HomeMy WebLinkAboutGREENLAND BLK 1 LT 2A Feb 10 22 06:17p Anchorage Well & Pump Ser 9072430742 p.1 MUNICIPALITY OF ANCHORAGE Development Services Departmenty- ! Phone: 907-343-7904 On -Site Water & Wastewater Section �.�- % Fax: 907-343-7997 Pump Installation Log Well Drilling Permit Number: Parcel Identification Number: 015 17227 Legal Description GREENLAND Block I Lot 1 12A Pump Installation Date: 02 - 09 __i022 Date of Issue: Property Owner Name & Address: WINTER, TERESA C & TODD 4920 E 112TH AVENUE ANCHORAGE, AK 99516 Pump Intake Depth Below top of Well Casing: 360 feet Pump Manufacturer's Name: RED JACKET Pump Model: 100C211 -8S21 Pump Size: 1 hp Pitless Adapter Burial Depth: 15 feet Pitless Adapter Manufacturer's Name: MARTINSON Pitless Adapter Installer: Well Disinfected Upon Completion? X Yes ❑ No Method of Disinfection: PELLETS Comments: Pump Installer Name: ANCHORAGE WELL & PUMP SERVICE Company: ANCHORAGE WELL & PUMP SERVICE Mailing Address: 7640 KING STREET ANCHORAGE state: AK 7,j,. 99518 Attention: The pump installer shall provide a pump installation log to On-site within 30 days of pump installation. Permit No.-~Wc~O ~cj c~ Page. 3 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 L. egalDescriptJon: ~-- O~hSl~ ~¢,D. /'~/._Y,: I:/_¢',~ 2f~, PIDNo.: O! A -- F, Co 72-013 A (Rev. 9/91) MOA 25 ,~.Vw J..W · · · · · · · · · · POST IN A CONSPICUOUS PL',CE · · · · · · · · · · · 24 HOUR NOTICE IS REQUIRED FOR INSPECTION SERVICE L CTn,CAL DLJIL DING SAFE1 Y DIVISION 3500 East Tudor Road Phone 786~8376 i~PEGTION 5~ p~ ~lT EXPIRES IN ~ bAYS IF WOR~ ~t '~ ~"~" ,V ' ' :' ~ OUSTOMER J I~," Municq~!h9 X' ~-,,~ul~rag. e I~,~t'~ H~lttl _~,,Human MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 PAGE 1 OF ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMIT PERMIT NUMBER:SW920199 DESIGN ENGINEER:S & S ENGINEERING OWNER NAME:WINTER TODD & TERESA C OWNER ADDRESS:2090 Dimond Dr. Anchorage Ak 99507 DATE ISSUED: 7/27/92 EXPIRATION DATE: 7/27/93 PARCEL ID:01517220 LEGAL DESCRIPTION: GREENLAND BLK 1 LT 2 LOT SIZE: 27146 (SQ. FT.) NUMBER OF BEDROOMS: 4 THIS PERMIT: 4 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD /SEPTIC TANK 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 FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ENGINEER MUST NOTIFY DHHS AT LEAST TWO HOURS PRIOR TO EAC, H INSPECTION. ENGINEER MUST PROVIDE COPY OF REPLAT JOINING LOTS 2 AND 3 PRIOR TO FINAL APPROVAL. THE PERMITTED SYSTEM IS A PRESSURIZED MOUND. ~O~r ~ [ ~ ~ ~ ~ ~[[ ~ [ ~-D~5 X~l ~ RECEIVED BY: ~ C~, DATE: ISSUED BY' DATE: ~7/Z'1/~7__; HEALTH AUTHORITY APPROVALS SEWER & WATER MAIN EXTENSIONS SEWER & WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELL INSPECTION & FLOW TEST SITE PLANS ROAD DESIGN SOIL TEST PERCOLATION TEST STRUCTURAL & MECHANICAL INSPECTIONS ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN ROBERT SHAFER, P.E. ROGER SHAFER, P.E. July 14, 1992 CIVIL ENGINEERS (907) 694-2979 FAX 69aT 1211 Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES 825 L Street Anchorage, Alaska 99501 REFERENCE: Greenland Subdivision, Block 1, Lots 2 & 3 Request you issue a permit to upgrade the septic system serving the referenced property. The existing