HomeMy WebLinkAboutSTUCKAGAIN HEIGHTS #2 BLK 1 LT 7 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: ,,.~'V'¢ ~'~ OZ.~ PID Number: _~:;~/-///-~/
Na.~e: ~ ~ ~ ~~5 Wastewater System: ~New 0 Upgrade
~o~ 7~do~ ~ ~ ABSORPTION FIELD
Phone: ~?¢_ ¢7~ No. of Bedr~s: ~OeepTreRoh ~ Shallow Trench ~Bed ~Mound ~Other
Total Depth from original gra~
LEGAL DESCRIPTION Soil Raring: ~Z GPD/S,. Ft. -
Lot: ~ Block:/ ~~Subdiv~i°n:~ ~ Depth to pi~ boUom Irom origins[~grade: Ft. 6ravel depth beneath pipe ~ Ft.
Township: ~ Range: l~ection: Fill added above original grade: Gravel length:
Number of lines: [Dislance ~twee~ lines:
WELL: ~New ~ Upgrade Gravel width: ~ Ft. / ~ Ft
Classification (P~ivate, A,B,C): Total Depth: Cased TO: Total absorption area: Pipe materlak
Driller: , Date dlled: StalicWater Level: ~ Date [nst~lled;
Yield: Pump Set at: ' Casing Heighl A~ve Ground:
% 6.~ ~ .~. ~ ~,. TANK
SEPARATION DISTANCES ~Septic ~ Holding ~ S,T.E.P.
TO Septic Absorption Lift Holding ~ublic/PdvateManufacturer: Capacityin gallons:
we,- /~ ~ ~ ~
Sudace ,
W~ter /~ ~ /¢~ -- ~ -- LIFT STATION
LOt Size in gallons: I Manu,a~
Remarks: h~n¢ ~n~R BENCH MARK
ENGINEER'S SEAL
Inspections pedormed by: ~D~¢~ Pates:lst /~5/f7
Department of Healt~ and Muman Se~ices ap~ov21
Reviewed and approved by: ~; ~ Date:/- 2 2-~
72~13 (Rev. 9/91) MOA 25
AS ~UILT SYSTEH DETAILS/SITE PLAN
STUCI<AGA][N HIEGHTS SU~}DIVlSIBN ~, ~}LBCI< 1, LBT 7
/ ~ LBT 6
a-[=65.s' LBT 8 ~ ~ I nT~ /
~ ..... F~NiSHED GRADE
U Q1250 GAL~ ' T
~ / BANL ~ SESER RBCK ~,
~ O~ a~ PREPARED FBR: SCALE, N'rs
CMM GENERAL CBNTRACTBRS
, P,B. BOX 77404e
~°~ss~°~~ ~ *s.~,.~: I.*~: ~AGL~ EIV~R, A~ g9577-8736
~~ owe r,~: ~,~: 2045
Ac*er,m97021.DWG ,o..~., 97021 (go?)696-61t~/rAX (907~696-8tt~
............ .. .
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.~.~ . . . . . .......... . .
~,.~Ft to--FL' aO*~ hO~d~ ~ /. From Ft. to~Ft, ,
:....~.~,~,,oga. ~,. ~,~ &~ ~/~.,. ~,.,o .. ~,, . · .
?. :-.~'.~:,~.~"~ .:: , ..,.. . · . . ,.. . , - .. ..~-,~/.. ,. .-.. ,....:~.-....,.:,..-..~ ,
,' .'..,'~.-~%q . -' ~- . , ' - t. ' .'-' : ''" . ".' · · '
'. :.- ?.,~..: .-~:a... ' . ~'a~TS.-..~ ,,,---a~ ~ ~' ~c~.~ -' ' . -
~t.".'.- ¥ ,'. .' · - · "'~r~h' ' ........ ~ ........ ~ ""
., :..:' · ,. : ' .' ' ".. . ' · .-':. 7', .,. -':--'. :--'.' .
