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Home My WebLink AboutSTEWART #1 BLK 2 TR A 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 ~ Upgrade Ad~t~[ ~~['~ ~. ABSORPTION FIELD Phone: ~No.~drooms: ~eepTrench ~ShallowTrench ~Bed ~Mound ~Other LEGAL DESCRIPTION Soif Rating: ~'~ GPD/Sq. Ft. Total Depth from originality/ ~. ~ .loc~: ~ ~~Subdivisi°n: ~l Depth topipebottomfromodgi~algra~,~ Ft.e: Gravel depthbeneathpipe~ I Ft. Township:II Range:fl Section: Fill added above~original~grade: Ft. Gravel length: ~/ Ft. / Number of lines: Distence bet wen lines: WELL: ~New ~ Upgrade Gravel width: ~ssilication (Private, A,B,C): / Total Depth: Cased TO: Total absorption area: Pipe Yield: GPMIl Pump Set at: EtI~ Casing Height Above GroundFt, TANK SEPARATION DISTANCES ~epti~ U Ho~di.g U S.T.~.~. TO Septic Absorption Lift Holding >ub~ic/Pcivat6 anufactu er: Capacity in gallons: From Tank Field Station Tank SewerLines ~~ ~ ~ Well ~ ~t~ ~ ~ Materia~ NumberofCompartments: Surface Water ~'~ ~¢'~ ~ ~ ~ LIFT STATION Lot Size in ~ Manufacturer: Foundation l~' /D' ~ / ~ "Pump on' level ~~~water alarm at: Remarks: BENCH MARK Location and Description: Assumed Elevation: ~ ~¢ ~, E~~ Inspections performed by: ............. , .......... Dates: 1st ~D-,D-~ Department of Health aPd H~man Serv~ approval '~;~,,~ ~' ~eviewed and approved by: te: /------~ 72~013 (Re'., 9/91) MOA 25 'Permit NO. ~-'~ ~:~' O~...~' Page 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 LegalDescription: '"~[.~C~-t,~-- '~ ,~ ~----'"~ ~:"' PIDNo.: ~'~'~ 72-013 A (Rev. 9/91) MOA 25 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 WASTEWATER DISPOSAL SYSTEM PERMIT PERMIT NUMBER:SW920268 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:EARP KEVIN W & BARBARA K OWNER ADDRESS:20111 CONSTITUTION DR. ANCHORAGE AK 99577 DATE ISSUED: 9/03/92 EXPIRATION DATE: 9/03/93 PARCEL ID:05047202 LEGAL DESCRIPTION: STEWART #1 BLK 2 TR A LOT SIZE: 72600 (SQ. FT.) NUMBER 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: RECEIVED BY: ISSUED BY: HEALTH AUTHORITY APPROVALS SEWER &WATER MAIN EXTENSIONS INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL& MECHANICAL INSPECTIONS ROBERTSHAFER, P.E. ROGERSNAFER, P.E. August 28, 1992 CIVIL ENGINEERS (907) 694-2979 FAX 694-1211 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, Alaska 99501 RECEIVED SEP 1992 D Munic~pah~y of Anchorage ept. Health & Human Services REFERENCE: Stewart Subdivision #1, Block 2, Tract A Request you issue a permit to install a septic system to serve the proposed four bedroom home on the referenced property. Two test holes were excavated and percolation tests performed in the area of the proposed septic system. The approximate location of the test holes are located on the attached site plan. This property is served by a Community water system. There are no protective well radii which encroach upon the property. As can be seen from the site plan this lot is large enough for another future upgrade. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic system. If you have any questions or require additional information for your review, please contact us. Sincerely, ROGER J. SHAFER, P.E. RJS/LSU/lsu ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER, ALASKA 99577 SCALE LOTs Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST DATE PERFORMED: 1 2 3- 4- 6- 7- 8- 9- 10- 11 13- 14- 15- 16 17- 18- 19- 20- /~ ~-'~. 'Z-. Township, Range, Section: WAS GROUND WATER ENCOUNTERED?~ IF YES, AT WHAT DEPTH? pO E Depth te Water Alter __ Monilorino? '~::~'~ Date: SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop -2. -~,. ~.~ ~,-~,~, t~5[~.' I PERCOLATION RATE __ TEST RUN BETWEEN (minutes/inch) PERC HOLE DIAMETER __ COMMENTS PERFORMED BY: $ & $ ENGINEERING 17054 F~n~Jle River Loop Road No. ~J34 ........THIS DATE ACCORDANCE W~TH ,~/[~e~ ~C~UIDELiNEb 72-008 (Rev. 4/85) CERTIFY THAT THIS TEST WAS PERFORMED IN DATE: ~ ~ 2~''( ~-~j ~ Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERFORMED: LEGAL DE SCRIPT ID 1 2 3 4 5 6 8 9 10 11 13 14 15- ~7- 18- 20- Township, Range, Section: SLOPE WAS GROUND WATER ENCOUNTERED? L IF YES, AT WHAT O DEPTH? p Depth lo Water,.,~.A~.