HomeMy WebLinkAboutT12N R3W SEC 15 LT 98AT12N, R3W,
Section 15
Lot 98
#015-481-12
(907)343-7904
Pump Installation Log
Well Drilling Permit Number: SW.
Parcel Identification Number: 0.1 5 _ `i S 1-12
Date of Issue:
Legal Description Property Owner Name & Address:
1 c 15 `� �-1 ()�t^ B oy e tle
y3
Pump Installation Date: Co1lq/`8
Pump Intake Depth Below Top of Well Casing: e -M feet
Pump Manufacturer's Name:
Pump Model:l
Pump Size hp
Pitless Adapter Burial Depth: !f► feet
Pitless Adapter Manufacturer's Name: A le_f_41�_5 00_�
Pitless Adapter Installer:
Well Disinfected Upon Completion? �YesO No
Method of Disinfection-
Comments:
isinfectionComments: UG E
°M ANCHORAGE WELL & PUMP SERV.
Pump Installer Name: /� 330 EAST 76TH AVENUE
ANCHORAGE, AK 99518
PHONE: 907-243-0740
AWPS.COM
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program o
4700 Elmore Road u
P.O. Box 196650
Mark Begich
Anchorage, AK 99507 "AE
Mayor
www.muni.orcdonsite
(907)343-7904
Pump Installation Log
Well Drilling Permit Number: SW.
Parcel Identification Number: 0.1 5 _ `i S 1-12
Date of Issue:
Legal Description Property Owner Name & Address:
1 c 15 `� �-1 ()�t^ B oy e tle
y3
Pump Installation Date: Co1lq/`8
Pump Intake Depth Below Top of Well Casing: e -M feet
Pump Manufacturer's Name:
Pump Model:l
Pump Size hp
Pitless Adapter Burial Depth: !f► feet
Pitless Adapter Manufacturer's Name: A le_f_41�_5 00_�
Pitless Adapter Installer:
Well Disinfected Upon Completion? �YesO No
Method of Disinfection-
Comments:
isinfectionComments: UG E
°M ANCHORAGE WELL & PUMP SERV.
Pump Installer Name: /� 330 EAST 76TH AVENUE
ANCHORAGE, AK 99518
PHONE: 907-243-0740
AWPS.COM
Attention: The pump installer shall provide a pump installation log to the DSD within 30 days of pump installation.
Municipality of Anchorage Page
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: L~-//~ ~)d (~/7 7 PID Number'. ~/"~/-'~'~
N.~ ~ ~, ~~ ~/ Wastewater System: ~w ~ Upgrade
Addres~7/~ ~~ ~~/_/ ~ ABSORPTION FIELD
Phone:~ ~ ~ ~ ~ No,~edrooms: D Deep Trench ~allowTrench ~ Bed ~ Mound ~ Other
Total Depth from original grade:
LEGAL DESCRIPTION s°"'"~g~ ~,~/s~.~,. /~
Lot: ~ Block: ~ Subdlv~ion: ~ Depthtopipe~fromodg[nalgrade:Ft. Graveldepth beneath pipeo, ~ Ft,
Fill added above original grade: Gravel lea th:
Gravel width: Number of lines: Distance be~een lines;
WELL:woT Y~e~/~EDD Upgrade ~ Ft.
Classification (Private, A,B,C): Total Depth: Cased To: Total absorption rea~ Pipe material:
Ft.
Yield: GPM PumpSetat: Fb CasingHeiohtAboveGround:Ft. TANK
S~PARATION DISTANCES ~tic Q Holding U S.T.E.P.
From Tank Eteld Slatio~ Taak Sewer Lines
Weir ff~ ~p~ /~ ~ p~/~ ~ Materiel: ~~ Number of ~padments:
8udaCewater 7~~ ~~ ~ LIFT STATION
Lot Size in gallons: ~ Manufacturer:
Cu~ainDrain ~ . ~ ~ ~ ~ Pump Make & Model Electrical inspections pedormed by:
Remarks: BENCH MARK
EN~L
~ '~%,~:...~-~
....
Inspections performed by tes:ls~~
C -
~ -'~ ' ,th and~Human_~ Se~i~. Date://-/~
Reviewed
and
approved
72-013 (Rev, 9/91) MOA 25
Permit rio. SW940177
Page 1 ar 2
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-.6650 Telephone: 545-4744
On-Site Wastewater OisposaJ System and/or Well Inspection Report
Legal Description: Lot 98, T12N, R3W, Sec.15
:~.~ Lot
Ur) ~l
,o.
0
98
Perc 1
Perc i5
PID No.: 01548110
I
37.50'
27.5'
i' 52.7'
2 91.2'
105.9'
Proposed :,Well
S 89'57'55" W
~.' .'... '..'...: .........
SYSTEM RECORD DRAWING
Scale: 1"=
Note-TBM 1: Spike in Power Pole; Elev.- 510.84
TBM
Tank
bJ
C),
WRIGHT
CE 0156
DATE: 5/4-/94
JOB #:94004 FILE:94004SEP PLOT SCALE:I"= 50'
pe,~it uo. SW940177 ~po~e 2 o~ 2
Municipolit¥ of Anchoroge I~1-~1
DEPARTMENT OF- HEALTH AND HUMAN SERVICE~
ENVIRONMENTAL SERVICES DIVISION
.--_
P.O. Box.196650 Anchoroge, Alosko 99519-.6650 Telephone: 343-4/44
On-S~te Wosteweter Disposol System end/or Well Inspection Report
Legol Description: Lot 98. T12N, R3W, Sec.15 PID No.: .01548110
O.
