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HomeMy WebLinkAboutT12N R3W SEC 33 LT 187T12N, R3W, Section 33 Lot 187 #018-282-15  Municipality of Anchorage Department of Health and Human Services ( Division of Environmental Services On-Site Services Section 825"L" Street Room 502 P.O, Box 196650 Anchorage, AK 99519-6650 Page t/ of v.'v,~v,ci.anchorage.ak.us (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Permit Number: C-~.o ct~ ~ Lq ¢~ PlO Number: ©L~ - ~-~'2.--1%-- N .... ~, e. tQ~ ['~ [~-, Wastewater System: ~ New ~ Upgrade LEGAL DESCRIPTION / ~ ~. ~..~e 1~;~ // ' F,. Well: ~:~ '~"~n5 ~ New ~ Upgrade ~-, ~') Ft. {I ..... FL SEPARATION DISTANCES ~septic ~ Holding ~ 8.T.E.P. ~ Other: ~ Msnuf7 ..... ~ ~ ~:~ -~ Capac~ To Septic Absorption LiQ Holding Public/Private Tank Field Station Tank Sewer Line ~' . ~ O~ J~Z ~() Gal. '~ZO~ '5C~ [/ "Pumpon"levelat: "~le~t High~teralamat: Rem.~s: BENCH MARK Engine~r'~ [t~mp Depa~ment of Health and Human Services approval ~%~,. cE-9~9 ~.viow~,n~.pprowd by: ,~ ~ U. ~ D,t.: ~'m ~-~ O ,,:,~,~_ .~--"'.'."' ~,-~ 2 2 Permit No. SW990298 Page .of 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 Description: T12N R5W SEC55 LOT 187 PID No.: 018-282-15 -BLM 166- 329.81' S89'59'47"E 35' pR~L-'cRVATION~,,. EASEMENT I -BLM 188- 250 GALLON TANK- ~ e~~ ~TH~)~ .... ~SECON~ARY~ I S FSTEM ,' ,,,,. f/ x 329.83' N90'O0'O ~ / GRND. PIPE % MARK A 8 ~ R A B B I T C ~/E E K R 0 A D - ELEV. ELEV, --~ ~ ~ ~ ~ ~-¢ C01 48.2' 32.1' 99.2' 97,3' C02 35,6' 51,3' 99.3' 97.5' TC01 36.1' 55.0' 99.5' TO02 40.1' 59.9' 99.5' C0,3 42.~' 60.5' 99.8' 96,4' C0,4 46.0' 60,8' 99.8' 96.4' C0.5 88,4' 59.4' ~99.5' 95.5' MT 65.9' 58.0' ~ 99.8' BENCH MARK tS GARAGE S~B ELEVATION 100' ASBUlLT SCALE: 1"=80' ~~ 95.4 TANK o o~o~( DRAIN ROCK °~ , GRND. PIPE MARK A 8 ELEV. ELEV, C01 48.2' 32.1' 99.2' 97,3' C02 35,6' 51,,3' 99.3' 97.5' TC01 36.1' 55.0' 99.5' TO02 40.1' 59.9' 99.5' C0,5 42.1' 60.5' 99.8' 96,4' C0,4 46.0' 60,8' 99.8' 96.4' C0.5 88,4' 59.4' 99.5' 95.5' MT 65.9' 58.0' 99.8' MUNICIPALITY OF ANCHORAGE Department of Hea#h and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box 196650, Anchorage~ AK 99519-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM PERMIT Initial Date Issued: Aug 23, 1999 Expiration Date: Aug 22, 2000 Permit Number: SW990298 Legal Description: T12N R3W SEC 33 LT 187 Design Engineer: 0088 Anderson Construction & Eng'g Owner Name: Jeff Holt Owner Address: PO BOX 2821 DEMING, NM 88031-2821 Parcel ID: 018-282-15 Site Address: Lot Size: 108900 SQ, FT. Total Bedrooms: 4 Permit Bedrooms: 4 This permit is for the construction of: [] Disposal Field [] SepticTank [] Holding Tank [] Privy [] Private Well [] Water Storage 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 ( t8AAC72 ) and Drinking Water Regulations ( 18AAC80 ). 3. The engineer must notify DHHS at least 2 hours prior to each inspection. Provide notification by calling (907) 343-4744 ( 24 hours ). ( Not required for a Water Supply Permit only ). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must be either: A. Open and closed on the same day. B. Covered, sealed, and heated to prevent freezing. Date: Date: Michael N. Anderson, P.E. 14250 GoldenviewDr. Anchorage, Alaska 99516 Ph 345-3377 Fax 345-1391 Date August 20, 1999 Municipality of Anchorage Department of Health and Human Services On-site Services P.O. Box 196650 Anchorage, Alaska 99519-6650 R}'CEI i/ED AUG 20 1999 Mu/~ici Dali~ .... 