HomeMy WebLinkAboutWALTER G PIPPEL ADDITION BLK 10 LT 1
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: ~'~]~/-./?.5- PID Number: C~'O
Name:Wastewater System: [] New [~ Upgrade
Address: ABSORPTION FIELD
Phone: J No. el Bedrooms:
~ ~DeepTrench ~Shal~owTrench ~ Bed ~ Mound ~Other
LEGAL DESCRIPTION Soil Rating: Total Depth from original grade:
/,~ GPD/Sq. Ft.
Lot: ~[ock: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe
Township: I Range: I Section: Fill added above originar grade: Gravel length:
I
I
/ Ft. ~2 Ft.
Gravel width: Number of lines: 10istancebetween lines:
WELL:
New
Upgrade
Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: ~
Driller: Date Drilled: Static Water Level: Installer: Date installed:
Yield:~ Pump Set at:~ CasM9 Height Above Ground:
TANK
SEPARATION DISTANCES ~Septic ~ Holding ~ S.T.E.P.
To Sepdc Absorption Lift Holding ~ublic/Privat6 Manufacturer: Capacity in gallons:
Fto~ Tank Fie~d Stallon Tank Sewer Lines ~ ~
Well ~ ¢ I /~ / ~ ~ ~ ~ Material:~ ~ Number of Compartments:
Water ~ ~o~ -- -- LIFT STATION
~¢~ ~~ BENCH MARK
Location and Description:
I Assumed Elevation:
ENGINEER'S SEAL
S & S ENGINEERING ¢ "~'
170~4 Eagle R~ve~ L~ad, ~. ~4
Inspections performed by: ..... uates: 1st I[ I ~ } A 3 ~ ~., ' .~ _. .............. .
2nd J qf ~ ~; ............... ~
Reviewed and approved by: Date: /2 -/~ ~ '.
72-013 (Rev. 9/91 ) MOA 25
Permit No. SW9304~5
2 2
Page of
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
WALTER G. PIPPEL ADDITION,
Legal Description: BLOCK 10, LOT 1 PID No.: 0501 2,319
- 100.6'
TANK , .7'
...............................................................................ii ........................................ ~ .................................................. 9'0':'i'~ ............................................... i ..........................................
C01 12'~ II~i I ~'84.1' NO WATE~ FOUND
MT1 I 32 I 40! I i
LAZY S~REET
\%
50'! WELL RADIUS
3 BDRM
H~USE i E~ST.
~ . 750 GAL SEPTIC TANK
VER~IED 10/9/98
i GRANDFATHERED
ENG
1 OF
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 (UPGRADE) PERMIT
PERMIT NUMBER:SW930485
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:GREELEY GLENN & BETTY L
OWNER ADDRESS:P.O. BOX 771189
EAGLE RIVER, AK 99517-1189
DATE ISSUED:il/18/93
EXPIRATION DATE:il/18/94
PARCEL ID:05012319
LEGAL DESCRIPTION: WALTER G PIPPEL ADDITION BLK
10 LT 1
LOT SIZE: 13500 (SQ. FT.)
NUMBER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD 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 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
SPECIAL PROVISIONS:
THE EXISTING 750 GALLON SEPTIC TANK MUST BE REPLACED WITH A
1,000 GALLON TANK WHEN THE EXISTING TANK MUST BE REPLACED.
EC IWD DATE:
ISSUED BY:_ ~ DATE:
ROBERT SHAFER, P.E.
ROGER SHAFER, P.E.
November 15, 1993
CIVIL ENGINEERS
(907) 694-2979
FAX 694-1211
HEALTH AUTHORITY
APPROVALS
SEWER & WATER
MAIN EXTENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUD]ES
AND REPORTS
WELL INSPECTION
& PLOW TEST
SITE PLANS
ROAD DESIGN
SOI[~ TEST
PERCOLATION
TEST
STRUCTURAL &
MECHANICAL
INSPECTIONS
Municipality of Anchorage
DEPARTMENT OF HEAL TH AND HUMAN SERVICES
825 L Street
anchorage, Alaska 99519-6650
'EFERENCE: W. G. Pipple Subdivision, Block 10, Lot I
We request you issue a permit to upgrade the septic system serving the
three bedroom house on the referenced property.