+
JOB ~: 94004 FILE:g40040RP PLOT SCALE:I"= 20' DATE: 6/4/94
MUNICIPALITY OF ANCHORAGE
DEPARTMENT OF HEALTH AND HUMAN SERVICES
P.O. BOX 196650, 825 "L" STREET, ROOM 502
ANCHORAGE, ALASKA 99519-6650
ON-SITE WELL AND WASTEWATER DISPOSAL SYSTEM PERMIT
PAGE 1 OF
PERMIT NUMBER:SW940177
DESIGN ENGINEER:ROBERT W. WRIGHT, P.E.
OWNER NAME:TERRY MARK A & BETH A
OWNER ADDRESS:2710 JUNEAU STREET
ANCHORAGE, ALASKA 99508
DATE ISSUED: 6/16/94
EXPIRATION DATE: 6/16/95
PARCEL ID:01548110
LEGAL DESCRIPTION: T12N R3W SEC 15 LT 98
LOT SIZE: 46200 (SQ. FT.)
~ER OF BEDROOMS: 3 THIS PERMIT: 3
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
1. THE ATTACHED APPROVED DESIGN.
2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS
15.55 ~ 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL
REGULATIONS (18AAC?2) ~ DRINKING WATER REGULATIONS (18AAC80).
3. THE ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS
PRIOR TO EACH INSPECTION. PROVIDE NOTIFICATION BY
CALLING 343-4744 (24 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.
SPECIAL PROVISIONS:
THE SAND USED IN THE FILTER LAYER MUST BE A CLEAN COURSE
SAND WITH 4% OR LESS PASSING THE #100 SIEVE AND 2% OR LESS
PASSING THE #200 SIEVE. IF THE SAND USED IS NOT FROM A PRE-
APPROVED SOURCE 3~EN A SIEVE ANALYSIS MUST B~ PROVIDED ON
THE SAND USED./ / · ~ ,// /~/ ////
W,.ight-~klaska Engineering $cvvices · 6004 Gle~lkervy Dr. · Anchorage, AK 99504
June 6, 1994
Municipality of Anchorage
Dept. of Health & Human Services
On-Site Services Division
P.O. Box 196650
Anchorage, AK 99519-6650
Re: Well & Septic System Permit
Lot 98, T12N, R3W, Sec. 15
Dear Sirs,
With the submittal of the attached design package and Permit Fees check in the amount
of $440.00, the owners of the above noted lot, Mr. & Mrs. Mark Terry request the granting
of a Well & Septic permit for a three bedroom house.
Should you have any questions or require additional information, please feel free to call
or fax me at the numbers indicated below.
Sincerely,
Telepl,one (907) 338-6230 · Fax (907) 337.5182
Wrigl[t-Alaska Engineering Services · 6004 Glenke]'ry Dr. · Anchorage, AK 99504-
June 6, 1994 ""'"'""'
vv.o. 4004
Site Narrative
The followin~ sito narrativo doscribos tho proBablo impacts of a proposod woll and on-
sito wastowator disposal systom for lot
The subject lot is located approximately 165 ft. west of the intersection of Carlson Rd.
and E. 102nd. Ave. in Grid 2536. Access is gained from the right of way to the west of
the intersection.
The lot is generally covered in Black Spruce trees varying in height to 20+ ft. The
ground cover is moss and some small shrubs. The site topography is sloping, downward
from south to north. The first 80+ ft slope at 18+%, a steep 39+% slope follows for a
distance of 15+ ft, becoming shallower at the toe to a 23+% slope and finally levelling
out at a slope of less than 10% for the last 100 ft. of the lot. No development has
occurred below the north lot line, to Little Campbell Cr., a distance in excess of 400'.
The proposed house is sited within the top 80+ ft. of the lot for access. The septic tank
will be placed adjacent to the house, to allow for access by septic pumpers. The system
is located approximately 110' below the tank in the flatter terrain.
Lot 98 is bounded on the east by Lot 99, also owner by Mr. & Mrs. Terry. The 100' right
of ways to the south of these two lots and to the east of Lot 99 provide an adequate
separation distance between any well and septic development on these two lots, and
surrounding lots to the south and east. The location of the septic system will intrude a
setback distance of 25+ into Lot 97 to the north, and a setback distance of 90+ ft. into
the 4.25 Ac tract to the west. The proposed well will intrude a setback radius of less than
90 ft. into this tract.
The general site drainage is to the north. The upper 2/3 of the lot drains toward the
proposed septic system. A Final Grading Plan has been designed to prevent run-off
from standing on or near the field. Drainage from the lower portion of the system is
positive to the north, and will cause no problems with ponding. No drainage patterns
have been created by development of this lot which will direct run-off onto neighboring
lots.
Impacts from the Well & Septic System as designed for Lot 98 are minimal on two
adjacent pieces of property, and non-existent on all others. No adverse effects are
forseen.
