The URL can be used to link to this page

Home My WebLink AboutSOUTHPARK #2 BLK 3 LT 19 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES Environmental Health Division 825 "L' Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES ./4/c/~ ~e~ / ~£r/'///o4 FROM'~"~-.......~ SEPTIC ABSORPTION WELL Addre~ TANK FIELD Phone(s) -- LEGAL{E~:p~fjPermit N~. No. of 7rooms L0T uNEWELL /~' I ~;o~ P~r& ~/~ ~ FOUNDATION Township, Range, Section ~ /Z q AS-BUILT DIAGRAM (Show location ol well, septic system, prope~y lines, [oundation, //~ ~ ~/~ ~(~ 3 ~ ~ ~ -~ ~ ~ driveway, water bodies, etc.) TANKS N ~ SEPTIC ~ HOLDING TYPE OF SYSTEM S TRENCH g BED ~ W. DRAIN ~ OTHER Depth to pipe bottom from Total depth from original grade ~' original grade ~ / FT ~, _?~ FT Fill added above original grade Gravel depth beneath pipe ~ ET ¢ ~ Gmvel length Gravel width FI ~; ,~. Total a~sorption ama Distance between lines ~ sg FT ~ / FT Number of lines Soil rating Pipe material Installer Date Ins~alle~ WELLS ~ PRIVATE ~ OTHER ~ ~ -- C~a~ifica0o.(A.~,C) ~ Casedto .: -- $O/ Ins~ Date Ins,aired: ~ ' REMARKS: ~ ~ ~P.~i Scale: ENGINEER'~ ~EAL I [ ~ /~ ~ ce~ily thatlhis inspe~io~ was p~dormed according to all .unicipal and State guidelin, i. efta. o. this dale: /~//¢7 Health .epadme., Approval: ~0"~ S~'~ 72-013 (3/85) J:::'~ f' (::: (.:~ ], ]] cJ -" ']'H]:~i~ SY[3-FEM I!~ 'TC) BE :[IxI[:I'I"AI,..,I.,..I!~:)L-,~ IN ACC:DRDANI:::E: W I"FH THE AI::'F,'F(CIVED Ei:N['):[NE:;EFt'S I)ESIC{)N. DI*IHB FILII3T DE: IxI[:I'TIF':[[~:i) F'Fi'.IDR TO) EI~CH lhlEJPE[CT .... 13NLY~ ~ND.EXI:'ZI::IEI3 DN :1.;2/:3:1./[]9. P~ L. ZFT I~TPFT'ZC)N ~]ILL RE:DUI[RE ']'HE: (~F:'PRI3F:'I;:;:]:~TE: IEL.I~C'f'F/]:C(~L, IN$:iPIEC']'IDIq. ]: []EI:TI'!F:'Y THAT: ~.~ I am (ami].iaP w:i.t.h t. he r(eqL.~il~em-~.nt.s {cra i_~n-~.~:Lt.e sewer,s and wel],s~ as set. ~'(~r't.l'~ by ?,.hoe J~L~riicij:)a].i'J:.y ~][ (-~n~ch~:ma~.]~e (FI~) and 'l'..he ~t. atce o[ (~laska,, :[ will J,n~i'l'.al], 'Lhla ~)/~st.t~lfi :i,n ac:i:::c~p(:lai'ic:[~e ~i'~.h ail and in [:Oml:]lJ, anc:~ ~it.h t.h~ de)sign c:r.i'Le~p:La tit' th;L~ pe:,PmiC,, ALASKA nUIROnmEnTAL conTROL SE[qUICkS, ~nqineedmI 5 ~nuironmenlal Studies InC. SPECIFICATIONS FOR BED WASTEWATER TREATMENT SYSTEM LEGAL DESCRIPTION: LOT 19, BLOCK 3, SOUTH PARK ADDITION #2 i.0 GENERAL 1.1 The Drawings, sheets 1 through 5, shall he part of this specification. 1.2 All materials and workmanship shall meet the requirements of the Municipality of Anchorage, Departmeut of Health & Human Services (DHNS), the conditious of the permit, and all applicable rules regulations curreutly in effect. 1.3 All excavations aud depths are advisory, aud are to be verified or modified in the field by the Engineer or inspecting agency. 1.4 It is the responsibility of the property owner or installer to adhere to approved design for the installation, to maintain the specified separation distances and to have the appropriate inspections. 1.5 It is 'the responsibility of the property owner or installer to report to tile engineer any observed conditions which would put the system in violation of state or Municipal regulations. 