HomeMy WebLinkAboutPARK PLACE #1 BLK 1 LT 6F�I
Mark Begich
Mayor
Development Services Department
Building Safety Division
On -Site Water & Wastewater Program
4700 Elmore Road
P.O. Box 196650
Anchorage, AK 99507
w .muni.oro/onsite
(907) 343-7904
Pump Installation Log
Well Drilling Permit Number: SW
Parcel Identification Number:
Bate of Issue:
Legal Description Property Owner Name & Address:
PA
767 3S 6457t)"AiJ sT
4 k 495/6
Pump Installation Date: y-; y _ 15r
Pump Intake Depth Below Top of Well Casing: ISO feet
Pump Manufacturer's Name: Rrl) TflckaT
Pump Model: Sb<$►%aSla-
Pump Size l/.I—hp
Pitless Adapter Burial Depth: /0 feet
Pitless Adapter Manufacturer's Name:
Pitless Adapter Installer:
Well Disinfected Upon Completion'.' { Yes I -i No
Method of Disinfection: CLost%1)IL let N£T5
Comments:
Pump Installer Name: (411oeNaR414
Anchorage, AK 99518
Phone: 907-243.0740
Fax: 907-243-0742
MU
CZ
Attention: The pump installer shall provide a pump installatiAn log to the DSD within 30 days of pump installation.
Municipality of Anchorage Page I of a
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: SWCiSOM-7 PID Number: Oaooga-7 t
Name:
�GNNIS 1. CFIAIJ
Wastewater System: q New ❑ Upgrade
Y P9
Address: ANVc.F4oZAGIV L1950 -f
15100 e.TVOOt IRD, p LA-6KA
ABSORPTION FIELD
Phone:
No. of Bedrooms: [1
0Deep Trench ❑Shallow Trench Cl Bed ❑Mound ❑Other
LEGAL DESCRIPTION
Soil Rating:
Total Depth from original grade:
O •=o GPD/Sq. Ft.
t I I�
Lot: / Block: Subdivision:
Depth to pipe bottom from original grade:
G ravel depth beneath pipe
l0 i�A2K P LAe W d I
l•5' I.1' As P�TiufL Ft.
Ra"pen-CLi Ft.
Township:
Range:
Section:
Fill added above original grade:
'
Gravel length : ?. TawCNrs
01 TO I Ft.
1@aSl I P38' Sb' TOTAL Ft.
WELL: ®-New 11 U rade
P9
Gravel width:
a.5
Number of lines:
a
Distance between lines:
Iq'
Ft.
Ft.
Classification (Private, A,B,C):
Total Depth:
Cased To:
Total absorption area:
Pipe malarial: ASTv.A
_1?121VATI,
I 'i')' Ft.
1 -3 ' Ft.
1005 SO. Ft.
1)3153y SCft rib wC
Driller:
Date Drilled:
I Static Water Level:
Installer:
Date installed:
S
AL711KM DVt1u_INL+
Qt --1-95
1 OI Ft.
OWNEAI a5TALL
Yield:�^1
Pump Set at:
Casing Height Above Ground:
1,
TANK
os- GPM
U I te- Ft.
1 Ft.
SEPARATION
DISTANCES
1:1 Septic ❑Holding )dS.T.E.P.
To
Septic
Absorption
Lift
Holding
Public/Private
Manufacturer:
RA&4c: -T
Capacity in gallons:
15Vo
From
Tank
Field
Station
Tank
Sewer Lines
-Awc.Ho
Well
1�3
137
1�3'
I
as +
Material:
STYE I_
Number of Compartments:
a
Surface
too'+
too'+
__
—
LIFT STATION
Water
JLX,I+
Lot
Line
I
S3
t
a�
1
S3
--
Size in gallons:
ISoU
Manufacturer:
I A"e HbVA(>S -TANK
Foundation
5
t D
"Pump on" level at:
4 3 .r
"Pump off' level at:
33
High water alarm at:
g
Curtain
No/15
11
KN
1...7N
Pump Make &Model
I Electrical inspections performed by:
NI,o, A
Drain
oSt bSHH
.
