HomeMy WebLinkAboutZODIAK MANOR ALASKA BLK 5 LT 16
NAME ~
MAILING AD DR E.S~_) '.~ /
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION
ENVIRONMENTAL ENGINEERING DIVISION
825 L Street- Anchorage, Alaska 99501 Tglgphone 264-4720
ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT
PHONE · NEW
DISTANCE TO: ~ell ¢~ Absorpti ea/ Dwelling
Materi~
[Liq. cal IF HOME.DE: I~ ,,,[nsid°length Widtl~
DISTANCE TQ: Well ~ ~ ~ng
Manufacturer ~¢ t Material
DISTANCE TO: ~ ~ Foundation ~ /
I~e Total length of~ ~TTrench w~h~
/ ~ ® inches
Top of tile to finisl~ra~..T..
Length Width
Material beneath tile
Depth
NO. ~BEDROOMS
No. of co~..rtments
Liquid depth
PERMIT NO.
L. ktuicl capacity in gallans
Distance bet ~/7~e,
Type of crib Crib diameter Crib depth Total effective absorption area
Well Building foundation Nearest lot line
DISTANCE TO:
Class Depth Driller Distance to lot line PERMIT NO.
DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s)
OTHER
DATE LEGAL
liE; i !i:i',i(!?l 1! ,:: :!: i"4 J:::E:li; I' ::, ElF: ! Il!: ! f;;:li:i',iE:J ! (d:;: [:d,::~::i :! ',ii:' :! F:! E:,.
I:';~;t ;t:::i; 'ii'II!; [:', i:?: Fl:'llqC:!!:
I'I il:. F; :: :; E:I:::I 'v' I:::1 I :!, 13 I",l
I: !",11 i"ll.It'"! I::,t:ii:l::"l I-1
I ;::'::E:l:::l'v'l::l i' :I; Cli'.,I ,:; :[ I",I
Se[:uember 6, 1978
Mr. Ken Simpson
P.O. Box 10-1648
Anchorage, Alaska 99511
Subject: Soils investigation for sanitary sewer system on; Lot 16, Block 5, Zodiac
Manor Subdivision, Anchorage, Alaska.
Dear Mr. Simpson
At your request of August 31, 1978, I conducted a soils investigation at the proposed
location of a sanitary sewer system on the subject lot.
This investigation, which was accomplished on September 1, 1978, consisted of the
inspection of soils removed durr]ng digging of a test pit to a total depth of ]6.0
feet, using a wheel mounted backhoe. After completion of the dlgging of the test plt,
a bench was dug adjacent to the test pit, to a depth of 4 feet, and a posthole digger
was used to sink a 6 inch diameter, 22 inch deep hole into the bottom of the bench. A
percolation test was then performed using this hole. The results of the percolation
test are tabulated on an accompanying sheet.
The soils encountered are graphically shown on the accompanying test hole log. The
soils consisted of a 1.5 foot thick layer of organics and organic silt overlying a
gravelly sand with a trace silt to a total depth of 16.0 feet. This lower horizon
contained abundant cobbles and boulders. A thin ash layer was noted directly beneath
the surficial organics.
The topography of the subject lot is generally flat with a very slight slope to the
west. Vegetation on the lot consists of moderately dense spruce and birch to 50-60
feet tall, with some alders and willows, and a ground cover of grasses and mosses.
No water table was encountered.
An accompanying sketch shows the subject lot with the approximate location of the test
pit in relation to the propeYty l~nes.
I appreciate the opportunity to be of service to you. Please contact me if you have
any questions regarding this soils investigation.
Very truly yours,
Michael B/~ergmann
ConsultL6g Geologist
Box 191, Star Route A
Anchorage, Alaska 99502
(907)344-9150
Attachments: Drawing of test hole log with location sketch, and tabulation of
percolation test results.
xc: Department of Health and Environmental Protection
SeRtember 6, 1978
Lot 16, Block 5,
Zodiac Manor Subdivision,
Anchorage, Alaska
Percolation test performed September 1, 1978, by filling the 6 inch diameter, 22 inch
deep hand dug test hole w~th water, and measuring tile water level drop periodically
for one hour.