Telepl,.one (907) 336-6230 · Fax (907) 337-5102
Wright-Alaska Engineering Services
6004 Glenkerry Dr. · Anchorage, AK 99504 · Telephone: (907) 338-6230 Fax: (907) 337-5182
Percolotion Log Report/ Soils Log
Performed for: Mark Terry. Hole No: 1 Dote: 5/7/94
Legol Description: Lot 98 BIock. NA Troc( NA Subdivision:NA
Township, Ranqe, Section: T12N RSW Sec, 15, SW 1/4, $W 1/4
Groundwater Cross Net Depth ~ Net Adlusted
Encountered? NO Readin~ Date Time Time (min.) Water .) Drop (in.) Rate (min,/in,,
I ~ 2 5/7/94 19:0~:45 6:~ 1" 24" (t~ Twl~el 0,44
At what depth? NA 1 5Z7~94 19:16:28 3:32 1' ~ 0.92
Wdter level dfter ~ 5~7/94 19:23:20 3:40 1" ~ 0.95
5~7Z94 19=28=20 3=56 1' ~ 1.02
Monitoring? ~O~e 4 5/7/94 19:33:5~ 4:07 1" 1.07
D~te: 5/15/94 = 5/7~94 19:41:58 4:02 1" ~ 1.05
6 5/7/94 19:45:40 4:20 1" ~ 1,1~
Percolation Rate 7 5~7~94 19:47:00 4:16 1" ~' 1.11
8 5/7/94 19;56:~8 4:22 1" 6" 1,14
1,14 mln/In.
Performed by: Bob Wrlahf I,
Certify that this test w~s perfor~d ~¢cordonce with QII State A Municipal guidelines in
effect on this dote. Date:
I I I I I I ~,.--.t--"~"~"--'t--"~"--'1--"~"~"--'t~
;PT; ~op~o,, frozen. ~_~_+_~_~ ~$%--~--~----I---N--¢~H----I---~--~-~--:~
~ Frozen in first ~-~-~1-[-~ ~-~-{~ .... ~-~
i I I
5 , ' ''
L_L~--~--J Lp%_%_~__I__L_~ ...........
~ 5-8.5 Brown to grey sandy I ~ I I I I I I I I I I I I I I
6 -~- silt, moist. Mot'l becoming I ~ I I : I I I I I
___ herder, dryer. ~T-q-~ F~T-T-q--I--F-Tqq--I--~-T-7~q
~11 I ~ I I i ~ I L~/ I~ I I LU/~ I
8 I I I I ] [ I ~..--.i--..*..~..--.~--..$.~..--.I--..$..~..--.1~
9 , ~ .~ ..m 8.5-11.5 Grey send w/grevel. Slope Site Plon
~.~ ~.-,;"~ more difficulty. Dry
Smears on sides from bucket.
~:'..~;",:~,'~Y~ 13-16.0 Grey sand w/grovel
- ~,,,,, .....Estimate 50~ sand
';,tSp.:';, 5o~ grovel
Ho,.
Wright-^laska Engineering Services
6004 Glenkerry Dr. · Anchorage, AK 99504 · Telel~hone: (907) 638-6230 Fax: (907) 337-5182
Percolafion Log Reporf/ Soils Log
Performed for: Mark Terry Hole No: 2 Date: 5/7/94
Legal Description: Lot 98 Block NA Tract NA Subdivision:NA
Township, Ranqe, Section: T12N R3W Sec. 15, SW 1/4, SW 1/4
Groundwater Gross Net Oepth to Net Adiusted ,
Encountered? NO Reodin9 Date Time Time (rain.) W~ter in.) Drop (in.) R~e (min./in.,
At what depth? ~A ~ 5/7/94 20=38 1:29 1" 1~ 0.19
Water level g~ter 2 5;:;~ 20,42 1:05 1" 6' 0.28
Monitoring? None 3 5, 20:43 1:12 1" ¢ 0~1
Date: 5/15/94 4 5;7/94 21;17 1:06.45 1" ~ 0.29
Percolofion Role 7 5~7/94 21:25 1:56 1" ~ 0,50
0.49 rain/In. 8 0/7/94 21:S0 1:5~ 1" ~ 0,49
Comments:
Performed by: Bob Wrlghf I,
Certify that this test w~s performed~n ~cord~nce with ~11 store A Municipol guidelines in
effect on ~his date. Date:
1 ~ I I I
3 ~ML~ few inches. I I
.... I I J I I I : I I I I I I :1 I I I I :
2222 5-9 Brawn to grey sandy silt I I~ I I I I I I I I I I I I I I I I I I
g ::z: Slope Site Plon
12 ~'~,L Level Parc'd= 9'-9.5'
.... 12-15.25 Grey silt w/gravel
.... to grey plastic silt, Dry. ~eeeeeeeee~.~_
13 _~ Smears on sides from buckeL _
~ '% · Ce-I
14 ZZZZ
15 _ ~ 5.25
E~d
Wright-Alaska Engineering Services
6004 Glenkerry Dr. · Anchorage, AK 99504 · Telephone: (907) 338-6230 Fax: (907) 337-5182
Percolation Log Report/ Soils Log
Performed for: Mark Terry Hole No:$ Date: 5/7/94
Legal Description: Lot 98 Block NA Tract NA Subdivision:NA
Township, Ranqe, Section: T12N R3W Sec. 15, SW 1/4, $W 1/4
Groundwater Gross Net Depth to Net Adlusted ,
Encountered? NO Readin~ Dote Time Time lmin.) Water in.) Drop (in.) Rate (min./in,,