Remarks: M:f,' N7r L«.eTLro-F_aOor- -raiz"cHEs
BENCH MARK
Location and Description: _
e �r,1cH�S Ate lrlsvLA-rice
GM U
r ,
Assumed Elevation:
Ibo.o
Y
ENGIII �QL
�....OP
. .•...t.1
S 8. s ENGINEERING
4 A
Inspections performed gyn34 Eagle River Loop Road, No.2obates: 1st -9S
..
Eagle River, Alaska 995972nd 10 �a-ct5
p p ` ROBERT C. COWAN /@
Department of Heal d Hum ervices approval
Y
V "cam •• CE -8POI
44 Zs ..,
�
;.• ,,o�r;�`w
bt, Fri;,;;; �:':;,.°•,�r.
�
Reviewed and approved bye — --Date: 1•� ��
'��y�:�
72-013 (Rev. 9/911 MOA 25
Permit No.
SW950077
Page 2 of 2
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
Legal Description:
LOT 6, BLOCK 1, PARK PLACE #1
PID No.:
02009271
STl
ST2
FINAL GRAD
95.3'
89.
FINAL GRADE
M
MTI8'
8
.2' MH
IN
ULATION
NEW
1500
87.0' CAL.
S.T.E. P. 0.8'
SYST,M
93.W
R
7.81,R
84.3'
79.0'
A
B
32'
1 8'
EG
♦ 79.3' WA
ER FOUND
CO
34'
19'
78.3'1
OS4.
STI
33'
20'
WEL
ST
27'
28'
1}
MH
26'
31'
g
MT
37'
59'
AT2
21'
57'
1 pp
NEW 1500
GAL.
S. T. E. P. T
I
kNK
MT1
I
i
MT2__--
BARN
I �IilI2--
I
vco
NEW TREI
I
CI -IES A
4 BDRM
HOUSE
AJR#J
,NOffi.
N
yl ROBERT C. COWAN
CE - 8601
SCALE 1" = 40,
�\
�t�=��`?,., r.•�,;;�.9" .
ALF.
SITE
72-013 A (Rev. 9/911 MOA 25 _ 1
99
P:
vy"F�� IIA�I 14Yi, Vf�,4}yl M141
IV UNICIIaAI..MY OF ANCHORAGE, BUILDING MPM DIVIsfoN
3600 PAST TUDOR ROAD
IIV;MJION: FAX (90'
"? n INP0,- SA3.0211
i d'Ts:oalfA e luven
i's��t`�I:d<;e 'f4�f%;) ��i�iiz�PY&T�tJ i?�Ft1r.J S�d-��I�� �i'• 34�� � �=4Z6�
$umm'SIM3 Ppt Jxl.-sce DATE
TYYIWYn Kram vMw.RiflaVlNN� 4W[�T�vOI.:_ Mo^'�aa�'+Tn....
,,� !,
r }i 1f' 5pacton 6„434'S ibw'71'S:i iS ' ; t,ib",'s44�i iA 14'm irafi) V1, 1j5 o fei tt a MOM off 0} L rle Vc, ilght to 090 I1d1Sq-
1,.' !`Y1 i CaJ 1Q(1fdS?$' BtdF' iSYR{Q�' � Ixa :,a', 113+% �;IfiG113�}fif1�1} Mwn Gfirdti WK 2"SM6 HM.- 345-4219
.__.:.-"-�4' `7'�5a,.rvs.�:.:: m.`:�c:•�:_.�� �masvaia:r _ mi _.
`C' >E OF IN.S. VE 7Mt WP,401F .-V FMQJ
.....-�..:vv.'S:.Ra�mGy��uv;{c'�q...v.�ypaR�4%:".'✓.`�-4'tiCs^�ktrX.[:'MM.`Kvwc-caC9'a-iM54M.WS6WYW%pcRON.OIhvEY'�s:; a1�(i�51>XFYFl
4�0 fVfvN0VoY"rf>S'�A�dP'uv-'4r� �kiEV`L/. D
`? Y-`OReKOIOI;Ii AR EXPL411uFO OLLOW
1 WILL It+ PECTft N 1100 NOT CQNL;M UNM AEIN,9pF- .TFt?
f 71
1 � M1r
rvuFC:.'>:ad�i 5.`.""1 ,...i ..............�vu>q.:.:�Mcps,,, ..<..-c _ e:u^W!as....r.nwz:*•=an�r
+,'�, W-fM"'v-Vlrssx"T1!. N ARE MADE PLFAIN CALL FOR REINOPM1 I0
STATS OF ALASKA
rMENT OF NATURAL RESOURCES
DIQ OF MINING & WATER MGMT
WATER WELL RECORD
F.V WMIIV+t VI •�wr
L
BOROU13K. .-�y SU8 ION &ION GTRS ; - . SECTO4 .TOWNSHIP � RAN6! MERIDIAN.