TABULATION OF PERCOLATION TEST RESULTS
TIME LEVEL(inches) DROP(inches) ET (min)
1551 2.0" start start start
1601 7.0" 5.0" 10 2.0
1611 11.0" 4.0" 10 2.5
1621 13.5" 2.5" 10 4.0
1631 16.0" 2.5" 10 4.0
164]. ].7.0" 1.0" 10 10.0
1651 18.0" ].. 0" 10 ].0.0
RATE(min per inch)
Average percolation rate for entire hour = 3.8 minutes per inch
Average percolation rate for last one half hour = 6.7 minutes per inch
Michael B. Bergmann
Cosu].ting Geologist
Box 191, Star Route A
Anchorage, Alaska 99502
(907)344-9150
120.0' N ].5000'00'' E
10' Utility Easement
50'
Lot 16, Block 5,
Zodiac Manor Subd.
Anchorage, Alaska
310,
78.75' Nl5°00' 00"E '~,6'
Pluto Drive
/I
NOT TO SCALE
Distances are approximate and have not
been measured by surveying methods as
to location of test hole.
Michael B. Bergmann
Consulting Geologist
Box 191, Star Route A
Anchorage, Alaska 99502
(907)344-9150
T.II. NO.
9-1-78
--0.0'
anlcs & Organic Si].t,
reddish brn.
an].c Silt: w/trc to some
organics, dry, loose,
reddish bm.
%-- ........ 1.5'
Note: Gray layer of ash approx-
imately 1" Ehlck at base
of organics.
Gravelly Sand: w/trc Silt,
abund cobbles & boulders,
boulders to 2' diameter,
sand pred fn to vy fn, sl
moist, med dense to dense,
occ pockets of Sandy Gravel,
gray to gray brn.
(GM)
NO WATER TABLE ENCOUNTERED
--16.0'TD
Test Hole Log represents soils
encounterd on Lot 16, Block 5,
Zodiac Manor Subdivision,
Anchorage, Alaska
!i:::!i:'i::'
WONICIPALITY OF ANCHORAGE
DIVISION OF ENVIRONM~N~rAL REALTH
DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION
APPLICATION FOR F~ALTH AUTHORITY APPROVAL CERTIFICATE
1o General Infotnnation Application Date 22 Aagust, 1985
(a) Legal Description (include lot~ block, subdivision, section, township, range)
Lot 16, Bloc[< 5, ZodJak Manor Alaska SubdivJsion Sec ]0, T12N, R3W, S.M.
Location (address or directions)
44'13 Zod~al< Drive, Anchorage, Alaska
Applicants Name Blafne Ghan Telej~hone - Home346-3651 Business276-4800
Applicants Address Same
(b)
(c) Applicant is (check one) Lending Institution ~_~ ; Owner/builder
Buyer Z---~[ ; Other l~--~ (explain);
(d) Lending Institution ^laska M~tual Bank Tele~_~o_ne__
Address
(e)
(f)
Real Estate Co. & Agent
Address
Telephone
Mail the ItAA to the following ~dress:
Call for~9_~ u_p= - 276-4800 or 346-3651
'f__y?~_ R__e s id eric e
Number of Bedrooms
Mot~: If community well system~ must have ~t~ten co~imation from the State
Department of Envirm~ental Conservation attesting to the legality and status.
Sewage Dis~ SEE MOTE
Onsite [[--~I Public
Note: If community well. system, must have ~itten co~irmation from the State
Department of Environmental Conservation attesting to the legality and statns.
[Page 1 of 2]
5. _E.~ineering Firm Providin. g..Inspect___zi_o_ns_~ Tes__ts_z__Fi_~e___S_e:_arch,_ Data and Information
As certified by my seal affixed hereto and as of the validation date showo 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 aud adequate for
the number of bedrooms and type of structure indicated herein° I further verify that,
based on the information obtained from the Y~anicipality of Anchorage files and from my
investigation and inspection, the on-site water supply and/or wastewater disposal
system is in compliance ~th all Municipal and State codes, ordinances, and regula-
tions in effect on the date of this inspection.
