HomeMy WebLinkAboutWILLIAMSON #2 BLK 3 LT 6
MUNICIPALITY OF ANCHORAGE
! DEPARTMENT OF HEAL'FH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street - Anchorage, Alaska 9950'1 Telephone 2_64-4720
ON-SITE SEWAGE DISPOSAL. SYSTEM AND/OR WELL INSPECTION REPORT
MAILING ADDRESS
DESCRIPTION, ~
~, capacity in gallons (~ Width Liquid depth
-- ~O O O IF HOMEMADE: ~ Inside length
O g ~ ManufactUrer Material Liquid capacity in gallons
= ~ Foundation Nearest I~i~) PERMIT NO.
Total length of
~}~'~ NO. of 'ine~ ~,__ DISTANCE 'O: Length of e~g,% Trench wide. ~ -4- Distance belweei~m¢~
m Length ~L ~ Width Depth PERMITNO.
~p Type of crib Crib diameter Crib depth Total effective absorption area
tu Well Building foundation Nearest lot line
~ DISTANCE TO:
~ C~s~ Depth Driller Distance to lot line PERMIT NO,
~ DISTANCE TO: Building foundation Sewer line Septic tank Absorption area{s)
~IPE MATERIALS /~
REMARKS
72-013 (Rev.(~/78) ~'
T'T'F'E OF::' '.".~;O I L. I:IE:':'!i;OF4:EI~T I ON :E;"r':~7'FIF:]"I I :~:;: "I'I~:EI~'4C:H
MF:I::.:',IMI..IM NIJF'IEAE:I,;i: OF E:IE[:,I~:OOML::i; =: 3:
THE: L..ENC~"I'H I) I I"lE:i,qS; I Oi~',[ 121; THE LE:N(]i"I"I'I ,:: ]: i,',l F'EETI' ) OF' 'FHE: "f'RE:i'.,IC:H I::i~l;i: C, Fi:FI i,: IqF' I EL.E).
'THE E:,Er:"T'H OF' F:I -rl;i:EIqC:H OP. F:'IT I'..7 'T'HE DISTF:II~.,ICE E:E"I"HEEhl THE :i~;I_,II~;I~FrI::IIZ:E O1::: 'T'HE
i}iF~:OIJl'.,[[:, FIND 'f'HIE E'KYTTOM i::11::' THE E',:-:;CF:I',,,'I::ITION ,:::IN F'E['::]"::,.
TFII!EI:~:E I~; I'*,10 :E;E'I"' I.,I]:DTH I:-*OF~: 'T'REI'.,ICHEL:L
"I"HE GF~:FI',,,'EL [::,[::F'TH IS THE MI I",IIMLIIr'I DEI~F:'TH OF:' GF::FI'v'EiL. E:E'THIZIEN ]"HIE OUTFrFIL.I,. F:'I~:F:'IZ
I':INI) THE BOTTlU)i,,1 OF::' ]'HE EI~-:',CFY,,,'F:I'T'ICII'.4 ,::IN F:'EE'f'::,,
................................................................ ~=> IF:II ~]]: ]-:::: IF:::II ,]:~ E!: F" IL_ IF=II P-..~ -tF' ~."Z~ F:" -tF" ]E n:Z, Ih.i, ..............................................................
F:I Fz'FIC:I-::]:rlL:iE F'I.FINT I'"11':1"~ EI~E INS'T'RL.L. ED FIT THE PEF['.I,'II'FTEL::'"% CIP'TION :~i;IJE~:.J'EC]" TO '('HE:
FOL,LOH t I'qG C'OND I T I OI'.,IS:
i. EITHE:]:~'. F:I E:LI::I':?,~; I O1:~: I I i~,~'_":;i~::' FIF'F:'F,]:O',,,'IF:E:, f::'LlZli~qT MF:I"r' E:E ]:I",I'-:TI'TtI...LEI2,.