❑N. nE
lff�y .Z710a re
Cls ❑W
, 'f . WELL OWNER:
ni:a-11,sa�Y�vt
;sic=t�lZvi
[7L20CATIONIS'KETCH!
DEPTHS MEASURED FROM: casing t0 8 : WELL DEPTH: DATE OF COMPLETION
Depth of hole: it
BOREHOLE DATA: s Depth of casing:
Materisl'Type and Color
DEPTH TO STATIC WATER LEVEL:
r I�'
ss ter.`.
n ft below ;EE top of casing ❑ ground surface
Date: IJ
ri
METHOD OF DRILLING: 42.,air rotary ❑ Cable tool
❑Other
USE OF WELL: Z domestic ❑ irrigation D monitor
'�
❑ public supply ❑ other
CASING STICK-UP: ft. Diam: �in. to_� ft
Casing type: In. to ft
WELL INTAKE OPENING TYPE: ❑ open end 12 screened
❑ perforated A open hole
Via'^ frt
pths of openings: to �_ ft
De..�
+� <�
SCREEN TYPE: _Diam: in.
i
Slot/Mash Size: _Length: it
GRAVEL PACK TYPE:
Volume used: Depth to top: —
GROUT TYPE: Volume:
i
Depth, from ___ ft to it
DEVELOPMENT MEJHOD: C`—'
i
Duration:
i Dept. Health & Human
t% idw
-
PUMPING LEVEL AND YIELD:
it after hrs pumpin gpm
L
PUMP INTAKE DEPTH: it Horsepower:
WELL DISINFECTED UPON COMPLETION? DYES ❑ NO
:CONTRACTOR INFORMATION: M1'
Nagiale Xsiness Name y:
inaA ur®o Aut nnze esore ntative - We
REMARKSi
PLEASE MAIL WHITE COPY OF LOG TO:
DNR/DIVISION OF MINING & WATER MGMT
PO 80X.107006
ANCHORAGE AK 99510.7005
inq
ROBERT C. COWAN, P.E.
ROBERTA. SHAFER. P.E.
CIVIL ENGINEE=RS
(907)694-2979
FAX(907)694-1211
Date:
HEALTHAUTHORITY
APPROVALS
RECEIVED ED
Municipality of Anchorage
SEWER&WATER DEPARTMENT OF HEALTH AND HUMAN SERVICES FEB 261996
MIN EXTENSIONS 825 L Street
P.O. Box 196650 Municipality of Anchorage
Anchorage, Alaska 99519-6650 Dept. Health &Human Services
SEWER&WATER
INSPECTION I 1
REFERENCE:
ENGINEERING STUDIES
AND REPORTS The septic inspections for the referenced property were
performed on and (9 2L -5S Prior to submitting
the On-site Wastewater Disposal System and/or Well Inspection
Report we are waiting for the F �ore,cnn A� �IxT to be
&FLOW
WELcompleted.
WTEST CTION TESp
If we may be of further service please contact us.
SITE PLANS S17ZIIZ4'_
incerely,,
ROADOESIGN �
Robert C. Cowan, P.E.
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ONSITE
WASTEWATER
DISPOSM-SYSTEM
DESIGN
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
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
PERMIT NUMBER:SW950077
DESIGN ENGINEER:S & S ENGINEERING
OWNER NAME:CHAN DENNIS J
OWNER ADDRESS:P.O. BOX 110931
ANCHORAGE, AK 99511
PARCEL ID:02009271
LEGAL DESCRIPTION:
PARK PLACE #1 BLK 1 LT 6
LOT SIZE: 109246 (SQ. FT.)
