HomeMy WebLinkAboutT12N R3W SEC 33 LT 194T12N, R3W Section 33 Lot 194 #018-331-07 Municipality of Anchorage Page I of '~'~ 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 ~d ~1~ ~/~,~ ~.~ c.'/-~ ~.'~ Wastewater System: ~ New ~ Upgrade Address: Phone: .% ~j /[ ~ ~ ¢ .~ ~ No. of Bedrooms:.~ ¢~ ~'~ O .~J ~ ~ B Deep Trench B Shallow Trench BBed ~Mound DOther Total Depth from original grade:j Lot: JO~. Block: Subdiv~ion: Deplh to pipe bottom from odgiaal~de: Graver depth beneath pipe T**,..:iX I~,n,: ,~ ~ ISection: ~ Fifladdedaboveoriginalgrade:~¢~.,Ft. Gravellength: ~0' Ft. Number of lines: Distance between lines: WELL: B New ~ Upgrade Gravelwidth: i-g' Ft. Z% I ~/..-~' Ft. Classification (Private, A,B,C): Total Depth: Cased TO: Total absorption area: Pi e material: Driller' Da e Dr ed' S atio Water Level' Date installed: Yield: ~ Pump 8~at: Casing Height Abo~e Ground: SEPARATION DISTANCES ~s~p,ic u Holding U S.T.E.P. TO Sepdc Absorption Lgt Holding '.,gc/Pd,a/e M~,faot,rer:~,~.~?~l/j Capacityi, gallon,= /OOO From Tank Field Slatio. Ta.k Sewer Li.es n~-b~ ~ ..... Material: ~' ~ Number of Compartments: , Surface ~ Water (~' ~00't', LIFT STATION Lot Curtain ~ I~ctri~llnspectionsperformedby: ~ ('r ~ ~ 3 ) P ~& .~ ' ~ Location and Description: Inspections performed by ~gle.iver, Alaska ~ Dates: ~st 2-11'-q*~ Department of Health and Human Serwces approval 72-013 (Rev. 9/91} MOA 25 PERMIT NO. SW990234 PAGE 2 OF 3 iV)u nicip, o, Li~. oF' Anchor'o, oe DEPARTMENT OF HEAYLTH AND HUPfAN SERVICES ENVIRONMENTAL SERVICES DIVISION P,O, Box )96650 tAnchoro, oe, Mo, sRo, 99519-6650eTe~ephone: 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LOT 194, SECTION 55, T12N, RSW P.].]). No. 018-551-07 PERMIT NO. SW990234 PAGE 3 . OF 3 Municip, ~i% o£ AnchoraGe DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.B, Box 196650 IAnchor-cge, ALcskc 99519-6650eTeLephone~ 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT LEGAL LOT 194, SECTION 33, T12N, R3W P.LD. NO. 018--331--07 FINAL GRADE o~,~, C01MT1 / MT2 C02 , , GRADE ~FINAL GRADE ST1 /ST2~-90'5' % · NO WATER FOUND 69.0' B.O.H. A B FCO 30.0' 31.5' ST1 84.0' 107.0' ST2 90,5' 114,5' DBL1 93,5' 117,5' DBL2 95,0' 119,5' C01 134,0' 167.0' MT1 122.5' 157,5' C02 124.0' 136.0' MT2 135.5' 148.0' Municipality o! Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST PERPORMEO POR: 7 8 9 10 · 11 12 13 14 15- 16- 17- 18- 19- 20- COMMENTS ?,5 ~"~ , I , ~CERTIFYTHATTHIS~j~ESTvZ~ AS PERFORMED IN 72-008 (Rev. 4/85) IF YES, AT WHAT DEPTH? Depth Io Water AFter Monilorino? Dale: Gross Net Depth to Net Reading Date Time Time Water Drop WAS GROUND WATER ENCOUNTERED? PERCOLATION RATE ~o ~ (m~nutes/inch) PERC HOLE DIAMETER __ TEST RUN BETWEEN ~ FT AND ~ FT Township, Range, Section: 'l-'/.~.h,..[) '/~ SLOPE SITE PLAN Municipality of Anchorage Department of Health and Human Services 825 "L" Street P.O. Box 196650 Anchorage, Alaska 99519-6850 Rick Mystrom htr p://www.ci.a nchorag e,a k.us Mayor Permit Number: #SW 990234 Date of Issue: 7-29-99 Parcel Identification Number: 018-331-07 Date Started: ~-9-9 DateComl)leted: B'28.99 Is well located at approved permit location?~ Yes ~ No Legal Descriptions; T 12 N R3 WSec 33 Lot 194 Property Owner'Name & Address: Newby Construction 12929 Tracy Way Anchorage, Ak 99516 Borehole Data: Depth (ft) Soil Type, Thickness & Water Strata From To Stick-Up 0 2 silty gravel 2 37 gravelly silt 37 112 silty water sand & gravel 112 114 silt 114 t35 gravelly silt 135 147 silty water sand & gravel 147 150 Bedrock 150 190 Method of Drilling [] air rotary [] cable tool Casing type: steel Wall Thickness: .250 inches Diameter: _6 inches Depth: 155 feet Liner Type: Diameter: __ inches Depth: __ Casing stickup above ground: _2 feet feet Static water level (from ground level): 63 feet Pumping level: 190 feet after _2 hours pumping 5 gpm Recovery Rate: 5 gpm Method