'Tealth ~'1~~, AnChoran~ ~erwoe Subject: BLM Lot 187 To Whom it may concern: This a request for a new four bedroom septic system permit on the above lot. The lot size is 2.5 acres with an existing well as the plan shows. The existing well has no records but the owner did have the well tested for flow, depth, and volume and I will include that data in the asbuilt. The soils were gray sandy gravel with no water observed after the seven day monitoring period. The perc rate was 1 minute per inch which translates into a trench length of 42 feet with 6 feet affective depth. No surface water was found and the lot slopes away to the south. The system will be more than 50 feet away from the 25% slope to the north. This new system will not prevent future wastewater and well development on the adjoining lots. The existing systems on the surrounding lots appear to be performing adequately. Please feel free to call with any questions concerning this system at 345-3377. Michael N. Anderson, P.E. I -BLM 168- r-TEST HOLE (TH) Ii PROPOSED55' PRESERVATION EASEMENT ¢.---./30' RADIUS 4 BEDROOM RESIDENCE--x. /" ', : -BLM 186- I ~ / "', ~'~) EXISTI~O' ~ ~-- ,o~F_ ~O~l°: ~ i WELL RADttJ'S~.% ~../'~.~;. ,=,.k. I L. 0: ~ I [ -BLM 188- * 329.85' Ngo'oo'oo"E / _.l. I ~ ~ - R A B B I T C R E E K// R O A D - ~MOUND OVER DESIGN CRITERIA: ~GRADE 4 BDRM = 600 GPD SOILS = 1.2 GPD/SQ, ~, -~' OR ,~l % ~FILTER FABRIC 600/1.2 = 500 SQ. ~. REQ'D ~ TRENCH: ~ 9.0' DEEP 6' EFFECTIVE OM 2.0' WIDE ~20'~RAIN ROCK ~2' LONG SEPTIC DESIGN PREPARED FOR dEFF HOLT ~4~., . ..y~ LOT 187 ...... MICHAEL N. ANDERSON, P.E. 14250 N. GOLDENVIEW DRIVE (907) 345-3377 / FAX (907) 545-1391 SCALE: 1"=60' JULY 16, 1999 PRESERVATION EASEMENT /" ;ECONDARY / SYSTEM DOUBLE I250 GALLONG TANK SEPTIC DESIGN PREPARED FOR JEFF HOLT LOT 187 BLM SUBDIVISION PREPARED BY MICHAEL N, ANDERSON. P.E. 14250 N. GOLDENVIEW DRIVE (907) 545-5577 / FAX (907) 345-1391 SCALE: 1"=,30' WELL RADIUS ,~.~. · A .',~ ~% ~ICI'IAEL N, ANDERSON JULY 16, 1999 ~A~~ Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOI~ATION TEST PERFORMED FOR:~ e ¢"~'J~ LEGAL DESCRtPTION: ~b'~ 2 3 4 5 6 7 8 9- 10- 11 13- 14- 15- 16- 17- Township, Range, Section: SLOPE 19- 20- WAS GROUND WATER ENCOUNTERED? IF YES, AT WHA'r DEPTH? /7~?E Oep~ lo Water Afl.er, Monilonng? ~,f C~ ~Oate~ SITE PLAN I N Gross Net Oel3th to Net Reading Date Time Time Water Drol3 ~',,~ ;., ~e~-~f ~;~" / PERCOLATION RATE ~/ (m~nutes/~ncr~) PERC HOLE DIAMETER TEST RUN BETWEEN ~ FT AND ~ FT .~OMMENTS ~U, ¢ ~ ,I PERFORMED BY: ~'~J /~ I CERTIFY THAT,~HIS TEST WAS PE'RFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 72-008 (Rev. 4/851 Municipality °fAnchorage Department of Health and Human Services Division of Environmental Servicesr: - On-Site Services Section 825 "L" Street Room 502 P,O. Box 196650 Anchorage, AK 99519-6650 www.ci.ancho rage.ak.us (907) 343-4.744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL' FOR A SINGLE FAMILY DWELLING Parcel I.D:~', ~ '- 1; GENERAL'INFORMATION Complete Ibgal description · ' Location (site address or directions) . Current Properti,.:0wr{er(s) ~--~ Mailing address __ Expiration Date: Lending agency Mailing address Day phone Real Estate Agent Mailing Address DaY phone Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 3. TypE oF WATER SUPPLY: Individual Well · Individual Water Storage · Community Class