HomeMy WebLinkAboutSUNNY VALLEY LT 9 REM,/-~GREA~'~R ANCHORAGE AREA BORbdGH
Department of Environmental Quality
3330 C Street
Anchorage, Alaska 99503
,.~-, INSPECTION REPORT ON-SITE SEWAGE DISPO?~.~j SYSTEM
SEPTIC TANK:
DISTANCE _Ct_
FROM WELL //O("1' MANUFACTURER
?
INSIDE LENGTH /~ INSIDE WIDTH
~:-~- ~-- MATERIAL
LIQUID DEPTH
NUMBER OF ~,,,~-- ......
COMPARTMENTS
LIQUID CAPACITY )""J~ ~,--' ~') GALLONS,
SEEPAGE PI-T~.-' '--~LcL~g.~ / . / /
OR W,DTH , LENGT '-'
LI~I~G ~ATE~IAL C~IB SlZE~ DIA ETE .__ T~ ~[STANCE F~OM~ WELL /~'~
/ TOTAL EFFECTIVE :://~Q
BUILDING FOUNDATION NEAREST LOT LINE~)~. ABSORPTION AREA (WALL AREA) . FT,
ADDITIONAL ABSORPTION
':~- ?
WELL:
TYPE ~'' ~'~.A~.: CONSTRUCTION DEPTH DISTANCE FROM:
BUILDING NEAREST / / /
FOUNDATION LOT LINE C.~-C') ~ NEAREST SEPTIC SEEPAGE
__ SEWER LINE /C')~-7L. TANK ~/O'~-/-, SYSTEM
CESSPOOL
OTHER SOURCES
APPROVED DISAPPROVED REMARKS
DISTANCES:
DIAGRAM Of SYSTEM
INSTALLED BY:
PIPE MATERIAL:
LOT SLOPE:
REMARKS:
Form No. EQ-031
PERMIT NO.
DEPARTblENT C,/ HEALTH BND ENVIRENMENTRL ~-~RZTEZTIEN
2516 E. TUDOR RD.., RNCHORRGE, BK. 99507
276-222t
( 768ii )
BPPLICRNT
LOCATION
LEGAL
JIM CBRLSON
~AGLE RIVER RD
L9 SUNNY VALLEY SUBD
7929 LAKE
OTIS
LOT SIZE
~44-2~42
871.20 SQUARE FEET
TYPE OF SOIL ABSORBTION SYSTEM IS: TRENCH
MAXIMUM NUMBER OF BEDROOMS = 4
SOIL RATING <SQ FT/BR)= ±~0
THE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS:
[:.EF'TH= 16 LE~A_3TH= _~:2-: G F." FB "..." E L. [:. E F" ]]-~ ::
THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD.
THE DEPTH OF R TRENCH OF.'. PI]' IS THE DISTANCE BETWEEN THE 9JRFACE OF THE
GROUND AND THE BOTTOM OF THE E,v, cAVATION ,::IN FEET).
THERE IS NO SET WIDTH FOR 'TRENCHES.
THE GRRVEL [EFTH IS THE MINIMUM DEPTH OF GRAVEL BETWEEN 'THE E]UTFAL. L PIPE
AND THE BOTTOM OF THE EXCRVATION (IN FEET).
T[4Ct (2) ~ ~4$]PEC:-F ZC~-~; RR:E RE~]~LHZ ~:E[:.
BRCKFILLING OF ANY SYSTEM WITHOUT FINAL INSPECTION RND RPPROVRL BM THIS
DEPARTMENT WILL BE SUBJECT TO PROSECUTION.
MINIMUM DISTANCE BETWEEN A WELL RND ANY ON-SITE SEWRGE DISPOSRL SYSTEf4 IS
±00 FEET FOR A PRIVATE WELL OR 200 FEET FOR R PUBLIC WELL.
SPECIFICATIONS AND CONSTRUCTION DIAGRRMS ARE AVRILRBLE TO INSURE PROF'ER
INSTBLLRTION.
I
2L:
FORTH 8'¢ THE MUNICIPFILITY OF ANCHORAGE.
2: I WILL INSTALL THE SYSTEM IN ACCORDANCE WITH THE CODES.
