HomeMy WebLinkAboutBRUIN PARK BLK 5 LT 10 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
Permit Number: ~ ~"'j ~'"/I PID Number: E)t~ t[I
Name[~ ~i~... , ~"~t'~C.x~,3 _~u. ~. WastewaterSystem: ~New ~ Upgrade
Address:
Chono: ~o. o~odrooms: ~eep Trench ~ Shallow Tronch ~ Bed ~ Mound
L E G A L D E S C R I PTI O N So~l Rating:o.~GPD/Sq.Ft. TotalDepth~f?omoriginalgrade:
Lot: Block: Subdiv~ion: Oepth to pipe bottom from original grade: Gravel depth b~neath pipe
Township: ~ Range: Section: Fill added above original grade: ~ Gravel len~ I
Number of lines: ~Distance baleen lines:
WELL: ~New D Upgrade Gravel width:~ Ft. I, --
Classification
~ (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material:j
Date Drilled: Static Water Level: Installer: Date installed:
Yield: ~ Pump Set at: ~sing Height Above Ground: TAN K
I ~ GPM ~ Ft. ~ Et
SEPARATION DISTANCES ~Septic ~ Holding~ S.T.E.P.
TO Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons:
From Tank Field Station Tank Sewer Lines ~~ ~ ~ J ~
Waif j~l~ ~ ~ ~ ~ ~ ~ ~ ~ I~ Material: ~~ Number of~Compa~ments:
S~,~ce ~ ~ LIFT STATION
/
Lot I /~ , ~~turer:
Line I~ ~ + ~ ~ ~ ~
Foundation [o'~ ~ ~ -- ~ .¢um~ on,, level ~t:
Remarks: ~ ~ ~ ~,~-_ ~v~ BENCH MARK
Location and Description:
- ~ Assumed Elevation:
ENGINEER'S SEAL
Department of Health and Human Se~ices approva~ 5, ?~'..~ ,. ~ ~, .,~'~
Reviewed and approved by: ~ ~~ Date: ~/~ "~ '~'{~{'{~"
72-013 (Rev. 9/91) MOA 25
AS-~BUILT SYSTEM ]DETAILS/SITE PLAN Pe~-m~ swsTooTi
BRUIN PARK, BLOCK 5, L[]T 10 PID~O16 111 36
P~BP~S B E~
0 WELk
I ~ ~ ; I
U I I
s-c=ls,a I't , / 1
A-D=41,5 i ~
B-E=a5,5 ~ --
A-F=27,1 SCALE, 1" =
3-F=54,3
~ d ~ d ~
~ FJNJSHE~ GRA~E
~ I
U - alaGO GAL
/
~/~Ta.X ~ ~X~R R~
KENNETH M. ~US
~ ~P~O~ssI0~ ~
°° ?~ FINISHED GRAI]E (~
~lBGO GAL
/I SEPTIC ~ ~ ~
~' I TANK~ SE~ER RBCK
SCALE~ NTS
PREPARED FOR: KND ENGINEERING
LEE BAKER P044~ PTARMIGAN BLVD
DISCOVERY CONSTRUCTION, INC, EAGLE RIVER, AK, 99577
P,B, BOX 11-1411 (907)696-6111/F~x (907)696-8111
ANCHORAGE, ALASKA 99511 DATE~ 8/18/97 DRAWING ~
SCALE: AS NOTED 970aD-Si
..~,~" --'J STATE OF ALASKA
~,-" DEPARTMENT OF NATURAL RESQURCF. S "
O1Vl$1ON OF MINING & WATER MGMT
WATER WELL R.~ECORD
LOCATION OF WELL
BOROUOH SUBDIVII~,ION~ LOT BLOCK $£CTIoN QTR8 SECTION TOWNSHIP RANGE ~AN
,/ I' ,,, ,' , I" ,, ,~' .I~, ',.t., ~..r. . ~
DEPTHS M~SURED FROM:~asinfl top ~grour~d surface WELL DEPTH: '[ ' 'DATE OF COMPL~ION
Material Type and Color ,Fr~m To ' ' '
~ DEPTH TO STATIC WATER L~EL: /'
, ', ~ 0 ~- , _.. m~. ft below ~top of casing~ ground
· ,, ~ perforated .~ open hole