NUMBER OF BEDROOMS: 4 THIS PERMIT: 4
THIS PERMIT IS FOR THE CONTRUCTION OF:
DISPOSAL FIELD /SEPTIC TANK / WELL SYSTEM
ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH:
PAGE 1 OF 1
ani
DATE ISSUED: 5/16/95
EXPIRATION DATE: 5/16/96
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 343-4744 ( 24 HOURS ) . (NOT REQUIRED FOR WELL ONLY PERMIT)
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 HI9ATED TO PREVENT FREEZING
5. THE FOLLOWING SPECIAL PROVISIONS.
SPECIAL P
RECEIVED
ISSUED BY:
R
OVISIOI�S': 1
BY: (\6 / �'�ti_ DATE:-
DATE:
ATE:DATE:
S&S
HEALTHAUTHORITY
APPROVALS
SEWER & WATER
MAIN IXTENS IONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
Inaaraay
9eiulnS0111
SOIL TEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ONSITE
WASTEWATER
DISPOSALSYSTEM
DESIGN
nG
May 9, 1995
MUNICIPALITY OF ANCHORAGE
Depcuctment o6 Heatth and Human SeAvica
P.U. Box 196650
Anchorage, AK 99519
REFERENCE: Lot 6; Bloch. 1; Pahk Ptace, Subdivision 01
16741 Stone. Ridge. Road
ROBERT C. COWAN, P.E.
ROBERTA. SHAFER, P.E.
CIVIL ENGINEERS
(907)694-2979
FAX (907) 694-1211
Requat you issue- a peAmit to d4 i U a weGe and inAtaU a Aep is a ys tem
to seAve the proposed 6ouA bedroom house on .the ne.6eAenced phopeA,ty.
Test hota weAe excavated and a pencotati.on test peA4onme.d. The
apphoximate, tocation o6 the, test hote.6 ane Located on the attached
site, plan.
At the. time o4 excavation no wateA was eneounteAed and a6teA th.ixty
day gn.ound wateA monitoring, wateA was bound at sixteen 4e.et.
Thi6 pn.openty has enough area bon a 4utune, se.pti.c upgrade. which can be.
seen on the, attached site. plan. We, do not anticipate any advehse
e,44e.ets on neighbohing pnopeAti.e6 by the. installation o6 the paoposed
se.ptie system.
There ahe no points o4 contamination within the. pnopo6ed well nadiu's
which can be seen on the, attached site plan.
The proposed 1500 gallon septic tank is to be placed outside. the, wett
piLotec ti ve radius. Attached is a site plan which depicts the to cation
o6 the proposed tank.
14 you ne.qu,iAe additionat .in4onmat.ion please contact uz
SinceAely,
Robert C. Cowan, P.E.
RCC/gk
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
FM
c
V
o Z
n
N 0
ymPy
n_ � y
C'
I" = 50' SITE PLAN
SCALE dm y7p
O x
w (N (A N Un -0 m
\ O (,n U1 C P
o r' q �\ D G) y --i
D O O\
m
orCA �x >vr i o �uti
�roo-Di @ W O oO.p b r
DmD oN m
-- � — D m r N WOO o— o
20' UTIL. ESMT. -Z2
m ➢ r� 2 NC'.
D
O N n O O� = rn N
m n z nP ul "
\ \ 20- �,' is mro oma'' O N O m
moo, G m co —I m O S•
\\ \\\ 00 lil� %I go ' D m m h� _b O
Y
\ \ o D O m O o m
N e .0a o p Cp=ryJ
Ifi
\
mro
Dry 000 { \\o
ZSR
W
nOC \ \\ zO� 1 AZA-1�NZ-i r
\\ \ t -i cci��'m"�acOA
Zzow
______________ \
A Z V
i 'OnNW�jmz 1 (Il
0>
rC- ZDM [O
VI
'xcl o p nc0
O,m�y->
,
— / ��Q, AmNNAAD 10w O '
V1
Cl v°tCM
a BqC TQC i n A i/1
zw Oo-'Z ' i o oN o
� <n ;h r � z � i i z� z -q
�• « ti D / (n N
y O
DO
n
C
m D➢D / \ /1In
cl
ma
N.T.S. CROSS-SECTION
DETAIL
SCALE dm V
� 1
11' DCG O r
D D
�J.5' P,FFCCTIvr z r
g— - W - o
6 O� 9_
C/) d
Itj
y�4 o
C p td
a�^
1-� 0 d p b0 O
b7
w
h�
�b0 �
D
(/n
I
ul
p Ul
'a7
GI
z
� m
n -=i
a N
d
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N
n
a193 ��
ri
KpIj _„ , n _9 '1+
i 1
m -i
__ _ i � m h j •i i. 11
\� o I
� c
5
PERFORMED FOR: `
LEGAL DESCRIPTION:
DF PH
55;EE4T) OR&
AAL
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
COMMENTS T
crM
3,OrN.