~i~ '94 09:34 1:49,77 1" 1 2" 0.24
At what depth? NA ~2 5/_8~'94 09;37 2:24.76 1' 12" 0.31
[i~l~ '94 09:40 2:05.69 5" 6" 0.54
Water level q~ter I 5~8~'94 09:43 2:07.17 5"' 0,55
Monitoring? flone 3 5/8, '94 09:46 2:09.02 5" 0.56
Date: 5/15/94 4 ss//~ '94 09:48 2:06,26 5"' 0.55
5 ~, '94 09:52 2:08.86 5" 0.56
Percolation Rate 6 5lei '94 09:55 2:13.61 5" 6 0.58
7 5/8, '94 09:58 2:t7.37 5" 6" 0.60
See Sht 2.mln/in. 6 5/8~'94 10:03 2:15.76 5" 6" 0.59
9 5/8, '94 10:07 2:18.04 5" 6" 0.60
Comments:
Performed by: Bob Wrlghf I, ~/~ ~ ,~"~/~
Certify that this test was perf_or/"~/ez~3i,~/accordance with ell State & Municipal guidelines in
effect on this date. Date: -~/7/~'~t'
t---1 , , , ,~ , , , , , , ,
..... -~'~'),4-~-+i---+---~---+~-~-~
.... 1-5 Reddish grading to brownk---]---u,--.-~----ff ,L k---~
2 .... silt (Loam). Moist, firm, , , , J I , ~ J\~..Jl ,k?O.~K' J J ! J , , , ~, ·
.... smears, Frozen in first , , .~ , , ~_[_J_¥1~2f.___~__~___~___~'_~_~___~ ............ ~_J_~
~ few inches. , , I~, ,
.... ~-I ....................... 1 ................... J-~
5 .,:,:,.,,~. ...... , , ~ ~ ,, ,, ,, I ' ...... ' ' ' ' ' ! ' ..... ' ' ' ' !,
~,SP,.:', Moist, firm. I I
.,. '~,:.",.6-1o Grey gravelly sand· ~ ;~/' ~ ~ ~ , · . :
-~:,...:,.. poorly graded, gravel to, .... , , , LOT,DB! , , EOT 9,9 ,
:':":: .", ~,,. ~ll ..................
'~SP ...........' ' ' ' '
8 ~','. ,; Estimate 60% sand ' [-~---" '
.. v: '/.~... <2% silt Slope Site Plan
-,.":.,: Level Pert'd= 6'-6.5' ~ .......
.... 10-16 Grey to tan, sondy O, , , , , , ' ' ' ' ' '
11 .... silt w/grovel. Firm, dry. P, ............ , , , , , , , , , , ,
13 _~MLi ,-~,,~..- g..~.,,f. ,,.:,_ .,
::::
14 ....
- --T-- --
16 ::::
6.o
17 E n d
18 Hole oete:
Wright-Alaska Engineering Services
6004 Glenkerry Dr. · Anchorage, AK 99604 · Telephone: (907) 33§-6230 Fax: (907) 337-5162
Percolation Log Report/ Soils Log
Performed for: Mark Terry Hole No:3 Date: 5/7/94
Legal Description: Lot 98 Block Fl& Tract NA Subdivision:
Township, Ronqe, Section: T12N R3W Sec, 15, SW 1/4, SW 1/4
Groundwater Oross Net Depth to Net Adjusted
Encountered? NO Readin9 Date Time Time (min.) Water in.) Drop (in.) Ra{e (min./in.,
10 5~8~94 10:11 2:t5.85 1" 6' 0,59
At what depth? NA 11 5/8/94 ;0:15 2:08,14 1" 6' 0.58
Water level g~ter
Monitoring? None
Date: 5/15/94
Percolation R=fe
0.58 mln/In.
Comments: -/:""-)- ·// /~/
Performed by: Bob Wright I,'/~--~ _.~
Certify that this test was per,f_o_.r~TL~/d,/~_~ .Gccordance with oll State & Municipal guidelines in
effect on this date. Date: 4~-.-.-.-.-.-.-.-.-~/
' ' ' /' ' I I~,"--'I--"T"-F'--'I--"~T-I,"--'I-"T"~"'--'ITM
:PT:: topsoil, frozen.' ' ' ' ' ~-: ....................... + ..................... -~-~
.... '---]---'--. ' '-
1-5 Reddish grading to brown? ~, _~___~ ,L }-__-~
2 silt (Loom), Moist, firm, , , , I I ..........
.... .... , , , , , i ',~,t% ,'N.~"[ I I il .... .,
.... smears. Frozen in first ~- i ~ ~-'-~-'-"---~ ...... '---~--'-' ........ "---~-" -'-~'~' '
5 few inches, i ~~ .......~i ! i I '
...... - f ---- Ji L-- ~ --J- __J__--L----I----~--, , I I ~' - £----- J-------L-----J-., , I I --L---~- Ji ,
~,SP,, Moist, firm. , , , I I
, ,~-, , , , f , , , I, , , , , 1,
.... +___~o , , , , , , , .......
-~:...~.. poorly groded, grove~ to ~I ...... L~T ,gSi , , , ilLOT ~,~ , ,
8 -:.,:SP, Estimate 60% sand , ..... , , , , , I ,,,._,,, , ............... , , , .~..I ,',._.,,
'),.'.H~'" <2% silt Slope Site Plan
..... 1~% ......