1.6 If the installation is not inspected by an AECS eugiaeer, AECS will not be responsible for the installed system. An engineer at AECS should be consulted prior to construction, to determine tile number of inspections that will be required and to explaiu what these inspectious will involve. and 2.0 SEPTIC TANK 2.1 If there is an existing septic tank it may be used if it meets the capacity requirement for tile residence. The structural integrity of the tank must be verified, 2.2 The septic tank shall be a UPC-approved two-compartment tank, constructed of 12 gauge steel with bitumastic coating and set level on undisturbed soil. If the tank is buried at a depth of 4 feet or less, it must be insulated with an overlying layer of 2 inch burial type polystyrene rigid board insulation. 2.3 2.4 2.5 2.6 2.7 The septic tank shall be a minimum of 5 feet from the house foundation, and a minimum of 5 feet from the absorption area. The septic tank and bed shall be a minimum of 100 feet from any private well or body of water, 150 feet from Class "C" wells, and 200 feet from Class "A' or "B" wells, unless otherwise specified. Less than the required separation distance must have prior approval or waiver by DHHS or Alaska Department of Environmental Conservation (ADEC). Piping shall be fitted with a mechanical watertight calder coupling on the outlet aad inlet of the septic tank. Piping shall be 4 inch solid PVC ASTM D-30g4 or cast iron, sloped a minimum of 1/4 inch per lineal foot on tire inlet side and 1/8 inch per foot on the outlet side. If tire piping is buried at a depth of 4 feet or less, it must be insulated with an overlying layer of 2 inch burial 'type polystyrene rigid board insulation. Cleanouts shall be installed as designated and capped with air-tight rain caps (Jim Caps or equivalent), and extend a minimum of 1 foot above ground level. If a lift station is required it shall he a combination lift station septic tank per Anchorage Tank and Welding, Inc. design. Specifications and design drawings are on file with the municipality and the engineer. 3,0 SEEPAGE BED 3.1 The gravel for the bed shall be 0.5 to 2.5 inch, screened rock with less than 3 percent passing tlre No. 200 sieve. All substitutes must have prior DHHS approval. 3.2 The bottom of the excavation shall be level and raked with tire backhoe blade to ensure that the bottom has not been compacted during excavation. 3.3 Sand, for leveling, shall have a size distribution which meets the reqnirements of MOA code 15.65.077. 2.4 The distribution pipe shall be perforated 4 inch rigid PVC with a minimum crush strength of 1500 3,5 3.6 3.7 3.8 pounds and shall meet the approval of DHHS for as drainfield pipe. All pipes shall be laid level, and spaced according to the drawings. Monitor standpipes shall be placed as shown in tile drawings. They shall be 4 inch rigid PVC ASTM D--3034, or cast iron, The section shown with holes may be either drilled 0.5 inch holes on 6 inch centers on opposing sides of the pipe, or a section of regular perforated sewer pipe may be clamped to the solid section with a no-hub coupling or solvent joint. The perforated section of tile monitor tube shall be located ill gravel only. The portion of pipe above the sewer rock shall be solid. A rubber raincap (Jim Cap or equivalent) shall he placed over the top of the pipe. Insulation is required, using burial type polystyrene rigid board insulation. There shall be 1 inch of insulation for every foot of soil less tbaa tile required 4 feet of cover, but there must be at least 24 inches of soil even though insulation is used. The solid pipe exteading from the septic tank to the drainfield shall also have a minimum of 4 feet of cover or an equivalent layer of insulatiou combiaed with soil. The side slope of the mound shall be slope 1 foot vertical to 3 feet horizontal. The bed shall be planted with a white clover and red fescue mix, or with Kentucky bluegrass. 