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HomeMy WebLinkAboutUS SURVEY 3200 LT 13D ' . ENVIRONMENTAL ENGINEERING DIVISION 825 L Street- Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT · [] UPGRADE MAILING ADDRESS LEGAL DESCRIPTION 2. OlSTANCE TO: I weu/O~ IAbs°'pti~n ~r"~0 Dwelling PER~2ot~ITNO. ~< 6*g~ ' Materi~ ~I No. of c~artments = ~ ~ 8 DISTANCE TO: Well [~O ~ Foundation Nearest lot line PERMIT NO. ~ -- ~Z~ No. of linesI Length ~c~ line Total I~ ~f lines Trench width, ~' inches Distanc~:t~:n lines ~ ~ Top of tile t~inish grad~ Material beneath tile ~ ,¢~ inches ~ Class ~epth Driller Distance to~ot lin* ~fiF~l ~0. ~ DISTANCE TO: "uilding foundation Sewer llne,,>~__ Septic t~g Absorption aroa(s~ OTHER PIPE MATERIALS RX/~' SOIL TEST RATING (907) 274-461] ANCHORAGE, ALASKA 99509 Well Owuer Steve Jones DRILLING LOG I/6~ation (address of: Township, Range, Section, if knosvn; / g~UN'ICiPALiTY Oi' AN. DPT. C: LiN & or distance main road Indian Size of casing_6" Depth of Hole Static water level 22 _ft. Screen ( ); Perforated ( Describe screen or perforationS/ Well pumping test at of drawdown from static level. Date of completion_ ] 0/1 8/79 J4J~. __feet Cased to__40.4 feet (below) land surface. Finish of well (check one) open end ( ). xx ); (minute) for__l hours with ~k WELL LOG Del)th iu feet from ground surface Give details of formations penetrated, size of material, color and hardness 0 TO 2 Casing stickup _ 2_ TO_ 3 Fill 3~0_ 5 5 TO_ 30 · ~kTo 3 9 __~o 41_ .TO _ _TO ..... TO TO ..... TO _. _TO .... TO_ TO ~0rgaBics S i 1 ty_ rg~av e~] G r_asge_liy~aarxt pan ]¢amer~x:av~l 1 ~ CUSTOMER PERMIT NO. · DEP~RTMENT-~' OF HEBLTH 8ND ENVIRONMENTAL PROTECTI~ 8=.. 'k' STREET., ~ELL ~NC~ 0~4--S I TE SE~ER PERM 8PPLICRNT STEVEN T. JONES '1205 OXFORD DRIVE 9950--:'.. LOCFIT I ON WBLLS CIRCLE LEGRL T!E4N R6~,~ SEC 6 NE i/4 L i~D ~ LOT =,I~E TYPE OF SOIL RBSORPTION SYSTEM IS: TRENCH 276-40~8 43560 SQURRE FEET MRXIMtJM NUMBER OF BEDROOMS SOIL RRTING (SQ FT?BR)= 125 THE REQUIRED SIZE OF THE SOIL RBSORPTION SYSTEM IS: DEPTHI= L-~ LENISTH= __2-~8 G R R"',,'" E L IDEPTH---- 5 THE LENGTH DIMENSION IS THE LENGTH (IN FEET) OF THE TRENCH OR DRRINFIELD. THE DEPTH OF ~ TRENCH OR PIT IS THE DISTRNCE BETWEEN THE SURFRCE OF THE GROUND RND THE BOTTOM OF THE EXCRV8TION (IN FEET). THERE IS NO SET WIDTH FOR TRENCHES. THE GRBVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTF8LL PIPE RND THE BOTTOM OF THE EXCRVRTION (IN FEET). REL-] L: I F-.' E [:, '..SEPT I C TFII'-,II< $ 'ir ZE= ::1_OOO C:iRLLOI'-,IS PERMIT RPPLICRNT HRS THE RESPONSIBILITY TO INFORM'THIS DEPRRTMENT DURING THE INST8LLRTION INSPECTIONS OF 8NY WELLS RDJRCENT TO THIS PROPERTY RND THE NUMBER OF RESIDENCES THRT THE WELL WILL SERVE. Tb~O (2) I ~-~SPECTI El~S RRE REQUIREC~ BRCI<FILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION RND RPPROVRL BV THIS DEPRRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R WELL RND 8NY ON-SITE SEWRGE DISPOSRL SYSTEM IS 100 FEET FOR R PRIVRTE WELL OR i50 TO 200 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELt_. MINIMUM DISTBNCE FROM R PRIVRTE WELL TO R PRIVRTE SEWER LINE IS 25 FEET RND TO R COMMUNITY SEWER LINE IS 75 FEET. WELL LOGS RRE REQUIRED RND MUST BE RETURNED TO THE DEPRRTMENT WITHIN 20 DRYS OF THE WELL COMPLETION. OTHER REQUIREMENTS MRY 8PPLV. SPECIFICRTIONS RND CONSTRUCTION DIRGR8MS BRE 8VRILRBLE TO INSURE PROPER INSTRLLRTION. F'ERM I T E)4F' I RES [:,,EC:ErdE, ER 3~,-,- :L98EI I CERTIFY THRT l: IRM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND WELLS RS SET FORTH BY THE MUNICIP8LITY OF RNCHORRGE. 