--'.':: I UNDERSTRND THAT THE ON-SITE SEWER SYSTEM MAY REQUIRE ENLRRGEMENT
RESIDENCE IS REMODELED TO INCLUDE MORE THi]~'~ 4 BEDF.:00MS.
-z¢--'* ........
iSSUED B' ' ,//:C"
CERTIFY THRT
I FtM FAMILIFtR WITH THE REQUIREMENTS FOR ON-SITE SEWERS FtND HELLS RS SE]"
I F THE
P~r,or~ed for
Legal Description:
~'his form reports:
Pouch 6-650, 99509, - 2518 E, TudoP Road '} Anchorage, Alaska t ,
Soils ~og~ P e~c ~ ~~--~ .........
Depth
Feet
2-
4-
5-
6-
7-
8~
lO-
ll-
12-,
13-
14-
PIa~ 9round water ~ncountered? _~ .......
~ yes~ at what depth? ' '
Reading
Percola~L~ on rate
Date
Gro~s Ti~ae
Net Time Depth to [t20 ~tet Drop
minute,
Proposed installation: Seepage Pit '' Drain Field
hel-~t~, of Inlet~/5 ~ , Dd~p,t~ to bottom of' pit or trench , .
CO:,INENTS:
DRILLING,
/ * -, DRILLING LOG
Well O. wner· James Carlson ...... - -.~-.
' Use-of Well Dom.
I~cation (address of: Township, Range, Section: if known; or
Lot 9 Sunny Vai'le¥ Subdivi:sion--a~/~
~ ~/.,~ ~'/N, ~ -
'.: - 6" : 90 '..
S~e of easing Depth of Hole 28~ feet Casedto feet .=' ~927~
- - Stat e water level ft. [~e) ~ (below) land surface. ~m~sh of well (check one) open
~ Screen ( ); .Perforated .( L). '
...... ~ ,~. ~" ..,
~.~ ' / ' ' -', '~N/~'q~
Describe screen or perforation ~
. ?--]. ~. ..
~:: Well pumping, ~~ ~test at _ _gallo~s'~pe~(:.. -, ~g) (minute) for. 1 hours ~ith 100~
from statm level.~:?~ :;'~ ;!
-~'-..:~'~ ? >' '~ WELL LOG ~ .'
G~e ~e~H~ O~ ~o~on~ ~ene~ed, s~e ~ ~e~], eo~o~ ~ ~e~s
Bed~o~ci%;:water seaps in sporadic fractures
throughout
TO
TO.
_TO
.TO
TO
TO.
N\VWA Certified Conh'aeIor ~
~',erfificc, te No's. 814 & 973
- TO
2 -- STATE
Owner
': ": ' ' - rv1-W DRILLING, Inc. .
P. O. 5ox 4-1224 · 1310C International Airpor[ Road
(907) 274-4611 ..
ANCHORAGE, ALASKA 99509
' Location (address of: Township, Range, Section, if known; or distance main road
-" DRILLING LOG
James Carlson : r'' -- '' :"· :' ' ' ' Use of Well Dom
" "' Su~rny VAlley Subdiv. s-E~, NW~, Sec. 16, T14Ns R1W.~ Ea River
;~$3:S~ of cas~g ~ :. Depth of Hol~ ~ -·feet .' ~- .Cased to :' ' ~' - feet"'.:f-~ b [.~ .;; .~]' "~:.'.: ~ .
.:.... Statm water level 90 ft. '(~).~ .(below) land surface.: F~ish of well (check one) open end ( x
~.t~: ." Well pumping test at 3 gallons p~r, ~) (minute) for.. ]. :'." ho~rs., with ~ h~ ..-.,. ....
:~'~ Da~ of completio~ 11 July 1975 ...... .
...... ~ LL L
::'~ Depth in feet from
ground surface Give details of formations penetrated, size of mat~'ial, color and hardness" .:~'-
.... ' ' ty Gravel
:" O '.TO ~55 Si "Cobble
55 '"TO 90 Gravelly?Hardpan ~'ill :"
"-' 90 TO 225
'-' TO " ..........1 '-" _ _ ~ _ _: _
.: ~: _ ...... . ,. :~...: :-..- { . ::,. ,~ .. ,:..:~,_:. :::,.: .
TO
TO.