10 ....,.,,..,: ......., , , , , , ,
10-16 Grey to ton, sandy 0 ' ' ' ' ' '
11 ::_-: silt w/grovel. Firm, dry. P, , ,' ,' ,' ,' ,' ,' ,' ,' ' '
12 _::::
13 - ~.ML~ ',~ ,..- -
14 :::: ' ~-~
16 ,?'.. CE~5~ .
17 - End '~ ~', Profess'~o~+*
18
Percolation Test Rate Adjustment
All percolation tests conducted for this project have been completed using a 4"
diameter tube in a 6" diameter hole. The annular space between the tube and the
hole walls is filled with 3/8" pea gravel.
The following adjustment has been made to all readings to account for the volume
occupied by the annular gravel pack.
h:-8
d: 5.25
h d
- 0.344
h
P := 0.344
The porosity of the gravel has been determined using two
identical 64 oz. containers. One filled with water, the other with
gravel. The depth of water (h) was measured. Water was
poured into the gravel container. The depth of the remaining
water was measured. P= (h-d)/h.
The correction factor 'R' was calculated using the formula from page 76 of Dr. O.
Benjamin Kaplan's book "Septic Systems Handbook":
r1 :=2
r2 :=3
1
r2. rl = 1.5
radius of 4" diameter perc tube
radius of 6" diameter perc hole
C :- 1.5
I t p.~2_ 1~ =0.636
C2
R :- 0.64
R= V1N2 where Vl is the total water vol. in the hole, and V2 is water volume with no
gravel.
Example:
6" water drop in 2:13 min.
2.22
- 0.37
6
0.37 min/in with gravel pack.
0.37
- 0.578
0.64
0.57 min/in without gravel pack in 6" hole.
May 16, 1994
W.O. 94OO4
Lot 98, T12N, R3W, Sec. 15, SW 1/4, SW1/4
Absorption Area Calculations:
Soil percolation rate is 0.49 min./in., therefore a sand filter is required.
Sand Filter application rate for design purposes= 1 s.f./ gal./ day
Number of bedrooms= 3
Gallons of septic effluent/bedroom/day= 150
3. 150 = 450 gals/day
45O
-- = 450 s.f.
1
Assume a wide, shallow trench where width= 5 ft.
45O
-- = 90 I.f.
5
Therefore, assuming bottom absorption only, trench length= 90 I.f.
Permit No.
Poge 1 of 9
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-.6650 Telephone:
· On-Site Wastewater Disposal System end/or Well Inspection
345-4744
Report
Legel Description: Lot 98, T12N, R3W, Sec.15
LOt 98
PID No.:
Lot 99
Proposed Well
JOB #: 94004 FILE:§4OO¢SEP
of System.
[75,0 ,'
Tonk
GENERAL SITE PLAN
Note-~M 1: Spike In Power Pole,~ Bev.- 510,84
Permit No. Page ~) of 9
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 Wostewoter Disposal System and/or We Inspection Report
Lego, I Description: Lot 98, T12N, R3W, Sec.15 PlO No.:
. ::89'56'15" E / 164.87 :: ~
"~'~ ~'"F ....... '~ ...............
./
~tic Tank
o .... i'..' ....'164.~94- · ' S' .89'57~5~)'F~ W.
SYSTEM LOCATION SKETCH
......... !' scaiei 1"'=!'30'
JOB ~: g400~
FILE:g4004SY$ PLOT SCALE:l"= 30'
S 14'31'52~ E
30,6¢'
OATE: ./4/94
Permit No~ Poge ~ of ~
Municipolity of Anchoroge
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box.196650 Anchoroge, Alosko gg51g-.6650 Telephon. e: .34.3-4744
On-S~te Wostewoter Disposol System ond/or Well Inspection Report
Le9ol OescripUon: Lot 98, T12N, R3W, Sec.15 PID No,:
d08 §: 94004 FILE:9{D0~PRO PLOT SCALE:I"= 20' DATE; 6/4/94
Permit No.
Page 4 of 9
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box.196650 Anchorage Alaska 99519-6650 Telephone: 543-4744
On-Site Wostewater Disposel System and/or We Inspection Report
Legal Description: Lot 98, T12N, R3W, Sec,15 PID No,:
4" Clean,ut (t,~ yp)/ fNtr~e~in~teOr~rnegnScha?~reDitt;i~sc~h~oW~h
/ ~ trenches. : :
/
?
/
"F'I E'ED' ' 'D E TA:'I'L ........
Scale:l"- 20'
JOB ~: 94004 FILE:O4004AB6 PLOT SCAL£:I": 20' DATE: 6/2/94
PermR No.
Poge 5 of g
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchorage, Alaska 99519-6650 Telephone: .345-4744
On-Site Wastewater Disposal System and/or Well Inspection Report
Legal OescripUon: Lot 98, T12N, RSW, Sec,15
PID No.:
4" iPerf. PVC Pipe (typ)~
...... 15.00'
Long 'sweep '4,,' 90. Bend.. 'l : ....... : ......... i .....
at Bottom to Manifold
i i '~
..... ; .... i .... ~ N 21'15'55"'W' '22.82' .... ~''
I
Cleonou:t (typ)
/:
DISTRIBUTION
.... sca.la:. !"= i'?