2: I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES. 2: I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MRY REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THBN 2 BEDROOMS. SIGNED: ......................................... 8PPLIC8NT STEYEN T. JONES ISSUED BM .................................. DRTE ................ V4.0 DEPRRTMENT~-% HERLTH RND~EN¢IRONMENTRL( ~OTECTION 825 ' _ STREET, RNE. HORRGE, RK. ~ ~ELL R~-~B 0f4--5 I -rE 5E~JER F'ER~I I T PERi, IT NO. ( hPPL~cnNT ~~ ~ LOC~T~ON ~&S LEGRL ~¢T/~ &~'~/ ~0 ~/ T/~ ~¢~Ol SIZE OF sO L BSOR TZON SYSTEM ' ' '= ~ SOIL RGTING MGNIMUM NUMBER OF BEDROOM-, = ~ ~SQLIRRE FEET (SQ FT?BR>= /~2~ THE REQUIRED SIZE OF THE SOIl. RBSORPTION SYSTEM IS: DEPTH= ~, LE~IG-]-'H= ~ GRR%.'EL FJ. EPTF~= ~ GROUND RND THE BOTTOM OF THE EXCRVGTION (IN FEET>. THERE IS NO SET WIDTH FOR TRENCHES. THE GRRVEL DEPTH IS THE MINIMUM DEPTH OF GRRVEL BETWEEN THE OUTFRLL PIPE RNB THE BOTTOM DF THE EXCRVRTION <IN FEET>. PERMIT RPPI_ICRNT HRS THE RESPONSIBILITY TO INFORM THIS DEPRRTMENT DURING THE i INSTRLLI~TION INSPECTIONS OF RNY WELLS ~]DJRCENT TO THIS PROPERTY RND THE 'NUMBER OF RESIDENCE_ THRT THE WELL WILL SERVE. TL40 (2) I~4SPECTIO~4S i-IRE REQUIRED. BRCKFILLING OF RNY SYSTEM WITHOUT FINRL INSPECTION RND RPPROVRL BY THIS DEPRRTMENT WILL BE SUBJECT TO PROSECUTION. MINIMUM DISTRNCE BETWEEN R WELL RND RNY ON-SITE SEWRGE DISPOSRL SYSTEM IS 200 FEET FOR R PRIVRTE WELL~ OR 150 TO 288 FEET FROM R PUBLIC WELL DEPENDING UPON THE TYPE OF PUBLIC WELL WELL LOGS RRE REQUIRED RND MUST BE RETURNED TO THE DEPRRTMENT WITHIN,~O DRYS OF THE WELL COMPLETION. : OTHER REQUIREMENTS MRY RPPLY. SPECIFICRTIONS RND CONSTRUCTION DI~GR~MS RRE 8VRILRGLE TO INSURE PROPER INSTRLLRTION. PERI"11 T EXP :~ RES DECEMBER ~-I .. ::L~~:~ 80 I CERTIFY THR~ %: I RM FRMILIRR WITH THE REQUIREMENTS FOR ON-SITE SEWERS RND__~ELLS RS SET . FORTH BY THE MUNICIPRLIT¥ OF RNCHORRGE. 2: I WILL INSTRLL THE SYSTEM IN RCCORDRNCE WITH THE CODES. ): I UNDERSTRND THRT THE ON-SITE SEWER SYSTEM MR~ REQUIRE ENLRRGEMENT IF THE RESIDENCE IS REMODELED TO INCLUDE MORE THRN ~ BEDROOMS. SIGNED: .......... ~_ ISSUED .... DRTE - V~.2 PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3 4 5 6 8 ~0 ~2 13 14- 15- 16- 17 18 20- COMMENTS PERFORMED BY: [] SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION Pouch 6-650, Anchorage, Alaska 99502 276-222'[ SOILS LOG -- PERCOLATION TEST [] PERCOLATION TEST 8LOPE WA, .OUNO WATER ,'1/O ENCOUNTERED' IF YES, AT WHAT DEPTH? DATE PERFORMED: .j' SITE PLAN Gross Net Depth to Net Reading Date Time Time Water Drop ~ o. Telbot TEST RUN BETWEEN DATE: ?0 ,~/~/'~,~:2 72 008 (7/76) MUNICIPA' TY OF ANCHORAOE -L-\ DEPARTMENT OF HEALTH AND ENVmONMENTAL P.OTECT ON DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY 264-4720 Application Date ~ 1. GENERAL INFORMATION (a) (b) (c) Legal Description (include lot, block, subdivision, section, township, range) Location (address or directions) Applicant Name ~-"~"-~/h/~',~"~ Telephone: Home