of Testing: air lift Well Intake Opening Type: [] Open End [] Open Hole [] Screened Start__ feet Stepped feet [] Perforations Start 1t2 feet Stopped 114 feet Grout Type: bentonite # 8 Volume: 1 bag Depth: Start_0 feet Stopped feet Pump: Intake Depth__ feet Pump size __ hp Brand Name Well Disinfected Upon Completion? [] Yes [] No Method of Disinfection: Comments: also pe/forated ]48 to 154 feet Well Driller: Alpine Drilling & Enterprisesl P.O. Box 110496 Anchorage AK 995t T-h~41ter-shatl~provide~a-wdl logto~the-prc~pc,"'c/cwn~wvit-l~ 30-<ta~ys~f~completion and the property MUNICIPALITY OF ANCHORAGE Department of Health and Human Services On-Site Services Program 825 L Street, Room 502 P.O. Box '196650, Anchorage, AK 995'19-6650 (907) 343-4744 ON-SITE WASTEWATER DISPOSAL SYSTEM / WATER SUPPLY PERMIT Initial Date Issued: Jul 29, 1999 Expiration Date: Jul 28, 2000 Permit Number: SW990234 Legal Description: T12N R3W SEC 33 LT 194 Design Engineer: 0003 S & S Engineering Owner Name: Newby Construction Owner Address: 12929 Tracy Way ANCHORAGE, AK 99516-0000 Parcel ID: 018-331-07 Site Address: 003900 RABBIT CREEK RD Lot Size: 82500 SQ. FT. Total Bedrooms: 3 Permit Bedrooms: 3 This permit is for the construction of: [] Disposal Field [] Septic Tank [] 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 ( 18AAC72 ) 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. Received By: Issued By: ROBERT C, COWAN, P.E. July 14, 1999 CIVIL ENGINEERS (907) 694-2979 FAX (907) 694-1211 SEWER&WATER INSPECTION ENGINEERING STUDIES AND REPORTS WELLINSPECTION & FLOWTEST ROAD DESIGN SOILTEST PERCOLATION lEST MUNICIPALITY OF ANCHORAGE Department of Health and Human Services P.O. Box 196650 Anchorage, AK. 99519 REFERENCE: Lot 194, Section 33, T12N, R3W Request you issue a permit to drill a well and install a septic system to serve the proposed three bedroom dwelling on the referenced property. Two test holes were excavated and percolation tests performed. The approximate location of the test holes are located on the attached site plan. At the time of excavation, 6-5-99 water was not found. After seven days of ground water monitoring, no water was found. We do not anticipate any adverse effects on neighboring wells, septic systems, reserve areas or drainage patterns by the installation of the proposed septic system. The construction of this system will not prevent any future development on any of the adjacent prop erties. If you require additional information, please contact us. Sincerely, Robert C. Cowan, P.E. RCC/bjj Enclosure 17034 NORTH EAGLE RIVER LOOP · SUITE 204 ' EAGLE RIVER, ALASKA 99577 PERFORMED FOR: LEGAL DESCRIPTION: 1 2 3- 4- 5- 6- 7- 8- 9- 10- 11 13- 14- 15- 16 17 18 19 20 COMMENTS Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG -- PERCOLATION TEST A ca-sso /.472 Township, Range, Section: F- I ~-~ ~ ~c~.:~ r ~ J WAS GROUND WATER ENCOUNTERED? SLOPE SITE PLAN S IF YES, AT WHAT ~ DEPTH? p E O,pl" tO Waler A~ter Oate: ~/! '~/~:~cj Monitorin§? J~ P~ ~ /:-J-7t Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATD)N RATE __ (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN ~ ~/~- FT AND /f '/>, FT fi '/~. '~ ACCORDANCE W~F-H~I.g[,~VT~I~I~'~I~'~PAL GUIDELINES IN EFFECT ON THIS DATE. 72-008 (Rev. 4/85) Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG m PERCOLATION TEST PERFORMED FOR:, LEGAL DESCRIPTION: 2 DATE PERFORME~:, (, Township, Range, Section: ~' I ,~ ~/ ~ ] SLOPE SITE PLAN 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19- 20- WAS GROUND WATER ENCOUNTERED? ~/ ~ IF YES, AT WHAT -~ SL DEPTH? pO E Monitoring? ~ ~"~/ 13ate: Gross Net Depth to Net Reading Date Time Time Water Drop PERCOLATION RATE 4~0. (o (m~nutes/~nch) PERC HOLE DIAMETER ~" TEST RUN BETWEEN ~ '/¢- FTAND ;-~ '~ FT COMMENTS 1 ~034 Eagle River Loop I,[oar. i i~Jo. 2.0.;. I . ' ;'~-~ CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCECy~I::I [~£Ae$')'~1Ee~[~I~[~CIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE; 72-008 (Rev. 4/85) 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 Lot 194, T12N~ R3W~ Sectinn ~3 Location (site address or directions) 3900 Rabbit Creek Road Property owner Mailing address Lending agency Mailin. g address Agent Address Newby Construction Dayphone 240-5312 12929 Tracy Way, Anchorage, AK 99516 Day phone Day phone Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: NOTE: 3 individual well ×X× Community well Public water 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: XXX If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1191) From 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 17024 Eagle River Loop Road No. 204 Phone Date S,G.^TU.E Approved for /~~j~- Disapproved. Conditional approval for bedrooms. bedrooms, with th-e following stipulations: Additional Comments By: 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 DH HS does this as a courtesy to pu rchssers 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. (Rev. 1/91) 8ack MOA ¢21 Municipality of Anchorage /_~J~l~ DEPARTMENT OF HEALTH & HUMAN .... D,,qVIRONM~[[ ALSERVICESNT " S Env ronmental Serwces D~v~s~on 825 L Street, Room 502 · Anchorage, Alaska 99501 · (907) 343-4744 Health Authority Approval Checklist Legal Description:;Lo'F I¢lq / A. WELL DATA "' ,' 'T ~ ,'2 j .,t'$ ~ Parcel I.D.: Well type /~21 ',/RTE_ Log present~.~N) Total depth Sanitary seal (..~) If A, B, or C, attach ADEC letter. ADEC water system number ~Y~.J' Date completed ~ / '~3/ q 'I ) °t O ' Cased to 6' 3- Casing height (above ground) Wires properly protected ~'.'~) Date of test Static water level Well production FROM WELL LOG AT INSPECTION WATER SAMPLE RESULTS: Coliform Date of sample: ) B. SEPTIC/HOLDING TANK DATA Date installed ~ /11 / ~ ~ Tank size Foundation cleanout ~N) Date of Pumping ~//~ - "J'~ Pumper Nitrate O, 5' ~1 Other bacteria Collected by: ENGINEERING 17034 Eagle River Loop Road No. 204 Eagle River, Alaska ¢9512 //00 O Number of Compartments '.~-L Cleanouts(~N) Y'¢J' Depresmon (Y/I~ ~,.' 0 High water alarm (Y,~ /v' 0 C. ABSORPTION FIELD DATA Date installed ~ /11/ ~ ~rl Length (O0 f Width Effective absorption area c} co Date of adequacy test N/,'~ Soil rating g~.p~or fF/bdrm) ~0, ~ System type /~¢ D / Gravel thickness below pipe I ' Total depth ~' i 't- Monitoring Tube present ON) Y4 J Depression over field (Y~) ~, k,' Results (Pass/Fail) For ~ bedrooms Fluid depth in absorption field before test (i~iately-a-f~ gal. water added (in.~ ~-~ Fluid depth __~e:teTT.' Absorption rate = _ .g.p.d. Peroxide.~trea~t (past 12 months) (Y/N) If yes. give date 72-026 (Rev. 3/96)* D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* Cycle~ Size in gallons /- ''Pump on" level at* ~' level at* E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic/holding tank on lot ) OO On adjacent lots ) O0 ~L Absorption field on lot /oO -f'- On adjacent lots ? oo C- Public sewer main /v/~ Public sewer manhole/cleanout zv//.) Sewer/septic service line ~ ~ ~ Lift station "¢/A SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation (~ ,5 Property line ~ 3 Absorption field Water main/service line ] 0 4- Surface water/drainage J°¢ -~ Wells on adiacent lots '¢ )oo · SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ~ o Building foundation J I ~¢ Water main/service line / O '- Surface water ) & 0 4- Driveway, parking/vehicle storage area ) O ''/- ~ o.,-, ~ .~ ,,~ o ~,¢ ,~ Wells on adjacent lots ?Od 4 Curtain drain ENGINEER'S CERTIFICATION I certify that l have determined thru field inspections and review of Municipal record, c~&~'Ch..?,~i~f#ms are in conformance with MOA HAA Quldehnes in effect on this date. En~lneera' 's Name __ HAA Fee $_ Date of Payment Receipt Number 72-026 (Rev. 3/96)* Waiver Fee $ Date of Payment Receipt Number