septic system which was serving a log cabin is to be abandoned. The upgrade will serve a new four bedroom home therefore an alternate site has been depicted on the attached site plan. Two test holes were excavated and percolation tests were performed in the area of the proposed upgrade on November 6, 1989. The test holes were checked on July 2, 1992 and water was found in test hole one at 5' and in test hole two at 6'. Attached is the proposed upgrade design. We do not anticipate any adverse effects on neighboring properties by the installation of the proposed septic upgrade. If you have any questions or require additional information for your review, please contact us. Sincerely, RJS/LSU/lsu 17034 EAGLE RIVER LOOP, SUITE 204, EAGLE RIVER. ALASKA 99577 1"=40' SCALE SCALE DET,41L PERFORMED FOR: Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION 'TEST 9 10 11 12 13 14 PERFORME(~ ' SITE PLAN Township, Range, Section: SLOPE m 15 16 17 18 19 20 f L DEPTH?tF YES, AT WHAT ~_~;~;:~ pO E Depth 10 Water After ~ MonitorinD? -~, Date: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE ~ (minutes/inch} PERC HOLE DIAMETER TEST RUN BETWEEN ~' FT AND ~ FT COMMENTS PERFORMEDy ~ I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDAI',J~ZE W,~'~L STATE AND MUNICIPAL GUIDELINES iN EFFECT ON THiS DATE. DATE: Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 LEGAL DESCRIPTION: L,,,,'~':=,, ~,.~[""~.~ '1~[.~--- I Township, Range, Section: WAS GROUND WATER ENCOUNTERED? 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19- 20- S IF YES, AT WHAT DEPTH? ~'.,~;~.~ pO E Oeplh l0 Watar Aller ~ Moniloring? ~" Dale: ~'~'~q DATE PERFORMEr SITE PLAN Reading Date Gross Net Depth to Net Time Time Water Drop PERCOLATION RATE ~"~ (minutes/inch) PERC HOLE DIAMETER  TEST RUN BETWEEN ~ FT AND ~ FT COMMENTS ./ / PERFORMED BY: ~/' /-~___.~'- , .... CERTIFY THATTHISTESTWASPERFORMEDIN ACCORDANCE W~TE AND MUNICIPAL GUIDELINES IN EFFECf ON THIS DATE. DATE: 72-008 (Rev. 4/85) OSI © 199o 350' 300 LU u. 250 "~ 150 O '"20 OS115 HH - 11 Stage ......i ...................... ~ ........ ~.'"~="'""; .............. ~: .................... :" P~- I · , . ~ ~ ".'"'i'"' ..... ~ ............ i ........ :"T'"'"i'" '"i'":'": .......... ~ ....... ; 20 OSI HH ' · ..:..--..! ........ . -~.-.i...i...i.....i...i ........ ;"'~:'-'"'".'"'i'"'"'~ "{ ........ ""'i ............ :~'"'"': ........... }"':~"'"":'"! ........... 115/230 VOLT 1,9,90 :. .:':':':':':':':::~:' ,.~:....,..;:,:..:.:.:~:::::::::::::::::::::::::::.:.:.?....~,~~...,~ ........... ~ .......... ~ ........ ~ ...................... ~: .................... ;.,.~ ....... ~:,,..~ ~ . ~ ::'::::~::::::: ::- ........ :..¥.. 50 ~ +'' ..................... ~ ................. ~'"~ ........... ~ ..................... :: .................. ~ ...... ~ ._~.......:...~.....~:...~= ........ ;...~,..:..,~....~...?.~...~ ........ . ? ........... ?..:..,.: ...... :..~.~ ~ -.. .-....~ ........... :,..~....~ .......... ~.......;..,.:~ ...................... ::. ................ ;....::..:~~00SI 05 HH- 2 S~ge ........... .,..~ ................. ..; .............. ~...~...~....+...,.