conditionalapprovalfor 4~._ bedrooms, with the following stipulations:
Money in the amount Of 1~5 times the high bid of a minimum of two bids from approved
pumPers Shall be put in escrow to pump th~ Septic tank on the subject property by
no later than June 15, 2004.
has 8iven final approval.
Additional Comments
Money in escrow shall not be released until this office
Attachments:
HA,& Checklist
· Septic System Advisory
' Well Flow Advisory
Maintenance Agreements
Supplemental Engineer's Report
Other
Original Cedificate Date: March 15, '2004
(Rev, 01/02)
· , Mumcmah Anchorage
Developme s DePartment
Build!ng Safety Division
On-Site Water & Wastewater Program
4700 South Bragaw St.
P.O.Box 196650 An~:h0rage, AK 99519-6650
I www.~:i.an~;h6rage.ak.us
(907) 343:7904
HEALTH AUTHORITY,APPROVAL CHECKLIST
Legal Description:
A. WELL DATA
Well type ~
Date comPlete~
Total depth ~2~ ft.
Date ofte~t
if A, B, or c provide PWSI'D #
I
Sanitary seaJ (Y/N)'
Cased to .
FROM WELL LOG
g.p.m.
Nitrate o. iq _¢ mg./l.
Date of samplei '2',//5/: Y
Static water level
Well productioh
WATER SAMP~.E RESULTS:.
Coliform FO ! , colonies/100 ml.
Arsenic: v'¢,. mg./i.
SEPTIC/HOLD'lNG TANK DATA
Soil rating (g.p.d./ft
Parcel iD: ii i .
o$o-zoz- 17
Well Log ~/N) .~
Wires properly protected (Y/N) ~-/
uasing height (above groom,d) ! ~ in.
· AT INSPECTION
Be
ft
~g
Tank Type/Material ~.er) L~&. / 5'll'~--~'("
,, Tank size ~/~'~} gal. .. Number of Compadments ~
Foundation cleaneut (Y/N) '"¢- Depression over tank (Y/N)
Date of Pumpin~l :('~ .~ ~--~¢~',,,mumper
'. ~C..' ABSORPTION ;FIELD DATA .
Date installed ~[~ ~
Length : ~. I~O ft.
,. Totaldepth' /~ -ft.
','. Date of adequacy test
Fluid depth'in ab, sorption field before test ~ in.
Elapsed Time: ,1~o min. Final fluid depth .~
^ny rejuvenatiofi treatment (past '12 mo.) (Y/N 8, type)
Other bacteria
:~ colomesllO0 mi.
Collected by:
Date installed
Cleanouts (Y/N) ! 1
High Water alarm~(~', i)
System type' 'i~ ~4 ~4
Width ~:~ ft. Gravel belo~ Jpi~ 7' :' ft.
Eft. absorption area '~'O ft2 Monitoring tube ~ Depress,6n ~ver field ~
~/~//0 ~ Results(Pass/Fail) ~ '"'~
. ' FOr bedrooms
Water added ¢0Ogal. ~e~ depth ~ ~in.
g.p.d.
D. LIFT STATION
Se
S~ize'in ;
/ gallons
"Pump off' level ~t
Cy~:les tested
Date installed
"Pump on" level at''"~'
Datum
SEPARATION DISTANCES
SEPARATION DIsTANcES FROM WELL ON LOT TO:
Septic tank/lift station on lOt:
Absorption field on lot i '{ !:(.~
Public sewer main' i =
Sewer/septicI service lirie "7 0
Property line t 0 "
Water Service line
Curtain drain i'~ I O .
· Manh N)
ih.' '.: :' ,J;IY'gh'water alarm level at
alarm
&
circuit
requirements?
L~
On adjacent lots
On adiacent lots
Public sewer manholelcleanout
Holding tank
SEPARATION DISTANCES FROIV{ SEPTIC/HOLDING TANK ON LOT,TO:·
Building foundation
Water main I"t/,'z~'! Water service line
Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
'B~,uilding founda~tion
~Surface water t'~ [ O I '
Wells on adjacent lots
F~ COMMENTS
HAA Fee $
Date of Payment
Receipt Number
(Rev, 12/01)
Absorption field ..~
Surface water ['-4, I'~
Water main ~/,Z.~
Driveway, parking/vehicle storage
ENGINEER'S cERTIFICATION ,; , 2' :'
review of Muhicipal rebb~.that'~hb ab&Ve sy~leMs are in
~on~o~'~i~h MOA H~ g~d~/(~ ~ ~ o~ ~h~ d~.. i
Engineer's Printed Name .~'.~ ~.~ ',o !~u ~t~
"
waiver Fee'S
,' Ii' ''
Date of Payment
Receipt Number
in.
A/~Gka
or ~0. ~ 770197
Fax GSa.~aS ~7~ CE~IFiED PUMP
o-' - N~ 99i7.
~t ~e on acei~ ~ I~l~ unless mer a~men~ m~.
~t~n P~e ~ount
¥ C~dltlon
' Ple~n pay by lnvelee, All ~GOU~I Pelt Due will b ~ha~ 1~%.
~5 ~d' b~0 ~e~. ·
THANK YOU
LL..
T. SPURKLAND P.E.
203 W. 15th. AVE. SUITE 203
ANCHORAGE, ALASKA 99501
(907) 279-3916
Fax (907)-276-6013
Municipality of Anchorage
Development Services Depamnent
On Site Water and Wastewater Program
4700 South Bragaw St.
Anchorage, Alaska 99519
February 23, 2004
Subject:
Waiver Request
Lot 5, Block 2 Blueberry Hill S/D
PID 050-202-17
Gentlemen;
We are applying for a 52foot waiver of the separation distance required between the septic tank and the well serving this
lot.
