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HomeMy WebLinkAboutSOUTHPARK #2 BLK 3 LT 32 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: ~'W¢~oo~'' PID Number: Name: Wastewater System: B New ~ Upgrade %o~0. INo'°f Bedrooms: ~Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other LEGAL DESCRIPTION Soil Rating: ¢. ~GPD/Sq. Ft. Total Depth from original Lot: Block: Subdivision: Depth to pipe botiom from original grade: Gravel depth beneath p~pe Township: I Range: I Section: Fill added above original grade: Gravel length; I WELL: B New ~ Upgrade Gravelwidth: Numberoflines: I Distance between lines: Z~Ft. / Ft. Driller: Bate Drilled: gatic Water Level: Installer: ~ Date installed: Yield: GPM IP~r"p s"tat: Ft. Icasing Height Ab°ye Gr°undFt. TANK SEPARATION DISTANCES ~Septic ~ Holding U S.T.E.P. To Septic Absorption Lift Holding Publ[c/Privat( Manufacturer; Capacityin gallons: From Tank Field Station Tank Sewer Lines ~¢~¢E T~ Number of Compartments: Surface Water /00 '* ~¢¢ ,~ .... LIFT STATION Lot "Pump on" level at: ~leve~ at: ~ High water alarm at: CurtainDrain ~ , ~0~E ~0~ M" ~ I Electrical Inspections performed by: Remarks: BENCH MARK Location and Description: Department of Healt Hum Services approval 72-013 (Rev. 9/91) MOA 25 Permit No.SW940095 Page 2 of 2 Municipality of Anchorage 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 Legal Descriptio~°UTHPARK ADD.#2, BLOCK $, LOT $2 PID No.: C01 CO2 ~Ew..~ ......... -- 1250 ~GAL FINAL GRADE i CO (CO3& C04) .................. 85:0'.~Z... · '79.0' NO WATER FOUND A B C FCU ~770 1'6:5' ~,~ C01 [0.5 22.5 - C02 LB.0 29.5 -- C03 ~19.0 57.5 - C04 - 14.5 20.0 MT1 13.5 27.5 02005245 A i TRENCH SEPTIC CO SCALE f' = 40' 72-013 A (1/93) ' PAGE 1 OF 1 MUNICIPALITY OF ANCHOP_AGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHOP.-AGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW940095 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:SOUTHPARK DEVELOPMENT CO OWNER ADDRESS:5401 N INDIAN TKAIL TUSCON, ARIZONA 85715 DATE ISSUED: 4/26/94 EXPIRATION DATE: 4/26/95 PARCEL ID:02005243 LEGAL DESCRIPTION: SOUTHPARK ADDN 2 BLK 2 3 LT 3 LOT SIZE: 27666 (SQ. FT.) AU3MBER OF BEDROOMS: 4 THIS PERMIT: 4 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 OR 343-4681 AFTER BUSINESS HOURS 4. FROM OCTOBER 15 TO APRIL 15 A SUBSURFACE SOIL ABSORPTION SYSTEMUNDER 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 RECEIVED BY: ISSUED BY: . '~J~' DATE: <'-'f (/~- (-~ 1~"~/ ROBERT SHAFER, P.E. ROGER SHAFER, P.E. April 21, 1994 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & ,MECHANICAL INSPECTIONS Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 'L' Street P.O. Box 196650 Anchorage, Alaska 99519-6650 REFERENCE: Southpark Subdivision #2; Block 3; Lot 32 Request you issue a permit to drill a well and install a septic system to serve the proposed four bedroomhouse onthe referenced property. Test holes were excavated and percolation tests performed. The approximate location of the test holes are located~q~the attached site plan. The monitoring tubes within the test holes havre been checked and found to be dry. This property has enough area for a future septic upgrade which can be seen on the attached site plan. The referenced property is served by a Community Water System. There are no protective well radii which encroach upon the property. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions, review, please contact us. SU/jk or require additional information for your ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 NORTH EAGLE RIVER LOOP" SUITE 204 · EAGLE RIVER, ALASKA 99577 0 om~o oo~ N¥'ld 3lIS [ ON-SITE WASYW~A'I'~/( DISPOSAn SYSM CONSTRUCTION PRACTICES and MA'£~/<I AL SPECIFICATIONS R~F~KENCE: Southpark Subdivision ~2; Block 3; Lot 32 The scope of this project includes the installation of a 1250 gallon septic tank and a leachfield trench to serve the proposed four bedroom residence located on the referenced property. Construction shall be in accordance with the approved site plan and design drawings, Municipal permit with any special provisions or conditions, and all applicable State and Municipal Wastewater Disposal Regulations. 