An adequacy test performed on the existing system for Health Authority Approval
;urposes found the ~bsorption capacity of the existing system to be inadequate.
test hole was excavated and a percolation test performed in the area of the
proposed upgrade. The approximate location of the test hole is located on the
attached site plan. 'The monitoring tube within the test hole has been checked
and found to be dry. Attached it the proposed upgrade design.
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.
· Shafer, P.E.
P(RAS/LSU/Isu
ON SITE
WASTE WATER
DISPOSAL SYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP · SUITE 204 · EAGLE RIVER, ALASKA 99577
MAIN(1
~IMAVM9
8
ca
HOU~
NVgd 3J. lg ,01~ ='
ON-SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MA TERIAL SPEClFICATIONS
REFERENCE: W. G. Pipple Subdivision, Block 10, Lot I
GENERAL:
1.
3.
The scope of this project includes the installation of a leachfield trench to
serve the three bedroom residence located on the referenced property. The
existing trench is to be abandoned such that it may be used in the future.
Construction shaft 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.
The contractor shaft be responsible for obtaining any necessary
underground utility locates.
Unless specifically agreed otherwise, the property owner shaft be
responsible for final grading areas subsequently depressed from soil
settling.
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.
SEPTIC TANK INSTALLATION:
1. A septic tank is to be constructed by a certified septic tank manufacturer.
Construction shaft include two 4" cleanouts for pumping access.
2. The septic tank shall be sufficiently bedded to prevent settling or shifting of
the tank.
3. Aft standpipes on the septic tank shaft extend a minimum of 12 inches
above final grade.
4. Septic tanks installed with less than 4 ft. of cover shaft be insulated.
Page Two
W. G. Pipple Subdivision, Block 10, Lot 1
November 13, 1993
6.
A foundation cleanout shaft 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 soft not more
than 10 ft. from the tank. The first cleanout, in line, shaft be to clean toward
the leachfield. The second cleanout shaft 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/DRAINFIELD 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
(ruffed-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
soft backfill. Ensure the silt barrier covers the entire gravel surface before
placing backfill.
Monitor tubes shaft 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 shaft 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.
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
IN. G. Pipple Subdivision, Block 10, Lot 1
November 13, 1993
MINIMUM MA TERIAL SPECIFICATIONS:
Any septic tank proposed for installation must be constructed by a
Municipally approved septic tank manufacturer.
The following pipe materials are approved for use in septic system
installations in the Municipality of Anchorage:
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.
Insulation shaft be at least 2" thick extruded direct burial polystyrene (Dow
Chemical Company Styrofoam HI or equal).
Septic tank inlets and outlets shaft be fitted with watertight couplings
(Caulder, Femco, or equal).
A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N, or equal) must
be installed between the final leachfield gravel layer and the native soil
backfill.
Aft leachfield gravel (sewer rock) shaft be 0.5"-2.5" screened gravel with
less than 3% passing the #200 sieve.
When sand is being used as a filter material, it's gradation specifications
must conform to current M.O.A. or D.E.C. requirements.
Page Four
W. G. Pipple Subdivision, Block 10, Lot 1
November 13, 1993
INSPECTIONS:
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:
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.
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.
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.
Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
so,.s .oG - .E.COL^T'O" TEST
PERFO"MEDPOR: ~--~ ~~q
WAS GROUND WATER ~.~
~"~) ENCOUNTERED?