PIPING
JOB j~: 94004 FILE:94004Vl. V PLOT SCALE:I"~ 4' DATE: 6/2/94
Permit No. Page 6 of 9
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box 196650 Anchor(3ge, Alask(3 99519-.6650 Telephone: 343-4744
On-Site Wostewoter Disposol System end/or Well Inspection Report
Le~ al OescrlpUon: Lot gs, T12N, R3W, Sec.15
PID No.:
,JOB ~: 9~,004· FILE:g~.OO~.TRN PLOT SCALE:t"= 4'
OATE:6/2/94
Pe~mik No,
Page 7 of g
Municipality of Anchorage
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P.O. Box.196650 Anchorage, Alaska 99519-.6650 Telephone:
On-Site Wostewoter Disposal System and/or Well Inspection
343-4744
Report
Legal Description: Lot 98, T12N, RSW, Sec.15
PID No,:
Z .
dg
Id,,,,,,
i';',: 0
Z
Z'Z<C
O!b.I 0
.. 8i
ROBERT W, WRIGHT
CE 8156
,lOB ~: §400'¢ FILE:B"tOO4TNR PLOT SCALE:I"= ,3' OATE: 6/2/94
Permit No, Page 8 of 9
Municipolity of Anchor(~ge
DEPARTMENT OF HEALTH AND HUMAN SERVICES
ENVIRONMENTAL SERVICES DIVISION
P,O, Box 196650 Anchoroge, Al<3sk(3 99519-.6650 Telephone: 343-4744
On-Site W(3stewoter Disposal System end/or Well Inspection Report
Legol Description: Lot 98, T12N, RSW, Sec,15 PID No,:
...... ,~~ ~' '~--' < ~ Z ~' ? .........
/ / ~ / ~1~.0
' ~ ~~0.0
...... ...... ~~~
ROBERT W, WRIGHT ~
~ .... FINAL'GRADING PLAN ,~,~:~.:; :,~. ~;~?
JOB ~: 94004 FILE:B4a04FIN PLOT SCALE:l"= 20' DATE: 6/5/94
8
9
10
11
12
13
14
18
16
17
...... ,"'
Permit No. ~~'~~~.0. 94004
Legol Description: Eof 98. T12N. RSW. Sec..~.1~R ,O.ERT W. W.~O,T /~ - 6/4/94/94
ALL CONSTRUCTION SHALL BE IN ACCORDANCE WITH CHAPTER 15,65, WASTEWATER DISPOSAL REGULATIONS
OF THE MUNICIPAL COOE AS CURRENTLY AMENOED.
INSTALL NEW 1000 GAL SEPTIC TANK AS SHOWN ON THE DRAWINGS. RECORD INLET AND OUTLET
ELEVATIONS OF THE TANK, TANK BOTTOM SHALL BE PLACED LEVEL ON UNDISTURBED NATIVE SOIL,
SITE TOPOGRAPHIC SURVEY CONOUCTED ON 5/18/94. EXISTING STRUCTURES. WELLS, SEPTIC
SYSTEMS OBSERVED ARE SHOWN ON DESrGN DRAWINGS.
ANY DEVIATION FROM THE DESIGN MUST BE AUTHORIZED BY THE ENGINEER PRIOR TO ITS INCORPORATION
INTO THE SYSTEM.
CONTRACTOR TO LOCATE ALL UNDERGROUND UTILITIES, PROPERTY LINES, EXISTING WELLS, WATERWAYS,
SURFACE AND SUBSURFACE DRAINAGE FACILITIES, LAKES, PONDS, AND OTHER FACILITIES REQUIRING
SEPARATION DISTANCES FROM THE PROPOSED SEPTIC SYSTEM, CONTRACTOR TO STAKE PROPOSED SYSTEM
PRIOR TO CONSTRUCTION, NOTIFY THE ENGINEER OF ANY OBSERVED CONFLICTS PRIOR TO CONSTRUCTION,
CONTRACTOR TO NOTIFY THE ENGINEER AND DHHS 24 HOURS PRIOR TO COMMENCING WITH CONSTRUCTION.
A MINIMUM OF THREE INSPECTIONS ARE REQUIRED, THE FIRST INSPECTION SHALL BE OF THE SUBCRADE
PRIOR TO PLACING THE SEWER ROCK. THE SECOND INSPECTION SHALL BE AFTER THE PLACEMENT OF
GRAVEL. DISTRIBUTION PIPING, STANDPIPES, TANK, AND OTHER COMPONENTS AS SPECIFIED. THE THIRD
INSPECTION SHALL BE AFTER THE WORK IS COMPLETED.
CONTRACTOR SHALL DELIVER TO THE ENGINEER A SET OF RED-LINED, AS-BUILT ORAWINGS SHOWING ALL DATA
AS SPECIFIED IN SEC. 15.65.F.2, 3, ~, 5, 6 OF MUNICIPAL WASTEWATER DISPOSAL REGULATIONS WITHIN FIVE
DAYS OF THE FINAL INSPECTION. INVERTS SHALL BE MEASURED TO THE NEAREST HUNDREDTH OF A FOOT.
SWING TIE LOCATES SHALL BE MEASURED TO THE NEAREST TENTH OF A FOOT.
THESE AS-BUILTS SHALL BE USED BY THE ENGINEER TO PREPARE AND SUBMIT RECORD DRAWINGS TO DHHS,
ALL EXCAVATION DEPTHS ARE AOVISORY. THEY ARE TO BE VERIFIED AND MAY BE MODIFIED BY THE
ENGINEER IF ACTUAL FIELD CONDITIONS VARY FROM THOSE USED TO PREPARE THE DESIGN.