Name of Firm CRW ENGINEERIMG GROUP
Telephone 562-3252
Address 3900 Arctic Blvd., Suite 203, Anchora~_~, Alask'a 99503
Date 22 August, 1985
NOTE: The on-site sewage
disposal system
found adequate for ~ ......
two bedrooms.
Approved for'~V.~t~bedrooms
Appreued ~ Utsapprovsd
Te~nns of Conditional Approval
CABTION
THE bfdNICIPALITY OF ~2{CHORAGE DEPARTMENT OF h~'~ALTH AND ENVIRONbfENTAL PROTECTION
(DHEP) iSSUES HEALTH AUTHORITY APPROVAL CERTIFICATES BASED SOLELY UPON THE REPRESENT-
ATIONS GIVEN IN PARAGRAPH 5 ABOVE BY AN INDEPENDENT PROFESSIO~lgI, ENGINEER REGISTERED
IN Tt~ STATE OF ALASKA° TIiE DHEP DOES THIS AS A COURTESY TO PURCHASERS OF
THEIR LENDING °INSTITUTIONS IN ORDER TO SATISFY CERTAIN FEDER~ AND STATE REQUIRE-
MENTS. 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 ENGINq~ER'S WORK.
(DHEP SEAL)
RR4/eJ/D18
[Page 2 of 2]
7-19-84
A. W~LL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
H~I~LTH AUTHORITY APPROVAL (HAA)
CHECKLIST - FEBRUARY 1984
Well Classification
Well Log P~esent (Y/N) N
Total Depth 165'
Static Water Level 13q '
Casing Height Above Ground
Eleetmieal Wiring in Cx~nduit (Y/N)
Separation Distances fl:om Well:
To ~ptie/Holding Tank on Lot
Pr] vate
Date Completed
Cased tD 165'
~]mp Set At
2½'
Legal Description: Lot 16, Block 5,
If A, B, c~ C, D.E.C. Approved(Y/N)
1979+ Yield
Depth of Groutin~ Unknown
Sanitary Seal on Casing (Y/N)~e__s
Yes Depression A~ound Wellhead (__Y/N)No__
102' "'
4.5gpm ~
; On Adjoining Lots 165 '
TO Nearest Edge of Absorption Field on Lot 110 ' ~'~' ; On Adjoining Lots 120 '
To Nearest Public E~wer Line N/A To Nearest Public Sewer
Clea~out/~anhole N/A To Weakest: Sewer service Line on Lot 80'
Wate~ Sample'Colleeted By B~ ~ooney ; Date 8/8/85 ~
Water Sample Test Results Satisfactory ~
Cc~a~nts
B. SEF~IC/HOLDING TANK DATA
Date Installed 1978 ~- Size 1000
Standpipes (Y/N) Yes Ail~,-tight Caps (Y/N)
Depression over Ta~k (Y/N) No Date Last Pumped 8/8/85,-
Pumping/Maintenance Contract on File (Y/N) N/A ; for N/A
Holding Tank High-Water Alarm (Y/N) N/A Temporary Holdillg Tank Permit (Y/N)
Separation Distances f~om septic/Holding Tank:
To Water-Supply Well ] 02 ' ~- To Building Foundation. I 3 '
To P~operty Line . 25' To Disposal Field ~ 5'
To Wete~ Main/Servic~ Line __ N/A
No. of Compartments 2
Yes Foundation Cleanout (Y/N) Yes,
N/A
TO Stream, Pond, Lake, c~ Major D~.ainage
Cott~se 100, +
Con~nents
[Pa~e 1 of 2] 2-15-84
C. ABSORPTION FIELD DATA
Soils Rating in Absorption Strata
Date Installed 1978
Width of Field
Square Feet of Absorption Area
Depression over Field (Y/N) No
Results of Last Adequacy Test
145 S.F./BR Type of System Design Trench
Length of Field 40'
Dept/a of Field ~ 2 '
Gravel Bed Thickness
480 ~'~ Standpipes P~esent (Y/N) Yes
Date of Last Adequacy Test 8/8/85
System adequate for 2 bedrooms
Separation Distance from Absorption Field:
To Water-Supply Well
To Building Foundation
Lot N/~
To Water Main/Service Line
To Stream/Pond/Lake/c~ Major D~ainage Course N/A
To D~iveway, Parking Area, or Vehicle Storage Area 50'
Cor~nts Property currently served by on-site sewer but
110' f TO P~operty Line 20'
35' To Existing or Abandoned System cn
; On Adjoining Lots 80,+
N/A To Cutbank(if present) N/A
shall be set-
ved bv communJ ty
LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes(Y/N)
Dimsnsions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles du~ing Adequacy Test.