· '" ~rb~m:.''''- "' ~. to Ft. .,, ' ' ~rom ' , Ft. to'" ",FI, ' : "
[:~.:: .:~,...~ ::z~...:~'~t':', · '- ": , - '; :.':?~.. . %' ~'~-'.- -, .'~?~,,'~,i::,'~:F:':.-::,';.-a,:.,:~.': · ~ .... :,. ': '. '~
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PAGE
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:SW970234
DESIGN ENGINEER:KND ENGINEERING
OWNER NAME:SEDLACEK THOMAS R & KAREN K
OWNER ADDRESS:P.O. BOX 774042
EAGLE RIVER, AK 99577
DATE ISSUED: 8/01/97
EXPIRATION DATE:
PARCEL ID:04102136
LEGAL DESCRIPTION:
STUCKAGAIN HEIGHTS #2 BLK
1 LT 7
LOT SIZE: 43796 (SQ. FT.)
NUMBER OF BEDROOMS:' 4 THIS PERMIT: 4
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.
1 OF
8/01/98
SPECIAL PROVISIONS:
AS DISCUSSED ON AUGU/~T 1,
NEED A MINIMUM OF 3/F~ET
PROVISION AND TH~
RECEIVED BY :~, -~--~/f l/
ISSUED BY: ~
1997, THE DRAIN FIELD WILL
)F~BACKFILL OR EQUIVALENT. THIS
~Ly VALID FOR~E ABOVE DESIGN.
DATE:
~ N D ENGINEERING
20441 PTARMIGAN BLVD.
EAGLE RIVER, AK 99577-8736
(907)696-6111/FAX (907)696-8111
July23,1997
Municipality of Anchorage
Dept. of Health & Human Services
On-Site Services Section
P. O. Box 196650
Anchorage, Alaska 99519-6650
Subject: Sewer/Well Permit - Stuckagain Heights Subdivision #2, Block 1, Lot 7
Gentlemen:
Following a request from the owner, on March 20, 1997 we dug testholes for the proposed
new system. The results of this percolation test are attached. The lot is to be served by an
individual well.
The proposed system will be placed on the west side of the property. As indicated on the
site plan there is sufficient grade to maintain a gravity system. A 1250 gallon tank will be
used. The proposed system will be for a four bedroom house.
As indicated by the site plan drainage arrows, natural drainage is away from this site and
will be maintained after construction. There is no surface water within 100' of the
proposed installation. There are no known curtain drains within 50' of the proposed
installation. No wells exist within 100' of the proposed installation and the community
well is over 200' away from the proposed site. This upgrade should have no adverse effect
on development of adjacent lots.
If you have any questions about this application, please call me at 696-6111/FAX 696-8111.
Respectfully submitted,
~) Engineering
Kenneth M. Duf s,~P.E.
attachments:
On-Site Well and Sewer Application
Wastewater Absorption System Details
Site Plan
Soils Log/Percolation Test
WASTEWATER glSPBSAL SYSTEM/SZTE PLAN
STUCKAGAIN HIEGHTS SUDDIVISIIDN ~2, ]3LOCK 1, LOT 7
VACANT
LOT 4
LOT 3
WELL '
LOT 8
WELL
]POSED WEL
LOT 1
DESIGN CRITERIA
1, 4 BEDROOMS X 150 GAL./DAY/BEDROOM = 600 GPO
2. SOILS RATING~ 1,0 HIM/INCH = APPL. RATE I.B GPB/SF
3, 600 GPB/i,2 6PD/SF = 500 SF
4, 500 SF /(2' x 6') = 41,67'L
5, MIN, DESIGN SIZE = 1 TRENCH 42' LONG x B' WIDE x 6' DEEP
6. DEPTH OF GRAVEL BELOW PIPE IS 6'.
7, TOTAL DEPTH OF SYSTEM IS 8.0' FROM ORIGINAL GRADE,
NOTES:
1, TIE INTO TRENCH AT END,
2. INSTALL 1250 GALLON SEPTIC TANK, INSULATE TANK IF <4' COVER.
3, INSULATE TRENCH WITH 2' HD BURIAL FnAN IF <3' COVER,
4. CONTRACTOR WILL ENSURE MAXlMUH 2Z SLOPE INTO SEPTIC TANK,
PREPARED FFIR~
ROBERT HAYWODD
OMM GENERAL CONTRACTORS
P,O, Bnx 77q042
EAGLE RIVER, AK 99577
KN]] ENGINEERING
P0441 PTARMIGAN BLVD
EAGLE RIVER, AK, 99577
(907)696-6111/Fa× (907)696-8111
SCALE: 1' = 100' 97021-S!
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 -L" Street, Anchorage, Alaska 99502 0650
SOILS LOG -- PERCOLATION TEST
WAS GROUND WATER
ENCOUNTERED?