EXCAVATE THE ABSORPTION FIELD. BOTTOM OF EXCAVATION SHALL BE LEVEL AND SCARIFIED. RECORD
ELEVATIONS AT BEGINNING, MIDDLE, ANO END OF TRENCH BOTTOM. CONSTRUCTION EQUIPMENT SHALL
NOT OPERATE ON THE FLOOR OF THE EXCAVATION. ANY MATERIAL COMPACTED BY THE OPERATION OF
THE CONSTRUCTION EQUIPMENT SHALL BE REMOVED AND REPLACED WITH UNCOMPACTEO MATERIAL.
PLACE THE SEWER ROCK TO THE SPECIFIED DEPTHS. DO NOT CONTAMINATE SEWER ROCK WITH NATIVE MATERIAL
OR SPOIL FROM EXCAVATION. LEVEL ROCK SURFACE TO + 1" PRIOR TO INSTALLING THE PERFORATED PIPE.
ALL PIPE SHALL BE PVC CONFORMING TO ASTM D5034 OR ENGINEER-APPROVEO EQUAL. MINIMUM SOIL
COVER SHALL BE 3 FEET OVER THE PIPE ANO 4 FEET OVER THE SEPTIC TANK, ONE INCH OF INSULATION MAY
BE SUBSTITUTED FOR 1 FOOT OF SOIL COVER. (SEE NOTE 12)
ALL INSULATION BOARD SHALL BE 2" THICK DOW HI-35 INSULBOARD OR ENGINEER-APPROVEO EQUAL.
CENTER INSULBOARD WIDTH OVER SEPTIC TANK, EXTEND BOARD 4' BEYONO LIMITS OF TANK IN ALL DIRECTIONS,
GEOTEXTILE SHALL BE MIRAFI 140S OR ENGINEER-APPROVED EQUAL, LAP ALL JOINTS 2' MIN.
COVER THE DISTRIBUTION PIPE WITH A MIN. OF 2" OF SEWER ROCK, AND COVER WITH GEOTEXTILE BEFORE
PLACING INSULATION AND BACKFILL.
MATERIAL USED AS FILL SHALL BE CLEAN AND FREE OF ORGANICS, TRASH AND CONSTRUCTION DEBRIS.
SLOPE ALL FILL MATERIAL TO BRAIN AT 2~ MIN. SLOPE, AND .3:1 MAX SLOPE, AND IN SUCH A MANNER THAT
PONDING AT OR NEAR THE DRAIN FIELD DOES NOT OCCUR. THE FILL SHALL BE LEFT AT 6" HIGHER THAN
O.G. TO ALLOW FOR SETTLEMENT. SEED SURFACE AFTER COMPLETING INSTALLATION AS PER MUNICIPAL SPECS.
RECORD THE FINISH GROUND ELEVATION OVER THE BEGINNING, MIODLE, AND END OF SYSTEM.
JI~OREHOLR DATAt Depth
Matedal Type Ind Color From To
INFORMATION:
t NATURAL REiOURCEI * , g r '
DM~ION OF MINING & WA,~I~R MflMT
WATER WI~LI, RECORD
BIN
~S
WLrLL OWI~IERz
WELL DEPTH:
Depth of hale:, ~,J
Depth of Cilia: ~.,~. |
DATP~ OF COMPLETION
ti
D,~)'H TO STATIC WATER LEVEL:
Ir)q , ftbelow r'l top of ca~lnO
Date: .... ,~__,_./_.,~__./~
ground ludece
METHOD OF DRILLING: 1~ ag rotary ~) cable tool
/"1 other,
USE OF WELL~ '~ d~estlc ~ iffioation ~ monitor
~ p~llc ;~lv ~ Olaf,,
~L ~AKE OP~WO TYPE: ~ o~n e~ ~ tcree~d
Depthl of open~nol: ~.~/ lo ~..q-- ( fl
SCREEN TYPE: _A,/O~( Delta:.
Slot/T,4esh Size:
GRAVEL PACK TYPE:
Volume uled: Ol0lh to toD:
GROUT TY~f ~ Vol~e:
~h: fr~ h
D~atlOn'r
PUMP~G L~EL AND ELD:
~ DfSWFE~E~ UPON COMPL~ION2 ~ YES ~ NO
REMARKS:
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
GENERAL INFORMATION
Complete'legal description
Location (site address or directions) q.-%1.5 ~_ Io~
Property owner
Mailing address
Lending agency
Mailin. g address
~5i5 [~ Iol ~-G. A
Day phone 3 ~- & q'St
Day phone
Agent
Address
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: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
TYPE OF WASTEWATER 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.
?2-025(Rev. 1/91) Front MOA~I
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 verifythat 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.
Engineer's signature
DHHS SIGNATURE
Approved for
Disapproved.
__ Conditional approval for
bedrooms.
bedrooms, with thee 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 enginee¢s work.
Municipality of Anchorage 0
DEPARTMENT OF HEALTH & HUMAN SERVICE,~UNiC~P^L[T¥ o~^nC~l~ei~l~'~
Environmental Services Division ENVIRONMENTALSERWCE
825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744
Legal Description:
A. WELL DATA
Well type '-~
Log present (Y/N)
Total depth ,2.2/
Sanitary seal (WN)
Health Authority Approval Checklist
Lo~' ~ .'~_(L. t~, '~t~N~ParcelI.D.:
Y
If A, B, or C, attach ADEC letter. ADEC water system number
Date completed
Cased to ,2-~- I
Y
FROM WELL LOG
Date of test 3~//~ ¢/? ~
Static water level /'7 ?