11 IF YES, AT WHAT I~ ~,
DEPTH? -- P
E
nepth to WaIer,P~LLi-
13 - Monitoring?' ,' ~ ~""~ Dote:
DATE PERFOI
Township, Range, Section:
14-
15-
16
17-
18
19
.~ENGINEER'S SEAL)
SITE PLAN
Gross Net Depth to Net
Reading Date Time Time Water Drop
20 PERCOLATION RATE ~ (minutes/inch) PERC HOLE DIAMETER
T~ST RU. ~ETWEEN /-f,~"-~TAND
COMMENTS
// 1703~ Ea_ale River Loop Road Ne. 204
AOCORDANCE~_TJrf~ALL~E AND MUN,CIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE:
72-008 (Rev. 4/85)
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & HUMAN SERVlOES
Division of Environmental Services
On-Site Services Section
P.O. Box 196650 Anchorage, Alaska 99519-6650
343-4744
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
1. GENERAL INFORMATION
Complete legal description
Lot I; Block lO; Walter ~, Pipp
Location (site address or directions) 11655 Lazy Street Ea.qle River
Property owner
Mailing address
Lending agency
Glenn Greelq Day phone
C/O DON MCKENZIE REAL ESTATE 13135 Old Glenn Hwy. Suite 100
Day phone
Mailing address
Agent Lol~ Pedersen/ DON MYKENZIE REAL ESTATE Day phone 694-9035
Address 13135 Old Glenn Hwy. S~it¢ 100 Eagle River, AK 99577
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 3 ~
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
XXX
NOTE:
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
x~
TYPE OF WASTEWATER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
attesting to the legality and status of system.
If community wastewater system, provide written confirmation from State ADEC
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 inves!!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 dat..e~of-tt~is inspection.
Name of Firm S &$ ENGINEERING i' ~' / Phone c'~
Engineer's signature ~~~~~~ -- Date
Se
DHHS SIGNATURE
Approved for -~
Disapproved.
Conditional approval for
bedrooms.
bedrooms, with the following stipulations:
Additional Comments
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 DHHS 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:
A. Well Data
Log pre~ent (~)
Total depth ~, CO r..~ Cased to
Sanitary seal(~N)
/
FROM WELL LOG
SEPARATION DISTANCES FROM WELL TO:
Septic/hokfi~cj tank on lot ~O f
Absorption field on lot .//~O "
Public sewer main ~ ~ ,,_.r ~F
Sewer service line /Ct ~ ~ ~
Date of test
Static water level
Well flow
Pump level1
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed /"~¢~'~Z Driller ~ ~ ~:~ ,_.~
/-7zc° ~- Casing height /2,
Wires propedy protected N) /
AT INSPECTION
; On adjacent lots
; On adjacent lots ~ ~',~
Public sewer manhole/cleanout
Petroleum tank /~J co ,,.J /~
WATER SAMPLE RESULTS:
Coliform (~
Date of sample: ~:~/~-//~
B. SEPTIC/HOLDING TANK DATA
Date installed /'~;~ r7
Nitrate
,.~.. /7Z /¢'//./~- Other bacteria
Collected by: $ & $ ENGINEERING
17034 Eagle River Loop Road Ne.
Eagle River, Alaska 99577
Tank size /'~.~'"--E~ Compartments /
/aa
Cleanouts~/N) ~/-~ J'~/F°undati°n cleanout (Y~) /,-)0 Depression (~'~
/ ·
,/1..///-'~ Alarm tested (Y/N) ~ /
High
water
alarm
(Y/N)
Date of pumping
SEPARATION DISTANCES FROM SEPTIC/~TANK TO:
Well(s) on lot ~ ~ r ~
On adjacent lots ~ '~ Foundation ~
To prope~y line ~ Absorption field .~ ~ (
~ Water main/sewice line
Sudace water/drainage ~O ~ ~ /~ r~
CONTINUED ON BACK PAGE
72-026 (3/93)* Front
C. LIFT STATION
Date installed % Manufacturer
Size in gallons
Vent (Y/N) "Pump on" revel]~-7'~17'~-~-~ "Pump off" Level at
High water alarm level ~ / ~ ~Ggcles~
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot ~ / ~ OJ~adjaeeFft4ots ~u,ace 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/N)
Soil rating (GPD/Ft2) /" ~ System type /~'~/C ~
_Width 2 , ~ Gravel thickness ~ , c~ Total depth //Z /
'~ ~ ~ Cleanout presen(~N) ,./~//~'-J' Depression over field (YN~ /c'r'O
/¢~---~ ~ Results (pass/fail) ~ for ~-~-~-~-~ Bedrooms
'~ / ~ After test /~/}/¢'h-
· /47 / ~ If yes, give date ~-~------
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot /~0 ~o ( On adjacent lots //~ 0 / Property line ~-
To building foundation Z /~ ( To existing or~ystem on lot
On adjacent lots //~:7 (_9 ~' Cutbank /-C/¢2 ~ ~ Water main/service line
Surface water /X_.JO ~'~A Driveway, parking/vehicle storage area ,~¢~)
Curtain drain ~J'O M/.~ /'~/~/0~)
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effe¢(on
Signature
Engineer's Na~.~!NE.E"IN, ....... , ,,,,,. ,~r~..
