HomeMy WebLinkAboutPROSPECT HEIGHTS #4 BLK 2 LT 12Pro
pect
Heights
Block
Lot
#015-091-56
MUNICIPALITY OF ANCHORAGE
Development Services Department Phone: 907-343-7904
On-Site Water & Wastewater Section Fax: 907-343-7997
Pump Installation Log
Well Drilling Permit Number: _______________ Date of Issue: ____-____-____
Parcel Identification Number: ____-____-____
Legal Description Block Lot Property Owner Name & Address:
Pump Installation Date: _____-_____-_____
Pump Intake Depth Below Top of Well Casing: __________ feet
Pump Manufacturer’s Name: ___________________________ Pump
Model: _____________________________________
Pump Size: ____________hp
Pitless Adapter Burial Depth: _________ feet
Pitless Adapter Manufacturer’s Name: _________________________
Pitless Adapter Installer: ____________________________
Well Disinfected Upon Completion? XX Yes No
Method of Disinfection: _____________________________
Comments:
Pump Installer Name: __________________________________
Company: ___________________________________________
Mailing Address: ______________________________________
City: ___________________ State: __________Zip: _________
Attention: The pump installer shall provide a pump installation log to On-site 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
Name:¢,~ ~_.~ ~v~ ~.-~"~L,,,L~ Wastewater System: [] New [] Upgrade
, ~6 ABSORPTION FIELD
Phone: ~-I~O ,o.~¢oo~: ~Deep Trench ~ Shallow Trench ~ Bed ~ Mound ~ Other
LEGAL DESCRIPTION ~og Rating:~ ~ CPD,'Oq~t. Total Depth from originalll grade:
Lot: [ ~ BIock:~ ~~Subdivision:~ ~ ~ Depth~to pipe bottom_ from or~inal~ ~grade:~ Ft. Gravel depth benea~pipe Ft.
Township: Range: Section: Fill added above original grade: Gravel length:
Number of lines: J Distance between lines:
WELL:. New ~ Upgrade Gravelwidth: ~ Ft. ~ ~O Ft.
Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material:
Driller:
Da~e D i~led~ StaticWater Level: Installer: Date installed:
Yield: ~ Pump Set at: Casing Height Above Ground:
'~-- GPM ~ Ft. ~ r~. TANK
SEPARATION DISTANCES ~Se.tio ~ Ho~di.g ~ S.T.~.P.
TO Septic Absorption Lift Holding ~ublic/Private Manufacturer: Capacity in gallons:
From Tank Field Slation Tank S .... Lines
Surface
Lot ~t ~' / / / Size in gallons: r:
Line
Foundation ~r (~I / / / "Pump°n"levela': ~"~elat: IHighwateralarm~t:
Curtain Drain ~[~ Pump Make & Model El~caJ Inspectio~med by:
Remarks: BENCH MARK
Location and Description:
Inspections performed by: ~~ ~¢ 1st
Department of Heal.nd Human Services approva[
(Rev. 9/91) MOA 25
F~ermit No. ~A2 ~'zo~-~'~ Page ~ 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
Legal Description: ~¢-O~--1- ~l-~u~/ L-I'7_) I~'2- PID No.: oJ 5-~/I ~
...................... Swing.-.-Ties- :.~
Fixture HC .~ HC B
I 11,25 20,8
CO 2 12,4 21,2
CO 3 56,2 60,6
CO 4 57,4 60,6
CO 5 111,2 108,5
· '(~O'-'6 ........... fl?;'3"'~ ...........
ST I 42.4 47,4
ST 2 51.0 55,2
MT I 159,5i 157,0
MT 2 154,0i 147,6
Totol Trench
Length = 91 FTi
72-013 A
SINGLI
ST 4
iST )tici Tonk
1,250 bo,on
~ELL
V. PEARSON
CE - 7760
Per~it No.