WAS GROUND WATER A 1 0
ENCOUNTERED? IN
S
L
0
Date;
IF YES, AT WHAT
DEPTH?
DR 1(
Depth to Water Aller ,
Monitoring?
ReadingDate Gross
Time
Net
Time
Depth to
Water
Net
Drop
/ S F�JA
6i
�5
low,
a%z
Y„
10
21/
LS
0
3/a
Vs''
r,
PERCOLATION RATE (mmutesiinch)) PERC HOLE DIAMETER 6
TEST RUN BETWEEN FT AND J FT
PERFORMED BY: �--,g,7& ¢�ENhJNFCDIAI��[nn: QQ .�1u gg CERTIFY THAT THIS T/E/gT WAS PERFORMED IN
ACCORDANCE WIV ALLSTATE AND MUNICIPAL GUIEagle oLkO9;�A'fE.�'P
72-008 (Rev. 4785)
Municipality of Anchorage
`` DEPARTMENT OF HEALTH & HUMAN SERVICES G , ?rn !A
i 825 "L" Street, Anchorage, Alaska 99502-0650 j
SOILS LOG — PERCOLATION TEST T A09ENT C. COWAN
g ti
CE -8801
fit
PERFORMED FOR: I 'Er 6 LS �N! `� DATE PERFORMEbI Z
LEGAL DESCRIPTION: IA>, 4J— 1, Ai2l(—ILFlGG SIC) Township, Range, Section:
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
6)26Al,JICS
(S
g,U. u.
SLOPE
WAS GROUND WATER
ENCOUNTERED? Na
S
IF YES, AT WHAT L
O
DEPTH? p
Ny y119s E
Depth to Water Aller i
Monitoring? /6 Date: 511/
SITE PLAN
Reading Date Gross
Time
Net
Time
Depth to
Water
Net
Drop
D
-
3A
-
0
0
.IVO
/0
' So
7d
S'/8
s•
PERCOLATION RATE .�2r1 (mmutesnnCh)//,,PERC HOLE DIAMETER
TEST RUN BETWEEN IS FT AND � FT
COMMENTS T H , FICAU07ED b' CW .
PERFORMED By V S & S EN?lNEERIIN 'j
T CERTIFY THAT THIS TJST WAS PERFORMED IN
—T7094 Eagle River L Rad Neff
ACCORDANCE TM ALL STATE AND MUNICIPAL GW�OiERIAI�j(e�I��Fy THIS DA ATE:
72-008 (Rev. 4/85)
s&S�
grneenrnG
HEALTHAUTHORITY
APPROVALS
SEWER&WATER
MAIN DITENSIONS
SEWER & WATER
INSPECTION
ENGINEERING STUDIES
AND REPORTS
WELL INSPECTION
& FLOW TEST
SITE PLANS
ROAD DESIGN
SOILTEST
PERCOLATION
TEST
STRUCTURAL&
MECHANICAL
INSPECTIONS
ONSITE
WASTEWATER
DISPOSALSYSTEM
DESIGN
ON -•SITE WASTEWATER DISPOSAL SYSTEM
CONSTRUCTION PRACTICES
and
MATERIAL SPECIFICATIONS
Lot 6, Block 1, Park Place subd. $1
May 5, 1995
GENERAL:
ROBERT C. COWAN, P.E.
ROBERTA. SHAFER, P.E.
CIVIL ENGINEERS
(907)694-2979
FAX (907) 694-1211
1. The scope of this project includes the installation of
a 1500 gallon wastewater S.T.E.P. system (septic tank)
and a pressurized absorption trench to serve the four
bedroom residence located on the referenced property.
2. Construction shall be in accordance with the approved
site plan and design drawings, Municipal permit with
any special provisions or conditions, and all
applicable State and Municipal Wastewater Disposal
Regulations.
3. The contractor shall be responsible for obtaining any
necessary underground utility locates.
4. Unless specifically agreed otherwise, the property
owner shall be responsible for final grading areas
subsequently depressed from soil settling. On all
leachfield mound systems, the property owner shall be
responsible for ensuring a satisfactory vegetation
growth over the mounded area.