G~V~L PACK TYPE:
.. Volume used: Depth to top:
,,, D~ELOPMENT M~HOD:
Municipality of Anchorage PUMPING L~EL AND YIELD:
Dept. H==l~k ~ Human Serwces ..... /~ ft after ~ hrs,?u.mping , / ~ ~gpm
PUMP INTAKE DEPTH: ft Horsepower: ~
WELL DISINFECTED UPON CQMPL~ION? ~ES ~ NO
CONTRACTOR INFORMATION: REMARKS:
DNR/DIVISION OF MINING & WATER MGMT
Signature of" A'ufh0ri~d Respresekta~e Date 3601 C St, Suite GOO
ANCHORAGE AK 99503-B935
Phone (907)269-8639, Fax t907)562-1384
PAGE 1 OF 1
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PERMIT NUMBER:SW970071
DESIGN ENGINEER:KND ENGINEERING
OWNER NAME:BROADY JAi~ES T
OWNER ADDRESS:Il231 POLAR DR
ANCHORAGE, ALASKA 99516
DATE ISSUED: 4/24/97
EXPIRATION DATE: 4/24/98
PARCEL ID:01611136
LEGAL DESCRIPTION:
BRUIN PARK BLK 5 LT 10
LOT SIZE: 20000 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT:
THIS PERMIT IS FOR THE CONSTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL 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.
SPECIAL PROVISIONS:
DATE:
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)696-6111/FAX (907)696-8111
April 13, 1997
Municipality of Anchorage
Dept. of Health & Human Services
On-Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519-6650
Subject: New sewer/well permit - Bruin Park S/D, Block 5, Lot 10
Gentlemen:
On April 5, 1997, we excavated two testholes for the subject property. The results of
these tests and water monitoring are attached.
We propose to install an 8' deep 2' wide trench. There was no water found after one
week of monitoring. Additional fill will be placed over the system to provide a
minimum of 3' of cover when complete if required.
There are no public or private wells within 200' of our proposed system location
except as noted. There is neither surface water within 100' nor any curtain drain
within 50'. The surrounding lots are developed and we do not expect that there will
be any adverse effect on adjacent lots by the development of this system.
If you have any questions, please contact me at 696-6111/FAX 696-8111.
Respectfully submitted,
II~1~I~ Engineering
Kenneth M. Duffus, P.E.
attachments:
On-Site Well and Sewer Application
Wastewater Absorption System Details/Site Plan
Soils Log/Percolation Test
WASTEWATER DISPOSAL
BRUIN PARK, ]SLOCK
~"x SEPTIC
WELL0 xx .
~LOT ¢
11
SYSTEM/SITE
5, LOT 10
LOT 22
0 WELL
LOT 21
0 WELL
LOT
T 19
SEPTIC
SEPTIC
SEPTIC
PLAN
30' ',30'
LOT 12
ND SEPTIC SYSTEMS WITHIN 200' OF
PROPOSED WELL, EXCEPT AS NOTED.
NO PRIVATE OR PUBLIC WELLS WITHIN 200' OF
PROPOSED SYSTEM EXCEPT AS NOTED.