of -~
~'7.-Oq-I ::~ Page "~
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:
t, n3
~ D3
E' IS
! .LS
E 03
[03 ~
72-013 A (2/91) MOA 25
PID No.:
/V~ARK W. PEARSON
CE - 7760
From : ALPINE DRILL 907 345 0202 Jul. 1G. 199~ 08:'41 PM PO1
STATE OF ALASKA
DEPARTMENT OF NATUI;tAL RESOURCE~
DIVISION OF WATER
LOCATION OF WELL WATER WELL RECORD
BOROUGH · SUBDIVISION LOT t~LOCK SECTION QTRG SECTION TOWNSHIP RANGE MF..RJDIAN
LOCATION/SKETCH: WELL OWNER:
DEPTHS MEASURED FROM:l-]casing top {~ground surface WELL DEPTH: DATE OF COMPLETION
Depth of hole: '~'~'7 ft
Materiel Type and Color From To
~ DEPTH TO STATIC WATER LEVEL:
~" ~ 0 "~ ' ~ ~ ft below ~ top of casino [] ground surface
'~.~, METHOD OF DRILLING: /~/..ail~ rotary [~ cable tool
USE OF WELl.: ~ domestic 1-1 lrrioeflon. [] monitor
_.. t-I public supply [] other.,
~ ~;"~C] ~' WELL INTAKE OPENING TYPE: I-1 open end [:] soreened
.. [] perforated /~ open hole
Depths of openingsf . to .... ft
SCREEN TYPE: Diam:... .f tn,
,~ ~./'~ ~; ~ Slot/Mesh Size: 'Length: ft
GRAVEL PACK TYPE:
-- ~ i I~ ~ ~ Volume used:. Depth to top:
lViUnic~a~il~' o~ ' GROUT TYPE: Volume: -
...... ' ~xi~urna~ 8erv~e'~ DEVELOPMENT METHOD:
Duration:
PUMPING LEVEL AND YIELD:
~ ft after ~f/ hfs pump nil ~ gpm
PUMP INTAKE DEPTH: . ft Horsepower: ~
WELL DISINFECTED UPON COMPLETION? J~ YES J~ NO
REMARKS:
PLEASE MAIL WHITE COPY OF LOG TO:
DNR/DIVISION OF WATER
PO BOX 772116
PAGE 1 OF 1
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:SW920417
DESIGN ENGINEER:MOUNTAIN ENGINEERING
OWNER NAME:MAXWELL MICHAEL A &
OWNER ADDRESS:9900 SIDOROF LN
ANCHORAGE, ALASKA 99516
DATE ISSUED:12/15/92
EXPIRATION DATE:12/15/93
PARCEL ID:01509156
LEGAL DESCRIPTION: PROSPECT HEIGHTS #4 BLK
12
2 LT
LOT SIZE: 79660 (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:
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
RECEIVED BY: ~~/
DATE:
December 7, 1992
MOUNTAIN ENGINEERING
3868 Shannon Circle
Anchorage, Alaska 99508
(907) 562-1500
Municipality of Anchorage
On-Site Services
P.O. Box 19-16506
Anchorage, AK 99519
Dear Sirs:
Re: Prospect Heights, Lot 12, Block 2
The purpose of this letter is to provide the required design
narrative in support of our application for a permit to install a
well and septic system on the above referenced lot. Attached for
your reference are the soils log, percolation test results, a
site plan, and design drawings.
The owner intends· to build a 4 bedroom single family home on the
lot. We have performed a soils log and percolation testing at
the locations indicated on the design drawing. The resultant
percolation rate was 33 min/inch. No groundwater was
encountered, and the monitoring tube was dry at the conclusion of
the monitoring period in Test Hole #2. Test Hole #1 had water at
16 FT at the end of the monitoring period. A trench-type
drainfield design was chosen.
An application rate of .45 GPD/SF was used. The house has four
bedrooms, and the required absorption area is 4 X 150 / .45 =
1,333 SF. We have elected to use two trenches, each with a
length of 42 FT, and a gravel depth of 8 FT. Total system depth
is not to exceed 11 FT.
The topography of the lot slopes down to the west/ northwest at
10 to 20 percent. The drainfields will be installed parallel to
the contours.
Please contact me at 562-1500 if you will need any additional
information.
Sincerely,
MOUNTAIN ENGINEERING
Mark Pearson, P.E.
~mrn
Municipalily of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
LEGAL DESCRIPTION: ~ [~L~.i(~/~¢o~¢,¢~ ~ Township, Range, Section:
1
2
3
4
5
6
7
8
9
10
11
12
13-
14
15
16
17
18
19
2O
COMMENTS
SLOPE SITE PLAN
WAS G ROUND WATER
ENCOUNTERED?