5. Contractors installing wastewater disposal systems
must be: certified by the Municipal Health Department
for system installations. Owners installing their own
systems must also receive prior approval from the
Municipal Health Department.
SEPTIC TANK INSTALLATION:
1. A septic tank is to be constructed by a certified
septic tank manufacturer. Construction shall include
two 411 cleanouts for pumping access.
2. The septic tank shall be sufficiently bedded to
prevent settling or shifting of the tank.
17034 NORTH EAGLE RIVER LOOP • SUITE 204 • EAGLE RIVER, ALASKA 99577
Page Two
Lot 6, Block 1, Park Place Subd. $1
May 5, 1995
3. All standpipes on the septic tank shall extend a minimum of
12 inches above final grade.
4. Septic tanks installed with less than 4 ft. of cover shall
be insulated.
5. A :foundation cleanout shall be installed one to four feet
from the building foundation. In the line between the tank
and the leachfield theme shall be two adjacent cleanouts
(unless an effluent pumping system exists within the septic
tank). These cleanouts shall be located on undisturbed
soil not more than 10 ft. from the tank. The first
cleanout, in line, shall be to clean toward the leachfield.
The second cleanout shall be to clean toward the septic
tank.
6. Final grading over the septic tank shall be such that a
positive slope exists away from the septic tank.
PRESSURIZED ABSORBTION TRENCH/DRAINFIELD INSTALLATION:
1. Excavate the proposed trench to the dimensions shown on the
design. The bottm of the excavation shall be within 2
inches of level.. If the sidewall.s of the excavation become
smeared, they wust be raked or scratched (ruffed --up) before
gravel. (sewer rock) placement.
2. Once the gravel is installed, the distribution pipe is to
be installed level with the perforations faced downward.
Gravel is then to be placed wver the distribution pipe to
provide a. minimum of 2 inches of cover over the pipe.
3. The distribution piping is to be of PVC (ASTM D3034 or
equal). All joints are to be solvent cemented.
4. Silt barrier material must be installed between the final
gravel layer and the native soil backfill. Ensure the silt
barrier covers the entire gravel surface before placing
backfill.
Monitor tubes shall be of. four (4) inch diameter, installed
approximately in the locations shown on the design, and
extend a mini:ctum of 12 inches above final grade. The
portion of the monitoring tube extending through the gravel
shall be perforated from the bottom of the trench to the
invert of the distribution pipe. This is equivalent to the
effective depth of the gravel as noted on the design.
Page Three
Lot 6, Block 1, Park Place Subd. #1
May 5, 1995
6. Backfill over the final gravel layer must not be less than
twenty-four (24) inches. Insulation must be installed when
the backfill depth is less than thirty-six (36) inches.
MINIMUM MATERIAL SPECIFICATIONS:
1. Any septic tank proposed for installation must be
constructed by a Municipally approved septic tank
manufacturer.
2. The following pipe materials are approved for use in septic
system installations in the Municipality of Anchorage:
Type of Pipe Perforated Solid
Cast
Iron
Yes
Yes
ASTM
D3034
(PVC)
Yes
Yes
ASTM
F810
(HDPE)
Yes
No
ASTM
D2662
(ABS)
Yes
Yes
Use of a type of pipe other than listed above must be
approved by the inspecting engineer.
3. Insulation shall be at least 2" thick extruded direct
burial polystyrene (Dow Chemical Company Styrofoam HI or
equal).
4. Septic tank inlets and outlets shall be fitted with
watertight couplings (Caulder, Fernco, or equal).
5. A permeable nontoxic silt barrier (Typar 3401, Mirafi 140N,
or equal) must be installed between the final leachfield
gravel layer and the native soil backfill.
6. All leachfield gravel (sewer rock) shall be 0.5"-2.5"
screened gravel with less than 3% passing the #200 sieve.
7. When sand is being used as a filter material, its gradation
specifications must conform to current M.O.A. or D.E.C.
requirements.
Page Four
Lot 61 Block 1, Park Place Subd. $1
May 5, 1995
Typically there will be a minimum of three (3) inspections
required during the installation of the wastewater disposal
system. These inspections will occur as follows:
1. The first inspection must be conducted after the
excavation of ditches, pits, trenches, or beds and
before the installation of any gravel. A septic tank
may be set in place, but may not be backfilled before
this inspection.