F'I C:Oi",IT]:i",ILII:31.J~; i"ll-':t]:i"CI"I':Zi",IFli~'~CE FIGF:'.EEI~'IENT IE; [~:'.EQUIREI). ]:1:::' I:::1 HI:rK[I",I]"[EIqI::'II",ICli![
I::IGi'~'.EEMEI~',IT IS NOT I<EI:::'T C:IJI;~'.P. EI",IT "tOLl MF:I"/ BE F~t[~:l..ql. Jll:;i~Ei~[:) TO Ehll_l:::lr;i~GE THEI~ ?,OIL.
FIDSOFtPTIOI'.~ '.2'T'?YI"EM I::Ii'.,IC,,,'OF:: "r'OLI J"II':I'T' EIE SIJ[.:L.)'I,~I~::]" "Ff] F'f~:O'.E;I:_::C:Lr'I":[ON.
BFICh::F' ]: L...L. I big 01:: FIN~'' E;"/S"I'IEI~'I I.,I i~: 'THOIJT F:' I NRL, :[ I'q:SPECT I ON I::ll",l[) I:::IF:'F::'I~~:O'v'I:::IL. EFt 'I"H i E;
DE:Pt':IRTMENT HII_L E:E E;IJE:..TI,ECT TCI I::'F;~O"2;ECU"I'IOI'.,I.
M I h,t I MUM D ]: S'TI':tNCE: E:E:"I"HEIZIq f:i HEI_L. RF,I[:, FIl",l"r' ON-'E; I 'FIE E;E].,.II:::IGE
J..C:ir~i~ F'EET F:'IDF;I~ Ft F'F~:I',,,'F:I'I'E NELl... OR ::.:'.::~:~el FEET F:rOFi'.
OTHEF~:'. I:;~'.EQU :[ IRE!]"IEI",IT2:'; I"lFl~.r~ F:IPF:'L"r'. ':'k;F:'EC: I F I CI:::IT I O[q':-:; FIND C:OI~qSTI:;I~UC]'I ON [:) I FI(iiF:I~F]M'.:5 FiFI~E:
I::I',,,'I:::I]:LFII'3LE: 'l"O II",l'.:::;IJf,~:E~ F)F;b31::'El:;i~ II",I~!;Tf:II...L.F':tTZOI",~.
]: []:IZI:I~T I F:'~'r' 'I'HI::IT
:1..: I I'-'IM I~:r:IMILIFIF~: HITH ]"HE P. EQLIIp. E~:MEI~I~.,ITS F:DR i]ll,~.-:~!; ]: ]'l:!: E;I-ZI.,.IEFI~Ei; RNE:, HEI~I..LL::!; F:IE; SET
[:'l:::ll~:"l"l-[ Ei~~,r' 'T'HE MLINICIF'FII..I'I-"r' OF'
2: I HILL. I['-,I'-::FFFIL.L 'THIZ S"/STEM :1:1",1 F:K::COF?.DF'INCE HITH THE:
::i':: I L.INDEF;:S'I"FiI'.,I[:, ]"HFI]' TFIE OIW-':E;I]"E i~::[:ZklEl~i~ ~i~;"r'S'T'Eh'[ MR"r' I~~:EQUZRE ENI..J::I~I;:GEMEI',,IT IF 'I'T.IE~
I;'.E~;II3, EI'.,IC:E I'.2 Fi:IZMODEL. E:D TO Ii',[C:LIJC, E; i,ql]ll'~:E 'T'HFIIq E:
.,......,_,:. ....
April 19,1977
R & M NO. 751143
Mr. Bruce Barrett
1231 Friendly Lane
Anchorage, Alaska
99504
IiE:
Test Hole and Soil Log Report for Sanitary System
Lot 6, Block 3, Williamson Subdivision No. 2
Dear Mr. Barrett:
We are submitting herewith the test boring results and our comments
regarding soil conditions encountered at the s%~ject site. This in-
vestigation was performed in accordance with your request of April
14, 1957 and t]ose procedures outlined in a letter dated July 10,
1975, by Mr. Rolf Strickland of the Muncipality of ~]chorage Department
of nvlronmental Quality. E '
A single test hole was drilled within the subject site area for the
purpose of defining general subsurface soil conditions for the proposed
sanitary system. Drilling was accomplished with an auger type rig and
the test hole was extended to a total depth of 17.5 feet below ground
surface. The final log prepared for the test hole has been included
in Drawing A-01.