of this inspection.
HAA Fee $
Date of Payment
Receipt Number
72-0~8 (~/~3}* Back
Waiver Fee $
Date of Payment
Receipt Number
COMMERCIAL TESTING & ENGINEERING CO.
ENVIRONMENTAL LABORATORY SERVICES
s,~¢E,9o~ REPORT of ANALYSIS
Chemlab Ref.~ :93.5004-3
Client Sample ID :L1 Bi0 W.G. PIPPLE
Matrix :WATER
5633 8 STREET
ANCHORAGE, AK 99518
TEL: (907) 562-2343
FAX: (907) 561-5301
Client Name :S & S ENGINEERING WORK Order :71332
Ordered By :R. SHAFER Report Completed :09/28/93
Project Name : Collected :09/21/93 @ 14:35 hrs.
Projects : Received :09/22/93 @ 16:00 hrs.
PWSID :UA Technical Director:STEPHElg~. EDE
Released By : /Z~//~
Sample Remarks: ROUTINE SAMPLE COLLECTED BY: RAY.
QC Allowable Ext. Anal
Parameter Results Qual Units Method Limits Date Date Init
Nitrate-N 3.4 mg/L EPA 353.2/300.0 10 09/23 CMR
* See Special Instructions Above UA = Unavailable
** See Sample Remarks Above NA = Not Analyzed
U = Undetected, Reported value is the practical quantification limit. LT = Less Than
D = Secondary dilution. GT = Greater Than
~SGS Member of the SGS Group (Soci~t~ G~n~rale de Surveillance)
· * ENVIRONMENTAL SERVICES IN ALASKA, COLORADO, UTAH, ILL[NOIS, OHIO, MARYLAND, WEST VIRGINIA, NEW JERSEY, SOUTH CAROLINA
COMMERCIAL TESTING & ENGINEERING CO. AK DIV
CHEMICAL & GEOLOGICAL LABORATORY
TELEPHONE (907) 562-2343
5633 B Street
Anchorage, Alaska 99518
Drinking Water Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
[] PUBLIC WATER SYSTEM I,D. #
~SL, PRIVATE WATER SYSTEM
Phone No.
c~y
SAMPLE DATE: ~T'~ ~
Mo. Day
SAMPLE TYPE:
'~ Routine
[] Check Sample (for routine sample
with lab raf. no. )
[] Special Purpose
Year
[] Treated Water
~[] Untreated Water
SAMPLE Time Collected
NO. LOCATION Collected By
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
~Sat[sfac~o,'y
[] Unsatisfactory
[] Sample too long in transit; sample should
not be over 30 hours old at examination
to indicate reliable results. Please ser,~l
new sample via special delivery mail.
Date Received ~ /2- '~
Time Received - / ~o O o
Analytical Method: Membrane Filter
* No. of colonies/100 mL
Lab Ref. No. Result*
I I
r
READ INSTRUCTIONS Membrane Filter: Direct Count '(~ Collfornl/100 mi
BEFORE
COLLECTING SAMPLE
Verification: LSB BGB
Fecal Coliform Confirmation
TNTC -- Too Numerous To Count
OB = Other Bacteria
~~ Member of the SG.
Final Membrane ~e,r--I?aulta ,.~ Coliform/lO0 mi
PART ONE OF TWO:
REMAINDER TO FOLLOW