Public Water System TYPE OF WASTEWATER DISPOSAL: ¢~' IndividuAl on:site [] · Individual Holding Tank Well [] Community On-site b~ public Sewer The Municipality of An~h0rage Department of'Health and Human Services (DHHsi i~sUes C~difi~ates of Health AuthorityApproval (HAA) based only upon th~ representations given in para'CaPI~ 5 by an ir~8~Pendent professional 8ivil engineer: registered in the State of Alaska. Certificates of Health Authority Approval are required for the '{~:ansfer of title (except between spouses) on propedies served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for propedies served by a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 01/00)* = STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed here{o andas of the validation date shown below, ~ verify that my investigation based on procedures outlined in the Health Authority Approval Guidelines for the Health Authority Approval application show 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 applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Address Engineer's Printed Name DHHS SIGNATURE' ' ' Approved for LC. bedrooms. Disapproved. Conditional approval for __ Phone Date "'~/~ ~/~/'¢~.¢~ ¢~ ~,.. CE~ 9409 . .~ bedrooms, with the following stipulations. --~.., . .Addltional Comments Attachments: HAA Checklist Septic System Advisory Well Flow Advisory Maintenance Agreements · Supplemental Engineer's Report ,' "i Other ...... - ..... " Expiration Date: ~ "~ ~'- 0 0 Original Certificate Date: Reissue Date: 75-o25{Rev. 01/00)' Municipality of Anchorage Department of Health and Human Services Division of Environmental Services On-Site Services Section 825 "L" Street Room . P.O. Box 196650 Anchorage, AK 99519-6650 www.ci.anchorage.ak.us (907) 343-4744 Legal Description: HEALTH AUTHORITY APPROVAL CHECKLIST Parcel I.D.: A. WELL DATA Well type ~¥-'~,0,~- ~ If A, B, or C provide PWSID # Date completed ~,~,~,~¢t Sanitary seal Total depth ~ 'b(,, ft Cased to I ~C¢ ft FROM WELL LOG Date of test /., ~o~:,~ 6(*'°~ Static water level ~ ft Well production ,.,.-/'/' g.p.m WATER SAMPLE RESULTS: Coliform ~__colonies/1 O0 mi Nitrate ~,~o, '?'~¢1 mg/I / Date of sample: ?;/~/o(_) Collected by: B. SEPTIC/HOLDING TANK DATA Tank Type/Material ~-5 (- ~-~ Date installed ¢( /'z- //-l "f Tanksize ~'2-5'(2 gal Cleanouts ~/ Foundation cleanout 'Y' Date of pumping /',.~ c Well Log Wires properly protected Casing height (above ground) /¢~/' in. AT INSPECTION t ~ ft g.p.m Other bacteria / colonies/100 mi Number of Compartments '2. Depression over tank /~ High water alarm Pumper C. ABSORPTION FIELD DATA Date installed ':t/? I/R ~"t Soil rating (g.p.d./ft2 or ft2/bdrm) It ~ System type I?ength ¢~/~ ft Width ~ ft Gravel below pipe '~', c, ft Total depth /¢',~ ft Effective absorption area ~,¢~ ft2 Monitoring tube Y' Depression over field Date of adequacy test -~- Results (Pass/Fail) ~ For "y/' bedrooms Fluid depth in absorption field before test -~-~- in Water added ~¢gal. New depth .