3. The contractor shall be responsible for obtaining any necessary underground utility locates. Unless specifically agreed otherwise, the property owner shall be responsible for final grading areas subsequently depressed from soil settling. On all leachfield mound systems, the property owner shall be responsible for ensuring a satisfactory vegetation growth over the mounded area. Contractors installing wastewater disposal systems must be certified by the Municipal Health Department for system installations. Owners installing their own systems must also receive prior approval from the Municipal Health Department. S~PTICTANK INSTALLATION: 1. A septic tank is to be constructed by a certified septic tank manufacturer. Construction shall include two 4" cleanouts for pumping access. 2. The septic tank shall be sufficiently bedded to prevent settling or shifting of the tank. 3. All standpipes on the septic tank shall extend a minimum of 12 inches above final grade. 4. Septic tanks installed with less than 4' of cover shall be insulated. Page Two Southpark Subdivision ~2; Block 3; Lot 32 April 21, 1994 A foundation cleanout shall be installed one to four feet from the building foundation. In the line between the tank and the leachfield there shall be two adjacent cleanouts (unless an effluent pumping system exists within the septic tank). These cleanouts shall be located on undisturbed soil not more than 10' from the tank. The first cleanout, in line, shall be to clean toward the leachfield. The second cleanout shall be to clean toward the septic tank. Final grading over the septic tank shall be such that a positive slope exists away from the septic tank. ABSORPTION TRENCH/DRAINFI~.~ INSTALLATION: Excavate the proposed trench to the dimensions shown on the design. The bottom of the excavation shall be within 2 inches of level. If the sidewalls of the excavation become smeared, they must be raked or scratched (roughed-up) before gravel (sewer rock) placement. Once the gravel is installed, the distribution pipe is to be installed level with the perforations faced downward. Gravel is then to be placed over the distribution pipe to provide a minimum of 2 inches of cover over the pipe. A silt barrier must be installed between the final gravel layer and the native soil backfill. Ensure the silt barrier covers the entire gravel surface before placing backfill. Monitor tubes shall be of four (4) inch diameter and installed approximately in the locations shown on the design. The portion of the monitoring tube extending through the gravel shall be perforated from the bottom of the trench to the invert of the distribution pipe. This is equivalent to the effective depth of the gravel as noted on the design. o Backfill over the final gravel layer must not be less than twenty-four (24) inches. Insulation must be installed when the backfill depth is less than thirty-six (36) inches. The finish grade over the trench must be mounded to prevent the formation of a depression after settling. Page Three Southpark Subdivision #2; Block 3; Lot 32 April 21, 1994 1. MA'i'KwJAL SPECIFICATIONS: Any septic tank proposed for installation must Municipally approved septic tank manufacturer. 2. The following pipe materials are approved for installations in the Municipality of Anchorage: be constructed by a use in septic system Type of Pipe Perforated Solid Cast Iron Yes Yes ASTM D3034 (PVC) Yes Yes ASTM F810 (HDPE) Yes NO ASTM D2662 (ABS) Yes Yes Use of a type of pipe other than listed above must be approved by the inspecting engineer. 3. Insulation shall be at least 2" thick extruded direct burial polystyrene (Dow Chemical Company Styrofoam HI or equal). 4. Septic tank inlets and outlets shall be fitted with watertight couplings (Caulder, Fernco, or equal). 5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140/N, or equal) must be installed between the final leachfield gravel layer and the native soil backfill. Ail leachfield gravel (sewer rock) shall be 0.5"-2.5" screened gravel with less than 3% passing the #200 sieve. 7. When sand is being used as a filter material, its gradation specifications must conform to current M.O.A. or D.E.C. requirements. INSPEI.