Meets MDA
Con~nts
Con. any CRW ENGINEERING GROU?
KB1/d5/s
** Check Permitted Bedmoom Rating A~ainst HAA Request **
I certify that I have checked, verified, or conformed to all MOA HAA Guidelines in effect
on the o~~pe
date ,,
etlon.
Signed
Date a/Pp/a5 ,~?~w.. ........ ~,4.~ ~
MOA No. ST-Sq-Paq ,.~: ENGI~ .<w ~
[Page 2 of 2]
MUNiCiPALiTY OF ANCHORAGE
'DEP'r. OF HEALTH &
· ENVIRONMENTAL PROTECTION
RECEIVED
A. WELL DATA
MUNICIPALITY OF ANCHORAGE (MOA)
HEALTH AUTHORITY APPROVAL (HAA)
CHFCKLIST- FEBFIUARY 1984
264-4720
Legal Description: Lot 16~ Block
Manor Alaska Subdivision
%; ZodJak
Well Classification PrJ va h~ _
Well Log Present (Y/N)
Total Depth 165 ~ Cased to __
Static Water Level 135
Casing Height Above Ground __ 2
Electrical Wiring in Conduit (Y/N) Yes
Separation Distan'ces from Well:
To Septic/Holding Tank on Lot 102
To Nearest Edge of Absorption Field on Lot 110
To Nearest Public Sewer Line N/A
Cleanout/Manhole. N /
Water Sample Collected by
If A, B, C, D.E.C. Approved (Y/N)
Date Completed 19 ? 9,,~ Yield
16_5 ' Depth of Grouting . UFIk~1OWJ9
Pump Set At 1 65
Sanitary Seal on Casing (Y/N)
Depression Around Wellhead (Y/N)
-N:~.~A ; On Adjoining Lots
; On Adjoining Lots
To Nearest Public Sewer
To Nearest Sewer Service Line on Lot
;Date ~3/8/85
Water Sample Test Results _ ,g a his/La c t. o rw
Comments
gpm
Yes
165'
120'
80'
B. SEPTIC/HOLDING TANK DATA
See Comment
Date Installed
Siandpipes (Y/N) Air-tight Caps (Y/N)
Depression over Tank (Y/N)
Pumping/Maintenance Contract on File (Y/N)
Holding Tank High-Water Alarm (Y/N)
Separation Distances from Septic/Holding Tank:
To Water-Supply Well
To Property Line
To Water Main/Service Line
Course
Size No. of Compartments
Foundation Cleanout (Y/N)
Date Last Pumped
; for
__ Temporary Holding Tank Permit (Y/N)
To Building Foundation
To Disposal Field
To Stream, Pond, Lake, or Major Drainage
Comments_Property currentlv served by
_by community_sewer in near future per att, ached
Page 1 of 2
on-si he se. weP bnt ~h~l 1
1 ~tt.~Y,.