Groundwater was not encountered in t~e test hole while rllllng.
A pereolation test was performed from a depth indicated on the attached
table and reflects average J. nfiltration from that depth to the bottom of
the hole.
We appreciate being given this opportunity to be of service to you.
Should you have any questions wit]] regard to the above, please do not
hesitate to contact USo
Very ktruly yours,
R & M CONSULTANTS, INC.
J. Michael Stanley
G '
eologlcal Engineer
~S/sl
xc:
Municipality of /~lchorage
Lot 7
Lot 6 TH 1
Lot 5
Test hole location is
approximate and has not
been located by survey
methods.
TH- 1
4-18-77 All Samples A
ORGANIC MATERIAL
0.0~
0.5'
SANDY GRAVEL W/SOME
SILT (GM)
Brown, Slightly Moist,
Nedium Dense
............... 5.0'
SILT W/TRACE SAND
Brown, Dry, Firm
Tra'ce Gravel @7.0'
(ML)
6.0'
SILTY SAND (SM)
Brown, DrylMedium Dense
Trace Gravel @10.0'
TRACE GRAVEL 812.0'
13.0'
SANDY GRAVEl, W/SO~iE SILT (GM)
Brown, Dry, Medium Dense
17.0'
/SILTY SAND (SM)
Scattered cobble~ Brown, Dry, Dense
Refusal On Cobble ~7.5'1 TD
No Ground Water Encountered
2437
; JMS
~': 4-'19-77
~[E: 1"=3'
PERCOLATION TEST
BRUCE BARRETT
R & M NO. 751143
Lot 6, Block 3
Williamson Subdivision t~2
Anchorage, Alaska
April 19, 1977
11:20
11:21
11:22
11:23
11:24
11:25
11:26
11:27
11:28
11:29
11:30
11:35
11:40
1:[:45
11:50
12:00
12:10
12:20
ELAPSED
TI~4E DROP IN
~ INCHES INCHES
0 14.50 0.00
1 19.75 5.25
2 22.25 7.75
3 25.25 10.~5
4 27.00 12.50
5 28.00 13.50
6 29.50 15.00
7 30.25 15.75
8 '31.00 16.50
9 31.50 17.00
10 32.00 17.50
15 34.50 20.00
20
36.50 22.00
25 37.75 23.25
30~ 39.25
24'7~0
40 41.50 27.0~
50 43.25 28.75
60/ 45.00 ~0,SQ
30.50 Inches Total Drop or
'1.97 Minutes/Inch
,l:'., ........ ...
ENVIRONMENTAL CON SflI~F~VAT][ON
ANCHORAGE DISTRICT OFFICE
800 E, DIMOND BLVD,, SUITE; 2-470
ANCHORAGE, ALASKA 99815
WALT£R J. HIOKE. L, G;OVERNOR
(907) 349.7755
September 10, 1992
Ted Moore
SUBJECT: Willtmson'Subdlvision
Class "A" Public Water 9ystem, PWSID
Dear Moore:
I have completed a review of this office's files concerning the monitoring status ef the
above-referenced Class "A" Public Water System and found the following:
The last satisfactory Total Coliform Bacteria Sample results was submitted
to this Department on August 11, 1992. This does meet the provisions of
18 AAO 80.200(a) of the State Drlnkin9 Water Regulations.
The last inorganic Chemical Contaminants Sample results were submitted
to this Departmor~t on April 5, 1990. This does meet the provisions of 18
AAC 80.200(a).