~ ..... ~ ~ ~ :::::::::::::::::::::::::::::: ~; ~~.:. ::~:::::::::: ::::::::~:::~:::: :::;::: ::::: "¥';"T";"'~ ........... T" '"~'"~' '~ · .:~ ................... :: ........ ~.,.~.......;... ~....,..:,..~.....~.,..~~ ...... :........~....:,..;...:~.......; .......... -'~'-' "-~ .............. :"'~ 20 OSI 05 HH- 5 Stag ~ ................... ~" ~~:" '"~ ...... ~'"~ ........... ~'" ~ ~: :;:::~;:. ..... :: ::: :;:~::: :::~:::~:::::::~ with 1/4" Flow controller ::::::::::::::::::::: :' '~~:'~'~"~'~'"~'"~ ~' 3 Stage ..:~.--~---.-..~..-~ ............. :' ::~' :1 : ': ': I' : '' ': I I 0 i 0 20 30 40 50 60 NET DISCHARGE, GPM 2826 Colonial Road Roseburg,OR 97470 503/673-0165 July 28, 1992 Deparkment of Health & Social Services 825 L Street Anchorage, ~< 99501 RECEIVED JUL 2. B 1992 Municipality of Anchorage Dept. Health & Human Services RE: O%~]er Installation of Septic System for Greenland Subdivision Block 1, Lot 2 & 3 To Whom It May Concern; I would like you to be aware that we are planning to install our own Septic System. I understand that if future inspections are needed, we will be reponsible for them. ~-~--~ f,~'c~~- ~fT~ Sincerely, Teresa Winter 2090 Dimond Drive Anchorage, A/< 99507 ,,aamnd anO a.df 3!m~ ~o XdoD :ou~ 00E:m~I/MP ~obeueN me~bo~ '~L~-£PE ~ om!Jg° s!qq II~m os~oId ,suo!qssnb Xu~ · q!mzod IIO~ pu~ u~ aog 00'065 :o~e sosg oq3 ,q!~od ~ou ~ aog bu!XIdd~ uoqM .uo!g~3us~noop pu~ ieAoadd~ '~O!AOI IOJ OD!~gO S!qq Oq qUOS oq qsnm (mzog qa~d-~o~qq) q~odo~ uo!3~sdsu! ~I!nq o~7s-uo oq~ go uo!~II~qSu! 'q!m~od ssoI~ oq pu~ uo!~II~qSu! o3 ~uss oq oq spssu · oq~p uo!3~!dxo sq3 %q POII~qSu! 3ou psu!e~qo oq ~snm q!~od oUq go Xq!zoqqne Xq s!seq · 696I 'IE ~oq~@ooG ~o Ge pa~!dxo sou ~@qsXs ~o~e~oqs~M oq!s'-uo ~o/pu~ II0~ Xi!weJ OlbU!S e dog I~-~£I-§I0# uois!A!pqns pu~IuOO~D I ~mOlS £ ~o5 :~ms[qns II~66 eZSelV 'ob~ogouv I00EII xos O~ a ,e. ogauv : .i l: l,'.i ;'3 :iii ,:::I SCALE :3J_VC] NI G3V~I3OJH~]d SYAA 15]]1 SIM& IVM± b1313~VlO 3-1OH 3~J3d (qom/s@lnu~ud) ~ 3LVM NOIlVqOObl3d NV~d 311S 3dOq$ :uoiloeS 'efiUebl 'd!qsUMOl O~ 8L 9~ SL OL 6 8 L 9 0990-~0966 e~selV 'efieJoqouv 'teeJ]$ ,,-h, g88 ~ S3OlAbl3S NVV~QI-I 9 HI-iV-3H 40 ±N~]V~lbiVd3G NI (]~]lAl~JO:lkJ3d SV/W~ 1_~3± SIN/ /VHI_ AJI L)J30 ~ ' H3/3~'WICI 3lOPl O~J3cl (qou,/selnu,~u) ~ 3LV~ NOILVqOO~I3d (g8I'~ '^a~) 900-~L ,, Jall¥ Jale/~ ol qldaO 3 ~H Id]C] S  ZO3UgJ_NnOON3 '~.)~ c~ NVgd 3J-IS 3d095 O~ 8L ZL 9[ -gl, EL LI, OL 6 8 L 9 g ~7 L 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 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # _(~ \-.~'J- ~-/~- ,-'~"~ NAA # _ GENERAL INFORMATION Complete legal description Lot 2A~; Block.l;. 'GREENLAND SUBDIVISION Location (site address or directions) 4920 E. 112th Anchorage, AK NEW CONSTRUCTION - using existing well, has ne~ septic system (S&S did) Property owner Mailing address Todd Winters Day phone 561-2982 Lending agency Mailing address_ Day phone Agent ordered by: Ad dress Bi66 Wilkinson WILCO CONSTRUCTION Day phone 16701 Ransom Ridge, Anchorage, Alaska 345-6288 Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: 4 TYPE OF WATER SUPPLY: Individual well XXX Community well Public water NOTE: If community well system, provide written confirmation from State ADEC attest- lng to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: individual on-site Holding tank Community on-site Pubtic sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. XXX 72-025 (Rev, 1191) Front MOA #21 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 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. Name of Firm Address Engineer's signature DHHS SIGNATURE Approved. for /¢'~ ¢~) Disapproved. Conditional approval for Date 7/~'/¢-~ bedrooms. , / '/ bedrooms, with the following stipulations: Additional Comments 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: L-cT 2A ~L.,~ / ~f'LE'E/,J(..f~)¢ ,~//~ Parcel I.D. ~) '/J~'--~ / 7 Z- . 2-- 7 A. Well Data Well type f,~lf."/'Cr/~ Log present (Y~-~__ ,/C/(--~ Total depth Sanitary seal~cN) Date of test Static water level Well flow If A, B, or C, attach ADEC letter. ADEC water system number /U////Jr Date completed Driller ('~//'~ Cased to ~i/~O ~¢- Casing height ,/~. Cie- Wires properly protected (~) '7~'~ .~ Pump level1 FROM WELL LOG AT INSPECTION SEPARATION DISTANCES FROM WELL TO: Septic/hc!d!.-.g tank on lot /(--)(,.) f Absorption field on lot Public sewer main Sewer service line g.p.m. ; On adjacent lots ; On adjacent lots / (---3~-~ Public sewer manhole/cleanout //~'////~ Petroleum tank ,./C/o WATER SAMPLE RESULTS: Co,,o,m Date of sample: Nitrate (~,/O .¢,'u~? Other bacteria Collected by: B. SEPTIC/HOLDING TANK DATA ~'. T~~, ~, (.~"~¢/_-,F'7-,S/-,~T/~,,'J ~',¢C..?-'/'o¢-/ Cleanout~.~/N) ~ Foundation oleanout (~N) cr",¢ ¢ ~ Depression (Y,(~ High water alarm(~q) -~JJ/~- ~r,~c-'~'-~'L'-FA(-C) Alarm tested (Y~ ~ Date of pumping ~/~ - ~ ~ Pumper SEPARATION DISTANCES FROM SEPTIC/~ANK TO: Well(s) on lot ~ ¢ On adjacent lots ~ ~ Foundation To propedyline /O ~ Surface water/drainage Absorption field Water main/service line 72-026 (3/93)* Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed Size in gallons Vent (Y~..}~ /(/(2 "Pump on" level at High water alarm level ~:¢~ ¢ [ Meets MOA electrical code (~'4) Y~¢'.~ Manhole/Access~) "Pump off" Level at Cycles tested SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot //F._.~ -/- On adjacent lots /¢_.~/__.O/¢- Surface water D. ABSORPTION FIELD DATA Date installed Length ~;27¢ Width Total absorption area ~-.0/0 ~'' Cleanout present~4) Date of adequacy test _,,C)~¢7''J ~' Y'5/~ Results ~ail) Water level in absorption field before test /C,//~ Peroxide treatment (past 12 months) (Y/N) ,X'/¢/t,/~- /"(/L/db.J/../ SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot //("~ TO building foundation On adjacent lots Surface water ~_/23¢..)~"~ /~,,¢._~?S~-?~._.CC~Driveway, parking/vehicle storage area Curtain drain/¢~0 Soil rating (GPD/FF) (~, '~ System type /U~ © .~0 f Gravel thickness ~-~,~' / Total depth [/~ovE ~ Depression over field (Y/~ ~ for ~ Bedrooms After test If yes, give date On adjacent lots /~0 f¢ Prope~y line / To existing or abandoned system on lot .~o~ Cutbank W~~¢~¢~ater main/se~ice line E. ENGINEER'S CERTIFICATION I certify that l have checked, verified, or conformed toall~M~ and HAA guidelines in effect on the date of this inspection. Signatur.e 17034 Eagle River Loo~, ~ Engineers Na~e Eagle River, Alaska 99~7 Date HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (3/93)* Back