Well production
Casing height (above ground)
Wires properly protected (Y/N)
AT INSPECTION
,P-~ g.p.m. ~ g.p.m.
WATER SAMPLE RESULTS:
Coliform -~"~ Nitrate
Date of sample:
B, SEPTIC/HOLDING TANK DATA
Date installed ~2/-7/c~ ~ Tank size
Foundation cleanout (Y/N)
Date of Pumping
C. ABSORPTION FIELD DATA
Date installed
Length ,~.~ ~ Width
Effective absorption area
Date of adequacy test
Fluid depth in absorption field before test (in.);
Fluid depth -
Peroxide treatment (past 12 months) (Y/N)
~, ~ ~4~c/L, Other bacteria
Collected by: ~ ~q
IOo-c3 Number of Compartments ~ Cleanouts (Y/N) ~
Depression (Y/N) I~ High water alarm (y/N) I"-/
Pumper '~ +
Soil rating (g.p.d./ft
Gravel thickness below pipe
System type ~"
Total depth
Monitoring Tube present (Y/N)
Results (Pass/Fail)
. Depression over field (Y/N) __
For '~
Immediately after 5~,o gal. water added (in.):
Absorption rate = 7 /~ 5~ g.p.d.
If yes, give date J
t~
bedrooms
72-026 (Rev. 3/96)*
LIFT STATION
Date installed
Manhole/Access (Y/N)
High water alarm level at*
Cycles tested
~s
"~evel at*
*Datum
"Pump off" level at*
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot
Absorption field on lot
Public sewer main
Sewer/septic service line
On adjacent lots
On adjacent lots
Public sewer manhole/cleanout
Lift station
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
Foundation ~O '~ Property line 3_5 Absorption field ~c~ +
Water main/service line .,> ;z.~ Surface water/drainage ~ ~ ~ Wells on adjacent lots "7 /'~:~..~
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
~ ~ ~ Building foundation ~--~
Water main/service line '7 / ~
Property line
Surface water -~ / ~
Curtain drain N/0
F. ENGINEER'S CERTIFICATION
Driveway, parking/vehicle storage area
Wells on adjacent lots > /~o
I certify that I have determined thru field inspections and review of Municipal reco~Es,that the above systems are
in conformance with MOA HAA guidelines in effect on this date.
Signature --~-~~
Engineer's Name I ~ ~or~4.~.,~
Date ~ (/2-°/ /~?
HAA Fee $
Date of Payment
Receipt Number
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
12-03'99 14:14 FRO)~'¢TE ENVIRONUENTAL
ZTK CT&E Envi,onmen,al Services Inc,
%336 P.02/03 F-47§
CT&E Ref,#
Client Name
Projec[ Name/t/
Client Sample ID
Matrix
Ordered By
PWSID
996461001
Tobbcn Spurld~nd P.E
I-~; 98 Sec 15, T12N, RBW
Lm 9g Sec 15, T12N, R3W
Drinking Water
Remarks:
Client PO# Pre-Paid Colis/NO3
Printed Date/Time I2/0U99 14:35
Colle¢led~te/Time 11/29/99 13:30
Received Date/T~e 11129/99 14:~5
T~i~t Dir~tor: Stephen C, Ede
Rele~ed ~~
0
~.92
POk
0.300
Units Method
Limits Oa~e Dare Init
11/30/99 ~AP
10 max 11/Z9/99 11/29/99 ~CL
cot/10OmL $M18 9222~
mall EPA 500.0
ztL
Drinking Water Analysis Report for Total Coliform Bacteria
READ INSTRUCTIONS ON REVERSE SIDE BEFORE CO~.LECTING SAMPLE
CT&E Environmental Services inc.
Laboratory Division
MuST BE COMPLETED BY (NATER SUPPLIER
PUBLIC WATER SY~ITEM ID~ ~ ~
~, PRIVATE WATER aYSTEM
200W, Pot~er Drive
Anchorage, AK 99518-1605
Tel: (907) 562-2343
Fax: (907) 561-5301
'~ TO BE COMPI:~TED BY LABORAT(~RY
:'.~ ~ample over 30 noum 010 Resul~ may be unmhaO~e
- Treate~Water
-~ U~treatedWater
SAMPLE DATE.
SAMPLE TYPE
yRoutine '
Repeat Sample
(refer to lab
. Special Purpose'
Date Ro¢~ived'
Time Roce~veO:
Aflal~ca[ Method:
LaD Ret NO
MMO-MUG Result; To,al Coliform
MemDrat~e Filter: O~rGat Chum
verif~ca[ion; LTB
Fecal Coliform conhrmation;
~mat Membrane Fleer
Repo~e~ By: _~.
Commen~s
o
· MMO-MUG
Collecte~
by (initial):
Sam [o ADEC ANC FElt< JUN
[3am' . _
Client notified of unsatisfaotory reaults:
BACTERIOLOGICAL W~T~ A~~
E, Cod
-- O Colomeslld~ml
COLIFORM
~S Member of tho SOS Gr~.p (Soc,am Ganerale de @urVe¢lance)