S
IF YES, AT WHAT
DEPTH? p
E
Deplh to Water After
Monitoring? lbI Date:
Gross Net Depth to Net
Reading Date Time Time Water Drop
PERCOLATION RATE
TEST RUN BETWEEN
(minutes/inch) PERC HOLE DIAMETER
. FT AND '~' FT
PERFORMED BY: ~'O'~,r~'tSrtl'~ ~"4~(~"'lt'"'~:~ , ~.J~l~--- '~l¢~J~O'~/ CERTIFY THAT THIS TEST WAS PERFORMED IN
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: j,~j.~. O~,~.~.
~/~ ~'~' Municipality of Anchorage
DEPARTMENT OF HEALTH & HUMAN SERVICES
825 "L" Street, Anchorage, Alaska 99502-0650
SOILS LOG -- PERCOLATION TEST
P-~ER'FORM ED FOR:
LEGAL DESCRIPTION:
1
2
3
4
5-
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20-
~'t¢~ ~r'°w nshiP'sLopERange' Section:
COMMENTS ~;:~U ~ ~
WAS GROUND WATER
ENCOUNTERED?
S
L
IF YES, AT WHAT O
DEPTH? p
E
Oeplh to Water A[tel[ r,,.,,,,z; ~ ~l,.~.iq,,2,,.,.i..r[
Monitoring? ~F, Jv "-.-' Date:
SITE PLAN
Gross Net Depth to Net
Reading Date Time Time Water Drop
¢ '' l~,~ f '~ ~.o ' ' '
? I~~
PERCOLATION RATE '~'~, (minutes/inch) PERC HOLE DIAMETER
TEST RUN BETWEEN ~ FT AND ~ FT
PERFORMED BY: ~{~.JMl~PJ ~lN~__~lkJ~ I ~ ~~ CERTIFY THAT THIS TEST WAS PERFORMED In
ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: 1~[~]~
Municipality of Anchorage
Development Services Department
Building Safety Division
On-Site Water & Wastewater Program
4700 South Bragaw St.
P.O. Box 196650 Anchorage, AK 99519-6650
www.ct.anchorage.ak.us
(907) 343-7904
Parcel I.D.
1.
CERTIFICATE OF HEALTH .5,UTHORITY ,A, PPROVAL
FOR .5, SINGLE FAHILY DWELLING
015-091-56 HAA~
GENERAL INFORMATION Expiration Date:
Completelegaldescription PROSPECT HEIGHTS ~4 LOT 12, BLOCK 2
Location (site address or directions) 9900 SIDOROF DRIVE* 99507
Current Property owner(s) MIKE &: ADRIENNE MAXWELL Day phone
Mailing address 9900 SIDOROF DR. 99507
Lending agency Day phone
Mailing address
Real Estate Agent Day phone
Mailing address
346-3369
Unless otherwise requested, HAA will be held by DSD for pickup.
2. NUMBER OF BEDROOMS: 4
3. TYPE OF WATER SUPPLY:
Individual Well ~
Individual Water Storage
Community Class Well [-']
Public Water System
TYPE OF WASTEWATER DISPOSAL:
Individual On-site
Individual Holding tank
Community On-site
Public Sewer
The Municipality of Anchorage Development Sen/ices Department (DSD) Issues Certificates of Health Authority
Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil
engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer
of title (except between spouses) for properties served by a single family on-site wastewater disposal and/or
water supply system. DSD also issues HAAs upon request to homeowners. Certificates of Health Authority
Approval are valid for 90 days from the date of issue for properties sen/ed by a private or Class C well and may
be reissued with new water sample results less than 30 days old. (Certificates may be reissued for a period of
up to one year with valid water samples.) Certificates are valid for one year for properties sen/ed 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.
Note: Alaska Water and Wastewater Consultants, Inc. shall be paid $
· to closing for the engineering services provided.
4. STATEMENT OF INSPECTION BY ENGINEER '
at, or pdor I
As certified by my seal affixed hereto and as of the validation data shown be/ow, I vedfy that my
investigation, based on procedures outiined in the Health Authority Approval Guidelines for this application,
shows that the on-site water supply and/or wastewater disposal system is(am) safe, functional and adequate
forthe number of bedrooms and type of structure indicated herein. I further vedfy that based on the
information obtained from the Munidpa/ity of Anchorage fi/es and from my investigation and inspection, the
on-site water supply and/or wastewater disposal system is(am) in compliance with ali applicable Municipal
and State codes, ordinances, and regulations in effect at the time of installation.