~,; Monitoring? /~ E SITE PLAN I N Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~' ~ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND ~ FT COMMENTS $ & S ENGINEERING ~ r- ~,_.~ CERTIFY THAT THIS TEST WAS PERFORMED IN PERFORMED BY: 17034[ Eagle River Loop Eoa~ No. ~04 ' ! ~ "~'~7 ~ ~ ACCORDANCE W~T, ~,NR~t~C~,~U~EUNES ~N EFFECT ON TH~S PATE. DATE: 72-008 (Rev. 4/85) 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 FOR A SINGLE FAMILY DWELLING Parcel I.D.# ~C~- ~-I'-~'~-(~,,.~ HAA# L~ i~( ~\ 1. GENERAL INFORMATION Complete legal description Tract A, Block 2; Stewart subd±v±s±on, fl Location (site address or directions) r.owland Avenue Property owner Mailing address Lending agency Mailing address Agent Address P.O. Box 770164, Eagle River, Alaska 99577 Day phone Day phone 694-9681 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Unless otherwise requested, HAA will be held for pickup. 4 NOTE: Individual well Community well Public water X,XX If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. NOTE: 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 Address Engineer's signature DHHS SIGNATURE /~ Approved for __ Disapproved. __ Conditional approval for S & S ENGINEERING 17034 Eagle River Loop Road NO, 204 Fn~le ~iver. Alnska 99577 bedrooms. Phone, bedrooms, with the following stipulations: Additional Comments By: Date 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 DH HS 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. 72~25 (Rev. 1/91) BSCA MOA .~21 Municipality of Anchorage Department of Health & Human Services HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: "~(Z-~.~' ~ ~l,..'Z-- ~ Parcel I.D. ~'-~) - ]'//~.--~-- A. WELL DATA Well type Log present (Y/N) Total depth Sanitary seal (Y/N) If A, B, or C, attach ADEC letter. Date completed Cased to ADEC water system number Driller Casing height Wires properly protected (Y/N) FROM WELL LOG AT IN~TION Static water leve~ Well flow Pump level / SEPARATION DISTANCES FROM WEb'S'O: Septic/holding tank on lot / ; On adjacent lots Absorption field on lot / ~-~ o ~' On adjacent lots Public sewer main / Public sewer manhole/cleanout / Sewer service line~ pe, troleum tank WATER/~rvlPLE RESULTS: C o~gr'm Nitrate Other bacteria Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Date installed Cleanouts~-.~/N) High water alarm (Y(~) Dat~ of pumpin~ Tank size [,"Z-~' c~ Compartments Foundation cleanout~/N) ~ Depression (Y~ ~ Alarm tested (Y/N) h'~ (/~ It~ '~-t.~ Pumper To property line Surface water/drainage SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot ~ c> ~' On adjacent lots ~'/~ \~ ~ Absorption field ~' ~ Foundation Water main/service line 72-026 (Rev. 7/gl) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Manufacturer Size in gallons Vent (Y/N) High water alarm level Meets MOA elec~ ST*T'w ,on,ot Manhole/Access (Y/N) "Pump on" level at ~ ~es tested Surface water D. ABSORPTION FIELD DATA Date installed ~,o Length ~'~' -- Width Soil rating ~),LJ, Gravel thickness (-~e~'/'¢¢¢~" System type Lc' '~- Total depth Total absorption area Depression over field (Y~) Results (pass/fail) Peroxide treatment (past 12 months) (Y,~ ~ Cleanouts present ~/N) '~ Date of adequacy te~tt ~/,~. ~,-,~ ~-.- u..~ for ~'~.~," If yes, give date bedrooms SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot To building foundation ~, ~ ' On adjacent lots .~c:~ ~ Surface water \ c:,c::~ ~'~ Curtain drain On adjacent lots ~ ~J~.~ Property line To existing or abandoned system on lot Cutbank ,~' / ~.- Water main/service line Driveway, parking/vehicle storage area E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on Signature Engineer's Name Date $ & S ENGINEERING 17034 Eagle River Loop Road NO, 20~ Eagle Hivet~,/~iaska yyS~ of this inspection. t4AA Fee Date of Payment Receipt 72~O26 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number