-I'AONS: Typically there will be a minimum of three (3) inspections required during the installation of the wastewater disposal system. These inspections will occur as follows: 1. The first inspection must be conducted after the excavation of ditches, pits, trenches, or beds and before the installation of any gravel. A septic tank may be set in place, but may not be backfilled before this inspection. Page Four Southpark Subdivision 92: Block 3; Lot 32 April 21, 1994 2. The second inspection must be conducted after the placement of the silt barrier, gravel, distribution lines, standpipes, cleanouts, and insulation, but before the placement of any other backfill. 3. The final inspection is to occur upon final grading of the property. Often there will be more than these 3 inspections required, especially with the installation of multiple trenches, sand filters, pressurized distribution systems, etc. Thus, the inspecting engineer is to be contacted at least 24 hours prior to the start of construction. If necessary, a pre-construction meeting will take place on-site. The inspecting engineer will not coordinate, direct or control in any way the contractor's activities. The owner shall contract with the contractor to perform the work outlined in these specifications and plans and in accordance with the attached M.O.A. permit. There will be no contractual arrangement existing between the contractor and S & S Engineering. S & S Engineering shall be the owner's representative and will inspect the work as stated above to document the contractor's activities. Final acceptance of the contractor's work rests with the owner and the M.O.A. S & S Engineering shall have no liability to the owner or to others for acts or omissions of the contractor or any other persons performing work on this project or the failure of the contractor to carry out the work in accordance with these construction documents. S & S Engineering's inspecting engineer will not be responsible for the construction means, methods, techniques, sequence, procedures or the safety precautions incident to this project. CONTRACTOR/INSTALLER Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED FOR: ~/~ ~EGA' DESCR,FT,ON:.--~',~/~ ~.,/--'~'~' ~'~ 1 3 4 5- 8- ~0- 12 ~3 14 ~0 ~,(~,~. 18 19 / DATE PERPORI Township, Range, Section: SLOPE {~NGiNE~R's SEAL) SITE PLAN WAS GROUND WATER ~0 ENCOUNTERED;' IF YES, AT WHAT DEPTH? pO E Deplh to Waler Alter ..,-.,~. /..[ [~.,]~u~ M0niloriflg? [ ~¥)~'y Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ,~ (mmutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~____~__~ND -~' ~ FT COMMENTS PER~O'MED'~' ~'0" ~.~'.",.e.'oop"o.~"O. =0., // /~~ THAT T~,S TEST WAS PER~ORMEO,N ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES I~.~H~C~N THIS DATE. DATE: 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: DATE PE 1 2 3 Township, Range, Section: 7 8 9- 10- 11 13 WAS GROUND WATER ENCOUNTERED? DEPTH? geptb to Wal0r Monitoring? J..~" ~ SLOPE SITE PLAN 14 15 16 17 18 19- Gross Net Depth to Net Reading Date Time Time Water Drop 20 PERCOLATION RATE ~' ~ (minutes/inc _~__ PERC HOLE DIAMETER <Z TEST RUN BETWEEN ~ND ~ ' ET S & S ENGINEERING /'~"~/' //'/ N COMMENTS 17034 Eagle River Loop Read NO', 204 ~ ~V THAT THIS TEST WAS PERFORMED PERFORMED BY:Eagle River, Alaslra 9F572' ?//'~ ~ ........ ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELI~.~IN T ONON THIS DATE. DATE: 72-008 (Rev. 4/85) ~/ T 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 FO FI A SINGLE FAMILY DWELLING Parcel I.D.# 1. GENERAL INFORMATION Corn plete legal description 'Lot 32; Block 3; 'Sou~hpark Subdiv/~s~o~.2 Location (site address or directions) Property owner. Mailing address Lending agency Mailing address Agent Address The p~t~rson Group 3820 Lake Otis Parkway Day phone Su.~te 204 Anchora,qe, AK 99508 Day phone Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: ~ Individual well ......... Community Well XXX (/ Public water NOTE: "if community well system, provide written confirmation from State ADEC attest- ~ . lng to the legality and status of system. ' ~, ~,' \ ' '~' 1' '\ ,- 4.' TYPE OF, WASTEWATER DISPOSAL: Individual on-site XXX ' ': ~:: i~ Hide- 'ing"' ~' tank'S' .... ' "~- ' ' ''~:'''' "'- ..... :" ' ' ";~'~ ~'~'' ....." _,:-,.'