Township, Range, Section: '7'"",~'~-- /
SLOPE SITE PLAN
S
Deplh to Water AHgC?_~.
[
Gross Net Depth ID Net
Reading Oate Time Time Water Drop
I ~:fzo/~? /z: ~ - 6,,, -,
7. ' " /2:~? / m,',~ 77,~'I'/~"
~ lz'.41 I~;. 7Y~'' I"
7 ~ 1~:4~ - ~" -
~ /~ :~- /~ 7" /"
/~ /~7 /~z~ ?" /"
2
5
6
8
9
10
'11 IF YES, AT WHAT
DEPTH?
12
13
14
15
16
17
18-
19-
20-
}ES7 RUN BE]WEEN
COMMENTS
PERCOLATION RATE J ~1A' (m,nule~,ncht PERC HOLE DIAMETER
72-008 (Rev 4/85)
i
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L' Street, Anchorage, Alaska 99502 0650
SOILS LOG -- PERCOLATION TEST
L E G A L D E SC R i pti 0 N :~ .g~. ~..~ /~,,~ "~'~. ~ /
DEPTH
2
3
4
5
6
7
8
9
10
'11
12
13
14
15
16
17
18
19
2O
C),/-/,
Township, Range, Section:
SLOPE
WAS GROUND WATER
ENCOUNTERED?
SITE PLAN
$
IF YES. AT WHAT .~/~ (~
DEPTH? P
E
Moniloring7 .L/'f'~. Dale:
Gross Net Oepth to Net
Reading Date Time Time Water Drop
z /z:o~ I~,,'~ ~Y.~" /Y,~"
~ IZ:Oq - ~'9~,, _
~ /z~ I ~ ~ V~" ~/~"
b 1~:o7 I~,'~ 7Yz' l"
lO I~: /I /~,~ 7" 1"
PERCOLATION RATE _ [ _ (m~nuleS~nch) PERC NOLE DIAMETER
ACCORDANCE WI'H A"L STA~ AND 'U"~L GUIDELINES IN EFFEOT ON TNI; "AT~ DATE
· {~"~/ DEPARTMENT OF HEALTH & HUMAN'SERVICES
· ~/ , D~vm~on of Env~ronmenta Se~mes ~.- . ~ . .
] '.-',~ ·, · ' - .... ~--~ONMENTAL SERVICES DIVISIG
' :: ' o '
Parcel I.r
' Complete leg
Location (site address or directions)
Lending agency
Mailing address
Agent
Address .....
Unless otherwise requested, HAA will b~held for pickup.
2. NUMBER OF BEDROOMS:
3. TYPE OFWATER SUPPLY:.
' Individual Wel
· ' Community_ well
=, Public water
Day phone ' '
Day phone '
N~0_TE:'' .if commdnity well system, provide written confirmation from State ADEC attest-
... lng to the Iegality and status of system. -
4. TYPE.OF WASTEWATER DISPOSAL: :-
' _ Individual on-site '
:' Holding tan' ,
:-~ ::',-' :'~:-. -- k. "' ' '" ~'
Community on-site
Public sewer ,/ - .
?2-025(Rev. 1/91) Front MOA#21
NOTE: If c°mmunit~' ~¢~s~ewater'system, provide written confirmation from State ADEc'i ? ' ._-
' '- ~ttestin¢ to thb iegality~ndstatus of system..' '' '' "' '~ ~ ~ '
STATEMENT' O1" INSPECTION BY ENGINEER
AS certified by my seal affixed'hereto and as of the validation date shown below, I verity 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 verity 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 corn pliance with all Municipal and State codes,
ordinances, and regulations in effect on the date of this inspection,
Name of Firm _ KND En~ineering Phone ~'~-¢' ~ ~'///// .