DESIGN CRITERIA
1, 4 BEDROOMS X 150 GAL/DAY/BEDROOM = 600 GPO
2, SOILS RATING~ 8 MIN,/INCH = APPL, RATE 0,8 GPD/SF
3, 600 GPO/O,8 GPD/SF = 750 SF
41 750 SF /(2' x 8') = 46,88'L
5, MIN, DESIGN SIZE = 1 TRENCH - 47' LONG x 2' WIDE x 8' I]EEP
6. DEPTH OF GRAVEL BELOW PIPE IS 8',
7, TOTAL DEPTH OF SYSTEM IS 11,0' FROM ORIGINAL GRADE,
NOTES: ' 1. USE 1250 GALLON SEPTIC TANK, INSULATE TANK IF <,4' COVER,
2, INSULATE TRENCHES WITH 2' HI] BURIAL FOAM IF <'3' COVER,
3, CONTRACTOR WILL ENSURE MAXIMUM aY. SLOPE INTO SEPTIC TANK,
PREPARE]] FOR~
LEE BAKER
DISCOVERY CONSTRUCTION, INC,
P,O, BOX 11-1411
ANCHORAGE, ALASKA 99511
KN]] ENGINEERING
20441 PTARMIGAN i'BLVD
EAGLE RIVER, AK, 99577
(907)696-6111/Fox (907)696-8111
DATE,4/13/97 REV,4/lG/97 DRAWING if
SCALE, 1' = 100' 970a3-si
Municipality o! Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
2
3
4
5
6
7
8
9
10
'11
12
13
14
15
16
17
18
19
20
COMMENTS ,
~OH.
PERFORMED:
DATE
~ownship, ~an~e, Sectioa:~/
SLOPE SITE PLAN
WAS GROUND WATER
ENCOUNTERED? NO
IF YES, AT WHAT
DEPTH?
I
A
Deplh Io Waler Aller ,~// /C] 7
Monitoring? ~f'~ Date:
Gross Net Depth to Net
Reading Date Time Time Water Drop
/ /./-~-77 i~:,/z --- 7,, __
w~ 1~,- ,,~'~/~,~' lo, ~-¢' _~, ',~7,~ -
//:6¢' /~ ,,¢,~ " / ~ "
w~l~~ //:/~ -- ~'" --
//..~ /~,~ ~ Yz" /~"
~ '
PERCOLATION RATE ~,~/5 tm,nutes/,nch) PERC HOLE DIAMETER
72.008 (Rev 4/85)
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
PERFORMED FOR:
LEGAL DESCRIPTION: -~f'U~,i fl 'Po,,v,k ':~lk ~ Lo+/O Township, Range, Section:
WAS GROUND WATER
ENCOUNTERED?
2
3
4
5
6
7
8
9
10
'11
12
13
14
15
16
17
18
19
20
COMMENTS
SLOPE SITE PLAN
S
IF YES, AT WHAT
DEPTH? /~/,~, 0
P
E
Depth lo Waler
Moniloring? ~'J..'"~'~ Dale: z~//~'/~7
Gross Net Depth to Net
ReadingDate
Time Time Water Drop
! q-~W7 //,'~¢: - z¢~,~'' -
//.' f/? . /o ,¢ /~ /¢" / 7~ "
~/~ ~¢~ /I.'¢~ ~ ~ ~ ', ~
" i/.'~-~- /0~,~ //2" I /¢"
/~.'~ /~,~ 2 ~" / Y~ "
/~.'/~ /~,~ ~/~ .. / ~ .,
PERCOLATION RATE ~ tm,nutes/,nch) PERC HOLE DIAMETE
12-008 (Rev 4/851
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
QF~i~,ONMENTAL :~ENVICE$ DIVI,S',GN
AUG 1 9 1997
Parcel I.D.
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING R E C E IV E D
1. GENERAL INFORMATION
Complete legal description '-'~~ ~=,~ziZ_
Location (site address or directions)
Property owner
address
Mailing
Lending agency
Day phone
Day phone
Mailing address
Agent
Address
Day phone
Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS:
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/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 KND Engineering ,.. Phone
Address Eagle River, AK 99577-,e7.'~
Engineer's signature ,~~. ~ Date ¢1,~/~?
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 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~¢21
ENVIRONMENTAL SERVICES DIVISION
AUG 1 9 1DB7
Municipality of Anchorage r~ r'/-.