Name of Firm ALASKA WATER &: WASTE'WATER CONSULTANTS. INC,
Address 6901 DEBARR ROAD. SUITE 2B ' ANCHORAGE, AK 99504.
Phone 337-6179
Engineer's Printed Name JEFFREY A. GARNESS. P.E.
Date
Engineer's Comments:
In conducting this eva/uaflon. AKM/I/¢C, Inc. attempted to provide a thorough,
conscientious enginee#ng analysis of the system in accordance with ADEC and MOA
DSD Guidelines & Regulations. The reported results described the performance of the
system under the conditions encountered at the time of the test, and separation
distances measured to readily identifiable features. The operational life of ali we/la and
aeptic systema depend on the local soils condition, groundwater levels that may
fluctuate during the year, and the water usage of the family being sen/ed by the system.
These conditions are outside the control of the eva/uator of the system. Satisfactory test
results do not guarantee future performance of the system, nor do they guarantee that
there are no hidden defects or encroachments. AKWWC, Inc. can therefore not provide
any warranty or future estimate of how long the system wi//continue to meet the
operational requirements of the ADEC or MOA DSD. The content of this report is for
the sole benefit of the owner listed above. Any reliance upon or use of this report by any
other person or party is not autho#zed, nor will it confer any legal right whatsoever.
5. DSD SIGNATURE
Approved for L~ bedrooms.
Disapproved.
Conditional approval for
bedrooms, with the fllowing stipulations:
The well for this property meets extstfn~ State and'Municipal Codes, There are
nitrates present. It ~$ suggested that periodic testfn~ ~e performed to
the On-Site Services Pro,ram, at 3&3-7904
Attachments:
H~ Checklist ~
Septic System Adviso~
Well Flow Adviso~
Manitenance Agreements
Supplemental Engineer's Reort
Other
OriginalCertificateDate: ~ - //'~,~- d)
Municipality of Anchorage
Development Services Department
Building ~afety Division
On-Site Water & Waste~ater Program
4700 SOulh Bragaw St.
P.O. Box 196650 Anc~e, AK 99519-6650
(907) 343-79O4
Legal Description:
A. WELL DATA
HEALTH AUTHORITY APPROVAL CHECKLIST
PROSPECT HEIGHTS 1~4 LOT 12, BLOCK 2 Parcel ID:
WaU type rmvA~
Date completed 6/16/95
Total depth 507 ft.
Date of test
Static water level 28
Well production 0.5
WATER SAMPLE RESULTS:
Coliform B colonlas/100 mi.
Date of sample: 7/15/2002
6EPTIC/HOLDING TANK DATA
ifA, B, or C provide PWSID~ N,/A
Sanltmy seal (Y/N) YES
Cased to 30 ft.
FROM WELL LOG
6/t 6/93
ft*
g.p.m.
Nltzate 5.56 mg./L.
Collected by:
Tank Typa/Materlal
Tank size 1250 gal.
FounclatJon cleanout (Y/N) YES
Date of pumping 7/22/2002
ABSORPTION FIELD DATA
Date installed
Length 91
Total depth 11
015-091-56
well Log (Y/N)
Wires properly protected (y/N)
Casing height (above ground)
AT INSPECTION
7/10/01
21 fl.
1.6 g.p.m.
Other bacteria
NONWC
B colonies/100 mi.
ft*
Depression over field NO
Date of adequacy test 7/10/01 Results(Pass/Fall) PASS For 4 bedrooms
Fluid depth in absorption field before test 0" in. Water added 953 gal, New depth 0' in.
Elapsed Time: 459 min. Final fluid depth 0' in. Absorption rate >= 600+ g.p.d.
Any rejuvenation treatment (past 12 mo.) (y/N & type) NONE KNOWN If yes, give date --
* MT IN WEST TRENCH APPEARS TO EXTEND ONLY ABOUT 35' BELOW THE INVERT.
e/93 Soil rating ~ ftYedrm) 0.45 System type DEEP TRENCH
fl. Width ,3 fl. Gravel below pipe 8
fl. Eft. absorption ama 1,456 fl= Monitoring lube *YES
YES
YES
24"+ in.