4.0 INSPECTIONS 4.1 This bed will reqnire a minimum of three inspections. The first inspection will be of the open excavation, to assure that the system is installed in the proper soil strata, correct depth and meet minimum specified design parameters. 4.2 Tile secoad inspection will be after placement of gravel, monitor standpipes, and distribution pipe, to verify proper installation and position of pipes prior to backfill. 4.3 The third inspection will be after final backfill grading and seeding to ensure that adequate soil cover has been provided over tile bed. 4.4 4.5 The inspection of the septic tank or lift station installation can be incorporated with any one of the above listed inspections. The lift station will require either an MOA electrical inspection or certification by a licensed electrician depending on whether the building code applies to this part of the city. ALASKA ENVIRONMENTAL CONTROL SERVICES, INC. ,, 1200 West 33rd Avenue, Suite B ANCHORAGE, ALASKA 99503 (907) 56].-5040 CHECKED BY. CATE SCALE v Z t- H J 0 J 0 ,~ rr 0 Z 0 rr o 0 Z 0 -PLOT PLAN * ~.. MuniciPality °f Anch°rage DEPARTMENT OF HEALTH & HUMAN SERvICEs 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG ' PERCOLATION ,EST LEGAL DESCRIPTION: ~/~ ~ '-~ ~-O~J~/~ F~"~ ~f~-' Township, Range, Section: ~//~J~-.Tz.O ~'~..~ ,5-/< 1 2 3 4- 6 7 8 9 ~10 11 14 15- 16- 17- 18- 19- SLOPE / WAS GROUND WATER ENCOUNTERED? SITE PLAN S IF YES. AT WHAT ~L V DEPTH? p E Depth (o Water Alter Monitoring? ~ Dale: Reading Date Gross Net Depth to Net . Time Time Water Drop T~z ~ ~ ~ ~.~ PERCOLATION RATE TEST RUN BETWEEN (minutes/inch) PERC HOLE DIAMETER PERFORMED BY: '~' '/"~ ' O/ I "---'- CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: ~//~'/~ ~ 72-008 (Rev. 4/85) MUNICIPALITY OF ANCHORAGE Department of Health & Human Services DIVISION OF ENVIRONMENTAL SERVICES 343-4744 · Parcel I.D. # CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY FOR SINGLE FAMILY DWELLING 1. GENERAL INFORMATION (Must be completed prior to submittal) (a) Legal Description (include lot, block, subdivision, section, township, range) Location (~ddr~'s or,:~ctions)':' % (c) Lending InstitutiOn , .-', ' Telephone: (home) Telephone Business Mailing Address (d) Real Estate Company and Agent Address Telephone (e) Mail the HAA to the following address: (or check here I~, if hold for pick up.) List contact person and day phone number below: 2. TYPE OF RESIDENCE Single-Family~ Number of bedrooms 3. WATER SUPPLY Individual Well [] Community,~' Public [] Note: If community well system, must have written confirmation from the State Department of .Environmental Conservation attesting to th legality and status. ~ 4. SEWAGE DISPOSAL On-site, X2_ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 724)25 (Rev. 7/88) Page 1 of 2 5. ENGINEERING FIRM PROVIDING INSPECTIONS TESTS FILE SEARCH DATA AND NF~3RMAT ............... .A.s c.e,.rtif!ed..by my seal affixed hereto and as of*the Validation date shown below, I verify that my nvest gation of ,~ea~[.n /~.u;nodty Approval shows that the on-site water supply and/or wastewater disposal system is safe, runcuona~ and adequate for the number of bedrooms and type of structure indicated herein. 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 ,-~'-~--~ -~;-.~ Telephone Address ~ ,'~u~¢ ,p~O~¢~- · ..,~ .¢¢,~ ¢~¢-/'-,.2/v~'~o~- 6..