Business Applicant Address Applicant is (check one): Lending Institution,j~wner/builder~; Buyer []; Other [] (explain); (d) Lending Institution Telephone Address (e) Real Estate Company and Agent Address (f) Telephone ~' 7~ "/~_:;~3 Mail the HAA to the following addr,~. TYPE OF RESIDENCE Single-Family/~ Multi-Family [] Number of Bedrooms 3. WATER SUPPLY Other Individual Well~ Community[] Public [] ~ '. - Note; If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. ' ' ~ I ; ~ x ! ' ' 4. SEWAGE DISPOSAL Onsite.~ Public [] Community [] Holding Tank [] Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting tothe legality and status. Page 1 of 2 72-025 (11/84} ENGINEERING FIRM PROVIDh~G INSPECTIONS, TESTS, FILE SEARCH, b~ I'A AND INFORMATION As certified by my seal affixed hereto and as of the varidation date shown below, I verify that my investigation of this Health Authority Approval 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 flies 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 in--on_ ... ¢ Name of Firm Address ' Date Approved for ~ bedrooms by_ '¢ _ Date .~.._ Approved /~ Disapproved Conditional Terms of Conditional Approval CAUTION The Muncipality of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based solely upon the representations given in paragraph 5 above by an independent professionar engineer registered in the State of Alaska. The DHEP does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHEP 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. Page 2 of 2 72-025 (11/84) MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 264-4720 Legal Description: WELL DATA Cased tO ~'~',~ ~, Well Classification Well Log Present (Y/N) Total Depth Static Water Le~'el Casing Height Above Ground Electrical Wiring in Conduit (Y/N) -- Separation Distances from Well: / To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot '~ TO Nearest Public Sewer Line Cleanout/Manho e Water Sample Test Results Comments If A, B, C, D.E.C. Approved (Y/N) Date Completed__/./0/~2¢/;2~'_//.. Yield Depth of Grouting Pump Set At '(~.~ZG,~ Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) ; On Adjoining Lots ; On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot /cO / :Date _,'~/~n~- B. SEPTIC/HOLDING TANK DATA Date Installed /'~/¢'~/) Size /'~_ 0(P No. of Compartments ?-~- / Standpipes(Y/N'7~/ -%/ (/) Air-tightCaps(Y/N) Y FoundationCleanout(Y/N) Depression over Tank (Y/N) ,/~ Date Last Pumped Pumping/Maintenance Contract on File(Y/N) /~////~ ;for '~"//~',~""~ Holding Tank High-Water Alarm (Y/N) Separation Distances from Septic/Holding Tank: To Water-Supply Well ./~ ¢- / To ,Property Line ~O f To Water Main/Service Line ~' ~O / Course Y Temporary Holding Tank Permit (Y/N) ./,,///~ -- / To Building Foundation /~ To Disposal Field~ ~r To Stream, Pond, Lake, or Major Drainage Comments Page 1 of 2 72-026(11/84) C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Date InstalleU '~¢//~?,,~/[t Width of Field Square Feet of Absorption Area Depression over Field (Y/N) .,'~ Results of Last Adequacy Test Separation Distance from Absorption Field: To Water-Supply Well To Building Foundation . ~ 70/ Lot TO Water Main/Service Line To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments I ~J~'* /':"~ z/C~2~'~',Ct Type of System Des gn Length of Field Depth of Field Gravel Bed Thickness · ~z¢0¢~-- S~tandpipes Present (Y/N) Date of Last Adequacy Test To Property Line tO; To Existing or Abandoned System on ; On Adjoining Lots --~'"O / To Cutbank (if present) D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify t h q~._l.