The last Radioaotive Contaminants Sample results were submitted to the
Department on July 27, 1988. This does not me~)n~ ~O
.80,2~)_0(a), 8tete Drinking VY_At~F_BEglJ_tC_ECrlS.
The last Organic Chemical Con amlnants/Volat le Organic Chemicals were
submitted to this Department on May 26, 1992. This does meet the
provisions of 18 AAC 8D.200(a), State Drinking Water Regulations.
Issuance of thi~ latter does not imply that the above-referenced Class "A" Publlc Water
System is in comaance with other provisions of the State Drinking Regulations.
If you have any questions on the above information, please do not hesitate to contact thi.¢,
office ~t 349~77§5,
8in~cerely, ~ ///
//
Keven K, Klewer~o
District Englnee- (;.., ........ .,, ,,,, ,,~, ,.,.,~.,, ,,: ,,., ,. ;. ,~ ¢.~
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
Parcel I.D. #
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
1.
GENERAL INFORMATION
Complete legal description
Location (site address or directions)
,.
Property owner
Mailing address 5'o
Lending agency_
Mailing address_ 5'~'c~
MCr-/~. ¢ ~,.~,.¢;~,~._ /~r.cF~/-/-e~' Day phone
~o~o~e _ Day phone
'Unless otherwise requested, HAA will be held for pickup.
NUMBER OF BEDROOMS: ~ '~'
TYPE OF WATER SUPPLY:
Individual well
Community well
Public water
NOTE:
Day phone
If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF" WASTEWA'rER DISPOSAL:
Individual on-site
Holding tank
Community on-site
Public sewer
NOTE:
If community wastewater system, provide written confirmation from State ADEC
attesting to the legality and status of system,
72-025 (Rev. 1/91) Front MOA 021
o
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, h/,./ ~,.~C, ~c,c~o,~ p.~'/~,~.r
NameofFirm Ffa~ %e~n~f ~e¢¢~'c~z Phone ~Y~' /~3-
Address Iq~o ~04¢ ~/2 ~4~q, ~ ¢¢~-&
Engineer's signature ~ ~ ~ Date ¢//t/yE
DHHS SIGNATURE
~ Approved for
Disapproved.
bedrooms.
Conditional approval for
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 coudesy 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 & Human Services
HEALTH AUTHOFIITY APPROVAL. CHECKLIST
Legal Description: l. oT (¢, l~Lk' $,, WlLtl4N5o~ -ff~ Parcel I.D.
A. WELL DATA
Well type
If A, B, or C. attach ADEC letter. ADEC water system number
Log present (Y/N)
Date completed Driller
Total depth Cased to Casing height
Sanitary seal (Y/N)
Wires properly protected (Y/N)
FROM WELL LOG
AT INSPECTION
Date of test
Static water level
Well flow
Pump level
SFPARATION DISTANCES FROM WELL TO:
Septic/holding tank on lot
Absorption field on lot
g.p.m.
; On adjacent lots
; On adjacent lots
Public sewer main
Public sewer manhole/cleanout
Sewer service line
Petroleum tank
WATER SAMPLE RESULTS:
Coliform
Date of sample:
Nitrate _
Collected by:
, Other bacteria
B. SEPTIC/HOLDING TANK DATA
Date installed $/Io/78 ~'~ Tank size IOOO G/iL
Cleanouts (Y/N) )/ Foundation cleanout (Y/N)~
High water alarm (Y/N) _ ~.A,
Date of pumping
713 I~ z
Compartments
Depression (Y/N)
Alarm tested (Y/N) ~[,A ·
Pumper
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO:
Well(s) on lot ~,/~. Onadjacentlots ;>/oo ~
To property line ~2/ F~ot4 C.O, Absorptionfieid ct ~
Surface water/drainage ~:~ /oo
Foundation J2. F~or4 C,C.