~'i H S APPROVAL. .2/Apprgve~for ~; ' ' ' ~ ¢ :{~ bedrooms by ..,,,~pprdve~,~ ~ ~., Disapproved Terms of Conditio~i Approval Conditional Date /¢~/~ The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health AuthorityApproval cerificated 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 t° 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. 7/88) Back Page 2 of 2 DEPT. OF ENVIRONMENTAL CONSERVATION ANCHORAGE WESTERN DISTRICT OFFICE / 3601 C STREET, SUITE 322 ANCHORAGE, ALASKA 99503 November 13, 1989 Dr. Leroy C. Reid, Jr. Alaska Environmental Control Services P.O. Box 240668 Anchorage, AK 99524-0668 STEVE COWPER, GOVERNOR 563-6775 PWSID: # 213475 According to the records on file in this office, the South Park Terrace Subdivision Water System is in compliance with the State of Alaska Drinking Water Regulations. Sincerely, Officer VEC:bas A. WELL DATA Well Classification Well Log Present ~.~L Date Completed Total Depth Cased to Depth of Grouting MUNICIPALITY OF ANCHORAGE (MOA) Health.~uthority Approval (HAA) , ~,~ CH, EOI(LIST - FEBRUARY 1984 o,,-',,/~ b~?~;i0'343'4744 ~,~,vT~O,~,/,~NIA~o~ ....... Legal Description: ~/~/ R~C~ iV ~.~:i If(~B, C, D.E.C. Approved {~.) -- Yield .-." Static Water Level Pump Set At Grot~nd' Casing Height Above _' Sanitary Se~asing (Y/N) Electrical Wiring in Conduit (Y/N) ~'on Around Wellhead (Y/N) SEPARATION DISTANCES FROM WELL:,~ X ...... To Se~t,c/~o,ding Tank on Lot ....¢~, - ;On%o,n,;,.Lots__ To Nearest Edge o, Absorp~on Lot __~_~ On ^!!o,n,ng Lots__ To NeareSt PubF~earest Public Sewer Cleanout/Manhole To Neare~wer Service Line on Lot Wa.,~ Collected by ; Date W'~ter Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA Date Installed ~'/~/~¢/ Size .~/~. J-f~ No. of Compartments Standpipes~N) Air-tight Caps (~.~N) Depression over Tank (Y/~ Pumping/Maintenance Contact on File (Y/N) Holding Tank High-Water Alarm(.Y/N) SEPARAT ON O STANCES FROM?sEPTIC/HOLDING TANK: To Water-S~pplY Well ,. ,~ 2:~/.~= To Building Foundation To Propert~ I'ir¥~ :; . - ~'-,7 / · :, To Disposal Field / To Water Main/Service Line .,' : ~ /- To Stream, Pond; Lake or Malor Drainage Course Comments * Foundation Cleanout ~N) Date Last Pumped ;for Temporary Holding Tank Permit (Y/N) 72-026 (Rev. 7/88) Front Page 1 of 2 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date Installed 7/~/~-'? Width of Field Square Feet of Absortion Area Depression over Field (Y(~ Results of Last Adequacy Test SEPARATION DISTANCE FROM ABSORPTION FIELD: To Water-Supply Well .~ 2%0o / To Building Foundation ~Z~ / Lot '~.///)- TO Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Type of System Design Length of Field ~z-° ~ Depth of Field ¢?' ? Gravel Bed Thickness Statndpipes Present (~N) Date of Last Adequacy Test To Property Line /6 / To Existing or Abandoned System on ; On Adjoining Lots ~' ~:~ / To Cutback (if present) /4////- Comments D. LIFT STATION Date Installed Dimensions ,S. ize in Gallons Manhol~~ Pump On" Level at .--~'Pump Off" Level at High Water Alarm Level at f? ~'"'~ Vent (Y/N) Tested for _/ Pumping Cycles during Adequacy Test. Meets MOA Electr~.~Ce~/N) **Check Permitted Bedroom Rating Against HAA Request** I certify that I have checked, verified, or conformed to all MOA and HAA gui(; inspection. Sign ed Company Date // MOA No. ReceiptNo. ,'~'¢/ ~.).') %'"'"'/ :~-~ Date of Payment ///' /~/"-d~;'X Amount: $ /~ ~ ¢~ Receipt No. Waiver Fee: $ 72-026 (Rev 7/88) Back the date of this En~neer's Seal Date of Payment Page 2 of 2 ? ? ? ? ? / / / ('85'108)F'0 " '