20441 Ptarmigan Blvd.
Address _ Eagte R[vP.r AI~ ~7'/.~'/,~
Engineer's signature ~ Date -
DHHS SIGNATURE
'_/~ Approved for z~
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
Date /-22 -~'~
The M~nicipality of ,A.:~ch0rage Department of Health and Human Services (DHHS) issues Health Authority
,~PProval Certificates":i~)~sed only upon the representations given in paragraph 5 above by an independent
professional engih~;r registered in the State of Alaska, The DHHS does this as a cou rte,,~y 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:'
72~2s{Rev. 1/~l) Back MOA#21
Municipality of Anchorage . tI~ONM£NTAI-SERVICF$ DIVt$~
~. ', .. :!~ii~ ?.DEPARTME~T,OF HEALTH & HUMAN SERVICE~JAN ] 6 'J998
' ~ EnvirOnmental Services Division
825 L Street, Room 502. Anchorage, Alaska 99501. (907R~V E D
Health Authority Approval Checklist
I ,
Legal Description: ~.C~b:30--~,kl ~'~ '~',~ ~//~ [/~~1/~ Parcel I.D.: ~/--/[~
J
A. WELL DATA
Well type
Log present (Y/N)
Total depth
Sanitary seal (WN)
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed ~;~/~/.~/~?
/ /
Cased to ~--~' / Casing height (above ground)
y Wires properly protected (Y/N) Y
Date of test
Static water level
FROM WELL LOG
IZD '
Well production
WATER SAMPLE RESULTS:
Coliform /
B. SEPTIC/HOLDING TANK DATA
Date installed / ~/~.~/~ Tank size
Foundation cleanout (Y/N) ~/
AT INSPECTION
g.p.m. // g.p.m.
Nitrate
Z-~, ,,2.-/ Other bacteria
C olle ct e d by: .,~'//b/'/~ ~.,.~;;~/2/.~ ~">"'~'~/
/z~.~'-'O Number of Compartments ~ Cleanouts (Y/N)
Depression (Y/N) /~ High water alarm (Y/N)
Date of Pumping ~- Pumper
C. ABSORPTION FIELD DATA
Date installed /Zg//I~.?~'?
Length ~/~. ~ Width
Soil rating (g.p.d./fF or ft~/bdrm) /. ~ System type
~- ~ Gravel thickness below pipe ~ ~ Total depth
Effective absorption area :~OcJ Monitoring Tube present (Y/N) ~/ Depression over field (Y/N) /~/
Date of adequacy test / Results (Pass/Fail) /' For // bedrooms
Fluid depth in absorp~fore test (in.); Imply after gal. water a~in.):
Fluid depth / (ins) Minutes lateri / Absorption rate = / g.p.d.
Peroxide tre~ent (past 12 months)(Y/N)/ If yes, give d~'~
72-026 (Rev. 3/96)*
D, LIFT STATION
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Cycles tested
Size in gallons /
p.~ni't lue:el at* /// "Pump off" level at*
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot _
Absorption field on lot //~')['~ /-/~
Public sewer main
Sewer/septic service line _ ,~,;~ ' -'~
On adjacent lots
On adjacent lots
Public sewer manhole/cieanout
Lift station /~.'//~
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Foundation /~ ~ Property line /~ '~ Absorption field__ ,/~)
Water main/service line .~'_~ 4- Surface water/drainage//~t'~ -/~ Wells on adjacsnt lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line /~) !~P Building foundation /~> ~- Water main/service line
Surface water ,/~fP.P.~ r'4~ Driveway, parking/vehicle storage area
Curtain drain /~¢>~ /-/~ Wells on adjacent lots /~)~)
ENGINEER'S CERTIFICATION
I certify that I have determined thru field inspections and review of Munietpal ~corcls ti
Signature ~-~'~ ~J¢-~-.~
Engineer S Name
Date /~/~
HAA Fee $
Date of Payment
Receipt Number
Waiver Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
DEC 2~
NORTHERN TESTING LABORATORIES, INC.
3330 INDUSTRIAL AVENUE FAIRBANKS, ALASKA 99701 (907) 456~116 · FAX456-9125
8B~$ SCHOON STRE~-'f ANCHORAGE, ALA,~KA 99.51~ (907) 349-1000 , FAX 349- lO 16
KND Engineering
20441 Ptarmigan Blvd,
~agle River. AK 995?74736
Arm:
Client ID; Stuckagain Hts., B1L7
Client Project #:
~TTL Lab#; A153518
Sample Matrix: Water
Comr~enta;
[MethodParameter Units Result
RaDOn Date: 12/23197
Date Arrived: 12/12/97
Sampia Date: 12112197
Sample Thne: 15:o0
Collected By; Kelly
** Legend **
MRL = M~od~o~el
Dato Dat~
SM 4500 E
Nitrate-N mg/L 4.21
0.50 12/I$/97