: ;~. ' TO
..-:"?' .[.:. ,~S. TO
.TO
.TO.
.TO ~ '
.TO
BedroC~:'~?'~rav to gree~, muds_tone~ sparce wa~er in
-- CUSTOMER
~-; '--~ ;: ' ~ MUNIGIPALITYOFANCHO [-- . :W ~. -~. :: .-~, ....
.... : '-"-;~"; -~: "' ' - .,. DEPARTMENT OFHEALTH & HUMAN SERVICES
.4 ,. Division of Environmental Services
'*~"* ; ...... '~'"' On-Site Services Section ~ · ·
- '- ' :' P.O. B~ 196650 Anchorage, Alaska 99519-6650 '.- ,-~-* ~ '.~'
'~- ":"~-~'~' ":" ~:' ':" ~:'" '~;'" 343-4744 -:~' -
. : CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
..... GENERAL INFORMATION
.;;~. '"; ;:T'; '-
Comple~e.!~gal description
Loc~tIon:(,.s.i~ad~lress or directions) 22221 Eagl~ River Road
e ,:-~nK~ n~n~r .,~ ~ ~on Day phone -694-2091
'=~ .... add~es~'., -~-{~2221 Eagle, ~v~ Road Eagl~ ~ver,- AK
' ' ' p~"-hone ....
._. ;J:~ Day
;. -...-.. ~.,~Unless o~e~se ~quested; H~ w~ll be held for p~ckup; ;%;~;. .~:;~'~ ,~%, ~,-:~ -- .' :.~ ;;:'-~ -..~ ~.~ _
~ .~:-~ ._ ...~ .. _-_,.: :~;~:~.~:-.....:. :...~.~ ~ , __.....,; _ ..~ , :- .. - ___ ~;:~ ::- ~ ...:- -
, .~.. NOTE: .. If communi~ well system, provide walden conffrmatio~ (r~ State ADEC a~est-
- ?;.~ ::~;. "'ing to the legali~ and status of system
4. ~ TYPE OF WASTEWATER DISPOSAL:
. ~.-t~- - ~..;;~;r~.:~¥~,'~,~'t~-',:;-~ Individual on-site ..-..
, ~ ..... -,- r ~'-~,-~- .~.:~. Pub lc sewer. ~ ·
-NOTE: If communi~'Oaste~ater'system, provide wri~en confi~ation from State ADEC
le~ii~ and status of system
~"'~ -a.= .,.~s*;"- to the . ..............
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
investigatJon 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 inves_ti_gation 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.
S & S ENGINEERING
Name of Firm ,-~,,o- ---[- -:..--, --- ----, -, .... Phone
RaCe River, Alaska 99577
Address .
DHHS SIGNATURE
Approved for
Disapproved.
Conditional approval for
bedrooms.
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 [3 H 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.
Municipality of Anchorage
Department of Health and Human Services
HEALTH AUTHORITY APPROVAL CHECKLIST
Legal Description:
Parcel I.D.
A. Well Data
Well type '~ '~ ~T~~ if A, B, or C, attach ADEC letter. ADEC water system number /~,
Logpresent (Y/N) Y~J' Date completed ]/-3- 7'~7- Driller/~-W
Total depth -7. ~' 0 Cased to
Sanitary seal (Y/N) Ye ~c
FROM WELL LOG AT INSPECTION
Date of test //-- ,~ - ~ ~ ~'- ] - ~'
Static water level ~ 0
Well flow ~/. 0 g.p.m.
Pump level1 ~I/-- ~ ~ S"
Casing height z/~.. //
Wires properly protected (Y/N) Y¢_s'
~UNICIPALIT¥ OF ANCHOP. AGt::
i;~IRONMENTAL SERVICES DIVISION
,JUN 1 5 ~995
g.p.m.
RECEIVED
SEPARATION DISTANCES FROM WELL TO:
Septic/heldi~ tank on lot /00 "'/-
Absorption field on lot / 00
Public sewer main
Sewer service line
; On adjacent lots
; On adjacent lots
Public sewer manho e/cleanout
Petroleum tank
/o43
WATER SAMPLE RESULTS:
Coliform ~ Nitrate
Date of sample:
B. SEPTIC/N~EBtNG TANK DATA
Date nsta led ..'~.