~.e.?hec ked, verif~d, or conformed to/all tv) CA and HAA guidelines in effect on the date of this inspection. Signed ~' ~ Date ~¢/i,~,~'~ Company MOA No. ReceiptNo. ~O / ~O 3 Date of Payment ~ -~ Amount: $ ~ :~-. 0¢') Page 2 of 2 Engineer's Seal }203 W. 15th AVE "C" SUITE 203 ANCHORAGE, ALASKA 99501 TELEPHONE: (907) 279-3916 RESIDENTIAL WELL INSPECTION LOT 13D, SEC 6, INDIAN ROAD STEVE JONES LEGAL: LOCATION: OWNER: TYPE OF WELL: SINGLE FAMILY WELL LOG AVAILABLE: YES INSTALLATION REQUIREMENTS MET: YES WELL YIELD FROM WELL LOG: 10 GPM PUMP YIELD: 4 GPM~ DATE OF INSPECTION: AUGUST 6, 1986 TEST PROCEDURE: WELL WAS PUMPED AT A CONSTANT RATE OF 4 GALLONS PER MINUTE WHILE THE DRAWDOWN WAS MONITORED WITH AN ACOUSTIC PROBE. THE WELL T10N, R1W WAS PUMPED UNTIL THE DRAWDOWN STABILIZED, STATIC WATER LEVEL WAS FOUND AT 26 FEET. TWO HOURS OF PUMPING AT 4 GPM CAUSED THE WATER~-' LEVEL TO DROP FOUR FEET. RECOVERY TOOK 4 MINUTES.--- TEST FOR COLIFORMS: WATER WAS TESTED FOR COLIFORM BACTERIA ON AUGUST 11, 1986. TEST WAS NEGATIVE.c--- TEST RESULT: THIS WELL MEETS THE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The Municipal requirement for well flow is 150 gallons of water per bedroom per 24 hours.This well surpasses this requirement. The assessment of the condition of this well applies only to the conditions as of this date. The flow rate of the well may change due to subsurface conditions that may not be observed from the surface, and changes in use and other factors that may impact conditions of the aquifer feeding the ~ ~ ~ '~ land ~-- ~%. ·.. ?. ,.,,~ o~ ~} the ~-' /:~ '.j~ %~ well. ~,~ ,. JUNE ~ CONSULTING ENGINEER )203 W. 15th AVE -c" SUITE 203 ANCHORAGE. ALASKA 99501 TELEPHONE: (907) 279-3916 SEPTIC SYSTEM ADEQUACY TEST LEGAL: LOCATION: OWNER: RESIDENCE: WELL: SEPTIC SYSTEM: LOT 13D, SEC 6, T10N, R1W INDIAN ROAD STEVE JONES SINGLE FAMILY, THREE BEDROOMS PRIVATE, ON SITE FROM MUNICIPAL RECORDS: TANK: GREER STEEL, 1000 GAL. ABSORPTION SYSTEM: TRENCH ABSORPTION AREA: 375 SQ. FT. SOIL RATING: 125 INSTALLATION DATE: JUNE, 1980 DATE OF PUMPING: AUGUST 14, 1986. ISAACS PUMPING SERVICE DATE OF TEST: AUGUST 6, 1986 TEST PROCEDURE: SYSTEM WAS INSPECTED AND MEASURED. TANK WAS FOUND WITH 5 FEET OF COVER. LIQUID DEPTH WAS 47 INCHES. CLEANOUT TO TRENCH WAS NOT FOUND. TRENCH SUMP WAS 8 FEET DEEP AND DRY.~ WATER WAS ADDED TO THE SUMP AT A CONSTANT RATE OF 4 GALLONS PER MINUTE. THE WATER LEVELS IN SUMP AND TANK WERE MONITORED. A TOTAL OF 450 GALLONS WERE ADDED. THIS CAUSED THE WATER LEVEL IN THE SUMP TO RISE 16.25 INCHES. INFILTRATION WAS MONITORED FOR 1.25 HOURS.-~ WATER LEVEL DROPPED 8.25 INCHES.~- TEST RESULT: THIS SYSTEM MEETS THE CODE REQUIREMENTS OF THE MUNICIPALITY OF ANCHORAGE. The operational life of all septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of this septic system. We can therefore not give any estimate of how .long the system will continue to meet the operational requi- rements of the Municipality and State.