2. The second inspection must be conducted after the
placement oil the silt barrier, gravel, distribution
lines, standpipes, cleanouts, and insulation, but
before the placement of any other backfill.
3. The final inspection is to occur upon final grading of
the property.
Often there will be more than these 3 inspections required.
Especially with the installation of multiple trenches, sand
filters, pressurized distribution systems, etc. Thus, the
inspecting engineer is to be contacted at least 24 hours prior
to the start of construction. If necessary, a pre -construction
meeting will take place on-site. The inspecting engineer will
not coordinate, direct or control in any way the contractors
activities.
The owner shall contract with the contractor to perform the work
outlined in these specifications and plans and in accordance
with the attached M.O.A. permit. There will be no contractual
arrangement existing between the contractor and S & S
Engineering. S & S Engineering shall be the owner's
representative and will inspect the work as stated above to
document the contractors activities. Final acceptance of the
contractors work rests with the owner and the M.O.A.
Page Five
Lot 6, Block 1, Park Place Subd. $1
May 5. 1995
S & S Engineering shall have no liability to the owner or to
others for acts or omissions of the contractor or any other
persons performing work on this project or the failure of the
contractor to carry out the work in accordance with these
construction documents. S & S Engineering's inspecting engineer
will not be responsible for the construction means, methods,
techniques, sequence, procedures or the safety precautions
incident to this project.
CONTRACTOR/INSTALLER
f
Municipality of Anchorage
Department of Health & Human Services
Division of Environmental Services
Onsite Services Section
Attention Permitting:
RECEIVED
MAY 18 1995
• :y o Anchorage
neat• Health & Human Service6f
I, Dennis Chan, am currently applying for a septic permit for Lot 6, Block 1 of Park Place
Subdivision. I own this property and will build my house this summer. For financial
reasons, I would like to install the septic system. I own and have on the property
equipment capable of doing the work. I would appreciate your permission to install the
septic system.
Sincerely,
Dennis J. Chan
Property Owner
Mailing Address
P.O. Box 110931
Anchorage, AK
99511-0931
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
R4_ctaivwo 6y ,
CERTIFICATE OF HEALTH AUTHORITY
APPROVAL FOR A SINGLE FAMILY DWELLING
Parcel I.D. If t% aO — `I g- ` 7 ) HAA #
1. GENERAL INFORMATION
Complete legal description
Lot 6, Block 1, -Park Place #1
Location (site address or directions) 16740 Stoneridge Road
Propertyowner Dennis Chan Day phone 345-4219
..'mailing address PO Rox 110911 Anchorage AK99511
Lending agency Pacific Alaska/Phil Pope Day phone 258-7534
Mailing addressr2600 Denali Suite 702, Anchorage, AK 99503
Agent Day phone
Address-,
Unless
ddress-
Unless otherwise requested, HAA will be held for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual well XXX
Community well
Public water
NOTE: If community well system, provide written confirmation from State ADEC attest-
ing to the legality and status of system.
4. TYPE OF WASTEWATER DISPOSAL:
Individual on-site XXX
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.
72-025 (Sm 1/91) Front MOA M21
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 furtherverify 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.
5&S ENGINEERING j �I
Name of Firm 17034 Eagle River Loop Road, No. 204 Phone S�� 1 ' 2 % 7�
Eagle River, Alaska 995
Address
Engineer's signature
6. DHHS SIGNATURE
� Approved for FC U bedrooms.
Disapproved.
Conditional approval for
Additional Comments
0
Date 10/ X (, /
OF q
ROBERT C. COWAN /�1t /
1 II„7
bedrooms, with the following stipulations:
1 gs•.� CE -8801 :%a•
7
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.
2-025 (RBV. 1/91) eeck MOA q21
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.