Collected by:
Tank size / .2..,4- 0
Other bacteria
;~'& SENGINEER/NG
Compartments ~.-
Cleanou ' ,. 'Foundation cleanou E
High water~;larmi(Y~N) '~ 'i ~,,,/~ ~ Alarm tested (Y/N)
Date of pumpi'ng .5-" ~ ~. c ? ~- Pumper ~,/:~ '~
EPARATION DISTANCES FROM SEPTIC/H-Lq~,,,~ TA TO:
' '"' /oo /~
Well(s) on Icl ../,-~, 0 ~' On adjacent lots
To property line / ~, / ~ Absorption field /2. '
Surface water/drainage · ! ~ c~
Depression (Y/N)
Foundation
Water main/service line /o /
72-o2e ¢~9e)' Front CONTINUED ON BACK PAGE
C, LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
"Pump on" level at
High water alarm level
Meets MOA electrical codes (Y/N) .~
SEPARATION DISTA~IC~FF~M LIFT STATION TO:
~ On adjacent lots
Manufacturer
Manhole/Access (Y/N)
,,Pu C
c- es1 ed
.Surface water
D. ABSORPTION FIELD DATA
Date inStalled (~"
Length --~ ~/ / Width
Total absorption area .~' ~/
Date of adequacy test ~ -- / -
Water level in absorption field before test
Peroxide treatment (past 12 months)
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Wellon lot
To buiEling foundation
On adjacent lots
Surface water
..~Curtain drain
E. ENGINEER'S CERTIFICATION
3
Cleanout present (Y/N)
Results (pass/fail)
5-"
Soil rating (GPD/FF) /~7~ f/,~Z- System type T.~- ~, ~ c J7
Gravel thickness ~ / Total depth / ~ /
Depress on over field (Y,~ /
/C> ~ _.c'_.c' for ~// Bedrooms
Aftertest ..~ ~-. O
On adjacent lots / o o ~' ~' Property line
/ ~' / J'-- To existing or abandoned system on lot
Cutbank A/', /~. Water main/service line
Driveway, parking/vehicle storage area
I certify that I have checked, verified, or conformed to all MOA and HAA
Signature
Engineer's Name
HA,& Fee $
Date of Payment
Receipt Number
72-026 (3/93)* Back
Waiver Fee $
Date of Payment
Receipt Number
Rick Mystrom.
Mayor
Mummpality of Anchorage
Department of Health and Human Services
825 "L" Street
P.O. Box 196650 Anchorage, Alaska 99519-6650
June 28, 1995
Robert C. Cowan, P.E.
S & S Engineering
17034 Eagle River Loop Road
Suite 204
Eagle River, Alaska 99577
Subject: Waiver Request for Lot 9 Sunny Valley Subdivision
Waiver Request ~WR950027, PID ~050-354-33, HA950223
Dear Mr. Cowan:
Your request for a waiver of the required 10 foot separation
between a septic system and a lot line has been approv~.c. The
waived distance is the leachfield and the property line of
6 feet.
This approval applies to the existing septic system lot line
separation only. Any future upgrade to the septic system will
require all separations be met or another approval from this
department.
S in/~e~e ly, /~
Robert W. Robinson
Civil Engineer
On-site Services
RWR/ljm
ENGINEERING STUDIES
AND REPORTS
ROADDESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ROBERTC, COWAN, RE.
ROBERTA. SHAFER, RE.
June 9, 1995
4unicipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
825 L Street
P.O. Box 196650
Anchorage, Alaska 99519-6650
CIVIL ENGINEERS
(907) 694-2979
FAX (907) 694-1211
MUNICIPALITY OF ANCHORAGE
ENVIRONMENTAL SERVICES DIVISION'
1995
RECEIVED
REFERENCE: Lot 9; Sunny Valley Subdivision
Request you issue a Health Authority Approval on the
referenced property and grant a waiver for the horizontal
separation distance between the leachfield and the property
line at 6 feet.
We do not anticipate any adverse affects on the adjacent
properties.
If we may be of further service please contact us.
Sincerely,
Robert C. Cowan, P.E.
17034 NORTH EAGLE RIVER LOOP · SUITE 204 EAGLE RIVER, ALASKA 99577