72-026(11184)
C, ABSORPTION FIELD DATA See Comment
Soils Rating in Absorption Strata
Date installed
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
Lot
To Water Main/Service Line
To Stream/Pond/Lake/or Major Drainage Course
To Driveway, Parking Area, or Vehicle Storage Area
Comments Property currently served
Type of System Design
Length of Field
Depth of Field
Gravel Bed Thickness
Standpipes Present (Y/N)
Date of Last Adequacy Test
To Property Line
To Existing or Abandoned System on
; On Adjoining Lots
To Cutbank (if present)
by on-site sewer but shall be ser-
ved by community sewer in near future per attached letter.
D. LIFT STATION
Date Installed
Size in Gallons
"Pump On" Level at
High Water Alarm Level at
Tested for
Electrical Codes (Y/N)
Dimensions
Manhole/Access (Y/N)
"Pump Off" Level at
Vent (Y/N)
Pumping Cycles during Adequacy Test. Meets MOA
Comments
** Check Permitted Bedroom Rating Against HAA Request **
I certify that I.~h//~-c~_.,¢ked,.~?ified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection,
Signed ,~'//~-¢~¢'o~" Date 20 August, 1985
CompanyCRW ~G}NI~.RZk~G GROUP MOA No. ST-85-253
Receipt No. ;?-~"~ ~l~3) r~
Date of Payment ,r(¥,~,~.~,.,;~.~.,~
Amount: $ '¢'~'~'-~-("~"} Engineer's Seal
Page 2 of 2
72-026 (11/84)
MUNICIPALITY OF ANCHORAGE i-D~p~,. (.,,
~ DEP~ RTMENT ~F HEALTH & ENVIRONMENTAL PROTEC'rlO~'VIxeN'' ' NT/~L .
~__% 823 L Street-Anchorage, Alaska 99501
kk~l~// ENVIRONMENTAL ENGINEERING DIVIolON
REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWER FACILITIES
DIRECTIONS: Comolete al carts on page 1. Incomnlete requests will not he processed. Please allow ten (10) days for orocessing,
PH ON,E.
PHONE
PHON~=
~ ' ' .~ ~v'~ 1-PHONE ,
I pHONE
6, LEGAL DESCRIPTION
STR E E'i- LOCATION
fi. Typrl OF RESIDENCE NlJMBER OF BEDROOMS
[~] One E~ Four [~ Other
~ SINGLE FAMILY E] Two [] Five
[] MULTIPLE FAMILY ~]'/ Three EJ Six
7. WATER S~PLY
Z XIDIVI DUAL" ' ATTACH WELL LOG, A well Icg is requ red for all wells drilled
[] COMMUNITY since June 1975. For wells drilled urior to that date, give wel
[] PUBLIC UTILITY depth (attach log if available,)
8. SEWAGE DI/SPOSAL SYSTEM
~ NDIVIDUAL/ON-SITE** *~lf individual/on-site, give 'nstallation date ..~,~__ ~.,~xC-~ ..
If svs[em s over two (2) veers old an adeuuacy [es[ is reqmree
[] PUBLIC UTI LITY
DV this Depar[men~,
NOTI-'= THE INSPECTION EEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED.
72-010(3/78)
THIS SIDE FOR OFFICIAL USE ONLY
DATE RECEIVED
INSPECTION APPOINTMENTS
TIME TIME TIME
DATE DATE DATE
I NSPECTO R INSPECTOR INSPECTOR
DIRECTIONS:
1. TYPE OF RESIDENCE NUMBER OF REDROOMB
[] SINGLE FAMILY [] ONE [] THREE [] FIVE [] OTHER
[] MULTIPLE FAMILY [] TWO [] FOUR [] SIX
2, WATER SUPPLY PERMIT NUMBER
[] INDIVIDUAL DEPTH OF WELL
[] COMMUNITY
DATE DRILLED
[] PUBLIC UTi LITY
Connection Verified LOG RECEIVED
3. SEWAGE DISPOSAL SYSTEM PERMIT NUMBER
[]INDIVIDUAL/ON -SITE DATE INSTALLED
Connection Verified
INSTALLER
~]Septic Tank. or []Holding Tank
Size: /~ If Tank is homemade SOILS RATING
give dimensions: )
TYPE Of TANK MANU~
TOTAL ABSORPTION AREA MATERIAL
4. DISTANCES WELL TO: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line
Absorption Area to nearest Lot Line
PPROVED FOR 3 EDROOMS
[121-~CONDIIIONAL APPROVAL (letter must ~mpan¥ certificate}
LEGAL DfiSCRIPTION
72-010 (Rev, 3/78)
[ ~s'~ P.O. BOX 4-1276 ANCHORAGE, ALASKA !J¢)~09 4649 BUSINESS PARK BLVD.