According to Municipal files, a well and septic system was installed on this lot was installed in 1968. The septic system
was replaced in 1982. The As Built of this septic system shows a separation distance of 98 feet between the well and the
septic tank. Apparently the installation was approved without the granting of a formal waiver. At this time we are
applying for a On Site System Approval, and request that a formal waiver be granted.
The drive way to the residence is very steep, and at this time very icy. A septic tank pumper will not be able to access
the tank at this time. Please issue a Conditional approval, with pumping of the septic tank after break-up as a condition.
Yours
ASBUIL'r
S~4ARD & ~SOC/AT~ L~'D SUR%~/I~G 69fi-0829.
I HEREBY CERTIFY ·THAT ! HAVE SURVEYED THE
FOLLOW;NS D~S ~:RIB~..D PR OPgRTY,
INDICATFD. IT !$ THE RF.~BILITY OF' ~E
~~, ~TS, OR ~l~l~S
WHi~ ~ NOT ~R ~ THE R~
VIS:ON ~T. U~ NO CIRC~C~
~Y DATA H~ ~ U5~ ~R ~~ION
ARY LINES.
DATE,./. .
DRAWN,
Municipality of Anchorage
Mark Begica, Mayor :~~
P.O. Box 196650 · 4700 Bragaw Street
Anchorage, Alaska 99519-6650 · (907) 848-8301~ Fax (907) 843-8200
http://x~a~v.muni.org
03/18/2004
Tobben Spurkland
203 W 15th Avenue, #203
Anchorage, AK 99501
Subject:
Waivgr-R~-e-~i 'i~67~i~iiS'e-ri~3I-iifiSi ~ C~ '5 -i50'i-5- ............................................ ...........
Waiver Request #WR040012
Parcel ID #050-202-17
Dear Mr. Spurkland:
Your request for a waiver of the required 100 feet horizontal separation from the Septic
Tank to the Well has been approved. The approved separation distance is 98 feet.
This waiver approval applies to the existing Septic Tank to Well separation only. Any
future upgrade to the on-site wastewater disposal system' will require all separation
distances be met or another approval from this department.
If there are'any further concerns or questions regarding this waiver, please call our office
at 343-7904.
Sincerely,
Daniel J. Roth
Civil Engineer
On-Site Water & Wastewater Program
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water and Wastewater Program
4700 Bragaw Street
P.O. Box 196650 Anchorage, AK 99519-6650
www.ci.anchomge.ak.us
(907) 343-7904
Waiver Review Worksheet
WR#: 040012 PID#: 050-202-17
HA#: 040055 Permit#:
Date Received: 0212312004
Legal Description: Blueberry Hill Block 2 Lot 5
Engineer: Tobben Spurkland
203 W 15th Avenue #203
Applicant: Marc & Dean Dubkowski
Waiver Requested: 98 foot waiver Separation Distance bebNeen the Septic Tank and the Well.
Criteria: Geology Points:
A. Water Table
B. Soil Sorption
C. Permeability
D. Water Table Gradient
E. Horizontal Separation
Total:
Waiver is Granted: ~ Waiver is not Granted:
List Conditions or Reasons for above:
Date: .~/;~//O ~~' By:
Name of Reviewer
~mm~~~mm~~~mmm~mmmm~~~m~~~mm~~~mm~~mm~~~~~~~m~~~~~mmmm~~mmmmmm~mmm~~~m~~mmmm~m~~
Rec#: 48522 Amount: $920.00 Date Paid: 3117/2004
I
ou-zoz- w~r~ w~ 7'0 ~r~c T/g/W~
X = ,~IZ-I- 2.0
Re
2-,0
15-.8
J
T. SPURKLAND P.E.
203 W. 15th. AVE. SUITE 203
ANCHORAGE, ALASKA 99501
(907) 279-3916
Fax (907)-276-6013
Municipality of Anchorage
Development Services Department
On Site Water and Wastewater Program
4700 South Bragaw St.
Anchorage, Alaska 99519
February 27, 2000
Subject:
Waiver Request
Lot 5, Block 2 Blueberry Hill S/D
PID 050-202-17
Gentlemen;
We are applying for a 2 foot waiver of the separation distance required between the septic tank and the well serving this
lot.
According to Municipal files, a well and septic system was installed on this lot was installed in 1968. The septic system
was replaced in 1982. The As Built of this septic system shows a separation distance of 98 feet between the well and the
septic tank. Apparently the installation was approved without the granting of a formal waiver. At this time we are
applying for a On Site System Approval, and request that a formal waiver be granted.
There is no well log on file for this property, but I have enclosed copies of three well logs in the immediate
neighborhood. These logs are very similar, showing bedrock at less than 40 feet, with water bearing soils above
bedrock. The reported water yields are also similar, 5-6 gallons per minute.
Water samples collected in February 0f2004 show no contamination. The Nitrate level was 0.199 mg/l which is well
within the expected background level.
The topography of the site is such that waste water from the tank or the absorption field will flow away from the well.
The 2-feet discrepancy between the required separation distance and the actual distance poses no danger of
contamination this well.
The drive way to the residence is very steep, and at this time very icy. A septic tank pumper will not be able to access
the tank at this time. Please issue a Conditional approval, with pumping of the septic tank after break-up as a condition.
Yours