=i~F,L Date installed 6/93
Number of Compartments 2 Cleanouts (y/N) YES
Depression over tank (Y/N) NO High water alarm (Y/N) N/A
Pumper A+ HOME SERVICES
Yr.~icD WEST TRENCH ONLY. (FAST TRENCH FULL)
D.~ UI~T STATION
Date installed Size in gallons
,'Pump on' level at in. "Pump olt' I~u-/I at in.
Datum Cycles tested
E. SEPARATION DISTANCES
SEPARATION DISTANCES FROM WELL ON LOT TO:
Septic tank/lilt station on lot100'+
Absorption field on lot 100'+
Publio sewer main N/A
Sewer/septic service line 25'+
Holding tank
Manhole/Acce<~ (Y/t4)
High water alarm level at
Meets alarm & circuit requirements?
On adjacent lots 100'+
On adjacent lots 100'+
Public sewer manhole/cieenout
N/A
SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO:
Building foundation 5'+ Property line 5'+
Water main N/A Water sewice line 10'+
Walls on adjacent lots 100'+
SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO:
Property line 10'+ Building foundaflee 10'+
Water sewice line 10'+ Surface water 100'+
Curtain drain NONE KNOWN Wells on adjacent lots 100'+
COMMENTS
FAST TRENCH IS SURCHARGED
G. ENGINEER'S CERTIFICATION
I certify that I have determined through field inspections end
ret4ew of Municipal reconfe that the above systems are in
conformance with MOA HAA guidelines in effect on this date.
Engineer's Printed Name dtPe~EY A. OARNESS
Date
N/A
.aJ3soq3tion field 5'+
Sudace water 100'+
Date of Payment ~/~0~
Receipt Number
(Rev. ~ 2/00)
Water main N/A
Ddve'~ay, perkingNehlcie storage
WaKer Fee $
Date of Payment
Receipt Number
1
83-296
PROSPECT HEIGHTS SUBD.,
LOT 12, BLOCK 2
79,660 $.F,
NO. 4
PROPERTY OEPi[;iu~ l~]OV~ AND THAT NC
~1 ~D SU~N~CR~CHM~ ~ ~C~ ~ INDI~.
~CHO~GE. ~ g9~ OR R~TRI~ONS ~]CH ~ q~
PHONE 248-5454 ~P~ ON ~E RECORDED SUBDMSION P~T.
UND~ NO ClRCUU~CE5 SHOU~ ~ ~TA
~ ~o ~CHO~E RE~RDINO DI~I~, ~
~.~ p~ NO~ NO CORN.S S~ ~IS ~
JUL-22-02 03:SSPIA FI~U-CT&E ENVII~I~KTAL SRV
,~tr~ CT&E Environmental Service. Inc.
90~5515;01
T-0$? P.02/03 F-195
cr&£ Ref.~
Client Name
Cliool Sample ID
Ordered By
PWSID
Sample Remarks:
1024426001
AK Water & Wastewnter Cons~lt~nu In,'.
Pmspcc! Hts. ~4 tot 12. B2
Prospect Hts. #,4 lot 12. B2
Drhfldng Water
All Dates/Tlmts are Alaska Standard Time
Printed Date/Time 07/22/2002 14:49
Collected Date/Time 07/1~2002 14:00
Received Date/Time 07/17/2002 12:00
Technical Director Stephe,
Relented By ~~
'Total Nitrate/Nih'itc
5.56
~L
Units Me~od
1.00 mg/I.. EPA 300.0
A~low~bla Prep Analysis
Limiu D~te DaTe
Init
07/20/02 JDT
M:l, crobLolog'y Laborat:ory
Total Coli£orm 0
col/lOOmL SMI8 g22213
(<1)
07/17/o2 KAP
07/24/2002 17:26 FAZ 9078686770 A+ llome Services. Inc. ~001
HOME SERVICES, INC.
CUSTOMER
7501E. 140thAvenue
Anchorage, Alaska 99516
345-1890
~900 Sidorof I~ae
A~ A{2 99{16
r
INVOICE// 22029
Block Lot
- DATE DESCRIPTION AMOUNT
Gallons [/~Septic Leach Area Holding Tank ~ Standpipes /~; / N/Time
~.~,JPROBLEM AREA ~ CALL FOR MORE INFORMATION
J~ NEEDs TO BE DONE AGAIN IN 6 .MONTHS
{'"] Good Shape [;~ludge buildup on bottom
[] Jim cap missing or I-{ Cut standpipe to 1' above ground
needs replacing
"'~loater on top
[] Needs Septictflne