2-025 (RBV. 1/91) eeck MOA q21
RECEIVED
Municipality of Anchorage OCT 26 199
DEPARTMENT OF HEALTH & HUMAN SERVICES MUNICIPALITY of AN
Environmental Services Division ENVIRONMENTAL SERVIC
825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744
// Health Authority Approval Checklist
Legal Description:&1`6 6&06k /: PSP ��c �J Parcel I.D.: OZO 'd9G
A. WELL DATA
Well typele / If A, B, or C, attach ADEC letter. ADEC water system number
ll �
Log present 6N) GS Date completed
Total depth 4 Cased to 30 Casing height (above ground)
(C 5 % a�9eve�
Sanitary seal IN) Wires properly protected &WN) _
FROM WELL LOG
Date of test
Static water level
Well production
WATER SAMPLE RESULTS:
AT INSPECTION
ES
g.p.m.° 5 g.p.m.
Coliform Nitrate
Date of sample: l /z�9 Collected by:
Other bacteria ASDI
/s e�-AIc-
B. SEPTIC/HOLDING TANK DATA
Date installed Z Tank size 1!500 6- Number of Compartments Cleanout06 N) C -_IS
Foundation cleanou&/N) CS Depression (Y&466High water alarmol)
Date of Pumping /O Pumper ��4AC r S
C. ABSORPTION FIELD DATA
Date installed � L_L`% > Soil rating c).p. t2 or ft2/bdrm) System type,/ - L1 126 H
Length /T/Z /Width �� lc i Gravel thickness below pipe / Total depth ���� /0/0
Effective absorption area � S0 . Monitoring Tube present �TY/N)� <_ Depression over field (Y��
Date of adequacy test �� /Z Results (Pass/Fail) (/��55 For _bedrooms
Fluid depth in absorption field before test (in.); _ _ Immediately afte4ro gal. water added (in.):
Fluid depth !ir (ins) Minutes later: Z-62 _ Absorption rate = ��'{ g.p.d.
Peroxide treatment (past 12 months) (Y/N) NO &16 eAAryl�N If yes, give date
72-026 (Rev. 3/96)*
D. LIFT STATION
Date installed ZZ Size in gallons`�'� /f ��� Vii,
Manhole/Access (Y N) L S "Pump on" level at* f% "Pump off" level at*
High water alarm level at* �� *Datum pa rTun
Cycles tested a
E. SEPARATION DISTANCES
oi= 74Nz
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic/holding tank on lot /00 On adjacent lots ld t
Absorption field on lot /00,1
On adjacent lots /0O
Public sewer main NZ4 Public sewer manhole/cleanout A//4
Sewer /septic service line /00 72- Lift station /0 _/�
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO:
i
Foundation 5 '71— Property line
lJ ��
Absorption
Water main/service line /D 1- Surface water/drainage /W �_ Wells on adjacent lots
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO:
Property line /0 f Building foundation /0 /--Water main/service line f
/O /f
Surface water 160f— Driveway, parking/vehicle. storage area
Curtain drain AlIV,( rl,yA&2 dAJ Wells on adjacent lots X00 r _/_
F. ENGINEER'S CERTIFICATION
/ certify that 1 have determined thru field inspections and review of Municipal
in conformance with MCA HAAguidelinesin effect on this date.
Signature/ 6L,_
Engineer's Name / /� C` )C� w'y ✓
Date l�/ D �'/ q%
HAA Fee $ 1->,L5i?-
Date of Payment}��`�
Receipt Number 4L
72-026 (Rev. 3/96)*
Waiver Fee $
Date of Payment
Receipt Number
IERT C. COWAN 1,"
CE -8801
are
DCT -20-99 16:31 PROM -CTE ENVIRONMENTAL 5615301 T-130 P. 02/03 P-634
CT&E Environmental Services Inc.
rrros r..,.� � .vrrrR.eoriesriiw
CT&E Rel.k
995632001
Client PQ1/
Client Name
Project Name/2/
S & S Engineering
L6 Bl Park PI 1
Printed Date/Time
10/20/99 09:19
Client Sample ID
L6 Bl Park PI 1
Collected DatelTime
10/12/99 16:00
Matra`
Drinking Water
Received Date/Time
10/13/99 13:25
Ordered By
Technical Director: ephen C. Ede
PWSYD
0
Releaxed B
,*3a1J)
QZ.0
Sample Remarks:
Parllmeter
Toral Coliform
nitrate -x
ALLowaDLe Prep AnaLysiS
Reaulxs _ pQl Units Method -- LIMITS _ Date Date lnit
0 cot/lOOML SM10 92228 10/13/99 KAP
0.500 u 0.500 mg/L EPA 300.0 10 max 10/13/99 10/13/99 SC6