Drinking Water Analysis IReport for Total Coliform Bacteria
TELEPHONE
(907) 279-4014
TO BE COMPLETED BY WATI-'R SUPPLIER
PUBLIC WATER SYSTEM:
Pu ii.water Syste~Name
M~lng A-ddreee' *
I,D. NO.
City
State
Mo. Day
SAMPLE TYPE:
[] Routine
[] Check Sample (for routine sample
with lab ref. rio.
[] Special Purpose
[] Treated Water
[] Untreated Water
Zip Code
SAMPLE
NO.
LOCATION
4 I
Time Collected
Collected By
1'0 BE COMPLETED BY LABORATORY
LABORATORY:
NAME
Date Received V"/(~
Time Received / ~ ~"-0
Analytical Method:
[] Fermentation Tube
'~ Membrane Filter
Lab Ref. No.
Result* Analyst
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
Form No. 18-310 (3-78)
06-1220 (b) BACTERIO£.OG ICAL WATER ANALY515 RECORD
Rev. 1978
Date Collected Source
ANCHOR.
Tony Knowle$,
Mayor
WATER & WASTEWATL , UTILITY
3000 Arctic Boulevard
Anchorage, Al(907) as ka 99503-3898
Owned by tho Municipality
of Anchorage
August 19, 1985
Alaska Mutual Bank
1500 W. Benson Blvd.
Anchorage, Alaska 99503
RE:
ZODIAK MANOR L.I.D. ~154
PUBLIC SEWER SERVICE TO LOT 16, BLK 5,
ZODIAK MANOR ALASKA SUBDIVISION
Gentlemen:
Public sanitary sewer service shall be extended to the
above property this fall or early next summer. The bid
opening for the improvements is scheduled for August 30,
1985 and all intentions are to complete as much of the
project as possible this fall.
Yours very truly,
WALLACE N. CORY/
Engiueering DesL~3d Supervisor
Anchorage Water & Wastewater Utility
DWB/dwR82
NORTHERN TI!STING LABORATORIES, INC.
600 UNIVERSITY pLAZA WEST, SUITE A FAIRBANKS, ALASKA 99701 907-479-3115
6957 OLD SEWARO HIGHWAY, SUITE 101 ANCHORAGE, ALASKA 99502 909-349-8623
Drinking Water Analysis Report for Total Coliform Bacteria
TO RE COMPLETED BY CLIEN'r
J~' PRIVATE wA'rER SYSTEM
NAME
Mailing Address
SAMPLE DATE: ,' "
Mo. Day
SAMPLE TYPE:
L~ Routine
[] Special Purpose
Purchase Order No.
[] Check Sample (for original contaminated
sample with lab reference no.
Sample Tlme
NO. Location Collected
I "' ('~ , ;~, ,~
2
3
4
5
6
7
8
9
10
[] Treated Water
[] Untreated Water
Collected by Laboratory Rof, NO,
Signature of Representative
FOR LABORATORY USE ONLY
TO BE COMPLETE[) BY LABORATORY
Received at: [] Anch. [] Fbks.
Date Received ,
Time Received
Next Sample Due
COMMENTS:
SATISFACTORY ~ S
UNSATISFACTORY U
RESAMPLE R
OTHER BACTERIA ,' OB ~ ' '
TOO NUMEROUS :rNTC
TO COUNT
*No.:of Total Coliform (:91onies per 100 mis.
R~porte!l by
Date
Time