~' ;'~,~ ..... ....... '"- ?'~ '" Cornmun 0n2site ~. -: :,- -,,-, ,,~ ~. ~'.,,, Public sewer , '-:-' : ' ' " :-' ;: '* .,;?, 'i' NO~:'. if community wastowator sysmm, provide written confirma ion fro~'~ ;;~ta..., ...... n to the le alt and status of syste . ~. , , .,,~ ......... 5. STATEMENT OF INSPECTION BY ENGINEER " , ' .. -~. 'As certified by my seal affixed hereto and as of the validation'd~te shown·~loW, I verify that my investigation of this Health Authori.ty Approval application shows t:hat the on-site water supp y' and/oF wastewater di.spos~l*Sy~tem ;S safel.functi0nal'and adequate for the number of bedrooms and ~pe of structure ~ndicated herein. I fudher veH~ that based on the information obtained from the Municipali~ of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance ~ith all Municipal and State codes, ordinances, and ~egulations in effect on the date~nspection. Address Engineer's signature / Date DHHS~SlGNATURE ...... :"': Approved for ' "bedrooms. ~''''' ............ . Disapproved - :: Conditional approval for bedrooms, with the following stipulations: · Additional Comments The Muni,clpality of Anchorage Department of Health and Human Service§ (DHHS) issues Health Authority Approval Certificates baseC only'upon the representations given in paragraph 5 above by an independent profe~!?nal e~gineer registered in the State of Alaska The DHHS does th s 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 ~'0h'dt~ct inspections or analyze data before a certificate is issued The M,~nicipallty Of Anchorage is not ; ~ · ',,.:, 'regP'6hsibi~ for'~rrors or om ss or~s' n ih~ I~r(~fess or{a en~l neer's ~/o~ 'i;:~,~i~' -'~',, ~4~i.~:'~4~,~',' : ~ ,-.;~-" :. ',"~; .;;~:';.'- Municipality of Anchorage Department of Health and Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: t,---o-r ;57.--~t.v_~ ~-~,:=.¢rAP~c-C-'~'~-~-Parcel I.D. If A, B, or C, attach ADEC letter. ADEC water system number Date completed Driller Cased to Casing height A. Well Data Well type A Log present (Y/N) Total depth Sanitary seal (Y/N) FROM WELL LOG Wires properly protected (Y/N) .g.p.m. 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 ; On adjacent lots '?,-c,O ; On adjacent lots ATINSPECTION Public sewer manhole/cleanout Petroleum tank WATER SAMPLE RESULTS: Coliform Date of sample: Nitrate Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts (~1) ',./ High water alarm (Y~;~ Date of pumping Tank size /'~5'~ Compartments Foundation cleanout(~) '-/ Depression (Y~. ~ Alarm tested (Y/N) ~- r~L Pumper SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: 1 ~ .V- ~ \ ~, Foundation Well(s) on lot "7~o ~ On adjacent lots To property line \o t''v' Absorption field \*:=,~ Water main/service line Sudace water/drainage ~ 72.026(3/93)OFro~1t , ,,~ CONTINUED ON. BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Manhole/Access (Y/N) Vent (Y/N). "Pump on" level at "P~t High water alarm level Meets MOA electrical codes (Y/N) SEPA~M LIFT STATION TO: WelFon lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed Length Total absorption area Date of adequacy test Water level in absorption field before test Peroxide treatment (past 12 months) (Y~. ~ -- ~'5 ~ c~ ~ Soil rating (GPD/Ft2) O, Lc, Width '7..- ,%- Gravel thickness ~ ~ ~ ~ Cleanout present ~) "~1~' - ~'~v-\ Results (~ass/fail) .System type ""~'-~r~ ~, '"7, ~' Total depth ~ ~ ,f Depressionoverfield (Y~. r~ ~ J & for ~' Bedrooms After test ,3,\~ If yes. give date ,'~1 A, SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot '~/? ~ ~ To building foundation On adjacent lots '5 ~ t ~- Surface water \ ~> c, ~ ''~ Curtain drain ~//~ On adjacent lots ~->-- Property line / ~ ~ To existing or abandoned system on lot Cutbank ~ ,~- Water main/service line Driveway, parking/vehicle storage area ~,~ E, ENGINEER'S CERTIFICATION I cern'fy that I have checked, verified, or conform~l, to~OA and HAA guidelines in effect Engineers Name Ea~;e HAA Fee $, ~Oo Date of Payment Receipt Number 72-026 (3/93)* Waiver Fee $ Date of Payment Receipt Number ~his inspe?tion.