t
.Water main/service line ~'
72-026 (Rev. 7/91) Front CONTINUED ON BACK I AGE
C. LIFT STATION
Date installed
Size in gallons
Vent (Y/N)
High water alarm level
"Pump on" level at
Manufacturer
Manhole/Access (Y/N)
"Pump off" level at
Cycles tested
Meets MOA electrical codes (Y/N)
SEPARATION DISTANCE FROM LIFT STATION TO:
Well on lot On adjacent lots
Surface water
D. ABSORPTION FIELD DATA
Date installed 5/lo
Length urt -- Width 36
Total absorption area /+/0 .~
Depression over field (Y/N)
Results (pass/fail) P/~ ,~ ~
Peroxide treatment (past 12 months) (Y/N)
Soilrating lSD ,q~/t~,~k Systemtype 1',~/c/~
Gravel thickness ~ .Total depth
Cleanouts present (Y/N) )/"
Date of adequacy test 8 / 2.,~/~'Z
for ,~ ~
K~o~'N o¢' If yes, give date N,/~,
bedrooms
SEPARATION DISTANCE FROM ABSORPTION FIELD TO:
Well on lot ~.A, On adjacent lots ~ /00~ Propertyline I~,
To building foundation 2~' To existing or abandoned system on lot ~., ~,
On adjacent lots ~' ~-0' Cutbank ~ ~°o~ Watermain/serviceline '~O
Surface water ~> /°~ Driveway, parking/vehicle storage area ~0 '
Curtain drain
E. ENGINEER'S CERTIFICATION
I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection.
HAA Fee $ /
Date of Payment
Receipt Number
Waiver Fee: $
Date of Payment
Receipt Number
72~026 (Rev 3/91) Back MOA 21
MUNICIPALITY OF ANCHORAGE
DEPARTMENT el= HEALTH & ENVIRONMENTAL PROTECTION
52S L Street - Anchoraae, AIssk~ 99501
ENVIRONMENTAL ENGINEERING DIVISION
Telephone 264-472{)
REQUEST FOR APPROVAL (:)F INDIVIDUAL WATER AND SEWER FACILITIES
D R ECTIONS: Complete a I parts on page ', Incomp ete requests w] not bl~ processed. Please al ow ten 10) days for processing,
1. PROPERTY DWNEI PHONE
MAILING ADDFIESS
6. TYPE OF RESIDENCE
/~ SINGLE FAMILY
~ MULTIPLE FAMILY
7. WATER SUPPLY
I--I INDIVIDUAL'
COMMUNITY
PUBLIC UTILITY
NUMBER OF BEDROOMS
[] One ~- Four --] Other
~ Two Z Five
[] Three --I Six
ATTACH WELL LOG. A well log is required for all wells drilled
since June 1975. For wells drilled prior to that date, (.live well
depth (attach log if available.)
8, SEWAGE DISPOSAL SYSTEM
~ ND V DUAL/ON S TE'' '*If individual/on-site, give installation date.~.~///_~<~::~
If system is over two (2) years old an adeau~cv testis required
I~] PUBLIC UTI LITY by this Departmen
NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORI_= PROCESSING CAN BE INITIATED,
72-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS ,.~
r'IME TIME TIME
DATE DATE DATE
INSPECTOR INSPECTOR INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF BEDROOMS
[~SINGLE FAMILY [] ONE [~'~TH R EE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
PERMIT NUMBER
2, WATER SUPPLY
[] INDIVIDUAL DEPTH OF WELL
[i~OM MUNITY
DATE DRILLED
[] PUBLIC UTI LITY
Connection Verified LOG RECEIVED
VIDUAL/ON -SITE DATE INSTALLED
Connection Verified INSTALLER
Size: /(~)C) IfTank [shomemade SOILS RATING
give dimensions: t -~ C~
TYPE T MAN" .r
4. DISTANCESwELL TO: Septic/Holdin§Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
5. COMMENTS
L~ APPROVED FOR % BEDROOMS
[] CONDITIONAL APPROVAL (letter must accompany certificate)
E~ DISAPPROVED
DATE BY (Title) /
72-010 (Rev. 3/78)