~-~'in. Elapsed Time: ~ min Final fluid depth. ~ in Absorption rate >= ¢--~g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) ¢,(~-), .If yes, give date __ 72-026 (Rev. 01/00)* D. LIFT STATION Date installed "Pump on" level at in .L'~ump-ofl* eq~vvel at __ D~!u~ ~ Cycles tested E. SEPARATION DISTANCES Size in gallons ~~----ManlTol~A~s in High water alarm level at SEPARATION DISTANCES FROM WELL ON LOT TO: Septictank/lift station on lot / Absorption field on lot / O Public sewer main ~ Sewer /septic service line {c~ in Meets alarm & circuit requirements On adjacent lots / o(a r /_ On adjacent lots / ¢:,~ '../- Public sewer manhole/cleanout ~/// Holding tank '////¢, SEPARATION DISTANCES FROM SEPTIC/FIOL-DI~'G TANK ON LOT TO: Property line ~"o~ Water service line ~'}'o Wells on adjacent lots Building foundation Water main Drainage ¢¢/¢o ¢.¢ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line z~ c .-/~ Water Service line Curtain drain h/ Building foundation '~ Surface water f 0 (~ Wells on adjacent lots F. COMMENTS Absorption field ~-/' O t / Surface water / ¢o //- Water main ~'/.-¢' Driveway, parking/vehicle storage G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA HAA guidelines in effect on this date. Engineer's Printed Name ~, t-~,~¢ l ~.[ ,'¢,~ ~1 ~.~ 4 ~,q Date '~/X~ ~/,/'~, o HAA Fee $ Date of Payment Receipt Number Waiver Fee $ Date of Payment Receipt Number 72-026 (Rev. 0~/00)* O~-2S-O0 1~:41 FROM'CTE ENVIRON~EHT^L 2Tk C T&EEnvironmen,nl~rviceelnc. 5515301 T-841 P.02/05 F-856 CT&E Ref.# Client Name Client $~mpl¢ ID Man'ix Orderecl By PWSID 0 I00116400 i W.D. DoRsn ~ Sons (Hol0 1~124 LocLoman (tJol0 ~$124 Lo~Lomao DrinkL~g WaTer I~/L EPA 300.0 Client PO# I)Fint~d Date/Time 03t24/2000 15:49 Collected Daytime 03~2/2000 10:00 R~eived Date~ime 0~/22~000 10:~0 T~chnleal Oi~t~ Stephen C, ~de Rtlcas~d~ ~~' PRO~-¢TE ENVIRON~TAL )BIB801 T-841 P.05/05 P-BSB CT&E Environmental Services Inc. Laborato~/Division ~~...~_.?_--;_~,~-.,-_J~'araeer~r.~r,~r~l~a~wr~a 200 W. Pouer Drive Drinking Water Analysis Report for Total Coliform Bacteria Anc.o,a.o. AK 80.~8-,~s Tel (9071562-2343 READ INSTRUCTIONS UN REVERSE $IDI~ BEFORE COLI. E(.'TIN~~. ?t~I~'.$.3.0~I ..... ~ TO BE COMPLF-T£D BY I.~,BO¢ ~TOR¥ Analy~ta ~h0ws this Wu~¢r SAMPLE' Ia be. ~PRIVATE WATER sYSTEM S^MPt.~ TYpF: rl Routine fl Trea,ed Warn ~ R~pgag S~mplu (for roudne sample ~ Untreated Wa~er with lab r~f. no. . . ) D Special Purpose Time Collec~ SAMPLE LOCATION Colle~ By ~Sample over 30 hours old. resuBs may be unreliable Sample too long m ~nSl~; sample shoul~ not be ov~ 48 hours old a~ examina*lon m ind~ca~ reliable results. ~leas~ s~nd n~w ~amplu via s~ dehve? mail, Dine R~ceiv~d ~ 'D~MMO-MUG * Numb~ ofcoloni~l~ mi. .............. ' Result~ Aflalys[ neb Fb8s Jun [] CIie~l noltti~:l, of ugsafisfactory ~O°~wno Tim= BACTERIOLOGICAL WATER ANALYSIS RECORD MMO-MUG R~II: Total Coliform MembrSae t*it~er: Dlr~ Count (~' Vuritlcattoa[ LTB .... _ flGB ~ Fecal Coliform Confirmation Final Memb~e ffilver R~ulls ~ Repulse By ~aw £. Coil Colonle~/HlO mi ,. COLIFIRM~ Coliform/lO0 mi Mum"er of me SOil Group lBoclem GenOral~..ae SutvSsllanCe) __ ENVIRONMENTAL FACILITIES IN ALASKA. CALIFORNIA, FLORIDA, ILL,iNOI~, MARYLAND. MI(IHIGAN. MISSOURI, NEW dEWEY, OHIO. W~ST VIRGI~ Well NO, Measuring equipment AQUIFER TEST DATA Page .... Tlme Data Water Le,,~l Data Discharge Data Pump on: Date ~ Time ~ (to) I~/ How Q measured ~ e.'~ ~' Comments on ~c~ers Pump elf: Date ~13 Time ~(~) Static water level D e plh o~'p"~air lin e ~ Durationofaquifertest: Measutingpeint hal,u, TOP. Previeus~'~ing?Yes No ,~ aifectingtestaata Pumping '~ k,r-~ Recede y '"-- Eleval[on of measuring point Duration "'-'-' ~ ~ ~ · ~ ~ Water ~/~ ,,,~ ~' I F~¢ 57~ 170~7 ~:~ 77' ~' ,,;,~ I ,q 3~ i I I J [ I ! I i Address County ,~C k State /~ lq