DEPARTMENT OF HEALTH & HUMAN SER~ii;;l~.E I ¥ E D
Environmental Services Division
825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744
Health Authority Approval Checklist
Legal Description: '"~'t'z~.~ ~,4~.~L.. L t,~. c~ ~' Parcel I.D.:
Cased to
FROM WELL LOG
A. WELL DATA
Well type '-"~-%d ~
Log present (Y/N)
Total depth 1'7_ ~
Sanitary seal (Y/N)
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed
Casing height (above ground)
g.p.m,
Wires properly protected (Y/N)
AT INSPECTION
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
Coliform
Date of sample:
B. SEPTIC/HOLDING TANK DATA
Date installed ~--'~ Icl~ Tank size
Foundation cleanout (Y/N)
Date of Pumping -~-
C. ABSORPTION FIELD DATA
Date installed . ~-----J"/\
Length ~ ~.~' Width
Effective absorption area "7'~'7
Date of adequacy test - ,
Fluid depth in absorption field before test (in.);
Fluid depth -'-- (ins) Minutes later:
Peroxide treatment (past 12 months) (Y/N)
Nitrate
g.p.m.
Collected by: ~d..'~
Other bacteria
~,,3~ .~~ ,.~ (~
i--~'~ Number of Compartments ~- Cleanouts,(Y/N)~__
Depression (Y/N) ~ High water alarm (Y/N) '---'
Pumper '---'
Soil rating (g.p.d./fF or fF/bdrm) C). ~.~
Gravel thickness below pipe
System type 'b~--~-l~
Total depth Ir
Monitoring Tube present (Y/N)_._~{__ Depression over field (Y/N) q
Results (Pass/Fail) ----- For --'--
bedrooms
---- Immediately after. ~----cjal. water added (in.):
Absorption rate = - .g.p.d.
'-'"-' If yes, give date '-"-"
72-026 (Rev. 3/96)*
D. LIFT STATION
Date installed
Size in gallons
Manhole/Access (Y/N)~ "Pump on" level at*-"-'-'-'----------__ ,P~ump off" level at*
High water alarm level at* ~ *Datum
Cycles tested ~
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot tc:~
Absorption field on lot t¢:~~ 'l--
Public sewer main
Sewer/septic service line
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation icc:, -f- Property line ~ Absorption field I~m
Water main/service line to t 4- Surface water/drainage ['~,-~t-+- Wells on adjacent lots
F.
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Property line
Building, foundation [ o' 4--
Surface water
Curtain drain'~ I.~,o [ -~
ENGINEER S CERTIFICATION
Water main/service line ~o 4--
Driveway, parking/vehicle storage area
Wells on adjacent lots I.c~ .~.
I certify that I have determined thru field inspections and review of Municipal records
in conformance with MOA HAA guidelines in effect on this date.
Signature ~-~'~~ ~ .~~ ~
Engineer's Name /~'~Tr~
Date ~//~/~?
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
NORTHERN TESTING LABORATORIES, INC.
3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 456-3116 · FAX 456-3125
8005 SCHOON STREET ANCHORAGE, ALASKA 99518 (907) 349-1000 · FAX 349-1016
KND Engineering
20441 Ptarmigan Blvd.
Eagle River, AK 99577
Attn: Ken or Dee
Our Lab #:
Location/Project:
Your Sample ID:
Sample Matrix:
Comments:
Lab
Number Method
A151287
Bruin Park - Lot 8
Water
Parameter
Units
Report Date:
Date Arrived:
Date Sampled:
Time Sampled:
Collected By:
08/14/97
08/13/97
08/13/97
1500
Kelly
** Definitions **
B = Present in Blank
H = Above Regulatory Max
E = Estimated Value
M = Matrix Interference
D = Lost to Dilution
MDL = Method Detection Limit
Date Date
Result * MDL Prepared Analyzed
A151287 SM 4500E Nitrate-N
mg/L
<MDL 0.10 08/13/97
p e y Daniel J
Operations Manager
Bacon